Igh rochester march final by In Good Health: Rochester's Healthcare Newspaper

in good DETECTING OVARIAN CANCER Physician Richard G. Moore, chief of gynecologic oncology at Wilmot talks about his FDA-approved Risk of Ovarian Malignancy Algorithm test and how it helps in the detection and treatment of ovarian cancer

Dealing With Medical Debt Collectors Too many debt collectors knocking on your door? Know your rights

MEN’S SPECIAL ISSUE

• More options to fight prostate cancer • Fat Dads = Fat Children

March 2016 • Issue 127

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The Long Road to Get a New Kidney Paul Bloser of Rochester is one of 100,791 people waiting for a lifesaving kidney transplant in the U.S. The median wait time to get the organ is 3.6 years. The 58-year-old shares his story

See story inside Page 14

11 Food Trends

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Page 10 Twenty-eight percent of consumers in the U.S. are preparing ethnic foods more frequently than five years ago. Bowl of Thai is just an example. See story inside

5 Reasons to Do Aquatic Therapy Tax Filing for Retirees

Fat Dads = Fat Children A recent study indicates that maternal health isn’t the only influence on childhood obesity. Having a father who is obese may increase the child’s chances of becoming obese as well Page 15

Oh Boy, Is Bok Choy Nutritious! And it is loaded with an impressive array of nutrients, so loaded that the wellregarded World Health Organization considers bok choy to be one of their highest nutritionally ranked vegetables. March 2016 •

Water Quality: Rochester is No Flint

But officials say lead still poses a problem to local drinking water, especially in older houses

Q&A with Sankar Sewnauth President and CEO of CDS Life Transitions, formerly known as CDS Monarch, discusses what his agency does to empower individuals with disabilities to live a fulfilling lives IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Taking Your Medications Campaign taps into daily reminders to ensure that life-saving medications are not forgotten

hat’s your reminder for taking medication? That’s the question posed by a new public health campaign aimed at helping people get dangerous high blood pressure under control. The new bilingual campaign features billboards, radio spots, bus railcards and posters. Community members can also request free pill boxes at the English and Spanish

websites www.MyReminder.org and www.MiRecordatorio.org or by calling 585-224-3170. The campaign was developed by the community-wide High Blood Pressure Collaborative, which is spearheaded by the region’s largest employers, hospitals and health insurance companies and managed through a partnership between Finger Lakes Health Systems Agency and Greater Rochester Chamber of

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Commerce. “The My Reminder campaign is an important new tool for creating a culture of health in Rochester,” said Collaborative Chairman Paul Speranza. “This new campaign will help residents keep health at the top of their minds as they ride the bus, listen to the radio and travel city streets.” “In the five years since the initiative began, the collaborative has had

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

success reaching out to individuals through doctors’ offices, at workplaces, in community centers and in barbershops and salons,” said Speranza, the vice chairman and secretary of Wegmans Food Markets, Inc. According to clinical data collected by the collaborative, hypertension control for adults in Monroe County has improved 13.7 percent since 2010 — progress so dramatic that it attracted the attention and praise of the federal Million Hearts program. “But there’s still work to be done, particularly in high poverty neighborhoods,” said Speranza. Residents in the city’s high poverty neighborhoods are 18 percent less likely to have high blood pressure in check than are individuals living in more affluent communities, clinical data show. The 2012 Monroe County Adult Health Survey also reported that African Americans are 1.6 times more likely and Latinos 1.1 times more likely than whites to have the chronic illness. To address these health disparities, the My Reminder project targets ZIP codes in the city of Rochester with the highest rates of high blood pressure. Those ZIP codes also have some of the highest poverty rates in the region. The My Reminder campaign encourages residents to develop routines that make taking daily medication a habit. For instance, patients may choose to set a cellphone alarm, place a pill bottle by their tootbrush or store their pillbox in their morning coffee cup. Designed by Roberts Communications, My Reminder complements a broader med-adherence campaign by Excellus BlueCross BlueShield and builds on research by the local insurer and others.

High Deductibles = Fewer Imaging Tests Insurance costs keep patients from seeking X-ray, CT or MRI scans, researchers report

.S. patients whose health insurance plans have high deductibles undergo fewer diagnostic imaging tests, a nationwide study finds. Researchers analyzed 2010 insurance data from more than 21 million adults nationwide and considered plans with high deductibles to be those with an annual deductible of at least $1,200 for one person and $2,400 for a family. They found that patients in plans with high deductibles underwent 7.5 percent fewer diagnostic imaging tests, such as X-rays and CT or MRI scans, than those with other plans. This resulted in 10.2 percent less in imaging payments, according to the study in the journal Medical Care. "I think what we found most surprising is the large reductions in imaging use among people with high deductibles. We had hoped to find that patients were reducing use of low-value imaging, but we found they reduced all use similarly," study senior author Kimberley Geissler,

from the University of Massachusetts at Amherst, said in a university news release. Geissler, an assistant professor of health policy and management, noted that a growing number of people are enrolling in high-deductible plans because of the lower premiums. But, she added, "It seems patients are not informed enough to discern which tests are more optional and which are medically necessary." Low-value imaging tests are those that are less critical, such as MRIs for low back pain. The study findings raise concerns that high-deductible health plans "may be a blunt instrument reducing all diagnostic imaging, rather than helping physicians and patients choose high-value imaging," the researchers wrote. Efforts to reduce diagnostic imaging tests should be combined with improved patient awareness and education about the appropriate use of such tests, the researchers said.

Fight back against gout with medication and lifestyle changes

out is like no other joint pain. It strikes suddenly, like flicking on a light switch, and brings pain that is often severe, with intense swelling and redness. It is triggered by the crystallization of uric acid within the joints. It affects more than eight million people, but older adults are the most susceptible, according to the February 2016 issue of Harvard Men’s Health Watch. The large joint of the big toe is the most commonly affected area, followed by the side of the foot and ankle, along with the knees, hands, and wrists. In general, if a person has one gout attack, there is a good chance he will have another within the next year. “The first line of treatment is medication,” says Robert Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center. This includes

common over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve). Pain relievers and prescription anti-inflammatories like colchicine (Colcrys) and corticosteroids also can help. But medication is only one way to fight gout attacks. “Altering lifestyle habits can add further protection,” says Shmerling. Some lifestyle changes that can help with gout include: • Reduce intake of meat and shellfish, which can raise uric acid levels. • Limit intake of alcohol and drinks with high-fructose corn syrup, such as soft drinks. • Increase intake of coffee, cherry juice, and vitamin C–rich foods like bell peppers, broccoli, strawberries, and oranges, all of which have been shown to lower uric acid levels. March 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

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

March 2, 9, 29

March 9

Free workshops to highlight health issues

Hip pain seminar held at Unity at Ridgeway

The Wayne County Action Program, a nonprofit agency based in Lyons whose objective is to offer programs and services to help people in need, is sponsoring a series of workshops in the region. There are no charges to participate and they will all address the topics “Living Health With Chronic Conditions.” . They are: • From 9 to 11:30 a.m., March 1, at Geneva Community Center. • From 1:30 to 4 p.m., March 2, at Newark Wayne Community Hospital. • From 1:30 to 4 p.m., March 9 at Newark Wayne Community Hospital. • March 29 at UR/Thompson Hospital, a four-day peer leader training for the organization’s living health with chronic conditions program. For more information, call 315665-0131, email kim.lucianovic@ waynecap.org or visit www.waynecap.org.

Do you experience hip pain? Rochester Regional Health experts will discuss common causes of hip pain and the latest treatment options that are available. It will be presented by Michael Stanton, an orthopedic surgeon who is trained in sports medicine, and Erika Kozlowski, a physical therapist with 20 years of experience in orthopedic rehabilitation. Both will be available to talk to participants about concerns and hip questions. Participants will also learn more about aquatic therapy and will be offered a tour of the facility. The free event will take place from 6 to 7 p.m., Wednesday, March 9, at Unity at Ridgeway, 2655 Ridgeway Ave., suite 320, Rochester. Registration is required. Visit www.rochesterregionalhealth.org/classes-events/footpain-pt/

March 8

Those who suffer from prostate cancer, their friends and family members are invited to hear researchers Joseph Roscoe Ph.D. and Luke Peppone Ph.D. to discuss “Local Symptom Management Research for Prostate Cancer Patients Currently on ADT.” The event will take place at 7 p.m., Thursday, March 10, at the main conference room at Jewish Community Center of Greater Rochester, 1200 Edgewood Ave. in Rochester. Registration is not required but participants are encouraged to arrive early for best seating. For more information, email ustoorochesterny@ gmail.com.

Alzheimer’s advocates plan Albany visit Advocates from the Rochester area will travel to Albany on Tuesday, March 8, to rally on behalf of individuals and families who are affected by Alzheimer’s disease and other forms of dementia. The group — including people with Alzheimer’s, caregivers, family members and others — will travel by bus to visit with local representatives and their staff. They will join hundreds of others from around the state at the Capitol for the Rally to End Alzheimer’s to raise awareness of the impact of the disease and the needs of families. They will also call on the governor and the legislature to increase funding for Alzheimer’s disease initiatives in the budget. An estimated 380,000 New Yorkers are living with Alzheimer’s disease, and just over 1,017,000 are caregivers to someone with Alzheimer's. Women are at the epicenter of this disease, as two-thirds of Americans living with the disease are women, and 65 percent of caregivers to those with Alzheimer’s are women. Seats are still available on the bus for the daylong trip, sponsored by the Alzheimer’s Association Rochester & Finger Lakes Region. Registration is required. To learn more or to register, call 585-760-5405, email kharris@alz.org or visit rally2016.eventbrite.com.

March 10

Researchers to discuss prostate cancer issues

March 10

Fairport Baptist Homes holds event in Victor Fairport Baptist Homes is holding “A Charmed by Charity” event at Alex and Ani, 236 High St. Extension in Victor, from 6 to 9 p.m., Thursday March 10.. Fairport Baptist Homes is a nonprofit organization that has been delivering a more personalized level of care for area seniors for more than 100 years. Fifteen percent of all proceeds will benefit Fairport Baptist Homes. RSVP to Kathleen Zastrow at kzastrow@fbhcm.org or by calling 585-388-2322.

March 19

Ataxia Foundation holds March Madness fundraiser The Rochester Ataxia Founda-

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tion (RAF) will hold its third annual March Madness fundraising event from 5 to 9 p.m., Saturday, March 19, at Jeremiah’s Tavern, 2200 Buffalo Road in Gates. Ataxia causes loss of balance and coordination and difficulties with eye movements, speech and swallowing. Hereditary ataxia is a neuro-genetic disease that affects approximately 150,000 Americans. There is no cure, and people in the advanced stages require round-the-clock care. RAF is committed to raising awareness and funds that will help researchers find a cure for hereditary ataxia. RAF helped to create the Hereditary Ataxia Program at the University of Rochester Medical Center, which offers coordinated care for patients with genetic forms of ataxia. The program takes patient referrals from area physicians for diagnosis, genetic testing and multidisciplinary disease management. March Madness tickets are $40 per person, and include beer, wine and heavy appetizers during March Madness basketball. The event will also feature a 50/50 raffle and basketball squares. Proceeds will benefit the work of the foundation. For tickets, please visit rochesterataxia.org. Attendees can park at the Gates Presbyterian Church at 1049 Wegman Road and hop a shuttle bus to Jeremiah’s.

March 17

St. Patrick’s Day at Legacy at Park Crescent Legacy at Park Crescent is hosting a St. Patrick’s Day happy hour. The event is free and open to the public. Green beer, Irish soda bread, reuben dip and shamrock cookies will be on the menu. From 3 to 6 p.m., March 17, at Legacy, 1000 Providence Circle, just off of Mt. Read Blvd between Stone Road and Maiden Lane. RSVPs are required by calling 585-865-0680.

March 21

Veterans invited to P.A.C.E. Challenge Canandaigua VA Medical Center is inviting local veterans interested in a healthy and friendly competition among veterans nationwide to participate in the eight-week P.A.C.E. (physical activity and conscious eat-

PROSTATE CANCER? Attend & Learn • Free Local Symptom Management Research for Prostate Cancer Patients Currently on ADT, by researchers Joseph Roscoe Ph.D. and Luke Peppone Ph.D. M.P.H.

Thursday March 10 • 7pm Conference Room, Jewish Community Center of Greater Rochester, 1200 Edgewood Ave., 14618. Spouses and significant others welcome. Registration not required. Arrive early for best seating.

Email:ustoorochesterny@gmail.com

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

ing) competition challenge. The event will start March 21.Teams are now being formed at the Canandaigua VA Medical Center and the Rochester VA Outpatient Clinic. The P.A.C.E. Challenge will include: Physical activity: Be active 30 minutes a day, at least five days a week. Healthy eating: Choose one of eight healthy eating goals each week. • Tracking: Free personal activity log using the president’s Challenge website (www.presidentschallenge. org). To participate, veterans must be eligible for the VA’s MOVE program and be interested in improving their fitness and eating habits to live happier, healthier lives. Veterans will compete with veterans nationwide to earn the PACE Trophy. For more information please contact Shawn O’Brien at 585-393–7268.

Cancer charities to start 15K race series

thirty Cancer Connect, Anna’s Wish and Christopher’s Challenge have announced a new collaborative race series. Throughout the 2016 racing season, the three organizations will offer a discounted rate to runners participating in all three races. The three individual 5K races will create the Kick Cancer 15K Race Series. A special prize will be given to runners completing the series. As leaders in the field of adolescent and young adult cancer, 13thirty Cancer Connect proposed this unique series to other community cancer organizations in order to better leverage our community resources. Anna’s Wish and Christopher’s Challenge shared the excitement and the Kick Cancer 15K Race Series materialized. With participation at each 5K expected to increase, awareness will be heightened and the vision of a world without cancer will be clearer. The 4th Annual 13thirty Bandana Bolt 5K will take place in Seneca Park on Sunday, May 15; the 4th Annual Anna’s Wish 5K will take place in Black Creek Park on Sunday, June 19; Christopher’s Challenge 5K will take place in Webster Park on Sunday, Aug. 14, the final leg of the Kick Cancer 15K Race Series. For more information, contact Joshua Symer, 13thirty special events coordinator, at 585-563-6221 and visit the official race series Facebook page at facebook.com/KickCancer15KRochester.

Water Quality: Rochester is No Flint

But officials say lead still poses a problem to local drinking water, especially in older houses By Nina Alvarez

ochester and other towns in Monroe County are dotted with old water pipes, and while officials say the area won't see the same problems that Flint, Mich., residents faced recently, they warn that lead still poses a problem to the local drinking water in older homes. “Monroe County Water Authority is paying close attention to what unfolded in Flint, Michigan,” said Richard Metzger, chief engineer of the Monroe County Water Authority since 1989. “While we do not have firsthand information about what occurred in Flint, this much seems clear: When Flint switched its water supply source, it did not take the required steps to manage water chemistry. The new water caused lead to leach from service lines and home plumbing — lead that ended up in water coming out of the taps.” The Monroe County Water Authority (MCWA), which serves customers outside the city and portions of each of the five adjacent counties, removed all known lead services lines from their system in the 1990s.

“We have no known lead service lines in our system,” said Metzger. “If one were to be found, it would be replaced.” In 2014 the Rochester Water Bureau, which supplies clean water within city limits, spent $8 million on system improvements, including modernizing 10,000 feet of transmission conduit, cleaning and lining 1.2 miles of 36-foot conduit leading to Cobbs Hill Reservoir, laying 8,500 feet of a new water main, and cleaning and lining 7.5 miles of existing water main in the city’s distribution system. But even with all these precautions, if you live in an older home, lead can still find its way into your drinking water. “Some older utilities have lead service lines between the main and the customer’s plumbing,” said Metzger. “Lead in drinking water comes from lead service pipes, and lead found in the plumbing materials inside the home — solder, valves and faucets installed before ‘lead-free’ fixtures were mandated in the mid-

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1980s.” Scientists and government officials reassure that most of the U.S.’s 53,000 community water systems provide safe drinking water. But if you live in a home built before 1986, the Rochester Water Bureau recommends running a tap for one to two minutes before drinking from it or bathing in it. Hot water from taps, which leaches more lead from pipes,

should never be used for drinking or cooking. Pregnant women, infants and young children are more vulnerable to the effects of lead than the general population. If you are concerned about lead in your drinking water, call the Safe Drinking Water Hotline at 1-800-426-4792 or visit: www.epa.gov/safewater/lead.

Lead From Paint

In 2014, 139 children in Monroe Country were reported to have lead paint poisoning. The Western New York Lead Poisoning Resource Center at the University of Rochester suggests having children tested for lead poisoning at ages 1 and 2, as well as women who are pregnant. Lead poisoning causes long-term mental and emotional disorders, even decreased IQ. You can get in contact with Monroe County’s Childhood Lead Poisoning Prevention Program at 585-753-5087 if you are worried your child might have lead poisoning. The majority of children receive lead poisoning from dust and paint chips from windows and doors painted before 1978. The Coalition to Prevent Lead Poisoning suggests having your house and children tested if you live in a house built before 1978. If you live within the City of Rochester, you can request a free lead inspection by calling 585-428-6520. To help the people of Flint, instead of sending bottled water you can donate to the United Way of Genesee County in Michigan Flint Water Fund, or to the Flint Child Health and Development Fund.

Healthcare in a Minute By George W. Chapman

Best jobs

Healthcare jobs fared well in the US News & World Report’s 100 Best Jobs ranking. Five healthcare jobs were in the top 10. Rankings are based on salary, work-life balance, stress levels and opportunities for advancement. The rankings are: No. 4: nurse anesthetist; No. 5: physician assistant; No. 6: nurse practitioner; No. 8: pediatrician and No. 9: anesthesiologist.

Hospital cost cutting

The American Hospital Association is recommending that members cut down on paperwork by reducing and converting as many administrative processes to electronic as they can. In its report, the AHA estimates that overall, the healthcare delivery system in the United States spends 15 percent to 32 percent on administrative costs.

‘Narrow’ provider networks

Organized healthcare systems are moving toward narrower provider networks in order to control costs and improve outcomes. The upside for consumers is the providers in the system are much more familiar with each other and work more as a cohesive unit. The downside for consumers is less choice. The Affordable Care Act is encouraging the development of these more defined delivery systems, or accountable-care organizations. How the physicians in a network interact and communicate with each

other is far more important than the pure number of physicians in a network. To protect consumers, both federal and state regulators have issued proposals to better regulate narrow insurance and provider networks. Number of physicians, how well care is coordinated, communications and the average turnover rate are all useful information for consumers.

Satisfied consumers

The results of a poll taken by the Kaiser Family Foundation show many insured Americans are satisfied with their health plan. Seventy-four percent of those under 65 (non- Medicare) said their coverage was worth what it costs. Sixty-one percent rated their plan as a good or excellent value. Eighty-seven percent said they were satisfied with the choice of physicians. Only 12 percent said they had to change physicians because of their plan.

Hospital star ratings

Medicare bases its hospital rating system on 113 measures of inpatient and outpatient quality. A survey, called the Hospital Consumer Assessment of Healthcare Providers and Systems, is sent to patients recently discharged from a hospital. Quality measures are lumped into seven weighted categories: mortality, safety, readmissions, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging. Only 7 percent of 3,500 ranked March 2016 •

hospitals achieved five stars. Forty percent received three stars. The survey intentionally avoids asking patients about amenities that don’t impact quality and outcome like food, telephone and television services, parking, visiting hours, etc.

ACA enrollment

The Congressional Budget Office has lowered considerably its estimates for the number of people insured under the ACA in any month this year from 21 million to 13 million. For the first time, spending on federal healthcare programs — ACA, Medicare and Medicaid — exceeded spending on Social Security. The $936 billion spent in 2015 was 13 percent more than what was spent on healthcare in 2014. The CBO did predict spending would increase due to the increased life expectancy of baby boomers. The CBO report will surely add fuel to the debate in Congress over federal healthcare spending.

Geriatrician shortage

Related to increased life expectancy is the predicted shortage of geriatricians. The current supply of 7,000 geriatricians needs to grow to 30,000 by 2030, a recent New York Times’ article pointed out. Geriatricians focus on the chronic conditions brought about by normal aging such as hypertension, peripheral vascular disorders, dementia, mobility, medication management, depression, nutrition, hydration and social support.

Current compensation issues prevent many medical students from specializing in geriatrics. However, compensation may increase as market forces drive up demand for geriatric services.

Malpractice alternative

Hospitals and physicians spend almost $10 billion a year on payouts and associated administrative costs linked to malpractice. That is literally a drop in the bucket compared to total spending on health care that is more than $3 trillion. The problem isn’t the expense of malpractice; it’s the perpetuation of the blame shifting and adversarial relationship between patient and provider. Denmark and New Zealand compensate patients for harm due to medical errors, but then share the data with physicians, hospitals and researchers. It keeps all parties on the same side so to speak with the main interest being how to prevent the errors from reoccurring rather than simply pointing a finger at someone.

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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Page 5

or How one little letter can save a million lives

Smoking in movies results in 187 new teen smokers every year

By Cassie Gratton

ovie ratings inform parents about the content of the film. It is a tool that can help them determine what movies are appropriate for their children to see and at what age. Many youth-rated movies contain tobacco use or tobacco images. • PG-13 movies are the biggest concern since they account for a majority of on-screen smoking. • PG 13 movies delivered more than 50 percent of all tobacco impressions in the movies, in 2014. Watching movies that include smoking causes young people to start smoking. The more smoking young people see on screen, the more likely they are to start smoking. Actions that would eliminate the depiction of tobacco use in movies could have a significant effect on preventing youth from becoming tobacco users. According to the Surgeon General’s newest report, ending exposure to on-screen smoking from PG-13 movies would avert a million future tobacco deaths among America’s children. Giving an R rating to future movies with smoking would be expected to reduce the number of teen smokers by nearly one in five (18 percent) and prevent 1 million deaths from smoking among children alive today ii. For more information about smoke-free movies contact the Smoking and Health Action Coalition (SHAC): www.SmokeFreeMonroe.com or 585-666-1399. Cassie Gratton is the director of the Smoking and Health Action Coalition (SHAC), part of the American Lung Association of the Northeast. SHAC’s efforts help decrease youth tobacco use, motivate adult smokers to quit, and eliminate exposure to secondhand smoke.

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Meet

additional surgeries later on.

Your Doctor

By Chris Motola

Richard G. Moore, M.D Chief of gynecologic oncology at Wilmot talks about his FDA-approved Risk of Ovarian Malignancy Algorithm (ROMA) test and how it helps in the detection and treatment of ovarian cancer Q: What's your role at the Wilmot Cancer Institute? A: I'm a gyn-oncologist, so I deal with women's cancers, mainly cancers of the ovary, uterus, cervix, endometrial cancers and vulvar cancers. We're sort of unique because we both perform surgeries and take care of administering chemotherapy to our patients, which it is a little different than general surgical oncology, who just handle surgery. I'm the director of gyn-oncology. I also do some research. We're doing research into biomarkers for the detection of ovarian cancer. We also have a lab where we develop new treatments for gynecological cancers. Q: You've already had some success along that front. I understand you helped develop a detection process that was recently approved by the FDA. A: There's a test called the quad screen that is used to detect fetal anomalies. It uses multiple proteins to make a diagnosis. So we wondered why we couldn't use multiple markers to test for ovarian cancer. So we worked with a bunch of different biomarkers that we knew were all active during ovarian cancer. We looked at over 250 patients who had an ovarian cyst or pelvic mass. When we looked at all the data, we found that a protein called HE-4 that, if used along with the older biomarker CA-125, was more accurate than all the other biomarkers we looked at. This allowed us to develop a mathematical algorithm that could predict whether a cyst is cancerous or not. We used that algorithm in two national trials. We saw that we were able to detect ovarian cancer 95 percent of the time. Equally importantly, when the test was negative, the test was accurate 98 percent of the time, what we call the negative predictive value. So the FDA looked at the data and approved the test. It's called the Risk of Ovarian Cancer Algorithm (ROCA). It's been approved in Europe, Canada and Asia for a bit longer. Q: What does the test enable you to do? A: It allows us to more accu-

rately assess if a woman with a pelvic cyst is cancerous or benign tumor. This allows an OB-GYN or family practice physician to triage high-risk patients to specialty centers like URMC for their treatment. This is important because ovarian cancer patients' odds of survival are greatly improved if they have their initial surgery from a gyn-oncologist or at an institute specializing in ovarian cancer. Unfortunately less than half of the women diagnosed with ovarian cancer in the U.S. are treated by specialists who are experienced with ovarian cancer. The test helps get the women who need to be treated in those centers to those centers. Q: Is that a problem in our country specifically? A: No, it's worldwide. It has to do with the fact that ovarian cancer is very difficult to detect. It's tough to tell just with imaging whether a mass is malignant or not. So often these patients will end up having surgeries from non-subspecialists and require

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

Q: As one of the test's creators, how useful have you found it personally? A: We use it a lot. It's really changed how we approach ovarian cysts. It allows us, with some confidence, to tell a patient whether they have cancer or not, to be able to choose the type of surgery we want to do, how we approach that surgery and how we counsel patients. So it's fundamentally changed how we approach the disease. It turns out that the marker, HE4, is also good for following the disease during treatment. So the biomarker can tell us whether the cancer is responding to the treatment. So it helps in management and follow-up as well. It's a great step forward for us. Q: How well are patients aware of this diagnostic tool.” A: I think patients with ovarian cancers are very well-educated about their diseases and what's going to happen with them. They tend to be well-read, they know what kind of research is available, and they're very proactive with their treatment. And if they don't know what types of research are available, they tend to be open to it once it's explained to them. When we did the original pelvic mass trials, a lot of women volunteered for the trials because they knew there was no accurate detection prior to this. Q: Do you see any possible broader uses for the test or for similar tests going forward? A: Unfortunately right now, there's no screening test for ovarian cancer, and by that I mean one that can be given every year as part of an annual check-up. That's really the next step. Right now, we have to detect the cyst and then administer the test. We'd like to be able to find the cancer in its earliest stages, even as a pre-cancerous lesion. This brings us a step closer to that. The other biomarker that we use in the detection and that is used to detect other kinds of cancer, CA-125, was discovered in 1982. So it's been way too long since its discovery that we just found this new one. Hopefully with newer technologies, we'll find new biomarkers that will help us get to cancer screening.

Lifelines Name: Richard G. Moore, M.D. Position: Chief of gynecologic oncology at Wilmot Cancer Institute Career: Brown University and Women & Infants Hospital of Rhode Island Hometown: Montreal, Canada Education: University of Alberta; University of Eastern Virginia Medical School; Brown University Affiliations: University of Rochester Medical System Organizations: ACOG; Society of Gynecologic Oncologists, Family: Married, two children Hobbies: Hockey

Many U.S. Women Still Smoke Before, During Pregnancy: Report Smoking puts about 300,000 infants at risk each year, experts say

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espite the potential risks to their baby's health, roughly one in 10 women smoke in the three months before getting pregnant, U.S. health officials recently reported. And only one-quarter of those women quit before they become pregnant, the researchers said. "Smoking during pregnancy is double trouble," said lead researcher Sally Curtin, a statistician at the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics. "There is a mountain of research that shows it does affect the unborn child." Edward McCabe, senior vice president and chief medical officer at the March of Dimes, said, "We know that smoking is a problem for pregnancy, and we continue to see many women smoking." Smoking leads to premature birth and low birth weight infants, which increases the odds for mental and developmental problems that can affect someone for their whole life, McCabe said. Premature birth is also a risk factor for cerebral palsy, lung. According to the report, smoking was most prevalent among women aged 20 to 24 (13 percent). In addition, American Indian and Alaska Native women were most likely to be smokers (18 percent). Smoking during pregnancy in most states averaged about 10 percent, ranging from almost 2 percent in California to about 27 percent in West Virginia, Curtin said.

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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, Ernst Lamothe Jr., Chris Motola, George W. Chapman, Jessica Gaspar, Nina Alvarez, Katie Coleman, Alexander J. Douglas, Esq. 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.

March 2016 •

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Reach only the audience you want: those concerned with health issues. Advertise with In Good Health — Rochester’s Healthcare Newspaper. The only Rochester paper exclusively about healthcare. Please call 585-421-8109 or visit GVhealthnews.com. IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Live Alone & Thrive

first things I did after my divorce. I picked up the phone and made an appointment with a financial adviser. I now enjoy peace of mind."

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Making the Best of Living Alone: Are You a Pessimist or an Optimist? Is your glass half empty or half full? Take a look at the list below, which contains actual quotes from divorced or widowed women and men I've encountered along my journey and in my Living Alone workshops. Do you find yourself identifying with one perspective over another?

"Optimism is essential to achievement and it is also the foundation of courage and true progress." – Nicholas Murray Butler

NOT BEING MARRIED

icholas Murray Butler knows a thing or two about the power of optimism. He is an American philosopher, educator and diplomat. He was president of Columbia University and a recipient of the Nobel Peace Prize. Seeing the glass as half full rather than half empty is all about focusing on what's positive in our lives, regardless of what life offers up. It's about being thankful, appreciative and even grateful for the challenges we face. I’m convinced that our thoughts and attitudes determine the life we have. And experience has taught me that seeing the glass half full can make all the difference for those who live alone. We have a choice. We can choose to see the positive or we can choose to wallow in the negative — to close our eyes to possibilities and to begrudge the cards we have been dealt. So, how do you view your life?

• HALF EMPTY "Something must be wrong with me. All my friends are married, and here I am alone and miserable." • HALF FULL "Not in a million years did I expect to be divorced at my age, but I am resourceful and persistent. I've always wanted to travel and try new things, and now I have that opportunity — to create a life that's full of new people and experiences."

DECISION MAKING

• HALF EMPTY "Are you kidding? I don't know enough to buy a house or a car. Those are the big decisions my husband used to make. I wouldn't know where to begin." • HALF FULL "Finally, I get to make all my own decisions! No one's around to second-guess my choices. I just purchased my first car all on my own: a new Nissan Sentra. I did the research and was completely prepared when I went to the dealership. My color choice? Fresh Powder!"

IN A CRISIS

• HALF EMPTY "I'm no good in a crisis. I go to pieces. When I hear bad news, I long to be taken care of and protected, as if I'm a child. But, on my own, there's no one to turn to." • HALF FULL "Being alone in a crisis isn't the end of the earth. In fact, some of my most significant growth has been during tough times. When I got the call that my father had had a heart attack, I took charge, made calls, and brought the family together. I learned I could take care of myself and others, too."

DATING

• HALF EMPTY "I can't imagine dating at my age. What could anyone possibly see in a middle-aged, gray-haired retiree with grandchildren?" • HALF FULL "Warm friendships, even romance, can happen at any age. I met my second husband when I was 72. We met in a grief support group and the rest is history. Next year, we are celebrating our fourth anniversary."

FINANCES

• HALF EMPTY "He took care of all the finances, the bills, the taxes, everything. I feel helpless and, honestly, I fear dying alone and penniless." • HALF FULL "I knew it wouldn't be easy, but I figured I could do it. Getting help with my finances was one of the

COOKING FOR ONE

• HALF EMPTY "Why would I invest any time in creating a special meal for just myself? It hardly seems worth it. I often indulge in Ben and Jerry's and call it a night." • HALF FULL "Creating a pleasant 'table for one' makes me feel good about myself. It means I'm nourishing my body as well as my spirit. When I prepare a nice table setting and sit down to a healthy, home-cooked meal, a sense of serenity comes over me. I feel at home with my own good company."

TIME ALONE

• HALF EMPTY "Living alone is for the birds! I just want to stay in bed and pull the covers up over my head." • HALF FULL "Living alone need not be a time of diminished opportunities. It can be a time of expanding possibilities. Used wisely, time alone can be an adventure in self-discovery and reveal opportunities for personal growth and fulfillment." That last quote is one of mine. I discuss this at length in my workshops. If you don’t like the results you are getting in your life, consider changing the attitudes that are producing those results. Who knows what great adventures and joy await those who adopt an optimistic outlook and embrace the wisdom of seeing the glass half full. 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.

Gains in Kids' Health Coverage Continue, But Many Still Uninsured

KIDS Corner

Page 8

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NYS still has one of the highest percentages of kids with no insurance

espite a significant increase in the number of American children with health insurance, many still lack coverage, a new study reveals. From 2013 to 2014, the number of uninsured children fell from 5.9 million to 4.9 million. In 2013, 7.5 percent of youngsters were uninsured, compared to 6.3 percent in 2014 — a 16 percent decrease. While the findings show progress, nearly 5 million Americans under age 19 still lack health insurance, according to the Robert Wood Johnson Foundation report

prepared by University of Minnesota researchers. "Despite the politicking around health policy lately, I think we can all agree that coverage for kids is essential for their healthy development," Kathy Hempstead, the foundation's director of coverage issues, said in a news release from the organization. "The last year has shown continued progress in expanding coverage to children and the reduction of differences by race, ethnicity and income, but there is more work to be done," she added. The percentage of uninsured children fell sharply in 23 states and no states had significant increases, the investigators found. The states with the largest declines in uninsured children were Ar-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

izona, Colorado, Minnesota, Nevada and Rhode Island. Nearly half of the 4.9 million uninsured children are in six states: Texas (880,000), California (550,000), Florida (410,000), Georgia (210,000), Arizona (180,000), and New York (160,000). Of these six states, four had the largest decrease in the number of children without coverage from 2013 to 2014: California (down 210,000), Texas (down 95,000), Florida (down 87,000), and Georgia (down 53,000). Two states — Massachusetts and Vermont — had fewer than 2 percent of children who were uninsured. In three states, more than 10 percent of children lacked coverage: Alaska (12.3 percent), Texas (11.8 percent), and Arizona (10.5 percent).

Medical Debt Collectors

What You Need To Know

CALL

By Alexander J. Douglas, Esq.

npaid medical debt is the leading cause of personal bankruptcy in the country, according to CNBC. The Consumer Financial Protection Bureau reports that 43 million people — or nearly 20 percent of adults in America — have unpaid medical debt. If you find yourself unable to pay medical debt, you will probably receive phone calls and letters from debt collectors, and that can be unsettling or even intimidating. But you shouldn’t let the debt collectors scare you. Here are answers to some questions that you might have when dealing with debt collectors.

What should I do?

If you don’t recognize the debt, your first step is to send a letter to the debt collector informing them that you (1) dispute the debt, (2) request verification of the debt, and (3) request the name of the original creditor. You must send this letter within 30 days after you receive their first collection letter. After they receive this letter, the debt collector is required by law to stop collecting until it sends you verification of the debt. If debt collectors are calling you too much, you can also send a letter requesting that they cease communications. You must also make this request in writing. The law then requires the debt collector to obey this request.

Should I pay?

You should only pay if the debt collector seems legitimate and if you recognize the debt. Remember that legitimate debt collectors will not ask for your social security number — they can only ask for the last four digits in order to confirm your identity. If the debt collector seems legit-

imate and you recognize the debt, you should ask the debt collector if they can settle the debt for a lower amount. You can also try to negotiate a payment plan.

Mary Perry, ADR

585-385-6855 | www.disabilityrep.com

Are they breaking the law?

Debt collectors have to follow the Fair Debt Collection Practices Act (FDCPA). According to that law, debt collectors are not allowed to harass or abuse you when collecting. That means they cannot curse, yell at you or otherwise try to intimidate you to pay the debt. They also are prohibited from misrepresenting any information about the debt or using deceptive practices when collecting. If you think that they might be violating the FDCPA, you may wish to contact an attorney.

Are you unable to work because of a severe impairment or illness? I have over 20 years experience successfully obtaining Social Security Disability/SSI for those deserving benefits. For best results, let me represent you.

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What if you could choose?

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What if they sue me?

If a law firm sues you for the debt, you should contact an attorney as soon as possible. If you don’t answer the lawsuit in time, the debt collector can obtain a judgment against you. After that, the debt collector can garnish your paychecks and freeze your bank accounts. Dealing with a debt collector can be difficult and scary. However, if you follow the above suggestions, you can navigate this process in the least stressful way possible. Alexander J. Douglas is a Rochester attorney with Gesund & Pailet, LLC, a consumer protection firm. He focuses on filing lawsuits against debt collectors for deceptive and unfair practices. Email: alex@ gp-nola.com; phone: 585-703-9783.

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People born between 1945-1965 (baby boomer generation) are 5 times more likely to be infected with Hep C. March 2016 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Couch Potatoes May Have Smaller Brains Later in Life

oor physical fitness in middle age may be linked to a smaller brain size 20 years later, according to a study published in the February 10, online issue of Neurology, the medical journal of the American Academy of Neurology. “We found a direct correlation in our study between poor fitness and brain volume decades later, which indicates accelerated brain aging,” said study author Nicole Spartano, PhD, with Boston University School of

Medicine in Boston. The study also showed that people whose blood pressure and heart rate went up at a higher rate during exercise also were more likely to have smaller brain volumes two decades later. Spartano said that people with poor physical fitness often have higher blood pressure and heart rate responses to low levels of exercise compared to people with better fitness. “While not yet studied on a large scale, these results suggest that fitness in middle age may be particularly important for the many millions of people around the world who already have evidence of heart disease,” she said. The study was supported by the National Heart, Lung and Blood Institute, the National Institutes of Health and the American Heart Association. To learn more about brain health, please visitwww.aan.com/patients.

Hilton Parma Grass Roots Anti-Drug Coalition Returns from D.C. Representatives from Hilton / Parma recently returned from the Washington, D.C. area where they joined more than 2,700 substance abuse prevention specialists and advocates from throughout the country for Community Anti-Drug Coalitions of America's (CADCA) 26th Annual National Leadership Forum, the nation’s largest training conference for community prevention leaders, treatment professionals and researchers. “We were so excited to be able to spend several days with other similar organizations from across the country, learning and enhancing our prevention skills so our community can be a better place, one that doesn’t suffer from the harms of drug and alcohol abuse or the stigma that shadows addiction,” says Laurie Polatas, coalition founder. “We returned re-energized with new strategies to tackle drug use at the local level.” The coalition heard from several federal leaders including Michael Botticelli, director, Office of National Drug Control Policy and Congressman Hal Rogers (R-KY), who received CADCA’s National Leadership Award at the event. Highlights of the event were meeting one-on-one with staff of Congresswoman Louise Slaughter, Sen. Charles Schumer and Mary Bono, CADCA board dember. This year, the coalition was able to send its first youth participant to the event. “I never realized how much advertising and the music industry can influence youth on substances,” said Bryssa Polatas, a senior at Hilton High School. “I am eager to take what I have learned and motivate other kids in our community to join our cause.’ HPDICE meets the second Monday of every month at the Hilton High School. Visit www.hpdice.org to learn more.

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Facts About America’s Eating Habits

Bowl of Thai food. Twenty-eight percent of consumers are preparing ethnic foods more frequently than ﬁve years ago, according to an article in Food Technology magazine.

ore than ever consumers are identifying themselves as foodies with an on-the-go lifestyle that translates to food choices that are more experiential, convenient and impulse-driven. In the January issue of Food Technology magazine published by the Institute of Food Technologists (IFT), contributing editor A. Elizabeth Sloan writes about consumers’ mealtime choices and behaviors in 2015.

Forty-seven million adults define themselves as foodies, and 29 million are categorized as being part of a highly involved, serious culinary core group. Millenials account for 36 percent and baby boomers for 32 percent. In addition, those consumers who enjoy food as an “art form” climbed by 20 percent.

Best sellers in the fresh bakery category are breads, cakes, cookies and rolls. Desserts account for half of in-store bakery sales and specialty desserts and brownies/dessert bars show the highest sales growth.

When it comes to fast casual restaurants the Asian/noodle sectors is projected to lead growth followed by Mexican, coffee/ café, chicken and bakery café. The pizza, sandwich and burger segments are expected to underperform.

7. 8. 9. 10.

11.

Yogurt tops the list of foods/ beverages that are consumed more today than 10 years ago, followed by bottled water, pizza, poultry sandwiches, Mexican foods, fresh fruit, bars, frozen sandwiches, chips and pancakes. An increase in the number of meals prepared and eaten at home and a corresponding decline in restaurant usage is one the single biggest changes in eating patterns in the United States in the past five years. One-quarter of consumers ate soup at home at least once a week in 2014. While broth, stew, chowders and chili are Americans’ favorite forms of soup, one-third of consumers would eat more soup if it contained a serving of vegetables, was heart healthy, or high in protein.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

Twenty-eight percent of consumers are preparing ethnic foods more frequently than five years ago.

More than half of grocery shoppers buy fresh readyto-eat items like rotisserie chicken, sandwiches and sushi often or sometimes.

For the first time in more than five years, indulgent snack sales outpaced healthy in the $38 billion snack product category. Vegetarian tops the list of hot appetizer trends, followed by charcuterie/ house-cured meats; ethnic street food inspired appetizers; seafood charcuterie; and high-end chef-inspired appetizers and ethnic dips. Nine out of 10 adults say that information about fruit and vegetable content is important to them in determining if a food is healthy. That is followed by preservative-free, added nutrients or no artificial sweeteners, no antibiotics, unprocessed, natural or hormone free, organic or non-genetically modified, clean and “real.”

SmartBites

The skinny on healthy eating

Oh, Boy, Is Bok Choy Nutritious!

ooks can be deceiving, even with food. Consider bok choy. On the outside, bok choy — also known as Chinese cabbage — doesn’t look like a nutritional powerhouse. Its soft green leaves appear wan next to kale’s; and its rather pale stalks seem devoid of all value. Ho hum? Hardly. Bok choy is loaded with an impressive array of nutrients, so loaded that the well-regarded World Health Organization considers bok choy to be one of their highest nutritionally ranked vegetables. A member of the cruciferous vegetable family, bok choy has unique sulfur-containing compounds that help the body fight cancer. These magic bullets launch their attack in one of three ways: by helping the body eliminate carcinogens, by preventing cells from turning into cancer or by altering metabolism to stop the development of hormone-sensitive cancers. Several population studies, in fact, have shown that people who eat more cruciferous vegetables (cauliflower, cabbage, garden cress, broccoli, brussels sprouts) have a lower

risk of developing lung, prostrate, colorectal and breast cancer. Bok choy’s remarkable arsenal of antioxidants — from vitamins to minerals to phytonutrients — further boost its cancer-fighting properties. Antioxidants gobble up damaging free radicals, which have been implicated in many cancers, along with a host of chronic, age-related diseases. Bursting with vitamins A, C, and K, bok choy plays an important role in maintaining good eyesight and a healthy immune system, keeping our bones strong and our skin elastic, and helping our blood clot properly. Hearts benefit from bok choy, too, as this tasty vegetable teems with nutrients that keep our tickers tocking longer: potassium, folate, calcium and vitamin B6. Lastly — and more good reasons to reach for China’s most popular vegetable — bok choy is super low in calories (only 10 per shredded, raw cup), has no fat or cholesterol, and offers up some fiber and a bit of protein.

Helpful tips

Look for firm stalks and crisp,

green leaves. Avoid those that appear wilted, discolored, or distressed. With proper storage, bok choy can last up to a week in your refrigerator. To store, place bok choy in a plastic bag, removing as much air from the bag as possible, and put in the crisper section.

Healthy Bok Choy Salad with Sesame Dressing Dressing ingredients: ¼ cup red wine vinegar 2-3 tablespoons olive oil 2 garlic cloves, minced ¼ cup sesame seeds, toasted 2 tablespoons soy sauce ¼ teaspoon red pepper flakes (optional) salt and pepper, to taste Salad ingredients 1 head bok choy, rinsed and sliced (trim off tough base) 1 red pepper, chopped 4 scallions, sliced 2 carrots, shredded

¼ cup sliced almonds, toasted In small bowl, whisk together dressing ingredients. Prepare salad ingredients and place in large bowl. Toss dressing with salad and top with sliced almonds. (Toast sesame seeds in a dry skillet over medium heat for three to five minutes or until lightly browned, stirring occasionally. Toast sliced almonds—spread out on a cookie sheet—in a 350-degree oven for five to eight minutes; they easily burn, so closely monitor.)

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.

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

March 2016 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

Reasons to Do Aquatic Therapy

Water adds gentle resistance training for people who need recovering By Deborah Jeanne Sergeant

f you're recovering from a longterm illness, injury or surgery, consider aquatic therapy from a physical therapy office. It offers benefits you may not have previously considered. 1. You don't need a referral from your doctor. "New York state offers direct access," said Steve Koch, physical therapy assistant with Star Physical Therapy, PLLC in Fairport. Since you don't need a referral from a physician for treatment at a physical therapist, you can save the co-pay for the doctor visit. Physical therapy clients may receive treatment for up to 30 days or 10 visits. Beyond that point, you will need a doctor's prescription to receive in-

surance coverage. (Check your plan before seeking treatment to ensure coverage.) Medicare typically does not cover aquatic therapy. 2. Aquatic therapy can help you address a few problems at once. "Most of the clients I see have multiple diagnoses and more than one body part that needs to be treated," Koch said. "They're in a tremendous amount of pain." Instead of seeing various specialists, visiting a physical therapist can help you recover from more than one injury at once. 3. The water temperature can help hasten the healing progress. "We can manipulate the temperature to make it warmer or cooler,

which is a great advantage to have," said Jason Wambold, physical therapist and executive vice president of Agapé Physical Therapy, which operates facilities in Brockport, Webster, and Rochester. By keeping clients more comfortable, therapists and patients can accomplish more goals in each visit. 4. Buoyancy can relieve pain as you exercise. Agape uses anti-gravity treadmills developed by NASA in the pools. The equipment helps people with arthritis, knee injury and stress fracture recovery get moving again and with less pain than by performing land-based exercises. "It can bring a patient's relative body weight down to 20 percent,"

Wambold said. "It's a very different modality than land-based exercise because you can use buoyancy and turbulence to your advantage." 5. Aquatic therapy can help those who are weak or de-conditioned to slowly regain strength. "It's a good place to start out because we can keep them comfortable and eventually progress to landbased exercises," said Jill Valentino, doctor of physical therapy with Rochester Regional Health System. "We do a lot of strengthening, walking and mobility exercises that on land would otherwise be painful." Water adds gentle resistance training for people recovering, instead of pushing the body too hard too soon as with lifting weights or using other land-based forms of resistance. Those fearful of water-based exercise can relax. The water is usually kept chest-deep at its deepest and the pools' grab bars help patients remain stable. Like a gym membership, some physical therapy offices offer memberships for former clients or openly to use their equipment for a monthly rate. If you find an office you like, you may be able to continue self-guided exercise after your 10 treatments or 30 days have expired, so ask if the office provides a membership.

Q&A with Sankar Sewnauth

President and CEO of CDS Life Transitions (formerly known as CDS Monarch) discusses what his agency does to empower individuals with disabilities to live fulfilling lives By Ernst Lamothe Jr. Q: What can you tell us about your organization? A: We’ve been around for 38 years and all of the diversification we’ve experienced was really meant to strengthen the core mission to allow people with disabilities to lead fulfilling lives in the community Q: What are some of your core missions? A: We remain steadfast in serving and empowering individuals with intellectual and developmental disabilities to live a fulfilling life. We want to help people gain more employment opportunities and we also want to increase opportunities for community living and transition. Today, we fulfill transitional and employment needs of more than 1,700 people with developmental disabilities and their families Q: The company has gone through a shift with six subsidiary agencies falling under one umbrella. What is the beneﬁt you see? A: When you start up as a singular organization with a singular mission to support people with disabilities, you realize as you Page 12

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go that you need to add a menu of services. You are handling people with Medicaid-managed long-term care and other factors, and you start to understand that to truly do justice, you really have to separate them out. It is more effective to have individualized programs. By creating individual lanes for these programs to operate, they really get their own resources and they can be viable for the future. Q: How will you be tackling the developmentally disabled baby boomer generation? A: We are well aware of the baby boomer population coming and that there will be a large enrollment with people coming into the Medicaid system and possibly having a host of medical issues. They are going to need that kind of support system so they can be as independent as they can be. You are going to have people challenged to stay in their homes as they have a fixed income. This is why we established a housing division where they can have first-rate housing. We continue to build housing communities and we have 75-100 people who are waiting for the next one to be built. We have the ability

through our providers to serve them and get them what they need.

Q: Can you talk about your Warrior Salute? A: What we do is we invite soldiers who have post-traumatic stress disorder or traumatic brain injuries and we let them come and stay for mostly six months. Some will stay for four months while others need a little more time to graduate from the program. We don't charge them a penny and we do vocationally rehabilitation to help them get permanent jobs. It is important to us that we make every program individualized because we believe it better serves everyone involved. We stay in touch with them and do what we can to help them be successful. They stay in a beautiful residence and learn so much before they go home. In the past five years, we have served more than 150 veterans. We put them through an intensive clinical program with rehab that costs about $25,000 per veteran per year. Q: Why is this program so important to you? A: People often ask us why are we doing it. They say that it isn't part of our core mission and we know that it takes $800,000 a year to raise the funds necessary to support the program. My response

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

is that we are making it a part of our goals because it is simply the right thing to do. We believe if anyone is in a position to step up and do something positive for our veterans then we should be all about it. It’s not usual for a nonprofit to do something like this, to go find money to actually provide a service that wasn’t in your core mission but impacted the community. Q: What do you see for the future? A: That is difficult to tell. Two or three years from now, we may have more elements that allow us to grow. We are always watching for more opportunities and our management leaders are just focused on providing the best services we can do now and finding ways to make our business grow and help more people. It's essential to look for ways to diversify.

Heroin-related Deaths Increasing

volved fentanyl, compared with only five in 2013. Olinda Ford, manager for the community health initiative and Trillium Health outreach project, wants to see more treatment centers and agencies to combat the problem. "The length of time it takes for people to get into treatment in many cases is too long," Ford said. "Many people participating in our syringe exchange want to get in but can't because there's no room for them." Ford also believes that exploring controls emotions and pain sensitivity. Patients may no longer need pain additional means of pain management can help prevent addiction. control, but crave the effect the drug Opioids "have their place and prohas on blunting their emotions. Purvide people with relief, but we need chasing prescription opioids on the to look at alternatives with that," she street is expensive; heroin is much said. less expensive. Tony Klein, an alcohol substance Prescription drugs of this class abuse counselor and manager of have become much Rochester Regional Health Chemical Dependency, said that his organizaharder to obtain. tion is working to train medical per"Physicians sonnel and the families of addicts to prescribing these know signs of overdose and how to medications are more closely mon- administer naloxone, sold under the brand name Narcan, a heroin overitored now," Ott dose antidote. Naloxone may now be said. "We are trypurchased without a prescription. ing to raise com"Overdose concern is very signifmunity awareness Ott and make it a topic icant," Klein said. "We've had a rash of overdosing we've faced as well. of conversation." Those interventions are being more By turning to street drugs, adreadily addressed." dicts don't know the potency of the Using medication to reduce cravdrugs they're taking, or even if it is ings can help addicts recover, along the drug they think. Heroin is often with cognitive behavioral therapy laced with fentanyl, an opioid up to and peer support groups. 100 times stronger than morphine. "There's s a reason why you Or, a bag that should contain heroin mixed with fentanyl could be straight are using pain medication to numb things out," Klein said. "There's fentanyl. In 2014, 50 of the 80 heroin-relat- underlying factors we need to have a comprehensive assessment of." ed deaths in Monroe County in-

Experts say there aren’t enough treatment centers and agencies to combat the problem By Deborah Jeanne Sergeant

he Monroe County Health Department reports that 78 people died from heroin-related overdose from 2011 through 2013. That number soared to 80 in just one year —2014. Figures from 2015 are not yet available but experts believe the increase trend will continue. "From everything I'm hearing here in Ontario County, and from the statistics I've seen from the needle exchange program in Monroe County where some of our clients go, it's still a problem," said Kate Ott, a registered nurse and public health educator with Ontario County Public Health. As part of her role, she interacts with law enforcement and families that suffer the effects of heroin addiction. Ott said that part of the reason some people become addicted in the first place is that they were prescribed opioid painkillers after surgery. By the time their prescription ends, some have become dependent upon the opioid because of a genetic tendency toward addiction and a desire to escape struggles they face. This class of painkiller works by affecting the area of the brain that

Ford urges people taking opioid medication — or any medication — to make sure it's taken as directed by the instructions on the bottle and to monitor the prescription. "You may need to keep it locked up in a secure place," Ford said. "Check to make sure you know how many pills you have left. If there are any missing, that needs to be addressed." Signs of drug dependence could include abrupt changes in behavior, socializing, eating and sleeping. "Be careful if you're prescribed medication for a period of pain and when you're done, get them out of the house, particularly if you have kids," Ott said. "Their friends may peruse the medicine cabinet. We have medication drop-offs throughout the state." Check with your local pharmacy or police department for drop-off events and locations.

Fighting a Drug Epidemic

A new program based on empathy can make a difference By Janice Holmes

e are facing a national drug epidemic. According to the CDC, an estimated 21 million Americans are addicted to drugs or alcohol, and 120 die each day from overdose. Our community is no exception. According to the National Council on Alcoholism and Addictions of the Finger Lakes, our region has a 40 percent increase in overdose deaths. Local families with addicted loved ones have little support and face obstacles when seeking treatment. When my son became addicted at a young age, I felt I was the only one with this problem. I knew little about addiction, and there was no place to find help. As his addiction progressed, our family faced terrible judgment, dismissive advice and barriers to getting treatment. The way people with addictions are treated is fueling the increased number of deaths. If people understood how these substances damage the brain and impair the ability of people suffering from addiction to return to its normal state, I believe they would have more empathy. However, because people often condemn addicts, many of them lose hope and succumb to their disease. Without treatment, many end up in our jails and morgues instead. Police Chief Leonard Campan-

ello of Gloucester, Mass., started an “Angel” program to reduce the number of fatal overdoses in his area. The police help people get treatment instead of arresting them. Recently, our Family Recovery Network and DePaul NCADD, hosted the Gloucester chief. He described how the program sprang from their empathy and frustration over the number of overdose deaths. Since May, their program has helped 310 people find treatment. And, they have seen a 31 percent decrease in drug-related crimes. Similar programs are being adopted all over the country, including our neighbors in the Buffalo region. We encourage our community and local police to champion this for families in the Rochester area because it will make a difference. Janice Holmes is the founder of Family Recovery Network, a volunteer-based, nonproﬁt organization that is committed to providing families with education, support and increased access to recovery resources. Information about addiction, support groups, treatment options and events can be found at www.familyrecoverynet.org. March 2016 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

The Long Road to Receiving a New Kidney A local resident’s life with kidney failure By Katie Coleman

arch is National Kidney Month, and a great time to make sure yours are functioning properly. Our kidneys are bean-shaped organs that keep our blood healthy by filtering out waste and excess fluid through our urine. When they start malfunctioning, excess fluid and waste build up in our bodies and can lead to chronic kidney disease, kidney failure and other problems. The main causes of kidney failure are diabetes, high blood pressure and a family history of kidney failure. Paul Bloser has been on dialysis and waiting to receive a kidney transplant for the past two years.

100,791 People Await Kidney Transplantation

• There are currently 121,678 people waiting for lifesaving organ transplants in the U.S. Of these, 100,791 await kidney transplants. (as of Jan. 11) • The median wait time for an individual’s first kidney transplant is 3.6 years and can vary depending on health, compatibility and availability of organs. • In 2014, 17,107 kidney transplants took place in the US. Of these, 11,570 came from deceased donors and 5,537 came from living donors.

The 58-year-old Rochester resident is potentially going to receive a kidney donation from his sister Susan in the near future. “I’m anxious to get on with my life. It feels like the past two years of my life have been put on hold,” Bloser said. He had to leave his job a year ago due to the impact of his dialysis treatments. Bloser decided to travel to Charlotte, N.C., to get tested and make sure Susan is a successful match. When he initially went to doctors, they diagnosed his kidney disease as hypertension. He was taking up to 18 of the wrong pills for a long time until he

Source: National Kidney Foundation.

By Jessica Gaspar

Month One: The Lack of Sleep is Worth it

Page 14

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Chilling reality

Bloser is now on one prescription pill per day, but living on dialysis is still certainly a struggle. “I’m a really active guy but now I sit for four hours a day. I can’t move my arms. All I can do is watch TV

On average:

• Over 3,000 new patients are added to the kidney waiting list each month. • 13 people die each day while waiting for a life-saving kidney transplant. • Every 14 minutes someone is added to the kidney transplant list. In 2014, 4,761 patients died while waiting for a kidney transplant. Another, 3,668 people became too sick to receive a kidney transplant.

Parenting

fter a week of standing over Timmy’s bedside watching him breathe at night, I finally decided to get some much-needed shuteye of my own. I didn’t sleep a wink his first night home, but now I find myself dozing off for two or three hours at a time through the night. Lots of other parents offered the same line of advice, “Sleep when the baby is sleeping.” Sometimes, that is better said than done. While Timmy is catching his own Zs during the day, I find myself doing laundry, catching up on emails and phone calls, filling out insurance paperwork, preparing bottles for when he awakens, etc., etc. I tell people I am one good

said he started becoming his own advocate, eating healthy and taking vitamins.

blink away from a long nap! I had a difficult time the first two or three weeks into my maternity leave. I was literally going stir crazy. I’ve always been on the go. I work full-time, and I freelance write for a few area publications. I volunteer at my church as well as for two or three other local organizations. Before having Timmy, I was never home — literally. My apartment was just a place to crash from 10 p.m. to 5:30 a.m. Now? I’m homebound most of the time. Since I had a C-section, I couldn’t drive for two weeks, then I learned the baby hated — no, loathed — the car seat, so it’s been difficult organizing times to leave the house.

Paul Bloser has been on dialysis waiting to receive a kidney transplant for the past two years.

But the thing is, despite my obvious lack of sleep and the frustration of being confined inside the same four walls each day, I literally cannot imagine life any other way. There’s this little face staring back at me whose needs depend solely on me, and I made a promise to take care of him to the best of my ability. It’s a really intriguing process learning about him. For a few weeks, Timmy had periods of fussiness, particularly at night. My pediatrician warned me this might happen, so I wasn’t surprised when he cried for an hour one night for no particular reason (or so I thought). After a few nights of him crying inconsolably around 7 p.m., I finally realized what I think the source of his unhappiness was: he was tired. Since then, I have made sure to start rocking him to sleep around 6 or so. By 7, he’s out like a light and sleeping like a baby (pun intended!). As for leaving the house, it took me a week or two to realize I need to get myself ready first then get the baby ready. I began getting him ready first — ensuring he was fed, that his diaper was clean, that he was cozy in his car seat — and then I got myself ready only to realize his diaper was wet again or that he was crying because he was hungry. Now that I have myself ready first, I take

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

and I’m not a TV watcher. I’m kind of a hostage, and the treatment is very physically draining,” Bloser said. He wakes up at 4 a.m. every morning to put numbing cream on his dialysis site before heading to Unity Hospital in Spencerport to start his treatment at 6 a.m. He doesn’t leave until lunchtime. Bloser said this experience has been absolutely life-changing for him. He joined the board of the WNY Kidney Foundation, and donates a lot of his time to helping people, something he’s always been passionate about. Bloser recommends every patient out there to become his or her own advocate. “I absolutely rely on my doctors, but they don’t have all the answers. The National Kidney Foundation has helped and taught me so much.” Kidney failure has more than tripled in the United States since 1990, according to the Centers for Disease Control, and the CDC expects that number to keep climbing. Chronic kidney disease is diagnosed through a simple urine or blood test. Because there may be no symptoms present, it’s very important to get tested to slow or even prevent kidney disease and failure. Once your kidneys fail, you have to have regular dialysis or you need a kidney transplant. The National Kidney Foundation is a free resource dedicated to the awareness, prevention and treatment of kidney disease for healthcare professionals, patients and their families, and those at risk. “Twenty-six million people have kidney disease. Seventy-three million people in the U.S. are at risk for it,” said Elissa Rowley, program manager for the NKF. “Our goal is to spread the word.” To learn more about chronic kidney disease, kidney failure or resources available to you, go to www. kidney.org, call 800-622-9010 or email info@kidney.org.

care of his needs and we can leave the house a lot more easily. I generally wait for a time while he’s napping to leave since he screams when he realizes he’s in the car seat. The first night we ventured out, I met my mother at Target and then we went to Ruby Tuesday for dinner. When we left the house, Timmy was sound asleep. On our way home, Timmy began crying and screaming so badly, I pulled into an empty parking lot and took him from his car seat to console him. After a half hour or so, he fell asleep and we were able to finish the car ride home. Timmy is growing fast! At his 1-month well-child visit in February, he weighed 11 lbs. 14 oz., two pounds more than his birth weight. He also measures 23 inches long! Though he’s on the bigger side, Timmy’s pediatrician isn’t concerned. Though, he skipped right over any newborn clothes I had and jumped right into the 0-to-3 month clothes. (It’s a good thing I kept the tags on most of them!) I will return back to work around March 8, and I am already dreading leaving him while I’m working. Even though he will be with my aunt, who lives about two miles from my job, I will definitely miss being with him all day.

Men’sHealth

Options for Prostate Cancer Continue to Grow ‘It's a very exciting time. People can live many, many years after a diagnosis,’ says Wilmot oncologist By Deborah Jeanne Sergeant

Fat Dads = Fat Children Paternal health affects child's obesity, say experts By Deborah Jeanne Sergeant

recently released Danish study indicates that maternal health isn't the only influence on childhood obesity. Paternal obesity may affect the father's sperm so that his offspring's satiety cues mimic those of obese people. In essence, having a father who is obese may increase the child's chances of becoming obese. Physician Scot B. Kolsin, medical director of the Living Under Nutritional Challenges program with Lifecare Medical and Finger Lakes Health, said the study doesn’t surprise him. "It's well established that mom and dad's genetics both contribute to obesity," Kolsin said. He said that organizations such as the American Medical Association and the American College of Endocrinology have categorized obesity as a disease. Although lifestyle represents one component of obesity, other factors, including genetic ones, also play roles, according to Kolsin. "We know that people who have a family history of obesity that genetically, the children will be predisposed," Kolsin said. "The chances of a child having to deal with obesity are 50 percent if there's one obese parent and if both are, it is 80 percent. This is established." He likens the tendency to obesity to that of Type 2 diabetes. Knowing what triggers obesity in some and not in others still mystifies experts. Kolsin thinks that exposure to foods with a high glycemic effect and fats may influence the change. "Those might predispose someone to increase their thriftiness of metabolism," Kolsin said. "They will store more energy than they might otherwise. Our metabolism is adaptable. It will speed up or slow down depending upon the conditions we're in. A calorie isn't necessarily a calorie." High glycemic index foods include white flour-based products, white potatoes and sugar-sweetened

foods. Though lab tests can't determine if someone has a higher genetic risk of obesity, a blood test can indicate insulin resistance. Along with a family health history, physicians can help their patients determine if they should change their lifestyle. People with elevated risk for obesity may be able to avoid the stimuli that stifles their metabolism by limiting high glycemic foods. J. Elizabeth "Beth" Smythe, registered dietitian in private practice and director of the American Diabetes Association for Upstate New York, isn't as convinced by the Danish study, but said that the home environment and eating habits of the family can "directly affect a child's weight and that fathers absolutely can positively be role models in establishing a healthy relationship with food and good eating habits." Paying attention to a baby's satiety cues, such as turning away from the offered spoon, can start children on the path of a healthy perception of food. "Parents buy into the concept of cleaning the plate," Smythe said. "Children mirror parents. If you eat sugar-sweetened beverages and no vegetables, that's what they'll eat." Most children don't initially like many foods. It may take as many as a dozen times for them to eat a new item. Modeling healthy activity behaviors also help. Encourage physical hobbies and helping out with chores. "Especially if there's a propensity for being overweight, don't mention dieting, but model and encourage healthy behaviors," Smythe said. "Many school systems don't have the same PE that we had 20 to 30 years ago. It depends on the parents to encourage that, like going for a walk after dinner or having a dance party in the living room." Consulting the child's pediatrician can provide more detailed and specific information. March 2016 •

en have more options than ever for treating prostate cancer. As with other kinds of cancer, treatment continues to become more and more specialized, both to the cancer type and the individual. As recently as 2007, the only options were chemotherapy or surgery. In the past several years, more drugs have been approved, such as Enzalutamide (xtandi) and Zytiga (abiraterone acetate). "They have been shown to improve survival with metastatic prostate cancer," said physician Chunkit Fung, hematologist/oncologist with Wilmot Cancer Institute. "Taken daily, people tolerate them very, very well." Immunotherapy, another type of treatment for metastatic prostate cancer, uses the patient's own blood to expose the immune system to a protein in the prostate cancer and make a vaccine. Fung said that the immunotherapy Fung treatment improves the survival rate. For certain mutations, physicians can use lab tests to determine the most effective therapy, including clinical trials available nationwide. "This is personalized medicine," Fung said. "We have a lot of options. It is important to balance the risk and benefit. A lot of clinical trials are going on. It's a very exciting time. People can live many, many years after a diagnosis." Many other new drugs awaiting approval by the FDA show improvement in men's survival rates. Darryl Mitteldorf is a licensed clinical oncology social worker and founder and executive director of Malecare (www.malecare.org), a nationwide nonprofit men’s cancer survivor support and advocacy organization. He encourages men to take charge of their own health when it comes to prostate screening and, if needed, treatment. Although Mitteldorf is pleased that research is showing some promising treatments, he encourages men to feel confident in their decisions regarding prostate health. Prostatectomy, for example, bears the risk of urinary incontinence and impotency. "All men 35 and older should talk with their doctors about screening for prostate cancer," Mitteldorf said. "It has to be tailored to individual men and his desires. Some men will do anything to see the sunrise. Others

are willing to trade some years in their 70s for quality of life in their 50s and 60s." Unlike many types of cancer, when it comes to prostate cancer, early detection and treatment only saves the lives of very few patients, according to Mitteldorf. This is because not all cancers are fast-growing and require treatment. Elevated prostate specific antigen (PSA) levels can indicate prostate cancer or Mitteldorf health conditions unrelated to prostate cancer. That's why some men opt for scheduled surveillance. For some men, prostate cancer doesn't grow rapidly. "You have to treat 24 men to extend the life of one man," Mitteldorf said. "Another study says you have to treat 47 men to extend the life of one man. "Prostate cancer isn't just about cancer but overtreatment, surveillance, and what a man wants out of life. Most people just look at it as how to stop the progression of disease. From our support groups, it's not just about cell division but about life." Unlike other cancer-related surgeries, prostatectomy can significantly and negatively affect the patient's life even though he doesn't have "a visibly appreciated body part removed or have [his] hair fall out," Mitteldorf said. "But if you have to sit around your house because you have urinary incontinence or you're a single man, it's hard to seek out intimate partners if you're incapable of engaging in intimate acts. Prostate cancer treatment can do that to men." Because of the swelling number of support group members, Mitteldorf believes men undergoing prostate surgery do not have all the information they need to make a decision with which they will be happy. "It's a difficult thing to be told you might have cancer and that's followed up with, 'We don't know what to do about it.' It's not as easy a thing as people make it out to be to the point where if you have doctors you feel confident in, go for it. All the support groups say talk with someone who's already gone through it." He recommends his group, Us TOO Rochester, as a source of information. The organization can be found at www.facebook.com/ustoorochester. More information can be requested by emailing ustoorochesterny@gmail.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

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By Deborah Banikowski

Filing Taxes Just Got (a Little Bit) Easier

ow that it’s March, your annual tax filing deadline is fast approaching. If you receive Social Security benefits, one of the documents you need to file your federal income tax return is your Social Security Benefit Statement (Form SSA-1099/1042S). Your Social Security benefits may be taxable. This includes monthly retirement, survivor and disability benefits. About one third of people receiving Social Security benefits must pay taxes on some of these benefits, depending on the amount of their taxable income. This usually happens if you have other substantial income — such as wages, self-employment, interest, dividends and other taxable income that must be reported on your tax return — in addition to your Social Security benefits. You will never have to pay taxes on more than 85 percent of your Social Security benefits, based on Internal Revenue Service (IRS) rules. To find out if you must pay taxes on your benefits, you will need your Social Security Benefit Statement (Form SSA-1099/1042S). You should automatically receive it in the mail each January. It shows the total amount of benefits you received from Social Security in the previous year so you know how much Social Security income to report to the IRS on your tax return. The benefit statement is not available for people who receive Supplemental Security Income (SSI), as SSI payments are

not taxable. Whether you file your taxes early or wait until the deadline, Social Security makes it easy to obtain a replacement benefit statement if you didn’t receive one or misplaced it. You can get an instant replacement easily by using your secure online My Social Security account. If you don’t already have an account, you can create one in minutes. Follow the link below to the my Social Security page, and select “Sign In or Create an Account.” Once you are logged in, select the “Replacement Documents” tab to obtain your replacement 1099 or 1042S benefit statement. You can also use your personal My Social Security account to keep track of your earnings each year, manage your benefits, and more. You can also obtain a replacement benefit statement by calling us at 1-800-772-1213 (TTY 1-800-3250778), Monday through Friday from 7 a.m. to 7 p.m., or by contacting your local Social Security Office. If you live outside of the United States, please contact your nearest U.S. embassy or consulate. But by going online you can print your replacement benefit statement immediately and not have to wait to receive it in the mail. With a My Social Security account, gathering your Social Security information for tax season has never been easier. Open your own personal My Social Security account today at www.socialsecurity.gov/myaccount.

Q: Do I need a Social Security card? I want to get a summer job and my dad can’t ﬁnd my card. A: If you know your number, you probably don’t need to get another card. If you find out that you do need a replacement card, the best place to go to find out how to get a replacement is www.socialsecurity. gov/ssnumber. In some states and the District of Columbia, you might even be able to request a replacement Social Security card online. In other areas, you can download the application to print out, complete and submit by mail or in person. If you do get a replacement card or find the original, you shouldn’t carry it with you. Keep it in a safe place with your other important papers. Learn more at www.socialsecurity.gov/ssnumber.

Q: Can I get a new Social Security number if someone has stolen my identity? A: We don’t routinely assign a new number to someone whose identity has been stolen. Only as a last resort should you consider requesting a new Social Security number. Changing your number may adversely affect your ability to interact with federal and state agencies, employers, and others. This is because your financial, medical, employment and other records will be under your former Social Security number. We cannot guarantee that a new number will solve your problem. To learn more about your Social Security card and number, read our online publication “Your Social Security Number and Card_ at www.socialsecurity. gov/pubs/.

Q&A

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The Social Ask Security Ofﬁce

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

By Jim Miller

2016 Tax Filing Requirements for Retirees Dear Savvy Senior, What are the IRS income tax filing requirements going to be for this tax season? Due to health problems I stopped working early last year, so I’m wondering if I need to file. Unintended Retiree Dear Unintended,

There are a number of factors that affect whether or not you need to file a federal income tax return this year including how much you earned last year (in 2015), and the source of that income, as well as your age and filing status. Here’s a rundown of this tax season’s IRS filing requirements. For most people, this is pretty straightforward. If your 2015 gross income — which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately — was below the threshold for your age and filing status, you probably won’t have to file. But if it’s over, you will. • Single: $10,300 ($11,850 if you’re 65 or older by Jan. 1, 2016). • Married filing jointly: $20,600 ($21,850 if you or your spouse is 65 or older; or $23,100 if you’re both over 65). • Married filing separately: $4,000 at any age. • Head of household: $13,250 ($14,800 if age 65 or older). • Qualifying widow(er) with dependent child: $16,600 ($17,850 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see irs. gov/pub/irs-pdf/p554.pdf.

Special Requirements

There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment

in 2015 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file. To figure this out, the IRS offers an interactive tax assistant tool on its website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. You can access this tool at irs. gov/filing — click on “Do you need to file a return?” Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See irs.gov/localcontacts or call 800-829-1040 to locate a center near you.

Check Your State

Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency — https://www. tax.ny.gov/ — before concluding that you’re entirely in the clear.

Tax Prep Assistance

If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit irs.treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 5,000 sites nationwide. To locate an AARP Tax-Aide site call 888-2277669 or visit aarp.org/findtaxhelp. You don’t have to be an AARP member to use this service. 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. March 2016 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

Health News Audiologists relocate to Greece, Webster Audiologists Mallory Larsen and Dawn Weisenreider Patrick of Rochester Hearing and Speech Center have recently moved to the business’ satellite offices in Greece and Webster. Both were previously located at the Elmwood Avenue location. With deep family roots in Webster and a local herself, Patrick said she feels the Webster location will be a great fit for her. Using a client-focused approach; she treats each client as an individual and discovers the best hearing solutions and settings for their needs. Patrick Following graduation with her master’s degree in audiology from the University at Buffalo, Weisenreider Patrick practiced at Ontario Hearing Instruments, Webster Hearing Center and several other facilities before joining Rochester Hearing and Speech Center. Larsen, who received her audiology degree from Utah State University, has practiced at several local practices, including Clifton Springs Hearing Center, Decibels Audiology, and Hearing Larsen Aid Center, LLC Taking an educational approach to serving her clients, Mallory ensures clients understand their test results and feel comfortable with the action or hearing aid she recommends. “It helps patients feel confident using their hearing aids,” says Larsen, while maintaining realistic goals and expectations for communication. She also teaches clients communication strategies and draws attention to assistive technology that can enhance their communication.

Post Acute Partners buys Brockport nursing facility Post Acute Partners announced it has recently acquired Lakeside Beikirch Care Center, a 120-bed skilled nursing facility in Brockport that’s attached to Strong West Acute Care Center (formerly Lakeside Memorial Hospital), owned by the University of Rochester. The facility has provided shortterm and rehabilitative care in the Brockport community since 1998; the original nursing home was founded in 1944. Lakeside Beikirch Care Center’s board chairwoman, Patricia Hayles, said recent changes in health care Page 18

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reform have made it increasingly difficult for an independent facility that isn’t part of a larger heath care system to sustain itself in the long term. She said the board unanimously selected Post Acute Partners because of its record of commitment to employees and its reputation of providing high quality care in multiple New York communities with its affiliated Elderwood facilities. Post Acute Partners was established in 2010 and is expanding its footprint and services throughout Upstate New York, from Buffalo to as far north as Lake Placid. In 2013, it acquired Elderwood, one of the region’s premier facility-based senior-care service companies, with a total of 18 facilities. Post Acute Partners’ primary operations are in Western New York, Pennsylvania, Rhode Island and Massachusetts.

Thompson’s maternity gets designation

In an effort to help prospective parents find hospitals that deliver quality, affordable maternity care, Excellus BlueCross BlueShield announced that Thompson Hospital has been designated as one of the first hospitals to receive the Blue Distinction Center+ for Maternity Care designation, a new designation under the Blue Distinction Specialty Care program. This new Blue Distinction Centers+ for Maternity Care program evaluates hospitals on several quality measures, including the percentage of newborns that fall into the category of early elective delivery, an ongoing concern in the medical community. Compared with babies born 39 weeks or later, early term infants face higher risks of infant death and respiratory ailments such as respiratory distress syndrome, pneumonia, and respiratory failure, among other conditions. These babies also have a higher rate of admission to neonatal intensive care units. In addition, hospitals that receive a Blue Distinction Center+ for Maternity Care designation agreed to meet requirements that align with principles that support evidence-based practices of care, as well as having initiated programs to promote successful breastfeeding, as described in the Baby-Friendly Hospital Initiative by Baby-Friendly USA or the Mother-Friendly Hospital program by the Coalition for Improving Maternity Services (CIMS) through its “10 Steps of Mother-Friendly Care.” The program also evaluates hospitals on overallpatient satisfaction, including a willingness to recommend the hospital to others. “We are delighted to receive this recognition from Excellus BCBS because it acknowledges the quality, evidence-based care provided at Thompson,” said Director of Obstetrics Deborah Jones. “The designation highlights our zero rate of early

elective deliveries, our focus on family-centered care – including rooming-in and breastfeeding – and our patient satisfaction. We are extremely proud of the excellent care provided by our staff and providers.”

Child Care Council selected for brain study Child Care Council Inc. has been chosen as one of only 10 sites across the country to participate in a healthy child brain development project. Child Care Aware of America selected the local council as part of a national network of communities and organizations activating Vroom, a Bezos Family Foundation initiative that is helping parents nationwide promote brain development in children from birth to 5 years old. Child Care Council and other participating sites — part of Child Care Aware of America’s nationwide Child Care Resource and Referral (CCR&R) net-

work — will use Vroom to bolster its current work with families. Vroom provides interactive tools and resources that highlight the science behind early brain development, showing parents how they can turn activities like bath time and mealtime into opportunities that build their children’s brains. This partnership is particularly exciting in its ability to facilitate a far-reaching culture shift — one that begins with parents understanding early brain development and extends into how families, providers, businesses, and communities all work to support brain development during the first five years of life. “Child Care Council is pleased to be selected as one of the 10 sites in the nation to participate in this outstanding Vroom project,” said Child Care Council CEO Barbara-Ann Mattle. “Through Vroom, we will help nurture parent-child interaction and educate parents about brain-building messages, both of which are critical to healthy child brain development.”

Excellus Awards Hospitals $22.4 Million for Quality Improvements Eight hospitals in the Finger Lakes region shared $10.2 million   Forty-one Upstate New York hospitals and health centers last year earned $22.4 million in quality improvement payments from Excellus BlueCross BlueShield as part of its performance incentive program. Since 2005, Excellus BCBS's program has paid out more than $210 million.    "To provide the best value for our customers, collaboration with our provider partners is more important than ever as we identify new best practices to improve health outcomes and use health care resources more effectively," said Tony Vitagliano, Excellus BCBS vice president of health system performance.

Finger Lakes region  Eight hospitals in the Finger Lakes region participated in this program in 2015, sharing $10.2 million in quality improvement incentive payments. Participating hospitals included Clifton Springs Hospital and Clinic, F.F. Thompson Hospital, Highland Hospital, Newark-Wayne Community Hospital, Nicholas H. Noyes Memorial Hospital, Rochester General Hospital, Strong Memorial Hospital and Unity Hospital.   In 2015, Excellus BlueCross BlueShield’s Hospital Performance Incentive Program evaluated participating hospitals on more than 241 performance measures. Hospitals that received quality improvement incentive payments

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

achieved 90 percent of all quality improvement targets.    In addition to achieving required clinical and patient safety measures in 2015, other nationally-endorsed measures and target outcomes were jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, The Joint Commission, the Institute for Healthcare Improvement, and others.

Big savings From the Excellus BCBS Spring 2013 Fact Sheet on Hospital Acquired Infections in Upstate New York: In 2010, an estimated 108,000 hospital acquired infections occurred in New York state, including an estimated 24,000 in Upstate New York. Those hospital-acquired infections led to an estimated 5,000 New York state deaths, 1,100 of which were in upstate New York. If Upstate New York hospitals could lower the number of hospital-acquired infections by even 20 percent or 40 percent, there would be an estimated 5,000 to 10,000 fewer infections and 200 to 400 fewer associated deaths, the Excellus BCBS report concludes. That would also save Upstate New York hospitals an estimated $68 million to $137 million annually. To access the report, go to excellusbcbs.com/factsheets.

Hurlbut Care Communities recognized Two Hurlbut Care Communities and their administrators have been recognized by the American College of Health Care Administrators (ACHCA) as top performing skilled nursing facilities in the U.S. for 2015. The Conesus Lake Nursing Facility in Livonia, with Administrator Ann Harris; and Woodside Manor Nursing and Rehabilitation in Brighton, with Administrator Elisa Chambery both were awarded the Harris Eli Pick Facility Leadership Award. The annual recognition by the ACHCA identifies only the top-performing skilled nursing facilities nationwide. Selection criteria is based on exceptional performance on health safety, fire safety and complaint criteria, including categories such as: 80 percent or greater occupancy, avoidance

Health

of special focus facility status; at least one CMS quarter average QM score matching specific benchmarks related to pain, pressure ulcers, and other key healthcare measures. Information collected by the Centers for Medicare & Medicaid Services (CMS) is utilized in selecting award recipients, and this data is also Chambery evaluated by an independent third party. “We appreciate our facilities being recognized by the ACHCA,” said Connie Lester, marketing director for Hurlbut Care Communities. “Only 9 percent of facilities nationwide qualify, and all of our management and employees at Conesus and Woodside Manor work very hard to help our residents and rehabilitation patients experience a higher quality of life and care. And it’s a great tribute to two exceptional administrators, Ann Harris and Elisa Chambery.”

in good

ROCHESTER ’S HEALTHCARE PAPER

EMPLOYMENT

March 2016 •

Renowned oncologist moving to Buffalo Physician Marc S. Ernstoff has been appointed professor and chief of the division of hematology/oncology in the department of medicine in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo (UB), and chairman of the department of medicine and senior vice president of clinical investigation at Roswell Park Cancer Institute (RPCI). Ernstoff also will serve as chief of the division of hematology/oncology at UBMD Internal Medicine, the clinical practice plan of the UB department of medicine. The appointments take effect on April 1. “His joint appointment as chief of the division of hematology/oncology at the Jacobs School of Medicine and Biomedical Sciences at UB and chair of medicine at Roswell Park is a clear indication of the close collaboration we have between the two institutions. We look forward to working with Dr. Ernstoff to build clinical, educational, and research programs at Roswell Park, as well as with UB and

UBMD Internal Medicine,” physician Anne B. Curtis, chairwoman of the UB department of medicine. In 2014, Ernstoff became the director of the melanoma program at Cleveland Clinic’s Taussig Cancer Institute. From 1991 to 2014, he served as associate professor of medicine and professor of medicine at DartErnstoff mouth College’s Geisel School of Medicine and Dartmouth-Hitchcock Medical Center. During much of his tenure, Ernstoff was the director of the melanoma program at the Norris Cotton Cancer Center and the section chief of hematology/oncology. Ernstoff was previously a faculty member at the University of Pittsburgh’s School of Medicine, where he directed the hematology/oncology fellowship training program; he also was an assistant professor of medicine at Yale University and director of its clinical research office.

Drivers Wanted To distribute copies of In Good Health, Rochester’s

Healthcare Newspaper, in offices and other high traffic locations in the region. Great for active retirees or at-home moms in need of some extra cash. Not a regular job. Work only one or two days a month during office hours (9 to 5). Compensation: $9/h plus 30 cents per mile. It amounts to about $150 - $200 per month. Call 585-421-8109 and ask for Alice

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

Chicken Bacon Avocado

Cranberry Chicken Salad

Fritttata

Effortlessly Healthy’ s meal delivery service weight loss plan offers everything from breakfast choices of pina colada Greek yogurt parfait to a zucchini, mushroom and kale frittata as well as lunch and dinner options.

Clean and Lean How a former URMC administrator started her own healthy food truck and meal delivery service business By Lynette M. Loomis

E us.

ating healthy might sound easy, but first each of us has to define what eating healthy means to

Is it food free of preservatives? Is it fresh not frozen? Vegetarian? Vegan? Gluten-free? Do we have to sacrifice taste for health? Does it take a lot of time to prepare great meals if we only want fresh ingredients with no additives, artificial colors or flavors? Shaina Sidoti created a business that answered all of those questions. Sidoti was diagnosed with severe psoriatic arthritis at age 23 while attending SUNY Brockport. After participating in a clinical research study for a new medication to heal the illness, she became very sick. She visited a naturopathic physician who prescribed the Paleo diet, which she followed 100 percent for six months. It took her disease from severe to mild. In conjunction, she was able to lose 60 pounds and keep it off. After college, Sidoti became an administrator in the department of surgery at the University of Rochester Medical Center. During this time, she began telling co-workers her story, trying to teach others how to live happier, healthier lives, by eating a clean or Paleo diet. “One day I was home sick and I had this idea. What if I figured out a way to cook for people, that way they don’t have an excuse? So, without hesitation, I took out a personal loan, purchased a food truck, and left my amazing career. I knew if I created something that didn’t exist, a healthy meal delivery service providing fresh meals, and also a healthy food truck, I would begin my goal of helping others,” explains Sidoti. She launched Effortlessly Healthy in the fall of 2013 as a 25-year-old female with a dream. The business began as a healthy food truck and meal delivery service, and has now expanded with healthy

Roast Beef Page 20

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catering — primarily lunches — and a café, located at 1921 South Ave., Rochester. Now, after being in business for more than two years, her goal is to have a quick service chain featuring the Healthy Trash Plate. “I strongly believe America needs additional healthy options than just salads, and we are able to give people fresh, healthy, and delicious meals that help all different diets,” she said. Effortlessly Healthy features dairy free, gluten free, vegan and vegetarian options. After business began to grow, Sidoti contacted her mother, Sandra, who was living in Arizona, and begged her to come home to be her main chef. “I came from a family that always cooked and my aunt owned her own restaurant as well. Of course I would consider coming back to help my daughter achieve her dream,” Sandra said. “I believed in her concept and I could see what this change in eating had done to improve her health. It did not take a lot of convincing for me to return to Rochester.” The business soon grew to include catering, including home and business delivery. “My philosophy is if you can’t pronounce something on a food label, you shouldn’t eat it,” said Sidoti. People are appreciating the concept.

Healthy Trash Plates the rage To date, Effortlessly Healthy has served tens of thousands of Healthy Trash Plates, with the plate being the main feature on the food truck and in the cafe. Customers go to her café and create their own plate. First you choose your protein, chicken, hamburger, steak, tofu or mushrooms, and choose various add-ons. The most popular plate is the chicken, bacon, and avocado plate, used with

Spaghetti Squash Marinara

just enough bacon for flavor. In addition, the café has a variety of wraps, salads and sides. Effortlessly Healthy’ s meal delivery service includes its signature Healthy Trash Plate, but has more gourmet-style items such as shepherd’s pie, chicken Marsala, and Italian meatloaf with fresh marinara. Each recipe is original, including some healthy modifications of family favorites. Effortlessly Healthy’ s meal delivery service weight loss plan offers everything from breakfast choices of pina colada Greek yogurt parfait to a zucchini, mushroom and kale frittata as well as lunch and dinner options. All of its menu options include details on calories, fat, carbs, fiber and protein. Its home delivery business has been growing steadily. Sidoti explains, “People appreciate the fact our meals are fresh, not frozen. Increasingly, people are buying meals not only for themselves, but for new moms, family members in need of meals during continuing care, or simply for convenience. Who doesn’t love coming home and popping a fresh, healthy meal in the microwave to serve to their family? “We are also seeing steady growth in our catering business, primarily for lunch meetings. Our boxed lunches are really a hit.” Jeff is an enthusiastic customer who declined to share his last name. “Effortlessly Healthy has made my life better in more ways than one. First, it’s provided me with more time in my day and reduced stress. Gone are the days of me frantically looking for food after a long day at work. The food is great, and I have noticed substantial improvements in my physique,” he said.

Steak RRP AVO Plate

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2016

Shaina Sidoti (left) created her own business after she battled with severe psoriatic arthritis at age 23 while attending SUNY Brockport. The business — Effortlessly Healthy — has grown so much that she convinced her mother (right) to move back to Rochester from Arizona, she was living.

“I’m in my 30s and have worked out and lived a healthy lifestyle for over two years. However, I was under the wrong impression that I would never have a flat stomach. I figured it just wasn’t in my cards. Much to my surprise, a few months after starting on the meal plan, I now have the flat stomach of someone in his early 20s. I feel like a beast,” Jeff said. Physician Jason A. Kanel, a customer of Effortlessly Healthy, said, “As an anesthesiology resident, I am conscious about eating healthy and have little time to cook. Effortlessly Healthy is just that — it is delicious, healthy food, and the meal delivery service is super- convenient. The business is run extremely well and the food is fantastic. Definitely doctor recommended!”

Wrap and Fruit