in good GVhealthnews.com
April 2016 • Issue 128
EXPANDED ROLE FOR PARAMEDICS Emergency medical services responders may do more if NYS bill is approved
Going on Vacation? A week’s vacation may leave many adults with a heavier midsection — extra weight that can hang around even six weeks post-vacation.
Domestic Violence
One in four women has been the victim of severe physical violence by an intimate partner, while one in seven men have experienced the same. Why this is still a problem and how local groups are trying to tackle it
Back Pain: Excellus Study Urges Non-invasive Treatment First
priceless
Rochester’s Healthcare Newspaper
Online Breast Milk There has been an explosion of websites that buy and sell breast milk and traffic in those sites has continued to rise. Transactions have more than doubled in the past three years. And it’s not just moms buying it. But how safe is buying breast milk online? Page 9
UNINSURED RATE IN UPSTATE NEW YORK
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In 2014, Upstate New York’s uninsured rate was 52 percent lower than the national rate and 36 percent lower than the state rate, according to a report recently issued by Excellus BlueCross BlueShield. Story inside
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'Viagra’ for Women Pill May Not Be Worth It
Researchers: Addyi carries host of serious side effects without Page 8 delivering much more sexual satisfaction
The Surprising Benefits of Portobellos
This mushroom possesses such a unique and vast array of nutrients, it’s hard to know where to begin. April 2016 •
Tai Chi Could Be a Healthy Move for Your Heart
Tai chi and other traditional Chinese exercises might reduce depression, improve quality of life for heart patients
Q&A with Jennifer Kwon, MD URMC child neurologist works for better screening of rare diseases in newborns. She talks about her field and efforts to make screening more uniform. IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Pedestrian Deaths Projected to Jump 10%
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alking in the United States appears to be more hazardous than ever. A new report projects a 10 percent surge in pedestrian deaths between 2014 and 2015 — the largest annual rise on record. While no one cause is apparent, the rise in pedestrian deaths could reflect increased traffic volume, growing cellphone use by drivers and walkers, and more people walking for health, economic or environmental reasons, according to the report from the Governors Highway Safety Association. "We are projecting the largest year-to-year increase in pedestrian fatalities since national records have been kept, and therefore we are quite alarmed," said report co-author Richard Retting, of Sam Schwartz Consulting. Researchers made the estimate by comparing preliminary data on the number of U.S. pedestrian deaths in the first six months of 2014 (2,232) and the first six months of 2015 (2,368). Twenty-six states and Washington, D.C., reported increases in pedestrian deaths, the researchers said. Also, pedestrians now account for 15 percent of all motor vehicle crash-related deaths, compared with 11 percent a decade ago, according to the annual Spotlight on Highway Safety Report.
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Vacations Not Good for Your Waistline
Study: Vacations can lead to weight gain, contribute to ‘creeping obesity’
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week’s vacation may leave many adults with a heavier midsection — extra weight that can hang around even six weeks post-vacation. A faculty member in the University of Georgia’s College of Family and Consumer Sciences found that adults going on a one- to three-week vacation gained an average of nearly 1 pound during their trips. With the average American reportedly gaining 1-2 pounds a year, the study’s findings suggest an alarming trend. “If you’re only gaining a pound or two a year and you gained three-quarters of that on a one- to three-week vacation, that’s a pretty substantial weight gain during a short period of time,” said Jamie Cooper, an associate professor in the college’s department of foods and nutrition. The study supports the notion of “creeping obesity,” the common pat-
tern of adults gaining small amounts of weight over long periods of time, leading to increased health problems later in life. Cooper’s study involved 122 adults between the ages of 18 and 65 — average age of 32 — who went on vacations ranging from one to three weeks in length between the months of March and August. One of the factors that likely contributed to weight gain for study participants was increased caloric intake, especially Cooper from alcohol consumption. The average consumption prior to
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
vacation was eight drinks a week. That number went up to an average of 16 per week for study participants, which accounts for a significant increase in calories. “One of the challenges people face is unless you’re diligent about weighing yourself before and after vacation, usually you’re not going to notice a pound of weight gain,” Cooper said. “People don’t realize it’s happening, and that’s why they don’t lose weight following a vacation.” Cooper noted there were some benefits to vacations. Study participants showed significantly reduced stress levels and a slight reduction in systolic blood pressure that lasted even six weeks post-vacation. The study — “A prospective study on vacation weight gain in adults” — was published in the journal Physiology and Behavior and included Theresa Tokar of Texas Tech University as a co-author.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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CALENDAR of
HEALTH EVENTS
April 4
‘Christian Vocation Seminar For Seniors’ Episcopal SeniorLife Communities will host a Christian Vocation Seminar for Seniors from 4:30 to 8:30 p.m. Monday, April 4, at Valley Manor, 1570 East Ave. in Rochester The program is sponsored by a senior group at St. Thomas Episcopal Church. Topics covered in the seminar include finances, family, health and discretionary time. There is a nominal fee of $10 for dinner which can be paid at the door in cash or a
check made payable to Christian Vocation Seminar.To register or for more information, contact Mortan Nace, member at St. Thomas, at 585-2445594 or monacejr@frontiernet.net.
April 5
Hearing Loss Association holds programs Anyone interested in hearing loss is welcome at any or all of Hearing Loss Association of America Rochester Chapter's presentations set for Tuesday, April 5, at St. Paul’s Episcopal Church, East Avenue at West-
minster Road, across from the George Eastman Museum. From 10:30 to 11 a.m., "Hearing Other People's Experiences — HOPE" initiates a new opportunity for people with hearing loss to share information on hearing loss and hearing aids. Retired audiologist Joe Kozelsky, a long time hearing aid user, will moderate the informal half hour session in the vestry room. Following social time, refreshments, and the HLAA business meeting from 11 a.m. to noon in the Parish Hall, Kassey Granger, an outreach education and installation representative for CapTel Captioning Telephone, will demonstrate the phone's features and help prospective users to initiate service. Telephone calls can be excruciatingly frustrating for people with hearing loss. The CapTel phone displays readouts of incoming calls on a small screen in adjustable font sizes and colors. With a verified hearing loss, an individual can obtain the CapTel phone, captioning service, and home installation at no charge. The evening program opens at 7 p.m. with social time, refreshments, and the HLAA business meeting. At the 8 p.m. “Ask the Audiologists” program, hearing aid users are invited to bring their questions about hearing aids and hearing loss, to be answered by two audiologists. Ron D'Angelo is the coordinator of diagnostic and therapy programs at Clear Choice Hearing and Balance. Jared Teter owns Hearcare Hearing Center in Penfield. The presentation is completely impromptu and unrehearsed. For more information visit www. hlaa-rochester-ny.org or telephone 585-266-7890.
April 7
Classes for seniors to teach how to use iPads Fairport Baptist Homes, a nonprofit organization that has been delivering a more personalized level of care for area seniors for more than 100 years, is offering a series of four classes for people who understand the basics of the iPad, but want to learn more. In this course, students will be introduced to advanced apps and features and benefits of the iPad. The classes will take place from 1 to 2:30 p.m. on Wednesdays, April 6 through April 27 at the facility, 4646 Fairport Nine Mile Point Road in Fairport. The fee is $65 per class. For additional information and registration, contact 585-388-2349 or bzarcone@fbhcm.org.
‘Living Alone’ author to headline event Gwenn Voelckers, author of the column “Living Alone & Thrive” published in this newspaper, is the guest speaker at a meeting sponsored by Neutral Ground Support Organization, a nonprofit support group for people who are divorced, widowed, separated or ending a significant relationship. The event will take place from 7 to 9 p.m., April 7, at Henrietta United of Church of Christ, 1400 Leigh Station Road in Henrietta. Voelckers, who runs workshops on living alone, will discuss "On Your Own: Facing Your Fears and Finding Your Way Without a Partner." The event is open to the public. A donation of $4 (for members) or $5 (for guests) is requested. For more information, contact nancy14534@ yahoo.com Page 4
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
April 8
Breast cancer seminar: ‘Tools for the Journey’ The Breast Cancer Coalition of Rochester, with community co-sponsors, will host the 13th Annual Cindy L. Dertinger Advanced Breast Cancer Seminar: Tools for the Journey from 1 to 5 p.m., April 8, at Memorial Art Gallery, 500 University Ave., Rochester. The half-day event will celebrate and support those living with metastatic breast cancer. It will include presentations by physicians and wellness experts, as well as survivors who are living with metastatic breast cancer. A reception will follow the seminar. Funding for this event is provided by M&T Bank, in memory of their friend and colleague, Cindy L. Dertinger. Admission is free. For more information, call 473-8177 or email Jennifer@bccr.org. Reservation is required by March 28.
April 13
Event to discuss palliative care and hospice “Palliative Care: Transforming the Care of Serious Illness” is the topic of an educational event sponsored by Lifetime Care — Home Health Care and Hospice. Physician Aaron Olden, who specializes in internal medicine, will be the guest speaker and, among other things, will describe the differences between palliative care and hospice and explain the nature of interdisciplinary team in the care of patients. It will take place at 5 p.m., April 13, at Monroe’s Restaurant, 3001 Monroe Ave., Rochester. To register, call 585-214-1133 by April 6.
April 28
Employment conference to focus on individuals with special needs Rochester Rehabilitation is hosting the first-of-its-kind employment conference in Western New York from 8 a.m. to 4 p.m. on Thursday, April 28. Sponsored by Wegmans, Employment First is being held at the Radisson Rochester Riverside at 120 East Main St. in downtown Rochester. The conference will focus on employment outcomes for special populations, including individuals with a disadvantage, those in poverty, people with disabilities, refugees, and veterans. The conference will offer workshop sessions for both human service providers and other employers. It will feature evidenced-based, best practice models and highlight successful partnerships between nonprofit vocational employment programs and local businesses. More than 200 conference participants from Upstate New York are expected to attend this event. The keynote speaker will be Robert Egger, a nationally-known nonprofit leader, author, speaker and activist. Register for Employment First by contacting Jen Bellows at jbellows@ rochesterrehab.org or via phone at 585-473-2052. Information can also be found at www.rochesterrehab.org. The conference fee is $100 per person ($80 per person for groups of three or more from the same organization).
Upstate’s Uninsured Rate is 52 Percent Lower than U.S. Rate I
n 2014, Upstate New York’s uninsured rate was 52 percent lower than the national rate and 36 percent lower than the state rate, according to a report issued in March by Excellus BlueCross BlueShield. Favorable Upstate New York comparisons were the conclusion of the health plan’s analysis of the 2014 American Community Survey’s one-year estimates issued by the U.S. Census Bureau. They are the latest available figures that include comparable local regional estimates. Excellus BlueCross BlueShield’s infographic presents a snapshot com-
parison of access to health insurance coverage in 2014, the first full year of federal health care reform implementation that included the opening of exchanges. Upstate New York posted a 5.6 percent uninsured rate among all ages of the population. This compared to a rate of 8.7 percent for the state and 11.7 percent for the nation. “We continue to monitor these rates carefully as we do all we can to enhance access to coverage,” said Christopher Booth, chief executive officer of Excellus BlueCross BlueShield, the largest nonprofit health in-
surer within the region studied. “The low rates are a testament to a region where community-based nonprofit health systems and physicians work together with local nonprofit insurers and employers to finance it.” Regional rates for Upstate New York ranged from 5.4 percent for the Finger Lakes and Southern Tier regions to 6 percent in the Central New York and Watertown areas. Uninsured rates of 5.5 percent were reported in the Utica, Rome and North Country region and in Western New York. The U.S. Census Bureau’s Ameri-
can Community Survey is the largest available national data source that enables more accurate comparisons of national, state and regional figures. The uninsured rate is a measure of the percentage of people who were uninsured at the time of the interview. The one-year estimates are published for counties with populations of 65,000 or more (representing 84 percent of the non-institutionalized civilian population), so some Upstate New York counties are excluded from the analysis. To view the infographic, go to: http://tinyurl.com/j2pumzy.
Healthcare in a Minute By George W. Chapman
Malpractice alternative
Patients seeking damages would present their grievance to a panel of experts and an administrative law judge. Rather than wait years for a settlement, the claimant would be quickly compensated should their case have merit. This would ameliorate if not eliminate the adversarial relationship the current malpractice system creates between physician and patient. It would also allow providers to acknowledge an error without fear of litigation. This Alternative Patient Compensation System model is being contemplated in Georgia, Florida, Tennessee, Maine and Montana.
Hundreds of US rural hospitals in jeopardy
One third of all US rural hospitals are in danger of closing. Seventy percent of them have had negative operating margins for years. The loss to a community is more economic than clinical. While clinical care is typically available at other facilities in the area, rural hospitals are often one of the largest employers where they are located. States with the most distressed rural hospitals are Texas and Mississippi. There are about two dozen small/ rural hospitals in danger of closing in New York state. Two senators have introduced legislation, “Save Rural Hospitals Act,” to provide funding to keep the doors of rural hospitals open. Without special funding, most rural hospitals will close unless they affiliate with a larger hospital or join a hospital system.
Hospital jobs on the rise
According to the Bureau of Labor Statistics, hospital employment is at just over five million people. Hospitals added a net 188,000 jobs in 2015. Most of the growth is attributed to acquisitions of medical practices, increased demand for outpatient services and gearing up for population health management. The entire healthcare sector employs almost 19 million workers. Employment was down in dental offices and laboratories.
Happy Danes
Like most Western nations, Denmark has a universal healthcare system. Danes are very happy with their lives and their healthcare because the bureaucracy that is typically associated with universal systems has been vastly reduced. The Danish system emphasizes locally focused control. A lot of value is placed on close, unfettered relationships between patients and their primary physician. Danes average seven contacts (in person, phone, electronic) per year with their primary care provider. The US average is less than four contacts. The main goal in Denmark is to catch problems early and treat. Danish per capita costs are about $5,000 compared to about $9,000 in the US.
Employer-sponsored plans cause concern
Large employers can avoid a lot of insurance regulation and requirements by forming and designing their own plans. The
April 2016 •
hospital association is lobbying congress to close loopholes in coverage requirements. In a letter to Centers for Medicare & Medicaid Service (CMS), the American Hospital Association (AHA) expressed concern over the fact that that some employer plans are not covering outpatient surgery in order to cut costs. The AHA argues this puts employees at risk both clinically and financially, meeting neither the spirit nor mandate of the Affordable Care Act, which is to insure safe, affordable, accessible and comprehensive care to all Americans. The AHA suggests that CMS establish minimum coverage standards for all categories of care including surgery.
Healthcare advertising on the rise
The industry — providers and drug companies — spent $14 billion on ads in 2014, up 20 percent over 2011. Competition for patients and market share is fierce, causing concern among consumer groups about over utilization and higher prices to pay for the increased ads.
Moratorium on hospital mergers
While mergers can save vulnerable hospitals and/or improve services, many have resulted in nothing more than monopolies which typically lead to price hikes. Connecticut Gov. Dan Molly has placed a moratorium on hospital mergers in his state. He issued this statement, “We need balance. Fewer healthcare systems mean fewer
choices for consumers, and that can dramatically affect both the quality of care and costs. It’s time we take a holistic look at the acquisition process.” In the same vein, many are questioning the impact of insurance company mergers on eventual premiums.
Medicare Advantage plans
Last year, more than 17 million seniors (about one third of Medicare eligibles) chose to enroll in an Advantage plan offered by a private commercial insurer. Advantage plans attract seniors by offering more benefits than traditional Medicare. The feds entice private insurers to offer Advantage plans with more than $3 billion in incentives and bonuses. The insurer must reinvest monies earned into additional benefits and new approaches to manage chronic conditions like hypertension, diabetes and obesity. United Health, for example, could earn over $1 billion in bonuses this year. Overall, commercial insurers have done well under the ACA.
George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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U.S. Cancer Death Rate Continues to Fall
Meet
Your Doctor
By Chris Motola
Jennifer Kwon, M.D.
But there's been a concerning increase in URMC child neurologist working for better liver cancer, experts screening of rare diseases in newborns say
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verall rates of cancer and deaths from cancer in the United States continue to decline, a newly released report says. However, an increase in liver cancer deaths is cause for concern, the report authors noted. An increase in hepatitis C infections is likely a major reason for the increase, they said. "The latest data show many cancer prevention programs are working and saving lives," physician Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said in a news release from the organizations that issued the report. "But the growing burden of liver cancer is troublesome. We need to do more work promoting hepatitis testing, treatment, and vaccination," Frieden added. The Report to the Nation on the Status of Cancer is released each year by the American Cancer Society, the U.S. Centers for Disease Control and Prevention, the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries. Between 2003 and 2012, the overall death rate for all cancers fell 1.5 percent a year. There were decreases in cancer deaths for both men and women, and among all major racial and ethnic groups. During that time, rates of new cancer cases fell among men and remained stable for women. The drop in new cancer cases is largely due to progress in prevention and early detection, and the decrease in cancer deaths may also be due to improved treatments, the experts suggested. Tobacco control programs have contributed to lower rates of lung cancer, the leading cause of cancer death in the United States, along with other types of cancer, according to the report. While the overall news is good, liver cancer incidence and death rates rose sharply compared to other cancer types, the report revealed. Between 2008 and 2012, liver cancer cases rose an average of just over 2 percent a year, the findings showed. Liver cancer deaths increased nearly 3 percent a year among men and more than 3 percent a year among women during the same time. In all racial and ethnic groups, about twice as many men as women were diagnosed with liver cancer, the report noted. A major contributing factor to liver cancer in the United States is hepatitis C infection, which accounts for just over 20 percent of the most common liver cancers. People born between 1945 and 1965 have a six times increased risk of hepatitis C infection and the CDC recommends they be tested for it. Page 6
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Q: I understand you're doing some work with neonatal screening. Can you tell us about that? A: I'm a child neurologist. We care for children of all ages, including neonates. I'm also interested in newborn screening, which is a way of identifying diseases early, even before they present clinically, so that we can administer treatments that may be life-saving or really improve developmental outcomes. Q: What kinds of conditions can be greatly improved by diagnosing them early in life? A: There's PKU [also known as phenylketonuria]. It's a disorder that presents with progressive developmental disability in infancy if it's untreated. If we wait for them to present with it, it may be too late to prevent the brain injury from occurring or avoid developmental problems, even with treatment. It was for that reason that newborn screening was thought to be helpful is that it would identify babies with PKU and allow them to be treated with a special diet. The test for PKU was actually developed in Buffalo. Q: Is it difficult making diagnoses when the patient can't play a part in reporting symptoms? A: The newborn screening is designed to completely bypass any complaints about symptoms. We collect blood from all newborn infants and look for conditions that may put them at high risk for death or disability. Even if they were able to report symptoms, by the time they noticed them it would be too late to start effective therapy. The list of diseases we screen for is made up of conditions that we
think early treatment would be effective for, like PKU and congenital hypothyroidism. The most recent diseases that we've started screening for in New York include Pompe disease and x-linked adrenoleukodystrophy. New York screens for about 50 different disorders, so if you're interested you can Google it and see the full list. Q: I take it that last one is a chromosomal disease? A: Yes, it's a disease that affects boys. Girls are usually protected because they have two x chromosomes. There are a lot of different disorders that we screen for. Recently I had a meeting that focused on Pompe disease and another disorder called Duchenne muscular dystrophy. Q: What can you do for that disease if it turns up in a screening? A: There are treatments for Duchenne muscular dystrophy. Unfortunately, the diagnoses of Duchenne muscular dystrophy are often made late, when the boys are as old as 2, 2 1/2 or even older. So there have been several papers written about this diagnostic delay, which prevents them from getting effective and appropriate treatment for their Duchenne's. Q: A broader neurological disease question: are we starting to understand the processes that lead to nerve degeneration better? A: I think so. There's been some progress there. Pompe disease involves some nerve damage that we believe is related to the storage material that builds up in children. So for a lot of disorders, we have a pretty good idea of what's causing the nerve damage and how to correct it. Q: How old are your oldest patients? A: I'm a pediatric neurologist, so most of my patients are children, but I do follow some into adulthood.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
Q: How do you work with parents and help them understand diseases that aren't well-known to lay people? A: I usually start from how they come to me in clinic. If they come to me because their child has certain symptoms, we talk about the diagnosis
In the News URMC child neurologist Jennifer Kwon treats patients with rare diseases at UR Medicine's Golisano Children's Hospital. She recently organized an international two-day conference in St. Louis, Mo. — titled “Newborn Screening for Neuromuscular Diseases: Improving Patient Outcomes and Evaluating Public Health Impact” — that brought clinicians together to discuss how best to implement newborn screenings and care for patients after diagnosis. One issue Kwon finds concerning is that patients with rare diseases are given care that is variable across the nation. She says, “My goal is to make sure that the care of children identified by newborn mandatory screening is optimal and reasonable. If we are going to have a mandatory newborn screening program, then we really need to pay attention to how identified patients are cared for.” and sort of walk through what might happen to their child in the future. If it's a complicated disease, I'll sometimes do it in stages and present it in terms of what we need to do now and what will happen over the course of the next few months, and then go into more detail about what's involved. These are very complicated diseases, so it often takes some time to get people understanding. Q: In best-case scenarios, what kind of impact can you have on a kid's quality of life? A: So most people who have children don't even realize that their child has had newborn screening as it's done in the nursery after they're born. The reason we do it is because these indicators are too important to miss and can have a huge impact in their quality of life. Q: How did you become interested in all of this? A: When it comes to newborn screening, it's because we see a lot of children with developmental disabilities, so when there's an opportunity to prevent that from happening, that's really exciting. I think that, unfortunately, with brain disease and degenerative muscular diseases, it's really important to get to children and start counseling them before they develop symptoms. Q: What do the treatments usually entail? A: So steroid treatments can slow or prevent the muscular degeneration and prevent long-term disabilities. There are new treatments being studied for Duchenne's being looked at now. I'm involved in newborn screening research.
Lifelines Name: Jennifer Kwon, M.D. Hometown: Ann Arbor, Mich. Position: Associate professor of neurology, pediatrics and pathology and laboratory medicine at University of Rochester Education: University of Michigan Medical School Affiliations: University of Rochester Medical System Organizations: American Academy of Neurology, Child Neurology Society, International Society for Neonatal Screening Family: Married, two children Hobbies: Traveling with family
Heart Surgeon Runs His Daily Commute Michigan physician sets an example for patients by running to work every day
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heart surgeon at the University of Michigan Frankel Cardiovascular Center, who like the rest of us tries to fit in some daily exercise, has been running to work every day for the past 30 years. It’s physical activity and it’s stress relief for the 60-year-old who fixes faulty heart valves. He’s one of the busiest mitral valve surgeons in the country, helping patients whose hearts are forced to work harder when their mitral valve isn’t working properly. Before hitting the road in Ann Arbor, Mich., for his six-mile run, he shared a few thoughts about his routine: • “As a kid I was a swimmer. When I pulled myself out of the pool
I figured I'd better do something to stay active so I started running. I’ve basically run every day since then: college, medical school, residency and now that I’m on the faculty [as a professor of cardiac surgery]. • “My motivation to go to work running is basically that it’s my zen moment. I really take that time out and that’s when I think about stuff. • “Some of my patients know that I run to work every day and they think it’s fascinating. They think it’s great that I’m getting in cardio every day. To practice what you preach is a good philosophy. I don’t know that running to work every day isn't practical for everyone, but doctors really should be examples for our patients.”
Tai Chi Could Be a Healthy Move for Your Heart Traditional Chinese exercises might reduce depression, improve quality of life for heart patients
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ai chi and other traditional Chinese exercises may benefit people with heart disease, researchers report. The new review of 35 studies included more than 2,200 people in 10 countries. The investigators found that, among people with heart disease, these types of low-risk activities appeared to help lower blood pressure and levels of LDL ("bad") cholesterol and other unhealthy
blood fats. Tai chi, qigong and other traditional Chinese exercises were also linked to improved quality of life and reduced depression in heart disease patients, the study authors added. But the exercises did not significantly improve heart rate, aerobic fitness levels or general health scores, according to the report published March 9 in the Journal of the American Heart Association.
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In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. 154 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Jessica Gaspar, Mike Costanza, Ernst Lamothe, Jr., Kristina Gabalski Advertising: Donna Kimbrell, Anne Westcott Layout & Design: Eric J. Stevens • Office Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
April 2016 •
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 7
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Take Good Care: You're Worth it!
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his morning, I got up early, got dressed, and took a walk as the sun was peeking across the horizon. I do that every morning now. But that hasn’t always been the case. After my divorce, I adopted a “What’s the point?” approach to caring for myself and my home: What was the point of getting up early, walking, eating healthy meals or putting on lipstick when no one was watching or cared what I did? It’s not uncommon for people who live alone to fall into a “What’s the point?” frame of mind. Leaving the dirty dishes in the sink or wearing your pajamas all day may seem harmless, until you consider the impact these acts of indifference can have on your self-confidence and sense of self-worth. Taking good care — very good care — of yourself is about the value of you. It’s about your intrinsic value to yourself, to your family, and to those you encounter throughout your day. It’s an essential part of feeling good and living alone with success. Here’s why taking care of yourself is so important:
It builds self-esteem: When you take good care of yourself you send an important message to yourself that you are worth treating well, cleaning up after, fussing over and protecting. When I come home after a busy day and walk through my front door, I am reinforced when my house is tidy and the kitchen sink is empty. It means I care enough about myself to maintain an inviting home, even if it’s just for me. The appearance of my home is a visible, tangible barometer of how I value myself — and, this is just one of many examples. My self-esteem gets a boost whenever I exercise discipline and do the things I know will deliver positive and self-affirming results. It looks good on you: When you take care of yourself, it shows and people notice. It opens up your world. In my “What’s the point?” period — my blue period — I would leave the house without paying much attention to my appearance. My sorry, baggy attire was only made sorrier by the dour expression on my face.
'Viagra’ for Women Pill May Not Be Worth It Researchers: Addyi carries host of serious side effects without delivering much more sexual satisfaction
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he much-touted "female libido" pill — also known as “Viagra for women” — seems to cause a host of serious side effects while failing to spark much additional passion in a woman's life, a new review suggests. Addyi (flibanserin) quadruples the risk of dizziness and sleepiness, more than doubles the chances of nausea, and increases the risk of fatigue by more than half, according to the analysis. For all that trouble, a woman taking Addyi can expect to gain one-half of one additional satisfying sexual event per month, on average, according to the report. It was published online Feb. 29 in the journal JAMA Internal Medicine. "We found women had, on average, 2.5 satisfying sexual events per month before entering the study, and flibanserin added one-half additional satisfying sexual events per month," Page 8
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said senior study author Ellen Laan, a professor of sexology and psychosomatic gynecology at the University of Amsterdam, in the Netherlands. The side effects are troubling, said physician Mamta Mamik, an assistant professor of obstetrics, gynecology and reproductive science at Mount Sinai's Icahn School of Medicine in New York City. "The article is pretty comprehensive in addressing the issues. They raise valid concerns," Mamik said. "I think we have to be careful when a drug is marketed before its safety profile is approved and proper trials have been conducted." The U.S. Food and Drug Administration approved Addyi last year after a contentious review process, making it the nation's first drug designed to help women with low libido. Only 227 prescriptions for the drug were filled in its first few weeks
Needless to say, I didn’t turn many heads nor invite connection with others. But, those were the old days. Today, I take more care. My experience tells me that others notice when you pay attention to your outward appearance. When you care about yourself, you radiate vitality. It’s intriguing. And it may draw people, compliments, and unexpected connections your way. It enables you to better care for others: Taking care of yourself can be essential to taking care of others. I like the “airline” example. When traveling by plane, we are all given instructions on how to use an oxygen mask, and we are cautioned to put ours on first if we’re traveling with a child or dependent person. The reason is obvious: if we don't put our mask on first, we risk passing out and putting both lives in jeopardy. One of the best things you can do for others is to take care of yourself. That way, you’ll be better able — both physically and emotionally — to help your friends and family, when they need you. It is essential to your health: Eating healthy, enjoying a good night’s sleep, getting regular health check-ups, and exercising can all contribute to feeling good and alive. But living a healthy lifestyle can be a challenge when you live alone and there’s no one there to coax, inspire or embarrass you into action. This is when becoming your own nudge (your own personal coach) can be so helpful. I was having an awful time sticking to my exercise routine, so I decided to become a group exercise instructor. I knew I needed the “obligation” of leading a class to force myself to show up. Believe me, I wouldn’t be going to the Y as often had I not become an instructor.
on the market, Bloomberg reported. In the new review, Laan and her colleagues reviewed eight clinical trials conducted with Addyi, including five published and three unpublished studies involving almost 6,000 women. The combined evidence showed that Addyi provides marginal benefit for women who are suffering hypoactive sexual desire disorder, a condition involving a persistent or recurrent lack of interest in sex. For example, women taking the drug scored just 0.3 points higher on a 5-point sexual desire scale and experienced a minimal increase in satisfying sexual events each month, the review authors found. However, Mamik noted that it's hard to judge how well Addyi performs because female desire is difficult to assess.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
It was one way of taking better care of my physical health and it worked! It’s a self-care strategy you might consider for yourself. It is rewarding: And, it can lead to self-discovery. Like anything else, learning how to care for yourself can reveal opportunities for personal growth and fulfillment. It can be fun and it can take you places you wouldn’t normally go. Again, another personal example: I’ve discovered after years of living alone that my home environment is very important to me. To feel whole and complete, I need to be surrounded by inspirational images and objects, and to live in space that is at once peaceful and stimulating. Taking care of this “visual” need of mine is a way of taking care of myself, and it has motivated me to seek out artists and to pursue creative endeavors on my own. What do you need to do to take care of your needs and wants? I encourage you to give it some thought. So, what’s the point? You are the point. Your physical, mental and spiritual health are what matter. Taking good care of yourself can help you acquire the personal strength and balance you need to create or re-invent a life that you truly love and live with gusto. So . . . till next time, take care. Very good care. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call her at 585624-7887, email her at gvoelckers@ rochester.rr.com.
"When you try to judge efficacy for a drug without an accurate measure of what the drug's supposed to do, it becomes fairly difficult," she explained. "It's not like blood cholesterol levels, where there's a number. How do you measure it? That's where the problem lies."
Women’s HEALTH Breastfeeding: Is Milk Sharing Safe?
Experts say practice is OK if you know the source. For the most part, they warn moms against buying breast milk over Internet By Deborah Jeanne Sergeant
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he World Health Organization, American Academy of Pediatrics and likely any pediatrician asked would agree that "breast is best" for baby's health. When moms cannot provide their own breast milk, turning to other moms for help is becoming more accepted. But is milk sharing safe? Rebecca Surgoine, lactation consultant with Rochester Regional at Newark-Wayne Community Hospital, said that the medical community has been vigilant about promoting breastfeeding, but has not offered as much feedback on how to safely acquire breast milk if they need some. She recommends Human Milk Banking Association of North America (www.hmbana.org), a Texas-based organization that ships milk nationwide. "They look for high risk behavior, perform blood draws and test for things that could be transmitted through human milk," Surgoine said. "If they don't find risk factors, they take donations. It's recognized as a very safe way to get milk if you need it." Those who donate regularly re-test periodically. Surgoine said the milk is pooled together because milk varies in its beneficial properties based upon the baby for whom it's originally intended. Milk made for a week-old baby is different from that of milk made for a 3-month-old, for example. (A woman's body can actu-
ally fine-tune milk for an individual baby's needs throughout the day.) The milk is pasteurized at low temperature to eliminate bacteria and improve its safety. Neo-natal intensive care units (NICUs) receive top priority for premature and sick babies. "It's not like they have tons and tons of it," Surgoine said. It costs around $11 an ounce. Surgoine said that the education about importance of breast milk has influence more women to seek informal milk sharing. Some think milk banks are too complicated and offer or sell milk through online groups or Internet sites. She cautioned that's the riskiest way to obtain milk. Some flat-out dishonest people sell human milk diluted with water, formula or cow milk to make more money. Tainting human milk with other substances can cause harmful reactions to babies with allergies and diminishes the nutritional value of the milk. Some women distribute milk apart from milk banks because their lifestyle would disqualify them. Or some who do unknowingly cause problems through the milk they share. "They don't think they have communicable diseases or don't think it's a big deal they are taking prescription medication," Surgoine said. "I don't think people do it with horrible
intentions, but people don't know they have diseases." Some honest moms may have a clean bill of health, but poor hygiene. They may not use a new pump, for example. Most providers discourage sharing pumps because even with new tubing and flanges, bacteria can build up in the machines. They may not wash their hands before pumping, clean the pump parts correctly or use sterile containers for holding the milk. Pumping moms could leave the milk out of refrigeration or delay freezing the milk. "They may be shipped above the recommended temperature," Surgoine said. "It's often not handled appropriately." Moms could ship old milk but claim it's fresh. Bacteria still grows in frozen foods, just slower. "There are really big concerns," Surgoine said. "I have people say they're getting it from a family member or best friend. It's different to accept it from someone whose risk
Got Milk?
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he Food and Drug Administration does not regulate breast milk. Despite experts' concerns about safety and ethics, buying breast milk has become vastly popular on the Internet. A simple Google search shows several links of individuals and organizations selling or buying breast milk. According to www.theverge. com, traffic to online sites has continued to rise as more moms look to the Internet for help. Across the US, online transactions have more than doubled in the past three years, from around 22,000 in 2012 to about 55,000 today, according to The Verge, which quotes Jesse Kwiek, associate professor of microbiology at the University of Ohio and a co-author of a study on the subject. Craigslist.com and ebay.com prohibit the sale of breast milk on their sites.
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factors you know." Dianne Cassidy, owner of Dianne Cassidy Consulting in Rochester, is a lactation consultant. She advocates either going with a professional milk bank or someone you know well. "Ask questions like, 'What kind of food do you eat? Are you on medication? Do you drink alcohol?'" she said. Wet nursing and cross nursing used to be commonplace generations ago; however, Cassidy said these days it's "few and far between." Since most families spread out, it's unlikely that you live near extended family members with babies. "It's safest if you know your source and who the mom is," Cassidy said. "You know what kind of lifestyle she's living and what kind of conditions she's pumping in. That's obviously the safest way to go." Nursing mothers who struggle to produce milk for their babies should contact a lactation consultant for help in producing more milk. Most breast milk selling sites offer tips lactating women who want to donate or sell their milk to others. They serve as a portal to match up milk sources with those who want milk without revealing the identities of either until participants choose to do so. Most breast milk sites leave it up to the buyers to screen their milk sources and the milk itself. Buyers aren't just parents of babies who need milk. Plenty of others want it, too. Some purchase to supplement the diet of sick, injured, or elderly people. Some men drink breast milk as part of their athletic-enhancing diet, too. They claim it helps them build more muscle and protect them from illness. A CNN new story, aired April 2014 and posted online, quotes several government sources who say people should be cautious about buying breast milk online. The FDA recommends against feeding baby breast milk acquired directly from individuals or through the Internet.
259 Monroe Ave at Monroe Square Rochester, New York 14607 585.545.7200 | trilliumhealth.org
People born between 1945-1965 (baby boomer generation) are 5 times more likely to be infected with Hep C.
April 2016 •
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Women’s HEALTH
Domestic Violence Still a Scourge Experts say problem is common and it ‘goes on right next door’
By Deborah Jeanne Sergeant
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omestic violence has gained the national spotlight as it was revealed that American Saeed Abedini, recently freed from Iranian prison after three years of false imprisonment, had abused his wife, Naghmeh Abedini. Her plight is not rare. The CDC states "one in four women (22.3 percent) have been the victim of severe physical violence by an intimate partner, while one in seven men (14 percent) have experienced the same." When including any kind of abuse (emotional, sexual, financial or spiritual), the statistic for women jumps to one-third and to one-fourth for men. Local experts believe that those who have never experienced domestic violence largely do not understand its prevalence or dynamics. "It goes on right next door and they don't realize it," said Jessica
DeFazio, supervisor of the domestic violence program at Family Counseling Services of the Finger Lakes in Geneva. Abuse refers to a consistent pattern of manipulation and control meant to shift the power of the relationship to one partner. It usually starts subtly, increasing in intensity so slowly that the victim doesn't realize the growing danger. The perpetrator blames his problems and, subsequently the abuse, on the victim. Anything that goes wrong is automatically the victim's fault. Any infraction of ever-changing, nitpicky rules can trigger a tirade of insults, threats, violence or punishments such as withholding basic rights. Perpetrators often isolate victims to cut off their emotional supports, convince them that no one would believe them, downplay the abuse and play mind games to make
A Place of Safety Willow Domestic Violence Center helps domestic violence survivors heal, and move on to better lives By Mike Costanza
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Jaime Saunders is president and CEO of Willow Domestic Violence Center. In Rochester. Each year, thousands turn to the center — formally the Association for Battered Women — for the help they need to escape from abusive or violent domestic relationships, and to heal from their effects. Page 10
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nnie Lane remembers that terrible day back in 1995 when she felt her then-husband’s hands on her throat, strangling her. “We were both on the ground, and he’s on top of me,” she says. Lane managed to get away, and eventually made her way to what is now the Willow Domestic Violence Center, Monroe County’s only certified domestic violence services provider. With the nonprofit’s help, she managed to begin healing from the abuse and violence she’d suffered, and making a new life. Each year, thousands turn to the Willow Center—formally the Association for Battered Women—for the help they need to escape from abusive or violent domestic relationships, and to heal from their effects. “Our mission is ultimately to prevent domestic violence, and to ensure that every survivor has access to the services and supports needed along a journey to a safe and empowered life,” says president and CEO Jaime Saunders. The Willow Center seeks to achieve that mission by a variety of means, all of which are available free of charge. Though most who access its services are women and children, the nonprofit
victims second-guess themselves. Physical violence can include punching, pushing, slapping, hair pulling, choking and any other action or inaction meant to cause harm. The cycle of violence usually includes a long tension-building phase where survivors feel like they're walking on eggshells. After violence breaks the tension, a short "honeymoon phase" follows, filled with perpetrators' promises of good behavior and lavish gifts. But they never admit fault for their behavior. To outsiders, perpetrators often appear warm and caring partners; however, they diligently hide their behavior, which simultaneously solidifies their reputation while eroding that of victims’. Physician Tara Gellasch serves as associate chief of obstetrics and gynecology at Newark-Wayne Community Hospital. She said that screening
for domestic violence is routine for every new patient and each pregnancy, a policy becoming standard throughout the medical industry. "We look out for warning signs of domestic violence," Gellasch said. These could include excessive control and answering for the patient. Gellasch said they may arrange a one-on-one visit and assure her that the conversation is confidential unless a child in the home is in danger. Pam Graham, prevention education training coordinator for Willow Domestic Violence Center Graham
also serves male, transgender and lesbian, gay, and bisexual survivors. Almost all who the nonprofit serves are residents of Monroe County, where the rate of domestic violence is twice that of the state, excluding New York City. Domestic abuse or violence survivors can reach out to the Willow Center via its 24/7 hotline. Just one phone call
gives them access to crisis intervention and counseling, information about domestic abuse and violence, and other benefits. Survivors and their relatives, friends, co-workers, neighbors and children call the hotline about 5,000 times a year in bids for assistance. “We’ve had a 10-year-old boy call from a closet while his parents are fighting,” Saunders says. Callers who want to escape their domestic situations can also turn to the hotline for help. Since the act of trying to leave an abuser
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
Annie Lane is a business development consultant who volunteers as a domestic violence educator and advocate for survivors. In 1995 she turned to Association for Battered Women’s shelter, now known as Willow Domestic Violence Center, after being in an abusive relationship with her then-husband. “They just helped you kind of rebuild your life,” she says.
“It’s not just a mammogram, it’s my future.” Jessica DeFazio and Kaitlyn McWilliams work at Family Counseling Services of the Finger Lakes in Geneva. Among their duties is to help those who have suffered from domestic violence. of Rochester, encourages healthcare providers to ask about the person's life in general and work up to asking about relationships. "When we hear that they've been with the person for a long time, we ask how they are today," Graham said. "If they say, 'It's good,' we say, 'We're glad it's good, but if anything changes, we can talk.'" For those in a dangerous relationship, providers can offer appropriate resources. Simply leaving an abusive relationship increases the victim's chances of being murdered by 70 percent.
"People don't break up from abusive relationships," Graham said. "They escape them." Graham calls survivors the experts on perpetrators, which is why working with them to form an escape plan is so helpful in reducing the risks. It takes an average of seven attempts before successfully leaving. Just calling the police and receiving an order of protection may worsen the danger. "In the scheme of things, it's just a piece of paper," DeFazio said.
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For a complete list of locations and services, visit www.borgandideimaging.com
can increase the potential for harm, counselors are ready to help survivors exit as safely as possible. “A lot of times, when a client decides to leave, they’ll call us ahead of time, and we’ll develop a safety plan with the best options for how to coordinate that,” says Jeff Pier, the nonprofit’s director of programs and services. For those who choose to leave their situations, the Willow Center’s 40-bed emergency shelter offers a safe place to stay. Located at a closely guarded address in Rochester, the shelter offers warm beds, food, individual and group counseling, medical care and assistance with such practical matters as applying for public assistance or finding a job. There’s even some child programming and a space for kids. “We have toys and books and a nice playroom area,” Pier explains. Survivors who are not staying at the Willow Center’s shelter can also access the nonprofit’s services. Those who need the assistance of the courts to prevent their abusers from mistreating them again can turn to the Willow Court Advocacy Program. “We provide services to victims while they are obtaining a court order of protection,” Saunders says. Court advocates walk their charges through the often confusing application process and accompany them to Monroe County Family Court, where petitions for orders of protection are heard. While waiting to see a judge, survivors sit in a separate room from those who have abused or hurt them. While helping those who are suffering from or have suffered domestic abuse or violence, the Willow Center also seeks to prevent it from happening in the first place. The non-
profit’s educators regularly head out to the community to teach children and adults about domestic abuse and violence. “We are in pre-K classrooms all the way through college, talking about healthy relationships in a positive way,” Saunders explains. Lane’s husband was frequently verbally and psychologically abusive to her over the 10 years they were married, and sometimes threatened her with a gun. After he physically attacked her in their Perinton home, she went to live with her sister in a Rochester suburb. The situation quickly worsened. “There were several attempts on my life and on my family’s life, and threats of his own to kill himself if I didn’t return home,” she says. Lane felt she had no choice but to enter the Association for Battered Women’s shelter. There, she received the support, information on domestic violence, and other assistance that she needed, including one-on-one counseling. “I would be up lots of times in the night, really needing somebody just to talk to,” she explains. Lane left the shelter after 45 days, but continued going to the nonprofit for support services, including the group counseling she needed to continue healing from the traumatic events she’d endured. She subsequently divorced. Nowadays, Lane works full time as a business development consultant while volunteering as a domestic violence educator and advocate for survivors. The married stepmother lauds those who helped her start anew. “They just helped you kind of rebuild your life,” she says. April 2016 •
James W. Albright, CAPS, GMB, CGR, CGP 5205 Johnson Hill Drive, Canandaigua, NY 14424 Cell (5850 230-4280; Fax(585) 396- 5879 albright1.j.s@gmail.com www.AlbrightBuild.com
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Back Pain: Study Urges Non-invasive Treatment First
More people are undergoing surgery and taking opiates to treat the problem, Excellus says
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ore Upstate New Yorkers with back pain are undergoing surgery and taking prescription medication (including opiate painkillers), even though noninvasive treatments such as simple exercises and over-the-counter drugs usually work, according to a new Excellus BlueCross BlueShield report. “If patients receive the wrong care at the wrong time, it could actually lead to worse outcomes,” said Brian Justice, a chiropractor and medical Justice director at Excellus BlueCross BlueShield. “Back pain is not a disease in search of a cure. It’s a part of life that needs to be managed.” In their lifetimes, more than 80 percent of Upstate New York adults Page 12
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will experience low back pain, nearly two-thirds will experience neck pain, and some will endure chronic suffering. According to the report, Spine care in Upstate New York: • Surgeries for the treatment of back pain among Upstate New York adults saw a 10 percent rise in utilization from 2010 to 2013. • There was nearly a 14 percent increase in spine patients who were prescribed a medication within the first six weeks of diagnosis from 2010 to 2013. • In 2013, almost half of patients treated for spine pain received a prescription for medication to treat the condition within the first six weeks of diagnosis. More than half of patients who were prescribed medications received a prescription for an opiate. • In 2013, 626,000 Upstate New York adults ages 18 and older received back and/or neck pain care that added nearly $1 billion to total, direct health care costs in the region. About 36 percent of that amount was spent on surgery, 32.2 percent
was spent on diagnostic services and physician visits, and 32.9 percent was spent on non-surgical interventions. Choosing Wisely, an initiative of the American Board of Internal Medicine Foundation, collected the following care recommendations on treatment of spine pain from physician-led medical specialty societies: • The American Academy of Family Physicians advises spine pain patients to initially avoid imaging, due to the risks associated with radiation, the likelihood that additional and unnecessary tests and procedures without improved outcomes will follow, and also the high cost. • The North American Spine Society does not recommend magnetic resonance imaging in the first six weeks of care for patients with nonspecific acute low back pain, nor does it recommend bed rest for more than 48 hours when treating low back pain. • The American Academy of Physical Medicine and Rehabilitation recommends that health care providers only prescribe opiates for
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
acute disabling low back pain after an evaluation and when other alternatives have been tried. Prescribing opiates early for acute disabling low back pain is associated with longer disability, higher surgical rates and a greater risk of later opioid use. The goals of the Choosing Wisely initiative are to improve the quality of care and encourage physician-patient conversations about services that may be unnecessary and may cause harm. "As a primary care physician, spine pain is one of the more common conditions that I treat," said physician Joseph DiPoala Jr., president of the Monroe County Medical Society. "I see cases of chronic or acute neck or low back pain virtually every day. Fortunately almost all of the acute cases of spine pain resolve on their own within a few weeks." "I think it is very important for patients to understand the role of imaging tests such as CAT scans or MRIs," added DiPoala, of Ridgeview Internal Medicine in Irondequoit. "In the absence of signs of infection, cancer, weakness or change in bowel or bladder function, MRI or CAT scan will not help the patient even with very severe pain. It's also important for patients to understand that it's very common for an MRI or CAT scan to show significant abnormalities that have nothing to do with the patient's pain and/or for which there are not definitive treatments like surgery."
Meet Your Provider
Rochester Holistic Center Drug-free ways to treat anxiety and stress Handling the daily routine, from work and kids to managing aging parents and community involvement, has taken its toll on women. Prescriptions for anxiety medications are dispensed at an alarming rate but can be a God-send for those struggling to keep all the balls in the air. We hear complaints about stress and anxiety daily at the Rochester Holistic Center. Most patients have either tried prescriptions for anxiety and experienced side effects or just want an all-natural approach. We use scientifically-validated and researched nutrients from both plants and vitamins to address the root cause of anxiety, as well as most other health conditions.
A.: There are many ways to reduce anxiety that don’t involve medication. Exercise, meditation, yoga, tai chi, biofeedback, even praying the rosary all reduce anxiety by quieting the mind, relaxing focus and lowering stress hormones that surge in the body due to anxiety. Q.: Are there natural supplements that work as well as my Xanax? A.: Yes! There are several well-studied, safe supplements that have proven as effective or even superior to prescription anxiety medications. We offer a combination protocol, using two supplements whose ingredients effectively address the biochemistry of anxiety: overactive neurotransmitters. Neurotransmitters do exactly what their name implies: transmit messages from one brain Q.: What causes anxiety? A.: Anxiety stems from a variety of causes, from cell to another. The over-firing of neurotransmitters medical issues, such as heart disease and hyperthy- results in anxiety. Our proprietary formulas, Stress roidism, to emotional stress, genetic predisposition, Soothe and GABA Boost, offer patients relief from brain chemistry, as well as a side effect from certain anxiety by calming their over-stimulated excitatory neurotransmitters without negative side effects, medications taken for chronic health conditions. such as sleepiness, dependence and/or ‘hangover’ Many people equate stress with anxiety, so when a person calls us to discuss his or her complaint, they results seen with commonly-prescribed drugs such as benzodiazepines. use stress and anxiety interchangeably. Stressful Q.: Do you have medical doctors at the Rochester events can cause situational anxiety, but everyday Holistic Center? stress is an overlooked cause of chronic anxiety. A.: We have two licensed, board-certified medQ.: Are there ways to reduce anxiety that don’t ical doctors at Rochester Holistic Center. Both have involve taking a medication?
nearly 30 years’ experience each and offer patients a unique but progressive and effective approach to managing chronic illness as well as preventing chronic disease. I work as a Functional Medicine and Clinical Nutrition consultant, offering patients a personalized approach to achieving optimal health. Everything we do at RHC, from genetic testing to custom laboratory panels, is designed using the principles of Functional Medicine, which is the new name for holistic medicine, taking the whole body and mind into considKimberly Kavanagh is eration when treating a Functional Medicine illness, imbalance and and Clinical Nutrition consultant with Rochester disease. Our patients can trust that we’ll Holistic Center, known provide them with by her clients as “Nancy honesty, clarity and Drew of medicine.” hope when it comes to Call her today for a free tackling their health 15-minute consultation. challenges.
Rochester Holistic Center • 585-690-3782 • www.rochesterholisticcenter.com
Parenting By Jessica Gaspar
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Learning to Navigate the Healthcare Industry Can Be Difficult
ne of the hardest issues I’ve faced so far isn’t related to the baby at all. Insurance and healthcare has been a headache. Initially, I wanted to add Timmy to my health insurance through my full-time job. When I realized my plan would cost several hundred dollars more per month, I looked for an alternative. I’ve had a lot of people tell me to apply for certain government benefits. Two issues pose roadblocks in doing so. First, I am not one to take advantage of anything. I don’t like to ask for government handouts or anything that may be construed as such. Second, my income generally prohibits me from doing so. While I am considered a “single mother,” I make a comfortable salary, so I don’t qualify for a lot of those benefits. After some investigation, I did find that Timmy would actually qualify for Child Health Plus, but I would have to pay a $45-a-month premium. Much better than hundreds, right? For those who are unfamiliar, Child Health Plus is an income-based health insurance policy offered through the State of New York Health Insurance Marketplace. It debuted
in the mid-1990s as an affordable alternative for families. Based on one’s income, the insurance is either free, $15, $30, or $45 per month. Locally, Child Health Plus is available through either Excellus or MVP health insurance companies. I chose MVP. The online application process was relatively simple. At the end, I found the insurance would not take effect until March 1. He was born Jan. 6, so I wasn’t sure why the insurance would not be effective from his birth date. I called to inquire about the effective date. After being transferred to three different people, the call was disconnected. When I called back, a wonderful woman answered my call. She explained that benefits do not cover an infant’s first month of life. Why? She didn’t know. I asked why he would not be covered for February. Since I applied online after Jan. 15, coverage was pushed out until March. My application was dated Jan. 21. No matter what I did, February would not be covered. I decided I would have to pay his hospital bills and doctor’s visits for January and February out of pocket. April 2016 •
Second point of contention. His pediatrician’s office — Genesis Pediatrics in Gates. On a tour last fall, I really liked their office. The staff was friendly; the office was colorful and seemed unintimidating for children. His two appointments in January went smoothly. He had his one-month appointment in February, which also went smoothly. Those appointments were with his pediatrician. After his one-month wellness check, Timmy began vomiting after eating. The first time it happened, I wasn’t initially concerned. After it happened four times over three days, I called his doctor’s office. They were able to get me in that day with a nurse practitioner — or so I was told. In actuality, a nursing student was sent in place of the nurse practitioner. I was a little apprehensive, but I listened. While she spoke, her eyes would roll up as if she was bothered. She insisted his vomiting was normal (it wasn’t). I also inquired about a rash he had on his cheeks that was spreading down his neck, up over his forehead, and onto his ears. Normal, she said. When I hesitated to believe her, she went to get the nurse practitioner who came in and simply validated what the student said. I was uneasy. After he vomited a few more times, I attempted to make an appointment with his actual pediatrician. His two-month check was due, so I figured both could be addressed in one appointment. Though I told the office staff about his insurance on three separate occasions, I was not told that his doctor, who is young and new, was not yet credentialed to accept MVP. Having worked in the healthcare field for 11 years, I understood why she was not yet creden-
tialed, but I was angry no one told me before that moment. My options were to continue seeing nurse practitioners or another physician within the same practice until his pediatrician was credentialed. Because of the student nurse incident and the lack of communication from the office staff, I switched practices. I chose Elmwood Pediatrics in Brighton where my sister takes her children. In the meantime, I changed Timmy’s formula to Enfamil Gentlease thinking it would reduce the vomiting, which it did until his burps started to smell like sulfur and he began vomiting again — this time mostly at night while he was sleeping. His new pediatrician was experienced enough to recognize the signs and symptoms. She ordered an upper GI since something clearly was awry with his digestive tract. He then had an ultrasound, which showed his stomach contents were not passing through to his small intestine. He had something called pyloric stenosis, a thickening of the muscle around the pylorus, which restricts flow into the intestinal tract. Essentially the food had nowhere to go but back up again. This diagnosis required emergency surgery, which he had done at the Golisano Children’s Hospital in Rochester. Developmentally, may son is right on track. He has begun smiling and making baby sounds. I love the little noises he makes! He’s been lifting his head and looking around quite a bit, and he loves when I carry him around the house so he can observe everything. He’s growing like a weed — pushing 14 pounds and about 24 inches in length. He is wearing 6-to-9-month clothing already!
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Program Encourages Physical Therapy as Primary Caregivers for Spine Care
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pine related disorders – primarily low back and neck pain – are among the most common physical conditions affecting an individual’s ability to work and carry out daily activities. 80 percent of all upstate New York adults will experience low back pain at some point in their life. Nearly two-thirds will suffer neck pain. Many patients are prescribed medication, costly diagnostic services and surgery. Lattimore Physical Therapy and Sports Rehabilitation is part of an innovative training program created by Excellus BlueCross BlueShield that positions physical therapist as the primary care providers for spine-related disorders. The Spine Care Pathways initiative trained more than 40 physical therapists at Lattimore PT since the program was created in 2014. John Shuman, owner of Lattimore Physical Therapy says “Having physical therapists on the front lines of primary care for back pain gets patients the help they need at the right time, before there
is a more serious issue.” Shuman adds, “Lattimore Physical Therapy has long recognized that receiving the right physical therapy at the right time can reduce the need for costly diagnostic and surgical procedures. This training allows PT’s to now evaluate and treat spine issues without a referral.” Spine Care Pathways Goals: • PT’s becoming more important in primary care for spine care • PT’s have ability to evaluate and treat spine issues without referral • PT’s with spine care specialty can be a reliable resource for spine surgeons and specialists • Improves access to care • Use of PT’s is more cost effective for patients and insurance companies Shuman adds, “In many instances PT results in reduced symptoms and trains patients how to manage their pain throughout their lifetime. Our goal is to be the first stop for care when a patient is struggling with back pain.”
Avon Physical Therapy Phone: 585-226-2480
Lattimore PT - Elmwood Phone: 585-442-9110
Dansville Physical Therapy Phone: 585-335-2456
Lattimore PT - White Spruce Phone: 585-442-6067
Lattimore of Geneseo PT Phone: 585-243-9150
Lattimore of Greater Pittsford PT Phone: 585-387-7180
Lattimore of Webster PT Phone: 585-347-4990
Hilton Physical Therapy Phone: 585-392-8001
Lattimore of Greater Rochester PT Phone: 585-671-1030
Pianoworks Physical Therapy Phone: 585-264-0370
Pittsford Mendon Physical Therapy Phone: 585-582-1330
Lattimore of Gates Chili PT Phone: 585-247-0270
Lattimore of Rush Henrietta PT Phone: 585-444-0040
North Greece Physical Therapy Phone: 585-227-2310
Honeoye Falls-Lima PT Phone: 585-582-0034
Irondequoit Physical Therapy Phone: 585-286-9200
Lattimore of Fairport PT Lattimore of Spencerport PT Phone: 585-‐388-‐0444 Phone: 585-‐349-‐2860 18 Clinics across Monroe and Livingston Counties LattimorePT.com
18 clinics across Monroe and Livingston counties LattimorePT.com
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A group of people working at a community garden in Brockport. Because gardeners use sharp tools and dig in the soil, they need to stay protected from contracting tetanus, according to experts. Photo by Kristina Gabalski.
Gardeners Should Be Aware of Tetanus
Gardeners can expose themselves to tetanus bacteria while digging around with tools By Kristina Gabalski
N
ow that spring is here, gardeners are itching to get back out and start digging in the dirt, but with all that outdoor work comes the danger of contracting tetanus. Physician Matt Devine, associate medical director of Highland Family Medicine and assistant professor at URMC, says the bacteria that causes tetanus — Clostridium tetani — is found in soil. “Gardeners can expose themselves while they are digging around with tools,” he says. According to the Mayo Clinic, when the tetanus-causing bacteria enter a deep flesh wound, spores may produce a toxin that impairs motor neurons — the nerves that control muscles — causing muscle stiffness and spasms. The bacteria are also found in dust and animal feces, according to Mayo Clinic. Devine says that although reported cases of tetanus are quite low, (300 cases were identified in the U.S. in 2014) and the bacteria is more commonly found in warmer climates, those who do contract the disease, tend to be older. “Of the cases found in the U.S., it is a more common incidence in people greater than 65 years old,” he says. Devine says tetanus is something that should be avoided. It can be devastating and potentially fatal. To be safe, gardeners should make sure their tetanus immunization is up to date. Devine recommends the Tdap vaccine, which
includes tetanus and pertussis, offering additional protection against whooping cough. He additionally cautions gardeners to practice safe gardening habits by wearing good gloves and shoes or gardening boots to protect themselves. “Using tools can cause injury,” he says. Gardeners can choose whichever product is most comfortable for them. “During warmer weather, cotton may be more breathable [for gloves],” Devine suggests. Kathy Kepler, an avid gardener and owner of Sara’s Garden & Nursery in Brockport, says she never thought about getting a tetanus shot. “I had the flu last winter and at my doctor visit, he asked me about the last time I had one. He was pretty shocked that it had been about 35 years ago,” Kepler says. The doctor told Kepler she was lucky to have never encountered a problem, “considering the work I do and how, basically, I just wipe off any blood and keep on working, and he knows I am not a glove wearer,” she says. Kepler says she got her tetanus shot that day. “I have never known anyone who has had it,” she says of tetanus, “but apparently it is pretty good possibility to get it and my primary care doctor thinks it’s pretty important.”
Story ideas?
If you’d like to submit a story idea for In good Health, please send an email to editor@GVhealthnews.com
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
SmartBites
The skinny on healthy eating
Surprising Benefits of Earthy Portobellos
P
ortobellos are unlike any food you’ll encounter in the produce section. This mushroom, in fact, possesses such a unique and vast array of nutrients, it’s hard to know where to begin. But first: What exactly is a portobello? Neither a fruit nor a vegetable, this large, flavorful fungus — known for its meaty texture — is really just a mature dark-button mushroom. Indeed, portobellos are simply creminis that have been left to grow until their caps reach diameters of up to six inches. That portobellos are low in fat, calories, sodium and cholesterol may not come as a big surprise. Most produce is known for being attractively low in all of the above. What may come as a surprise, however, is that portobellos deliver a decent amount of muscle-building protein (a little over 5 grams per large cap) and a good helping of heart-healthy fiber (about 3 grams per cap). What may also raise eyebrows is that portobellos are a mineral superstar — with more potassium than a banana, nearly half of our daily copper needs, and enough selenium to make top-10 lists of foods highest in this mineral. Potassium helps to control blood pressure; copper is needed for energy; and selenium helps to protect cells from free-radical
damage. Another big eye-opener: Portobellos may help prevent cancer, especially hormone-dependent breast cancer. Due to a unique fatty acid in portobellos that helps to lessen the production of estrogen, this mushroom may actually lower the risk of this breast cancer type. And the icing on the cap: Eating mushrooms such as portobellos may be associated with reduced inflammation and a stronger immune response, according to researchers at Arizona State University and Penn State University. Translation? The humble portobello may reduce the risk of health problems associated with chronic inflammation, such as heart disease, certain cancers, and Type 2 diabetes. Lastly, while mushrooms are often touted as being a good source of vitamin D, the particular form found in mushrooms has led experts to agree that you cannot count on mushrooms to be helpful with your vitamin D requirements.
Helpful tips
When selecting mushrooms, avoid mushrooms with bruises or that feel slimy, and go for those that smell earthy. If there’s any hint of ammonia or another odd odor, then you know the mushroom has
spoiled. Store unwashed mushrooms in a brown paper bag (plastic traps moisture and encourages sliminess) and place in refrigerator for up to a week. Clean with a soft brush or a damp paper towel or by a super-quick dunk in water.
Grilled Portobello Burgers with Rosemary Mayo Adapted from Bon Appetit Serves four Rosemary Mayo ½ cup fat-reduced mayo 2 teaspoons Dijon mustard 1 teaspoon dried rosemary, crushed 1 garlic clove, minced ¼ teaspoon each: coarse black pepper, salt Balsamic marinade 1/3 cup balsamic vinegar 1/3 cup water 2 teaspoons sugar 1 garlic clove, minced 1 teaspoon dried rosemary, crushed 1/4 teaspoon cayenne pepper (optional) 2 tablespoons olive oil Portobello burgers Nonstick vegetable oil spray 4 large portobello mushrooms, stems trimmed
4 whole wheat buns lettuce, sliced onions (optional) Place cleaned and trimmed mushrooms in a glass dish, stem (gill) side up. In a small bowl, whisk together marinade ingredients. Drizzle marinade over the mushrooms; cover and place in refrigerator for about an hour, turning mushrooms once. While the mushrooms are marinating, mix mayo, mustard, rosemary, garlic and salt and pepper in a small bowl. Set aside. To cook: Spray grill rack with nonstick spray, then prepare barbecue (medium heat). Grill portobellos until tender, turning once or twice, about 8 minutes per side. Baste with marinade to keep from drying out. Place each mushroom on a bun and top with rosemary mayo, lettuce and onions (if desired). 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.
Correction: Last month’s bok choy recipe should have also included “1/4 cup sliced almonds, toasted.”
IT’S ONLY SUPER IF YOU TAKE IT. According to the National Institutes of Health, up to 20 percent of patients fail to fill new prescriptions, and 50 percent of people with chronic health conditions discontinue their medication within six months. If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember: If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/ TakeAsDirected.
#TakeAsDirected A nonprofit independent licensee of the Blue Cross Blue Shield Association
April 2016 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 15
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
By Jim Miller
How to Avoid Medicare Mistakes When You’re Still Working Dear Savvy Senior,
Should I enroll in Medicare at age 65 if I’m still working and have coverage through my employer?
Almost 65
Dear Almost,
The rules for enrolling in Medicare can be very confusing with all the different choices available today. But when you postpone retirement past age 65, as many people are doing, it becomes even more complicated. First, let’s review the basics. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people. And Part B, which covers doctor’s bills, lab tests and outpatient care. Part B also has a monthly premium of $104.90 in 2016 (though it’s higher for individuals earning $85,000 or more a year). If you are receiving Social Security, you will be enrolled automatically in parts A and B when you turn 65. If you aren’t yet receiving Social Security, you will have to apply, which you can do online at SSA.gov/medicare, over the phone at 800-772-1213 or through your local Social Security office. If you plan to continue working past the age of 65 and have health insurance from your job, your first step is to ask your benefits manager or human resources department how your employer insurance works with Medicare. In most cases, you should at least take Medicare Part A because it’s free. But to decide whether to take Part B or not will depend on the size of your employer.
Small employer
If your current employer (or spouse’s employer if it’s providing your coverage) has fewer than 20 employees, Medicare will be your primary insurer and you should enroll in Medicare Part B during your initial enrollment period. This is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. If you miss the seven-month sign-up window, you’ll have to wait until the next general enrollment period, which runs from Jan. 1 to
March 31 with benefits beginning the following July 1. You’ll also incur a 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium.
Large employer
If your employer has 20 or more employees, your employer’s group health plan will be your primary insurer as long as you (or your spouse if the coverage is from his/ her employer) remain an active employee. If this is the case, you don’t need to enroll in Part B when you turn 65 if you’re satisfied with the coverage you are getting through your job. But if you do decide to enroll in Medicare, it will supplement your employer insurance by paying secondary on all of your claims. Once your employment (or group health coverage) ends, you will then have eight months to sign up for Part B without a penalty. This is known as the Special Enrollment Period.
Drug coverage
You also need to verify your prescription drug coverage. Call your benefits manager or insurance company to find out if your employer’s prescription drug coverage is considered “creditable.” (Creditable prescription drug coverage is one that is considered to be as good as or better than the Medicare prescription drug benefit.) If it is, you don’t need to enroll in a Medicare Part D prescription drug plan. If it isn’t, you should purchase a plan (see medicare.gov/find-a-plan) during your initial enrollment period or you’ll incur a premium penalty (1 percent of the average national premium for every month you don’t have coverage) if you enroll later. For additional help, visit Medicare.gov or contact your State Health Insurance Assistance Program (SHIP) at Shiptacenter.org. The Medicare Rights Center also offers a free helpline at 800-333-4114. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. April 2016 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Visiting Nurse Service, UR Medicine’s home care agency, recently appointed Gregory T. Hutton as vice president of finance. His responsibilities include directing the fiscal functions of the agency in accordance with generally accepted accounting and cost reimbursement principles relating to the home health care industry and keeping the agency’s strategic plan. Hutton has a long history with University of Rochester Hutton not only as an employee but also a graduate of the Simon School MBA program. Most recently he served as the program administrator for the University of Rochester Medical Center Perioperative Services. His responsibilities included oversight of the financial and business functions of 49 operating rooms at Strong Memorial Hospital, Sawgrass and Strong West, as well as charge and expense budgets aiming for cost reduction opportunities. “We are thrilled that Greg has joined the Visiting Nurse Service team,” said Jane Shukitis, president and CEO. “He came to us with exceptional experience and is uniquely qualified to support not our only home care strategy, but as an affiliate of URMC, our role within the larger health system. He is a high caliber professional and demonstrates excellent leadership and organizational skills.” Hutton, who lives in Fairport, started his career as a respiratory therapist and later migrated toward finance and health care administration.
Local nursing professor at the White House A University of Rochester School of Nursing researcher specializing in the prevention of HIV and other sexually transmitted infections in high-risk populations was a panelist in March at a White House symposium focused on reducing the stigma surrounding HIV/AIDS. LaRon E. Nelson, the dean’s endowed fellow in health disparities and an assistant professor at the school of nursing, was among a select group of researchers, program directors and community leaders invited to participate in the conference, “Translating Research to Action: Reducing HIV Stigma to Optimize HIV Outcomes,” which took place March 3-4 at the White House. Over the course of the two-day event organized by the U.S. Office of National AIDS Policy in collaboration with the NIH Office of AIDS Research and the National Institute of Mental Health, Nelson and other scientists and stakeholders in the Page 18
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
fight against HIV/AIDS from around the world discussed best practices for measuring and monitoring HIV stigma, as well as methods of intervention focused on reducing stigma in order to improve HIV outcomes. “HIV stigma has been on the international radar for quite some time, but there has been limited scientific activity on how to take what we know and translate it into real world practice,” said Nelson. “This meeting [was] designed to help advise leaders on the state of the science for HIV stigma research. I’m honored to have my work be featured.”
Rochester Medical Museum receives award The Rochester Medical Museum and Archives, the historical repository of Rochester Regional Health, has been awarded a $3,500 NYS Documentary Heritage Program grant. The program, administered by the New York State Archives, provides assistance to nonprofit organizations that preserve New York state’s historical records and make them publically accessible. The grant will fund the arrangement and description of the Valenti Collection of early AIDS imprints. The documents, books, and photographs contained in the Valenti collection illustrate physician William Valenti’s efforts to develop a collaborative approach by Rochester’s faith, business, political, and medical communities in fighting HIV/AIDS during the early period of the epidemic. A co-founder of Trillium Health, Valenti has been instrumental in developing, organizing, and coordinating the Rochester community’s response to the AIDS epidemic. The materials in this collection reflect these efforts by gathering journal articles, news reports, educational materials, reference materials and Valenti’s records. The work funded by the grant will allow the museum to organize the records making them more accessible and usable by researchers and other interested people or organizations on local, state, and national levels.
Diabetes group recognizes organizations Seven local organizations have achieved the health champion designation from the American Diabetes Association, which recognizes companies and organizations that inspire and encourage organizational well-being as part of the association’s Wellness Lives Here initiative. “Wellness Lives Here is a new initiative designed to promote healthy lifestyles at work and beyond,” said Peter Knappen, area director for the American Diabetes Association. “These organizations should be commended for encouraging their employees to reduce their risk of developing Type 2 diabetes by adopting healthy habits throughout the year.” The Rochester area health champions are:
• Excellus BlueCross BlueShield • ITT Goulds Pumps Inc. • MVP Health Care • Monroe Community College • Rochester Regional Health • St. John’s • YourCare Health Plan, A Monroe Plan Company To qualify for the designation, a company or organization must meet a certain number of criteria in three areas: nutrition and weight management, physical activity and organizational well-being.
Golisano Restorative Neurology accreditated Rochester Regional Health’s Golisano Restorative Neurology and Rehabilitation Center at Unity Hospital has been awarded a three-year term of accreditation from the Commis-
sion on ccreditation of Rehabilitation Facilities (CARF). This was the program’s eighth consecutive CARF survey that resulted in a three-year (highest level) accreditation period for the following programs: inpatient rehabilitation – hospital (adults); inpatient rehabilitation — hospital: brain injury (adults, children and adolescents); inpatient rehabilitation — hospital: stroke specialty program (adults, children and adolescents); interdisciplinary outpatient medical rehabilitation: brain injury (adults, children and adolescents); interdisciplinary outpatient medical rehabilitation: stroke specialty (adults). CARF accreditation signals a service provider’s commitment to continually improving services, encouraging feedback, and serving the community.
Health in good
EMPLOYMENT ROCHESTER ’S HEALTHCARE PAPER
Golden Years Issue. Don’t miss the new issue of In Good Health—Rochester’s Healthcare Newspaper. For low-rate advertising information, call 421-8109.
April 2016 •
Carthage Area Hospital Attn: Human Resources 1001 West Street Carthage, NY 13619 Email: chart@cahny.org
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 19
State bill calls for a larger role for emergency medical services responders By Ernst Lamothe Jr.
T
he wind of change has hit almost every aspect of healthcare from hospital mergers to more transparent costs for procedures. The new way of thinking could soon hit emergency medical service responders. Community paramedicine is a new model of community-based healthcare in which paramedics function outside their customary emergency response and transport roles. They facilitate more appropriate emergency care resources by enhancing primary care for medically underserved populations. In addition, various new procedures taking place nationwide could change what happens when you call 9-1-1 for assistance. For example, if the Canandaigua Emergency Service is called out to a home for someone who needs stitches, instead of transporting the individual to the hospital, taking up space in a room for an individual who comes in with a true emergency, the EMS responders can simply suture the patient right in their home. “Imagine being at home preparing dinner and you go to cut something like an orange and you slip and accidentally slice the palm of your hand and it’s bleeding pretty good,” said Ken Beers, chief of the Canandaigua Emergency Service. “You need some attention and you would normally call 9-1-1 or get inside your car and go to the emergency room. You may need only a couple of stitches and that requires you to go spend Page 20
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maybe six to eight hours in the emergency department. But with this new system that we hope gets approved, a specialized care paramedic can come directly to your house after you call 9-1-1, stitch it up, connect you with antibiotics if you need it all while you never left your home.” Programs such as this already exist in California, Texas, Minnesota Colorado and Canada. Officials say the response is more efficient and more cost effective for the patient and the healthcare industry. Currently both the New York State Assembly and Senate have bills coming out to support community paramedicine. Hugh Chaplin, executive director of the New York Mobile Integrated Healthcare Association, is pushing for legislation when it comes to community paramedicine. “We propose to amend the public health law to explicitly allow EMS providers to operate in a wider variety of circumstances than they currently do,” said Chaplin. “This legislation will help EMS in New York state to become more patient-centered, more adaptive to changes in healthcare and more integrated into the continuum of healthcare delivery and public health.” Community programs typically are designed to address specific problems and to take advantage of locally developed collaborations between and among emergency medical services and other health care and social service providers. In addition, in the
age of the Affordable Care Act, where health organizations must offer higher quality care while lowering costs, the initiative is being seen as a way to improve access and reduce rising costs in the healthcare industry. “You have people who use the emergency room as their primary doctors. They come in for many things that are not necessary,” said Beers. “There is so much emergency department overcrowding that we hope this system will free them for more urgent needs.” Another advantage is furthering access to communities that struggle to receive it. For nearly 75 million people living in rural areas of the United States, healthcare needs far outnumber health care options. These communities already include disproportionate number of elderly citizens, immigrants, improvised families and those in poor health. Emergency responders in the future might also have to deal with chronically ill people who are discharged from the hospital who could have a higher amount of readmissions based on their condition. “We have to find a way to make life easier for our elderly population,” said Beers. Beers EMS re-
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2016
sponders can even help seniors who might need their prescriptions picked up, Beers said.
Getting appropriate training
Arnie LaRocca, 60, will be one of two men from Canandaigua Emergency Services who will be training this summer for community paramedicine. After being in EMS services for 14 years — with the past six years being advanced level — Chief Beers selected him for LaRocca the opportunity. “I was excited about the chance because I whole-heartedly see this training as something that is going to be the future of our profession,” said LaRocca. “This is something that will clearly take the burden off the emergency departments and physicians.” He said throughout his years, he believed a fair percentage ofpeople making calls to 9-1-1 could be treated by paramedics through community paramedicine. “Right now even if they only need a few stitches we can’t take them to urgent care. We are required to take them to the hospital which could be a very costly visit for things that may not really require an ER visit,” added LaRocca.