IGH Rochester #165 May 2019 by In Good Health: Rochester's Healthcare Newspaper

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MAY 2019 • ISSUE 165

ELDER ABUSE

Measles Crisis Golisano Children’s Hospital pediatrician discusses the measles outbreak in Rochester and NYS and why she thinks so many families are skipping vaccination

New report from the CDC shows a sharp rise in elder abuse in the U.S. — family members commit most of the violence, the report states Inside Find out how many cases of abuse have been registered in the Rochester P. 22

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Caregivers urged to hit the pause button to avoid burnout

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New Dental Guide Inside

Why You Should Eat More Broccoli P. 13

High Rate of Sex Before Age 13 Among Boys P. 8

So You’ve Had Weight-Loss Surgery. Now What?

E You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org

ating habits and physical activity have a greater impact on weight-loss surgery’s long-term success than measures like counting calories, a new study finds. Researchers also found that evaluation of patients’ mental health and eating habits before weight-loss (bariatric) surgery did not help predict who would be successful in keeping weight off years afterward. “Bariatric surgery is the most effective treatment for severe obesity. It results in sustained weight reduction and remission of diabetes and other health problems in the majority of patients,” said study author Wendy King. She’s an associate professor of epidemiology at the University of Pittsburgh’s School of Public Health. “However, as with all types of weight-loss interventions, patients usually regain at least some of the weight they initially lose,” she added in a university news release. The study included nearly 1,300 adults who had a type of weight-loss surgery called Roux-en-Y gastric bypass. The patients were followed for an average of six and half years. Limiting sedentary behaviors (such as watching TV), self-weighing at least once a week, avoiding fast food, and correcting “problematic” eating behaviors were all factors associated with a greater chance of limiting weight gain after weightloss surgery. Problematic behaviors included eating continuously, eating

when full, loss of control and binge eating. Younger patients were likely to gain more weight than older ones. Other characteristics linked with higher weight regain included having venous edema with ulcerations — a disease of the veins accompanied by sores on the skin; difficulty with daily physical tasks such as bathing, dressing and walking; and symptoms of depression after surgery. “This may sound like common sense,” King said. “But several behaviors and characteristics that clinicians hypothesized to matter were not related to weight regain. For example, while frequency of fast food consumption was associated with greater weight regain, frequency of meals and eating at restaurants were not,” she explained.

Caring for the Moﬆ Important People on Earth.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

According to study senior author m physician Anita Courcoulas, “As clinicians, we know that weight maintenance is the most important, yet challenging, aspect of longterm post-bariatric surgery care.” Courcoulas is chief of minimally invasive bariatric surgery at the University of Pittsburgh Medical Center. “Because we found that most individual patient characteristics at the time of surgery do not clearly identify those most at risk for poor weightloss maintenance after surgery, it is especially important that clinicians and programs engage with patients early and often after surgery about behaviors that can aid in limiting weight regain,” Courcoulas said. The study was published April 4 in the journal Annals of Surgery.

May 2019 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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May 19

HEALTH EVENTS

Expert to discuss plantbased diet and kidney disease Physician Scott Liebman will be the guest speaker at the May meeting of the Rochester Area Vegan Society. A local nephrologist and kidney specialist affiliated with the University of Rochester Medical Center, he will discuss plant-based diet and kidney disease. Liebman is also board-certified by the American Board of Lifestyle Medicine. The meeting will take place starting with a share-a-dish dinner at 5:30 p.m. May 19 at Brighton Town Park Lodge, 777 Westfall Road, Rochester. The program starts at 7 p.m. Dinner is a vegan potluck. Vegan means no animal products —meat, poultry, fish, eggs, dairy products or honey. Please bring a dish with enough to serve a crowd, and a serving utensil; also bring a place setting for your own dinner. For more information, call 234-8750 or visit rochesterveg.org.

May 31

One-day boot camp for women who live alone Do you live alone? Do you find it challenging? “Alone and Content” is a one-day boot camp offered for divorced and widowed women who want to rediscover contentment and gain the know-how to forge a meaningful life on their own. In this workshop, you’ll meet others in similar circumstances and

learn practical strategies to rewrite the next chapter of your life, whether it be to get unstuck, to cope better or to thrive. The program covers how to overcome loneliness, find contentment within yourself, and socialize in a couples’ world. The workshop takes place from 9:30 a.m. to 4 p.m. Friday, May 31, at House Content Bed & Breakfast in Mendon. Breakfast snacks/coffee/tea and a healthy lunch will be provided. The workshop fee of $165 includes interactive discussions, empowerment exercises, and helpful resources you can trust. To register, contact Gwenn Voelckers at 585-6247887, email gvoelckers@rochester. rr.com, or visit www.aloneandcontent.com.

June 1

Free dental care offered to 100 people in Greece Dentist Oliver Cabrera of Greece Family Dentistry and Implantology will host Dentistry From The Heart, an event that will provide free dental care to the first 100 patients who show up on his practice. It will take place from 8 a.m. to 4 p.m., June 1, at Greece Family Dentistry & Implantology, 120 Erie Canal Dr., suite 150, Rochester. Last year the practice provided more than $24,000 in free dental care to nearly 70 patients. Services provided range from extractions, fillings and cleaning. “Now more than ever, I know there’s people out there that need dental care, but have no means to afford treatment — whether they’re out of a job, or just don’t have dental insurance,” said Cabrera.

Lifespan unveils May calendar listing Lifespan, a Rochester nonprofit that provides information, guidance and more than 30 services and advocacy for older adults and caregivers, is sponsoring a series of free events taking place in May. Register online at www.lifespanrochester.org or call 585-244-8400, ext. 201. Classes take place at Lifespan, 1900 S. Clinton Ave., Rochester unless noted otherwise. Some of the programs are:

Home Care Options

Noon to 1 p.m., May 8. Having help at home is often the key to maintaining longer-term independence. Workshop will discuss types of home care, how to access services, and how the services are paid.

Supportive & Assistive Housing Options for Older Adults

From 9:30 to 11 a.m., May 9. Housing options are numerous, confusing and often expensive. A review of options from independent with services, assisted living, enriched, special certifications and to skilled nursing. Does not focus on affordable housing options.

Estate Planning Using Trusts

From 1 to 2 p.m., May 10.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

Overall estate planning conversation and how revocable trusts can be used in your planning.

Peace of Mind Planning

From 1 to 2:30 p.m., May 13. Learn about Lifespan’s Peace of Mind Planning service which can help you organize all your important legal, financial and medical information with attention to your personal needs. No cost. St. John’s, the Wintergarden at Brickstone, 1325 Elmwood Ave., Rochester.

Hearing Loss Demonstration Center

From 10 a.m. to 2 p.m., May 16. Volunteers from the Hearing Loss Association of America (HLAA) are available to demonstrate assistive listening equipment and answer questions. Just drop by.

Tai Chi for Arthritis

From 9:30 to 11 a.m., May 21. In introduction to tai chi which helps participants with pain reduction, stiffness, decreased range of motion and balance concerns associated with arthritis. For a complete list of May events, visit www.lifespanrochester.org or call 585-244-8400, ext. 201.

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Create a healthy home and enjoy peace of mind According to the U.S. EPA, indoor air pollution is far more concentrated than outdoor air pollution. Levels of many pollutants are 2-5 times higher indoors than outdoors.

May 2019 •

U.S. Environmental Protection Agency

Symptoms of

allergies and asthma among children have doubled in the last 20 years.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Elizabeth B. Murray, D.O. Golisano Children’s Hospital pediatrician discusses the measles outbreak in Rochester and NYS and why she thinks so many families are skipping vaccination Q: You do a lot of outreach, I understand. A: I’m a pediatrician at Golisano Children’s Hospital and I also am a spokesperson for the American Academy of Pediatrics, so I do a lot of work with the media both locally and nationally. Q: A big topic you’re dealing with now is vaccinations. What are some of the public health problems we’re seeing? A: The most pressing issue is the recent measles outbreak. Here in Monroe County we’ve had seven cases, which isn’t as bad as what they’re seeing downstate where they have hundreds and hundreds of cases, but it’s still a lot. The disease had effectively been eradicated in the United States, but with the rise of the anti-vaccination movement, these diseases are starting to come back. It’s such a terrible disease and such a contagious disease. Monroe County has historically had excellent vaccination rates, but there are some areas where the vaccination rates are low and, sure enough, the disease was able to spread into those communities. Q: Growing up, I knew measles by name, knew it existed and had a vague sense that it involved a rash. Why should parents, and the community in general, take it seriously? A: Well, it kills about one in every 1,000 people who get it. And if it doesn’t kill, it’s just a miserable illness to have. Fevers, congestion and a horrible, horrible rash. So it’s miserable and uncomfortable for many days, and then it can have a lot of side effects, including infections in the brain and the tissues around the brain. It may not be fatal, but it may make you unable to function normally. It’s also unusual in that it can have a delayed, fatal side effect many years later, where you develop an infection in the brain that, if you get it, is almost universally fatal. So you may make it through the illness just fine and then five, 10 years later develop this other process that you wouldn’t have gotten if you hadn’t had measles.

Q: Why do you think the anti-vaccination campaigns have been this “successful?” A: I think parents and people who care about children are doing what they think is right for their children and, unfortunately, there’s a lot of misinformation out there. Fear is a powerful motivator. So if you’re a parent and hear some very scary stories, it can motivate how you behave. The thing is, many of these stories are just that. They’re anecdotes not based in fact. This was coming up at a time when social media was coming up as well. So now we have an abundance of information that isn’t vetted. So there’s this incredible spread of incorrect messages. And we had some celebrities jump onto the idea and, unfortunately, they have a lot of influence in our culture. That kind of combination really helped the rise of misinformation. And now on top of that you have less trust in

government, fake news, so it’s harder to get people to trust institutions. And some of it, it’s just human nature. When something bad happens, we complain about it. When nothing bad happens, we don’t say anything. No one is tweeting out that their child got a vaccination and there were no problems even though thousands of children are being vaccinated at any given time. A child may get a vaccination and complain that his or her arm hurts, which is normal, but those will be the stories you hear about. We don’t publicize it when things go the way they’re supposed to. Q: What kinds of tactics have you found effective in reversing that trend? A: I think the most important thing is to have a good relationship with patients and parents, to understand where the parents are coming from, where they’re getting their information, what was it that they’re concerned about. You just have to have a conversation. I’ve heard the whole gamut. Sometimes it’s really easy to clarify misunderstandings, other times it’s something deeper or more complicated. Sometimes a parent has had a bad experience with the medical community. That can be harder to overcome. But saying anti-vaxxers are stupid isn’t going to get us anywhere. I believe they want to do the right thing for their children. Unfortunately evidence suggests they’re making decisions based on bad information. Q: Are there any other strategies that can help reduce the spread of infection to children who haven’t been vaccinated? A: Unfortunately not a lot. We love to vaccinate against every disease that we can. Unfortunately they don’t all lend themselves to vaccination. Others we’re still working on. A lot of these infections are incredibly dangerous. A lot of them are viruses, and viruses can’t be treated with antibiotics. It’s not really a washyour-hands-and-cover-your-mouth situation. As for controlling the spread, when someone gets measles, it’s a huge impact on the family, not just from being sick but because people need to be quarantined for a long period of time. So it’s loss of access to

Q: Is that the disease flaring up again or an opportunistic infection? A: It’s kind of complicated to explain. It’s a form of encephalitis that’s more or less a delayed reactionary process. It’s not a reactivation of the disease or different infection. It’s just kind of a very delayed process. The important thing to understand is that measles increases your risk of problems down the road. Page 6

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

In the News Physician Elizabeth Murray of Golisano Children’s Hospital was part of a collaborative effort to create and post a video appealing to parents who may be undecided about whether to vaccinate their children. The initiative also involved pediatricians from Elmwood Pediatric Group, English Road Pediatrics, Genesis Pediatrics, Lewis Pediatrics, Long Pond Pediatrics, Mendon Pediatrics, Parkway Pediatric & Adolescent Medicine, and UR Medicine. To view the video, go to urmc.edu and type “vaccine video” in the search menu. work, loss of access to school. Q: Can vaccinated individuals carry measles even if they’re not affected by the disease themselves? A: Once you get the initial vaccination and then the booster shot, the vaccine is about 96 – 98% effective. There are some people whose immune systems may work a little differently who don’t get as much immunity from it, so there’s a very small risk later in life that you could get it later in life if you were exposed. But high vaccination rates help keep it out of the community, so there’s less chance you’ll be exposed in the first place. Q: Are we victims of our own success when it comes to vaccinations? Many of these diseases probably don’t seem real to people now. A: Most definitely. If you talk to grandparents, they’ll tell you how awful it was. And if you look out West in Seattle and Oregon where they’ve had even bigger problems with measles, their vaccination rates are going up because people are seeing how bad it is again. Once people were faced with it, they decided to vaccinate. Q: What would you say to parents to put their minds at ease concerning the supposed risks from vaccines. A: There really aren’t any common dangerous side effects from vaccines. I make sure both myself and my children are vaccinated because I think it’s the safest choice to keep us healthy. The only real common side effect is a sore muscle at the site of the injection, and that’s it. There are very rare cases of allergic reactions, but again, the safest choice is to vaccinate.

Lifelines

Name: Elizabeth B. Murray, D.O. Position: Pediatrician at Golisano Children’s Hospital; assistant professor of clinical emergency medicine and pediatrics Hometown: Rochester Education: University of New England College of Osteopathic Medicine (OD degree); University of Rochester (MBA); Skidmore College (bachleor’s degree); fellowship in pediatric emergency medicine at URMC; residency in pediatrics at Dartmouth Medical School Affiliations: Golisano Children’s Hospital Organizations: American Academy of Pediatrics Family: Husband, two daughters Hobbies: Catching up on sleep (mother of two small children)

Do you have glaucoma or high eye pressure? Gun Deaths Up Sharply Among America’s Schoolkids Deaths of school students surpass number of deaths among police officers or active duty military personnel

un-related deaths among school-age children in the United States are increasing at alarming rates, researchers report. In 2017, gun violence claimed more 5- to 18-year-olds than it did police officers or active-duty members of the U.S. military, according to a chilling new study led by investigators from Florida Atlantic University. “It is sobering that in 2017, there were 144 police officers who died in the line of duty and about 1,000 active duty military throughout the world who died, whereas 2,462 school-age children were killed by firearms,” study senior author, physician Charles Hennekens said in a news release. He’s a professor of medicine at the University’s Schmidt College of Medicine. The nationwide study found nearly 39,000 gun-related deaths among 5-to-18-year-olds between 1999 and 2017. That included almost 6,500 deaths among kids between 5 and 14 years of age, and more than 32,400 among older teens. Significant increases began in 2009, with a wave of shootings among 5- to 14-year-olds, followed by a similar wave among teens starting in 2014. Both waves — which

researchers described as epidemics — continued through 2017, the most recent year for which data are available. Gun-related deaths over the period accounted for 5.6 percent of deaths in the younger group and nearly 20 percent among older kids. Researchers also found statistically significant increases in gun-related deaths among black children aged 5-14, starting in 2013. Hennekens likened attempts to halt the epidemic without gun control to trying to curb lung cancer deaths due to cigarettes without reducing tobacco use. The analysis of data from the U.S. National Center for Health Statistics also looked at causes of death among school-age children. It said 61 percent were the result of assault; 32 percent were from suicide; 5 percent were accidental; and 2 percent undetermined. Blacks accounted for 41 percent of all deaths, and 86 percent were in boys. The authors said the findings, published March 21 in the American Journal of Medicine, reveal significant public health and policy challenges.

Serving Monroe and Ontario Counties in good A monthly newspaper published

Health Rochester–GV Healthcare Newspaper

by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations.

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Rebecca Leclair, Ernst Lamothe Jr., Eudene Harry, MD • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office manager: Nancy Nietz 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.

May 2019 •

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone & Content Workshop: A One-Day Boot Camp Forging a New Life on Your Own

or some women, living alone in mid-to-later life is a welcome change, especially if they have chosen to step away from an unhappy marriage. But for others, the change is often sudden and not welcome. The prospect of living alone can appear on the horizon as a daunting challenge. The ending of my own marriage years ago fell into the latter category; it was not a welcome change. But it was a change nonetheless and I chose to accept it and ultimately to embrace what would become a defining chapter in my life. It took some time and some hard-knock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to offer support to other women in similar circumstances. “Alone & Content: Forging a New Life on Your Own” is a one-day boot camp I developed to help women discover the know how to create a more satisfying and enriching life on their own terms and timetable. I’ve been leading the workshop for over 14 years now, and often get questions from In Good Health readers about what the boot camp covers

and how it is organized: Q. What is the purpose of the boot camp and what do you cover?

A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude and perspective. At the end of our day together, it’s my hope you will feel a few steps closer to finding your way forward, whether it be to get unstuck, to cope better or to thrive. We’ll talk about how to overcome loneliness and other emotional pitfalls, rediscover your true self, socialize in a couples’ world, and let go of self-limiting beliefs or obstacles that get in the way of personal growth. The goal is to embrace what may be a once-in-a-lifetime opportunity to get to know yourself all over again and to create a rewarding life on your own, whether it be for a year or two or for the rest of your life. Feeling comfortable with your independence will improve your chances of finding happiness, and it will improve your chances of finding a new healthy relationship, if that’s what you desire.

s d i K Corner

High Rate of Sex Before Age 13 Among Boys

sing information from two national surveys, researchers from Johns Hopkins Medicine and the Guttmacher Institute have found that in some metropolitan areas, more than a quarter of young, African American men reported having sexual intercourse before age 13, and for about 45 percent of them, the sex was either unwanted or experienced with “mixed feelings.” The researchers caution that while self-reporting surveys have limitations, they say similar results drawn from multiple data sources suggest that rates of underage male Page 8

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sex in metropolitan areas are substantially higher than previously estimated using only national data. They also find that race, ethnicity and location play a larger-than-appreciated role. The researchers say their study, described in the April 8 issue of JAMA Pediatrics, points to the need for better and much earlier access not only to sex education, but also sexual health clinics, family planning and parenting services, and mental health counseling services for inner city male youth, particularly if they have experienced unwanted sex.

When you feel better about yourself — more self-assured and resourceful — life on your own or with a special someone can be richer and more satisfying. Q. Who attends the boot camp?

A. Most of the women who attend the workshop are in mid-to later life, around my age. I am 64 years young. Almost all have come out of a long marriage or relationship, and some are on their own for the first time in their lives. While their circumstances may differ, they share one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist, and/or their congregation.

Q. I’m still grieving the loss of my marriage/spouse. Is this boot camp right for me?

A. Good question. The Alone & Content boot camp is a “nuts and bolts” practical workshop to help women feel more whole and complete on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend attending a grief support group (check out Lifetime Care) or the help of a professional counselor. Q. What are your credentials?

A. I am not a licensed professional. My expertise is born out of real-life experience. I’ve been there. I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of living alone. After some hits and misses, I found my way and now thoroughly enjoy the freedom, independence and peace that come with living alone. My time-tested experience, resources, tips and techniques have inspired and helped many participants. My boot camp has been the jump-start they needed to rewrite this chapter in their lives. “Young men having sex before age 13 usually haven’t received the appropriate sex education and services, and we need a better system to respond to their needs,” said physician Arik Marcell, senior author of the study and associate professor of pediatrics at the Johns Hopkins University School of Medicine and Johns Hopkins Children’s Center. “The cultural double standard about sexual behavior in the United States, in which it is OK for young boys, but not girls, to be sexually active, has prevented us from effectively addressing male adolescents’ vulnerabilities and their healthy sexual development,” Marcell adds. Currently, 24 states and the District of Columbia mandate sex education at some level. Although most adolescents receive some form of sex education between grades six and 12, with some as early as grades four or five, the researchers say what they learn is highly dependent on their region, school and parents’ decisions to allow them in the classes. In 2014, fewer than half of high schools and only 20 percent of middle schools delivered sex education covering all 16 critical sexual education topics identified by the CDC, according to the Guttmacher Institute. “I have heard boys and adolescents talking about their first sex

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

Q. How large is the boot camp?

A. Ideally, I like to have eight women in each boot camp, although, on occasion, I have led the workshop with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly evolves into a comfortable camaraderie and it’s not uncommon for warm friendships to develop among participants that carry on long after the boot camp has ended. Q. Where is the Alone & Content boot

camp held?

A. The boot camp takes place at House Content Bed & Breakfast in Mendon, a few minutes south of Rochester. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the boot camp. What’s my next step?

A. Let’s talk by phone as a next step. That way, I can your answer your questions and you’ll know better whether this boot camp is right for you. Just call me at 585-624-7887 or email me at gvoelckers@rochester. rr.com, and we’ll schedule a time to chat. You’ll also find information about my upcoming boot camp in the Calendar of Health Events included in this issue.

Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon. She is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about her boot camp, to purchase her book, or invite her to speak call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com

encounters in a way that suggests they didn’t anticipate, understand or know what was happening or what’s appropriate and what’s not,” says Marcell, “I was concerned that such early sex experiences happening to boys could be unwanted and influence their future health. We used the data available to us in these surveys to attempt a better look at the scale and pattern of this problem across the nation.” Young men who reported in the national family growth survey that they first had sex before age 13 described a range of attitudes about this experience. Only 55 percent said that their first sexual experience was wanted, while 8 percent said it was unwanted and 37 percent said they had mixed feelings about it. The investigators underscored the importance of recognizing young people’s perspectives, and also noted that reports of whether a first sexual experience was wanted may be influenced by gender and race expectations, stereotypes, peer pressure and coercion. “Too often, the sexual health needs of young men are overlooked,” says Guttmacher Institute researcher Laura Lindberg. “Outdated attitudes and harmful gender stereotypes leave many young men without needed information and services.”

Nonprofit Invests $13.5M to Advance Healthcare System Transformation

inger Lakes Performing Provider System announces first wave of funding awarded to 41 groups across the Finger Lakes region; additional funding to be available in the coming months Finger Lakes Performing Provider System (FLPPS) recently announced that it has awarded $13.5 million to 41 community-based organizations across 13 counties in the Finger Lakes region, as part of a new system transformation fund. The fund aims to promote healthcare system transformation by developing programmatic infrastructure to support partners through their transition from fee-for-service reimbursement to value-based payment for Medicaid recipients. System transformation activities include: • Social determinants of health interventions; • Initiatives to achieve the “quadruple aim” (improved outcomes, patient experience, provider satisfaction and reduced costs); • Managed care engagement to support value-based payment; and • Improved quality and cost-reducing activities that target high-risk populations; In addition, fund initiatives focus on developing a sustainable activity that will improve healthcare delivery in the region past the term of funding. “We are proud to facilitate collaboration with hundreds of healthcare and community-based organizations across our 13-county region, striving to ensure that individuals are able to access both the clinical care and social services necessary to maintain their well-being,” said Carol Tegas, executive director, FLPPS. “We received an overwhelming response to this request for proposals and we’re planning to continue our investments throughout the year.” More than 40 community organizations were selected for awards in this first round of support totaling

$13.5 million. Some of the organizations include Lifespan, Children’s Institute, Catholic Charities of Chemung/Schuyler, Healthy Baby Network, CASA Trinity, Pembroke Family Medicine, Cayuga Counseling Services, Foodlink and Irondequoit Pediatrics. The FLPPS team collaborates with partners to create innovative programs, consultative support and provide strategic funding to improve population health outcomes. “FLPPS is a key partner helping us to address social determinants of health and impact reductions in unnecessary ED visits and hospital readmissions,” said Ann Marie Cook, CEO at Lifespan of Greater Rochester. “Our community-based healthcare navigation services assist adults, connecting them with access to the primary care they need, resulting in higher enrollments and increased appointment attendance rates.” The system transformation fund is one of many ways FLPPS partners with community organizations to advance healthcare system transformation. To learn more about FLPPS’s other projects and programs, visit https://flpps.org/Projects.

About Finger Lakes Performing Provider System

The Finger Lakes Performing Provider System (FLPPS) is a nonprofit organization that supports hundreds of clinical and non-clinical organizations working to transform the New York state Medicaid healthcare delivery system across the Finger Lakes region through the Delivery System Reform Incentive Payment (DSRIP) program. FLPPS exists to facilitate a collaboration among healthcare providers and human service organizations to ensure individuals are able to access both the clinical care and social services necessary to maintain their well-being.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Healthcare in a Minute By George W. Chapman

Large Employers Limiting Choices to Providers

aced with continually rising healthcare premiums and costs, many large employers like Walmart are receiving a lot of press for selecting/approving/limiting the physicians and hospitals their employees can use. This “narrowing” of the panel of providers to control costs and raise quality is not new. The concept has been around since the 1970s when staff model HMOs and Preferred Provider Organizations (PPOs) were established and members were limited to a select panel/network of providers. What is new is that the impetus to limit the panel/network is coming from the employer versus the HMO or insurer. In the past, some HMOs and PPOs actually failed because consumers were overly wary of limited networks and demanded almost unlimited choices. To attract business, commercial insurance

Hospital Ratings Challenged

The American Hospital Association is lobbying CMS to either improve its five-star hospital rating system (Hospital Compare) or take it off line. The AHA believes the 14-year-old rating system does not accurately portray hospital performance. Critics claim the star ratings, from one to five, are misleading and harmful oversimplifications of how a particular hospital performs. They suggest working with CMS on developing hospital peer groups (teaching, urban, rural, large, small, regional, etc.) for better and fairer comparisons. Currently, larger teaching hospitals that admit the sickest patients, often transferred from other hospitals, tend to fare worse in the current rating system. Page 10

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companies would tout their huge networks of physicians and hospitals, basically guaranteeing the consumer that their physician and their hospital were in the network. The problem is, it is difficult, if not impossible, to effectively contain costs and maximize quality with so many disparate providers. Taking matters into their own hands, employers are aggressively seeking out the most cost-effective physicians and hospitals with the best results. Walmart reports employees spend less time in the hospital, need less expensive follow-up care and avoid unnecessary procedures including surgeries. Walmart’s plan is administered by the Pacific Business Group on Health. In order to lower costs and improve outcomes, consumers must be willing to forego unlimited choices for smaller panels or networks.

Amazon Accepting HSA Cards

As part of its aggressive foray into healthcare, Amazon announced it will be accepting Health Saving Accounts cards for the purchase of medical supplies online. More than half of US employees are enrolled in high deductible, HSA-eligible, plans which means high out-of-pocket expenses. Out-of-pocket spending for healthcare was about $370 billion last year. By offering consumers an affordable and convenient option for medical supplies, Amazon hopes consumers will fund their HSAs and take advantage of the savings. A lot of the confusion with HSAs is over what products are eligible for purchase. Amazon will end the confusion by listing eligible products or items on your screen. HSAs are the

best tool for saving money because of the multiple tax advantages. You contribute per-tax dollars to a tax-free account, paying for eligible items tax free. There is no use or lose it requirement. Unspent dollars earn interest.

the opioid epidemic has worsened.

Primary Care 2.0

No industry is completely immune to cyberattacks. Hackers can breach or attack even the best defenses. If you refuse to pay up, they will destroy your files. For healthcare providers, years of records can be wiped out. There is breach insurance and these companies employ negotiators when a client is breached. Typically, negotiations are done through a third party and your ransom money is converted to bitcoin so it can’t be traced to the clandestine hacker. An ENT practice in Michigan was breached and the ransom was $6,500. In this case, the physicians refused to pay and decided to retire early. The hackers deleted all files, including patient records, appointment schedules, payment info. (The physicians are still faced with penalties for the breach.) Fortunately, their patient records were encrypted. IT experts feel HHS privacy and security standards are way too focused on compliance and penalties for breached providers versus focusing more on the criminal hackers.

It’s been proven that outcomes are better when your care is managed by a personal primary care physician who provides cost effective treatment and preventive services and acts as your quarterback for access to specialists and the healthcare system in general. Unfortunately, with the shortage of primary care physicians, people are seeking more short term, episodic and expensive alternatives like urgent care and emergency departments. Continuity of care is critical to better outcomes and lower costs. Those without a primary care provider or manager are finding that navigating our confusing healthcare system alone is a nightmare. Primary Care “1.0” must be updated to PC “2.0” to accommodate today’s reality. There must be increased incentives like free medical school tuition, higher residency pay and tax breaks for medical students selecting a primary care career. Empowered nurse practitioners and physician assistants, working in tandem with physicians, can help alleviate the shortage and provide increased access to quality care. But the real panacea will be the evolution of telemedicine as an accepted method of delivering coordinated, low cost, high outcome primary care.

An analysis funded by the National Institutes of Health estimated nearly 40 million of us experience severe levels of pain. An estimated 126 million reported some type of pain in the 90 days prior to being surveyed. It is hoped the study will help shape future research and development, target more effective pain relievers and complementary health approaches. The latter refers to non-prescription drug relief from yoga, massage and meditation. The study has attracted more attention as

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

Hackers and Ransom

A Nation in Pain

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

Meet Your Provider

‘Trust Your Gut’ By William S Ferris, DC

n today’s busy world people find it increasingly difficult to obtain the holy grail of a healthy balanced life. We all know we should be taking care of ourselves but the options are endless and the marketplace confusion heightens. Appointments pending, deadlines looming and a hand-held device that never stops “notifying” us. Where do you begin? Balanced life gurus approach you from all angles with a variety of messaging. So many areas to address we’re told as they hint, bark, persuade and email campaign us into submission. The well-intentioned incessant messaging includes spiritual clairvoyance, mental fitness, emotional fortitude and physical optimums all served up on a silver platter and yet most of us are thinking, “Geez can I just get a good night’s sleep?” After 13 years as a board certified Doctor of Chiropractic with specialization in functional medicine you can imagine I deal with musculoskeletal pain on a routine and daily basis with “associated complicating factors”. Let’s start today by focusing on one

of the above areas, which is your physical optimum. With smoke there’s fire. With pain there’s inflammation. Do you want to know one of the major producers of systemic (meaning all over you bodyoh joy!) inflammation? It often starts in your gut. How can we trust our gut to become our friend again and not some mortal enemy the likes of which resemble a leveling up villain in popular teenage video games. One of the simplest, fastest, safest ways to accomplish this is to do a fourpart remedy that you can start today. You can easily begin a home care program or seek out a healthcare provider near you that simplifies the complex interactions of gastrointestinal health into four basic parts: removal, replace, re-inoculate and repair. Step 1: Remove or limit toxins in food and gastric irritants (caffeine, alcohol and non-steroidal anti-inflammatory drugs). Food allergies, sensitivities or reactions chronic low-grade infections in the gut (e.g., yeast and parasites) Step 2: Replace stomach acid (or

stimulate stomach acid with bitters: lemon wedges in your water or apple cider vinegar). You can also add digestive enzymes to your meals for a more complete digestion process such as amylase, protease and lipase. Step 3: Re-inoculate and restore beneficial bacteria to reestablish a healthy balance of “friendly” microflora in the gut. Genus, species and strain become important here. Remember if you want to obtain a guard dog but simply order a “dog you hope a rottweiler shows up not a chihuahua. Simply saying “acidophilus” is too generic. Some excellent examples of indigenous human genus/species/strain probiotics are: L. plantarum HEALx9 and L. paracasei 8700:2, Lactobacillus salivarius UCC118. Step 4: Repair and provide nutrients to heal the gut wall and its lining while supporting the immune functioning of the gut. For example L Glutamine, deglycyrrhizinated licorice and aloe. All of these ingredients can be pieced together commonly at your local over-the-counter health food stores or you can find a reputable healthcare

Dr. Ferris at his Victor office. provider with experience in the four Rs using physician-grade synergist blends to save you time and money. You are what you eat? No, that’s no longer true. You are what you assimilate. The above steps will help you assimilate more nutrition from your diet quieting “the fire” (aka inflammation) while taking a big step forward toward your physical optimum. Think of it as “over seeding your lawn” once a year and you’ll be back on track in no time. Bill Ferris is a Doctor of Chiropractic with specialization in functional medicine. He is the President and Founder of Modern Chiropractic & Pain Relief and New York Weight Loss in Victor. Call 585-398-1201 or visit www.modernchiropractic.com

Modern Chiropractic & Pain Relief and New York Weight Loss 311 W. Main St., Victor n 585-398-1201 n www.modernchiropractic.com matic fraud blocking and suspected spam warnings, and you can manually block unwanted calls. Starting this month, Verizon is offering free spam alerting and call blocking tools to their users. T-Mobile offers free “Scam ID” and “Scam Block” to combat robocalls and spam. And Sprint customers can sign up for its “Premium Caller ID” service for $2.99 per month to guard against robocalls and caller ID spoofers.

Call Blocking Apps

How to Stop Frustrating Robocalls

By Jim Miller

obocalls make up around 50 percent of all phone calls today, and it’s only getting worse. Americans were hit with 26.3 billion robocalls in 2018, a whopping 46 percent increase from the year before. Fortunately, there are a variety of tools available today that can help you greatly reduce them.

If you haven’t already done so, your first step to limiting at least some unwanted calls is to make sure your home and cell phone numbers are registered with the National Do Not Call Registry. While this won’t stop illegal robocalls, it will stop unwanted calls from legitimate for-profit businesses who are trying to sell you something. But be aware that political organizations, charities and survey takers are still permitted

to call you, as are businesses you’ve bought something from or made a payment to in the last 18 months. To sign up, visit DoNotCall.gov or call 888-382-1222.

Home Landline Tools

To stop calls on your home phone set up the “anonymous call rejection” option. This is a free landline-calling feature available from most telephone companies. It lets you screen out calls from callers who have blocked their caller ID information — a favorite tactic of telemarketers. To set it up, you usually have to dial *77 from your landline, though different phone services may have different procedures to set it up. Call your telephone service provider to find out if they offer this feature, and if so, what you need to do to enable it. May 2019 •

Another solution is to sign up for Nomorobo, which is a free service for landline phones but only if you have a VoIP landline carrier. Nomorobo uses a “simultaneous ring” service that detects and blocks robocalls on a black list of known offender numbers. It isn’t 100 percent foolproof, but it is an extra layer of protection. To sign up or see if Nomorobo works with your phone service provider, visit Nomorobo.com.

Cell Phones Tools

To stop unwanted robocalls and texts to your cell phone, ask your carrier about caller ID options that help identify, filter or prevent callers that aren’t legitimate. For example, AT&T provides their subscribers a free app called “AT&T Call Protect” that has auto-

Another way to stop nuisance robocalls on your smartphone is with call blocking apps. These can identify who is calling you and block unwanted calls that show up on a crowd-sourced spam and robocaller lists. Some top call blocking app for iPhones and Androids include Nomorobo (Nomorobo.com), Hiya Caller ID and Spam Blocker (Hiya. com) and Truecaller (Truecaller.com). Nomorobo cost $2 per month, while Truecaller and Hiya apps are free to use, but offer upgraded services for $2 and $3 per month.

Spam Proof Phones

There are also phones you can buy, like the Samsung Galaxy S, Samsung Note, or Google Pixel phone that have built-in spam and robocall protection in place. Samsung’s Smart Call feature flags calls it suspects are spam, while Google Pixel phones have built-in spam call protection. With this feature, users with Caller ID enabled will get a warning if a suspected spam call or robocall is received.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Stroke: Death of TV Actor Confirms Trend

More young people are dying as a result of strokes, according to data By Ernst Lamothe Jr.

he news of TV star Luke Perry’s death hit people hard for many reasons. Some were his long-time fans. Others were just shocked about the speed in which he went from being hospitalized to being dead. Finally, many people just couldn’t believe that someone could die of stroke, especially someone in their 50s (he was 52 when he died). “Strokes are very common, and they are more likely to cause disability than death,” said Mary Dombovy, vice president of neurosciences for Rochester Regional Health. “People have to understand that many of the same risk factors that people have for heart attacks like high blood pressure, high cholesterol, smoking and diabetes are also causes of strokes.” Stroke is the second most common cause of death worldwide, according to the American Stroke Association and there are an estimated 17 million strokes worldwide each year. Stroke is the fifth leading cause of death in the U.S. killing 140,000 people a year. It is also the leading cause of disability among Americans, as it can leave survivors paralyzed or unable to communicate. When a stroke happens, part of the brain is being starved of oxygen because of a blocked blood vessel. The faster hospital officials can un-block that blood vessel, the better chance of limiting the size of the stroke. They can unblock blood vessels in two ways: alteplase tPA or tissue plasminogen activator, which is a clot busting medication that can dissolve the blood clot and restore blood flow to the brain. Some clots are too big to be dissolved, and in this case, a doctor in-

serts a catheter into an artery, snakes it up to the brain and pulls the clot out with a special device that looks like a net. Both of these treatments need to be done very quickly after a stroke starts in order to be effective. “Most people with a stroke will survive, but with lasting effects from the stroke, such as weakness, speech problems, balance problems or cognitive problems,” said. physician Kelly Matmati, director of the stroke program at Rochester General Hospital. Actor Perry was slightly young for a stroke victim, as 66 percent of those who suffer from such an attack are 65 or older, according to the Centers for Disease Control and Prevention. But strokes, which are behind about 5% of U.S. deaths annually, are on the rise among those between 25 and 44. Perry’s father died in his mid-30s from a heart attack. “Stroke can happen at any age, although it becomes more common as we get older,” said Matmati. “This is especially important in people of working age, as it may take them out of the workforce. And in older patients it can mean a loss of independence.” Dombovy said it’s important to understand that people should be hopeful even after their diagnosis. “Having a stroke is not a death sentence,” she said. “People think you would be disabled for the rest of your life and there is no treatment. Number one, we have treatment that can improve your outcome after a stroke. We have treatment that can help people who have trouble using their arms or speaking to keep them independent. It is not the end of your

Actor Luke Perry died recently at age 52. life as you know it. But we do want to stress people that time matters. The last suggestion is keeping in good shape. “You don’t have to be a gym rat even walking 30 minutes a day can

be effective. The better your heart and lungs are the more oxygen they pump into your brain and you will be in better condition to improve.”

Safe Ways to Get Rid of Expired, Unused Medicine By Jim Miller

leaning out the medicine cabinet is a chore that most people don’t think about, but it’s an important task that can help prevent medication problems, and protect children who may have access to these old, unused drugs. Here’s how you can clean out your mother’s medicine cabinet so it’s safe and useful.

Return Them

Your local pharmacy, as well as hospitals, clinics, long-term-care facilities and narcotic treatment programs, might accept your unused medications, often as part of programs that collect and destroy unused drugs. Search for an authorized facility near you at DisposeMyMeds. org. You can also drop off her unused meds at designated police departments, fire stations and other sites on certain dates. To find a collection site near you, visit TakeBackDay.dea.gov.

Use a Disposal Kiosk

Many Walgreens and CVS stores Page 12

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have free, anonymous and secure kiosks where you can dispose of any medication. Remove your personal information from the packaging and drop unwanted medication, including opioids, in the slot.

Mail Them

Costco, Rite Aid and CVS pharmacies sell postage-paid envelopes for customers to mail any prescription, including opioids and over-thecounter medications, to a disposal facility.

Throw Them Out

If mailing them in or getting to one of the drop-off sites is not an option, you can dispose of them yourself, but do so carefully. The Food and Drug Administration recommends taking the medications out of their original bottles and putting them in a sealable plastic bag with an undesirable substance like coffee grounds, dirt or kitty litter. Then seal the plastic bag and throw it in the trash. This will make the medication less appealing to children, pets or

other people who may fish through your trash. But don’t do this with dangerous drugs, such as opioids, which can be abused. For these, the FDA says flushing them down the toilet is OK. But trace amounts of drugs can end up in the water supply so this should be done only as a last resort. To see the FDA list of medications that should be flushed when they are no longer needed, go to FDA.gov and type “flush list” into the search box. Or, another option is to purchase some medication disposal bags like the Medsaway Medication Disposal System. These are carbon pouches that are designed to neutralize all medication including narcotics, liquid medication, transdermal patches and controlled substances so you can just add water, and toss them in the trash. You can find medication disposal bags at some local pharmacies or online at Amazon.com for around $15. You’ll also want to make sure to scratch out all your mom’s personal information on the empty medicine bottles or other packaging before

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

throwing it away to protect her identity and privacy. If you have other questions about proper drug disposal, talk to your pharmacist.

Health Tip: Preventing Falls Among Older Adults

Every 11 seconds, an elderly person is taken to the hospital for a fall-related injury, says the U.S. National Council on Aging. Though the number is staggering, most falls are preventable, the council says. The council encourages elderly people to: • Find a balance and exercise program. • Speak with a health care provider. • Regularly review your medications and note side effects. • Get your vision and hearing checked annually. • Keep your home safe. • Enlist the support of family members.

SmartBites

Helpful tips:

By Anne Palumbo

The skinny on healthy eating

Why We Should Eat More Broccoli

eat a lot of broccoli, probably more than your average Jane. When I was younger, I ate it for the taste. But now that I’m older, I make a concerted effort to eat broccoli for its comprehensive nutrition benefits — benefits, in particular, that help my aging body. Ever since I was diagnosed with osteopenia (low bone mass) a few years ago, I’ve been on a mission to slow further bone loss by eating foods that support bone health. While broccoli doesn’t provide much calcium or any vitamin D, it does provide a phenomenal amount of bone-strengthening vitamin K: over 100% of our daily needs in an average serving. Vitamin K improves bone health by helping our body absorb calcium and by keeping it in our bones. My concerns about cancer have intensified with age, especially since age alone is the No. 1 risk factor.

Aware also that cancer-causing substances are a top risk, I can’t help but shudder every time I recall running behind the DDT mosquito trucks when I was a kid. So I look to broccoli, a cruciferous vegetable, for its high concentration of sulforaphane — a powerful phytonutrient that has demonstrated an ability to prevent cancer or slow its progression in multiple studies. Thinning skin and the resulting tears also plague me, prompting me to consume foods that are high in vitamin C. Did you know that an average serving of broccoli serves up well over 100% of our daily needs? An essential nutrient, vitamin C plays a vital role in the formation of collagen and has even been linked with wrinkle reduction. Plus, this powerful antioxidant, which protects cells from free-radical damage, may also reduce our risk of certain cancers. Dogged by LDL (bad) cholesterol that has risen with age, I also seek foods that provide the kind of fiber that helps whisk cholesterol out of the body: soluble fiber. One cup of cooked broccoli has about 5 grams of fiber, of which more than half is soluble. I’m equally grateful for broccoli’s insoluble fiber, as it helps with digestion and promotes regularity. You know what else buoys me about broccoli? It’s super low in fat, cholesterol, and calories (only 60 per cooked cup!). Now, ready to eat more broccoli?

Choose broccoli heads with tight, deep green florets and firm stalks. The broccoli should feel heavy for its size, and the cut ends should be fresh looking. Avoid broccoli with browning stem ends or yellowing florets. Refrigerate unwashed broccoli in a loose plastic bag and wash just before using.

Broccoli-Cheddar Quiche with Quinoa Crust Serves 6

Crust:

2/3 cup dry quinoa, cooked and chilled 1 large egg, beaten ¼ cup grated Parmesan cheese ¼ teaspoon coarse black pepper Filling: 2 teaspoons olive oil 1 small onion, chopped 2-1/2 cups chopped broccoli florets 2 cloves garlic, minced ½ cup fat-reduced milk 4 large eggs 2 large egg whites ¾ teaspoon kosher salt ¼ teaspoon coarse black pepper ¼ teaspoon crushed red pepper (optional) 1 cup grated fat-reduced cheddar cheese

Preheat oven to 375 F. Lightly oil a 9-inch pie dish. Rinse quinoa in a fine-mesh sieve and transfer to a medium pot. Add 1-1/3 cups water and bring to a boil. Cover, reduce heat to low and simmer until water is absorbed, 15-20 minutes. Set aside off the heat for 5 minutes; uncover, fluff with fork, then chill in fridge for 10 minutes. Combine chilled quinoa, beaten egg, Parmesan cheese and black pepper in a bowl; stir well. Press mixture into bottom and up sides of pie dish. (Dust your hands with flour if mixture starts to stick.) Bake in preheated oven for 20 minutes; cool. In a large sauté pan, heat oil

over medium heat. Add onions and broccoli and cook slowly, stirring frequently until vegetables are soft (about 8-10 minutes). Add garlic and cook 1 minute more. Remove from heat; cool. Combine milk and next 5 ingredients; stir with a whisk. Arrange broccoli mixture over crust; top with grated cheese. Pour egg mixture into the dish and bake at 375 F for 35-40 minutes, until center is set. Let stand 5 minutes; cut into 6 wedges. Note: Prefer no crust? Skip the crust steps and head straight to spreading the broccoli mixture in the lightly oiled pie dish.

Anne Palumbo is a lifestyle colum-

nist, 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.

Foods to Lower Your Cholesterol Count Oat bran, apples, grapes are among foods that experts believe can lower cholesterol

t’s not always possible to lower cholesterol through diet alone — sometimes there’s no way to override your DNA, and medication becomes a must. But certain foods can be part of the plan to improve your numbers, to both lower low-density lipoprotein (LDL) cholesterol, the bad one, and raise your high-density lipoprotein (HDL), the good one. First, choose foods with soluble fiber. Think of this type of fiber as a magnet, drawing cholesterol out of your body. Good sources are oats, oat bran and barley, along with beans, eggplant and okra. When used in recipes, these foods tend to take on the flavors of other ingredients, so be adventurous with recipe planning — and generous with herbs and spices. Apples, grapes, strawberries and citrus

fruits are good choices because of their pectin, a type of soluble fiber. Next, go for foods with polyunsaturated fats. These include vegetable oils like canola, sunflower and safflower,

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as well as fatty fish like salmon, rich with omega-3 fatty acids, and most types of seeds and nuts. Plant-based foods also contain substances called plant sterols and stanols, which

help keep the body from absorbing cholesterol. Particularly good sources are Brussel sprouts, wheat germ and wheat bran, peanuts and almonds, and olive, sesame and canola oils. In terms of foods to limit, talk to your doctor about your unique needs. High-cholesterol foods like shellfish and eggs aren’t as dangerous as once thought. The verdict is still out on the saturated fat found in meat, but some research has found that full-fat yogurt, milk and even cheese may be good for you. The one type of fat to completely avoid is trans fat. The U.S. Food and Drug Administration banned its addition to foods in 2018, but because of extensions granted to some manufacturers, certain items could be on store shelves until January 2021. So keep checking the ingredients on any packaged foods you’re considering.

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Study Shows Dogs Can Accurately Sniff Out Cancer in Blood

ogs have smell receptors 10,000 times more accurate than humans’, making them highly sensitive to odors we can’t perceive. A new study has shown that dogs can use their highly evolved sense of smell to pick out blood samples from people with cancer with almost 97 percent accuracy. The results could lead to new cancer-screening approaches that are inexpensive and accurate without being invasive. “Although there is currently no cure for cancer, early detection offers the best hope of survival,” said Heather Junqueira, who is lead researcher at BioScentDx and performed the study. “A highly sensitive test for detecting cancer could potentially save thousands of lives and change the way the disease is treated.” Junqueira presented this research in April at the American Society for Biochemistry and Molecular Biology annual meeting in Orlando. For the new study, Junqueira and her colleagues used a form of clicker training to teach four beagles to distinguish between normal blood serum and samples from patients with malignant lung cancer. Although one beagle — aptly named Snuggles — was unmotivated to perform, the other three dogs correctly identified lung cancer samples 96.7 percent of the time and normal samples 97.5 percent of the time. “This work is very exciting because it paves the way for further research along two paths, both of which could lead to new cancer-detection tools,” said Junqueira. “One is using canine scent detection as a screening method for cancers, and the other would be to determine the biologic compounds the dogs detect and then design cancer-screening tests based on those compounds.” BioScentDx plans to use canine scent detection to develop a non-invasive way of screening for cancer and other life-threatening diseases. As a next step, the company launched a breast cancer study in November in which participants donate samples of their breath for screening by trained cancer-sniffing dogs. The researchers also plan to separate the samples into their chemical components and present these to the dogs to isolate the substances causing the odor that the dogs detect.

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Mom Nurse Inspires Daughter’s Career By Deborah Jeanne Sergeant

or pediatric nurse Jennifer Dedman, her mom, the late Karen Peters of Batavia, offered the perfect example of what a nurse should be, inspiring Dedman to also become a nurse. “I have always wanted to be a nurse,” she said. “I looked up to her. She was an amazing mom, nurse and role model.” Dedman said that her mother taught at the local community college and at times Dedman could tag along. “I saw her go from working on the floor to supervisor to vice president of nursing at a local hospital,” she said. “I’ve looked up to her for sure.” Dedman moved to Rochester to attend Monroe Community College and start working at Rochester General Hospital on a medical-surgical floor while a student. She shadowed a nurse and learned about various areas of nursing.

“The good thing about nursing is there are so many opportunities,” Dedman said. She found cardiology interesting and gravitated toward that specialty. She stayed on at Rochester General for a time, but found that the shift changes required by hospital nursing wouldn’t fit with her dreams of starting a family with her new husband, Jason. “That’s when I thought, ‘I love kids’ and wanted to be in pediatrics,” Dedman said. “That’s when I found Elmwood Pediatric Group.” Like most doctor’s offices, the Rochester-based practice is open office hours, so Dedman could achieve the work-life balance she wanted. She’s been pleased to work there a decade. “For me, I find kids to be fun,” she said. “Some kids

Pediatric nurse Jennifer Dedman works at Elmwood Pediatric Group in Rochester.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

In 1993, the American Nurses Association declared May 6-12 as the national week to celebrate and elevate the nursing profession. National Nurses Week is a time for everyone — individuals, employers, other health care professionals, community leaders and nurses — to recognize the vast contributions and positive impact of America’s 4 million registered nurses. Each year, the celebration ends on May 12, Florence Nightingale’s birthday. Nightingale, the founder of modern nursing. I’ve seen as newborns and it’s fun seeing them grow through the years. You build a rapport with them and with their parents. The nurses work as a link between patients and parents and doctors. I learn about their medical history and we talk with triage nurses as well.” She also enjoys the advances in the medical field that bring new information she can share with patients. Nursing also brings plenty of challenges. “Like with any job, you have to work well with others and respect who you’re working for,” Dedman said. Pediatrics in particular has its own difficulties at times because it involves treating kids who are sick. “You have to build up that immunity,” Dedman said. “We’re exposed to so many viruses, especially with flu exposure. When we have kids who have symptoms, we may grab a mask or protective equipment, especially with a throat culture.” One of the big changes she has observed since she started nursing is the parental refusal of routine vaccines, such as the combined mumps, measles and rubella vaccine. She said that misleading stories in social media and the news media have played a factor in parents rejecting vaccinations, including refuted theories about correlation between MMR and autism. “Now we’re seeing a measles outbreak, which I’ve never seen before,” she said. “We have a vaccine and it’s important to immunize and keep these diseases at bay.” She added that since measles and other nearly eradicated diseases are now on the rise, her generation of nurses must learn how to recognize them. Nurses are now performing more screenings to help doctors have more time with patients and focus on patient care. “We hand out assessment tools such as for ADHD, depression and more so we can cover everything we need to,” Dedman said. “We work well as a team to try to make their visit as productive as possible. We do a lot of triage behind the scenes to get questions answered and get the patient on the right path.” She advises anyone interested in nursing to complete whatever prerequisites they can before entering the nursing program so they can focus on their studies better. “Once you get into nursing school, do as many shadowing opportunities you can so you can decide where your niche may be,” Dedman said. “You have so many choices sometimes, it takes a bit to find it.” She and her husband and two children enjoy traveling and staying active.

2019

GUIDE INSIDE

How Often Do You Really Need to Replace Your Toothbrush?

Bad Breath

The Fastest Ways to Get Rid of the Problem

Foods That Are Proven to Whiten Your Teeth

SPONSORED BY Emery & Scuro DMD, PC

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Saving Teeth with Endodontic Treatment

Michael S. Mayer DMD

A Quarter of a Century of Smiles! May 2019 •

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he dentists at Emery & Scuro DMD and staff are dedicated to the art and science of modern dentistry. Because of our extensive continuing education commitment and diverse special interests, our three doctors and professional staff can offer complete, comprehensive dental care all under one roof. At Drs. Emery & Scuro, we can treat gum disease by using the latest technology in laser dentistry. With this gum therapy you don’t have to fear as there are no incisions or stiches and your healthy gums are not removed. We also offer many tooth replacement options including implants, and can even place them to be used on existing dentures for a more secure and comfortable fit. Uniquely at our office, we make oral sleep appliances that may be able to replace a CPAP machine. We also can treat teeth needing extractions, root canals, tooth colored fillings, crowns, bridges and braces. Since dental care is such a personal service, we pride ourselves on getting to know our patients personally and their individual needs, so your dental care can be tailored well to your specific situation. We strongly believe that an informed patient is an empowered one. Therefore, we make it a priority to educate our patients on their dental conditions and the proposed possible treatments to remedy them. Your health is our most important product.

Foods That Are Proven to Naturally Whiten Your Teeth

e all know the common (delicious) culprits that stain our pearly whites: Coffee, tea, red wine. But are there any foods or drinks that can actually do the opposite? Believe it or not, the answer is yes. Not only can the right foods and drinks help scrub away stains and make your teeth look brighter, but some can also actually strengthen your chompers from the inside —and make them whiter on the outside. So if you’re curious about how to whiten teeth naturally, here are eight dentist-approved picks to add to your menu.

Plain Yogurt

It’s a double-whammy, dental-wise. Yogurt is rich in calcium, which is essential for keeping your teeth looking healthy and bright. “Calcium-rich foods help strengthen the enamel, the outer layer of teeth that give them their whiteness,” says Timothy Chase, a cosmetic dentist at SmilesNY in Manhattan. It’s also a good source of phosphorus, a mineral that works like a wingman to make calcium’s effects more potent. “While phosphorus doesn’t have a specific whitening ef-

fect, it does help maintain the enamel that gives teeth their outer beauty,” Chase says. Just steer clear of the flavored stuff. Over time, those added sugars can break down tooth enamel, dulling your smile.

Cheese

Like yogurt, it’s rich in the enamel strengtheners calcium and phosphorus. You’ll get the biggest bang for your buck from hard cheeses like cheddar, Gruyere, and Parmesan. Of course, you might not notice as much whitening action if you wash down your cheese plate with a glass of red wine.

Apples

Think of them as nature’s best designer toothbrush. The crunchy texture of apples acts as a gentle abrasive to scrub away the plaque that can leave your teeth looking dull. “The chewing that’s required also promotes the production of saliva, which helps keep plaque from developing. And stains attach to plaque like Velcro,” says periodontist and nutrition expert Sandra Moldovan.

Carrots

Just like apples, carrots’ hard,

crunchy texture can actually help scrub your teeth clean, say Muldovan and Freeman. You’ll want to stick with raw ones, though. Cooked carrots are too soft to deliver much scrubbing action.

Milk

Drink up for stronger bones — and whiter teeth. Milk is another top source of both calcium and phosphorus. Keep in mind that the mineral content goes up as the fat content goes down, so you’ll get the most of both nutrients from skim milk. (A cup of skim milk has 316 mg of calcium and 255 mg of phosphorus, while a cup of whole milk has 276 mg of calcium and 205 mg of phosphorus.)

Celery

Breaking down the crisp, fibrous stalks with your chompers helps scrape away stain-causing plaque and boosts the production of saliva. Crunch away, people. And maybe dip into a little peanut butter while you’re at it.

Strawberries

Not only will they not stain your teeth red, but strawberries may also help make your teeth appear brighter

and whiter. “They contain an enzyme called malic acid that works as a natural astringent to remove surface discoloration,” says Steven Freeman, DDS, owner of Elite Smiles in St. Augustine, Fla. For even more whitening action, try applying mashed strawberries to your teeth like a paste for five minutes then rinsing and brushing as normal, he suggests. One study found that this method can help remove plaque to give it a whiter appearance without actually bleaching the teeth.

Xylitol-Sweetened Gum

OK, so it’s not technically a food. But chewing gum helps your mouth produce more saliva. Why pick one sweetened with xylitol? It’ll help you avoid plaque-promoting added sugars, to start. But even more important, the sugar alcohol has been shown to reduce the formation of plaque, which makes it harder for stains to stick to your teeth. Try cinnamon or spearmint flavors— findings suggest they enhance saliva production more than fruity flavors.

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here is misconception out there that root canals are painful? The fact is that root canal treatment actually relieves pain caused by a tooth that is severely decayed, infected or fractured. Millions of teeth each year are treated and saved with root canal (endodontic) treatment. Dr. Harp Deol and Dr. Tanjit Taggar of Progressive Endodontics are specialists in saving teeth and solely provide endodontic care using state-of-the-art technology. When a tooth becomes badly diseased or infected, simply removing it can lead to another set of oral health problems altogether. Root canal treatment can save the tooth and, with the latest dental advances available in local anesthetics, most patients have little to no discomfort with treatment. “If the alternative is just having your tooth extracted with no replacement, then this procedure can definitely save your natural tooth,” adds Dr. Deol. Endodontists are dental specialists with specialized training beyond dental school. With modern technologies and advanced anesthetic techniques, endodontic treatment can often be completed in a single-visit. Progressive Endodontics also offers oral conscious and nitrous oxide sedation to supplement local anesthesia to help patients to feel calm and relaxed in the dental chair—making their visit to the dentist seem like a dream.

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How Often Do You Really Need to Replace Your Toothbrush?

hanks to constant reminders from dentists, we know the golden rule when it comes to keeping our pearly whites in tip-top shape: Brush twice a day for two minutes and floss once. But all of that time spent brushing might be a waste if you’re using an old toothbrush. “If the bristles are splayed or frayed, they won’t be pointing in the same direction, and they’re not as effective at cleaning your teeth,” explains Matt Messina, a dentist and spokesperson for the American Dental Association. Worn bristles mean that even a good brush could miss plaque and debris, Messina says. So most dentists recommend replacing your toothbrush every three months or before wear and tear becomes noticeable. And yes, these guidelines also apply to replacing the heads of

electric toothbrushes Remembering to replace your toothbrush is easy, even if you don’t have superhuman memory. When you open a new brush, do some quick math, and write the date you need to bid it adieu at the bottom of your toothbrush in permanent marker. One more thing: We don’t need to lose sleep over bacteria accumulating on the bristles of our toothbrush, which means there’s no need to chuck our brush every time we get sick, Messina says. “Bacteria in the mouth can’t survive a dry environment. So you don’t need to go to extreme measures to sterilize your brush.” Just make sure you rinse it after every use and store it with the bristles facing up in a convenient place where it can air-dry.

— chemical compounds found in black and green tea — can prevent the growth of the bacteria that causes bad breath. Bring on tea time!

4. Apples

at Tel Aviv University found that regular coffee can stop bad breath in its tracks. Coffee leaves most people a little dehydrated, so make sure to steer clear of milk or creamer, which can be pungent in a dry mouth.

5. Coffee

How many times have you ordered a dish that’s loaded with garlic, only to realize you’ve run out of gum? Talk about a mood killer. If you’re in a pinch, chew on the parsley that’s garnishing your meal. A recent study found certain enzymes in parsley helped to neutralize garlic breath.

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The Fastest Ways to Get Rid of Bad Breath (When You Don’t Have Gum)

ven if you steer clear of the garlic bread and booze, bad breath can sneak up on you. And anyone who’s ever been caught before a big meeting or a date without an emergency mint or trusty stick of gum knows it can be a big issue. To neutralize these smelly situations, you have to know what causes them. Most of the time, we can blame bacteria — the kind that naturally occurs in our mouths — says Sunil Wadhwa, associate professor of dental medicine and director of orthodontics at Columbia University. Brushing your teeth regularly is the best defense, but Wadhwa says many people forget to brush two major bacteria breeding grounds: their gums and tongue. If you’re practicing good dental hygiene and still experiencing rank breath, you may be dealing with a bigger issue like post-nasal drip or a sinus infection. But before you call your own dentist in a panic, experts advise using a tongue scraper to be sure you’re getting at the source of the stinky stuff. Of course, sometimes despite our regular brushing regimen, we still get caught with funky breath. Here’s what you should reach for to stifle the stank.

1. Water

When you’re really in a pinch, grab a glass of water. The bacteria in our mouths naturally releases a foul gas as it goes about its job of keeping our bodies healthy and balanced. “The saliva in your mouth actually prevents the release of gas,” Wadhwa says. “So anytime you have a dry mouth, more of the gas is released.” Stay hydrated to keep your salivary glands happy.

2. Carrots or Celery

Next time you’re stuck at cocktail party sans breath fresheners, reach for the crudités. Watery veggies, like carrots and celery, can act like a toothbrush substitute by clearing your mouth of food debris before they start to create a stench. Their real power, though, is in in the stimulation of saliva production. “A lot of things we think cure bad breath are really just increasing your saliva, which helps,” Wadhwa says.

3. Tea

In addition to helping with the dry mouth issue, tea has some other breath-boosting properties. Scientists have found that polyphenols

Before you head into your next meeting, grab an apple from the office break room. Apples contain oxidized polyphenols, which help to neutralize the odor produced by bacteria in your mouth. Bonus: Biting into the firm texture of the apple helps to scrub bacteria off of your teeth too. But only if it’s black. Researchers

6. Parsley

Golden Years

Medical Marijuana: A Boon for Older Adults? By Deborah Jeanne Sergeant

he incidence of pain affecting older adults is widespread: half of this population who live independently and about 80% of those who live in long-term care facilities suffer from chronic pain, according to the National Institutes of Health. As medical marijuana gains traction across the US, should older adults seek its use? That depends upon whom one asks. Physician Az Tahir, who practices holistic integrative medicine at Internal Medicine Internal Care in Henrietta, said that many of his older patients have “reported beneficial effects of medical marijuana and canabidoil.” To take medical marijuana, patients must have physician approval to obtain it at a legal dispensary. Canabidoil, also known as CBD, is a supplement from the hemp plant which contains only minute traces of THC, the compound inherent to marijuana that causes hallucinogenic effects. It’s available over the counter since it’s a supplement and therefore not regulated by the Food & Drug

Administration. “A lot of chronic pain patients had spoken about this,” Tahir said. “It’s very, very beneficial. I don’t see much risk involved with CBD or medical marijuana for chronic pain.” He added that conferring with a doctor about taking either is a good idea to avoid any negative prescription interactions. For a generation that took recreational marijuana, taking prescribed marijuana may seem a more natural course than conventional pain medication; however, Stephen Ryan, geriatrician with ElderONE, an affiliate of Rochester General Health System, cautioned that “there’s not much published medical literature on its effectiveness. It’s as much political and social as it is medical.” If medical marijuana isn’t smoked but taken orally or topically, the experience may be quite different for those who experimented with it recreationally in the past, since its effects take more time to begin and last longer. “Those colleagues who write medical marijuana prescriptions say

of their patients who had a positive recreational experience in the past, half didn’t have a positive experience with medical marijuana,” Ryan said. Part of that may be because medical marijuana is more of a nutraceutical containing many different compounds than a lab-derived pain medication. Consistency in the product can be hard to achieve. “It may be different from what they’ll have from a month from now because they’re plants, not chemistry,” Ryan said. The age of the patients involved also can make a difference. In their 20s, their faster moving metabolism handled marijuana differently than now, when a slower metabolism, other medication and age-related disease processes can impact how marijuana affects the body. “It could cause medication to build up in the system,” Ryan said. “It becomes more complicated. Medical marijuana isn’t one substance; it might be 10 in that preparation.” According to Ryan, who said that only a handful of physicians in the area prescribe it, medical marijuana

isn’t their first choice — and they aren’t outspoken in their ability to prescribe it because of the stigma surrounding the drug. “They are willing to try it when they’ve tried other traditional medical modalities and are more likely to try if they feel the person’s in the middle of a transition and they’re approaching the end of chemotherapy or the end of their life,” Ryan said. He said that further research could help physicians know whether medical marijuana could help older adults; however, like any medication, it’s a tough age group to study because most have several health conditions and other prescriptions. Long-term studies are difficult because their health status can change over the years, which complicates the study.

Second New MS Drug Secures FDA Approval T he U.S. Food and Drug Administration has approved another new multiple sclerosis drug the second in one week. Mavenclad (cladribine) pills can be used to treat relapsing forms of MS in adults, including relapsing-remitting disease and active secondary progressive disease. The drug is not recommended for MS patients with a course of the disease known as clinically isolated syndrome. Due to safety concerns, Mavenclad is generally recommended for patients who have not responded to or can’t tolerate other MS drugs, the FDA said. The drug is from EMD Serono, Inc. “The approval of Mavenclad rep-

resents an additional option for patients who have tried another treatment without success,” physician Billy Dunn said in an agency news release. Dunn is director of neurology products in the FDA’s Center for Drug Evaluation and Research. Earlier in April, the FDA approved Mayzent (siponimod) pills, also for relapsing forms of MS. Patients with relapsing MS have periods of worsening symptoms followed by recovery periods. The Mavenclad trial involved more than 1,300 patients with relapsing forms of MS who had at least one relapse in the previous 12 months. Those who took Mavenclad had a

significant decrease in the number of relapses and slower progression to disability, according to the FDA. But Mavenclad has a boxed warning for an increased risk of cancer and fetal harm. The drug should not be used in patients with current cancer. In patients who’ve had cancer or have an increased risk of cancer, doctors should weigh the benefits and risks of Mavenclad, the FDA said. Because of the potential for fetal harm, Mavenclad should be avoided in pregnancy. And it should not be taken by women and men who do not plan to use effective contraception during treatment or for six months after treatment ends. If

a woman becomes pregnant, she should stop taking Mavenclad, the FDA noted. Other warnings include the risk of decreased white blood cell counts, increased risk of infections, and liver injury. The most common side effects among patients taking the drug were upper respiratory tract infections, headache and a decrease in white blood cells. MS is an autoimmune disorder targeting the central nervous system. It is one of the most common causes of neurological disability in young adults. It occurs more often in women than in men.

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May 2019 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Golden Years

Elder Abuse On the Rise in America CDC: Family members commit most of the violence

s the American population ages, elder abuse rates are increasing, particularly among men, federal health officials reported in April. Between 2002 and 2016, the rate of assaults among men 60 and older jumped 75%, while it rose 35% among women between 2007 and 2016. Among older men, the homicide rate increased 7% between 2010 and 2016, according to the U.S. Centers for Disease Control and Prevention. “We are still examining the circumstances that appear to be associated with the increase in violence against this age demographic,” said lead researcher Joseph Logan, from the CDC’s National Center for Injury Prevention and Control. “We have identified that many of the assailants were known to the victims and in a position of trust,” Logan noted. Physician Ronan Factora, chairman of the Special Interest Group on Elder Abuse and Mistreatment at the American Geriatrics Society, thinks the problem is probably even worse than the report suggests. “These data underestimate the extent of elder abuse in America,” he said. “We probably underestimate the amount of physical violence, because this study only used records from emergency departments.” Many more cases of abuse were

probably seen by private doctors or not reported at all, said Factora, who had no part in the study. “This is really a small fraction that represents a larger problem that has been growing,” he added. The biggest issue is that most elder abuse isn’t recognized, Factora said. That’s because there isn’t a standard way to screen for it or recognize it. Factora believes, however, that elder abuse is gaining more visibility, which may be part of why it’s seen as increasing. “As the years have gone by, elder abuse has become more highlighted and thus better detected,” he said. “But the increase is not just a demographic issue.” Factora said that much of the abuse among people who are physically or mentally impaired is perpetrated by caregivers who are stressed out by the demands of caring for a loved one. Still, “abuse can have lasting effects that aren’t reversible after a certain point,” he said. “People who need help with transportation, finances and medication put a lot of burden on caregivers,” Factora said. According to the CDC report, it’s family members who commit most of the violence. “A lot of this

is because of the demands placed on them for care, which really puts a stress on them,” Factora said. Unfortunately, many seniors are in jeopardy because of their physical or mental condition, and can’t defend themselves, he said. Abuse is really related to dependency, Factora explained. Help in finding ways to cope with the burden of caring for someone is available. Perhaps if more people took advantage of programs for family caregivers, a lot of elder abuse could be stopped before it starts, he suggested. “The resources are there. The problem is connecting the caregivers who are burned out with the resources that can help them,” Factora said. The best way to deal with elder abuse is through awareness of all its forms. This study deals with physical abuse and murder, he pointed out, but abuse also includes neglect and financial exploitation. Often a person is the victim of several kinds of abuse. Someone who is physically abused can also be neglected

Nearly 400 Cases of Abuse Registered in Monroe County Experts say only one in 24 cases are usually reported

lder abuse is more prevalent vides in-home services to older in Rochester than many peo- adults. Kostiw is a certified trainer By Deborah Jeanne Sergeant ple may realize. According to for the Alzheimer’s Association. Her the NYS Committee for the Coordi- late mother, while in her 80s, suffered nation of Police Services to the El- physical and financial abuse and nederly 2014 Annual Report, Monroe glect from another family member. County had 373 cases of domestic Unfortunately, Kostiw hears this kind abuse committed against those 65 of story often. and older. Ontario County had 34 “Almost every person I talk with cases of elderly abuse while Wayne about what I went through with my County had 39 cases. mom has a story about someone The report further determined who’s been abused,” she said. “It’s a that only one in 24 cases of elder huge, huge problem.” physical abuse in the community Kostiw said that family members is ever reported to authorities, in- commit most of the violence against dicating the problem is far more senior persons, with only 14 percent widespread. caused by paid aides at home or in a The report provides the most facility. recent local information available. She said that holds true locally Debra Kostiw owns Home as well, whether it stems from drug Helpers in Rochester, which pro- abuse, history of violence or lack of

Page 20

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information. Some caregiving situations may begin well, but deteriorate. “They are just completely overwhelmed and uneducated about the caregiving process,” Kostiw said. “They’re so frustrated and at their wit’s ends and don’t know they need to seek help.” Another factor lies in the physical and mental health needs of the elder declining with age. Their growing needs may exceed their caregiver’s capacity to provide care. According to Kostiw, many prosecutors don’t want to take elder abuse cases because they’re difficult to win and they don’t understand how to communicate with seniors who may have cognitive disabilities. Kostiw offers free training to help law enforcement, attorneys and case

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

and financially exploited. Factora believes that if you see or suspect someone is a victim of elder abuse, you should report it to adult protective services. “We need to find these cases, and once we find how big this epidemic is, that may be a push to identify the abuse we don’t see,” he said. “What we are seeing is the tip of the iceberg.” For the study, researchers used data from the U.S. National Electronic Injury Surveillance System -- All Injury Program and National Vital Statistics System to look for trends in assaults and murders among men and women aged 60 and older. The report was published April 5 in the CDC’s Morbidity and Mortality Weekly Report.

For help, call: • LIFESPAN’S Elder Abuse Prevention Program 1-800-454-5030 • Monroe County Department of Human Services Adult Protective Services 585 753-6532 • New York State Office for the Aging Information Line 1-800-342-9871 • New York State Crime Victims Hotline 1-800-771-7755 managers to better understand how to communicate effectively with elderly victims. She feels strongly that if more cases are prosecuted, the statistics on elder abuse can decrease. By Deborah Jeanne Sergeant

R-E-S-P-I-T-E Caregivers urged to get frequent breaks to avoid burnout By Deborah Jeanne Sergeant

f you care for an elderly loved one at home, particularly one with memory issues, you should consider respite care. Liz Sheen, clinical team manager at UR Medicine Home Care in Webster, said that respite helps caregivers not feel like they have to be on duty all the time. “They need to recharge their batteries to be at their best for their loved one,” she said. “As caregivers become stressed, that turns into compassion fatigue, which leads to burnout. What I’ve seen is burnout leads to resentment and withdrawal. We’ve seen it spiral out of control and lead to abuse and more tragic outcomes. Respite is not a luxury; it’s a necessity.” Sheen also encourages caregivers to take care of themselves by getting proper rest, nutrition, exercise and medical care. She added that ignoring these needs also leads to burnout. Eve Moses, caregiver coordinator for Monroe County Caregiver Re source Center and Caregiver Respite Program, said that many caregivers feel guilty about leaving their loved one in someone else’s care. “I remind them that they’re doing Moses the best they can and they’re in unchartered territory for the most part,” Moses said.

“It’s very difficult.” Moses’ organization offers a six-week class to help address the emotions that surround caregivers, as well as to inform participants about the resources available. Among these are respite services, which may be offered at a day program, at home for short-term or long-term periods, or at nursing homes for long-term, such as for a vacation. The types of care for the elderly can include companion care, where meal preparation may be provided, but no personal care. The next level is a personal aide who might help with chores like bathing or toileting and reminders to take medication. The highest level of care is medical care, which includes assistance with taking medication. “We will often remind them that if they take care of themselves, they will be better caregivers,” Moses said. “They may know they need to get away for pleasure, but unless it’s a major even like a wedding, they often won’t do that. They don’t call it respite when they need to go into surgery. They know they need someone to help out and they call it ‘someone helping out.’” Changing the mindset about respite involves helping caregivers realize that respite is both good for them and their loved one. Many frail, elderly adults can’t get out much. Seeing a fresh face or visiting a senior center with activities can provide a pleasant diversion from chronic pain and boredom. “I know from experience one of the first things a person hears after

Golden Years

a diagnosis from a neurologist is to stay engaged,” said Jessie Gyr, respite coordinator for Finger Lakes Caregiver Institute. “Respite can really keep someone engaged for longer, which is so, so important.” The institute is provided through Lifespan of Greater Rochester and the Alzheimer’s Association Gyr recommended starting respite sooner than later to prevent caregiver burnout. Care doesn’t have to be expensive. When trusted neighbors, friends or family members ask what they can do to help, see Gyr if they can sit with your loved one for a few hours once or twice a month. Enlisting several helpers can offer you regular time away. Church or civic organizations may provide respite by either visiting homes or providing a day program to help keep costs down. Many of these receive funding and training from organizations like the Alzheimer’s Association but are all-volunteer run. Paid services can also help provide respite. “There’s sometimes the perception that there’s not reliable help out there or that no one can do what they do,” said Mark McDermott, owner of Touching Hearts at Home in Rochester. “But there is a lot of reliable help.” Organizations perform thorough vetting and screening of applicants and train employees. Professional caregiving facilities can include senior centers, which typically don’t provide personal care, senior daycare, which may provide personal care, and medical day care. McDermott said that initially, most caregivers seeking his organization to provide re-

spite do so for a special occasion, but eventually incorporate it into their regular routine, such as a full morning and afternoon weekly so they can run errands and get out socially. “Regular scheduling allows the provider of respite to become a familiar face,” McDermott said. “We can assign the same person to be there week after week and that builds trust. Most of us in general like predictability with critical routines.” Respite workers can also come overnight so caregivers can sleep better. Veterans enrolled for benefits can receive in-home care or up to 30 days per year at the Community Living Center and Nursing Home in Canandaigua. “These day programs are really very helpful to caregivers,” said Janice Putrino, caregiver support coordinator and certified case manager for the VA in Canandaigua. “We have contracts with agencies the area and do our own program at the VA five days a week.” The VA provides a caregiver support line and hosts special events in the community to help caregivers. The organization also counsels caregivers about the help available in the community and “encourages people to look at every resource out there and use whatever supports they have,” Putrino said. To locate respite services near you, contact New York Connects and at 800-342-9871 or www.nyconnects. ny.gov.

Only 40% Adults in Upstate Have a Health Care Proxy Most are aware of the importance of the document but less than half have completed it

early nine out of 10 Upstate New York adults are aware of the term, “health care proxy,” according to a survey commissioned by Excellus BlueCross BlueShield. Among respondents who had heard the term, 89 percent know that it is a way to legally designate someone as your health care agent to represent you during a medical crisis if you can’t speak for yourself. Despite high awareness and knowledge of the health care proxy term, the survey also revealed that only about four out of 10 Upstate New York adults have completed a health care proxy form to designate a spokesperson who will represent them if they can’t represent them-

selves. “That’s disappointing because so many people have had the experience of making gut-wrenching medical decisions for loved ones who were unable to communicate,” said geriatrician Patricia Bomba, vice president of geriatrics at Excellus BCBS. According to Bomba, advance care planning can make those decisions easier. “Conversations change lives. It always seems too early, until it’s too late,” she said. ”Advance care planning lets you authorize someone you trust to make your health care decisions if or when you can’t make them yourself.” Excellus BCBS encourages all May 2019 •

adults aged 18 and older to start conversations with their health care providers and then extend them to family members and trusted friends. The goal is for all adults to have conversations and complete a health care proxy to choose and formally name a health care agent who is aware of their values, beliefs and goals for care and treatment and is willing to speak on their behalf. “It’s not just for older adults or for people with a serious illness,” said Bomba. “Anyone can suddenly lose the ability to make his or her own medical decisions about the treatment they wish to receive, and what they would like to avoid.” Bomba breaks advance care plan-

ning down into five easy steps: 1. Learn about advance directives (New York state health care proxy and living will). 2. Remove barriers to completing advance directives 3. Motivate yourself by watching testimonial videos at CompassionAndSupport.org 4. Complete your health care proxy and living will. Talk to your family and physician or nurse practitioner about what matters to you 5. Periodically review and update your advance directives. Excellus BCBS led the development of a free community website, CompassionAndSupport.org, that includes information on advance care planning, free downloadable forms and instructional videos. To start your own conversations, download the infographic, Who Will Speak for You? at https://bit. ly/2XRpeni.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 21

End-of-Life Plans

Baby boomers reflect the ‘I did it my way’ anthem of their generation even in funeral pre-planning By Deborah Jeanne Sergeant

ewer people are choosing the traditional embalming and casket burial in a cemetery, according to the area’s funeral industry experts. Though still a popular option, other choices are becoming more common. For some, it’s all about personalizing the experience as a fitting tribute. Others want to reflect their culture of origin. Still others want

their body to benefit mankind or the environment. Baby boomers reflect the “I did it my way” anthem of their generation even in funeral pre-planning. Whether their ashes become lab-created diamonds, are shot into space in a rocket, or scattered at their favorite fishing spot, it’s all about tying their memorial into something that no one will forget.

“People have a brand-new concept of what to do once someone passes,” said JudieLynn McAvinney, president and CEO of White Haven Memorial Park in Pittsford. Her business provides a parklike setting with a fountain, green burial section and the option to “reconnect with nature for the burial of cremains,” she added. “Cremains” is industry-speak for

cremated remains. The property is Audubon Society-registered and passersby often hike through the area. The green burial area grows wildflowers and native grasses. A flat marker may indicate the grave, or the family may opt to receive GPS coordinates to find it. Nate Romagnola, vice president at White Haven, explained that the green burial has to do with avoiding chemicals and using natural methods, which could include a biodegradable casket, such as wicker, or using a simple shroud. He said the tradition with embalming began around Civil War times, when bodies had to travel long distances before burial. Going green hearkens back to earlier and simpler times when the deceased were buried and allowed to return to the earth. Romagnola said that White Haven has sold more than 300 of its 400 spaces in the green burial area. The green burial also saves the family money, since they don’t have to buy a concrete vault, casket and headstone. Though there’s no viewing, families can still have a service or calling hours at the chapel as long as it’s within a day or two of the death. In recent years, cremation has outpaced burial. Romagnola and McAvinney agree that cost is a big factor, but personalization represents another important factor. “We make sure they’re remembered in a way that they wanted to be remembered,” Romagnola said. Instead of keeping cremains in a purchased ceramic urn on the shelf, some ask for a biodegradable container or make their own. Romagnola has seen a motorcycle helmet turned into an urn, for example. Those

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

asking for biodegradable urns often choose to bury them and plant a tree or bush on top of it. The demand for flowers at White Haven grew so much that the business started a greenhouse to supply the park’s flowerbeds. “We’re a celebration of life,” McAvinney said. “A lot of people are stunned as to how un-cemetery like we are.” For people who want a green burial but cannot conduct the funeral within two days, green embalming fluids can lengthen the time, according to David Crawford, owner of Crawford Funeral Home, Inc. in Rochester. “They’re formulated with natural elements that delay decomposition for about five to six days, which permits open casket viewing and people can come in plenty of time,” Crawford said. “It’s a nice option for some people.” He said that those who opt for green burial should ensure their plot accepts this choice, since conventional plots require casket vaults, for example. Another trend Crawford has observed is departure from a traditional funeral service to more of a family gathering at a place the deceased enjoyed, such as the family’s camp or restaurant. “It’s more about remembering the person and how their life was lived,” Crawford said. “Everyone has different rites and ceremonies that are meaningful to them.” Keeping a bit of their loved one with them helps some families cope. Crawford said that some families have jewelry made from the cremains, such as diamonds (www.lifeGem.com, www.heart-in-diamond. com and www.lonite.com are three

such vendors). The process can take months to complete, but processors use only a small amount of hair or ashes for lab-created gems. For scattering cremains, Crawford recommends doing so on private land, as some municipalities have statutes against the practice, since it has been abused in the past. “Do it at a private time so it has meaning as a family,” Crawford said. “They should not do it at county parks or public property. Choose a private place like a family camp.” Some people choose to leave their body as a means of helping others. While indicating organ donation on the driver’s license is a simple way to leave a legacy, donating one’s entire body to scientific study can help medical schools train the next generation of physicians. Anatomical gifts are accepted only from those 18 and older and those of sound mind. The only disqualifying conditions include infectious or contagious disease, obesity and autopsy. The whole body must be surrendered, with the exception of the eyes if they are donated separately. Sixteen medical schools in New York maintain a donor program, including University of Rochester Medical Center. In addition to pre-registering, their loved ones know about their choice so the medical school is made aware of the donor’s death right away. Bodies must be accepted within 24 hours. Bodies remain with the medical school for about two years, after which time they’re cremated at the school’s expense. The cremains may be returned to the family or buried, if they wish.

May 2019 •

Should You Consider Cremation?

cott Meeson, owner of Rochester Cremation, in Rochester, offered a few reasons why people should opt for cremation: • “It’s much more affordable. When people go to a traditional funeral home for a simple cremation, they pay 70% more because the overhead is larger. We charge $985 for cremation without a viewing and service. Funeral homes may charge as much as $3,500 to $4,000 for a simple cremation. With a service and viewing, we charge about $1,300 and with a traditional service followed by cremation, it’s up to $3,000, including a rental casket. If you go with a regular funeral home’s embalming, service, casket and burial, it can be $10,000. Look around at different options.” • You can keep it simple. “I think

people have a generalized idea that planning at a traditional funeral home is complex and people want to keep it simple. Some people don’t want a funeral director to tell them what to do.” • You still have many options. Meeson said that when he receives a call from a client’s family, his company receives the body, meets with the family or makes arrangements online, and, with the family’s input and the deceased’s stated wishes, plans a simple cremation, private viewing, or cremation to follow a traditional funeral service or less-than-traditional memorial. “We use outside facilities for our public services like country clubs, hotels and parks,” Meeson said. “We try to keep the traditional funeral home out of the equation.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 23

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Caregiver Relief Nonprofit Healing Hands for Helping Hearts offers massage relief to those giving care to loved ones By Rebecca Leclair

magine taking care of a brain-injured, quadriplegic child with no ability to speak. Performing endless tasks like feeding, bathing and physical stimulation — round the clock, as the child grows into a man. Being a constant caregiver — that was Lauren Hider’s life for more than two decades after her 4-year old son, Daniel, was hit by a car. She remained a primary caregiver until he died last August at the age of 30. “It was pretty heartbreaking. We never gave up hope, but we also knew he would never get better — only incrementally worse. My life was pretty narrow,” said the mother of three from Fairport. As the years progressed and Daniel’s health declined, Hider also needed to give more attention to her aging parents. They still lived in their home but neither could drive any longer. Then her father had a stroke. “My dad had been taking care of my mother who has dementia. He could no longer function in that role. They needed groceries. They needed meals. They needed to be driven to doctor’s appointments. I guess you could say the past seven years of my life have been crazy,” said Hider. Healthcare professionals would label what Lauren Hider was experiencing as “caregiver stress.” In general, the signs and symptoms include feeling overwhelmed, feeling tired most of the time, losing interest in activities you enjoy, becoming easily irritated, being worried or sad, having headaches or body aches, plus gaining or losing a lot of weight. Luckily, Hider was leading yoga classes, so she was able to stay fit but she still experienced aches and pains and felt isolated and exhausted. Deborah Aylward of Webster says she’s experienced the whole range of those symptoms while caring for her 81-year-old husband. She helped him through throat cancer in 2017. More recently, he was diagnosed with vascular dementia. “You are basically housebound. You can’t leave a person with dementia alone. They might wander. You are worried they will leave the stove on. The constant fear saps your energy and you never get to focus on yourself,” said the retired psychiatric nurse. Recently, both women have been able to connect with the organization called Healing Hands for Helping Hearts. It operates out of the Wellness Center Fairport at 29 Pleasant St. in Fairport. The owner, Linda Demme, created the nonprofit to provide discounted massage to people who serve as caregivers. Demme is the director of Wellness Center Fairport and founder of Healing Hands for Helping Hearts. She is a registered nurse and licensed massage therapist. She is also certified in oncology massage and manual lymphatic drainage focusing on women with a history of breast

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

cancer. “Caregivers are terrible about taking care of themselves,” Demme says. “They bear the weight of the world on their shoulders. Many need true pain relief because of the physical nature of taking care of someone who is bed-ridden or who is not very mobile. Getting a massage can really help the caregiver stay healthy.” Massage typically involves soft-tissue manipulation techniques and touch therapies that are intended to relieve tension, reduce stress and fatigue while improving circulation. Both Hider and Aylward knew they would benefit from getting a massage, but admit it was hard to schedule time for themselves. “You just have to decide to make the appointment,” said Hider. “I’m a licensed massage therapist myself and would tell people how great massage is at reducing stress. However, it took this program to really get me focused on my needs. Now, my husband is taking advantage of Healing Hands, too.” Aylward describes the program as a godsend. “It has given me a way to forget about my troubles for an hour—to just let things go. When the massage is over, I feel like a new person because I can actually ‘feel’ my body again.” Healing Hands for Helping Hearts is ready to take on more caregivers. Those interested in the discounted massage ($30 an hour) must fill out an application. Demme then assigns a participating therapist to meet the caregiver’s physical and emotional needs. “Personally, I offer traditional massage for stress reduction but we also have a therapist who specializes in injuries. We just teamed up with a massage therapist who offers grief massage, so there really is a range,” said Demme. Caregivers can receive services for up to six months after their loved one dies. Demme is looking for more massage therapists to join her nonprofit and is seeking grants and sponsors to pay the therapists fees and underwrite expenses. For more information or to schedule a massage, visit www. wellnesscenterfairport.com or call 585-797-5752.

self up to receive warmth, love and support, then simply cross your arms around your shoulders and give yourself a hug. Cross your arms until you feel the muscles in the upper back gentle stretch and start relieving some of that built up tension. After all, we do tend to carry a lot of stress in the upper back and neck. Bonus, hugs help to relieve stress and improve moods.

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It is as simple as laughing. It decreases cortisol levels and improves moods. A simple way to watch a funny clip or even more simple, record a baby’s laughter and listen to it. That sound of pure joy and wonder can bring a smile back to your face and do wonders for your mood. Lastly, practice stopping and breathing. Four counts in, hold for four and release for four. Do this about four times and feel the stress slowly ebb away.

Eudene Harry is the medical director for Oasis Wellness and Rejuvenation Center in Orlando, a wellness practice devoted to integrative holistic care. She is a veteran physician with more than 20 years of experience. She earned her medical degree and performed her residency at Thomas Jefferson University in Philadelphia. Her most recent book, “Be Iconic: How to be Healthy and Sexy at Any Age” is now available on Amazon. She regularly contributes to television and radio shows nationwide.

Tips to Get Through Your Midday Slump By Eudene Harry, MD

e have all felt it. After lunchtime, you’re lethargic, tired and constantly checking the clock waiting for the day to be over. But fear not! Your day will no longer be ruined by the afternoon lull. Here are some quick tips to avoid the midday slump and allow you to end your day rejuvenated!

tion? Take a break and take out the adult coloring book you have not taken the time to use. This distraction gives the brain the space it needs to tackle the problem while you focus on the joys of choosing the colors that make you feel better. Pro tip: Choose yellow and other bright colors if you need a pick me up.

Spend Five Minutes in Nature

Incorporate Natural Mid-Afternoon Boosts

According to a study published in the Journal of Positive Psychology in 2019, just five minutes sitting in nature improves moods, decreases negative feelings and increases your sense of being awe and wonder at being a part of something bigger than yourself. If you have more time, combine being in nature with exercise. This can include hiking of simply taking a walk through the park lined with trees. This can reduce your heart rate and improve your ability to recover from stressful events.

Bring the Outdoors In Feeling overwhelmed and can’t leave the building? Hang paintings of nature scenes on the walls, look out a window or a nature scene on your video device. It seems that even the picture of nature had the potential to reduce feelings of stress.

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Grab some green tea, it is high in antioxidants, contains a small amount of caffeine and also has an ingredient that can help create a sense of calmness. If you combine this with a little aromatherapy, either peppermint or lemon to quick lift or lavender to keep the calm going, you might find yourself feeling better after a quick 10-minute break.

Quick Exercises to Do at Your Desk Here are two quick exercises that helps to release stress, restore a sense of calm while improving moods. Do any exercise that helps bring the heart rate up a little bit to get blood pumping while also releasing the energy of frustration. First, do some quick tricep extensions using a chair. Then follow with a stretch that helps to relieve the tension. Shrug shoulders up to ear and gentle rotate forward then backward. Follow this with an open stance arms open wide and slightly raised as if to open myMay 2019 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 25

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Golden Years

Things You Need to Know About Hearing Loss By Ernst Lamothe Jr.

osing your hearing can be a scary experience. The unknown or panic of decreasing hearing ability can send many people into depression or nervousness and even cause them to withdraw from important social interactions. Hearing loss can be so gradual that many people don’t notice the effects until it is too late. Hearing is one of the five senses, which is a complex process of picking up sound and attaching meaning to it. There are many things about hearing and hearing loss that people don’t know and hearing specialists are available to help people navigate all the complexity involving the issue, which can reduce many of their fears and concerns. “Hearing is one of our essential senses and the ability to hear well is important to our environment and quality of life,” said Gregory Horton, audiologist at the Rochester Hearing and Speech Center. Horton highlights five things people should know about hearing and hearing loss.

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Seek out routine check ups People tend to go to their primary care doctors for regular check-ups but that doesn’t always happen when it comes to visiting an audiologist. “You have to stay ahead of the curve and understand everything you need to know about your hearing health,” said Horton. “Changes could be happening because hearing loss tends to be gradual. Early detection is the key.”

Avoid using cotton swabs or excessively cleaning your ear canals. Our parent used to say “Don’t put anything in your ear smaller than your elbow!” Those little puffy cotton swabs that you may burrow into your ear canal to clean your ears are not as harmless as you think. While we think we are doing our ears a favor, using them to clean our ears could be having the opposite effect. “Ear wax is not bad for you,” said Horton. “It is actually part of our body’s natural defenses. We need to keep our ears moist and healthy. When our ear canal gets too dried, that skin becomes prone to cracking, which can lead to painful infections. Also, when cotton swabs are inserted too deep into the canal, they can puncture the ear drum, which is very painful and can cause permanent hearing loss.”

Beware of loud sounds Our lives are very noisy as a whole, let alone if you work in a factory or in construction. It doesn’t have to be incredibly loud for damage to happen to your ears; even lower level of noise for extended period of times can cause permanent issues to our hearing. Many people also participate in recreational activities that produce harmful sound levels, such as attending loud sporting events, music concerts and using power tools. When these activities are repeated over time, the risk of hearing loss increases. “You have to make sure you are protecting your hearing under all circumstances,” said Horton. “Loud noises in varying degrees can cause permanent damage to your ears. We also do ourselves a disservice when we turn the music all the way up on our earbuds. Research suggests that your volume should be at no more than 80 percent for no more than 90 minutes at a time.” Horton said people must understand their limits and make sure to reduce volumes or exposure times when they are listening to any of their personal devices. The World Health Organization stated that 1.1 billion people worldwide are at risk for hearing loss due to recreational noise.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

Gregory Horton, audiologist at the Rochester Hearing and Speech Center.

Pay attention to your symptoms When someone first begins to feel a decrease in hearing abilities, certain symptoms come to the forefront. That includes muffling of speech and other sounds, difficulty understanding words especially in the presence of crowd or background noise, trouble hearing consonants and frequently asking others to speak slower, clearer or louder. “A lot of times families and loved ones will notice our hearing loss before we do,” said Horton. “Sometimes it is when others are watching television or listening to music with you that they notice the volume is at a higher level than usual. You may not notice it because you are used to whatever volume you set for yourself.” Tinnitus, or ringing in the ears, is another common symptom of hearing loss. If you start experiencing persistent, constant or even intermittent noises in your ears that lasts for more than a few seconds, it could be related to something going on with your hearing.

Listen to your body. If you start suspecting that you have some of these symptoms discussed above you should see an audiologist for a comprehensive hearing evaluation. “There are people who do nothing and put it off for seven to 10 years. The sooner we can intervene with hearing loss, the more we can do,” said Horton. “People gloss over the effects that hearing loss can have in your daily life which can really affect a persons’ quality-of-life.”

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contact a broker or agent to assist you. See LocalHelp.HealthCare. gov to locate someone in your area. Short-Term Health Insurance If you can’t find an affordable ACA plan, you may want to consider short-term health insurance, which is much cheaper. These plans, which are not available in every state, are bare-bones health plans that provide coverage for three, six or 12 months – depending on state/federal rules. But be aware that short-term plans don’t comply with the ACA so they can deny sick people coverage, they don’t cover preexisting conditions and they can exclude coverage essentials like prescription drugs. To shop for short-term health insurance, visit eHealthInsurance. com or contact a local broker or agent via LocalHelp.HealthCare.gov. COBRA If you need health insurance coverage for less than 18 months, another option you may want to consider is COBRA, which allows you to remain on your former employer’s group health plan, but not every employer plan is COBRAeligible. Contact your employer benefits administrator to find out if yours is. In most cases COBRA is expensive, requiring you to pay the full monthly premium yourself. But, if you’ve already met or nearly met your employer plan’s deductible and/or out-of-pocket maximum for the year, and don’t want to start over with a new plan; or if you find your employer’s health plan to be better or more affordable that the other options, it makes sense to keep your current coverage under COBRA. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. May 2019 •

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Page 27

Ask St. Ann’s

When is a Good Time to Talk to My Aging Parents About Finances? By Sharon Osborne

ne of the most meaningful things adult children can do for aging parents is to honor their wishes regarding eldercare. There’s no better time than the present to ask about their plans to ensure they have the resources necessary to receive the quality of care they may need in the future. Engaging a loved one in the often well-guarded subject of finances takes time and patience because seniors may not want to ask for help, even when they need it. Experts at St. Ann’s Community offer the following tips to help you ease into the conversation. Start talking now Talk with your loved one about the future before the added stress of an emergency enters the mix. When you visit, are there signs help may be needed such as stacks of unpaid bills, maintenance issues or a lack of groceries? Daily living tasks like these are good conversation starters. Ask what supports can be put in place now, like setting up automatic bill pay or a home shopping service, to help your parents remain as independent as possible. Also, talk with other family members about how they can support your parents so you can preserve financial resources for future eldercare needs. Help organize important information

Are you able to pay a bill or handle a transaction on your parents’ behalf in the event of a health emergency? Work with them to gather financial and health information early on so you understand their obligations and what resources are available to pay expenses. Store this information in a safe place so you and other fiduciaries can access it easily. Another important document is a power of attorney that indicates who

your parent(s) appointed to manage their affairs if they become unable to do so. If they don’t have one, put that at the top of your to-do list. Other common essential documents to look for include: • Mortgage and loan debt, including all credit card accounts • Monthly utility and household bills • Bank account statements • Retirement accounts and social security income statements • Mutual funds, brokerage accounts, stock certificates, savings bonds • Insurance policies (Medicare, Medicaid, health, and long-term care) • Property deeds and titles • Recent tax returns • Doctors’ names and contact information • Health care proxy: Who is it and does this person have a good understanding of your loved one’s health condition, medical history, medications, and end-of-life wishes? Guidance from professionals Consider talking with eldercare professionals to help your parents review the big picture and make informed decisions. Be sure to include family members with decision-making power in these meetings from the very beginning to assure that everyone is on the same page. In time, doing small tasks to support your parents’ independence or helping gather financial, healthcare, and legal documents will help your parents see you are there to help. By talking to your parents while their health is good, you’ll have a plan in place to truly honor their eldercare wishes. Submitted by St. Ann’s Community, a senior community offering a full continuum of care in Rochester, NY. For more information, call us at 585-6976000 or visit www.stannscommunity.com.

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ow that tax season is over, it’s probably a good time to evaluate some financial “best practices” for the rest of the year. A good spring-cleaning can clear out the clutter to let you see a clear path for your future. Social Security is always here to help. Even if you just started working, now is the time to start preparing for retirement. Achieving the dream of a secure, comfortable retirement is much easier with a strong financial plan. Tip 1: Start Early Our online retirement planning resources are helpful to people at any stage of their career. Our many calculators, Benefit Eligibility Screening Tool, and disability resources are all available at www.socialsecurity. gov/planners. From here, you can read and download publications and also email and share with colleagues, friends and family. Remember, the earlier you start, the better chance you have at saving what you need. Tip 2: Be Informed We’re often asked, “What’s the

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Q: My same-sex partner and I recently married. Will we qualify for Social Security benefits? A: You may be eligible to apply for Social Security benefits. Many factors affect your eligibility for benefits, including how long you worked and your age. Social Security is now processing more claims in which entitlement or eligibility is affected by a same-sex relationship. We encourage you to apply for benefits right away, even if you aren’t sure you’re eligible. Applying now will protect you against the loss of any potential benefits. You can apply safely and securely at www.socialsecurity. gov/applyonline. Learn more about Social Security for same-sex couples by visiting www.socialsecurity.gov/ same-sexcouples. Q: Is it illegal to laminate your Social Security card? A: No, it is not illegal, but we discourage it. It’s best not to laminate your card. Laminated cards make it difficult — sometimes even impossible — to detect important security features and an employer may refuse to accept them. The Social Security Act requires the Commissioner of Social Security to issue cards that cannot be counterfeited. We incorporate many features that protect the card’s integrity. They include highly

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2019

best age to start receiving retirement benefits?” The answer is that there’s no single “best age” for everyone and, ultimately, it’s your choice. The most important thing is to make an informed decision, based on your individual and family circumstances. To help you make that decision, see our retirement publications at www. socialsecurity.gov/pubs/?topic=Retirement. Tip 3: Estimate the Benefits You Might Get Knowing the amount of money you could get is pivotal in planning your finances. With the Retirement Estimator, you can plug in some basic information to get an instant, personalized estimate of your future benefits. Try out different scenarios, such as higher or lower future earnings amounts and various retirement dates to see the various potential effects on your future benefit amounts. Visit www.socialsecurity.gov/benefits/retirement/estimator.html. Social Security can help you spring into action and take control of your future with the proper planning tools. Share these online resources with friends and family so they, too, will have the tools.

specialized paper and printing techniques, some of which are invisible to the naked eye. Keep your Social Security card in a safe place with your other important papers. Do not carry it with you. Learn more at www.socialsecurity.gov. Q: My daughter receives SSI and child support from her father. Does the child support have to be reported? A: Yes. The child support your daughter receives is countable income for SSI purposes. As with any income received for an individual or a parent, if the child is under 18, it needs to be reported to your local Social Security office. For more information regarding the SSI program, visit www.socialsecurity.gov/disabilityssi/ssi.html. Q: I have medical coverage through my employer. Do I have to take Medicare Part B? A: You are not required to take Medicare Part B if you are covered by a group healthcare plan based on either your employment or the employment of a spouse. When your coverage ends, you may contact Social Security to request a special enrollment for Medicare Part B. We will need to verify your coverage through your employer in order for you to be eligible for a special enrollment. For more information, visit www. medicare.gov.

H ealth News St. Ann’s acquires senior housing in Genesee County St. Ann’s Community, a leading provider of senior housing and health services in Rochester, recently acquired The Greens of LeRoy, an independent senior living community in Genesee County. For 20 years, The McRae Greens of LeRoy has provided quality housing for seniors in Genesee County with values that mirror those of St. Ann’s, according to St. Ann’s. The new location will now be known as St. Ann’s Community at The Greens. Over the years, St. Ann’s has strategically evolved and continually aligned services to address the changing, complex needs of older adults. One area in particular that has been a focus is to expand the availability of independent living options. St. Ann’s believes seniors should have the opportunity to enjoy their lives to the fullest while also maintaining their independence. “We are confident that by bringing St. Ann’s Community at The Greens into our continuum of care, we will benefit from our collective histories, values and missions to provide residents with the best quality of life,” said Michael McRae, president and CEO of St. Ann’s Community. “St. Ann’s Community is looking forward to this new journey in senior housing and in continuing to provide excellent service to the residents of St. Ann’s Community at The Greens.”

cance.” Only 7% of SNFs nationwide qualify. “This award is a testament to our incredible staff at the M.M. Ewing Continuing Care Center. They are hard-working individuals who are dedicated to our residents and to providing high-quality care. I could not be more proud of them for achieving this honor,” said Amy Daly, Thompson Health vice president of long-term care.

Fleet Feet named one of best running stores Fleet Feet Rochester, a local specialty running retailer with two locations in Rochester, was recognized as one of the Best Running Stores in America by leading trade and vendor running community. Fleet Feet took its place among the country’s elite retailers following an extensive nomination and review process. The nomination process began early in February 2019 with readers nominating their favorite shops. This was followed by a rigorous evaluation process, including runner nominations, mystery shopping to assess customer service, credit ratings from vendors, and assessments about local programs and community involvement. More than 300 stores across the country were nominated and were narrowed down to 60 stores, of which Fleet Feet Rochester was one of them.

OB-GYN ultrasound suite opens at CMG An ultrasound suite opened recently in UR Medicine Thompson Health’s new Canandaigua Medical Group (CMG) building at 335 Parrish St. Located to the left as one enters the main lobby, the suite is specifically for OB-GYN patients, whether they are patients of CMG’s OB-GYN

group or not. Currently, the majority of OB-GYN volume previously done at Thompson Hospital is being channeled to the new suite. Canan Al-Mawaz is the lead sonographer. She started her ultra sound career at Thompson in 2013 after doing her clinical rotation at the hospital, leaving in 2014 to pursue a career in high-risk OOB-GYN ultrasound because that’s Al-Mawaz “where I knew my heart was.” As a registered diagnostic medical and fetal cardiac sonographer with a master’s in health management, Al-Mawaz is able to serve patients with high-risk pregnancies. Previously, these patients had to travel to Rochester for every ultrasound procedure. Al-Mawaz will be joined soon by another high-risk sonographer. The new CMG building opened in December, directly behind the building that had housed the medical group since the early 1970s. In addition to the OB-GYN practice and the new ultrasound suite, the building also houses internal medicine, pediatrics, a lab draw station and a drive-thru pharmacy. Attending the grant award ceremony were, from left, Coalition Research Administrator Helene Snihur; Hartmut K. Land, professor and chairman of biomedical genetics at the University of Rochester School of Medicine & Dentistry; grant recipient Danielle Desa; grant recipient Mark Noble; physician Jonathan Freidberg, director of the Wilmot Cancer Center; and Coalition Executive Director Holly Anderson.

M.M. Ewing gets ‘Distinction of Significance’ The M.M. Ewing Continuing Care Center recently received the Eli Pick Facility Leadership Award from the American College of Health Care Administrators (ACHCA). A 178-bed skilled-nursing facility (SNF) operated by UR Medicine Thompson Health, M.M. Ewing is located at 350 Parrish St. in Canandaigua. The facility offers, among other things, dementia care, long-term services for individuals who need 24-hour skilled nursing care and post-hospital services to help individuals requiring rehabilitation or restoration recover from illness, surgery and hospital stays. Recipients of the Eli Pick award are identified using publicly collected data from the Centers for Medicare & Medicaid Services, with the data evaluated by an independent, third party. There are a number of eligibility requirements, including a variety of quality measures. According to the ACHCA, the award “is a distinction of signifi-

“This recognition is so exciting not only for Rochester, but for our staff, who work day in and day out to provide exemplary service to our customers,” said Ellen Brenner-Boutillier, co-owner of Fleet Feet Rochester, Fleet Feet Buffalo and YellowJacket Racing with her husband, David J. Boutillier (Boots). “Our staff prides themselves on their knowledge and ability to help change people’s lives. Being named a best running store in the US is a testament to their success. We are also very grateful to our customers and vendors who allowed us the opportunity to be in the group of stores.” Fleet Feet Rochester will be featured in a special issue of Running Insight distributed nationally. The store will also receive a commemorative plaque to mark the award and a special window sign that indicates the store is a Best 2019 winner. They will also be recognized at a special event in Tuscon, Ariz., with all winners on May 21.

to their treatments. Desa was awarded the $25,000 pre-and-post-doctoral grant to support her proposal “Understanding the Mechanisms Underlying a Novel Predictor of Metastasis.” Desa will investigate how the er and Treatment Development for way light scatters off fibrillar collaBreast Cancer with Acquired Tamoxigen, a protein in the space between fen Resistance.” healthy cells through which tumor Noble will study whether a cells move, helps predict metastasis specific drug already approved in certain breast cancers. She will by the FDA for other purposes (and develop a tumor model free of other for which his team discovered new properties), combined with the breast cell types, which will allow her to focus on the relationship between cancer treatment drugs tamoxifen and cyclophosphamide will block the cell motility and the collagen properties affecting light scattering. ability of tamoxifen-resistant breast The data from Desa’s study will cancer cells to metastasize. be used for more complex experiThe research will advance ments that could lead to the develunderstanding of how resistance to opment of new therapies to prevent the drug tamoxifen, which is used to metastatic disease. treat ER+ breast cancer, may develop. Since 2003, the Breast Cancer He will also focus on diagnostics Coalition of Rochester has awarded and, in collaboration with a surgical $851,125 to researchers in Upstate pathologist, work on developing imand Western New York. mune-staining protocols that could prospectively identify patients with the greatest likelihood of responding

U of R Researchers Awarded Breast Cancer Coalition of Rochester Grants Danielle Erin Desa, a third-year biomedical engineering Ph.D. student at the University of Rochester, and Mark David Noble, a professor in the University’s School of Medicine and Dentistry, have received the Breast Cancer Coalition of Rochester’s 2019 Research Initiative grants. The grants are awarded annually to fund innovative new projects with the potential to yield significant medical breakthroughs in the cause and prevention of breast cancer, prevention of metastasis, and cure. Noble, who holds the Martha M. Freeman Professorship in biomedical genetics in the School of Medicine and Dentistry, was awarded the $50,000 Faculty Grant. His proposal is titled “BiomarkMay 2019 •

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4.0% UNINSURED RATE 30% LOWER

THAN THE NEW YORK STATE AVERAGE

54% LOWER

THAN THE NATIONAL AVERAGE In 2017, the uninsured rate across upstate New York averaged just 4.0 percent. This maintains our region’s historically low uninsured rate. It compares with a New York state average of 5.7 percent and a national average of 8.7 percent. Our 2018 and 2019 rate increases in the small group and individual markets were among the lowest in upstate New York, which helped keep our local health insurance affordable and uninsured rate low.

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