PRICELESS
Helping the Educated Refugee Physician Deborah Rib, a local OB-GYN, helps refugees with background in health get training, jobs
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personal items you probably should replace today
Medicare for All
A recent survey of 10,000 people shows a divided opinion: 30% are in support of the proposal made by some presidential candidates while 28% oppose it
Weighty Issues
GVHEALTHNEWS.COM
SEPTEMBER 2019 • ISSUE 169
Back to School n This is usually challenging time for those within the autism spectrum. Find out why n Medical groups recommend that middle and high schools should start 8:30 a.m. or later. See why n Seven myths about children’s eyes n Asthma, allergies: New school year can bring major flare-ups n Starts on p. 11
Excessive Video Game Playing Now Considered a Disorder P. 23
Mother, daughter discuss healthy weight journey
CBD OIL
A new study shows that a person taking the medicinal cannabis derivative cannabidiol (CBD) won’t fail a drug test for marijuana
Please Give Me My Zuchini Find out why SmartBites’ columnist is elated when zucchini season rolls around. “It’s as nutritious as it is delicious,” she says P. 19
Are Too Many Kids Prescribed Antihistamines? Drugs such as Benadryl provide little benefit to kids with cold P. 10
Safe and Quality Nursing Home Care and Community Forum
Charting the Course Your MEDICARE Road Map When you take a trip, you have your destination in mind...
WHY SHOULD CHOOSING YOUR MEDICARE PLAN BE ANY DIFFERENT?
To Demonstrate the Need for Safe Staffing in Nursing Homes The Elder Justice Committee of Metro Justice invites: • Nursing Home Residents • Friends and Family • Direct Care Providers
To voice your opinions about safe staffing and quality care in nursing homes Thursday, October 17. 2019 10:00 a.m. to Noon Pittsford Community Library Fisher Meeting Room - First Floor 24 State Street Pittsford, NY 14534 • If you want to speak, contact elderjustice@metrojustice.com • 3-minute time limit per speaker • Disability-accessible Location
Join attorney Lori Parker for a FREE educational seminar featuring NY-Licensed Medicare Agent Cheri Ciaglia Learn how YOU can: • Get the most from your Medicare coverage; • Avoid wrong turns, dead ends, and bumps in the road; • Tailor a Medicare plan to meet your specific needs. Dates/Times: • Tuesday September 10, 2019 at 10 a.m. • Tuesday September 17, 2019 at 6 p.m.
Location:
• Greece Chamber of Commerce 2402 West Ridge Road, Rochester, NY 14626 • Parking and Entrance at the Back of the Building Important! Space Is Limited Reserve Your Seat Now! Call 585-973-5337 Or E-Mail Info@Parker-Law-Office.com Parker Law Office - 2024 W. Henrietta Rd. #2A Rochester NY 14623 - 585-281-0717 attorney advertising
1 IN 10 CHILDREN IS AFFECTED BY ASTHMA BE PREPARED. The return to school is tough for
kids with asthma. Because they head straight into peak virus season and may be exposed to new triggers, they’re more likely to have an asthma attack. Make sure you have an action plan.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
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COMPANION CARE • HOUSEKEEPING • RESPITE & 24 HOUR CARE September 2019 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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CALENDAR of
HEALTH EVENTS
Sept. 10
Hearing loss group announces programming Hearing Loss Association of America, Rochester chapter, invites anyone interested in hearing loss to any or all of several programs on Tuesday, Sept. 10. All are held at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester, across from the George Eastman Museum. • 10 a.m. in the vestry room. “HOPE (Hearing Other People’s Experiences) with With Joe Kozelsky.” Prospective, new or long-time hearing aid users share their experiences, questions and hearing loss journeys in an informal round table discussion facilitated by retired audiologist and hearing aid user, Joe Kozelsky. • 11 a.m. to 1 p.m. in the parish hall. “Relationships at Sea: Returning Them Safely to Port With Samuel Trychin, Ph.D.” Hearing loss can create behavioral, cognitive and emotional difficulties in relationships for both the person who has it and her/ his communication partner. Lacking information about how to understand what is being said can yield negative thoughts and feelings, often damaging relationships and leaving a person at sea. Learning to manage communication better results in calmer thinking, positive feeling and improved relationships, returning individuals safely to port. Trychin is a psychologist in private practice in Erie, Pennsylvania. He focuses on psycho-social interventions for people with hearing loss and their communication partners. He also helps train individuals with stress-related disorders. He is the mental health and rehabilitation adviser to HLAA and serves on the Pennsylvania Governor’s Council on Aging. • 7 to 9 p.m. in the parish hall. “ABC’s of Living Well with Hearing Loss With Samuel Trychin, Ph.D.” Effectively managing hearing loss requires viewing it as a communication disorder affecting both listeners and speakers and requiring some communication behavior changes on the part of each. What are the optimal conditions for communication when hearing loss is present — the As what must both the person with hearing loss and the communication partner do differently to increase understanding — the Bs What can help both to manage themselves better, eg, regulate emotional reactions — the Cs. All HLAA programs are free. For more information view the web site at www.hearinglossrochester.org or telephone. 585-266-7890.
Sept. 12-13, Oct. 4
LGBTQ Academy offers training programs The Out Alliance LGBTQ Academy has two upcoming in-house training courses that are open to the public. Both will take place at 100 College Ave., suite. 100 in Rochester. Page 4
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• SafeZone Train-the-Trainer certification program will take place from 9 a.m. to 4 p.m. Sept. 12 and 13. A fast paced and interactive workshop created to develop confident, knowledgeable and effective SafeZone trainers who can establish sustainable SafeZone programs on their college campuses, K-12 schools and their workplace. Fee is $450 or $400 if paid in advance. It includes manual, three years of on-going support from LGBTQ Academy, three years of access to all of updated handouts, two days of breakfast and lunch, and a certificate, among other things. • SafeZone Training will take place from 9 a.m. to 1 p.m. Oct. 4. A four-hour dynamic, interactive workshop that includes activities and discussion around LGBTQ inclusive and respectful language, the process of coming out, understanding sexual and gender identity, taking action in schools and workplaces, where to go for help and much more. Fee is $100 and includes manuals, stickers, lapel pin and breakfast. For more information, call 585244-8640 ex. 23 or visit www.OutAlliance.org. To register, go to www. trailblz.info/gayalliance/eventcomplete.aspx?eventid=2392
Sept. 7
Walk to End Hydrocephalus scheduled for Grand Island The Western New York chapter of the Hydrocephalus Association is organizing the Walk to End Hydrocephalus, which will take place 9 a.m., Saturday, Sept. 7, at Beaver Island State Park in Grand Island in Erie County. The event raises fund for research and cure of hydrocephalus and raises awareness for the condition. Hydrocephalus is the abnormal accumulation of cerebrospinal fluid in the brain. Over one million Americans are born with or develop this condition. The only treatment to date is brain surgery. Hydrocephalus is more common than Downs syndrome, according to the organizers. The WNY Walk was started seven years ago by Stacey Monaco Fonagy, a woman in her 30s who had been having symptoms of hydrocephalus for years before she was diagnosed correctly in her mid-20s. By that time, she had to undergo emergency brain surgery to relieve the abnormal buildup of cerebrospinal fluid. Since then, she has married, has a young boy, and has been working full time for National Fuel Gas. During her recovery from brain surgery, she decided to initiate a Western New York walk in conjunction with the national Hydrocephalus Association. Over the last six years the local walk has grown to more than 300 participants. There is no registration fee for the event. There will be face painting, magicians, dancers, appearances by Sabertooth and Wonderwoman and a basket raffle. Lunch is provided by a series of generous donors. The festiv-
VegFest, other events highlight alternative diet September is a major month for those who are vegetarians or vegans or are interested in learning more about those alternative diets. The events are: • Sept. 14 (Saturday) — The Third Annual Rochester VegFest! It will take place from 10 a.m. to 4 p.m. at Martin Luther King, Jr. Memorial Park. Vegan food, yoga, art, information tables, activities for kids, speakers, and much more. For more information, visit rocvegfest. org. • Sept. 15 (Sunday) — September Meeting of the Rochester Area Vegan Society. It starts at 5:30 p.m. with a vegan share-a-dish dinner following by a program at 7 p.m. ities last until about 1:30 p.m. For more information, email samonaco25@gmail.com or FonagyS@natfuel.com or call 716-5105075.
Sept. 14
Walk to Defeat ALS takes place in Liverpool
ALS Association, Upstate New York chapter, invites the public to join patients and family members and participate in its annual Lowell Smith Circle of Courage Walk to defeat ALS. The event will feature music, food and giveaways. The band, Hand of Fate will perform throughout the event. The one-mile walk will start at 11 a.m. Sept. 14 (Saturday), at Long Branch Park, 3813 Long Branch Road, Liverpool. Check-in starts at 9:30 a.m. Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects the function of nerves and muscles. The progressive degeneration of the motor neurons in ALS eventually leads to death. Based on U.S. population studies, more than 6,000 people in the U.S. are diagnosed with ALS each year. (That’s 15 new cases a day.) It is estimated that at least 16,000 Americans have the disease at any given time. For more information, contact Monica Shworles, regional development manager at 315-413-0121 or mshworles@alsaupstateny.org.
Sept. 15
Prostate Cancer Walk held in Greece The Fifth Annual Prostate Cancer Walk in Rochester, organized by Us TOO Rochester, will take place from 8:30 a.m. to noon, Sunday, Sept. 15, inside The Mall at Greece Ridge. The walk is open to everyone concerned about prostate cancer and kicks off National Prostate Cancer Awareness Week in Rochester. By attending, participants help to convey the importance of early detection while showing support for more than 16,000 local men, and those who love them, who struggle every day with a prostate cancer diagnosis. Registration is $30 at the event, or $20 online and includes free refreshments and free PSA screening by UR Medicine Labs & Urology for men aged 50 and older. Proceeds
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
The program will be presented by Roberta Schiff, a health educator, nutrition counselor and coordinator of Hudson Valley Vegans, who will discuss “Making Healthful Choices: How to Incorporate Dr. Greger’s ‘Daily Dozen’ Into Your Meals and Snacks.” The event takes place at the Brighton Town Park Lodge, 777 Westfall Road, Rochester. It is open for both members and non members. For more information, visit rochesterveg.org. • Sept. 16 (Monday) —National premiere of “The Game Changers” a new film produced by James Cameron (“Titanic,” “Avatar”). Showing at Regal Eastview, Regal Henrietta, and Tinseltown IMAX. Go to gamechangersmovie.com for tickets. “The Game Changers” is about the impact of plant-based diet on athletic and sexual performance. stay local to benefit patient programs provided at no cost by Us TOO Rochester. For more information about Us TOO Rochester, visit www. ustoorochester.org or send email to: ustoorochesterny@gmail.com. For more information about the prostate cancer walk and to register as a participant, or to be included as an event co-sponsor, visit the event website at www.ProstateCancerWalk.org or send email to pfisher0317@gmail. com.
Sept. 28
Doctors to speak at Amyloidosis Upstate meeting The Amyloidosis Upstate NY support group will host four physicians during its meeting from 8:30 a.m. to 1:30 p.m., Sept. 28, at Wilmot Cancer Institute, 601 Elmwood Ave. in Rochester (conference center on the second floor). The nearly all day meeting will provide participants with light breakfast and lunch and a discussion about the latest on amyloidosis (amy-la-dosis), a blood protein disease originating in the bone marrow that are abnormally formed, traveling through the blood stream and depositing in one or more organs, which leads to organ failure. The guest-speaker physicians are Anita D’Souza, Frank Passero, Himabindu Vidula and Ronald Schwartz. Patients, caregivers, family members and interested medical personnel are urged to attend. For more information call or email Maryann Kraft, thumbelinamk@yahoo.com, 585-334-7501; Paula Schmitt, paula@ amyloidosissupport.org or 866-4047539. For more information, visit www.amyloidosiossupport.org.
Got a health-related event you’d like to share with our readers? Email the information to editor@GVhealthnews.com Deadline: the 10th of the month preceding the event.
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CBD Won’t Cause Users to Fail a Drug Test However, new study shows that its lesser-known cousin CBN will
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new study shows that a person taking the medicinal cannabis derivative cannabidiol (CBD) won’t fail a drug test for marijuana — but a person taking the emerging sleep aid cannabinol (CBN) will. These findings were presented in July at the 71st AACC Annual Scientific Meeting & Clinical Lab Expo, and could prevent people from being unfairly penalized for using CBN. CBD and CBN are both cannabis derivatives that have been gaining attention for their ability to confer potential health benefits without causing intoxication. The wellness industry has exploded with CBD-based products that claim to help conditions ranging from anxiety to acne, and last year, the Food and Drug Administration approved the first CBD-based drug for the treatment of severe epilepsy. Though CBN is not as well known yet as CBD, more people are also starting to use it as a sleep aid. According to a news release issued by the AACC, with the popu-
larity of these compounds rising, it is vital for healthcare providers to understand how CBD and CBN interact with screening tests for drug abuse. As just one example of why this is important, certain healthcare institutes do not allow patients to use marijuana if they are taking opioids for pain management. If these patients test falsely positive for marijuana use due to CBD or CBN, they could be unfairly denied their prescriptions as a result. “These findings will help with interpreting drug screening immunoassay results,” said Grace Kroner, Ph.D., of the University of Utah Health Sciences Center in Salt Lake City. “If physicians and laboratorians know a patient is taking CBN, they can consider that if they get a positive from an immunoassay. On the flip side, providers can also be more certain when they get a positive marijuana result that it’s not due to pure CBD oil alone. These results are always assay-dependent, though, so the field needs to keep this in mind.”
Serving Monroe and Ontario Counties A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations. In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Patrick Fisher, Amy Cavalier, Lynette M. Loomis, Lori Parker (Esq.), Triciajean Jones • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office manager: Nancy Nitz 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.
September 2019 •
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www.blossomhypnosis.org IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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U.S. Fertility Rate at AllTime Low
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he U.S. fertility rate continued to fall last year and reached an all-time low, the Centers for Disease Control and Prevention says. The general fertility rate fell 2% between 2017 and 2018 among girls and women aged 1544, according to a report released in July by the CDC’s National Center for Health Statistics. By race, fertility rates fell 2% for white and black women, and 3% for Hispanic women. Births among teens aged 15-19 fell 7%, with decreases of 4% among black teens and 8% among white and Hispanic teens. The rate of preterm births rose from 9.93% to 10.02% and the rate of early-term births rose from 26% to 26.53%. The proportion of full-term births fell from 57.49% to 57.24% and post-term births declined from 6.58% to 6.2%. A report released earlier this year by the National Center for Health Statistics said the 2017 U.S. fertility rate continued to fall below what’s needed for the population to replace itself, according to reports.
Drug OD Death Rates Now Higher in Cities Than Rural Areas
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ig cities once again have higher drug overdose death rates than rural areas of the United States, the Centers for Disease Control and Prevention says. Such deaths had been concentrated in rural areas for more than a dozen years, the Associated Press reported. A CDC report released early August said that in 2016 and 2017, overdose death rates in cities were higher than in rural areas. In 2017, the urban rate was 22 overdose deaths per 100,000 people, compared with 20 per 100,000 in rural areas. Rates for 2018 and 2019 are not yet available, but experts believe the urban rate is likely to remain higher in the near future, the AP reported. The U.S. is facing its deadliest drug overdose epidemic ever, and there were about 68,000 overdose deaths last year, according to preliminary CDC data released last month.
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Meet
Your Doctor
By Chris Motola
Deborah Rib, MD
Local OB-GYN helping refugees with background in health get training, jobs Q: How did you get involved with the Rochester Refugee Resettlement Services and the Health Professional Opportunity Grant? A: I think it was a couple years ago. I was at a gathering and a friend of mine approached me about talking to a couple physicians who were from Afghanistan. She is involved in working with this group and this grant in a number of different ways and she does a lot of things in the community. I said I wasn’t sure that there was a whole lot I could do for them, and she said please just look at their resumes. And she told me a little bit about the grant. Q: How does the grant help people in their position? A: It’s to help people with health backgrounds get into areas that would use their expertise. So I read the resumes of two Afghani physicians and was really impressed with their credentials. Both of them are in public health and they’d both run studies and projects on a national and international level. It was very high-level work that they’d done. They’d been in the United States for about nine months, didn’t have jobs and weren’t having a lot of luck finding their way here. I met with them, went over their resumes, credentials, what they were interested in doing here and then it was a matter of figuring out what I could do for them. Q: What were you able to do for them? A: Basically through networking. I’ve been in the area for over 30 years, so I have a lot of contacts at the university, I know a lot of people in town. So through talking and networking, I was able to put one of them in contact with people in public health. The other is not working in medicine yet, but the other is putting some work into getting an American degree here. So that’s how I got involved. I thought that was going to be the end of it and then Mike Coniff, the lead person on the grant at Rochester Refugee Resettlement Services, contacted me and said they had a whole bunch of other doctors — like 22 of them, who are looking to get involved. So I’ve been involved with them ever since, trying to get them into activities in their line of work or
help them work toward getting a U.S. M.D. license. Q: What are the major obstacles to getting them placed within their fields? A: It kind of depends on the person. I’ve interviewed a lot of them and there are people from a lot of different backgrounds, but also different ideas about what they want to do here. Some people do want to go and practice medicine. Some people want to go and do research. Some people don’t want to go for licensure because it’s a very uphill battle and prefer to be a nurse or a physician assistant. It’s really figuring out where people are and what they’re interested in doing. So the obstacles depend on the pathway. Q: What are some of the pathways? A: So one’s getting their U.S. M.D. licensure. And of course that’s a lot of studying and work. They have to take the same tests that our medical students in the United States take, but our students take them around their third, fourth year of medical school. A lot of these people have been practicing medicine for years, so they’ve been away from the academic stuff for a while. So they have to go back and do it again. They may have families they need to support, so having the time and money to do that may be prohibitive. If they don’t have to get a job and can arrange enough time to study, it can potentially work. The other issue is the language barrier. All of the tests are in English, and one is in person, where you have to ask questions of a patient in English. And the cost of the tests themselves and study
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
materials is very high. The grant does cover a lot of those last expenses, but it’s still a big investment. It takes years. Then the next big obstacle is getting interviews for a residency in a system where preference is given to American medical school graduates. So each step along the way has a lot of obstacles. It’s not impossible, but it’s very difficult. For people who go the research path, if they get the job, they’ll usually get some training on the job, but there still are a lot of language issues. For the people who go to nursing, you again have the language issues and schooling again, but the programs are shorter and it’s more feasible overall. And of course, you still have to pay for the program. A lot of them need to work more immediately because you only get social services for a limited amount of time. So all this depends on their family situation and their flexibility. Q: What kind of jobs are you able to get them? A: We have some connections through Strong and the Rochester Regional Health System. That would be doing things like drawing blood, being a patient tech. It gives them a chance to see how things are done in America because our system tends to be very different than the one they came from. And it gets them some on-the job training. Q: What would you like to see done to smooth the pathways a bit? A: I would say that, if we look at what other places do, Minnesota is the leader in this situation. At the state level they have a lot of supporting programs for these doctors. They realize they have a doctor shortage in their rural areas, so they’ve made a point of trying to capture the talent of these refugee physicians. So having counseling, helping to make them aware of opportunities, help them get their medical licensure. The problem is they only have a small number of spots available per year. So we’re looking at what we could replicate here. One thing I’d really like to see is more people who work in healthcare in our area get involved to help mentoring and providing support for whatever they decide they want to do. Remember, these aren’t necessarily people who came here to be doctors, they’re refugees.
Lifelines Name: Deborah Marie Rib, M.D. Position: Clinical associate professor of OB-GYN at the University of Rochester Career: Has worked in an OB-GYN practice in Rochester for over 25 years then retired to work at URMC where she is involved in medically related community activities. Currently sees patients and works as preceptor (teacher) for medical students. She sees gynecology patients at St. Joseph’s Neighborhood Center in the South Wedge Hometown: Fairfax, Virginia Education: Medical College of Virginia; University of Virginia Affiliations: Strong Memorial Hospital; URMC Organizations: American College of OB-GYN; Monroe County Medical Society; North American Society for Pediatric and Adolescent Gynecology. Fellow of American College of Obstetrics/Gynecology Hobbies: Outdoors, sports
4 Personal Items You Probably Should Replace Today
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s your toothbrush more than four months old? And how about your contact lens case? These and other everyday essentials need regular replacing, no matter how comfortable you are with them. At the top of the list is your toothbrush. To benefit oral health, your toothbrush needs to be in tiptop form. The American Dental Association suggests replacing it as soon as bristles start to fray, usually every three to four months.
If you wear contact lenses, you should replace your contact lens case every three months, sooner if you see any cracks, which can harbor bacteria. For proper care, after putting your lenses in your eyes, rinse the
by your eye care professional. If you’re like many Americans, you probably don’t use as much sunscreen as you should. That could mean leftover product once summer ends, season after season. The U.S. Food and Drug Administration requires sunscreens, like other nonprescription drugs, to have an expiration date unless testing conducted by the manufacturer has shown that the product will remain stable for at least three years. So don’t use sun-
screens after their expiration date or, if there’s no date, if purchased more than three years ago. The hardest item to let go of could be in your bedroom — your pillow. There are no hard and fast rules about when to toss an old pillow, but the National Sleep
Foundation suggests every one to two years, especially if it hasn’t been protected from dust mites with a zippered cover. (Consider getting one for your next pillow.) Washing helps, but check label instructions before tossing a pillow into the washing machine — some won’t survive the spin action.
case with fresh lens solution, shake out excess liquid, and leave the empty case open to air dry. P.S.: Don’t keep contacts in your eyes for longer than they’re designed to be worn, and always replace them according to the schedule prescribed
Healthcare in a Minute By George W. Chapman
Medicare for All: 30% Support it, 28% Oppose it
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ith a national election next year, the subject of healthcare dominates debates, news and talk shows. Medicare for All, universal coverage and single-payer models are being touted. The Urban Institute recently surveyed close to 10,000 people about their thoughts on healthcare. When asked about a “single payer” system, 41% responded they neither supported nor opposed the concept. But when asked about “Medicare for
Best states for Healthcare WalletHub has ranked the five states and DC, from best to worse, for healthcare. Rankings were based on a variety of factors including availability, access, cost and outcomes. The top five states beginning with No. 1 are: Minnesota, Massachusetts, Rhode Island, District of Columbia, and Vermont. The bottom five states beginning with No. 47 are: Arkansas, South Carolina, Mississippi, North Carolina and Alaska. New York ranked in the middle at No. 24. Notably, four of the top five states are in the northeast, while four of the five worst states for healthcare are in the southeast.
Telehealth growing slowly
According to a survey by J.D. Power, patient usage/acceptance of telehealth services is growing slower than envisioned. Just under 10% of those surveyed said they used telehealth in lieu of an onsite visit to a physician, urgent care center or emergency room. J.D. Power, known for rating cars, is going to set benchmarks for patient satisfaction later this year so they can measure consumer satisfaction with telehealth.
All,” 30% were in support and 28% opposed. (Medicare for All is a single payer system.) Forty-five percent of the respondents said they do not support or oppose a “public health option.” while 32% would support it and 21% would oppose it. The obvious problem here is healthcare is very complicated and often confusing. Consequently, the majority of Americans are ambivalent about the various models of care and are understandably fearful of change. Fifty-six percent of those surveyed said they would be more inclined to use telemedicine if there was some sort of ranking or satisfaction measurements. Most of those surveyed weren’t sure whether or not their insurance covered telehealth. Only 17% were sure either way. Most insurers cover telehealth, but are reluctant to “sell” it fearing over utilization of medical services. The survey produced six key findings. 1. Almost half of the respondents thought the quality of care would be diminished via telehealth. 2. Lack of awareness is most pronounced in rural areas (72%) where telehealth makes the most sense. 3. None (0%) of the patients indicating they are in poor health used telehealth. People in good or better health are more likely to use telehealth. 4. Consumers aren’t sure what it costs. 5. Consumers are split on whether telehealth is more or less as personal than an onsite visit with a provider. 6. Telehealth is used more out West (11%) than here in the East (6%).
Opioid deaths decline
For the first time in 30 years, deaths due to opioid abuse actually fell about 5% from approximately September 2019 •
72,000 in 2017 to approximately 68,000 in 2018. A decline in prescriptions for opioids was an obvious factor in the recent decline in deaths. Despite the decline, the number of 68,000 unnecessary deaths is still unacceptable. The CDC contributed to the decline in deaths by clarifying opioid prescribing guidelines for providers. Success varies by state. Sixteen states had more deaths in 2018 versus 2017. Two states with the worst drug problems fared far differently from each other. Missouri opioid overdoses increased 16% while New Hampshire experienced a 7% decrease in deaths.
Best NYS Hospitals
Per U.S. News and World Report, three of the top six are in New York City: Presbyterian-Columbia, Mount Sinai and Lenox Hill. Two are on long Island: St. Francis and NYU Winthrop. The sixth is Strong Memorial in Rochester.
Most common medical conditions
If you have been to your doctor’s office lately, your chief medical complaint or condition was probably from the top 10. They are in no particular order: skin disorders, stiff joints, bad back, high cholesterol, upper respiratory infection, anxiety/ depression, chronic neurological disorder, high blood pressure, headaches and diabetes.
Climate Anxiety/Grief
The clinical term is “solastalgia”. Unfortunately, it is on a precipitous increase worldwide. It is defined as the distress or anxiety produced by environmental change impacting people while they are directly connected to their home environment. The American Psychiatric Association has produced a climate change guide to help physicians and mental
health providers diagnosis and treat. Rising temperatures have actually led to more suicides. It is estimated that climate change contributes to 250,000 deaths per year worldwide.
Gun violence prevention
Medical professionals are speaking out, again. In the aftermath of several mass shootings, several physician associations co-authored an article in the Annals of Internal Medicine calling for immediate action to prevent gun violence. Gun violence is now acknowledged as a public health risk. The article was sponsored and written by the heads of: American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Psychiatric Association and the American Public Health Association. Some of the recommendations include: enactment of “red alert” laws which allow judges to temporarily remove firearms from individuals at risk to do harm to others or themselves; requiring comprehensive criminal background checks; encourage research into the causes of gun violence and recommendations to reduce; improving access to mental health care; supporting physicians on how to advise families and at risk patients about potential gun violence and how to mitigate the risk. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
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Men’s Health
Should Men Be Screened for Prostate Cancer? A survivor’s perspective By Patrick Fisher
S
eptember is National Prostate Cancer Awareness Month. According to the American Cancer Society, other than skin cancer, prostate cancer is the most common cancer in men and the leading cause of cancer death in men second only to lung cancer. African American men are at even greater risk. While it is widely understood early detection of any cancer may yield the best outcome, there remains debate among providers regarding usefulness of the prostate specific antigen (PSA) blood test. Worse, a stigma exists among some men about being screened. The real challenge is that typically there are no symptoms for early stage disease but left untreated prostate cancer may spread to other organs or lead to bone cancer. At one time, surgery or radiation “seeds” were the basic treatment options. That’s no longer true. Today, more than ever before, there are multiple diagnostic tools and treatment options. Men need to talk with their providers, inquire about being screened (especially as they age) and get multiple medical opinions before making a treatment decision. A high percentage of men I talk with were naive about all their options or looked to the internet as their trusted resource. However, most of them agree the PSA test was the first level of screening that made them aware they may be at greater risk and could benefit by treatment or continued active surveillance. The impact of being told you have prostate cancer can be over-
whelming. Researching pros and cons for a variety of treatments is exhausting. Medical providers do not have time to educate patients about the risk vs. benefit for all their options, especially those the provider may not be aware of or not qualified to perform, and options that are not locally available or considered experimental by the Food and Drug Administration. Thankfully, Us TOO International is a no-cost clearing house on the topic and has become a leader for prostate cancer support and patient education. Rochester is fortunate to now have an affiliate chapter. The parent nonprofit was founded in Chicago in 1990 by two prostate cancer survivors. Today, there are more than 200 chapters around the world. The affiliate chapter, Us TOO Rochester, has no paid staff and is managed by local survivor families. Printed materials are provided at no cost and websites are kept current at www.ustoo.org and www.ustoorochester.org. Monthly chapter meetings help those newly diagnosed and those with metastatic disease become aware to a full menu of treatment options while providing hope and support. At Us TOO Rochester meetings and seminars local urologists, oncologists and subject matter experts are often invited as guest speakers. Attendees learn about advances in diagnostics such as color doppler ultrasound, multiparametric magnetic resonance imaging (MRI), or gene and biomarker testing. Speakers
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Patrick Fisher is a Vietnam era veteran, a survivor of prostate cancer and co-founder of the affiliate chapter Us TOO Rochester. He resides in Penfield with his husband Roger and their service dog, Otto. To contact him, email pfisher0317@gmail.com.
may also share knowledge about treatment options including laparoscopic surgery, high dose rate (HDR) brachytherapy, stereotactic body radiotherapy (SBRT), intensity modulated radiation therapy (IMRT) or high intensity focal ultrasound (HIFU) which is now FDA-approved and available locally. Some men prefer to learn from another’s experience. Meetings give them that opportunity. Others share their experience with pelvic floor rehabilitation, proton beam radiation, plant-based nutrition, implants or additional therapies that proved helpful. Us TOO Rochester relies on donations and fundraisers to meet expenses.
Prostate Cancer Walk The Fifth Annual Prostate Cancer Walk will take place from 8:30 a.m. to noon, Sunday, Sept. 15, inside The Mall at Greece Ridge. By attending, participants help to convey the importance of early detection while showing support for more than 16,000 local men, and those who love them, who struggle every day with a prostate cancer diagnosis.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
The walk is open to everyone concerned about prostate cancer and kicks off National Prostate Cancer Awareness Week in Rochester. On-site registration is $30 ($20 online) and opens at 8:30 a. m. Admission includes free refreshments, free PSA screening by UR Medicine Labs & Urology for men age 50 and older and 40 and older if there is a family history of prostate cancer. It also provides access to a collection of antique and classic cars provided by Street Machines of Rochester, performances by Oasis Senior Tap Dancers and small dogs seeking their forever home by Buffalo Pugs and Small Dog Rescue. For more information about Us TOO Rochester, visit www. ustoorochester.org or send email to: ustoorochesterny@gmail.com. For more information about the prostate cancer walk and to register as a participant, or to be included as an event co-sponsor, visit the event website at www.ProstateCancerWalk.org or send email to pfisher0317@gmail. com.
Men’s Health
Sperm Banking Helps Men Protect Fertility By Deborah Jeanne Sergeant
W
hile many men can become parents much later in life compared to most women, sperm banking may provide a means for men to preserve their fertility for a variety of reasons. Physician Rob Kiltz, founder of CNY Fertility, said that although men’s fertility doesn’t decline as much as women’s, other factors have in general caused male fertility to decrease. “Men more and more are being exposed to environmental factors, diabetes, autoimmune diseases, cancers that affect fertility even before they have a chance to bank sperm,” Kiltz said. “It may be more reasonable to bank sperm in their early to mid-20s before these things happen.” Kiltz operates fertility offices that treat men and women in Rochester and other locations. He explained that over the past 20 years, the quality of sperm has been changing, along with the shift of couples delaying children until their later 30s. As a result, more men find it difficult to father children. “Many of the sperm abnormalities are related to morphology and function and DNA fragmentation and it’s only picked up on because
the guy is infertile,” Kiltz said. “It might be that we don’t even notice these things because no one is trying to get pregnant up to that point. These things may be factors that if you had preserved your sperm in your early 20s, you maybe could have avoided.” Other factors may also prompt men to consider sperm banking as young men. Some couples want permanent contraception and choose vasectomy; however, reversing vasectomy should they change their minds can be difficult and not always successful. Reversal also costs quite a bit of money — $5,000 to $20,000 — and isn’t covered by insurance, according to a search in several medical online sources. “More and more men should consider it because of the issues they encounter that can affect their sperm,” Kiltz said. “Banking is more affordable than people think.” He said that sperm banking costs a few hundred dollars initially and about $3,000 to store for 10 years. “If a man is considering a vasectomy or permanent form of contraception, freezing sperm may give him opportunities to have children without a reversal or IVF,” Kiltz said.
“A lot of men and women think they won’t want children when they’re young and want a form of contraception that won’t fail but if they change their mind in the future, they can use banked sperm rather than have a reversal.” Employment or medical procedures that expose men to toxic chemicals, radiation or physical damage to the testicles is another reason to consider sperm preservation. Kiltz said that the success rate of conception is “very high” with sperm saved through cryopreservation. Boys who experience cancer therapy before puberty can still preserve their chances of fatherhood. Kiltz said surgeons can remove testicular material and after their cancer treatment, it can be implanted again to allow them the opportunity to
generate sperm. In general, men can improve their chances of healthy sperm by avoiding drugs including marijuana alcohol, and smoking. Kiltz said that for diet, he promotes a keto Kiltz or paleo diet. He also believes it’s important for men to slow down. “Enjoy more easy living and less treating your body like you live in a carnival,” he said. “Treat it like a temple.”
Sunday, September 15 Prostate Cancer Walk & Health Fair Walk for the men in YOUR life. Inside The Mall at Greece Ridge
Affiliate Chapter: Us TOO Rochester
$30 at event. $20 online. Full details at:
ProstateCancerWalk.org Proceeds benefit local prostate cancer patient programs at Us TOO Rochester. September 2019 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Live Alone & Thrive
inside you? Set it free! Treating yourself well builds self-esteem. Prepare and enjoy healthy meals at home. Get enough sleep. Walk, move or exercise every day. Stay engaged with others and your community. Pamper yourself. You’re worth it. Do it! Living alone takes practice. Know that there is always someone you can call or something you can do to improve your situation. Getting out of your comfort zone is worth the discomfort. Try something new — pick up a musical instrument, take a memoir-writing class, learn a new language, start a book club, explore a plant-based diet — whatever piques your interest. It’s a great way to stretch yourself and meet others along the way. Isolating on holidays, birthdays, Sundays, etc. is for the birds. Solitary confinement is punishment for criminals, not single people. Make plans. Comb your hair. Lose the baggy sweatpants. Put a smile on your face. It’s important to create your own positive feedback. Caring about your appearance says a lot about how you value yourself. Traveling solo can lead to self-discovery and grow your self-reliance. Whether it’s Paris or Peoria, striking out on your own will expand your horizons, build self-awareness and increase your appreciation for diversity. You will become a more interesting person, not only to yourself, but to others as well. There’s no shame in asking for help. It’s not a sign of weakness. On the contrary. Asking for help shows confidence and resourcefulness. If feelings of fear, vulnerability or self-doubt overcome you; a little quiet time, meditation, and/ or prayer can be an answer. Embrace your spiritual side, however that
manifests itself in you. Your dream house can be yours. Whether it’s a cozy apartment or cottage in the country, you can — at long last! — make your home your own. Expanding your definition of love beyond “romantic love” will stand you in good stead. Embrace “passionate friendships” — those relationships in which you can be yourself and feel completely comfortable. It’s all yours — the good, the bad, the chores, the bills. Living alone, like married life, is not Shangri-La. It’s real life. And that’s a beautiful thing. Embrace it. Still in your PJ’s at noon? No one needs to know.
11.
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This We Know: 25 Things Living 12. Alone Has Taught Us
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By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
T
his September marks the 14th anniversary of my solo trip to Paris to celebrate turning 50. It also marks the anniversary of a decision I made that changed my life. It was in the “City of Light” that I decided to create a workshop designed to help women live on their own with more confidence and joy. Since launching the workshop in 2005, I have met and been inspired by countless courageous and resourceful women (and men, too) who are now living alone with success. They reinforce what I practice every day and what I “preach” in this column and my “Alone and Content” workshops — that the relationship with ourselves is the most enduring of all and worth nurturing. While many of the women and men I’ve met have encountered some very real and painful obstacles, they now embrace their independence and are busy leading interesting, full lives. They are making it on their own. These independent pioneers have discovered, as have I, that marriage is not the only state in which we can be truly happy, fulfilled, secure and complete. Whether divorced, widowed or “confirmed” bachelors or bachelorettes, they are not spending their time bemoaning their fate. They have taken their lives into their own hands and have come to appreciate the choices and opportunities that living alone has to offer.
This we know:
existing friendships, make new and interesting connections and spend quality time with family members. Loneliness is not a state of being reserved for single people. Did you ever feel lonely or neglected while being married or in a committed relationship? With time alone, spent with intention, you can re-awaken your true self and identify those things that bring you joy. When that happens, living alone can become a profound adventure of the spirit. The stereotypical image of single women and men as desperate and miserable are exaggerated and just plain untrue. Recent studies on the subject bear this out. Accepting party invitations is worth doing, even if you suspect the party will be mostly couples. Remind yourself that guests often separate into groups of women and men, so singles blend right in. Figuring out how to hire a contractor, buy a car or even replace the flapper valve in your toilet — all by yourself — can be very satisfying! Pursuing a new career, volunteer job or college degree in midlife can be liberating and rewarding. Doing a random act of kindness is a great antidote when you’re feeling alone or sorry for yourself. Despite past hurts, try your best to remain open to others who would like to get to know you. Relationships can add dimension and meaning to your life. That said, responding “yes” to a dinner date does not obligate you to anything. Living alone can release your inner Martha Stewart. Do you have a craft project secretly lurking
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7. 8. 9.
Drugs such as Benadryl provide little benefit to kids with cold
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Hanging out with negative 23. people is a real downer. Put yourself with upbeat people who
5.
Are Too Many Kids Prescribed Antihistamines?
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s d i K Corner
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Living alone doesn’t mean being 10. 1. alone. In fact, it can offer more time and opportunities to deepen
any U.S. doctors are much less likely to recommend cough and cold medicines for young children ever since experts advised against it in 2008, new research shows. That’s the good news. The bad news? Physicians are still more likely
13.
to recommend antihistamines for children under age 12 with colds, despite the fact that they provide little known benefit, the researchers from Rutgers University in New Jersey said. “Sedating antihistamines such as diphenhydramine [Benadryl] may have a small effect on some cold
17. 18.
symptoms in adults,” said study lead author Daniel Horton. He is a physician and assistant professor of pediatrics at Rutgers Robert Wood Johnson Medical School. “However, there is little evidence that antihistamines actually help children with colds feel better or recover faster. We do know that these medicines can make kids sleepy and some kids quite hyper,” Horton said in a university news release. Just over a decade ago, the U.S. Food and Drug Administration recommended against cough and cold medicines for children under age 2 due to safety concerns and uncertain benefits. The American Academy of Pediatrics later advised against cough and cold medicines in children under age 6. “Families often treat their children’s respiratory infections with cough and cold medicines, some of which include opioid ingredients, such as codeine or hydrocodone. However, there is little proof that these medications effectively ease the symptoms in young children,” Horton explained. “Also, many cough and cold medicines have multiple ingredients, which increases the chance of serious
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
make you feel good about yourself and about life. Mac and cheese may be just what the doctor ordered. There’s no harm in occasionally indulging in your favorite comfort food and tear-jerky movie. “The Way We Were” is my three-hankie movie of choice. Finding your home in your heart can deliver peace as well as power. Harness that potential and your contentment will know no bounds. Don’t we know it!
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 accidental overdose when combined with another product,” he added. In the study, the researchers analyzed more than 3 billion visits by children to U.S. clinics and emergency departments from 2002 to 2015. They found that physicians ordered a total of about 95.7 million cough and cold medications, 12% of which contained opioids. After the FDA’s advisory, there was a 56% drop in physician recommendations for non-opioid cough and cold medicines in children under 2 and a 68% decrease in recommendations for opioid-containing medicines in children under 6. Yet the researchers also found a 25% increase in doctor recommendations for antihistamines to treat respiratory infections in children under 12. “It is nice to see physicians are heeding the advice to avoid cough and cold medications for children, but switching them to antihistamines is not necessarily an improvement,” said study co-author Dr. Brian Strom, chancellor of Rutgers Biomedical and Health Sciences. The study was published July 29 in the journal JAMA Pediatrics.
Back to School on the Autism Spectrum A new academic year is always a challenge for some on the autism spectrum. But parents can take some steps to reduce the problem By Deborah Jeanne Sergeant
F
or some children on the autism spectrum, the change from summertime to school time represents a challenging ordeal. In general, children on the autism spectrum tend to rely upon predictability to feel more comfortable. New teachers, classmates, classrooms, books and more — all at once — can cause a good deal of distress for some. Lisa M. Latten, health project coordinator of the Southern Tier Initiative at University of Rochester Medical Center in the division of developmental and behavioral pediatrics, is also mom of Ian, 14, a new ninth-grader beginning his first year of high school this year. He’s also on the autism spectrum. Regardless of the grade Ian starts, Latten has always prepared for back-to-school by planning ahead. She advises other parents of children on the spectrum to do the same to make easier the switch from summer to school. A few times before school begins, she takes Ian to the school so he can tour the building. As they walk around where Ian will spend his school days, Latten takes photos and videos of where Ian will get on and off the bus and the rooms where Ian will attend classes and eat lunch. Meeting new school personnel in advance or obtaining photos is also helpful. “Schools are usually super accommodating if you call ahead,” Latten said. “We have never had an issue with that in the past. When parents explain what the need is and why they need to do it, people don’t have a problem.” She tries to prevent transportation mishaps by recording Ian’s bus number, too. She writes on a calendar dates such as when they’ll tour the school and the first day of school so he can anticipate what will come next. “Having the schedules and visuals like a calendar are ways to decrease some of the anxiety with school coming up,” Latten said. “It can be hard getting them back into the routine when there’s a long break.” That’s why she also keeps Ian on the same sleeping schedule throughout the summer so he has one fewer adjustment to make. Latten also tries to prevent misunderstandings by creating what she calls a “one-pager,” a printed explanation of Ian’s challenges since it’s difficult for him to verbalize his needs. She said that many parents of children on the spectrum do this. The adults Ian encounters throughout his school day each receive a copy of his “one-pager” such as his bus driver and teachers. It’s not an academic
plan, but a list of what he likes and things that make him feel anxious, along with a photo of Ian. “Parents typically send it with the child on the first day or email it,” Latten said. “Every year I send an updated one-pager. That can prepare your child to be more successful. That can make the start of the school year a little less stressful.” She also buys supplies and new clothes early to avoid a last-minute rush and makes a checklist so she doesn’t overlook anything. These measures help Ian and his mom feel better prepared. At home, Latten helps Ian adjust by not planning anything in the evening for the first few weeks of school so Ian can get more rest. Parental response to the backto-school period also matters. Latten said that if parents worry about what their children will face, their children can pick up on that anxiety, so re-
maining calm can help foster a sense of calm in their children. Joyce Wagner, Ph.D at Restoration Counseling of Rochester, supervises at Mary Cariola Children’s Center, a school for children on the autism spectrum and with learning challenges. She encourages parents to involve their children’s sense in their back-to-school planning with a bedtime story that will take them through their day. A scrapbook with photos of their school, teachers, and bus can be helpful, along with things
that engage their senses, like feeling a piece of smooth wood to remind them of their school desk. “Put their meal on a tray at home like at school and have them drink from little cartons,” Wagner suggested. “Bus drivers will run their routes early. If you can, ask the transportation department to let your child see the bus and meet the driver.” She also said parents should remind their children of possible triggers such as a fire drill so they can plan ahead.
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www.golisanoautismcenter.org September 2019 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Asthma, Allergies: New School Year Can Bring Flare-Ups
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s kids head back to school, it’s important for parents to keep potential asthma and allergy challenges in mind. “In the fall, allergists see an increase in kids’ visits for allergies and asthma because of a combination of factors,” said physician Todd Mahr, president of the American College of Allergy, Asthma and Immunology (ACAAI). “And hospitals see what’s known as the ‘September spike’ because kids who have been off asthma controller medications for the summer start experiencing flare-ups in the fall.” As a new school year begins, kids are exposed to allergens in the
classroom, on playing fields and in the cafeteria that many probably haven’t run into all summer, he said in an ACAAI news release. On top of that, it’s ragweed season — a terrible time of year for kids who are allergic. Mahr suggests parents meet with their child’s allergist this month to create an allergy action plan. Parents should also try to identify potential asthma and allergy triggers that their children may encounter at school. These may include chemical compounds from new carpeting, pollen drifting into classrooms through open windows, or mold in bathrooms. Parents should discuss poten-
tial triggers with teachers and school administrators to help ease symptoms. Children with asthma or allergies should still be able to play any sport as long as they follow their allergist’s advice, according to the ACAAI. While physical activity can cause airways to constrict, if your child’s asthma is under control, he or she should be able to participate. Make sure coaches and physical education teachers know what to do if a problem arises. If your child has a food allergy, make sure the school is fully informed. Work with your allergist
and school staff to develop an action plan that lists foods your child is allergic to, treatment procedures and emergency contact information, the ACAAI advised. Be sure your child understands what to do if he or she suffers an allergy or asthma emergency at school. They should carry and know how to use asthma and anaphylaxis medications, and school staff also should know how to administer them.
Sensory Clothing Meets Kids’ Needs
By Deborah Jeanne Sergeant
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or many families, shopping for back-to-school clothes is more than another errand. It’s a big challenge because their children’s sensory issues make ordinary garments extremely uncomfortable — even painful — to wear. A tickly tag or garment’s seam easily ignored by other children feels very bothersome to a child with sensory differences. Stiff fabric, bumpy textures and hard garment features like zippers, grommets and buttons rule out many garments, as these cause non-stop irritation. Sensory issues are common among people on the autism spectrum. Joyce Wagner, Ph.D. at Restoration Counseling of Rochester, supervises at Mary Cariola Children’s Center, a school for children on the autism spectrum and with learning challenges. Paraphrasing autism expert Temple Grandin, Wagner said that people not on the autism spectrum have 10 “cables” wired to their
brain, with two going to each of the senses. In autistic children, “some are re-wired,” Wagner said. “They may have four or five going to the sense of touch. It is like a typical person wearing a scratchy wool sweater against the skin. If you can’t get comfortable you can’t calm down. Their skin is super sensitive.” It’s not a simple preference for soft clothing, which neuro-typical people experience. It’s a necessity to feel comfortable and relaxed. Children with sensory disorders may have different clothing needs and aversions. For 14-year-old Ian Latten, silk screen decals on T-shirts are among the clothing features that he cannot tolerate. His mom is Lisa M. Latten, health project coordinator of the Southern Tier Initiative at University of Rochester Medical Center division of developmental and behavioral pediatrics. Latten has noticed that as Ian has grown older, it’s been more chal-
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lenging to find comfortable fabrics and fits for him. A ninth-grader this year, Ian likes shirts with no tags or embellishments and socks without seams inside. “He has to look at everything and make sure there’s no tag,” Latten said. “If the tag is on the side, he wants the tag cut off. He feels it and knows to look for it.” Many mainstream manufacturers have opted for printed tags instead of physical tags, which has made finding shirts a little easier. Finding pants Ian likes is more difficult. Latten feels thankful for the current athletic wear or leisure wear trend that favors slip-on pants in soft fabrics, since Ian cannot wear jeans, corduroy or khaki fabrics or pants that zip and button. She said that some parents of children on the autism spectrum relate that their children experience similar issues. Some have limited fine motor skills, so clothing with hidden Velcro fasteners and shoes that slip on and off make dressing easier. Children with sensory issues usually let their parents know what irritates them. The problem lies in finding clothing that accommodates their children’s needs, looks like their friends’ clothing, and fits within the family budget. “Having other parents within the autism community to ask about what worked for their child is really important,” Latten said. “Parents who have done this before you know all the tricks.” While specialty stores and websites sell sensory sensitive clothing, the colors and styles are usually very limited and not stylish. Older children may not want to wear something different from their friends. Since “feeling is believing” for many children like Ian, shopping at retailers in-person may spare a family a huge pile of returns to ship back. Clothing from specialty stores also tends to cost more than clothing from mainstream stores in many cases. “It’s about finding what works,” Latten said. She noted that a few stores are beginning to stock sensory clothing as they become more aware and accepting of children’s needs and realize that sensory clothing isn’t a
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
trend but a previously unfilled need for some families. Latten wants more children to become more accepting, too. “Parents, in general, if you can teach your children to be kind and accepting of every child, that can help children who are different,” Latten said. “As they age, their differences can be more pronounced. Kids can be mean.”
Where to Find Sensory-Friendly Clothing
So where can parents find sensory friendly clothing in mainstream stores? • Target offers numerous sensory friendly selections among their Cat & Jack line. • Kohl’s Jumping Beans, SO and Urban Pipeline clothing also provide sensory conscious features. • Tommy Hilfiger’s Adaptive line includes clothing with features such as magnetic closures for people with fine motor difficulties, pre-washed softness and printed tags. • Many shirts at Old Navy and Under Armor feature printed tags, no silk screens or appliqués and soft fabrics. The latter also carries compression clothing. Though intended for athletes, these tight garments in moisture-wicking fabrics appeal to those who feel soothed by snug clothing. • Zappos sells many lines of clothing and shoes that meet a variety of needs, such as clothing that can be worn inside out or backwards (Independence Day, 4Ward), zipper-opening shoes (Billy Footwear, Nike), and easy-closure garments (MagnaReady). Stores that specifically target sensory needs include: • www.kozieclothes.com (sensory clothing, including compression) • www.funandfunction.com (sensory clothing, including compression) • www.worldssoftest.com (soft socks) • www.nonetz.com (swim trunks with no net liner)
Why Doctors Want School Bells to Ring Later Medical groups recommend that middle and high schools should start 8:30 a.m. or later
K
ids may be sleeping in to rest up for the upcoming school year, but there are some big questions keeping experts up at night. Is lack of sleep among adolescents paving the way for future health problems? Are school bells ringing too early in the morning? The answer is yes on both counts, according to Marie-Pierre St-Onge,
associate professor of nutritional medicine at Columbia University in New York. She is a leading researcher on the links between sleep and overall health. “Obviously heart disease is not as much of a problem in teenagers,” said St-Onge, who led a panel that wrote a 2016 American Heart Association scientific statement on sleep and heart disease. “But we’re becoming more and more knowledgeable
about the adverse health effects of inadequate sleep, and we’re setting them up on a bad trajectory.” In the short run, she said, sleep-deprived teens are more prone to risk-taking behaviors ranging from careless driving to drug abuse. They also are losing valuable hours of memory consolidation. That is a process in the brain during sleep that is key to learning. Longer term, St-Onge said, teenagers who sleep in on weekends after an exhausting week develop “what we call a social jet lag. Having a two-hour jet lag has been associated with increased risk of obesity and diabetes. These poor lifestyle habits are being formed in a critical period of development.” A study published last year in the journal Pediatrics echoed that finding. Researchers tracked 829 adolescents and concluded those with longer and better-quality sleep had lower blood pressure, better cholesterol results and less tendency to be overweight. The study concluded it makes sense to assess how improving sleep quantity and quality can be a strategy to improve the “cardiovascular risk profiles” of teenagers. It’s not just that young people like to stay up late. Their circadian rhythms, the internal body clock that determines whether one is sleepy or alert, are changing. “Young children are always up early,” St-Onge said. “But as you get older your circadian rhythms get delayed. It’s a true biological response.” That has led many medical groups, including the American Medical Association, the American Academy of Pediatrics and the
Are Your Children Getting Enough Sleep? The consensus is that school children could have a few more hours of sleep By Deborah Jeanne Sergeant
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ost parents realize that their children need a good night’s sleep for good health and academic performance, but few children sleep enough. Only one-fifth of children and teens get enough sleep each night, according to a study released in February 2019 by author Gregory Knell, PhD, a postdoctoral research fellow at UT Health School of Public Health in Dallas. The National Sleep Foundation’s website states that only 15% of teens sleep enough on school nights. “Sleep is the most important thing you can do for mental health,” said Joyce Wagner Ph.D at Restoration Counseling of Rochester. “The No. 1 intervention for all mental health disorders is to go to bed and get up at the same time. Kids need the structure and routine. Their bodies like it.” Children and teens who do not get enough sleep at night can have more problems the next day at school. Meghann Peters, registered polysomnography technician with Sleep and Wellness Centers of Western New York, said that lack of sleep can foster behavior that “mimics attention deficit disorder, but it’s not. It’s lack of sleep. It can affect mood and cognitive ability.” Sleep and Wellness Centers operate offices in several Upstate New
York locations Peters added that the long-term effects of chronic lack of sleep in children can include obesity, heart disease and diabetes. Peters said that children and teens need more sleep than adults — 10 to 12 hours, compared with eight for adults — because their growth hormones are released during sleep. Peters recommended several steps for improving sleep: • “Parents need to have children and teens go to bed earlier. They need a set bedtime. • “The parent needs to make sure they set up a controlled environment: a bedroom that’s cool, dark, quiet and comfortable. Turn off the radio. Sleeping to music isn’t helping you. • “Kids should avoid caffeine. Even chocolate has enough to affect September 2019 •
sleep. • “Have a set bedtime and don’t deviate from it unless you absolutely have to. • “Especially for younger children, develop a routine like reading for them. Spend 10 to 30 minutes with them before bedtime. • “Do not let your child watch something inappropriate like a scary movie, as that will tend to increase nightmares. • “If the child is still tired and they’re getting 10 to 11 hours of sleep, contact the doctor, as the child may have sleep apnea caused by enlarged tonsils or certain facial features. Elizabeth Murray, pediatrician at Golisano Children’s Hospital, also offered suggestions: • “Do your best to have a set
American Academy of Sleep Medicine, to recommend that middle and high schools should start no earlier than 8:30 a.m. “It’s a complicated public policy problem, but the science is really quite clear,” said Terra Ziporyn Snider, executive director of Start School Later, a nonprofit advocacy group whose name makes its goal clear. “We’re really talking about enforced sleep deprivation across an entire society.” Snider estimates only about 15% of the nearly 14,000 school districts in the U.S. meet the 8:30 a.m. guideline for their high schools. While some districts have changed in recent years, late-start advocates have run into a range of objections: the effects on school bus routes; extracurricular activities; accommodating parent work schedules; and not letting teens sleep in. “People have this old-fashioned reaction. ‘You’re coddling your kids; I did chores at 5 a.m.,’” Snider said. “Community life revolves around school times, and the idea of change gets a lot of people very upset.”
schedule, especially on the weekend. It’s easy to have a sleep-a-thon over the weekend but it doesn’t help when the weekday is back. Teens often have after school sports and want to go out with friends and spend time with family. Parents should work with school districts to set a better schedule, but with changes in childcare and after school activities, it becomes complicated. • “Make sure they have technology out of their room as much as possible. We know teenagers need that social community and feeling of connection with peers but they shouldn’t text all hours of the night. It’s difficult if they feel they’re missing out, but get all tech out of the bedroom. No child should have a TV in their room. Get tablets, phones and computers out of the sleep space. Avoid screen time in the hour before sleep. Elizabeth Murray, pediatrician at Golisano Children’s Hospital, also offered suggestions: • “If they have more lights than a nightlight, get it out of the room. Don’t put up Christmas lights around the room or things like that. You need dark, cool and quiet, unless you use white noise. • “If kids are having problems sleeping, we ask if there’s anything about their bedroom that bothers them. We often hear, ‘I hate the mirror’ or ‘The shadow behind the door bothers me’ or ‘I don’t like the lamp.’ Ask if there’s anything you can do to ‘feng shui’ the room. • “Check the mattress. • “See if something is troubling them socially.”
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Myths About Children’s Eyes
The American Academy of Ophthalmology reveals seven common misunderstandings about children’s eye health
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hink you have the facts on your child’s eye care? When is the right time to have their eyes checked? Is too much screen time damaging their eyes? Do they need to wear sunglasses? There are a lot of myths and misinformation out there about children’s eye health. Don’t turn to Dr. Google for answers, ask your ophthalmologist — a physician who specializes in medical and surgical eye care — if you want to set your child up for a lifetime of good vision. Here, the American Academy of Ophthalmology debunks seven common myths about children’s eye health:
Pink eye only happens in young 1. children. While young kids are known for getting pink eye, due to
close contact in day care centers, so can teenagers, college students, and adults — especially those who don’t clean their contacts. The best way to keep pink eye from spreading is to practice good hygiene, including washing your hands, not touching your eyes, and using clean towels and other products around the face.
Antibiotics are necessary to cure 2. your child’s pink eye. Antibiotics are rarely necessary to treat pink eye.
There are three types of pink eye: viral, bacterial and allergic conjunctivitis. Most cases are caused by viral infections or allergies and do not respond to antibiotics. Antibiotics may be prescribed for bacterial conjunctivitis depending on severity. Mild cases of bacterial conjunctivitis usually resolve on their own within 7 to 14 days without treatment.
Sun is bad for your eyes. While it’s 3. true that long-term exposure to the sun without proper protec-
tion can increase the risk of eye disease, some studies suggest sun exposure is necessary for normal visual development. Children who have less sun exposure seem to be at higher risk for developing myopia or nearsightedness. Just make sure they’re protected with UV-blocking sunglasses and sunscreen.
Blue light from screens is damaging 4. children’s vision. Contrary to what you may be reading on the
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Internet, blue light is not blinding you or your screen-obsessed kids. While it is true that nearsightedness is becoming more common, blue light isn’t the
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culprit. In fact, we are exposed to much more blue light naturally from the sun than we are from our screens. The important thing to remember is to take frequent breaks. The Academy recommends a 20-20-20 rule: look at an object at least 20 feet away every 20 minutes for at least 20 seconds. Vision loss only happens to adults. 5. The eyes of a child with amblyopia (lazy eye) may look normal,
but this eye condition can steal sight if not treated. Amblyopia is when vision in one of the child’s eyes is reduced because the eye and brain are not working together properly. Strabismus (crossed eyes) is another eye condition that can cause vision loss in a child. Strabismus is when the eyes do not line up in the same direction when focusing on an object.
All farsighted children need glass6. es. Most children are farsighted early in life. It’s actually normal. It
doesn’t necessarily mean your child needs glasses because they use their focusing muscles to provide clear vision for both distance and near vision. Children do need glasses when their farsightedness blurs their vision or leads to strabismus. They will also need glasses if they are significantly more farsighted in one eye compared with the other, a condition that puts them at risk of developing amblyopia.
There is no difference between 7. a vision screening and a vision exam. While it’s true that your child’s
eyes should be checked regularly, a less invasive vision screening by a pediatrician, family doctor, ophthalmologist, optometrist, orthoptist or person trained in vision assessment of preschool children, is adequate for most children. If the screening detects a problem, the child may need to see an ophthalmologist or other eye care professional. A comprehensive exam involves the use of eye drops to dilate the pupil, enabling a more thorough investigation of the overall health of the eye and visual system. “As the kids head back to school, show them that you’ve done your homework,” said physician Dianna Seldomridge, clinical spokesperson for the American Academy of Ophthalmology. “Educate yourself so they will have the best chance to preserve their vision for a lifetime.”
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SmartBites
By Anne Palumbo
The skinny on healthy eating
Lose Weight, Improve Skin with Zucchini Y ears ago, when gardening friends left baskets of zucchini on my front porch, I used to get so rattled. Blind to its taste, ignorant of its nutrition, I’d fret over what to do with the unwelcome lot. But now that I’ve become zucchini-savvy, I’m genuinely elated when zucchini season rolls around. I adore this versatile summer squash! It’s as nutritious as it is delicious. Similar to watermelon, zucchini’s most bountiful nutrient is water: 95%. This all-important nutrient helps to regulate temperature, promote healthy digestion and curb constipation by producing softer stools. And while zucchini doesn’t have the fiber content of, say, peas or broccoli, it’s got enough to help move things along by producing bulkier stools. Zucchini teems with vitamin C, with one small zucchini providing close to 40% of our daily needs. A powerful antioxidant and immune-booster, vitamin C is certifiably our skin’s best friend: it helps keep skin strong and firm by triggering the production of collagen; it helps prevent sun damage by neutralizing
damaging free radicals; and it promotes wound healing. Some say you can even use zucchini to treat puffy eyes by placing raw slices over your eyes for 10 minutes. Feeling blah? Reach for some zucchini! Because zucchini provides healthy doses of many B vitamins, especially vitamin B6, it can help boost energy production and reduce fatigue. What’s more, vitamin B6, which is involved in the production of mood-elevating serotonin, may also help regulate sleep and lift spirits. And, like most plant-based foods, zucchini is packed with antioxidants, those magical molecules that minimize cell damage that may lead to heart disease, cancer, macular degeneration, and other age-related diseases. Research indicates the highest levels are found in the zucchini’s skin and that yellow zucchinis may contain slightly higher levels than green ones. Finally, regular consumption of zucchini may help you lose weight. Rich in water and fiber and yet low in calories (only 40 per small zuc-
chini), zucchini may help you feel full longer and reduce hunger—potentially leading to weight loss over time.
Zucchini “Noodles” with Sesame-Peanut Sauce
Adapted from Fat-Free Vegan Kitchen
3 small zucchini (or, one package of fresh zucchini noodles) 1 red bell pepper, julienned 2 tablespoons peanut butter 2 tablespoons water 1 tablespoon cider or rice vinegar 1 tablespoon soy sauce 2 – 3 cloves garlic, minced ½ - 1 teaspoon Sriracha or hot sauce 1 teaspoon sesame oil 1 teaspoon grated fresh ginger Salt and pepper to taste Wash zucchini; trim ends. Use a spiralizer to turn zucchini into “noodles.” Line a large bowl with paper
Helpful tips:
Select small- to medium-sized zucchini with shiny, unblemished skin; it should feel firm and heavy for its size. Smaller zucchini tend to taste better. Don’t cut up or wash zucchini until ready to use. Store it in a loosely closed plastic bag for up to one week. Leave the rind on whenever possible: it’s loaded with nutrients! towels; place zucchini noodles in the bowl along with the julienned red bell pepper. Let rest 10 minutes. In a small bowl, whisk the peanut butter with the water until well combined; then mix in all the remaining ingredients. Taste and adjust seasonings. Remove the towels from under the zucchini. Add the sauce and stir well to coat the noodles completely. Serve immediately, garnishing it with fresh basil if desired. (Optional: Add a legume such as edamame or black beans to make it more filling.)
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.
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Why take the risk? Pregnancy and alcohol don’t mix By Jennifer Faringer
A
s we approach fall and the month of September, let’s consider spreading the word regarding Fetal Alcohol Spectrum Disorders (FASD) Awareness Month, and Sept. 9 International FASD Awareness Day. The effects of FASD related disorders can last a lifetime but FASD is 100% preventable. Avoiding all forms of alcohol throughout pregnancy (or even while at risk for or considering pregnancy) will guarantee that a child will not be born with a FASD. A new National Institutes of Health study found that rates of FASD are comparable to that of autism. Up to one in 20 U.S. school children may have a FASD, many of those children are undiagnosed. The approximate 40,000 babies born each year with a FASD, often resulting birth defects, intellectual or learning disabilities, behavior problems, and difficulties learning life skills. Yet about one in 10 pregnant women in the U.S., ages 18-44, reports having at least one alcoholic beverage in the past 30 days while pregnant according to the Center for Disease Control (CDC). Plan for a healthy baby, don’t drink any alcohol if you are pregnant or could become pregnant. If you become pregnant, stop drinking alcohol, everyday matters. The sooner you stop drinking the better the outcome for your baby. Help is available. For resources that include education, diagnosis, intervention, treatment referral visit our website at: www.ncadd-ra.org. See our FASD resource page at: https:// ncadd-ra.org/ resources/awareness-campaigns/ fetal-alcohol-spectrum-disorder/ or call 585-719-3480 for more information.
The Psychology of Happiness in the Modern World In a recent book, local professor Jim Allen examines how cultural and economic factors affect personal happiness By Amy Cavalier
U
nlocking the key to happiness is a million-dollar industry. From positive thinking and meditating to losing weight and getting rich quick, everyone is looking for a silver bullet to everlasting splendor. “I think there’s a misconception that happiness is something ‘out there’ that we can find,” said Jim Allen, a professor at the SUNY Geneseo who has been teaching a course on happiness for the past 10 years. “For instance, people in Western New York seem positive that they’d be happier if they could live in South Carolina or people think they’d be happier if they could just get married,” he explains. In his experience teaching, Allen found most textbooks were focused on “positive psychology” or the individual factors that can influence personal happiness, things like practicing gratitude, being kind and optimistic and seeking positive social interactions. While that approach to happiness is credible, Allen said, there’s more to it. “Sure, individuals are responsible for their own happiness, but that’s not the entire story,” said Allen. “The culture and economy around them also matters a lot.” That’s why Allen decided to dig deeper into the societal, cultural and economic factors that influence our well being in his own textbook.
Money can’t buy happiness First and foremost, happiness requires a minimum standard of living in which the basic needs for safety, shelter and sustenance are met, also known as the “bread line,” said Al-
len. That cost varies based on culture and living standards. In the United States, it’s estimated the breadline is $85,000 a year for a family of four. “This number reflects having met the basic necessities of food, shelter, clothing, safety, but it also seems to reflect the ability to fully participate in one’s society, enough money to feel like you’re not left out of what most people around you are doing,” said Allen. According to the World Happiness Report, the United States ranks 19th out of 156 countries. That’s despite low crime rates and a strong economy. Northern European countries such as Denmark and Switzerland traditionally rank highest in happiness. One thing they all have in common is a basic sense of decent living for all citizens, said Allen. Research shows that income equity benefits not just the poor but also the wealthy by way of fewer suicides, less crime and better overall health. Other factors of a nation’s overall happiness include a functioning democracy, a clean environment and lack of corruption. It’s certainly not a case of bigger is better. The average home in Demark is 1,200-square-feet versus 2,300-square-feet in the United States. It’s not necessarily the number of things we own but how much we value those things and to what extent do we allow those things to define us that determines well being, Allen explains. “If I buy a guitar to pursue a genuine music interest, that’s likely to make me happier,” he said. “If it facilitates genuinely close emotional relationships, that’s even better.” Beyond money and stability,
SUNY Geneseo professor Jim Allen has been teaching a course on happiness for the past 10 years. He’s scheduled to talk about his new book Sept. 10 at Brighton Memorial Library.
Jennifer Faringer is the director, DePaul’s NCADD-RA (National Council on Alcoholism & Drug DependenceRochester Area). Page 20
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
New book by Jim Allen, a professor at the SUNY Geneseo.
Meet the Author Join the Rochester Minimalists from 6:30-8:30 p.m. Tuesday, Sept. 10 at Brighton Memorial Library, 2300 Elmwood Ave. for a discussion with Jim Allen, author of “The Psychology of Happiness in the Modern World.” there are basic psychological needs that need to be met in order for a person to function at a high level. Allen said emotionally close relationships with a relatively small number of other people is probably the single most important factor in happiness. “They can’t be mere acquaintances,” he said. “We have to expect they will occur regularly, they must be positive and emotionally supportive.” We all have a need for a sense of purpose, a feeling that we’re competent and a feeling of autonomy or a feeling that we’re in control of our own lives and decisions to be happy. While avoiding social comparisons is also linked to satisfaction, it’s something that can be difficult to achieve in a capitalist culture that promotes materialistic values and allows almost no restrictions on advertising, said Allen. Along with the need to keep up with the Joneses comes the emphasis on being a “good” worker and putting in long hours at the office which interferes with family life and establishing relationships. “The point is, our culture often makes it difficult for us as individuals to do things that would make us happier,” Allen said. While all these things can help, Allen said it’s also important to temper your expectations for happiness. “These things only work if we don’t monitor our moment to moment happiness too closely and if we’re realistic about how happy we can expect to be,” Allen said. “No one is going to be over the moon happy all the time.”
W
hen Charelle Smith turned 21, it hit her that she did not like herself. “I tried many different things and I would lose maybe 20 pounds and then nothing. So, I would get frustrated and give up.” Sound familiar? In 2014, she decided to get serious about her weight loss journey and began to work out three to six hours a day, five to six days a week. She lost 90 pounds within a year and a half, but back issues brought that strenuous workout schedule to a halt. She had back surgery in 2017 and 2018. Understandably, because she was restricted in the type of exercise she could do, she gained most of her weight back. “I was becoming depressed because I couldn’t work out and had to find something to help me. I had a friend who had done a custom program and had lost a significant amount of weight,” she said. “I followed his journey — he became kind of a mentor-coach for me — and I did the program as well. I lost about 31 pounds through the program. However, I lost the rest of my weight on my own by incorporating into my daily life what I learned and how my body works with different foods,” explains Smith. She has lost 155 pounds — nearly half her starting weight. “Through the process I learned a lot of important key factors to help me succeed long term. I also don’t like calling it a diet, or when someone else calls it that. It’s not a diet. I’ve tried diets and they failed. This is a lifestyle change,” she noted. Major factors in the lifestyle change included understanding portions, healthy fats, good carbs and the best ratio of proteins, fats and carbs that works best for her body metabolism. Initially, she ate foods from an “approved” list featuring those with low sugar or that were good carbs. There was a huge selection to choose from, so her meals still offered variety, and that was key to avoiding meal boredom. In addition to eating the right choice and combination of foods, she fasted intermittently to boost her metabolism. Smith has realized that she still
Weighty Issues Charelle Smith talks about losing 155 pounds — nearly half her starting weight By Lynette M. Loomis needs to experiment with new ways of preparing foods to determine how they react with her metabolism. Anyone who has tried to overcome any obstacle in life understands the importance of having people in your corner — those people who encourage you even when you want to give up. In addition to her mother, Smith’s fiancé was a strong supporter. “My fiancé, Ryan Davis, stood by me 100% He was so supportive and helped keep my spirits up when I got down because I plateaued or gained even a few ounces.” “He tried eating like I did so I would have no temptation, and he pretty much still does eat the same
September 2019 •
as me. If he wanted a snack, he wouldn’t eat it around me, especially in the beginning when it was hard, and my body was adjusting to the eating changes,” she noted. “On the program, I learned that when you eat is also as important as the food you eat. I try to eat at certain times to keep my metabolism working so it doesn’t slow down and store fat. To help, Ryan does most of the cooking since he gets home before me and he can have our dinner done when I get home which helps me keep to the mealtime schedule I like to follow. “
‘Don’t give up’
Smith said the most difficult part
was adjusting to the changes necessary in her eating habits and, in the beginning, being hungry all the time and feeling nauseous because she was hungry. “I used to eat anything and anytime I wanted, so I had to retrain my body and appetite to follow a different schedule. I also tried foods I would never have eaten before — like zucchini — and really liked it. I knew I had to lose the weight for my health and to be happy with myself, but there were times it was hard. So, to help with the hunger, I chewed a lot of gum and tried drinking as much water as possible to make myself feel full,” Smith said. Her mother, Mary Ellen Smith, said Smith was 4 when she began gaining weight and gained on average over 25 pounds a year. “It just didn’t seem right to me that she would gain that much each year — when most adults don’t — since I prepared her meals and she was either at home, school or day care. I knew what she was eating. I cooked lean meats, low fat foods, and vegetables. Of course, there would be snacks — but not any more than most children would be allowed to eat. “I would always question her doctor about her weight. And, of course, I would hear the same old thing about eating less and exercising more.” Mary Ellen Smith wasn’t happy with these stock answers because she knew what her daughter ate and how active she was in sports, including softball and swimming.
Pinpointing causes
The chemistry behind it wasn’t making sense to Mary Ellen and when Charelle was a ‘tween, she developed a dark thickening of her skin around her neck — acanthosis nigricans. That led to a diagnosis of pre-diabetes as well as a hormonal imbalance. Mary Ellen recalls, “Finally, we knew that her struggle with her weight had at least two causes behind it. That didn’t mean she couldn’t lose weight. But it was part
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of the reason why she struggled to lose it in her younger years. As she got older, and was in control of her food choices, her weight did continue to increase because her food choices were bad and unhealthy. “It became a vicious cycle — she ate, gained weight, was unhappy, was angry, was sad and depressed, felt rejected, and then she ate more. Her weight and a skin condition both added to her insecurities and low self-esteem.” No mother likes to see her child hurt, even when the child becomes an adult. Mary Ellen knew the verbal cruelty, lack of respect and discrimination that occurred in Charelle’s workplace. “At first, I researched her symptoms that may have been contrib-
uting to her weight gain and then advocated for her with her doctors to check her thyroid and hormones. Then, I did what I could to block out the negative things people were saying and restore her self-worth by reinforcing her strengths, her positive attributes, and being there when she needed and not judging her. “I tried not to make her weight a big issue — she knew her weight was a problem — and there was no good to come from me harping on it. I wanted her healthy and happy, but she had to want it first. Whenever she was ready to do something about it, I was there to support her. “Sadly, girls more than boys are often judged by their looks and body type — of what’s culturally and socially appealing — so when you
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add being overweight with the skin condition, her insecurities and low self-esteem were no surprise. Even though she tried to hide a lot of her pain and feelings, I hated the thought of how people’s cruel comments and actions toward her made her feel so horribly bad. “And it didn’t get any better as she became an adult as such mistreatment continued in the workforce — the jobs she didn’t get due to weight discrimination and the lack of respect on the job.” Now that Charelle Smith has maintained her healthy weight and has a much better understanding of her metabolism, both mother and daughter are relieved and happy. She reports that she feels better physically and can do more things that she couldn’t before. “I am happy with myself and feel alive now and want to go out and do more things.
I don’t feel judged or looked at differently because I am smaller now,” she said. “Before I was embarrassed to eat around people. I would get more nervous on job interviews because they look at bigger people and assume larger people probably don’t work as hard and that they are lazy. And now, people are just nicer all the way around.” Charelle Smith offers some words of encouragement to other people facing the same challenges as she has faced. She said people can do anything they want, but that they really have to want it badly enough to put in the effort. “It’s not a quick fix. But nothing in life is easy and when you see the result, it makes all the frustration, tears, and whatever you go through in your journey well worth it,” she said.
CARE that CHANGES LIVES.
Charelle Smith recalls her journey of losing 155 pounds
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Excessive Video Game Playing Now Considered a Disorder By Deborah Jeanne Sergeant
T
he World Health Organization in May classified excessive video gaming as a disorder, and the American Psychiatric Association has included “internet gaming disorder” as a diagnosis. What is so captivating about gaming that players can, essentially, become dependent on it? Isn’t it just another fun pastime for children and teens? Joyce Wagner, Ph.D. of Restoration Counseling of Rochester, said that gaming possesses an addictive quality that other hobbies don’t. “What a lot of people say is they really like the community they find online,” Wagner said. “Instead of relationships face to face, they have relationships online.” The gaming world also allows users to vicariously live their fantasies as a break from the mundane world and a self image they may not like. “They can be whoever they want to be,” Wagner said. “People who struggle because they’re small want to be strong, so they pick a character who’s strong. People can look sexy if they want to. They can be who they want to be in real life.” She also believes that games featuring rewards such as points, prizes or access to the next level, along with bright graphics and upbeat music and sound effects, “really light up the pleasure center of the brain,” Wagner said. “For people addicted to gaming, it’s no different than people addicted to shopping.” The pleasure center craves more and more stimuli to remain satisfied. When this phenomenon occurs, many gamers lose awareness of what they’re doing or the passing of time. And that “zoned out” feeling enhances the experience for gamers who want to escape their lives. They become dependent upon gaming as a coping mechanism. “It would be like any other addiction, if a person had to do it, not that they wanted to,” Wagner said. “If it took more time, money or resources than what they had intended, it’s an addiction. If it affects significantly personal relationships at work or school, it’s an addiction.” Erin Weingart, licensed clinical social worker and practice owner of Quiet Mind Therapy Services in Rochester, said that some people long for social attachments and find them — on a certain level — through online video gaming. Other gamers already have something in common, their love of video games. That helps break through the awkward gettingto-know-you phase of acquaintance. Some gamers may feel frustrated
by their inability to succeed in their daily lives; however, while playing games they can save the day, win the race, or beat the bad guys. “There is also the challenge component where one can feel accomplishment and achievement by gaining rewards, tokens, status, etcetera,” Weingart said. “In my opinion, gaming that is problematic can be an issue of a larger system issue. With less and less in-person social connections, family systems that are stressed, coupled with the basic human need for attachment, gaming becomes a relationship that can meet these emotional needs for some. “Gaming can also become an avoidant behavior, an escape of having to cope in a world that has become very difficult for our youth.” But spending too much time gaming and talking about gaming constantly yet skipping previously enjoyed activities, family time, meals, personal care and slacking off at work or school indicates that it has become a real issue. Weingart said that addressing this issue can easily turn into a power struggle with children and teens; however, parents must limit gaming, along with providing wholesome activities and seeking professional help to address underlying issues. She listed social anxiety and difficulty with interpersonal relationships as possible contributors to gaming disorder. “With most parenting, consistency, setting limits and follow through is a must,” she said. Wagner also said that forcing a child or teen to quit cold turkey won’t work, but gradually decreasing the amount of time gaming and replacing it with an enjoyable activity, paired with a small, healthful reward helps since they have to switch from immediate gratification in the gaming world to delayed gratification in the real world. For example, in a video game, a level of the game may be completed and the player rewarded within half an hour. In real life, training to play on a soccer team and winning a game takes many weeks’ practice. But parents can offer small, incremental rewards for sticking with it. In the meantime, the child may form real world friendships as they participate in a sport, club or activity with others. “Real-world relationships take time,” Wagner said. “You have to build trust and social skills are involved. You have to move them out of this fantasy world and into the real world.” September 2019 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Meet Your Provider “Expect the Best from Today’s Modern Chiropractor” By William S Ferris, DC Q: What does the first visit at Modern Chiropractic & Pain Relief look like?
Q: How are you able to determine the alignment of my spine?
The initial visit is simple and quick. There is no removal of clothing, just a simple intake form and you immediately meet with the doctor. The doctor will take time to listen to your story and any treatments you’ve tried in the past and how the current pain is affecting your life. He or she may conduct in house X-rays if necessary and will then give you an accurate diagnosis and treatment plan.
Modern Chiropractic & Pain Relief has in-house state-of-the-art, hospital-grade Digital X-ray. The result is an extremely clear picture of spinal alignment or any mis-alignments. From there an accurate treatment plan can be made accordingly.
Q: Once I start going to a chiropractor do I have to keep going?
Yes. If you go to a dentist, he or she can clean your teeth but the alignment of your newly cleaned teeth remains unchanged. It is the orthodontist who deals with alignment issues. Within chiropractic very few have a subspecialty in correcting global alignment problems such as “tech neck,” which is characterized by loss of the normal cervical curve referred to as a lordotic curve. Modern Chiropractic & Pain Relief offers a sub-specialty to improve or correct such problems, which is quite unique in the Rochester area. We are able to quantify the improvements with
Not at all. At Modern Chiropractic we take pride in successfully “closing cases.” In other words, patients who come to us receive a start date and an end date for maximum clinical improvement so they can return quickly to the activities they enjoy.
Q: Can tech neck and hunching with aging be prevented?
pre- and post-radiographic images and teach you how to keep it that way.
Q: Why should I use Modern Chiropractic & Pain Relief over other choices in the area? Check out our online reviews. Real people, real results.
Q: Do medical professionals recognize your work as scientific, safe and effective? Absolutely they do. In fact, Modern Chiropractic & Pain Relief has distinguished itself in the area as innovative, evidence-based and technologically advanced. Not only do we have a very strong cross referral programs with local medical doctors, the fact is many actually come to us for their own musculoskeletal pain relief needs. In our view that is the strongest endorsement.
Q: How can I schedule a free consultation? Simply call 585-398-1201 and tell our front desk you would like a free
Dr. Ferris at his Victor office. consultation to meet with one of our doctors. After the free consultation if the doctor feels he can accept your case and you like the facility and doctor’s bedside manner, you can opt in for a full comprehensive exam and accurate diagnosis for only $29. Coming in to meet the doctor for simple discussion about your painful situation is offered as a free consultation before you make any further decisions.
Modern Chiropractic & Pain Relief and New York Weight Loss 311 W. Main St., Victor n 585-398-1201 n www.modernchiropractic.com
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Community Medicaid Promotes Long-Term Care at Home By Lori Parker, Esq.
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hen a loved one needs help with daily activities — bathing, dressing, eating, and personal hygiene — many people believe that a nursing home is their only option. In many cases, however, care can be delivered in the comfortable and familiar surroundings of home.
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Easing Your Worries to About Home Care Families considering home care frequently mention two concerns: 1) The burden of caregiving; and 2.) The cost of home care. New York’s Community Medicaid program can put both of those worries to rest. Community Medicaid helps families to arrange support and pay for in-home care that is tailored to their loved one’s needs. When someone enters a nursing home, they have no choice about who will provide their care. Under Community Medicaid, however, the ill person (or their authorized representative) chooses, trains and schedules the caregivers. One-to-one care can be directed to the patient’s specific needs — and Medicaid funds pay for the caregivers’ time. Anyone other than the ill person’s spouse can be a paid caregiver.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
Qualifying for Community Medicaid Financial eligibility for Community Medicaid depends on the applicant’s assets and income — but community Medicaid is not subject to the “five-year lookback” associated with Medicaid for nursing home care. In other words, a person can give away their assets and soon thereafter be eligible for Community Medicaid. Recipients of Community Medicaid may keep up to $879 of their monthly income. This amount might seem alarmingly low — but never fear: There are legal ways for recipients of Community Medicaid to get the full value of their monthly income. An attorney can help you to understand the techniques used to qualify applicants based on both assets and income. This has been a very brief discussion of a complicated process. An attorney can serve as your guide and explain details that may be important to your situation. Attorney Lori Parker is the principal at Parker Law Office, 2024 W. Henrietta Road, Rochester, NY 14523. To contact her, call 585-281-0717.
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Is Pet Insurance a Good Idea for Seniors on a Budget?
Dear Savvy Senior,
I own two dogs and a cat that I would do almost anything for, but expensive veterinary bills put a strain on my budget. Is pet insurance a good idea?
Older Pet Owner
Dear Pet Owner, If you’re the kind of pet owner who would do anything for their furry family, including spending thousands of dollars on medical care, pet insurance definitely is an option to consider. Here’s what you should know. Rising Vet Costs The cost of owning a pet has gone up in recent years. New technologies now make it possible for pets to undergo sophisticated medical treatments for many lifethreatening diseases, just like humans. But these treatments don’t come cheap. That’s why pet insurance has gotten more popular in recent years. More than 2 million pets are currently insured in the U.S. and Canada, according to the North American Pet Health Insurance Association. How Pet Plans Works Pet insurance is actually very similar to human health insurance. Pet policies typically come with premiums, deductibles, co-payments and caps that limit how much will be paid out annually. But unlike people coverage, you usually have to pay the vet bills in full and wait for reimbursement from the insurer. Pet policies vary greatly from basic plans that cover only accidents and illness, to comprehensive policies that provide complete noseto-tail protection including annual checkups and vaccinations, spaying or neutering and death benefits. You should also be aware that pet policies typically don’t cover preexisting conditions, and premiums are generally lower when your pet is young and healthy. Costs for pet insurance will also vary by insurer and policy, but premiums typically depend on factors like the cost of veterinary care where you live and the age and breed of the pet. The average annual premium for basic accident and illness coverage was $516 per pet in 2017, while the average claim paid was $278, according to the pet health insurance association. Shopping Tips Major pet policy providers
include the ASPCA, Embrace, Healthy Paws, Nationwide, PetFirst, Petplan and Trupanion. To help you shop and compare coverage and costs from pet insurers, go to PetInsuranceReview.com. If you’re still working, one way to pay lower premiums, and possibly get broader coverage, is to buy pet insurance through your employer, if available. Eleven percent of employers in the U.S. offer pet health insurance benefits, according to the Society for Human Resource Management, and these plans are usually discounted. Alternative Option Many animal advocates think most pet owners are better off forgoing pet insurance and instead putting the money you would have spent on premiums into a dedicated savings account to pay for vet care as needed. Depending on the policy, pet insurance can cost $1,500 to $6,000 over the life of an average pet, and most pet owners will never spend that much for treatment. Ways to Save If you can’t afford pet insurance or choose not to buy it, there are other ways you can save. For example, many local animal shelters offer free or low-cost spaying and neutering programs and vaccinations, and some shelters work with local vets who are willing to provide care at reduced prices for low-income and senior pet owners. There are also a number of organizations that provide financial assistance to pet owners in need. To locate these programs, visit HumaneSociety.org/PetFinancialAid. To save on pet medications, get a prescription from your vet (ask for generic is possible) so you can shop for the best price. Medicine purchased at the vet’s office is usually more expensive than you can get from a regular pharmacy or online. Most pharmacies fill prescriptions for pets inexpensively, and many pharmacies offer pet discount savings programs too. You can also save by shopping online at a verified pharmacy like 1800PetMeds. com, DrsFosterSmith.com and PetCareRX.com.
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No person shall be denied benefits or subjected to discrimination under any program or activity receiving Federal Assistance on grounds of race, color, sex, religion, national origin, disability, or marital status. This program is funded by participants’ contributions, U.S. Administration on Aging, N.Y. State Office for the Aging, N.Y. State Department of Health, Monroe County Dept. of Human Services / Office for the Aging.
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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. September 2019 •
Learn more at hoacny.com/Cyberknife CyberKnife treats tumors in the brain, spine, lung, liver, prostate and more. IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Ask St. Ann’s
Ask The Social
Security Office
From the Social Security District Office
Changing Your Direct Deposit Information with Social Security
W Spending Time With Grandparents By Triciajean Jones
D
id you know that Sept. 8 is National Grandparents Day? Celebrating Grandparents Day allows us to honor and experience the strength, knowledge and companionship our elders have to offer. At St. Ann’s Community, we value these opportunities and find great joy in honoring our seniors with special celebrations. For Grandparents Day this year, with the help of St. Ann’s Life Enrichment advocate team, the residents of St. Ann’s planned a teddy bear picnic. In addition to spending precious time with their grandchildren or great-grandchildren, residents will give each child a teddy bear to dress and keep. There will also be music and picnic foods to enjoy while they create new memories together. Here are some ways to connect with grandparents or special loved ones every day, not just Sept. 8.
Easy ways to connect The secret to bringing generations together is simple: spend time together doing everyday things. St. Ann’s Community offers a host of ideas to help you get started: • Food: Learning how to make a favorite meal or bake cookies are sensory experiences that nourish the soul as well as the body. • Stories: Interviewing an elder is an excellent way for kids to develop good communications skills and learn about their family’s history. • Photos: Create an album and identify the date, people and places in the pictures for future generations. • Hobbies: Identify multi-generational activities to enjoy together like a family book club or collecting stamps. • Music: Listening to a grandparent’s favorite song for connection can be especially engaging for those living with dementia • Family traditions: Whether it’s Sunday dinner or an annual roller coaster ride, moments become memories. • Keepsakes: Give a family heirloom to a grandchild, along with its story and meaning. Page 26
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Embrace technology
Time and distance don’t have to stand in your way when you can stay connected via Skype, FaceTime, and social media. Storytelling apps like Facebook, Forget Me Not Book, and StoryPress can help you share stories and photos for future generations. Tech-savvy grandparents can even shoot cooking demos to share with their grandkids on YouTube. Technology is helping families connect with their loved ones. For example, residents whose families cannot attend special gatherings like the teddy bear picnic at St. Ann’s Community, can use an iPad provided by St. Ann’s to connect with the young people in their lives.
Follow your heart
If you or a loved one are considering a move to a senior living community, choose one that encourages family participation and partnership. Look for meaningful activities, technology and spaces that make you feel welcome and comfortable. Grandparents Day is a gentle reminder that now’s the time to honor aging loved ones with love and gratitude whenever possible. If your grandparents are gone, there’s probably an older adult in your neighborhood or at a local senior living community who would appreciate your company. Seniors have much wisdom, encouragement and love to share, and what better place to be than on the receiving end? Triciajean Jones is director of Life Enrichment at St. Ann’s Community. Contact her at tjones@ MyStAnns.com or visit www. stannscommunity. com.
ith our busy lives, it’s easy to fall into that cycle of postponing some tasks because of other priorities. This may be true for you when it comes to changing your payment method for Social Security benefits. Unfortunately, forgetting to change your payment method can lead to delayed payments. The most convenient way to change your direct deposit information with Social Security is by creating a my Social Security account online at www.socialsecurity.gov/ myaccount. Once you create your account, you can update your bank information without leaving the comfort of your home. Another way to change your direct deposit is by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to make the change over the phone. If you prefer to speak to someone in person, you can visit your local Social Security office with the necessary information. Because we are committed to protecting your personal information, we need some form of identification to verify who you are. If you are online, we verified your identity when you initially created your my Social Security account. All you need to do is log in at www.socialsecurity. gov/myaccount with your secure username and password to gain access
Q&A Q: I am very happy that I was just approved to receive disability benefits. How long will it be before I get my first payment? A: If you’re eligible for Social Security disability benefits, there is a five-month waiting period before your benefits begin. We’ll pay your first benefit for the sixth full month after the date we find your disability began. For example, if your disability began on June 15, your first benefit would be paid for the month of December, the sixth full month of disability, and you would receive your first benefit payment in January 2020. You can read more about the disability benefits approval process at www.socialsecurity.gov/planners/ disability/dapproval.html. Q: I have been collecting disability benefits for a few years, but I’m getting healthy enough to work again. Can I return to work while getting Social Security disability benefits? A: Yes, you can return to work while receiving Social Security disability benefits. We have special rules to help you get back to work without lowering your initial benefits. You may be able to have a trial work pe-
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
to your information. If you call Social Security, we will ask identifying questions to ensure we are speaking to the right person. If you visit the office, you will need to bring a driver’s license or some form of ID with you. Once we have identified that you are the correct person and are authorized to make changes on the Social Security record, all we need is the routing number, account number, and type of account established. We don’t ask for a voided check, nor do we obtain verification from the bank. Therefore, you should be sure you are providing accurate information to us. Because you may be unsure if your direct deposit change will affect your next payment, we highly recommend that you do not close the old bank account until you have seen your first Social Security deposit in the new bank account. That way, you can feel secure you will receive your benefits on time, regardless of when the change was reported to Social Security. When you have to report changes to your direct deposit, be sure to visit us online at www.socialsecurity. gov/myaccount. Social Security always strives to put you in control by providing the best experience and service no matter where, when, or how you decide to do business with us.
riod for nine months to test whether you can work. If you get disability benefits and your condition improves or you return to work, you must report these changes to us. Call us at 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office. You can find your local office by visiting www.socialsecurity.gov/ locator. Q: Who is eligible for Supplemental Security Income (SSI)? A: People who receive SSI are age 65 or older, blind or disabled with limited income and resources. Go to www.socialsecurity.gov for income and resource limits. The general fund of the U. S. Treasury makes SSI payments. They do not come out of the Social Security Trust Fund. Q: I was turned down for Supplemental Security Income (SSI). Can I appeal the decision? A: You can appeal a decision made on your SSI claim. Learn more about appealing a decision, including how to submit your appeal online, at www.socialsecurity.gov/benefits/ disability/appeal.html.
Heart Rate and Blood Pressure Apps Helpful By Deborah Jeanne Sergeant
M
any smartphones come pre-loaded with an app for measuring heart rate, sometimes as part of a fitness suite that also tracks calories, water intake and activity level. To measure the heart rate, simply holding the pad of your finger against the phone’s built-in sensor offers a reading. The results are compared to an average heart rate range for activity level: resting, post-exercise and before exercise and even feeling love struck. But how seriously should you take these readings? And how should you use this information? Maddie Nizamis, certified personal trainer and co-owner of Studio 22 Personal Training in East Rochester, said that knowing if your workout is within range the target heart rate can offer a key indicator of fitness level. If your workout sustains an elevated heart rate, you know that you’re increasing in fitness level, not just burning some calories. It can also help you know if you’re working out too hard. Nizamis said that the phone apps should “give you a general range of where you are. It’s good to be aware heart-wise if you’re out running in the sun, for example. You can keep an eye on it.” An elevated heart rate reading could indicate that the heart is working very hard and it’s time to slow down. If you don’t have a heart rate app or device, Nizamis suggested a good general rule. “You can also go by how you’re feeling,” she said. “If you can comfortably speak with someone, you’re at heart rate that you’re not overdoing it. They’re relatively accurate for
giving you a range that you can help you pay attention to how strenuously you’re working out.” Tracking heart rate has become such an important component of improving fitness that some gyms offer the use of heart rate belts so members can follow their heart rate and even compare them with one another. Barb St. Pierre, owner of Trillium Sport & Fitness in Syracuse, said that the gym’s My Zone heart rate belt is about 95% accurate, “much more accurate than apps on phones or other devices” because it straps across members’ hearts. St. Pierre has a bachelor’s degree in exercise science and is a certified personal trainer. “We use it for everything, to monitor intensity of what they’re doing something and if we want them to work in a certain range, we can know if their heart is in the right range,” St. Pierre said. “We can know how effective the workout is and what their calorie burn is.” For people training for a marathon, half marathon, triathlons or other endurance-based event, it’s important to train so that their heart rate in the lower percentage when they’re exercising on a treadmill, elliptical machine or other equipment. At Trillium, the gym members can see the information from their heart rate monitors on their phones or on the screen at the gym. St. Pierre said that the wall display is “a great way to motivate people” as they can see how well they’re doing compared with others. “The quicker the heart recovers, the better the heart’s condition is,” St. Pierre said. “I can immediately tell just watching their heart rate what they are or are not doing. It’s super beneficial.”
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Finding an Alternative to AARP
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hile AARP, with a membership of around 38 million, is by far the biggest and most powerful advocacy group for people age 50 and older, there are millions of older Americans that don’t like or agree with its stance on various issues. Many believe AARP leans too far to the left despite its stated nonpartisan nature. For seniors that disagree with AARP, there are other conservative leaning groups that seniors can join that may better represent your views. And, many of them offer their members discounts on things like travel, insurance, healthcare and more. Here are several to check into.
60 Plus: American Association of Senior Citizens
60plus.org
Established in 1992, this nonprofit group was founded to lobby for issues it holds dear, namely free enterprise, fewer taxes and less government. Its main priority is to end the federal estate tax and preserve Social Security. Membership fees run $12, $24 or $48 per year, or $299 for a lifetime membership. They also offer a bevy of discounts on travel and
entertainment, cable, Internet and satellite services, dental, vision and hearing packages, roadside assistance and more.
American Seniors Association
AmericanSeniors.org
Founded in 2005 for people aged 50 and older, this conservative organization is built on five foundations, which includes rebuilding national values, Social Security reform, Medicare reform, tax code reform and control of government overspending. Fees to join run $15 for one year, $25 for two or $35 for three years, and members receive access to a variety of benefit on travel, home and auto insurance, security services, health and wellness (medical, dental, vision and hearing) and more.
Association of Mature American Citizens
AMAC.us
With more than one million members, this organization was started in 2007 for people 50 and older. Its mission is to help seniors fight high taxes, reduce excessive government involvement in our day-to-day lives, and preserve American values. They September 2019 •
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The Seniors Coalition
Senior.org
Founded in 1990, this conservative public advocacy group claims to have around four million supporters. Its key issues are to protect Social Security benefits, stop Social Security payments to illegal aliens from
Mexico, eliminate the death tax, and reform the Social Security COLA system. TSC offers very few membership benefits. Annual fees run $10 for one person per, or $13 per couple and you can join at any age. Some other senior membership organizations to consider that offer discounts include the non-for-profit American Senior Benefits Association (ASBAonline.org), and the conservative leaning National Association of Conservative Seniors (NAOCS.us), and Christian Seniors Association (CSAbenefits.site-ym.com).
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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H ealth News URMC to train staff on dealing with racism, sexual harassment
with patients.”
University of Rochester Medical Center providers and staff will be better prepared for dealing with racism, sexual/gender harassment and bias, as a result of a new interactive training project. URMC is participating in the Theatre of the Oppressed (TO) project, in which a small group of faculty and staff will be trained on methodology and best practices for dealing with micro-aggressions and bias. Workshop participant interaction is facilitated through theater techniques dramatizing real situations faced by health care providers. Theatre of the Oppressed, created in Brazil with worker and peasant populations to rehearse for a revolution, now is used worldwide to develop tools for addressing conflict. Carli Gaughf, and an experienced TO educator, is facilitating the program. Gaughf has used TO techniques with prison inmates, youth offenders and other marginalized groups. “The tools of Theatre of the Oppressed provide an interactive way to analyze and address individual and structural biases, and they have been effective across many different disciplines and industries,” said Gaughf. “It is exciting that the University of Rochester Medical Center is using TO techniques to better handle situations that arise between physicians and their patients or colleagues.” “Unfortunately, we have seen instances of racism and bias in our hospitals, such as a patient asking for a different doctor simply because their provider is a person of color,” said Adrienne L. Morgan, Ph.D., senior director, Center for Advocacy, Community Health, Education and Diversity, University of Rochester School of Medicine and Dentistry. “Through this project, we hope to deal more effectively with uncomfortable patient situations arising from discrimination, sexual/ gender harassment and other forms of micro-aggression-and to help our providers preserve their relationships
UR Medicine/Highland Hospital recently welcomed physician Nathan Kaplan as assistant professor in the department of orthopedics and rehabilitation. Kaplan is an orthopedic surgeon who specializes in total knee replacements and total hip replacements. He will see patients and Kaplan perform surgery at Highland Hospital and will also see patients at UR Medicine Orthopaedics and Rehabilitation in Victor. Kaplan recently completed a fellowship in orthopedic surgery at Indiana University School of Medicine. He finished his residency in orthopedic surgery at the University of Rochester Medical Center in 2018 and earned his Doctor of Medicine from the University at Buffalo in 2013. “Dr. Kaplan has outstanding clinical skills, an outstanding bedside manner, and is a lifelong Rochesterian. He will be a tremendous addition to the outstanding joint replacement team at the Evarts Joint Replacement Center,” said physician Paul Rubery, professor and chairman of the department of orthopedics and director of the UR Medicine Musculoskeletal Institute. “Dr. Kaplan will make an excellent addition to our orthopedic team,” said physician Bilal Ahmed, associate medical director for Highland Hospital. “Highland’s Evarts Joint Center, staffed by UR Medicine surgeons, is the only total joint surgery center in the region where every surgeon has completed a fellowship, the highest level of training available. We’re proud that Dr. Kaplan continues in that tradition.”
Highland Hospital has new orthopedic surgeon
HCR Cares celebrates 40 years of service HCR Cares, a nonprofit organization focused on research and education, is celebrating its 40th anniversary this year. During its four decades, the organization has strived to address barriers to independent living and nursing-workforce shortages through research projects and educational initiatives. Programs include providing grants to nursing students, to help with expenses beyond tuition and to increase diversity in the nursing workforce; training programs to prevent falls among older adults; funding for pain-assessment-practice improvements for home-care clinicians; and funding to develop culturally competent homecare programs for underserved populations. Page 28
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HCR Cares held a reception to celebrate the 40th anniversary, which included a proclamation from Mayor Lovely A. Warren recognizing “HCR Cares Day” in Rochester. The event was attended by nursing-education grantees, board members, staff and funders. “For 40 years, HCR Cares has played a critical role in research and education on such issues as the nursing-workforce shortage, pain management, falls among older adults and cultural competence,” said Louise Woerner, volunteer executive director and president of HCR Cares.
Serving Diverse and LGBTQ Populations
Health care is often delivered in a standardized way, but HCR is always
Wegmans donates $500K to Thompson Health The F.F. Thompson Foundation has received a $500,000 gift from the Wegmans Family Foundation. The gift will help build an expanded intensive care unit (ICU) and pulmonary medicine clinic set to open at UR Medicine Thompson Hospital in the spring of 2020. “Thompson Health is so grateful to the Wegmans Family Foundation for this latest gift, which continues a long series of generous support by the Wegman family for our local health system. We are very proud to be able to partner with them and our other community supporters to bring forward this latest innovation in health care,” said Thompson Health President and CEO Michael F. Stapleton, Jr. Designed by LaBella Associates, the ICU/pulmonary medicine expansion is being erected by The Pike Company, Inc. On-site work began in late January, and excavation began in April. Mechanical, electrical and plumbing coordination is complete, with an elevator shaft already erected and steel framing work under way. According to Stapleton, the project is on track and on budget. It involves growing from the current seven ICU beds to 12 ICU beds, enabling Thompson to have full-time coverage from physicians specially trained in the care and management of critical care patients. In addition, the hospital will send fewer patients to Rochester due to limited capacity, keeping an additional 250 to 330 critically ill patients close to home annually. The pulmonary clinic will see patients suffering from chronic lung conditions such as asthma, emphysema, congestive obstructive pulmonary disorder (COPD) and other diseases. It will be approximately triple the size of the current pulmonary clinic, enabling Thompson to see more patients than current space allows and shortening appointment wait times. Thanks to the recent gift from the Wegmans Family Foundation, Thompson has now raised approxfocused on ways to innovate to better serve people, with a particular emphasis on reaching people who are not being served, according to HCR Cares board member Sarah Miner. “How to incorporate the social aspects of a person, such as family culture and traditions, is a hot topic in health care today,” Miner said. “Louise Woerner was well ahead of her time for addressing the social determinants of health. Through HCR Cares, we facilitated outreach and provided training to learn how to better serve the underserved populations, ranging from refugees to the LGBTQ community.” Miner cited as an example that HCR Cares recognized that Rochester had a large Cuban and Bhutanese population. With support from HCR Cares and the Greater Rochester Health Foundation, HCR Home
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2019
imately $11.1 million of the $12 million needed for the expansion and renovation.
New doctor sees patients in Clifton Springs Midlakes Medical Care in Clifton Springs has a new family medicine physician with more than 20 years of experience. Jonathon V. Lammers of Hopewell joined the primary care practice effective July 22 and is accepting new patients of all ages. A Chicago native who graduated from Marion Central High School in Marion, Wayne County, Lammers is a U.S. Lammers Air Force veteran who obtained a bachelor’s degree in biology from Cornell University in Ithaca and a master’s in natural sciences from SUNY Buffalo. With a medical degree from Uniformed Services University of the Health Sciences in Bethesda, Maryland, Lammers did his internship and residency at the Malcolm Grow Medical Center on Andrews Air Force Base in Maryland and most recently was a partner in Findlay Family Practice in Findlay, Ohio. Lammers, who arrives at Midlakes Medical Care upon the retirement of physician Zbigniew Lukawski, has special interests in sports medicine and diabetes. He says his goal is to create long-standing relationships with his patients and provide continuity of care for them. Midlakes Medical Care is recognized by the National Committee for Quality Assurance as a patient-centered medical home and is one of 11 primary care practices operated by UR Medicine Thompson Health.
Care built a team of caregivers who speak Spanish to reach out to these communities, and it resulted in improved health outcomes. During the last decade, HCR Cares has provided 45 nursing-education grants to assist with non-tuition costs, such as books, childcare costs and transportation. Grantees also benefit from mentoring Louise Woerner from HCR Cares board members, who help them with studying techniques and preparation for licensing exams.
Mary Russo appointed CEO of Mental Health Association Mary Russo has been appointed president and chief executive officer of The Mental Health Association of Rochester/Monroe County (MHA). Until recently she served on the same position on an interim basis. “The board is excited to have Mary join us,” said in a press release Michael Moeller, board president. “Mary has displayed tremendous leadership during her interim role and brings extensive nonprofit management experience to us. Her passion and dedication to our mission will position our organization for an exciting future ahead helping us serve more people in our community.” Previous to her joining MHA, Russo served as the chief financial officer at the Jewish Community Center. She brings more than 15 years of service in the nonprofit sector. Russo will focus on expanding programs and services offered at the MHA, with a grand reopening of its newly renovated Life Skills building scheduled for this September. “The Mental Health Association has been promoting mental wellness through a spectrum of culturally competent services for more than 30 years,” said Russo. “Thanks to our dedicated staff, board members, volunteers and generous donors we have been able to provide excellent services and programs in the Rochester community. I am excited to build and expand on that great work,” Russo will draw on her profes-
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sional and her life experience to lead the organization. “Growing up in the city of Rochester with a single parent who was diagnosed with paranoid Schizophrenia allowed for me to experience compassion in foster homes and appreciate family. Understanding that mental illness is not a choice allowed me to understand that my mother’s inpatient stay was not a choice of abandonment, but rather an opportunity for her to gain the support necessary to rebuild our family” said Russo. “My employment here at MHA is my opportunity to support others in the community of where I received so much assistance over my lifetime.”
Community Outreach Specialist Rural (Livingston/Ontario) Community Outreach Specialist Rural (Schuyler/Chemung) Community Outreach Specialist (Health Homes) Data and Support Specialist Patient Navigator – Agency Patient Service Representative Prevention Navigator Referral Specialist Social Worker Adult Day Health and more!
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Join the Cariola Community! A Cariola Career: Nursing Mary Cariola Children’s Center is seeking Registered Nurses (RN) in both our school and residences, providing skilled nursing care for childern with multiple disabilities and complex medical conditions. School nurses will work a regular school schedule while residential nurses will have flexibility in hours. Mary Cariola offers scholarship programs for those who want to earn a higher degree or additional certifications. Mary Cariola Children’s Center has a 70-year tradition of providing life skill solutions that inspire and empower those we serve. See if a Cariola Career is right for you. Visit MaryCariola.org/employment and follow @CariolaCareers on Facebook. Mary Cariola Children’s Center is an independent non-profit agency.
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Depressed? Try Exercising Research: ‘Exercise as medicine’ for depression, a key but often overlooked role in prevention and treatment
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xercise training and increased physical activity are effective for both prevention and treatment of depression, concludes a research review in the August issue of Current Sports Medicine Reports, official journal of the American College of Sports Medicine. “The evidence of the use of physical activity and exercise for the management of depression is substantial and growing fast,” said Felipe Barretto Schuch, Ph.D., of Universidade Federal de Santa Maria,
Brazil, and Brendon Stubbs, Ph.D., of King’s College London, lead authors of the special “Exercise Is Medicine” article. “Despite this substantial evidence, the incorporation of exercise as a key component in treatment is often inconstant and often given a low priority.” Depression is a major health problem worldwide, with an enormous impact on mental and physical health for individuals and high costs for society. Current treatments focus on antidepressant medications and
Head Concussion URMC study identifies the ‘midbrain’ as the place to look for injury
W
hile a brain injury can be difficult to locate, new research identifies a single region of the brain that can be used to examine the impact of a concussion or repeated hits to the head. The finding, published recently in Science Advances, also supports the emerging idea that traumatic brain injury is not limited to people who sustain a concussion; it can result from repetitive head hits that are clinically silent those that do not produce the visible signs or symptoms of a concussion. These subconcussive hits have been increasingly recognized as a potential threat
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to long-term brain health and as a possible cause of chronic traumatic encephalopathy (CTE). Physician Jeffrey Bazarian, professor of emergency medicine, neurology, neurosurgery and public health sciences at the University of Rochester Medical Center and a co-author of the study, says that the location of a brain injury varies widely from person to person. This is a major obstacle for physicians trying to diagnose brain injury using imaging techniques. “This study is important because we found that no matter where the head gets hit, the force is translat-
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psychotherapy, each of which can help people but have important limitations. For example, only about half of people taking antidepressants will have a clinically significant response, and not all people will respond to psychotherapy. “[T]here is growing recognition that lifestyle behaviors, such as physical activity and exercise partially contribute to the risk of developing depression and can be useful strategies for treating depression, reducing depressive symptoms, improving quality of life, and improving health outcomes,” according to the authors. Across countries and cultures, studies consistently link higher levels of physical activity to lower depressive symptoms. But those cross-sectional studies don’t answer a key question: Can starting an exercise program or increasing physical activity reduces the risk of developing depression or reduce depressive
symptoms? Schuch and Stubbs and colleagues analyzed pooled data on 49 prospective studies including nearly 267,000 participants. This meta-analysis found physical activity reduces the odds of developing depression by 17%, after adjustment for other factors. The protective effect was significant in all countries and across patient subgroups. Physical activity is also an effective treatment for depression — some studies have shown that a single exercise session can reduce symptoms in patients with major depressive disorder. The authors performed another meta-analysis of 25 randomized trials in which nearly 1,500 people with depression were assigned to exercise training or comparison groups. The results suggested a “very large and significant antidepressant effect” of exercise.
ed into a single region of the brain known as the midbrain,” noted Bazarian, who treats concussion patients and conducts research related to traumatic brain injury. “Midbrain imaging might be a way in the future to diagnose injury from a single concussive head hit, as well as from repetitive sub-concussive head hits.” University of Rochester fourthyear medical student Adnan Hirad, Ph.D., the first author of the research added, “Our findings do not dispute the fact that head-injury effects are distributed throughout the brain, but the midbrain may serve as a ‘canary in a coal mine’ in terms of identifying damage. From this study we know that the midbrain region, which is linked to brain functions often affected by a concussion, is the place to look to identify the impact of clinically defined concussions with visible symptoms and silent brain injuries that can’t be observed simply by looking at or behaviorally testing a player, on or off the field.”
Data collected from 38 University of Rochester football players before and after three consecutive football seasons were analyzed for the study. The players’ brains were scanned in an MRI machine before and after a season of play, and the football helmets they wore throughout the season were equipped with impact sensors that captured all hits above 10g force sustained during practices and games. Race car drivers feel the effects of 6 gs, and car crashes can produce brief forces of more than 100 gs. The analysis showed a significant decrease in the integrity of the midbrain white matter following just one season of football as compared to the preseason. While only two players suffered clinically diagnosed concussions during the time they were followed in the study, the comparison of the post- and pre-season MRIs showed more than two-thirds of the players experienced a decrease in the structural integrity of their brain.
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