IGH Rochester #171 November 19 by In Good Health: Rochester's Healthcare Newspaper

PRICELESS

Furry Friends This Thanksgiving: A good time to be grateful for our furry friends. See “Live Alone & Thrive” column on page 10

n Related: Dog ownership associated with longer life Page 27 Geriatric physician Rebecca Kant is all about “deprescribing.” See ”Meet Your Doctor” inside

GVHEALTHNEWS.COM

NOVEMBER 2019 • ISSUE 171

Food for a Healthy Brain What types of food may benefit our brain the most? See page 18

Tying the Knot Tied to Longer Life Span, New Data Shows

3 Sexually Transmitted Diseases Surging in U.S.

Thank a Caregiver

Research also shows widowed have the highest death rate of all the categories Page 2

November is National Family Caregiver Month. Three caregivers share their experience

Special Issue

Golden Years Starts on Page 20

Parsnip, Anyone? Pity the poor parsnip. Often overlooked in favor of its more attractive cousin, the carrot, it begs for us to wake up to its distinct taste, versatility and rich nutritional profile. Page 19

5 Things You Should Know About Hypnosis Practitioners say technique can help with weight loss, depression, addictions and a variety of phobias. Page 15

Tying the Knot Is Tied to Longer Life Span, New Data Shows Research also shows widowed have the highest death rate of all the categories

arried folks not only live longer than singles, but the longevity gap between the two groups is growing, U.S. government health statisticians report. The age-adjusted death rate for the married declined by 7% between 2010 and 2017, according to a new study from the National Center for Health Statistics (NCHS), part of the U.S. Centers for Disease Control and Prevention. “Not only is the rate for married lower, but it’s declining more than

any other group,” said lead author Sally Curtin, an NCHS statistician. Statistically, death rate is the annual number of deaths for every 100,000 people. It’s adjusted so that a 26-year-old and an 80-year-old married or widowed or divorced are on equal footing. The new study reported that the death rate for never-marrieds declined only 2%, while that for divorced people hasn’t changed at all. Worst off were the widowed, for whom the death rate rose 6%. They

have the highest death rate of all the categories, researchers said. Married men in 2017 had an age-adjusted death rate of 943 per 100,000, compared to 2,239 for widowers. The death rate was 1,735 per 100,000 for lifelong bachelors and 1,773 for divorced men. Married women had a death rate of 569 per 100,000, two-and-a-half times lower than the 1,482 rate for widows. The death rate was 1,096 for divorcees and 1,166 for never-married women.

Part of the marriage benefit could be explained by the fact that people in good health are more likely to marry, said Katherine Ornstein, an associate professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City. Once you’re in a marriage, there are a host of tangible and intangible benefits that give you a health advantage, experts said. Married people are more likely to have health insurance, Ornstein said, and therefore, have better access to health care. Being married also means you have someone looking out for you and reinforcing healthy behaviors, said Michael Rendall, director of the Maryland Population Research Center at the University of Maryland. “Having somebody there who’s your spouse will tend to promote positive health behaviors — going to the doctor, eating better, getting screened,” he said. This is particularly true of men, who previous studies have shown derive more health benefits from marriage than women. “Men tend to have fewer skills than women in terms of looking after themselves,” Rendall said. Finally, the companionship of marriage staves off health problems associated with loneliness and isolation, Ornstein said. “Social support and the social engagement that comes with being married is a huge benefit for mental health and physical health,” she said. All these benefits also explain why widowed people tend to do so badly after the death of their spouse, Ornstein said.

COVERAGE FOR EVERY STAGE OF LIFE

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

The Physician House Calls program provides a convenient, manageable way for you to get the high-quality medical care you deserve in the comfort of your own home. For over 10 years, our medical team has provided one-on-one primary care, medical assessments and care coordination. Our team will work with you to develop a comprehensive care plan that will give you and your family peace of mind. This program is available to individuals 65 years and older.

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Foods to Avoid When You Have the Flu By Kasey Vavrek

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

Monday, December 16th, 2019 6:00 pm at Nazareth College

Dr. Thomas Campbell, M.D. has authored or co-authored two popular books on nutrition, including “The China Study”, a worldwide bestseller, and has presented widely on the topic of nutrition for optimal health.

hen you have the flu, it may seem like nothing can make you feel better (or worse). However, relief may come from an unexpected place. Oddly enough, some foods may make your flu symptoms worse — or better — without you ever realizing it. The flu often makes consuming food difficult, as flu symptoms can cause nausea or stomach symptoms. Nausea can decrease the desire to eat, and gastrointestinal symptoms like vomiting and diarrhea can be triggered if food is consumed too soon. Eating nutrient-dense foods is useful no matter what kind of sickness you have. In fact, it’s especially important when you have a fever. But not all food is created equal. While comfort foods may be what you want when you’re not feeling your best, they’re not necessarily going to make you feel better. In fact, I’d suggest avoiding your go-to comfort foods, as you may end up developing a distaste for them if you consume them when nauseated. I’d suggest avoiding these four foods when you have the flu:

Caffeinated drinks and alcohol

Between elevated temperatures and increased sweating, dehydration is something to be cautious of when you have a fever. Caffeine and alcohol

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can make your symptoms worse (especially stomach-related symptoms), so I’d recommend sipping on water and other clear liquids throughout the day to stay hydrated.

Greasy foods

You’ll want to avoid foods that are difficult to break down and hard on your gastrointestinal system. Foods high in saturated fat should be avoided or limited, as well as fried, greasy foods.

Hard to digest grains

The flu occasionally causes you to have an upset stomach, so sticking with foods that are easy to digest like simple/refined carbohydrates is recommended. Foods like dry saltine crackers, toast and pretzels are easy on your stomach and are most likely to be tolerated when you have the flu. That being said, foods that are higher in fiber are also harder to digest, so I’d recommend avoiding them at first.

Sugary food or drinks

You may think vitamin C rich fruit juices are the best things to drink when you’re sick, but most of these options aren’t nutritionally dense and can inflame your immune system. Again, I’d recommend sipping on water and other clear liquids to stay hydrated.

What should I eat instead?

Broth-based soups are a good choice when you’re sick, as they’re easily tolerated but will also help to replace any fluids and sodium that may have been lost. If you’re losing a lot of fluids from stomach issues (vomiting or diarrhea), drinks with electrolytes like sports drinks or Pedialyte will help keep you hydrated better than water. Once you’re able to tolerate liquids, try slowly moving to soft, bland foods that are less likely to trigger nausea. I’d also recommend consuming small, frequent meals once you’re able to eat, as an empty stomach can also worsen nausea in some people. Kasey Vavrek is a registered dietitian at The Ohio State University Wexner Medical Center. .. Achieving. ering. w o p m

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School nurses will work a regular school schedule while residential nurses Phone: 585-421-8109 Email: Editor@GVhealthnews.com will have flexibility in hours.•Mary Cariola offers scholarship programs for those want toWagner earn aDotto higher• degree or additional certifications. Mary Cariola Editor &who Publisher: Associate Editor: Lou Sorendo • Writers: Jim Miller, Children’s a 70-year tradition of providing life skill solutions that Deborah J. Sergeant,Center Gwennhas Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, inspire andErnst empower those serve. Lori Parker (Esq.), Lamothe Jr.,we Kasey Vavrek, Colleen M. Farrel, Christine Green,

Suellen PinedaCareer • Advertising: Westcott, Linda Covington See if a Cariola is right for Anne you. Visit MaryCariola.org/employment and followClew-Thomas @CariolaCareers on Facebook. • Layout & Design: Dylon • Office manager: Nancy Nitz Mary CariolainChildren’s is an independent non-profit No material may be reproduced whole or inCenter part from this publication without the agency. express written permission of the publisher. The information in this publication is intended to complement—not to take 1000 Elmwood Rochester, New York 14620 the place of—the recommendations of your Avenue, health provider. Consult your physician before making major (585)or271-0761 changes in your lifestyle health care regimen.

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

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Telehealth Growing Among SENIOR CARE that CHANGES LIVES. Mental Healthcare Providers By Deborah Jeanne Sergeant

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or patients in need of mental health help, assistance may be as close as their smartphone. According to a recent report from Behavioral Health Workforce Research Center in Michigan, nearly half of providers in 2018 offered telehealth at least part of the time in 2018, favoring direct videoconferencing over phone calls or email. So why go online instead of in person? Erin Sweeney, licensed clinical social worker at Quiet Mind Therapy Services in Rochester, has offered remote sessions. She feels doing so definitely increases access for many patients. “It’s helpful for individuals who are sick, have childcare issues or transportation issues. With bad weather, this is helpful and convenient for both the provider and the client,” she said. A few clients who have seen her in person did not think they would care for a telehealth session; however, once they tried it, they liked it much more than they thought they would. If a client is traveling or lives in the South during the winter, they can keep up their sessions and not lose any progress they’ve made. Of course, HIPAA law requires confidentiality about health matters. That’s why Sweeney uses the Doxy. me app, which is HIPAA-approved and easy to use. The app sends clients a link. Clients don’t have to download anything. They log onto the portal with a smartphone, desktop or tablet and it connects to Sweeney in seconds. Mark Fischer, licensed marriage and family therapist at Rochester Counseling in Rochester, said telehealth decreases the barrier of entry for people. “Going to therapy can be anxiety-inducing for some and if they already have anxiety, that could worsen it.” Some people feel stigmatized for seeking therapy; however, obtaining care remotely increases their privacy, Fisher said. Geographic barriers hamper some as well. Living a two-hour’s drive or more round-trip from the

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

nearest therapist (or the therapist covered by their health insurance) can make it very difficult to seek help while working and caring for family members. It may also help people who have mobility issues that prevent them from easily leaving home. Fischer said that remote sessions don’t always offer the same level of eye contact and interaction as those conducted in person. For example, people tend to look more at themselves instead of the other person when video chatting. It can also be more challenging to pick up on Fischer physical cues, such as body language, movement, grooming and clothing, that can help a therapist understand the client better. “As therapists, we know that one of the biggest predictors of good outcome is the connection to the therapist,” Fischer said. “If a client feels you care about them in a real way, you’ll do better.” Fischer prefers meeting clients first, though since he’s licensed to practice in New York, he can offer telehealth to anyone with permanent residency in New York. Some clients may not be good candidates for telehealth. Those who eschew technology may not feel as well connected to the therapist. Some lack reliable high-speed internet connections. With family or couple’s therapy, any delay in speech or movement is magnified since more people are involved. “It’s so nuanced,” Fischer said. “One word said the wrong way when people are struggling can tank a session. If I miss that because of a delay in speech or movement, I can’t do my job as well. There’s still some ground to be made up.”

Meet Your Provider

Hart Hearing and Balance Centers Audiologist Sarah Hodgson talks about what sets Hart Hearing apart from the competition. “We truly mean it when we say we take a ‘personal approach to hearing care,’” says Hodgson.

Q: Tell us about the history of Hart Hearing and Balance Centers (HHBC)

A: HHBC was founded over 40 years ago by audiologist Stephen Hart to provide comprehensive, state-of-theart hearing health care with a personal touch. The practice has grown to include five Rochester area locations, making it convenient for patients to schedule appointments. Each office is staffed by a doctor of audiology, trained in fitting and dispensing the most advanced hearing devices and accessories. Dr. Hart’s son, Peter, joined the practice in 2012 and I came on board in 2017. Most recently, Katie Murphy joined as audiology resident. She is excited to work with the team to guide patients on their journey to improved hearing, communication and consequently, enhanced quality of life.

Q: What makes your practice unique? A: At HHBC, we truly mean it

when we say we take a “personal approach to hearing care.” Our goal with every patient is to find the best solution for their needs, their hearing loss, their lifestyle and their budget. We see many patients who have been to other providers or big box retailers and are simply not satisfied. Every person’s situation is unique. We spend time getting to know our patients, and often ask that a family member or close friend come along so together we can devise a plan that best suits their situation. When someone suffers from hearing loss their whole family may be affected. Often people wait months or even years to do something about their hearing loss. We encourage them to have support at home in addition to the support they receive in our office.

Q: Do you only treat hearing hoss?

A: Some people may find they do not need hearing aids but suffer from another condition called tinnitus, or

Team at Hart Hearing and Balance Centers: audiologists Peter Hart, Sarah Hodgson and Stephen Hart. ringing in the ear. This is very common; in fact, more than 50 million Americans experience tinnitus. It can interfere with sleep, concentration and even job performance. There are several ways to minimize tinnitus. An evaluation with one of our audiologists will help determine the cause of your tinnitus and develop a management program.

Q: What exciting things are happening at Hart Hearing and Balance Centers ? We are excited to announce our

partnership with the American Institute of Balance (AIB). AIB is a leader in educating, diagnosing and treating equilibrium disorders. The Institute is widely recognized for providing practitioners with the most current clinical and scientific breakthroughs and treatments. Hart Hearing and Balance Centers has been awarded the designation of Center of Specialty Care. The addition of our balance program means we are now able to serve the comprehensive hearing and vestibular needs of the Greater Rochester area.

101 Canal Landing Blvd., suite 10, Rochester, NY 14626 www.HartHearing.com.

Check in online. November 2019 •

WellNow.com

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Meet

Your Doctor

By Chris Motola

Rebecca Kant, D.O. Geriatric physician focuses on ‘deprescribing’ — removing medications from patients’ regimen that are no longer effective

Beyonce’s Dad Reveals His Breast Cancer Diagnosis Mathew Knowles, father of singers Beyoncé and Solange, recently revealed that he has breast cancer. The 67-year-old music executive told host on “Good Morning America” host Michael Strahan he was diagnosed about two months ago after he and his wife noticed blood on his shirts and sheets. Although he admitted thinking, ‘Why me?’ about his situation, Knowles said he is doing well after undergoing surgery at the end of July. He added that due to a gene mutation, he is at risk of developing cancers of the pancreas and prostate, as well as melanoma. He shared his story to raise awareness about the condition and urge men to get tested. Breast cancer strikes one in eight women in the U.S., according to the American Cancer Society, which expects 2,670 new cases of invasive breast cancer to be diagnosed in men in 2019. “Male breast cancer is rare and accounts for only about 1% of all breast cancers,» according to physician Melissa Conrad Stöppler. She adds that prior radiation exposure, a family history of breast cancer, elevated blood levels of estrogen, and mutations in genes including BRCA2 all increase breast cancer risk in men. Treatment for breast cancer in men includes surgery to remove the tumor and any affected tissue and lymph nodes, Stöppler says. Adjuvant therapies are often prescribed afterwards, which may include chemotherapy, targeted therapy, hormone therapy, and radiation therapy. Early detection and treatment improves the chances of a good outcome. “It is not possible to completely prevent male breast cancer,” Stöppler says. “However, there are many healthy lifestyle choices that may help reduce the risk of breast cancer, including maintaining a normal healthy weight and getting regular exercise.” Page 8

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Q: What is “deprescribing,” and how does it apply to geriatrics? A: The way I think of deprescribing is as the opposite of prescribing. So, really, it’s the process of stopping medicine that may no longer be helping the patient, or may be causing the patient more harm than good. I think it’s especially prevalent in geriatrics, because a lot of our older adults are on many medications that they may no longer need. It might have been started at an earlier age, and it might not be benefiting them the way it was previously. I think it’s really important to review these medications with your older adult patients and make sure they aren’t causing unnecessary harm. Q: What kinds of medications tend to fall into this category? A: I think some of the biggest categories that we look for are medications that are associated with falls. Things like blood pressure medication, medications that can be involved in memory loss or cognitive decline and medications that lower blood sugar, since having low blood sugar can cause a lot of problems in older patients. Some of the other ones I’ve had to look at are vitamin supplements, aspirin, cholesterol medications. Those are some of the bigger categories that I look at. Q: Since I’m assuming the underlying conditions the medications were treating still exist, do you look at alternative medications, or is it more just a cost-benefit analysis for quality of life? A: I think it’s a lot of different things. I think each patient is a little bit different. It

gets really challenging when you have older adults who have many chronic medical problems, because there’s a lot of evidence that these medications should be used to treat these patients. The problem is a lot of these studies are looking at younger patients. There’s not a lot of data for people as they get over the age of 70, showing whether those medications are still beneficial. I really try to target medications that may be doing more harm than good, things like vitamin supplements where there’s evidence that they might not being doing as much good. Q: What kind of toll does taking medication take on the body over the longterm? A: That’s a great point to bring up. As we get older, a lot of the processes in our body tend to change; things like your liver, your kidney, the systems the body uses to clear those medications tend to slow down. The other thing to think about is that being on a lot of medications increases the chances of drug interactions and side effects. Any medication we put into the body has the potential to cause side effects. This can lead to more emergency room visits, falls, memory loss and hospital visits. So, we need to be thinking both about how the body clears medications and side effects.

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

Q: What concerns do patients have about deprescribing, and how do you work around them? A: I think a lot of times, people

get used to taking medications and are worried about what stopping it would mean. A lot of it is just having a conversation with your patient, going through the data and what the recommendations are, and going over the side effects. A lot of times people know what a medication can do for them but don’t really know much about how the side effects may be affecting them. I think that provides them with a little more comfort. They tend to be OK with stopping medication. In studies, when asked if they’d prefer to be on fewer medications, the majority of participants would prefer to be on fewer. So, it’s often just about reassuring them that it’s OK to stop taking them. Q: What brought you back to Rochester? A: I trained at the University of Colorado for internal medicine and then came back here for my fellowship, but after living around the country, I really like the Rochester community and wanted to be able to serve it. I feel really lucky that I’m able to. Q: Do attitudes toward medications differ across the country? A: I wouldn’t say they differ by region, more by specialty. I think geriatrics brings a bit more understanding to the table with regard to medications in older adults and medication interactions. Q: Did your training as D.O. inform some of your philosophy towards medications? A: To a certain degree. I think we’re trained from the perspective of looking at the whole person. We have very similar outlooks and training as M.D.s, but we have a little bit more of a holistic philosophy. Looking at quality of life, what’s important to the patient. That’s not to say M.D.s don’t do that, but we really stress looking at the whole being. Q: I’m told you’re an accomplished musician. A: Yes, I play the cello. I had joined the Brighton Orchestra for a little while, but with time constraints and trying to build my practice, I haven’t pursued that further. But I can see myself getting involved with local orchestras. I really enjoy playing. It’s something I’m very passionate about.

Lifelines

Name: Rebecca Kant, D.O. (Doctor of Osteopathic Medicine) Hometown: Pittsford Position: Geriatric physician at St. Ann’s Community and Pillar Medical Associates in Rochester. Education: University of Notre Dame (undergraduate degree); Philadelphia College of Osteopathic Medicine Training: Internal medicine residency program at the University of Colorado. Completed her training with a fellowship in geriatrics at the University of Rochester. Organizations: Affiliation: Boardcertified in internal medicine and geriatrics and a member of the American Geriatrics Society (AGS) and Society for Post-Acute and Long-Term Care Medicine (AMDA). Family: Two dachshunds Hobbies: Learning to cook, playing the cello, running

5.4%

3.5%

8.9%

Upstate New York Uninsured Rates Reach Best Levels Ever Recorded Health coverage Upstate

pstate New York’s health insurance uninsured rate fell to 3.5%, the lowest ever recorded, according to Excellus BlueCross BlueShield’s analysis of the U.S. Census Bureau’s 2018 American Community Survey issued today. The Upstate New York rate compares favorably to a new best record for the state of 5.4%. The national rate rose slightly to 8.9%. (Rates from 2017 were: 4% in Upstate New York; 5.7%, NYS; and 8.7%, U.S.) “These low rates of uninsured present an even better picture than what most people might realize,” said Christopher Booth, the health plan’s chief executive officer. “The real uninsured number is even less because these surveys only record those who report having coverage. There are thousands more who are eligible for coverage but simply have not enrolled in such programs as Medicaid, Child Health Plus and Medicare.”

New York state

Upstate New York’s health insurance uninsured rate fell to 3.5%, the lowest ever recorded, according to Excellus BlueCrossUnited BlueShield. Map by Excellus States shows breakdown by region.

in upstate New York 4.2%

For example, the uninsured num- els of health care spending due to a bers reported for 2018 include more marketplace of nonprofit health plans than 23,000 New Yorkers aged 65 and and nonprofit hospital systems.” older who would likely qualify for View an Excellus BCBS infoMedicare and more than 107,000 peo- graphic illustrating the census ple under age 19 who would likely numbers titled “Upstate NY’s quality for Child Health Plus. Uninsured Rate-infographic (SepThe American Community Surtember 2019).” vey is the largest and the U.S. Census Upstate New York’s Bureau’s recommended source for examining uninsured data at na2018 uninsured rate is: tional, state and regional levels. It reports the yearly uninsured rate for geographic areas with populations of than the U.S. rate 65,000 or more. The county-level data than New York’s rate were aggregated to calculate the upstate New York uninsured rate cited by the health plan. “Upstate New York’s uninsured rates have historically been lower than the numbers recorded for the state and nation,” Booth observed. “We believe the more favorable numbers here reflect the fact that the region has lower lev-

3.3% 35% lower + 61% lower 3.1%

2018 Uninsured Rates 3.6% 3.8% 3.5%

Upstate

5.4%

New York state

8.9%

United States

Healthcare in a Minute

4.2%

By George W. Chapman

NYS Lags When it Comes to Vaccines

he personal finance website WalletHub tracked 18 key metrics to determine state vaccination rates among children and adults. The states with the best vaccination rates are: 1, Massachusetts; 2,

ACA Continues to Perform

While everyone running for president is espousing what they would do about healthcare, the ACA keeps chugging along. The designers and proponents of the ACA predicted that once insurers became more comfortable with their new markets, premiums would stabilize. They were right. According to BlueCross BlueShield Association, the median preliminary premium increase across 23 exchanges so far, for 2020, is an impressive 2.3%. This continues a trend of minimal (relatively) premium increases for the ACA over the past few years. A recent survey conducted by eHealth revealed a majority of commercial insurers plan to increase the number of plans they offer on the exchanges. All of this has occurred while Washington continues to dismantle and attack the ACA by eliminating the mandatory insurance requirement and reducing marketing support. As a result, the rate of uninsured Americans is now increasing. Over the last two years, 2017 and 2018, 2.5 million people decided to drop insurance. The ACA requires all insurers to rebate any

ufacturer and typically were paid a commission based on the volume of prescriptions filled in their market. Drug detailers would show up at a busy practice and get valuable time with the medical staff in exchange for drug samples, pizza, doughnuts, pens and coffee cups. Detailers would also sell several physicians at once by providing drinks and dinner at a local restaurant. Kickback regulations have severely limited the gifts detailers can give to physicians. Consequently, busy practices have reduced the access and time they allow detailers. Thanks to technology, more and more physicians are getting their drug information online. Only 54% of physicians say they see drug reps in person. About 40% of physicians do not give any time to drug reps. Physicians say drug companies are doing a better job of providing effective, non-promotional, educational information online. Busy physicians do not want to be “sold” on a drug. They want access to clinical information that helps them treat their patients.

Future of Medicine

Source: 2018 American Community Survey, 1-Year Estimates. https://data.census.gov/cedsci/table?q=uninsured&table=DP03&tid=ACSDP1Y2018.DP03&lastDisplayedRow=15&hidePreview=true

Vermont; 3, Rhode Island; 4, North Dakota; 5, New Hampshire; 6, Nebraska; 7, Delaware; 8, South Dakota; 9, West Virginia; 10, Washington. New York state ranks in the bottom 10 at No. 43. profits/surpluses over 20% of total premiums collected. Consequently, insurers owe a record $1.3 billion to consumers this year. The rebate is further evidence that insurers are doing well and that the market has stabilized. Most of the rebates will go to individuals insured via the exchanges versus those covered by large employer-sponsored plans.

Pre-existing Conditions

According to the Kaiser Family Foundation, about 54 million of us have a pre-existing condition that could have been declined (not covered) if not for the ACA. The fate of the ACA awaits a constitutional challenge in federal courts. Any “replacement plan” suggested by Washington or any presidential candidate would certainly have to include the ACA’s crucial provision covering pre-existing conditions.

Drug Information

Years ago, most physicians would get information on new drugs from a drug “detailer” or drug rep. They were employed by a drug manNovember 2019 •

3.1%

3.6%

3.3%

3.8%

Large corporations, like Walmart, are sensing lots of opportunity in the healthcare industry. They are reacting to: fewer and fewer medical residents specializing in primary care every year; the predicted shortage of physicians growing to 122,000 by 2032; the fact that traditional providers of care are cash-strapped and slow to adapt; consumers are not getting what they want; and the overall cost of health is high. New players CVS and Aetna merged about a year ago. Still in the planning stages, they are committed to providing a high-tech healthcare experience utilizing artificial intelligence, virtual care (telehealth) along with their physical brick and mortar clinics. CVS plans to turn 1,500 of their stores into “HealthHUBs” which will focus on providing a variety of health services.

Source: 2018 American Community Survey, 1-Year Estimates. https://data.census.gov/cedsci/table?q=uninsured&table=DP03&tid=ACSDP1Y2018.DP03&lastDisplayedRow=15&hidePreview=true

Walmart University

Walmart’s 1.5 million employees can now further their education by obtaining a bachelor’s degree from “Live Better U.” The degrees are offered through Purdue University Global, Southern New Hampshire University, Bellevue University and Wilmington University. Employees will pay just $1 a day while pursuing degrees in health science, healthcare management, pharmacy technology, and optical care. Walmart will homegrow the professionals they will need to staff their 5,000 pharmacies, 3,000 vision centers and 400 hearing centers. Walmart is also trialing a full-service standalone clinic in Dallas, Georgia. The giant retailer plans to provide home healthcare in the future as well.

Healthcare Waste

According to a joint study from Humana insurance and the University of Pittsburg School of Medicine, a quarter of all annual healthcare spending — between $760 and $935 billion — is wasted. The study, published in the recent edition of the Journal of American Medicine, estimates that $266 billion of all waste is due to administrative costs associated with ever-changing billing, coding and quality reporting requirements. 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.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

This Thanksgiving: A Good Time to Be Grateful for Our Furry Friends

s Thanksgiving approaches, we are reminded to slow down and set aside time to remember, reflect and be thankful. To be grateful. And to count our many blessings. This year, in addition to being thankful for my good health, my dear friends and family, and some new opportunities to learn and grow, I am filled with a deep appreciation for Scout, my 3-year-old English springer spaniel. I named her after the feisty little girl in “To Kill a Mockingbird.” Scout has enriched my life in immeasurable ways, and I can speak with enthusiasm about the joys of sharing my life and home with her. In doing so, I hope to inspire you — especially those of you who live alone — to give pet ownership serious consideration. • Thanks to Scout ... I look forward to coming home and walking through my front door. No matter how stressful my day or how tired I might feel, I am filled with eager anticipation as I approach the entryway. My heart practically skips a beat. When I step inside, I am greeted by a full-body wag and some cheer-

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ful yapping that always make me smile. After I take off my coat, Scout and I enter into our welcome-home ritual: she pokes her head through my knees and I rub her ears until her hunger kicks in (which takes less than two seconds). It’s so good to be home! • Thanks to Scout ... I get to experience — really experience — the outdoors and all the beauty, mystery and drama that the weather and our four seasons hold. Scout insists we walk, run or play outside multiple times a day — rain or shine (or snow!). I consider her my personal trainer par excellence. While exercising Scout, I’ve witnessed breathtaking sunrises and sunsets. I’ve been soothed by the soft sound of raindrops on my umbrella. I’ve felt victorious against Nor’easters that threaten to rob me of my coat. And on crisp November days, I’ve been transported back to halcyon fall days in Ohio, where I grew up. Would I, on my own, spend this much time outdoors? Not a chance. In the dark of night or in bad weather, the comforts of home and a warm bed would prevail. Think of how much I would miss!

Give a

Gwenn Voelckers and her dog Scout recently enjoying some leaf peeping at Harriet Hollister Park at the end of Canandaigua Lake. • Thanks to Scout ... I know the nearly indescribable feelings of contentment and peace when she is snuggled up against me during my morning meditation. At my side, with her chin resting on my lap, our breathing begins to synchronize, in and out, in and out. In these relaxed, mindful moments, I have no cares. No one can reach me. For a few precious minutes each day, the world has stopped, and it’s just me and my dog in blissful tranquility. • Thanks to Scout ... I’ve met a wonderful and interesting assortment of dog lovers and their “best friends.” On our afternoon walks along the Erie Canal, Scout and I regularly meet and greet fellow two- and fourlegged walkers. Over the years, these

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

acquaintances, some of whom have become friends, have turned our daily walking routine into a spirited and meaningful “canal connection.” When our paths cross, we exchange more than just passing pleasantries; we stop, chat and, mostly, laugh while our dogs get reacquainted and tangled in each other’s leash. I leave these encounters with a warm heart, so happy to be part of a community of devoted animal lovers. • Thanks to Scout ... I’ve discovered my “inner parent” and am proud of her. Having no children, I used to wonder if I would have been a good mother and role model. Would I have been patient? Nurturing? Firm when needed? Calm in a crisis? Sacrificial? Scout has given me a chance to explore and express my maternal side, and to cultivate my caretaking skills. My relationship with Scout has led to increased self-awareness. She has helped me discover and develop some essential, as well as some elusive, parts of myself. • Thanks to Scout ... I now have a deeper appreciation for the messiness of life, and how much joy and humor can be generated by the chaos and clutter of a lovable pooch. Scout reminds me that I’m not really in control, and that life can march along just fine, thank you, despite the disarray and dog hair that blows like tumbleweed through my home. It’s a good life lesson. • Thanks to Scout ... I am happier living alone. She’s a second heartbeat in my home, a loving companion and a source of never-ending amusement. Even listening to her chew her food makes me chuckle! We share a human-animal bond anchored in mutual adoration and unconditional love. For that special bond and blessing, I am grateful. If you, too, enjoy the companionship of a dog or cat, let’s be thankful for the countless ways our furry friends expand and enhance our lives. In their presence, every day can be Thanksgiving! 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

Vaping Becoming a Public Health Crisis in the U.S. Vaping up 900% among teens in the U.S. In Monroe County, about 35% of youth — one in three — have tried vaping in 2018 By Deborah Jeanne Sergeant

se of electronic cigarettes — commonly called “vaping” — has become a top public health concern. The US Surgeon General Vivek H. Murthy states online that e-cigarette use has grown by 900% among high school students from 2011 to 2015, surpassing any other form of tobacco use among youth. A recent rash of serious illnesses relating to vaping and 19 deaths, including a 17-year-old living from the Bronx, has pushed the issue to the forefront. According to Gov. Andrew Cuomo’s website, as of Oct. 8, the New York Department of Health has received 110 reports from New York physicians of severe pulmonary illness related to vaping among patients ranging from 14 to 69 years of age. As of Oct. 1, there have been 1,000 cases of vaping-associated illnesses and 18 casualties. “This vaping is a public health crisis,” said Cuomo in a press release. “It is affecting our young people. It has been marketed to young people.” Though cigarette usage among youth has been declining in recent decades, using tobacco through vaporizing devices has increased rapidly since their introduction. Cuomo’s website states that a 2017 survey of 15- to 17-year-olds indicates that among those vaping, 19% said that flavors were the reason they initially tried it and 27% said that’s why they continue vaping. That’s why he has been pushing for a ban on the sale of flavored “vape juice,” the liquids used in the devices to create the inhaled vapor. The liquids are available in flavors appealing to young people, such as bubble gum and fruit flavors, which Cuomo and experts in healthcare believe indicates the tobacco compa-

nies’ intention to make the products more appealing to teens and young adults. Physician Matthew McGraw, a pulmonologist with University of Rochester Medicine, said that vaping liquids can contain any of 7,000 chemicals to create flavors. “Many are known irritants and known to be carcinogenic when inhaled,” McGraw said. “Some of those were previously used in cigarettes and now are in e-cigarettes.” He added that some of them are components that with chronic exposure are known to cause lung diseases such as popcorn lung, which afflicts workers lacking personal protective equipment while laboring in food factories. The exposure is in lower doses in e-cigarettes, but it’s unknown whether long-term exposure will have the same effect for people vaping. Physician Chanh Huynh, who practices at Churchville-Chili Family Medicine, LLC in North Chili, said that other compounds in vaping liquid can contain tin, lead, chromium, and arsenic. “They also contain volatile inorganic compounds,” Huynh said. “Depending upon the flavor, it can contain varying degrees of one compound or another. You can have identical packaging and wildly different chemical compounds. I definitely am very concerned about the public health concerns about this re-normalization of smoking behavior, and especially its impact on children and young adults.” According to the American Lung Association Rochester Chapter, 35% of youth in Monroe County have tried vaping in 2018, compared to 31% in 2015. “A lot of kids attracted to that product because of the flavors,” said November 2019 •

Annalisa Rogers, director of Smoking & Health Action Coalition for the American Lung Association, covering Monroe and Livingston counties. “Many people who start smoking are between 13 and 18. Starting so young, it’s less likely they’ll be able to quit easily. I believe that will carry over to vaping.” Rogers believes that the current marketing campaigns used by tobacco companies to sell consumers e-cigarettes are quite effective twists on old campaigns. One brand, Blu, made a video ad featuring panoramic shots of the Western plains. In a montage, modern cowpokes herd cattle with ATVs and helicopters. Dust billows. The cowboy-hat clad ranch workers wear bandanas to protect their faces. When the day’s work is done, the ranch worker lands the helicopter, lowers the bandana, and reveals it’s a female who then takes a well-deserved break only to puff on a Blu e-cigarette. The imagery evokes the Marlboro Man icon of traditional cigarettes, romanticizing tobacco use as a reward for a hard-working person, only the modernized message extends to women as well. “The marketing tactic has worked,” Rogers said. “Youth are sensitive to marketing, flavors and it’s used as the tobacco industry’s sustainability plan to attract youth as replacement smokers and long-term users.” She added that in general, most young people are more likely to listen to advertising and their peers than experts on the topic. Although touted as a smoking cessation tool, the devices actually deliver twice the amount of nicotine per puff than a conventional cigarette. In theory, the additional

nicotine can make quitting vape devices even more difficult to quit than cigarettes. In addition to the high likelihood of addiction, vaping also bears intrinsic dangers. Electronic cigarettes are not FDA regulated products. “You take a risk,” Rogers said. “I don’t recommend anyone uses an item that’s not FDA regulated.” Some companies source the liquid used in vape devices from companies in countries like China, which do business with far fewer consumer protections than those in the US. Flavored liquid also raises concerns. Rogers said that although the FDA has approved artificial flavoring agents for foods, those are meant for oral consumption. “They’re not approved for inhaling,” she said. “When it’s vaped, there’s a different chemistry than when consumed as a food. That doesn’t mean it’s approved for vaping. Having that FDA regulatory piece will help people know what’s in it. Without that science, you just don’t know.” Some youth also concoct their own vaping liquid, which may or may not be safe for inhalation. The sense of rebellion and the thrill of experimentation attracts many to try vaping, along with the new technology. “It’s a whole pop culture about vaping,” Rogers said. “They want make videos of doing tricks with vaping to post on YouTube.” Anyone who wants to quit tobacco should speak with a healthcare provider, call 1-800-QUIT-NOW or 1-866-NY-QUITS or visit https:// www.nysmokefree.com.

When Your Children Hurt As a mother, I have known no greater pain than to watch my son, Blake, struggle with a dark depression. Antidepressants, counseling and all the love and support we could shower him with did not make a difference. After he tried to kill himself and a brief hospitalization we surrounded him all day, every day, hoping that showering him with love would keep him safe but his depression only worsened. I first heard about Ketamine on “The Doctors.” I learned that it is more effective than any other medication at treating depression. After treatment, Blake’s dark thoughts were gone, he is a part of the family again that loves him and he is actually enjoying life for the first time since he was 8 years old. - Sandra, Rochester, New York

585-673-2319 | www.ketamine.care 3300 Monroe Avenue Suite 345, Rochester, New York 14618 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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s d i K Corner

Giving Your Child a Time-Out Won’t Cause Long-Term Damage: Study

ime-outs don’t increase kids’ risk of emotional or behavioral problems, according to a new study that researchers say dispels misleading information. The study included the children of nearly 1,400 U.S. parents. Of those parents, 28% said they used timeouts when their child was 3 years old. From age 3 through fifth grade, there were no differences in emotional and behavioral health between children who had time-outs and those who did not, the investigators found.

Rachel Knight, an assistant professor of clinical psychology at University of Michigan C.S. Mott Children’s Hospital in Ann Arbor, led the study, which was published online recently in the Journal of Developmental & Behavioral Pediatrics. “No differences were found with respect to child internalizing problems, including anxiety and depression, externalizing problems, including aggression and rule-breaking behavior, or self-control,” Knight’s team reported. The authors noted that time-out is one of the only child discipline

strategies recommended by the American Academy of Pediatrics. Even though extensive research has shown it to be effective, some online information and media reports have claimed time-outs increase the risk of behavioral problems and damage parent-child relationships, the study authors explained. “Parents often resort to the internet and social media for guidance, but the internet provides inaccurate information for families regarding the use of time-out,” Knight and her colleagues warned. Research findings on the topic

need to be offered in a “readily accessible and easily digestible format … to assuage possible parental concerns and promote the use of this highly effective child discipline strategy,” the study authors urged. However, as with previous research, the new study linked physical punishment to externalizing behaviors in kids. “We hope our findings will be helpful to parents who see confusing and at times alarming claims of negative side effects of time-out,” Knight said in a journal news release.

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

3 Sexually Transmitted Diseases Surging in U.S.

he number of people with chlamydia, gonorrhea, and syphilis is rising, according to a report by the Centers for Disease Control and Prevention, The information is part of CDC’s annual “Sexually Transmitted Disease Surveillance Report,” containing data from 2018. It was released early in October. In a companion press release, physician Gail Bolan, director of the division of sexually transmitted disease prevention, writes that this is the “fifth consecutive year of increases” for the three STDs.

STDs in numbers

Between 2017 and 2018, the number of gonorrhea cases increased by 5% to a total of 580,000 cases; this is the highest number of cases since 1991. As for chlamydia, cases hit the highest numbers ever recorded by the CDC. Compared with 2017, they

were 3% higher, making a total of 1.7 million cases. The number of primary and secondary syphilis cases, which are the most infectious stages of syphilis, increased by 14% to 35,000 cases; this is also the highest level since 1991. Syphilis can pass between a mother and her unborn child, which doctors refer to as congenital syphilis. In 2018, there were 1,300 cases of syphilis in newborns, an increase of 40%. In all, 70% of congenital syphilis cases occurred in five states: California, Florida, Texas, Arizona, and Louisiana. Congenital syphilis increases the risk of stillbirth, miscarriage, newborn death, and lifelong medical issues. Antibiotics can effectively treat all three of the above STDs. However, if they are left untreated, they can lead to infertility and ectopic pregnancies. STDs can also increase the risk of contracting HIV.

A Parent’s Guide to Managing Kids’ Asthma During the Fall

all can be a challenging time of the year for kids with asthma, an expert says. “Although asthma can flare up for a number of reasons, a lot of people with allergies also have asthma, and asthma can be triggered by allergies. So the fall is a tough time for asthmatic sufferers,” said Gaurav Kumar, a pediatrician at LifeBridge

Health in Baltimore. While many kids do well with their asthma during the summer, problems often accompany the return to school. “You go from taking these outdoor summer vacations to now being in a classroom again,” Kumar explained. “So now you’re in contact with people in closed spaces. And of

These increases are particularly striking given that STDs had, seemingly, been on the ropes. As the CDC report states in the foreword written by D. Bolan, “not that long ago, gonorrhea rates were at historic lows, and syphilis was close to elimination.”

Why the increase?

Several factors are likely to play a part in the increase in STDs. According to the CDC press release, these factors include poverty, drug use and unstable housing, all of which course, what happens is germs are more likely to spread that way. So you could get colds from friends who have colds, and then that becomes a trigger for asthma.” Parents need to make sure their child’s asthma is under control. If a child stopped taking preventive asthma medications regularly during the summer, they should resume daily use now, Kumar advised. Children with asthma should have checkups at least once a year, and in some cases as often as three or four times a year. “An asthma checkup is an opportunity for us to reassess how the

“reduce access to STD prevention and care.” The CDC also noted a reduction in condom use among some at risk demographics, such as young people, and gay and bisexual men. Added to this, the CDC explain in the press release how certain financial restraints have played a part: “[I]n recent years, more than half of local programs have experienced budget cuts, resulting in clinic closures, reduced screening, staff loss, and reduced patient follow-up and linkage to care services.” year has gone and to make plans in anticipation of what might happen,” Kumar said in a LifeBridge Health news release. A flu shot is also important, because kids with asthma are at high risk for serious flu-related complications. Asthma is the most common medical condition among children hospitalized with the flu. Flu vaccine is “very safe” in children with asthma and “will not cause any negative effects to trigger asthma attacks,” Kumar said.

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Page 13

Noah Marinelli, who died in a car accident June 26, 2016.

Noah’s Blessing Box on Parrish Street, Canandaigua.

The Story Behind Noah’s Blessing Box

The Marinellis of Canandaigua find new ways to cope after losing son who was addicted to heroine By Colleen M. Farrell

ne winter, the thief crept quietly into the tidy old home on Parrish Street. The residence, which has stood since President Abraham Lincoln’s era, could offer no protection against the intruder. Nor could the close-knit family — two parents and three children — inside the cozy Canandaigua home. The thief’s entry was discovered the week of Christmas. Noah Marinelli, the youngest of the three teens, woke his father in the middle of the night to alert him that the safety of their home had been breached. “Dad,” he said, “I think Michael is using heroin.” Noah was concerned: his father, Jeff, and mother, Suzanne, shocked. How could one of their sons be using heroin, let alone in the family home, unbeknownst to them? “I couldn’t believe this s*** was in my house,” Suzanne said. They knew both boys had experimented with marijuana. But this? Not this. Michael’s road to heroin use started with pain medication that had been prescribed after a bad car accident. He became hooked on it, and eventually turned to heroin. Jeff and Suzanne Marinelli talked with Michael. They talked with each other. They threatened and pleaded. Michael became sober — for periods at a time. In between came arrests and jail time, doctor visits and rehabs. Michael is currently sober. But Noah, the one concerned for his big brother’s well-being, who first alerted their parents to the problem of heroin, is dead. Inexplicably, he followed his big brother’s path into the hell of addiction. Only, this time, the thief took more than he had to give. Three summers ago in 2016, police believed that Noah and his girlfriend, in need of money, stole from

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a store in Farmington and headed to Rochester to sell the items for cash. Police attempted to stop them and they crashed on Interstate 490. Noah died at the scene. He was 33. His girlfriend, Danielle, the mother of a young child, died a few days later. “He was this wonderful, joyous man,” Suzanne said. “And there are no words to discuss the devastation of June 26, 2016.” They also had to deal with it while their other son was locked up. Michael learned of his brother’s death while he was in jail on charges related to his addiction, but he was able to attend Noah’s funeral. Michael has had to deal with the loss of his brother while knowing he was the one who first brought heroin into the house. He’s also the one who shot up Noah for the first time. “Addiction takes who it wants,” Suzanne said. “Certainly, we never thought this was something we’d have to deal with as parents.” As Michael’s addiction worsened, and his parents later learned Noah was using, they navigated a web of rehab facilities, detox centers, doctors, clinics and health insurance companies — all while holding down jobs, paying bills, managing life. “We walked down every avenue we could find to maybe get some help for them,” Jeff said. As they waded through their grief, they talked of Noah. It was not uncommon to find him playing guitar on the porch, the same porch where, as a boy, he was given an old TV to take apart to keep him busy. He enjoyed doing projects around the house with his dad. He had friends. He was a handsome young man who was normal in so many ways. “I don’t want Noah to be remembered for his worst day,” Suzanne said. “I don’t want to be remembered for my worst day. He was amazing to us — just like people’s children

should be.” One day, while visiting their daughter Rachel, who lives in Rochester, Suzanne spotted a small structure in front of a church. Rachel told her it was a blessing box in which people would leave donations of food and clothing for those in need. “I saw that, and I said to Jeff, ‘Build me a box,’” Suzanne recalled. In 2017, Noah’s Blessing Box was born. The wooden structure adorns their front yard and is open to all. Inside, they put personal care items and non-perishable food: anything to help someone going through hard times. The blessing box has evolved. When the weather gets cold, they hang scarves and mittens on a tree in their yard. They’ve put together backpacks with school supplies for kids in the fall. Given out bicycles. Meals during the holidays. Gifts at Christmas. “We did not expect this,” Suzanne said. “We just thought, ‘Well, we’ll maybe help a couple people out.” While the couple created the box, the community has kept it full. The Marinellis find everything from a few coins left behind to cases of food and large monetary donations. “I had a gentleman in Georgia send us a check,” Jeff said. Many of the donations come with stories. People who knew Noah reminisce with his parents. People who didn’t say they’ve been touched by his story. The level of generosity does not matter. They’re moved by all of it. “Those are powerful gifts,” Jeff said. They’ve also hosted meetings with other parents going through the same issue. Their advice? Call your child’s doctor if you suspect anything. And if they can’t help, call another and another until you find someone who can. Call rehabs until

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

you find one that can take your child. When someone is addicted, it’s nearly impossible for them to advocate for themselves, they said. They also recommend taking care of yourself. Talk to your faith leader. Go to Al-Anon or Nar-Anon, groups that provide support to loved ones of alcoholics and substance abuse sufferers. Learn as much as you can about the disease and why and how it affects your loved one. “I met a guy who went to rehab 15 times before he got it,” Jeff said. Above all, even in the darkest moments, hang on to hope and compassion, they said. “No one wakes up in the morning and says, ‘I’m going to do something today that is going to ruin the rest of my life.’” Suzanne said. It brings the Marinellis comfort to hear talk of their son. It gives them pride to know how many people cared about him and just how much his interactions and relationships with people mattered. They believe he’d be pleased with what they’ve done. Suzanne recalls how one morning she and Noah stopped at a fast food joint and saw two homeless men. “Noah came out and said, ‘Can we please buy them breakfast?,” she said. “That was Noah’s heart.” Noah’s final resting place is on the fireplace in the living room. He’s always with his family now, a family that has grown with the birth of two grandchildren for the Marinellis. But the loss still cuts deeply. A parent, Jeff said, only wants two things: for their child to be OK, and for their child not to die before them. “And if you get both of those things, you’re lucky then, you know?” To learn more, follow The Noah Project on Facebook

Things You Should Know About Hypnosis

By Ernst Lamothe Jr.

ith people seeking various non-medical, non-invasive treatments to heal various issues in their lives, hypnosis has slowly gained traction as an option. Hypnosis is a type of guided therapy used in psychological and medical treatments. Treating anxiety, depression, addictions and fears, hypnosis can improve sleep and quality of life. “Overall mental health has become a very prevalent issue,” said Rekha Shrivastava, a certified hypnotist and founder of Blossom Hypnosis in Pittsford. “There are many issues that a hypnotist can help individuals conquer — from migraines and arthritis to alcohol, food and drug addiction,” she said. Shrivastava holds a master’s degree in psychological development from the University of Rochester and has worked at Unity Health System for 20 years offering mental health services to treat a wide range of mental illnesses. “Medication is not the only answer to problems. Sometimes the side effects of prescribed medication are worse than original symptoms,” said Shrivastava. “There are many pain management solutions that don’t involve drugs.” Here are five issues that hypnosis can treat, according to her.

Public speaking

The fear of public speaking is the most common phobia ahead of death, spiders or heights. The National Institute of Mental Health reports that public speaking anxiety, or gloss phobia, affects about 73% of the population. The underlying fear is judgment or negative evaluation by others. Public speaking anxiety is considered a social anxiety disorder. One of Shrivastava’s clients had

such a fear of public speaking that he would get nervous even in conference calls. “He would have panic attacks before going on conference calls,” she said. “But after doing several regression sessions where you go into people’s childhood we figured his fear stemmed from a traumatic experience when he was young. We get the whole picture and it was because he was bullied in school at a young age when he had to give a speech where he forgot his lines.” She offered several phobia release sessions, using the neurolinguistic programming method. “I help people through their anxiety. You let the conscious mind go and allow people to get in a relaxed trance and then you talk to their subconscious and they hear a suggestion that gets embedded into that subconscious,” said Shrivastava. “The subconscious is the major part of our thinking system but it just happens to be a hidden layer of the mind. It has 90 % retention rate so the suggestions are retained long after the sessions.”

Phobia

Shrivastava has helped clients with fear of heights, elevators, medical doctors and other crippling phobias. While fear is natural and a healthy response to danger, especially in a survival instinct mode, phobias are different. They are more intense than fears and can lead to anxiety and panic attacks. “What I do with all that anxiety is I tell them to imagine those anxiety symptoms as a volleyball.” she said. “I tell them to now shrink it to the size of a golf ball in their minds and then allow it to roll off their shoulders, past their wrist and just hold it really tight in the palm. Then image

Improve your life with Hypnosis and Experience Results! Weight Loss • Smoking • Stress Self-esteem • Depression • Addiction Pain Management • Anxiety and Phobias “I am extremely pleased with the weight loss results I have achieved while working with Rekha. I feel healthier than I have in years and now I look forward to getting on the scale.” R.P. Syracuse, NY “I have been smoking for over forty years and tried many times to quit to no avail. Then my sister found out about Blossom Hypnosis and I can honestly say that I am smoke free. I sure wish I found out about Blossom Hypnosis years ago. It really works …….” V.C. Dansville, NY

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Rekha Shrivastava, a certified hypnotist based in Pittsford. releasing the ball and getting rid of it. They can see their anxiety being thrown away.”

Depression

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. “People come to me after the death of a mother, spouse or someone close with them and it causes a deep inner depression that can be difficult to come back from,” said Shrivastava. “I help them to stop the negative thoughts. There are many unwanted subconscious thoughts in your head and finding ways to get rid of them is a technique that [the] hypnotist utilizes.”

Weight loss

Gastric band hypnosis is a technique used to suggest to the subconscious that you’ve had a gastric band fitted around your stomach to help you lose weight. It is considered a non-invasive option compared to the actual gastric band surgery, which involves fitting a band around the upper part of the stomach. This limits the amount of food you can physically eat and encourages weight loss.

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“I record audio of the session where I plant the information to stay on track and not eat junk food and avoid binging,” said Shrivastava. In addition, hypnotherapy is more than just hypnosis as it offers services such as counseling. It is important to get an understanding of how a person ended up in the situation they’re in and other leading factors that may be affecting them. Once the therapist grasps a better understanding of the situation, then they can utilize the use of hypnosis.

Addiction to Drugs, Alcohol and Nicotine

Hypnosis is a very safe and effective tool to address addiction. She has helped multiple clients with alcohol, drug and nicotine addiction. “I embed the suggestions directly in the subconscious mind and it becomes a guide or inner adviser for the clients,” said Shrivastava, who is a credentialed alcohol and substance abuse counselor. “Addiction can be addressed with aversion and various hypnotic techniques and anchors. It brings long-term changes in the lifestyle of clients.” Shrivastava has successfully helped several clients who came with severe wine addiction and they achieved full sobriety with the help of hypnosis sessions and listening to the audios supplied by her.

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Study: Hospital Patients Benefit from Presence of Flowers Local professionals agree: Plants, flowers have positive effect on hospital patients By Deborah Jeanne Sergeant

o you know someone who’s ill or injured? If you’re going for a visit, chances are you’ll likely bring along a gift as good manners. But taking a bouquet or plant to a friend admitted to the hospital or recuperating at home is more than just a thoughtful gesture. A gift of flowers may actually help the patient get better. A study by the American Society for Horticultural Science indicates that post-surgery patients between age 19 and 60 recovering in 40 hospital rooms with 12 plants and flowers had measurably lower blood pressure and heart rates than the 40 patients in control rooms with no plants or flowers. Patients with foliage also reported less pain, reduced need for pain relievers and lower levels anxiety, plus greater patient satisfaction rates than the control rooms that were identical in every way, including the rooms’ views, except for the lack of plants. The patients were aware that the study provided the plants and flowers. “Green plants give off oxygen,” said Joyce Wagner, Ph.D. of Restoration Counseling of Rochester. “They’re living organisms.”

She said that because plants clean the air, they can help patients feel better and because “it’s less sterile, clinical and more personal” with plants. “It could evoke positive memories from the past.” Physician Chanh Huynh with Churchville-Chili Family Medicine LLC in North Chili said that the presence of flowers offers therapeutic effects on health. “The old adage is to ‘stop and smell the roses.’ A major part of it is the connotation that having nature in your immediate surrounding helps you embrace feelings of peace and refreshment,” Huynh said. “It’s a positive distraction and can provide a feeling of companionship.” Many studies indicate access to nature as beneficial to patients, such as a hospital window facing a park, photos of peaceful nature scenes or even viewing the color green. Flowers in a hospital room could provide another means for patients to connect with nature. Huynh said that when he sees a flower, “it reminds me of what Jesus said, ‘Look at the lilies of the field, yet I say unto you, that even Solomon in all his glory was not arrayed like one of these’ (Matthew 6:38). “The model for our practice is

cheerful, competent and to glorify God. The Lord provides for the lilies of the field. I was comforting a close friend and she was anxious. There was a flower next to us and I reminded her of that story. They’re reminders in nature that he planted to remind us of him. It points us to the glory of God.”

For some patients, closeness to elements from nature can help them feel better connected to the outside world beyond their four hospital walls and to the people who placed the flowers in their room. The study’s abstract said that the flowers provided “effective positive distraction, which may provide ample involuntary attention, increase positive feelings, block or reduce worrisome thoughts and promote restoration from stress.” Though the participants in the American Society for Horticultural Science were aware that they received their flowers as part of a study, the presence of the bouquets and plants seemed to make the patients’ rooms feel special, which can provide a powerful emotional benefit. Patients allergic to flowers may still benefit from images depicting nature, like a card with flowers on it or a gift like balloons, stuffed animals or cards.

Your Washing Machine Can Be a Home for Bacteria

oday’s high-efficiency home washing machines might not be eliminating bacteria as thoroughly as their older, less-efficient counterparts. This finding comes after a multidrug-resistant pathogen was found on the clothing of infants at a neonatal intensive care unit at a German children’s hospital — despite all normal precautions being taken to eliminate exposure to such superbugs. The eventual culprit, investigators found, was in the hospital’s laundry room. There the investigators found consumer-grade washing machines instead of the usual high-temperature industrial washing machines typically used in hospitals, researchers reported in the journal Applied and Environmental Microbiology. Fortunately the infants were only exposed to the drug-resistant Klebsiella oxytoca pathogen but not actually infected, the researchers said.

What’s in your washer? But the findings raise the question: If the problem is a consumer-grade washing machine, do consumers need to be concerned about harmful bacteria lingering in their machines at home? The answer is mixed. Page 16

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“This was a washer in a hospital so it would be exposed to bacteria — such as this one — that thrive in hospital environments,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security in Maryland. “This bacteria is resistant and

can cause severe infections but still requires a susceptible host. Many people can be exposed to drug-resistant bacteria and even colonized with them — like are many healthcare workers — yet have no infections occur,” he said. But in order to save energy, to-

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

day’s high-efficiency machines wash clothes at lower temperatures — less than 140°F. That means more bacteria survive the washing process, noted Ricarda M. Schmithausen, Ph.D., a lead author of the study and a senior physician at the Institute for Hygiene and Public Health at the WHO Collaboration Center at the University of Bonn, Germany, in an American Society for Microbiology press release. In particular, the researchers found bacteria growing in the rubber seals of the washer, which then spread during the unheated rinse cycle. However, most bacteria are benign or even beneficial. “For those of us who use cold or warm water wash and efficient short-drying cycles, some hardy germs will be left on our linens and clothes, [but] the possibility of dangerous, resistant bacteria in our washing machines causing disease is very remote,” said Bruce Hirsch, attending infectious disease physician at North Shore University Hospital in Manhasset, New York. “We’re all exposed to bacteria all the time without illness. This story suggests that if a household has a family member with a recent prolonged hospitalization, hot water and prolonged drying should be considered,” he said.

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Study: U.S. Firearm Death Rate Rises Sharply New analysis of 1999-2017 firearm deaths looks at changes in each state and within age, gender and racial/ethnic groups

he rate at which Americans died from firearm injuries increased sharply starting in 2015, a new study shows. The change occurred to varying degrees across different states, types of firearm death such as homicide and suicide, and demographics.

In all, the United States saw a 14% rise in the rate of firearm deaths from 2015 through 2017, compared with the rate seen in the years 1999 through 2014. During the entire 19-year period, 612,310 Americans died from firearm injuries that were self-inflicted, caused by others, accidental or of undetermined cause. Nearly one-fifth of the deaths happened in just the last three years of that time. The study, published in the October issue of Health Affairs by a

team led by University of Michigan researchers, used data from the federal Centers for Disease Control and Prevention. Jason Goldstick, Ph.D., a research assistant professor of emergency medicine at the U-M Medical School, led the analysis. “What we can see is a worsening epidemic of firearm mortality that is geographically and demographically broad,” he says. “But our analysis of subpopulations also reveals clues to how to focus efforts to reverse the overall trend.”

Geographic differences

The research reveals differences across states in the change in firearm mortality rates over time. From 1999 to 2017, a majority of states had firearm trends that increased by November 2019 •

more than 20%, but a few states had declines. For instance, New York, California and the District of Columbia bucked the national trend and saw decreases in their firearm death rates across most categories of people in 2015 through 2017. Those three areas, plus Arizona and Nevada, also saw an overall decrease in firearm deaths from 1999 to 2017.

Demographic differences

Across the country, nearly all demographic groups saw increases in firearm death rates, but the level of increase varied across groups. For example, males had larger absolute increases than females. Hispanic whites were the only racial or ethnic group that saw re-

ductions in mortality in recent years, while firearm mortality rates among both non-Hispanic whites and African-Americans increased significantly. There were broad increases across age groups.

Type of firearm death differences

Throughout the study period, suicides and homicides remained consistent in their share of all firearm-related deaths. Specifically, suicide accounted for about 60% of deaths, and homicides about 38%, in both 1999 to 2014, and 2015 to 2017. Rates of firearm deaths categorized as unintentional dropped in recent years, but these made up less than 1% of all firearm deaths.

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Page 17

Top Foods For Your Brain Studies point to several types of food linked to better brain power

oes what we eat affect the health of our brain? I ponder this question frequently now that I’m older and losing or forgetting things on a regular basis: glasses, keys, appointments, book titles, people’s names…you get the fuzzy picture. Since our brain is always “on” — working hard 24/7 and requiring fuel even while we sleep — why shouldn’t what we eat directly affect the structure and function of our brain? Many experts strongly believe it does, acknowledging that while there is no single almighty brain food that can ensure a sharp brain as we age, there are certain foods that are particularly rich in healthful components that support brain health. Research has shown that foods with certain nutrients that are touted to be healthy — omega-3s, choline, B vitamins and antioxidants, among others — actually correlated not only to cognitive function but also to how the brain itself functions. Many of the best brain foods are the same ones that protect our heart and blood vessels. Can the same benefits be obtained from consuming the same nutrients through supplements? Unfortunately, studies say “not entirely.” While the reasons aren’t completely understood, experts believe it has something to do with how our bodies metabolize pills versus food. If there’s any merit to that old adage “you are what you eat,” then perhaps eating a healthy, balanced diet that includes these top brain-boosting foods may help to keep our memory, concentration, and focus as sharp as it can be.

Leafy greens Dark leafy greens such as kale, spinach, collards and arugula stand out as an especially important category. A study from two acclaimed universities, recently published in the journal Neurology, found that a diet containing approximately one serving of green leafy vegetables a day is associated with slower age-related cognitive decline. Just one! The research suggested that the rich concentration of brain-healthy nutrients — vitamins A, E and K, lutein and folate — packed within the greens were likely contributors to the slower decline. Folate, in particular, may protect the brain by lowering the level of an amino acid (homocysteine) that, when elevated, may trigger the death of brain nerve cells.

Berries While all fruits do a body good, only berries seem to command attention when it comes to brain health. Experts credit the flavonoid anPage 18

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By Anne Palumbo

the only nut that contain significant amounts of omega-3s.

Dark chocolate For chocolate-lovers, news doesn’t get much better than this: Numerous studies strongly suggest that the right kinds of chocolate, consumed regularly, can help keep our mind sharp and alert, and our mood calm and happy. Cocoa beans are an excellent source of flavonoid antioxidants, which gather in the areas of the brain that deal with learning and memory. The benefit of such “gathering”? Researchers say these compounds may enhance memory and help slow down age-related decline. Even more good news? Two new studies have found that some of chocolate’s benefits may also occur at fairly doable doses: one-half ounce to one ounce a day. Generally, the darker the chocolate (70 % or more), the greater the benefits.

Eggs

tioxidants in berries, especially the anthocyanins that give berries their brilliant hues, for protecting our gray matter. These antioxidants help by reducing inflammation and oxidative stress, two processes that may accelerate the onset of age-related conditions such as Alzheimer’s and dementia. Researchers at Harvard’s Brigham and Women’s Hospital found that women who ate one or two half-cup servings of blueberries and strawberries per week delayed memory decline by up to two and a half years. Studies have also suggested that berries may improve communication between brain cells and that blueberries in particular may delay short-term memory loss.

Fatty Fish When people talk about brain foods, fatty fish swim to the top of the list because they teem with a nutrient that’s a major building block of the brain: omega-3 fatty acids. Omega-3s, which help build cell membranes throughout our body and brain, play an important role in sharpening memory, improving mood, and protecting our brain against decline. Studies

have found that people with high levels of omega-3s had increased blood flow in the brain, as well as more gray matter. Gray matter contains most of the nerve cells that control decision-making, memory and emotion. These healthy (unsaturated!) fats have also been linked to lower levels of beta-amyloid — the protein that forms damaging clumps in the brains of people with Alzheimer’s disease. Examples of fatty fish that contain high levels of omega-3s include salmon, mackerel, tuna, herring and sardines.

Nuts and Seeds Experts say we should all go a little nuts for nuts and seeds for this key benefit: nuts and seeds are especially rich in vitamin E. A potent antioxidant, vitamin E shields cell membranes from damage associated with oxidative stress, a disturbance that increases with age and is considered a major contributor to cognitive decline. According to a Harvard University study, women aged 70 or older who ate five or more servings of nuts per week scored higher on cognitive tests than women who didn’t eat nuts at all. Nuts and seeds also contain a host of other brain-boosting nutrients, including omega-3 fatty acids. Those with the highest amount of vitamin E include sunflower seeds, almonds, and hazelnuts. Walnuts are

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

While eggs provide a variety of nutrients, it’s their connection to choline that gives them their brainy edge. An essential nutrient that research says may protect against cognitive decline as we age, choline helps brain cells communicate with each other and keep memories intact. According to studies at Boston University and Harvard, adults with more choline in their diet scored higher on memory tests and experienced healthier aging of the brain. In fact, some experts believe that choline may hold promise in the war against Alzheimer’s. Given that egg yolks are among the most concentrated sources of this nutrient, we reap the most benefits by eating the whole egg (if your diet permits). Does eating eggs, which are also rich in brain-boosting B vitamins, help delay brain shrinkage, a natural loss linked to age-related cognitive decline? Current research suggests they may.

Whole Grains Nutrient-rich whole grains are an integral part of the Mediterranean diet — a diet linked to a reduced risk of memo-

decline in older adults, according to a study published in the Journal of the American Geriatrics Society. Whole grains contain soluble fiber, which ferries cholesterol from the body and prevents plaque from forming in arteries. Clear arteries promote good blood flow to the brain and may help reduce the risk of developing dementia and stroke. Healthy-carb whole grains also provide a steady supply of energy to the brain by releasing glucose slowly into the bloodstream. Our brain, which uses a whopping 20% of the energy we consume, benefits from whole grains by remaining more mentally alert throughout the day. Keys? Why, they’re right here!

Coffee If coffee is the highlight of your morning, you’ll be thrilled to hear it’s good for your brain. Beyond boosting alertness and potentially enhancing short-term memory, coffee may also protect the brain against cognitive impairments and heighten thinking skills. According to physician Donald Weaver of Krembil Brain Institute, “Coffee consumption does seem to have some correlation to a decreased risk of developing Alzheimer’s disease and Parkinson’s disease.” What’s more, in a recent study published in The Journal of Nutrition, participants with higher caffeine consumption scored higher on tests of mental function. Coffee is also an excellent source of powerful antioxidants, which may offer some protection against progressive cognitive decline.

Turmeric Could a curry a day keep the forgetfulness at bay? Numerous studies suggest it may. Turmeric, the spice that gives curry its bright yellow color, has been the focus of research lately due to its concentration of curcumin. A powerful antioxidant and anti-inflammatory, curcumin has been shown to improve memory and mood in people with mild, age-related memory loss, according to a study by UCLA. The latest research on turmeric has also shown that because curcumin can cross the blood-brain barrier, it may have the potential to help clear the amyloid plaques that are a hallmark of Alzheimer’s disease. In India, where turmeric is a regular staple in curry dishes, senior citizens traditionally have a lower risk of Alzheimer’s disease. More research is needed however to assess the impact of turmeric on this progressive brain disorder, as India’s low meat consumption may also contribute to the population’s reduced risk. Anne Palumbo is the author of SmartBites column, which appears in In Good

SmartBites

The skinny on healthy eating

Humble Parsnip Asserts Plenty of Nutrients

ity the poor parsnip. Often overlooked in favor of its more attractive cousin, the carrot, it yearns for our attention. Pale, anemic and rather awkwardly shaped, it begs for us to wake up to its distinct taste, versatility and rich nutritional profile. Let’s begin with what makes this particular root vegetable so nutritious. Parsnips, like many vegetables, are a great source of soluble and insoluble fiber, with one cooked cup providing nearly 25% of our daily fiber needs. While insoluble fiber promotes regularity, soluble fiber helps keep our tickers in tip-top shape by ferrying cholesterol out. Worried about Type 2 diabetes? Fiber may lower your risk of developing this chronic disease because it helps slow down the rate of glucose absorption after a meal. Despite its pale exterior, parsnips dish up a surprisingly healthy dose of vitamin C: about 25% of our daily needs in just one serving. Essential for the growth and repair of tissue all over the body, vitamin C also helps to increase the production of infection-fighting white blood cells, which is why many of us turn to vitamin C during cold and flu season. Though it may not keep you from catching a cold, there is some evidence that vitamin C may shorten the duration and intensity of a cold. Parsnips are a decent source of folate, a B vitamin especially important to woman of childbearing age because it reduces the risk of birth defects. Folate benefits the rest of us in three outstanding ways: by ridding the blood of an amino acid that has been linked to narrowing and hardening of the arteries; by regulating our moods due to its role in the production of serotonin (a.k.a. the “happy chemical”); and by helping to prevent gum disease by reducing inflammation. Rich in health-promoting antioxidants — with vitamin C and manganese leading the list — parsnips may provide protection against cell-dam-

aging free radicals that contribute to many chronic diseases, such as cancer, heart disease, Alzheimer’s and vision loss. As for its distinct taste and versatility, parsnips possess a sweet, nutty flavor unlike any other vegetable, lend themselves to a variety of cooking methods (roasted, sautéed, braised or boiled), and are a welcome addition to many dishes.

By Anne Palumbo

Helpful tips

Select parsnips that are firm, smooth and free of blemishes. In terms of size, small to medium offer the best flavor (fatter ones can be woody). Although parsnip’s peel can be eaten, many recommend peeling it to improve texture as well as taste (it can be bitter). Parsnips, stored in a plastic bag and placed in your refrigerator’s vegetable drawer, should last about two weeks. Wash just before use.

Parsnip-Pumpkin Soup with Coconut and Curry Adapted from Epicurious Serves 4-6

3 medium parsnips, peeled and cut into 1-inch chunks 1½ tablespoons olive oil, divided 1 medium onion, chopped 3 cloves garlic, minced 1 tablespoon Thai red curry paste (more, if desired) ¼ cup warm water 1 tablespoon ginger, peeled and minced 1 cup canned pumpkin 3 cups chicken broth 1 cup lite coconut milk Lime-Yogurt Drizzle 1 to 2 tablespoons fresh 3/4 cup raw shelled pumpkin seeds, roasted Heat oven to 400 degrees. Place parsnip chunks in a large bowl and toss with ½ tablespoon olive oil and a sprinkling of salt. Spread out on large baking sheet in a single layer and roast, stirring once or twice, for 25 minutes. Meanwhile, in a large soup pot, heat remaining 1 tablespoon olive oil over medium heat and sauté onion and garlic for about 5 minutes until soft. Add roasted parsnips to this pot, along with broth, and bring to a slow boil. Once soup is boiling, reduce heat to low, and add pumpkin and ginger. Before adding red curry paste, blend it with ¼ cup warm water in a small bowl. This makes it easier to incor-

porate into soup. Cover and simmer for about 15 minutes. Puree the soup with handheld immersion blender, stir in coconut milk, season with salt and pepper. Add more broth or coconut milk if soup seems too thick. Garnish with lime-yogurt drizzle and roasted pumpkin seeds. To make lime-yogurt drizzle: Whisk yogurt and lime juice (to taste) in a small bowl until well blended. Note: If you’re skipping the drizzle, you can add fresh lime juice directly to the soup when you stir in the coconut milk. To roast pumpkin seeds: Heat oven to 350 degrees. Spread the raw, shelled pumpkin seeds flat on a cookie sheet and bake for about 10 minutes, until lightly golden. Correction: October’s chia seed pudding recipe forgot the most important ingredient of all: 1/4 cup chia seeds. Clearly, I need to eat more brain foods!

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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Page 19

Sleeping Less Than 6 Hours May Raise Risk of Cancer, Even Death

ot getting enough sleep may put some people at risk for much more than being drowsy the next day, a new study says. Middle-aged people with high blood pressure, Type 2 diabetes, heart disease or stroke could be at increased risk for cancer and early death if they get less than six hours of sleep a night, researchers reported early in October in the Journal of the American Heart Association. Specifically, those with high blood pressure or diabetes who slept less than six hours had twice the risk of dying from heart disease or stroke compared with people who slept six or more hours. Sleep-deprived people with a history of heart disease or stroke had three times the increased risk of dying from cancer during the study that spanned three decades. “Our study suggests that achieving normal sleep may be protective for some people with these health conditions and risks,” the study’s lead author Julio Fernandez-Mendoza said in a news release. He’s an associate professor at Pennsylvania State College of Medicine and sleep psychologist at Penn State Health Milton S. Hershey Medical Center in Hershey. But more research will be needed to determine whether increasing sleep through medical or behavioral therapies could reduce risk of early death, Fernandez-Mendoza said. The study looked at more than 1,600 adults who were categorized into two groups. One had stage 2 high blood pressure or Type 2 diabetes. The other had heart disease or stroke. Participants were studied in a sleep lab for one night between 1991 and 1998. Researchers then tracked their cause of death up to the end of 2016. In that period, 512 people died — one-third of them from heart disease or stroke and one-fourth from cancer. Fernandez-Mendoza said better identification of people with specific sleep issues would potentially lead to better treatment. “Short sleep duration should be included as a useful risk factor to predict the long-term outcomes of people with these health conditions,” he said.

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Golden Years

A recent Walk to End Alzheimer’s event in the Finger Lakes. The Walk is one of the most popular events organized by Rochester chapter of Alzheimer’s Association.

Many Ways to Help Alzheimer’s Association Whether it’s a karate school kicking for the cause, a knitting club making a scarf in a day or a baking company baking for a cure, the events to help find a cure for Alzheimer’s put the “fun” in fundraisers By Deborah Jeanne Sergeant

oes it seem like many organizations and individuals you know are taking part in some sort of fundraiser for the Alzheimer’s Association? It’s just not an impression. The Rochester chapter of the nonprofit offers numerous opportunities for the community to become involved. Since dementia is the fifth leading cause of death in the U.S., officials say it’s vital to both fund research and provide help for those affected and their families. The Alzheimer’s Association represents the largest nonprofit funder of dementia research. Its main three fundraisers are The Longest Day, Walk to End Alzheimer’s and Culinary Clash. “We want organizations to know that it’s not just a good deed but [sponsoring these events] will reflect in a positive manner on their organization,” said Jeff Collins, senior director of development. “The corporate sponsorships are a big part of the events.” Events like these raise both funds and awareness. Patrick Sloan, a Penfield volunteer involved with The Walk, said that participating helps him honor his late mother. He cared for her while she had Alzheimer’s disease. He wants more people to know about the disease that caused his mother to “slowly deteriorate,” he said. With a background in marketing, Sloan helps in part by promoting The Walk and also by walking himself. He encourages participants in fundraisers to also leverage the power of social media. He posted a video on social media about his mother that he felt helped raise more funds and awareness. Julie Demersman, events spe-

cialist with the Rochester chapter, said that most participants are like Sloan — caregivers or someone with dementia. But others “see the value behind what we’re doing and our mission,” Demersman said. The Walk is the world’s largest event to raise awareness and funds for dementia care, support and research. It has been held annually for 30 years. More than 600 communities nationwide participate. The Rochester chapter hosts Walks for the Finger Lakes, Southern Tier and Rochester areas. The most recent Walk in Rochester on Oct. 12 raised more than $238,600 with 1,280 registered participants. “It was amazing,” said Shelby Ascroft, 2019 volunteer and 2020 chairwoman. “It overwhelming in the very best way. We walked because we want to be witnesses to the first survivor. We want caregivers to have somewhere to get support, we want everyone to know that dementia is not a normal part of aging.” Ascroft hopes that more individuals and businesses will participate next year as volunteers, walkers and donors. “If we have community support, we can accomplish anything,” she said. The Longest Day event is named for the long days caregivers put in with their loved ones with dementia and because it used to be held only on the longest day of the year in midJune. Participants can host a Longest Day event anytime of the year now, and can raise funds doing any activity they choose. “We want to get the business community more involved,” Demersman said. Whether it’s a karate school kicking for the cause, a knitting club

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

making a scarf in a day or a baking company baking for a cure, the events put the “fun” in fundraisers. Participating groups can choose to seek pledges and/or sell items to raise funds. “They can do Casual for a Cause on Fridays or collect bottles and cans or get pin-ups in the office to show support,” Demersman suggested. “It doesn’t have to be anything hard. It can be something you’re already doing.” Culinary Clash is an event specific to the Rochester chapter. Held May 9, 2019 the fifth annual event raised nearly $110,000 and attracted 400 guests. Executive chefs from six senior living communities and culinary arts students from Monroe Community College competed. “The Culinary Clash is an incredible event,” said Stephanie Johnson, board member of Culinary Clash First. “It is a celebration of food — great tasting food — and who doesn’t enjoy great food? It allows an opportunity for culinary students to showcase their skills, receive great coaching from a variety of chefs and receive many compliments. “The money raised will enable the Alzheimer’s Association to continue providing incredible support to families living with Alzheimer’s or another dementia and support the research efforts to find a cure for this terrible disease.” The next event is slated for May 8. The Alzheimer’s Association Rochester & Finger Lakes Region chapter serves a nine-county region. Its services include 24/7 helpline, care consultations for families affected by dementia, support groups for caregivers, social activities for individuals with dementia and their care partners, and educational programs. The Alzheimer’s Association’s free multilingual helpline provides reliable information and support to those in need of assistance 24 hours a day, 7 days a week: 1-800-272-3900. No cure or treatment exists for Alzheimer’s and other forms of dementia, although some medication can slow it down to offer patients and caregivers better quality of life.

The Alzheimer’s Association shares facts on the disease • Alzheimer’s is the most common type of dementia, which accounts for about 80 percent of dementia cases. • Dementia refers to a decline in mental ability severe enough to interfere with daily life. • According to the Alzheimer’s Association 2019 Alzheimer’s Disease Facts and Figures Report, every 65 seconds someone in the United States develops Alzheimer’s dementia. • One in ten people aged 65 and older lives with dementia and the percentage of people with dementia increases with age. • More than 400,000 individuals live with Alzheimer’s dementia in New York State. This number does not include individuals with other types of dementia. • More than 1.6 million New Yorkers provide unpaid care to their loved ones who live with dementia.

Golden Years

Say Thanks to a Caregiver

November is National Family Caregiver Month • Three caregivers share their experience By Christine Green

uperheroes have out-of-thisworld talents like flight, mind control and speed. But what if a hero could be in two places at once? One part of them could be at work, another with the kids and yet another doing the grocery shopping. It’s a talent many wish they had. Jackie Wittman, 56, of Brockport may only think of herself as an everyday teacher and mom, but in 2018 she had to muster her superpowers of courage and strength to do the impossible — be in two places at once. Her mother, suffering from lung cancer, was in hospice care in Hilton. At the same time, her brother was in a facility in Perinton as a tumor ravaged his brain. Wittman is one of the millions of people in the United States who are caregivers providing for a relative in need of support. Each November, caregivers are recognized for the hard and often thankless work they do. The Caregiver Action Network first promoted National Family Caregivers Month in 1994. In 1997, President Bill Clinton signed the first National Family Caregivers Month Presidential Proclamation. Since then every president has issued an annual proclamation honoring family caregivers in November. More than 43.4 million people in the U.S. have cared for an adult or child for no pay in the previous year, according to a 2015 study conducted by The National Alliance for Caregiving and the AARP Public Policy Institute.

Jackie Wittman, 56, of Brockport in 2018 was the primary caregiver of both her mother, Kathleen, 84, who suffered from lung cancer and was in hospice care in Hilton and her brother, Richard, 63, who was in a facility in Perinton as a tumor ravaged his brain. “You need to take care of yourself first. There were lots of times where I was ‘I can’t do this today.”

Jackie’s Story

Currently, Wittman is a teacher’s aide in a special needs classroom at Brockport’s A.D. Oliver Middle School. Last year when her mom and brother needed someone to care for them in their time of medical need Wittman was there without hesitation. She and her three sisters rallied to make sure Richard (their brother) and Kathleen (their mother) were well looked after. Together they made decisions about medical treatments and kept other family informed. She visited them often — every day, if needed. Her main role was emotional support. She helped her mom pray the rosary,

brought in soothing music and held her hand and talked to her even when Kathleen’s communication skills faded. Toward the end of Kathleen’s life Wittman was “basically living there.” Kathleen, 84, died in January 2018 and Richard, 63, died in March.

Ralph & Beverly

Beverly Olney, 65, of Spencerport was always dedicated to caring for others. Her work at BOCES centered on helping teen moms and their babies. She took special joy in all the baby cuddles she got. “I loved every minute,” she said. Those loving and attentive care-

giving skills came into play when her husband, Ralph, 66, was diagnosed with leukemia in 2011. Since then Ralph has gone through two stem cell transplants, has had a heart attack, suffered blood clots and a pulmonary embolism. He has been in and out of the hospital countless times. It wasn’t easy for this once high-ranking executive to deal with such health issues, but with Beverly by his side he got through. Today he is home and feeling relatively well though he still undergoes maintenance chemotherapy every five weeks. Beverly was looking after Ralph as his primary caregiver. Every time he was in the hospital, she was with him. At home, she managed his numerous medications. She kept friends and family informed, ran the household and paid the bills. She was exhausted but persevered. Just when Ralph’s health was stabilizing a bit Beverly started to present with some troubling symptoms. She was forgetful. She got lost just driving to the grocery store. Organizing Ralph’s medication became extremely challenging. Ralph was worried, but her doctor chalked it up to stress. They both knew it was more than that. Finally, after demanding more extensive cognitive testing, Beverly was diagnosed with early onset Alzheimer’s. “It was horrible,” said Beverly. “The whole thing was like, ‘This is not happening. What’s going on?’ I’m supposed to help other people. That’s what I do; that’s what I enjoy doing.”

Continued on next page

National Caregiving Theme: ‘Be Care Curious’

Group encourages caregivers to become advocates who are curious, proactive

he Caregiver Action Network (CAN), a Washington D.Cbased nonprofit organization, chooses a theme every year for National Family Caregivers Month. This year the theme is “Be Care Curious.” “We encourage family caregivers across the country to ask questions, explore options and share in the care decisions that affect the health and well-being of their loved ones,” read a statement in the group’s website, caregiveraction. org. The theme encourages caregivers to become advocates who are curious and proactive when it comes to their loved one’s goals, treatment options, medical research, care plans and insurance coverage. “To me being care curious is that there is a lot of support out there and you don’t know what you don’t know, and you have to ask questions,” said Ralph Olney, 66, of Spencerport of this year’s

CAN theme. “You have to be curious about what’s out there. You can’t go it alone, it’s impossible. As a C-level [high-ranking] executive, I can multitask and handle a fair amount of stress, but it is different when it’s your loved one and it’s your wife. We’ve been together 45 years.” He went on to say that caregiver stress can get very high and impede one’s ability to do a job. Being “care curious” also means looking into what you can do as a caregiver to take care of yourself. “When the emotions come in, the logic tends not to be there when you’re exhausted. Then you can’t function and you’re almost powerless to make a decision. It’s a horrible feeling. You really have to take care of yourself. What do you need to make sure you don’t get to that point? What’s that tipping point where you can’t care-give anymore? That’s really what the theme means to me.” He credited the local chapter November 2019 •

of Alzheimer’s Association with helping him after he and his wife Beverly learned of her diagnosis. He attended an eight-week class through the organization and said it was the best thing he could have done. He learned a great deal and met with others in the same situation. The Alzheimer’s Association also provided him with educational, medical and other support resources. They were able to meet with a social worker and other advocates that have made this difficult time easier. Dina Johnson is the Alzheimer’s Association of the Rochester and Finger Lakes Region’s director of care and support. She encourages caregivers for people with any form of dementia to take their caregiver stress test and contact them for support. She also said that connections to other caregivers can be a lifesaver. “They are very important because not only do you have us as experts you have the people in that circle being the experts, too,” said

Johnson.

Reaching Out

Jackie Wittman, 56, of Brockport suggests that if someone has a caregiver in their life to reach out to them and ask what they need to help them out. “Listen to what they have to say, talk to them, take them out, give them some free time. Just be there and listen,” she said. “Sometimes just a phone call or a text means so much just to know you have people in your corner.” Olney pointed out that, though it can be hard to be vulnerable with your support network, to let people know what you are going through as a caregiver. “Everybody’s journey is different, but if you asked us, we would strongly encourage people to be as open as you’re comfortable being because the love and support you’ll get back is ten times whatever you gave.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 21

Continued from previous page Now Ralph is Beverly’s caregiver. He does the grocery shopping, drives her to appointments, maintains the household chores and makes sure Beverly has nutritious foods. He does everything, “soup to nuts,” he remarked as Beverly reached out to take his hand in hers.

Coping with Caregiving

These stories show how complicated and overwhelming caregiving is. All three experienced intense stress, emotional ups and downs, and anxiety. Caregiving can upset the health of caregivers and put a strain on family finances, too. But, like every flight attendant knows, they had to put on their own oxygen masks in order to keep helping their loved ones. When asked how she coped with the pressure of it all Jackie Wittman said it was important to take time to care for herself. “You need to take care of yourself first. There were lots of times where I was ‘I can’t do this today.’” Self-care was spending time with her son, relaxing at home with a movie, riding her bike or getting together with girlfriends. Keeping her house neat and clean also gave her a chance to let off steam and have an ordered, pleasant place to unwind. “I feel better when my house is clean. I need to have all my ducks in a row, if I’m going from person to person trying to take care of everybody and my world is falling apart and I’m stressed out. I just need to take care of me.” For Beverly Olney self-care meant walking outside as much as possible even if it was just in circles around the hospital building. “I like to walk, I’m a walker. I can do it for five minutes or I can do it for 15 minutes. To me it was just really good to breathe in the fresh air and crisp air and then be like ‘OK, I’m going back in.’” When Olney’s husband, Ralph, stepped into his role as caregiver, he knew that taking care of himself meant looking to his church for support. “We’re people of faith,” he said. “I spend a fair amount of time reading faith-related books on healing and going back to the bible. Job is my favorite because it describes our situation better than anything. The devil keeps taking a run at us, but he’s not going to win.” Ralph also finds solace in giving back to his community. He volunteers at his church and is on the board at the Wilmot Cancer Center. In September he organized a team for the center’s 2019 Warrior Walk and raised over $25,000.

Resources for Caregivers • Alzheimer’s Association, Rochester & Finger Lakes Region alz.org/rochesterny Find the caregiver stress test & other resources including information on getting MedicAlert + Safe Return jewelry. Caregivers in the 9 counties the = chapter serve cans get it for free. • Alzheimer’s Association 24/7 Helpline 1-800-272-3900 • Caregiver Action Network caregiveraction.org or 1-855-CARE640 • National Alliance for Caregiving caregiving.org or 202-9181013 Page 22

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Golden Years

Key Questions Seniors Should Ask Their Doctors With doctor visits getting shorter and shorter, what are the key questions seniors should ask their doctors? By Deborah Jeanne Sergeant

ith electronic medical records, tighter margins for medical practices and a shortage of providers, most doctors cannot offer their patients much time to talk during visits. To get the most out of your visit, plan ahead the questions you should ask. Local experts offered a few ideas. • “It is very important to make decisions with your doctor. You will benefit most from a treatment if you are involved in making the decision. Ask about different treatment options. Are there any risks associated with the treatment? How soon should the treatment start? How long will it last? What should I do if I feel worse? How much does the treatment cost? Will it be covered by my insurance? Will this treatment be affected by or have an effect on medications I am already taking? What happens if I do nothing? Be an active participant in the final decision, after all: it is your health.” Jodi Cacciotti, registered nurse and program coordinator at Lifespan, Rochester. • “Ask about how to decide who’s going to help with their final wishes, a health care proxy. • “Patients should ask their primary care doctor about future planning. ‘Do you think I should start looking at a nursing home now?’ ‘Help me prepare for the future I’ll have because of this disease.’ • “A lot of older adults take medication for pain. They’re not always open if they cannot afford their medication. Some [medications] they must have, some medication is nice to have and others they can skip if they cannot afford it. We need to know if they cannot afford it. It’s rare for them to say they cannot afford it. • “Older adults are more stoic about their medical situations. We have to coax them to tell us this information. A part of it is how their parents handled chronic disease. • “Asking about how their disease will progress in five years and 10 years will make a difference. If you don’t ask you won’t know. • “I would like my patients to be more open about their incontinence.

Older adults don’t bring it up. It is very hard to discuss a topic when the patient doesn’t want to talk about it. It causes major impact on quality of life. It’s very common. The patients — and particularly male patients — are not open about those types of problems. They’re happy to talk about bowels, breathing and chest pain. But incontinence they don’t want t talk about. They probably feel it’s part of getting old and there’s nothing that can be done. Downplaying the problem is a major issue. • “They also may not want to talk about depression or isolation for the same reason. They’re not willing to seek treatment for it. When they start losing weight, someone else might say, ‘They’re not doing well; Furtuna what can we do?’ but we can start treatment for depression so much sooner. Physician Geria Furtuna, who works as geriatrician at University of Rochester Medical Center. • “’Are there any medications that I am currently prescribed that

Should Older Women Stop Getting Mammograms?

lthough regular screening mammograms can catch breast cancer early, new research suggests women over 75 who have chronic illnesses can probably skip this test. The study findings indicate that women with chronic conditions, such as heart disease or diabetes, would likely die from those conditions before developing breast cancer. “For those 75 and over with chronic illness, the benefit of con-

tinued mammography is minimal. Women 75 to 84 are 123 times more likely to die of other causes than breast cancer,” said the study’s senior author, Dejana Braithwaite. That doesn’t mean all women over 75 should forgo mammography. “In healthy women age 75 and older, perhaps mammograms may make sense. It’s important to individualize the decision. Women should discuss with their providers the potential benefits of continuing mam-

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

I do not necessarily need?’ Geriatricians are always thinking about deprescribing and willing to discuss the benefits as well as risks of doing so with you. • “’Are all of these labs, images, procedures vital to my health goals?’ While it is important to know the benefits of preventative health screening, it is equally important to discuss the necessity and even potential risks associated with screening and testing. • “’What recommendations do you have to prevent dementia?’ This is a vital topic to geriatricians and something we help manage daily. Every day new research is published regarding both treatment and Bonnet prevention of dementia. Your geriatrician can help you understand what is being written, said and published while integrating the information with your specific needs.’” Physician Mary Bonnet, instructor of clinical medicine, URMC, division of geriatrics and aging. mography,” Braithwaite said. She’s an associate professor of epidemiology and oncology at Georgetown University’s Lombardi Comprehensive Cancer Center, in Washington, D.C. Professional guidelines vary in their recommendations for mammography in older women. The American Cancer Society advises women to stop screening when their life expectancy is less than 10 years. Meanwhile, the U.S. Preventive Services Task Force (USPSTF) says there is not enough evidence to guide women’s decisions about mammography at age 75 and up. Many European breast cancer programs stop recommending screening between 69 and 74 years.

Golden Years

Even Age 80 Is Not Too Late to Begin Exercising: Study

E say.

ven seniors who never exercised regularly can benefit from a workout program, researchers

A new study found that men in their 70s and 80s who had never followed an exercise regimen could build muscle mass as well as “master athletes” — those of the same age who had worked out throughout their lives and still competed at the top levels of their sports. The U.K. researchers took muscle biopsies from both groups in the 48 hours before and after a single weight-training session on an exercise machine. The men were also given an isotope tracer before the workout in order to track how proteins were developing in their muscles. It was expected that the master athletes would be better able to build muscle during exercise, but both groups had an equal capacity to do so, the University of Birmingham team found. The study was published Aug. 30 in the journal Frontiers in Physiology. “Our study clearly shows that it

doesn’t matter if you haven’t been a regular exerciser throughout your life, you can still derive benefit from exercise whenever you start,” lead researcher Leigh Breen said in a university news release. He’s a senior lecturer in exercise physiology and metabolism. “Obviously a long-term commitment to good health and exercise is the best approach to achieve wholebody health, but even starting later on in life will help delay age-related frailty and muscle weakness,” Breen said. Current public health advice about strength training for older people tends to be “quite vague,” he noted. “What’s needed is more specific guidance on how individuals can improve their muscle strength, even outside of a gym setting through activities undertaken in their homes activities such as gardening, walking up and down stairs, or lifting up a shopping bag can all help if undertaken as part of a regular exercise regimen,” Breen said.

Adults Need Vaccines, Too

accines aren’t just for kids, a doctors’ group says. “Many adults are not aware that they need vaccines throughout their lives and so have not received recommended vaccinations,” physician Robert McLean, president of the American College of Physicians, said in a college news release. “Adults should get a seasonal flu shot and internists should use that opportunity to make sure their patients are up to date on the latest recommended immunizations,» he advised.

Along with an annual flu shot, other important adult vaccinations include: Tdap to protect against tetanus, diphtheria and whooping cough; pneumococcal to protect against pneumococcal pneumonia, bacteremia and meningitis; HPV (human papillomavirus) to prevent cervical, anal and other cancers; hepatitis B; and herpes zoster to help prevent shingles. Each vaccine should be given according to guidelines from the U.S. Centers for Disease Control and Prevention›s Advisory Committee on Immunization Practices (ACIP).

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“Vaccines are safe, effective and help prevent illness, hospitalization and even death, especially among the elderly and those with chronic conditions and weakened immune systems,” McLean said. “Physicians should conduct a

vaccine needs assessment with their patients regularly. People who cannot get a flu shot or other vaccines for medical reasons should talk to their internist about other ways of protecting themselves,” McLean recommended.

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• Page 23 9/19/19 4:44 PM

Tips to Keep You Safe Online By Marc-Anthony Arena

omputer users nowadays face all sorts of challenges, including spyware, fake cleaners and all sorts of scams. Here are some tips to in mind. • Only those using Internet Explorer (from 1995) should worry about online banking. Firefox or Chrome are light-years ahead in terms of security. • Anyone telling you to fear cookies doesn’t understand what they do. They know you are an existing customer and not an unknown person. • Anyone trying to sell you a firewall doesn’t understand that every computer and router in use today already has one built in. • Anyone telling you to fear public Wi-Fi doesn’t understand you’re already protected by something called HTTPS. Around 2008, bad guys stopped writing traditional viruses and now use other methods. So, no antivirus program in the world can protect you from the latest threats.

The Four New Threats • Corporate Spyware: Software that sneaks into your computer and ruins it, legally. Examples include: – Stowaways: The CDs that come with printers are no longer needed. They just spy on your printing behavior. – Fake Cleaners: Convince you that you have “errors,” then beg you for money. – Toolbars: Promise to help you find maps, PDFs, packages or recipes, but instead hijack your online searches and sell them. • Update Attacks: Usually come from the manufacturer, but do more harm than good. They slow your device massively, rearrange it, or even wipe it completely. • Cryptolocker/Hostageware/Ransomware: They scramble your documents and photos, and then beg for ransom money. Do not pay them. • Support Scams: Scary messages claim you have viruses and trojans, and beg you to call a phone number (or they call you directly). They claim they’re Microsoft and read a list of scary words (cookies, firewalls, trojans, foreign bank hackers). Ironically, the only time they can break into your computer is if you let them in. In summary, these new threats try to scare you into thinking you need something. Remember, “The only thing we have to fear is fear itself.” Marc-Anthony Arena is an honors grad of McQuaid and RIT, and president of Teknosophy, LLC, a business specializing in in-home computer services. He hosts WYSL’s “Computer Exorcist Show” and is the author of “How to Protect Yourself from Your Computer.” Page 24

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Getting Around When You No Longer Drive By Jim Miller

lternative transportation options for seniors who no longer drive vary widely by community, so what’s available to your parents will depend on where they live. Here’s what you should know. While most urban areas offer seniors a variety of alternative transportation services, the options may be few to none for those living in the suburbs, small towns and rural areas. Depending on where your mom lives, here’s a rundown of possible solutions that can help your parents get around, along with some resources to help you locate them. • Family and friends: This is the most often used and favorite option among seniors. So, make a list of all possible candidates your mom or dad can call on, along with their availability and contact information. • Volunteer transportation programs: These are usually run by local nonprofits or religious organizations and provide elderly seniors transportation to doctor’s appointments, shopping and more. These services may charge a small fee or accept donations and often operate with a network of volunteer drivers. To search for volunteer driving programs in your Upstate New York area visit NationalVolunteerTrans-

portationCenter.org — click on “Map of Volunteer Driver Programs.” • Demand response services: Often referred to as “dial-a-ride” or “elderly and disabled transportation service,” these are usually government-funded programs that provide door-to-door transportation services by appointment and usually charge a small fee or donation on a per ride basis. Many use vans and offer accessible services for riders with special needs. • Taxis and rideshare services: While taxis are a viable transportation option in many communities, rideshare services like Uber (Uber. com) and Lyft (Lyft.com), which are widely available, have become more popular among seniors who don’t drive. To get a ride, your mom or dad could simply use the Uber or Lyft smartphone app, a computer, or she can call a ride-hailing service like Go Go Grandparent (GoGoGrandparent. com). Or, you can make arrangements for her on your smartphone. Cost will vary depending on your mom’s location, distance traveled and peak travel time, but rideshare services are usually cheaper than taxis. Uber and Lyft also offer carpooling services that would allow your mom to save money by splitting

the tab with other consumers riding the same route. And for seniors with mobility problems, both Uber and Lyft have accessible vehicles that you can request in certain locations. • Hire someone: Consider hiring someone to drive your mom like a neighbor, retiree, high school or college student who has a flexible schedule and wouldn’t mind making a few extra bucks. You can also hire a senior driving companion through nonmedical home-care agencies, or you can find someone on your own at websites like Care.com or CareLinx.com. • Private business transportation services: Some hospitals, health clinics, senior centers, adult day centers, malls or other businesses may offer transportation for program participants or customers. • Mass transit: Public transportation (buses, trains, subways, etc.) where available, can also be an affordable option and may offer senior reduced rates.

Where to Look To find out what transportation services are available in your parents area contact Rides in Sight (RidesInSight.org, 855-607-4337), and the Eldercare Locator (800-677-1116), which will direct you to her area agency on aging for assistance. You should also contact local senior centers, places of worship and retirement communities for other possible options. Jim Miller is the author of Savvy Senior, a column that runs every month in In Good Health.

Gum Disease? LANAP May Help Laser-Assisted New Attachment Procedure offers dramatic benefits over traditional gum surgery

aser treatment is an advanced technique for your doctor to treat gum disease and save many teeth that were previously considered hopeless. A laser light is used to gently remove harmful bacteria and diseased tissue from the infected gum pocket. This allows the body to heal more naturally so that the diseased gum pockets improve and the teeth become more stable. The laser is an effective tool that will help many patients bring themselves to a healthier state. Laser-Assisted New Attachment Procedure (LANAP) offers dramatic benefits over traditional gum surgery. • No cutting of the gum tissue with a scalpel and no stitches means easy recovery with minimal bleeding. • Preserve gum tissue instead of cutting it away; • Dramatically less traumatic yet highly effective alternative to cut and sew gum surgery; • Reduces root exposure and sensitivity; • Reduces infection; • Reduces expense. Who is a candidate for this therapy? First, it is helpful to know who is not a candidate for laser gum treatment. Patients who have healthy gums do not need this treatment. Also, people with superficial gingivitis do not need this form of ther-

apy. Superficial gingivitis patients have red swollen gums but have gum pockets less than 5mm. These patients are classified as Class I. All other periodontal patients are Class II, Class III, or Class IV. All these people have gum pockets 5 mm or greater, and the higher classes of gum disease correspond to deeper gum pockets, and more loss of bone support to the teeth. All classes of gum disease greater than Class I are candidates for laser gum treatment.

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

For more information, about options to treat gum disease, call the dental office of Emery & Scuro DMD, PC at 2184 Chili Ave., Rochester, or call 585-247-7110. Drs. Emery and Scuro’s practice is one of the first two in the Rochester region trained and licensed to offer this FDA-approved patented procedure. For more information, visit www. drsemeryandscuro.com Submitted by Emery & Scuro DMD, PC

Laser Gum Treatment in Rochester, NY What is laser gum treatment or LANAP? By Jim Miller

Cremation:

An Affordable Way to Go

Dear Savvy Senior,

How much does cremation cost and how can I find a good deal in my area? I would like to get a simple, basic cremation that doesn’t cost me, or my family, a lot of money.

Shop Around

To you, the patient, this means less pain, less bleeding, less swelling, less tissue removed, less downtime, and less recovery time, which is decidedly less costly to you and your employer.

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Remove only diseased tissue without removing any of the healthy tissue, maintain the height of the tissue around the teeth, minimize pain and discomfort to the patient, get a closure of the periodontal pocket wound and allow healing to take place. Controlling periodontal disease makes it possible to save and restore otherwise hopeless involved teeth.

Dear Frugal,

Because prices can vary sharply by provider, the best way to get a good price on a simple “no frills” cremation is to call several funeral homes in your area (most funeral homes provide cremation services) and compare prices. When you call, ask them specifically how much they charge for a “direct cremation,” which is the basic option and the least expensive. With direct cremation, there’s no embalming, formal viewing or funeral. It only includes the essentials: picking up the body, completing the required paperwork, the cremation itself and providing ashes to the family. If your family wants to have a memorial service, they can have it at home or your place of worship after the cremation, in the presence of your remains. If you want additional services beyond what a direct cremation offers, ask the funeral home for an itemized price list that covers the other service costs, so you know exactly what you’re getting. All providers are required by law to provide this. To locate nearby funeral homes, look in your local yellow pages or Google “cremation” or “funeral” followed by your city and state. You can also get good information online at parting.com, which lets you compare prices from funeral providers in your area based on what you want. Or, if you need more help, contact your nearby funeral consumer alliance program (see Funerals.org/ local-fca or call 802-865-8300 for contact information). These are volunteer groups located in most regions around the country that offer a wide range of information and prices on local funeral and cremation providers.

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The reason we use Laser Periodontal TherapyTM are to:

Frugal Senior Cremation costs can vary widely. Depending on your location, the provider and the services you request, cremation can range anywhere from $500 to $7,500 or more. But that’s a lot cheaper than a full-service funeral and cemetery burial that averages nearly $11,000 today. Here are some tips to help you get a good deal.

Laser Periodontal Therapy TM is a laser based approach to gum disease using an ND:YAG free running pulsed laser requiring specific knowledge and skills drawn from the whole of dentistry.

Emery and Scuro DMD, PC 2184 Chili Ave, Rochester, NY 14624 (585) 247-7110 | www.drsemeryandscuro.com Pricey Urns

The urn is an item you need to be aware of that can drive up cremation costs. Funeral home urns usually cost around $100 to $300, but you aren’t required to get one. Most funeral homes initially place ashes in a plastic bag that is inserted into a thick cardboard box. The box is all you need if you intend to have your ashes scattered. But if you want something to display, you can probably find a nice urn or comparable container online. Walmart. com and Amazon.com for example, sell urns for under $50. Or, you may want to use an old cookie jar or container you have around the house instead of a traditional urn.

Free Cremation

Another option you may want to consider that provides free cremation is to donate your body to a university medical facility. After using your body for research, they will cremate your remains for free (some programs may charge a small fee to transport your body to their facility), and either bury or scatter your ashes in a local cemetery or return them to your family, usually within a year or two. To find a medical school near you that accepts body donations, the University of Florida maintains a directory at Anatbd.acb.med.ufl.edu/ usprograms. 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. November 2019 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 25

Ask St. Ann’s

By Suellen Pineda

Are Seniors at a Greater Risk for Developing Diabetes?

ome foods, like fine wine, cheese and cured meats, get better with age. As we age, though, it becomes more challenging for our bodies to convert these and other foods into the glucose our brain, muscle and tissue cells need for good health. When the challenge becomes too high, irregular blood sugar levels can lead to diabetes — a widespread chronic disease among adults, especially seniors. According to the American Diabetes Association, 84 million American adults have prediabetes, but nearly 90% of them don’t even know it. Prediabetes becomes Type 2 diabetes unless treated. Over time, it leads to serious health problems, including heart disease, stroke, kidney disease, eye problems, nerve damage, infections, foot sores and amputation. Also, diabetics may be at higher risk for cancer and Alzheimer’s disease. It’s easy for seniors to miss the early warning signs of diabetes, the most common of which are blurred vision, excessive urination, increased thirst and fatigue. Falls, frailty, incontinence, cognitive impairment and depression may also signal a problem. Fortunately, most people can normalize their blood sugar levels with diet and exercise. Some may also need medication or insulin to achieve results. Your age, test results and lifestyle will help your primary care provider determine the best course of treatment. Self-care takes a village It may be more difficult for older adults to prevent or treat diabetes. Seniors with physical, cognitive or financial limitations need family and friends to help them manage and support lifestyle choices. Connect them with resources. Drive them to doctor appointments and the grocery store. Cook nutritious meals together. Go for a walk. Listen when they feel down. Knowing you care will make a world of difference. Community programs provide another layer of support for seniors and their caregivers. St. Ann’s Community, for example, has registered dietitians and nurses who assist diabetic seniors in its Adult Day Services program. Caregivers gain peace of mind because their loved ones enjoy healthy food, social and physical activity, blood sugar and medication monitoring, and ongoing disease education. Also, St. Ann’s is a regular stop for Foodlink’s Curbside Market. This mobile grocery store brings fresh fruits and vegetables into the community, making it easy and affordable to get healthy foods. Seniors with dietary needs can also subscribe to Meals on Wheels (www.mealsonwheelsamerica.org) and receive prePage 26

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Ask The Social

Security Office

From the Social Security District Office

Certain Disability Payments and Workers’ Compensation May Affect Your Social Security Benefits

pared meals delivered to their door. To get out and exercise, aging adults can take advantage of Silver Sneakers and diabetes prevention programs at the YMCA (www.rochesterymca.org). Are seniors at a greater risk? Yes, lifelong eating and lifestyle habits can contribute to diabetes development. Have your blood glucose tested, especially if you’re over 45 years of age and diabetes runs in your family. Being overweight or obese, physically inactive or smoking and drinking too much also raise your risk. Health conditions like high cholesterol, high blood pressure, stress, inflammation, and taking certain medications also make you more susceptible. The holidays are just around the corner. Now is a great time to give thanks for the abundance of information, resources, and support available to help you manage your blood sugar levels. Visit the American Diabetes Association online at www.diabetes. org to learn more. Suellen Pineda, a registered dietitian nutritionist (RDN) and certified dietitian nutritionist (CDN), is a clinical dietitian for Adult Day Services at St. Ann’s Community. Contact her at spineda@mystanns.com or visit www. stannscommunity.com.

any people working nowadays have more than one job. This means they have several sources of income. It’s important to keep in mind that having multiple sources of income can sometimes affect your Social Security benefits; but, it depends on the source. Disability payments from private sources, such as private pensions or insurance benefits, don’t affect your Social Security disability benefits. Workers’ compensation and other public disability benefits, however, may reduce what you receive from Social Security. Workers’ compensation benefits are paid to a worker because of a job-related injury or illness. These benefits may be paid by federal or state workers’ compensation agencies, employers, or by insurance companies on behalf of employers. Public disability payments that may affect your Social Security benefits are those paid from a federal, state or local government for disabling medical conditions that are not job-related. Examples of these are civil service disability benefits, state temporary disability benefits, and state or local government retirement benefits that are based on disability. Some public benefits don’t affect your Social Security disability ben-

Q&A

Q: How much will I receive if I qualify for Supplemental Security Income (SSI) benefits? A: The amount of your SSI benefit depends on where you live and how much income you have. The maximum SSI payment varies nationwide. For 2019, the maximum federal SSI payment for an eligible individual is $771 a month and $1,157 a month for an eligible couple. However, many states add money to the basic payment. For more information, go to www.socialsecurity.gov/ssi. Q: Can I use the metal or plastic versions of Social Security cards that some companies make? A: We don’t recommend it. There is no need to have a replica of your card. In most cases, the only time you may need to produce your Social Security card is when you apply for employment. At other times, we strongly recommend that you keep anything with your Social Security number on it with your other important papers. Do not carry your Social Security card with you. Also, we strongly advise against laminating your card. Your Social Security card has many security features, which are not detectable if

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

efits. If you receive Social Security disability benefits, and one of the following types of public benefits, your Social Security benefits will not be reduced: • Veterans Administration benefits; • State and local government benefits, if Social Security taxes were deducted from your earnings; or • Supplemental Security Income (SSI). You can read more about the possible ways your benefits might be reduced at www.socialsecurity.gov/ pubs/EN-05-10018.pdf. Please be sure to report changes. If there is a change in the amount of your other disability payment, or if those benefits stop, please notify us right away. Tell us if the amount of your workers’ compensation or public disability payment increases or decreases. Any change in the amount or frequency of these benefits is likely to affect the amount of your Social Security benefits. An unexpected change in benefits can have unintended consequences. You can be better prepared if you’re informed and have financially prepared yourself. Visit our benefits planner webpage at www.socialsecurity.gov/planners for information about your options for securing your future.

laminated. Those features include latent images you can only see at an angle and color-shifting ink. You should question anyone else other than your employer who asks for your Social Security number or your card. Not everyone you do business with needs it. Learn more at www.socialsecurity. gov/ssnumber. Q: I’m not sure when I’m going to retire so I want to estimate my retirement benefit at several different ages. What’s the easiest way to do that? A: Using our Retirement Estimator is easy at www.socialsecurity. gov/estimator, and it’s the best way for you to get a good idea of what your monthly benefit payment may be after you retire. The Estimator gives estimates based on your actual Social Security earnings record. Keep in mind, these are estimates and we can’t provide your actual benefit amount until you apply for benefits. You can use the Estimator if you have enough work to qualify for benefits and aren’t currently receiving benefits. If you are currently receiving only Medicare benefits, you can still get an estimate. You can learn about this subject by reading our publication, “Retirement Information For Medicare Beneficiaries,” available at www. socialsecurity.gov/pubs.

Dog Ownership Associated with Longer Life Research shows more evidence your dog might lengthen your life The two new studies were published recently in “Circulation: Cardiovascular Quality and Outcomes.” One study, from Sweden, compared dog owners and non-owners after a heart attack or stroke. Records of nearly 182,000 people who’d had heart attacks and nearly 155,000 people who’d had strokes were examined. Dog ownership was confirmed with data from the Swedish Board of Agriculture, where registration of dog ownership has been mandatory since 2001, and the Swedish Kennel Club, where pedigreed dogs have been registered since 1889. When compared with people who didn’t own dogs, owners who lived alone had a 33% lower risk of dying after being hospitalized for a heart attack. For dog owners who lived with a partner or child, the risk was 15% lower. Dog-owning stroke survivors saw a similar benefit. The risk of death after hospitalization for those who lived alone was 27% lower. It was 12% lower if they lived with a partner or child. What’s behind the canine advantage? “We know that social isolation is a strong risk factor for worse health outcomes and premature death,” said study co-author Tove Fall, a doctor of veterinary medicine and a professor at Uppsala University in Sweden. “Previous studies have indicated that dog owners experience less social isolation and have more interaction with other people. Furthermore, keeping a dog is a good motivation for physical activity, which is an important factor in rehabilitation and mental health.”

‘Parking’ Age-Related Biases

The second set of researchers reviewed patient data from more than 3.8 million people in 10 separate studies. Compared to non-owners, dog owners had a 24% reduced risk of dying from any cause; a 31% reduced risk of dying from cardiovascular-related issues; and a 65% reduced risk dying after a heart attack. The study did not account for factors such as better fitness or an overall healthier lifestyle that could be associated with dog ownership,

CARE that CHANGES LIVES.

etting your health go to the dogs might turn out to be a great idea: New research bolsters the association between dog ownership and longer life, especially for people who have had heart attacks or strokes. Earlier studies have shown dog ownership alleviates social isolation, improves physical activity and lowers blood pressure. The new work builds on that, said physician Glenn N. Levine, who led a committee that wrote a 2013 report about pet ownership for the American Heart Association. “While these non-randomized studies cannot prove that adopting or owning a dog directly leads to reduced mortality, these robust findings are certainly at least suggestive of this,” he said in a news release.

said co-author Caroline Kramer, an endocrinologist and clinician scientist at Leadership Sinai Centre for Diabetes at Mount Sinai Hospital in Toronto. “The results, however, were very positive.” As a dog owner herself, Kramer said adopting her miniature schnauzer, Romeo, “increased my steps and physical activity each day, and he has filled my daily routine with joy and unconditional love.” Tove, however, cautioned more research needs to be done before people are prescribed dogs for health reasons. “Moreover, from an animal welfare perspective, dogs should only be acquired by people who feel they have the capacity and knowledge to give the pet a good life.”

By Lori Parker, Esq.

t can be tempting to attribute simple mistakes — mistakes that much younger people make with regularity — to someone’s status as an elder. Most of us have had the disconcerting experience of “losing” our vehicle in a large parking lot. If it happens to a younger person, it’s simply assumed that the person is concerned with other matters far more important than where they parked. It’s a minor inconvenience, and once the car is located, not given a second thought. If it happens to an elder, however, the immediate assumption is that the person has dementia. Well-intended family, friends and bystanders can find it easy to extrapolate — from that single event — that the elder cannot function independently. Such assumptions, in isolation, are unacceptable expressions of bias against aging individuals. Ironically, elders can themselves perpetuate such biases. Consider, for example, an older person’s joking reference to having had a “senior moment” when describing a temporary lapse in memory. There is no equivalent term to apply to a millennial or someone in

middle age. Age does not equal incapacity. Rather than making age-biased assumptions in, for example, the parking lot scenario, consider: • Has the person always been forgetful of where they park — during youth and middle age as well as in their elder years? • Is “losing” the car an isolated event or part of a pattern that is becoming more pronounced with age? • How is the person responding to the situation? Are they able to explain what has happened, or do they appear disoriented? • Could the “lost” vehicle and the person’s response be a result of something other than the aging process (for example, medication, emotional upset about another issue, or not feeling wellI)? No one wants to be judged based solely on one quality — whether their gender, their race, their religion, their ethnicity….or their age. It’s time to park our age-related biases, walk away, and never look back.

Attorney Lori Parker is the principal at Parker Law Office, 2024 W. Henrietta Road, Rochester. To contact her, call 585-281-0717. November 2019 •

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H ealth News UR awarded $29 Million for Cancer Research UR Medicine’s Wilmot Cancer Institute is continuing its practice-changing research into cancer side-effects and symptom management with a coveted $29 million grant from the National Cancer Institute. The award is the largest single grant currently funded at the University of Rochester Medical Center. The NCI selected Wilmot’s Cancer Control and Supportive Care research program as a hub for the National Community Oncology Research Program or NCORP. As such, the Wilmot team is charged with designing and managing clinical studies to be carried out at oncology clinics at more than 1,000 NCORP affiliates in 44 states, the District of Columbia, Puerto Rico and Guam. The grant not only honors longstanding research strength, but assures that the Wilmot Cancer Control program remains a leader for tackling issues of great concern to patients — nausea and chemo brain, neuropathy, fatigue, fitness and the use of supplements to quell common chemotherapy side effects and symptoms related to cancer and its treatments. With nearly 17 million cancer survivors in the U.S., which is an estimated 5% of the entire population, improving the lives of patients and survivors is a top priority, said

co-principal investigators Gary Morrow, Ph.D., M.S., and Karen Mustian, Ph.D. Both are dean’s professors in the UR Department of Surgery, and leaders at Wilmot. “It’s always been our mantra to help good people through lousy times,” Morrow said. “This new funding allows us to seamlessly continue our work while extending the mission to reach even more people on a national scale and throughout Rochester and the upstate New York region.” “The Wilmot Cancer Institute is a tremendous asset to the community,” said University of Rochester President Sarah Mangelsdorf. “This grant affirms our unquestioned leadership in the field of cancer control and adds another valuable component to what makes the University a great research institution.”

RRH gets exclusive contract from CDC After a national search, the United States Centers for Disease Control and Prevention selected Rochester Regional Health as the only healthcare provider in the nation to collect pivotal research on childhood ear infections. The research will guide national policy decisions and the development of antibiotic treatments and vaccines. Rochester Regional Health Research Institute Director Michael

Pichichero, a physician, is leading the project. He is the top-rated expert on ear infections in the world and Rochester General Hospital is the tenth-highest ranked institution in the world for ear infection expertise. “The strains of bacteria causing ear infections are different than even a few years ago,” said Pichichero. “Many ear infections today are being caused by different bacteria, and the bacteria can be resistant to the antibiotics typically used. The research we’re providing will inform the CDC and other institutions about the bacteria they should be targeting. Our work will also guide future vaccine development.” According to the World Health Organization, ear infections occur globally in 60% of children between the ages of 1 and 4, representing more than 700 million cases each year. In the United States, ear infections lead to roughly 30 million doctor’s office visits each year, and the annual cost to treat ear infections in this country is roughly $6 billion. The samples will be collected using an ear tap — a procedure that allows a physician to collect a fluid sample from an infected ear and pinpoint the bacteria causing the infection. In addition to informing critical research, the ear tap benefits the individual child. By draining the fluid, doctors can better treat the infection and the child is less likely to have re-

peat infections. “The ear tap is painless with Novocaine on the eardrum. It helps the child and informs critical research; but it requires the provider to have specialized training,” Pichichero explained. “We have a team of doctors well-versed in administering ear taps, and that’s one of the reasons the CDC chose Rochester Regional Health as the award recipient.” The ear infection samples will be collected at three Rochester Regional Health pediatric primary care sites, each led by a practicing physician. The lead practice will be Finger Lakes Medical Associates in Geneva, led by physician Steven Schulz. Pediatricians at Newark, led by Nevidita Prabhu, and Bay Creek Pediatrics in Penfield, led by physician Andrew Sherman, will also participate. “When research can benefit the greater good as well as the child sitting in front of me, that’s the kind of study I want to be part of,” Andrew Sherman, pediatrician at Rochester Regional Health’s Bay Creek Pediatrics.

St. Ann’s residents recognized for artistic talents Four St. Ann’s Community residents were recently recognized for

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Health News their artistic endeavors by LeadingAge New York, an organization that advocates for senior living communities across the state. LeadingAge New York received 267 art submissions from 56 participating organizations for its 2019 Art Exhibit. Paintings by Mary Lou Swicklik and Elizabeth Jennings, both residents from St. Ann’s Care Center in Webster, will be among the top 70 pieces chosen for display in a traveling art exhibit that will be seen across New York state. Paintings by Alice Theodore and Jacqueline Riley, also St. Ann’s Care Center residents, received Staff Choice awards and will hang in the offices of LeadingAge New York staff members for a year. “As we focus on a holistic approach to care at St. Ann’s Community, both art and creativity play an important role in the lives of our elders,” said Triciajean Jones, director of life enrichment. “The gift of creativity empowers our elders to express themselves and brings joy to their lives as well as those around them.” Resident art classes at St. Ann’s Community are funded by Annie’s Angels, a program created to give St. Ann’s residents with limited financial means an enjoyable and active life with enriching activities. The art classes have allowed seasoned artists and newcomers alike to unleash their creativity and help contribute to quality of life for residents.

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Chef at Genesee Valley Club wins St. Ann’s competition The winner of the 2019 FOOD FIGHT – An Epic Culinary Competition, an event that supports Annie’s Angel Fund which provides quality-of-life activities for St. Ann’s Home residents with limited financial means, is Michael Macri, certified executive chef at Genesee Valley Club in Rochester. Todd Klugh, executive chef of St. Ann’s Community at Chapel Oaks in Irondequoit, was crowned the ‘People’s Choice Award’ winner for a second year. The event took place Sept. 13 at the Joseph A. Floreano Rochester Riverside Convention Center. More than 450 guests participated. The event was also watched live by St. Ann’s residents at Chapel Oaks in Irondequoit and Cherry Ridge in Webster. Presenting sponsor was Daisy Marquis Jones Foundation. Angel Fund makes possible such things as lunch with friends, baseball tickets, a trip to the hair salon and other simple pleasures to enrich the lives of St. Ann’s long-term care residents. FOOD FIGHT featured one of St. Ann’s own executive chefs, along with three local chefs, each competing in a 30-minute cooking challenge to make an entrée from mystery ingredients.

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Researchers get $12 Million to visualize the immune system in action

utting-edge imaging technologies that allow scientists to watch the immune system work in real time are leading to a greater understanding of how we combat infection and disease. With a new $12 million grant, local researchers will use this knowledge to explore strategies to better fight infections like the flu and beat back overactive immune responses in disorders like rheumatoid arthritis and lupus. The five-year project, led by Deborah J. Fowell, Ph.D., dean’s professor in the department of microbiology and immunology at the University of Rochester Medical Center, builds on a $9 million grant that her team received in 2014. Both program project grants were awarded by the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. Experts in immunology, vaccine biology, biomedical engineering, optics and physics will come together to investigate how the immune system functions in live mice. They’ll take advantage of the University’s Multiphoton Core Facility, which contains state-of-the-art systems enabling in vivo (Latin for “in the living”) imaging and analysis. Immune cells imaged in the skin “When we take cells out of their natural environment and study them in a dish we’re missing out on a lot of biology,” said David J. Topham, Ph.D., a study project leader and professor of microbiology and immunol-

ogy at URMC. “Imaging and tracking live cells is an emerging theme in immunology and one that I think is going to move forward meaningful discoveries in the field.” In addition to Fowell and Topham, project leaders include Minsoo Kim, Ph.D., James F. Miller, Ph.D., and Patrick Oakes, Ph.D. scientists from Cornell and Loyola University will collaborate with the team, as well. “With the previous grant we made a lot of observations that led to potential pathways for manipulating the immune response,” said Fowell. “Now we have molecular targets to investigate to improve or suppress immune responses in the tissues we’re looking at.” Project goals for the new grant include: • Developing tools and techniques to mark and guide immune system cells into tissues • Exploring the movement of immune system cells through inflamed skin tissue • Understanding how the immune system responds to flu infection in the airways “Our projects are highly complementary, which makes each of the individual projects stronger than standing on their own,” said Topham, who will lead work related to flu infection. “Everyone involved – students, post-docs, and faculty – learn from each other. In our case, the whole is definitely greater than the sum of its parts.” November 2019 •

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