IGH Rochester #174 FEBRUARY 2020 by In Good Health: Rochester's Healthcare Newspaper

PRICELESS

Can You Actually Die from a ‘Broken Heart’? INSIDE: Love your heart: Top 10 things to improve heart health

PLANT-BASED Highland Hospital geriatrician Susan Friedman is a big proponent of plant-based diet. She explains why

PEDIATRIC HEARING LOSS Among children aged 6 to 19, 14.9% have some level of hearing loss. Local experts discuss the issue

URGENT CARE VS. ER If you or your child need healthcare, how do you determine the urgency of the need?Local experts discuss when people should to to the ER or the urgent care

GVHEALTHNEWS.COM

FEBRUARY 2019 • ISSUE 174

M E N TA L

H E A LT H

Foods to Boost Your Mood

What you eat matters for every aspect of your health —including your mental health. Find out what types of food can help you fight the winter blues. P. 13

New Drugs Getting FDA’s Blessing Faster, But Is That a Good Thing? P. 7

Oh, tofu. Poor, misunderstood tofu. It gets such a bad rap. But what exactly is tofu?

P. 12

Yes, We Do Sleep More in Winter Study shows many Americans spend more time sleeping during this cold, dark season

P. 18

So Long, 98.6: Average Human Body Temperature Is Dropping T hink the average human body temperature is 98.6 degrees Fahrenheit? Not anymore, new research suggests. “Our temperature’s not what people think it is,” said senior study author, physician Julie Parsonnet, a professor of medicine, health research and policy at Stanford University. “What everybody grew up learning, which is that our normal temperature is 98.6, is wrong.” That standard was established

in 1851, but a number of modern studies have suggested that it’s now too high. For example, a recent study found that the average body temperature of 25,000 British people was 97.9 F. In the latest study, Parsonnet and colleagues analyzed more than 677,000 body temperature measurements collected in the United States between 1862 and 2017. The results showed that the body temperature of men born in the 2000s is, on average, almost 1.1 F lower

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than that of men born in the early 1800s. Meanwhile, the body temperature of women born in the 2000s is, on average, nearly 0.6 F lower than that of women born in the 1890s. That translates into a body temperature decrease of 0.05 F every decade, according to the study published Jan. 7 in the journal eLife. One possible reason for the decrease in average body temperature in the United States could be a reduction in metabolic rate — the amount of energy that people burn — that may be due to a population-wide decline in inflammation. “Inflammation produces all sorts of proteins and cytokines that rev up your metabolism and raise your temperature,” Parsonnet said in a Stanford news release. She noted that over the past 200 years there have been dramatic improvements in public health due to advances in medical care, better hygiene, greater access to food and improved standards of living. It’s also possible that more comfortable homes have contributed to the decline in average body temperature. Homes in the 19th century had uneven heating and no cooling, but central heating and air conditioning are now commonplace. That means people don’t have to expend as much energy to maintain a constant body temperature.

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61% LOWER

THAN THE NATIONAL AVERAGE

“Physiologically, we’re just different from what we were in the past,” Parsonnet explained. “The environment that we’re living in has changed, including the temperature in our homes, our contact with microorganisms and the food that we have access to… We’re actually changing physiologically.”

Upstate New York’s 2018 uninsured rate is among the lowest ever recorded. According to recently released numbers from the U.S. Census Bureau, the uninsured rate in upstate New York was just 3.5 percent in 2018, compared with a New York state uninsured rate of 5.4 percent and a national rate of 8.9 percent. Low health-care costs are a key factor in upstate New York’s low uninsured rate.

For private insurance, Rochester and Syracuse are ranked as having among the lowest health care spending rates among 306 hospital referral regions across the country.* Upstate New York has a proud history of affordable, high-quality health care. It’s the result of regional partnerships and a commitment to nonprofit health care. It helps make our community a great place to live and work.

*Source: “The Experts Were Wrong About the Best Places for Better and Cheaper Health Care.” The New York Times, December 15, 2015 A nonprofit independent licensee of the Blue Cross Blue Shield Association

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Feb. 4

Ask the audiologists one of the topics discussed at HLAA meeting Hearing Loss Association of America Rochester Chapter invites anyone interested in hearing loss to any or all of several events on Tuesday, Feb. 4. All programs are held at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester, across from the George Eastman Museum. The schedule is as follows: • 10 a.m. “Hearing Other People’s Experiences.” Church Vestry Room. Prospective, new or experienced hearing aid users can share their experiences, questions, and hearing loss journeys in an informal round table discussion facilitated by retired audiologist and hearing aid user Joseph Kozelsky. • 11 a.m. to 1 p.m. “Ask the Audiologists.” Parish Hall. Program begins at noon. Bring your questions and audiologist John McNamara will answer them. The event is an opportunity to clarify and discover what you’ve wanted to know about hearing loss in real time. McNamara has owned Ontario Hearing Center since 1990. • 9 p.m. “Relationships/Communication Between Those With and Without Hearing Loss.” Parish Hall. Program begins at 8 p.m. With registered nurse Lisa Brooks, a home care nurse for Home Care of Rochester, and her husband Dan Brooks, president of HLAA New York state and co-chairman of Healthy Living with Hearing Loss (HLHL2). Discussing barriers to communication, they hope that people with hearing loss bring to the meeting spouses, children, co-workers, friends and other loved ones. They say, “Together we can strive to make hearing loss OUR barrier and together learn ways to communicate better with one another.”

All HLAA programs are free. Meetings feature an inductive loop hearing system and open captions. For more information, view the organization website at hearinglossrochester.org or call 585 266 7890.

Feb. 6

Stroke support group to hold first meeting UR Medicine Thompson Health is launching a new stroke support group for stroke survivors and for their loved ones and caregivers as well. Facilitated by stroke-certified registered nurse Sarah Gallagher, the stroke coordinator for Thompson, the group will meet the first Thursday of each month. The first meeting is from 1 to 2 p.m., Thursday, Feb. 6, in the first-floor conference room of the Constellation Center for Health and Healing, which is on the north side of F.F. Thompson Hospital, 350 Parrish St. in Canandaigua. No RSVP is required for the support group meetings. For more information about the group, call 585-396-6965 or email Sarah.Gallagher@ThompsonHealth.org. F.F. Thompson Hospital is a NYS Department of Health-designated stroke center and has received the American Heart Association/American Stroke Association’s Get With The Guidelines Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines.

Feb. 6 – March 26

Ferris Hills hosting free global affairs program Ferris Hills at West Lake, UR Medicine Thompson Health’s independent living community for seniors, will once again this year host

Great Decisions, the nation’s longest-running global affairs education program. The eight-week series of group discussions — facilitated by content experts — will take place at 11 a.m. on Thursdays, beginning Feb. 6 and concluding March 26. There is no cost to attend the one-hour discussions, and individuals may attend any or all, with no RSVP necessary. Although topic dates are subject to change, the schedule is as follows: • Feb. 6: Climate Change and the Global Order • Feb. 13: India and Pakistan • Feb. 20: Red Sea Security • Feb. 27: Modern Slavery and Human Trafficking • March 5: U.S. Relations with the Northern Triangle • March 12: China’s Road into Latin America • March 19: The Philippines and the U.S • March 26: Artificial Intelligence and Data Optional Great Decisions discussion books are available for purchase online, at www.fpa.org. Ferris Hills is best accessed from the 3300 block of West Lake Road (County Road 16) in Canandaigua, via Peg Rayburn Drive. For more information, call 585-393-0410.

Feb. 11, 13

St. Ann’s to hold AARP Smart Driver course St. Ann’s Community at Chapel Oaks has partnered with AARP to hold a two-day Smart Driver course. The course is designed especially for drivers age 50 and older. Participants will learn proven safety strategies, new traffic laws and rules of the road along with expanded information on automobile technology. Participants may also be eligible for a multi-year discount on car insurance, depending on their insurance policy. The two-day course will be held from 9 a.m. to noon on Tuesday, Feb. 11 and Thursday, Feb 13 at St. Ann’s Community at Chapel Oaks, 1550 Portland Ave., located behind St. Ann’s Home. Both days will run and participants must attend both days to complete the course. The cost for the AARP Smart Driver course is $20 for AARP members and $25 for non-members. Registration is required and seating is limited. Please call Josie DiPisa at 585-697-6606.

Feb. 18

Nominees for Second Half Heroes sought Lifespan, a Rochester-based nonprofit organization that helps older adults and caregivers take on the challenges and opportunities of longer life, is seeking nominations for the Second Half Hero awards. Each year, Lifespan honors five older adults — Second Half Heroes — at the Celebration of Aging. The organization is seeking nominations of people who believe in themselves, who never give up or who always strive to do the right thing. The Celebration of Aging will take place at noon, Thursday, March 26, at the Convention Center with guest speaker, John Quinones of ABC News and host of the show, “What Would You Do?” If you know someone aged 65 or older who fits this description, nominate him or her. Nominations are due by Tuesday, Feb. 18. Go to www.lifespanrochester. org to submit a nomination or call 585-287-6412 for more information.

March 21

Buy Nothing group to host three free-for-all events Monroe County’s Buy Nothing groups present three free-for-all’s in 2020. The first event takes place from 10:30 a.m. to 3 p.m., Saturday, March 21, at the Thomas P. Ryan Community Center, 530 Webster Ave. This is an event for the community to share items with one another for free. There will be no cash exchanged or bartering allowed. Bring what you wish to give away. Receive what others may no longer need. Tables will be provided. RSVPs are required. Contact amycavalier@hotmail.com if you plan to bring things to give away. Pre-set up will take place from 10 to 10:30 a.m. though you are welcome to bring your items for give-away at any point throughout the event. Buy Nothing groups are hyper-local, adult-only, gift-based economies in which members can “give away, lend or share” with their neighbors. There are currently more than 20 Buy Nothing communities in Monroe County. To find a group in your area, visit https://buynothingproject.org/ find-a-group/. Future events will take place June 13 and Oct. 3.

Nonprofits Urged to Apply for $115,000 in Grants Offered by Excellus

Deadline to submit application is Feb. 14

onprofit organizations in Upstate New York can apply for Excellus BlueCross BlueShield Community Health Award grants totaling $115,000 to help fund the health and wellness programs they offer local residents. Nonprofit, 501(c)(3) organizations in Excellus BlueCross BlueShield’s 31-county Upstate New York region are invited to apply for an award of up to $4,000 each. The award can be used for programs that have clear goals to improve the health or health care of a specific population. Programs that improve the health status of the community, reduce the incidence of specific diseases, promote health education and further overall wellness will be

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considered. The deadline to submit an application to be considered for the award is Friday, Feb. 14. For additional information and the online application, go to ExcellusBCBS.com/ Community. Award recipients will be announced in March. “The company’s Community Health Awards demonstrate a corporate commitment to support local organizations that share our mission as a nonprofit health plan,” said Holly Snow, community health engagement director for Excellus BlueCross BlueShield. “These awards complement our existing grants and sponsorships with agencies that work to enhance quality of life, including health status, in Upstate New York.”

Last year, eleven Rochester area organizations were selected to receive Excellus BlueCross BlueShield Community Health Awards from among more than 45 applications that were submitted by organizations in the six-county Rochester region. The winning organizations were Angel Care Ministry of St. Marianne Cope Parish; Asbury First United Methodist Church; Celebration of Life Community Inc.; House of Mercy, Health and Wellness Program; Jefferson Family Health Fund; Medical Motor Service of Rochester and Monroe County, Inc.; Mt. Hope Family Center; Nazareth College; United Way of Seneca County, Inc.; Wilson Commencement Park; and Witness Project of Western New York.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

Excellus BlueCross BlueShield divides its 31-county Upstate New York operating area into four regions: the Rochester region; the Central New York region; the Central New York Southern Tier region. The Rochester region enconpasses Livingston, Monroe, Ontario, Seneca, Wayne and Yates counties The company’s corporate giving follows all applicable laws and regulations and does not support funding organizations that conflict with its corporate mission, goals, policies or products.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Susan Friedman, M.D. Fewer Americans Have a PCP Now ‘There has been something of a convenience revolution in primary care,’ doc says

he number of Americans who have a primary care physician is shrinking — with potential consequences for their health, researchers say. Their new study found that in 2015, an estimated 75% of Americans had a primary care provider — down from 77% in 2002. The declines were most pronounced among people under 60: For Americans in their 30s, for example, the figure dropped from 71% to 64%. The study, published Dec. 16 in JAMA Internal Medicine, could not dig into the reasons. But the new “convenience culture” could be one driver of the trend, said lead researcher David Levine, a physician at Brigham and Women’s Hospital in Boston. Especially for people who are younger and in better health, walkin clinics — promising fast service at nontraditional hours — may be more appealing than an old-style primary care appointment. “There has been something of a convenience revolution in primary care,” Levine said. “And that’s likely one of the things going on in younger populations.” If that is the case, is it necessarily a bad thing? “Continuity of care — having a provider who knows you, and knows your history — is very important,” Levine said. In a study published earlier this year, he and his colleagues found that Americans with a primary care doctor were more likely to receive “high-value” types of care. That, Levine said, includes things like flu shots, counseling on weight loss and smoking cessation, blood pressure checks and standard cancer screening. There are, however, other culprits in Americans’ gradual departure from primary care. “Everywhere else in the world,” Levine said, “’primary care first’ is the health care model.” But in the United States, people often see specialists — who, in the medical world, reign in pay and prestige, Levine noted. And that draws many new doctors into specialties, and away from primary care.

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Highland Hospital geriatrician a big proponent of plant-based diet. She explains why Q: In addition to being a geriatrician, you’re a big advocate for lifestyle changes. How do those two factors inform each other? A: I’ve been a geriatrician now for about a quarter of a century. I’ve been a geriatric hospitalist for 20 years here at Highland Hospital. What geriatricians focus on are things like frailty and multiple chronic diseases and functional and cognitive impairment. When I started out, the patients I was seeing were 80, 90. A few years ago it struck me that I was seeing younger and younger patients with issues associated with older adults, specifically patients with multiple, chronic comorbidities. So I was seeing patients in their 50s, 40s, even their 30s with significant chronic illness. Q: How do you view lifestyle issues with regard to health? A: I’ve always been interested in systems and how they impact health outcomes. I started to think about what it was about our system that was leading to this. At the same time, as a geriatrician — there are only about 7,000 of us in the country — I’ve been thinking, how in the world are we going to take care of these people if they’re developing chronic illness in their 30s and 40s. What’s their life going to look like when they hit their 60s, 70s and 80s, and will they even live to that age? That was the rationale for starting to rethink what I was doing and try to figure out if there was a better way to do this. There’s a quote, “A system is perfectly designed to get the results it gets.” For me, that’s ominous, because the outcomes we’re getting are people with lots of chronic illness, and we’re paying over $3 trillion a year to get those outcomes. And what we’ve seen over the past three or four years is a decline in life expectancy. I think we really need to rethink what we’re doing if we really want to improve our out-

comes. Q: Before we touch on systems, what are the comorbidities you’re seeing? A: Cardiovascular disease, diabetes is big and on the upswing. The estimate for kids born after 2000 is that one in three will develop diabetes. For minorities, that number goes to one in two. So it’s a huge increase in diabetes. Two-thirds of our population are overweight or obese. Hypertension, hyperlipidemia. These all become risk factors for other diseases. Now, a lot of these are addressable by lifestyle. Q: Was there any turning point in your thinking? A: I had the good fortune to run into Dr. Ted Barnett and his wife Carol. They’ve been teaching a course on plant-based nutrition for over eight years. It really flipped the switch for me to realize the incredible impact nutrition has on chronic health. He also introduced me to the American College of Lifestyle Medicine [ACLM]; the first lifestyle boards were given in 2017. And Rochester is actually kind of an epicenter of lifestyle medicine in large part due to Dr. Barnett. There have also been many of us who have followed in those footsteps and become more and more interested in lifestyle medicine. One of the intriguing things about the field of lifestyle medicine is it’s so diverse in terms of the specialists who come to it. So at an ACLM meeting you’ll get psychiatrists, pediatricians, surgeons, pretty much every field you can imagine, and I think that’s because we’re all coming to the conclusion that what we’re doing in our healthcare system isn’t really working. We need to fundamentally rethink our approach to health.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

Q: So when I hear “system” in this context, I don’t just think of medicine. I think of food availability, work-life balance, access to healthy activities, economic incentives, community, fatigue, etc. To what degree can the medical industry even really make a dent in this unilaterally, without the cooperation of many other parts of society? A: That’s an interesting question. In theory, that’s our realm; education, raising public awareness. But as you say, it’s a complex issue that involves lots of other realms. Things like our food system. Things like education, our living spaces, how our environments are set up — do they encourage walking, socializing and are they safe to move around in? So, all of those things certainly contribute to how successfully we can promote health. There are areas around the world called blue zones where people live to very old ages with high levels of health and function. There are some commonalities to them. One of them is a predominantly plantbased diet. Another is sustained physical activity. The third piece has a lot to do with connectedness and maintaining a sense of meaning and purpose. at.

Q: So mostly stuff we’re pretty bad

A: All things where the pressures have been in the wrong direction, definitely. Sleep is a biggie. The estimate is that two-thirds of the population are sleep-deprived. And that affects our health hugely. It impacts our cardiovascular health. It impacts our mood. It impacts our cognitive function. We have all these pressures to just be nonstop until we collapse, so the only time we can borrow from is sleep. We’re under pressure to go to bed later, get up earlier, so we can cram our days full of more stuff. It definitely has an impact on our lives. Q: As far as plant-based diets, are we talking veganism? A: I consider myself more plant-based. There’s an overlap, but veganism is more about what you leave out where plant-based is more what you try to include in your diet. People go vegan for many reasons, like the environment and concern for animals — which I support. But there are many junk food vegans, so you can eat vegan and not be healthy. So as a physician, I think it’s more important to focus on the four food groups of plant-based eating which are vegetables, fruits, whole grains and peas, bean and lentils and then small amounts of fats from things like nuts and avocado.

Lifelines

Name: Susan Marie Friedman, M.D., MPH Position: Staff physician at Highland Hospital; professor of geriatric medicine at University of Rochester School of Medicine and Dentistry; she is also the medical director of Rochester Lifestyle Medicine Group and the director of clinical research for the Rochester Lifestyle Medicine Institute. Hometown: Chicago Education: Northwestern University Affiliations: Highland Hospital; Rochester Regional Health System Organizations: American Geriatrics Society; American College of Lifestyle Medicine Family: Married, three teenage boys Hobbies: Travel, music, reading

New Drugs Getting FDA’s Blessing Faster, But Is That a Good Thing? Eight out of 10 new drugs in 2018 benefited by special programs that streamline FDA’s approval process

ew drugs have been approved by the U.S. Food and Drug Administration for patients based on less and less solid evidence, thanks to incentive programs that have been created to promote drug development, a new study shows. Researchers report that more than eight out of 10 new drugs in 2018 benefited from at least one special program that streamlines the approval process. The result is that patients are being prescribed pricey new medications that have not been tested as rigorously, said lead researcher Jonathan Darrow, an assistant professor at Harvard Medical School. “The evidence standards have changed, but it’s not clear that physicians, let alone patients, understand either the basic FDA approval standard or that requirements have become increasingly flexible over the past 40 years,” Darrow said. The share of new drugs supported by two strong clinical trials, rather

than just one, decreased from 81% to 53% between the 1990s and the 2010s, researchers found. The time that the FDA spent reviewing each new drug dropped during the same period, from 2.8 years in the late 1980s to about 7.6 months in 2018, Darrow added. This might be good news if highly effective new drugs were reaching the market quicker, but other research has found that the large majority of newly approved drugs offer modest benefits over existing therapies, he said. “In many cases, you can get almost all of the benefit of the new drugs by taking older drugs,” such as generics, Darrow said. The programs also haven’t really improved the number of new drugs approved each year, either. “Even with that flexibility, there has been no strong upward trend in the number of drug approvals, which on average has remained about 30 new drugs approved per year since

the 1980s,” Darrow said. The average annual number of new drug approvals was 34 from 1990-1999, decreasing to 25 from 2000-2009 and then increasing to 41 from 2010-2018, researchers found. The FDA did not respond to a request for comment, nor did PhRMA, a trade group representing the pharmaceutical industry. Since the 1980s, various programs have been enacted by U.S. Congress or developed by the FDA to promote the creation of drugs for rare diseases or accelerate approval of promising medications that could benefit multitudes, researchers said in background notes. “In 2018, more than 80% of new drugs benefited from at least one special program,” Darrow said. These programs have weakened the review process by requiring the FDA to accept more flexible evidence, he said. For example, evidence of a drug’s effect on cholesterol lev-

els or tumor size can be used to get it approved, rather than evidence that the drug helped people live longer or feel better or avoid emergencies such a heart attacks, Darrow said. But there’s been no benefit from these programs in terms of how long it takes a company to create a new drug, he said. “We found there was a relatively stable period between when clinical trials began and when drugs were approved. We did not see a steep decline in the clinical development period,” Darrow said. Disturbingly, the FDA has also become more financially reliant on money from pharmaceutical companies, researchers found. The amount of the FDA budget that comes from the pharmaceutical industry has increased from about $300 million in the 1990s to just over $4 billion in the 2010s, researchers found. These fees are used to accelerate review times, researchers said.

Healthcare in a Minute

By George W. Chapman

Impact of Hospital Mergers: Higher Prices, No Significant Quality Improvement

he New England Journal of Medicine recently published a study concluding hospital mergers and acquisitions have had little positive impact on the quality of care and typically drive up prices in the market. The study compared 246 hospitals that were merged or acquired with 1,986 hospitals that weren’t, for: patient experience, mortality, readmissions and clinical process. As expected, the insurance industry was quick to pounce and agree with the study while the hospital industry was quick to rebut. Regardless, many mergers and

acquisitions have virtually salvaged financially challenged hospitals that would otherwise be closed. Many rural hospitals would not be open for business if they weren’t affiliated with a larger hospital or hospital system. Mergers make it easier for hospitals to attract, employ and retain scarce nurses and providers while offering a broader more expansive range of services to the consumers of the smaller, more remote or financially strapped facility. The department of justice monitors mergers and acquisitions for any untoward impact on prices.

Bill to Cut Drug Costs Stalled

Bill to End Surprise Billing Stalled

The bilateral bill passed by the House, which would empower Medicare to negotiate prices on 250 drugs over the next 10 years, is buried in the pile of 275-plus bills sitting on Senate majority leader Mitch McConnell’s desk. McConnell has “ruled out” taking up the bill which would lower Medicare spending by $456 billion over 10 years. With only two Republican congressmen voting for the bill, it will assuredly die anyway in the Republican controlled Senate. All the talk by elected officials to control and lower drug costs is stifled by the drug lobby.

Both houses of Congress thought ending surprise billing would be a no brainer. But that was before a barrage of last-minute lobbying by non participating providers and healthcare staffing companies that make money via surprise billing. Congress reached a “compromise” by establishing benchmark rates and an arbitration “backstop” for charges above $750. Vested interests in the status quo will continue to thwart efforts to reform healthcare and lower costs. February 2020 •

ACA Fate Undetermined

President Trump continues to vow to terminate the Affordable Care Act (Obamacare) without offering a viable replacement. Twenty million Americans are insured via the ACA. There has never been an outcry over the ACA from any of the major stakeholders, designers, or founders — including insurance companies, hospitals, physicians and consumers — because it is working. The courts have ruled the individual mandate to carry insurance was unconstitutional because the penalty to not carry insurance was considered an illegal tax. States against the ACA argue the whole law should be thrown out since the individual mandate was declared unconstitutional. A threejudge panel agrees the individual mandate is unconstitutional but has asked the lower courts to review whether or not the entire ACA should be declared unconstitutional. If the entire ACA is tossed, so will be coverage of pre-existing conditions.

NYS Medicaid Problems

NYS has the most expensive Medicaid program per capita in the country. Most of that can be attributed to relatively generous benefits and some of that can be attributed to fraud and mismanagement. Roughly: the federal government pays 50%, NYS pays 25% and local municipalities pay the remaining 25%. NYS enrollment has been steady at about 6.2 million people since 2015 thru 2020 (projected). The budget for the same period has increased from $60 billion in 2015 to a projected $74.5 billion this year. That means the per capita cost has increased from $9,677

in 2015 to a projected $12,000 this year. NYS is expecting an overall budget shortfall of $4 billion for the fiscal ending March 31,2020.

Genetic Testing Scam

Scammers are targeting seniors. They offer genetic testing kits, then ask for what they really want … your Medicare number. The scammers can be online, on the phone or in person at health fairs and senior centers. Never agree to genetic testing unless ordered by your physician.

Gun Violence Funding

Congress has authorized $25 million in funding for the Centers for Disease Control and National Institutes of Health to study gun violence, which has become one of the leading causes of death. Forty thousand Americans a year die via gun violence. Sixty percent — or about 24,000 of the deaths — are suicides. Although a relatively paltry amount (we spend over a trillion a year on healthcare) the bipartisan bill was seen as at least a start at addressing the issue and getting some evidence-based data for possible solutions. 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 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Touch: One of Life’s Essential Ingredients

kiss. A hug. A gentle touch. No, this is not a column about romance in anticipation of Valentine’s Day. I am writing, instead, about a related matter: the importance of touching and being touched. Both are essential to our sense of well-being. This subject is especially relevant for those who live alone, because — on our own — we can be susceptible to touch deprivation. When that happens, we miss out on all the benefits of healthy human contact. I’m no expert in this area, but others are, and their research has shown that touch is absolutely essential for emotional and physical health and development. Studies conducted by the University of Miami’s Touch Research Institute revealed that touch can do so much good: it can help reduce pain, anxiety and depression, lower heart rate and depression and even promote immune function and healing. But I don’t need a study to convince me of the value of touch and

affection. I have my own proof and it is revealed to me whenever I am touched or touch another. A friend’s warm hug can lift my spirits, a reassuring hand on my shoulder can hold the demons at bay, even a handshake can be affirming. Those who live alone can often unwittingly, almost unconsciously, neglect this vital component of a happy, healthy life. It’s easy to do, especially if you have a tendency toward isolation or are without a significant other in your life. If that’s the case, I encourage you to take notice. Is touch absent in your life? Has it been weeks or months since you enjoyed the warmth of an embrace? When was the last time you felt the comfort of a soothing caress? Or, exchanged backrubs with a friend? Below are a few tips to “keep in touch.” They have worked for me, and it’s my hope that you, too, will benefit from incorporating positive, loving touch into your life. • Become a hugger. It’s not for everyone, but if you’re not a hug-

ger, consider becoming one. A little practice is all it takes. Hugging didn’t come naturally to me. It wasn’t something I grew up with, so it felt awkward at first. I was forever bumbling the embrace: leaning left, when I should have been leaning right; knocking heads; or sending glasses askew. So, years ago, I made a deliberate decision to become a hugger. Intuitively, I knew I was missing out on this natural form of human expression. The good news? I got better at it over time, and life is sweeter as a result. • Volunteer to touch. The benefits of “loving touch” are not just for the ones receiving it. Those who deliver it also reap great personal rewards and satisfaction. If you look around, there are plenty of opportunities to administer positive, healthy touch to someone in need. Many hospitals have volunteer “rockers” for newborns, and nursing homes are often looking for volunteers to make personal connections with residents who may not have family nearby. Just an hour visiting with a resident, while applying hand lotion, could make her day. To volunteer in this way can be a healing act of kindness, one that says we are in this life together. What soothes one soothes us all. • Own a pet. Study after study has shown that petting a dog or gently stroking a cat can have a calming effect on people by lowering blood pressure and reducing anxiety. Again, I don’t need a study to validate my own experience. Petting my beloved springer spaniel Scout or snuggling with her on the couch has an immediate and relaxing effect on me. After a busy

day, almost nothing is as grounding as a few minutes with my affectionate pooch. • Get in touch with yourself. Self-gratification for pleasure or with the goal to sooth, heal or relieve tension is natural and can be a healthy expression of self-care and affirmation. When you “love the one you’re with,” something profound and restorative can result. • Splurge for a massage. I read recently that, “Massage is to the human body what a tune-up is for a car.” Among its many benefits, therapeutic massage can bring relief from anxiety, reduce stress, fight fatigue and increase your capacity for tranquil thinking and creativity. If touch is absent in your life, this form of safe, non-intimate human contact can refocus the body’s natural ability to heal and regenerate itself. Plus, it just feels wonderful! You can make a conscious effort to bring more touch into your daily life and, in doing so, bring more happiness to yourself and those around you. Touch enhances bonding and gives us a sense of belonging — important essentials for everyone, but especially for those who live alone.

In 2014, about 4% of publicly insured kids and 3% of privately insured children received unnecessary or low-value services at least twice. One of the reasons for these unneeded tests is the culture of American medicine where parents and doctors are expected to do something even if it’s not going to help, Chua said. “Parents understandably want to relieve their children’s suffering and to rule out serious problems,” he added. “Both parents and doctors sometimes have a tendency to believe that prescribing a drug or ordering a test is better than doing nothing, even though the right answer is often to do less.” Also, doctors tend to be overly

cautious. “Doctors have a strong fear of missing something,” Chua said. “Some doctors would rather overtreat and risk the side effects of the intervention than undertreat and risk missing a catastrophic problem.” But unnecessary tests and treatments waste money that could be used for other “valuable causes, and also force many families to pay out-of-pocket for unnecessary care,” Chua noted. “Reducing wasteful care will improve child health and decrease the financial burden of health care spending on society and families.” The report was published online Jan. 7 in the journal Pediatrics.

Gwenn Voelckers leads Alone and Content empowerment workshops for women held in Mendon and 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 workshops, to purchase her book, or invite her to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.

s d i K Corner

U.S. Doctors Often Test, Treat Kids Unnecessarily

egardless of their family’s insurance status, many children get medical care they don’t need, a new study suggests. One in 11 publicly insured and one in nine privately insured children in the United States were given what the researchers called unnecessary, “low-value” care in 2014, the researchers report. “While we found that publicly insured children were a little more likely to receive low-value services, the difference was not large. The more important finding is that children are highly likely to receive wasteful care, regardless of what type of insurance they have,” said researcher Kao-Ping Chua, a pediatrician at the University of Michigan’s

Page 8

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C.S. Mott Children’s Hospital. “This means that efforts to reduce waste should be global in nature and target the care of all children,” Chua noted in a hospital news release. For the study, his team looked at data on 8.6 million U.S. kids to see how often 20 low-value diagnostic tests, imaging tests and prescription drugs were given. These included unnecessary vitamin D screening, imaging for sinus infections and antibiotic prescriptions for colds. The liberal use of antibiotics can add to the spread of antibiotic-resistant germs and unneeded X-rays and CT scans can expose kids to radiation that might raise cancer risk later in life, Chua said.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

Among children aged 6 to 19, 14.9% have some level of hearing loss By Deborah Jeanne Sergeant

very baby born in a US hospital receives a hearing screening. Of those, only a fraction — .16% — have some level of hearing loss, according to the Centers for Disease Control and Prevention. But among children aged 6 to 19, 14.9% have some level of hearing loss because of later onset hearing issues. Addressing children’s communication needs as young as possible is very important and bears lifelong effects. “From the moment children are born, they begin to take in the world around them in many different ways, including through auditory input,” said Kristin Augustin, audiologist with UR Medicine Audiology. This input lays the foundation for language, communication, understanding emotions and forming relationships. Missing all of this without any means of intervention to improve communication can delay children’s learning, cognitive abilities, social development and eventual employment opportunities. That is why providers typically suggest fitting with hearing aids those babies who would benefit from the devices. “It is important to also note that, while hearing aids are most frequently used to provide access to sound to allow children with hearing loss the ability to develop spoken language, this is not always the case,” Augustin said. “Children with severe to profound degrees of hearing loss may not benefit from hearing aids

and may be candidates for cochlear implants instead. “Alternatively, some families will choose to have their children with severe to profound hearing loss learn and use sign language. No matter the suggested or chosen course of treatment, the goal for all children born with hearing loss is to allow them to develop language and a means of communication as soon as possible.” However children acquire communication skills, it’s important to start early. If they do so through hearing, “they need to have their hearing loss addressed very early so their brains can adapt to how they hear,” said Michelle Gross, member of the Hearing Loss Association of America Rochester Chapter and a resident of Brighton. “For adults with hearing loss, their speech pattern is already developed.” Gross lost most of her hearing when she was 8 years old. She thinks that hearing loss is a bigger deal to hearing parents than to the child who has always worn hearing aids. She added that years ago, wearing hearing aids felt stigmatizing once children hit the pre-teen years. “Nowadays, it’s still considered ‘different’ to wear hearing aids, but in a positive way, because everyone has something hanging out of their ears,” Gross said. Though hearing aids are different in design and purpose than ear buds and headsets, the latter have helped break down stigma.

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than their adult counterparts. Accessories can help keep hearing aids on children. Many parents use a clip similar to that of a pacifier to keep hearing aids together and attached to the infant’s clothing so they don’t get lost. Hats and headbands can also keep a child’s hearing aids in place, as can creating a well-fitting hearing aid. Fitting hearing aids is also different for children. Parents are more involved for pediatric fittings and device care, especially for infants who are both incapable of expressing their experience accurately and lack normal hearing experience for comparison. “Little ones have a harder time keeping hearing aids in their ears,” said Christine Tirk, founder of Clear Choice Hearing and Balance and a state licensed hearing instrument specialist. Tirk added that usually, infants receive a full prescription, unlike adults, who have to slowly adjust to hearing aids. Infants are seen every three to four months for adjustments as they grow. By about age 5 for most children, their ear canals are at adult size.

Helping Rochester's Children, Adults & Families Communication for Life

Addressing Pediatric Hearing Loss

Many objective tests exist for testing a baby for hearing loss. Ron D’Angelo, New York state licensed audiologist with Clear Choice Hearing and Balance in Brighton and Greece, said these can include placing electrodes on the head to measure the response of the auditory nerve. “The beauty is the ears are still pulling in sound and the brain is responding whether they’re awake or not,” D’Angelo said. Hearing aids for babies differ quite a bit from those intended for adults. To make them appeal to children, hearing aids come in bright colors and patterns, similar to the effect of fun options for glasses. They also have low battery lights so parents know when to charge or change the battery. Their tamper-resistant battery doors help prevent ingestion. Children’s hearing aids are also compatible with hearing assistive technology (HAT) systems that allow parents’ or teachers’ voices to transmit directly from a microphone into the hearing aid, which reduces the effect of ambient noise interfering with the message. Manufacturers make children’s hearing aids more durable

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Page 9

Urgent Care Vs.

Emergency Room How Urgent Is Your Health Need? By Deborah Jeanne Sergeant

f you or your child need healthcare, how do you determine the urgency of the need? Should you wait for a primary care provider appointment, rush to the local urgent care center or call an ambulance for an emergency room visit? Local experts offered a few guidelines: — Physician Kathy Grisanti, president and owner of Pediatric Urgent Care in Rochester and Buffalo: • “We generally encourage the parents to contact the pediatrician to help make that decision. The pediatrician knows the child and family and can help make that decision. It might need additional testing not available at an urgent care center. • “In general, injuries that require stitches or injuries that are possible fractures are usually something pediatricians don’t do in their office. That usually requires an urgent care center. CAT scans or ultrasound are not done at most urgent care centers and require a hospital ER. • “Difficulty breathing can be taken care of at any of the locations, but the pediatrician could refer to the ER or urgent care. Difficulty breath-

ing is always something we worry about, especially with young babies. • “The extreme things should go to the ER. Anything life threatening, parent should call an ambulance. You can get intervention right at the home. Many urgent care centers can intervene and help stabilize the patient. • “Getting their fever under control can slow down respiratory rate and make them more comfortable. • “If a baby or young infant is breathing fast, has blueness of fingers, lips, toes, lethargic, and is dehydrated, those require medical attention. Babies or young infants are the ones that struggle the most with RSV or influenza. Particularly those under 8 weeks who have a fever, it’s important to be evaluated or something that looks like a seizure. • “Some parents get alarmed by the height of a fever, if it’s over 104 or 105. We don’t necessarily worry about the height of the fever if the child is comfortable. Treat with ibuprofen or Tylenol. It’s the length of the fever that concerns us. Generally, the fever itself — unless in a young infant — we don’t worry about it if the child is well appearing and not dehydrated.

• “Pain is something that usually requires more immediate attention. If the child has fallen and refuses to bear weight and is crying or wakes up crying with ear pain,those are difficult to wait until the next day if the child is really uncomfortable. If the child can bear weight, it can probably wait. • “Pay attention to noisy breathing. We see a lot of croup, typified by a barky cough. The pediatrician often is able to decipher what can wait until the morning. We are staffed by pediatricians so we’re very comfortable in seeing children and making those decisions about which children can be managed at home. • “The primary care provider almost always has someone available on call after hours to help direct which patient needs to be seen immediately.” — Jenilee Foster, urgent care regional lead provider, WellNow Urgent Care, with locations in Rochester and throughout Upstate New York: • “For your run-of-the-mill cold, cough, congestion, sprain, sutures, they can come to urgent care. • “For higher acuity symptoms

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like chest pain, stroke, heart attack, go to the ER. That doesn’t mean we can’t stabilize them, but the ER has the capability to do more in-depth testing. • “If they’re not sure if it’s life-threatening, we’re happy to help them decide whether to treat or refer them to primary care or the ER. We’d rather see them than have them sit at home and let someone worry. We can try to determine if it’s life threatening versus non-life threatening. Urgent care is quick, convenient care. We want to be able to give back to our communities. • “If someone’s out of town and they’re at their kid’s house for a week and they forgot their blood pressure medication, we can fill that gap. We can accommodate people with whatever they need: IV hydration, sutures, and things to keep people out of the emergency room. I had an ER doctor tell me that we see 70 patients a day that aren’t in their hospital. We can handle the strep, stitches and other patients in a more timely manner so they can see the acute patients. • “We’re open seven days a week. We have a few clinics with extended hours.

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Things You Need to Know About SAD

Seasonal affective disorder affects people every year during winter By Ernst Lamothe Jr.

easonal change can be a nice change of scenery for a split second, but the long-term effects are not always pleasing to everyone. Seasonal affective disorder (SAD), which typically occurs during the winter, is a mood disorder characterized by depression. Mostly caused when there is less sunlight and the weather is colder, it can have a crippling and overwhelming sensation in the lives of affected people. “People are more apt to be diagnosed with SAD when they live farther north and farther away from the equator where there are notable symptoms of this depression disorder,” said Sarah Hopkins, licensed clinical social worker at Rochester Regional Health in Rochester. Hopkins discussed five facts that people should know about the condition.

Seasonal Change

Effects of SAD are directly related to the weather and usually happen during the winter — when weather becomes colder and cloudy and days are shorter. For example, 1% of those who live in Florida and 9% of those who live in New England or Alaska suffer from SAD, according to the National Institute of Mental Health. “People who are affected by seasonal affective disorder tend to experience symptoms during the winter time,” said Hopkins. “It becomes very difficult for them to accept the

weather drop and when daylight savings hit.”

People who are affected

About half a million people in the United States suffer from winter SAD, while 10% to 20% may suffer from a milder form of winter blues, according to the Cleveland Clinic. Three-quarters of the sufferers are women, and the depression usually starts in early adulthood. SAD also can occur in children and adolescents. Older adults are less likely to experience SAD. “Typically I see an increase of SAD in women, and they become more susceptible to it,” said Hopkins. Medical experts and psychologists say less exposure to sunlight alters the internal biological clock that regulates mood, sleep and hormones. Exposure to light may reset the biological clock.

Symptoms

Some of the symptoms include having low energy, hypersomnia, overeating, weight gain, craving carbohydrates and social withdrawal. “Just like any form of depression, symptoms that occur with people who suffer from SAD can range from mood swings, loss of appetite to overeating, having no interest in doing anything, and sleeping more,” said Hopkins. “In every way, it feels

like major depressive disorder.” Functioning in the body becomes disrupted when people are affected by SAD, and these symptoms can last a long time and can become very serious if they do not seek help. Another theory is that brain chemicals such as serotonin that transmit information between nerves may be changed in people with SAD. It is believed that exposure to light can correct these imbalances.

Coping strategies

People who seek help for SAD typically receive counseling as they normally would with a depressive disorder. “Some ways to ease the symptoms of SAD is to begin by talking to your doctor,” siad Hopkins. “Before I counsel my patients, it is important to ask if they are taking medication. Usually taking medication and counseling is very effective for patients and studies have shown that it is very helpful.” Not only can counseling help, but the patient has to be willing to want the change. “Seeking help and talking to someone is the first step to coping and understanding that change can be made,” said Hopkins. “Exercise is also important to help boost immunity and finding yourself to get back to doing what you used to do.” In addition, light therapy is a way to treat seasonal affective disorder and certain other conditions by

Sarah Hopkins is a licensed clinical social worker at Rochester Regional Health in Rochester. exposure to artificial light. During light therapy, a person sits or works near a device called a light therapy box. The box gives off bright light that mimics natural outdoor light. Light therapy is thought to affect brain chemicals linked to mood and sleep, easing SAD symptoms. Using a light therapy box may also help with other types of depression, sleep disorders and other conditions.

Seasonal Affect Disorder is not new

When people hear of SAD, many believe that it is something new that hasn’t affected many people. That is far from the case. “SAD has been affecting people for more than 20-30 years, but the issue is that it was never being recognized as a depressive disorder,” said Hopkins. “I have been working with mental health for over 25 years and it is important that people recognize that SAD is a massive depressive disorder and that it is very important to seek help.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

SmartBites

The skinny on healthy eating

Why You Should Give Tofu a Chance O h, tofu. Poor, misunderstood tofu. It gets such a bad rap. Too mushy, too bland, too unknown. I used to be in that “not-forme” camp, but all that ended when three important things happened: I cut down on my meat consumption; I discovered how to cook with tofu; and I realized how nutritious it was. What exactly is tofu? Tofu is condensed soymilk that has been curdled and pressed into blocks (much like cheese). And why should we be eating it? Environmental reasons notwithstanding — it only takes about 200 gallons of water to produce one gallon of soymilk versus the 1800 gallons it takes to produce one pound of beef — tofu is a nutritional powerhouse. Tofu is an excellent “complete” plant protein source, with an average serving of firm tofu providing about 10 grams. While most Americans get plenty of protein, certain groups — such as dieters restricting calories, the elderly and people with cancer — may have trouble eating as much of this vital nutrient as they need. Over time, a lack of protein can cause swelling, fatigue, a loss of muscle mass, dry skin and hair and mood

changes. This versatile food also packs a solid amount of calcium, an essential mineral that contributes to healthy bones. Although the amount of calcium varies between tofu types and brands, an average serving can deliver between 10-20% of our daily needs. Unlike protein, most Americans don’t get enough calcium in their diets. When this happens, children may not reach their full height potential and adults may have low bone mass, which is a risk factor for osteoporosis. Tofu is remarkably high in manganese, a vital mineral that plays an important role in many bodily functions, including the metabolism of glucose, carbohydrates and cholesterol, the formation of bones, the clotting of blood and the reduction of inflammation. Some research suggests that manganese, when combined with calcium, may act as a natural remedy for easing PMS symptoms. And for people with diabetes, manganese may help lower blood sugar levels. Isoflavones — a type of plant estrogen that is similar in function to human estrogen but with much weaker effects — are abundant in

By Anne Palumbo tofu. At one point, isoflavones were thought to increase the risk of breast cancer, but recent studies have suggested the opposite. In fact, the Shanghai Women’s Health Study revealed that Asian women who ate the most soy had a 59% lower risk of premenopausal breast cancer compared with those who ate the least amount. But that’s but one study; more research is needed. A few more reasons to give tofu a chance? It’s super low in fat, sodium and cholesterol, and fairly low in calories: only 90 per half cup!

Turkish-Spiced Baked Tofu 1 block extra-firm tofu, pressed and drained 2 tablespoons extra-virgin olive oil 1 teaspoon each: coriander, cumin, paprika, garlic powder, dried thyme 1/2 teaspoon each: turmeric, Kosher salt 1/4 teaspoon coarse black pepper 1/8 teaspoon cinnamon Garnishes: pickled onions, shredded carrots, cilantro Preheat oven to 400 degrees. To press and drain tofu: slice block into 4 horizontal slabs, lay some paper towels on a baking sheet, place the slabs side by side on top of the paper towels, cover with another layer of paper towels, place a cutting board on top, and stack something heavy on the cutting board. Let tofu drain for at least 20-30 minutes. Cut tofu slabs into cubes about 3/4-inch thick. Add cubes to large mixing bowl, drizzle with olive oil, and toss gently to coat. Combine all

Helpful tips:

Read tofu nutrition labels carefully as the nutrition differences between silken and firm tofu are pretty big. Once opened, any unused tofu may be stored in plain tap water for up to 10 days. Just make sure the water is clear when ready to use; if cloudy, discard tofu. seasonings in a small bowl, sprinkle over cubes, and toss gently again until the tofu is evenly coated. Turn seasoned tofu out onto a parchment-covered baking sheet, and arrange tofu in an even layer (not overlapping). Bake for 15 minutes. Then remove from oven, and flip the cubes for even cooking. Return to oven for 15 more minutes, or until the tofu reaches your desired level of crispiness. Garnish with topping of choice.

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.

Processed Foods Highly Correlated with Obesity Epidemic in the U.S.

s food consumed in the U.S. becomes more and more processed, obesity may become more prevalent. Through reviewing overall trends in food, George Washington University (GW) researcher Leigh A. Frame, PhD, concluded that detailed recommendations to improve diet quality and overall nutrition are needed for consumers, who are prioritizing food that is cheaper and more convenient, but also highly processed. Her conclusions are published in a review article in Current Treatment Options in Gastroenterology. “When comparing the U.S. diet to the diet of those who live in “blue zones” — areas with populations living to age 100 without chronic disease — the differences are stark,” said Frame, co-author of the article, executive director of the office of integrative medicine and health, and assistant professor of clinical research and leadership at the GW School of Medicine and Health Sciences. “Many of the food trends we reviewed are tied directly to a fastpaced U.S. lifestyle that contributes to the obesity epidemic we are now

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facing.” The rising obesity epidemic in the U.S., as well as related chronic diseases, are correlated with a rise in ultra-processed food consumption. The foods most associated with weight gain include potato chips, sugar sweetened beverages, sweets and desserts, refined grains, red meats and processed meats, while lower weight gain or even weight loss is associated with whole grains, fruits, and vegetables. Other food trends outlined in the report include insufficient dietary fiber intake, a dramatic increase in food additives like emulsifiers and gums, and a higher prevalence of obesity, particularly in women. In mice and in vitro trials, emulsifiers, found in processed foods, have been found to alter microbiome compositions, elevate fasting blood glucose, cause hyperphagia, increase weight gain and adiposity, and induce hepatic steatosis. Recent human trials have linked ultra-processed foods to decreased satiety (fullness), increased meal eating rates (speed), worsening biochemical markers, including inflammation and cholesterol, and more weight gain. In

The foods most associated with weight gain include potato chips, sugar sweetened beverages, sweets and desserts, refined grains, red meats and processed meats contrast, populations with low meat, high fiber, and minimally processed foods — the “blue zones” — have far less chronic diseases, obesity rates, and live longer disease-free. “Rather than solely treating the symptoms of obesity and related diseases with medication, we need to include efforts to use food as medicine,” said Frame. “Chronic disease

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

in later years is not predestined, but heavily influenced by lifestyle and diet. Decreasing obesity and chronic disease in the U.S. will require limiting processed foods and increasing intake of whole vegetables, legumes, nuts, fruits, and water. Health care providers must also emphasize lifestyle medicine, moving beyond ‘a pill for an ill.’ ”

“sunshine” vitamin because our body absorbs vitamin D primarily through sun exposure. It’s also called the sunshine vitamin because some studies suggest vitamin D can ease the symptoms of seasonal adjustment disorder (SAD), a form of depression that occurs at the same time each year, usually in the shorter, darker days of winter. According to researcher Peter Horvath of the University at Buffalo, many people have insufficient or deficient amounts of vitamin D during Upstate’s winter months, which over time, may result in a variety of health issues, including cognitive impairment. Maintaining proper levels is crucial to overall good health and can be accomplished by taking vitamin D supplements, increasing sun exposure, and eating foods that contain vitamin D or are fortified with vitamin D, such as oily fish, eggs, soy milk, and enriched cereals, milk and orange juice.

Eat endorphin-releasing foods

Foods to Boost Your Mood What you eat matters for every aspect of your health —including your mental health. Find out what types of food can help you fight the winter blues By Anne Palumbo

ome February, many of us slump into a winter funk. We’re worn down by the weather; we’re overwhelmed with post-holiday bills; and we’re angry with ourselves for already breaking our New Year’s resolutions. Tack on cabin fever and it’s no wonder we find ourselves parked in front of the TV with an open bag of chips. But chips — highly processed, refined-carb chips — are precisely the kinds of foods we should not be eating if we’re feeling blue. Growing evidence shows that getting the right nutrients — as well as implementing some basic nutrition strategies — can improve moods, tame stress, ease anxiety and even help fight depression. What are these nutrients and nutrition strategies? Though research regarding dietary factors and mental health is still inconclusive, there have been strong hints, according to leading experts, that certain foods may play a significant role in our mental well-being. For example, a recent study conducted at Loma Linda University and published in the “International Journal of Food Sciences and Nutrition” revealed that adults who consumed more junk food were more likely to report symptoms of psychological distress than their peers who consumed a healthier diet. Physician Jim E. Banta, lead author of the study, said that the results are similar to studies conduct-

ed in other countries that have found a link between depression and the consumption of foods that have been fried or contain high amounts of sugar and processed grains. Research using data from large observations studies — like the Nurses’ Health Study and the Women’s Health Initiative — has also found links between food and mood. A study published in the “American Journal of Clinical Nutrition” found that women who ate more vitamin D-rich foods had a lower risk of depression than those who got less vitamin D in their diets. One diet in particular, however, repeatedly garners more than just “hints” of playing a role in depression: the Mediterranean diet. According to Patricia Chocano-Bedoya, a visiting scientist who participated in nutrition research at the Harvard T.H. Chan School of Public Health, “There is consistent evidence for a Mediterranean-style dietary pattern and lower risk of depression.” What you eat matters for every aspect of your health, including your mental health. On that note, let’s take a look at some well-founded suggestions for ways we might boost our mood with food.

Work more omega-3 fatty acids into your meals Omega-3s, a major building block of the brain, play an important role in sharpening memory February 2020 •

and improving mood. Because depression appears less common in nations where people consume large amounts of fish, scientists have zeroed in on this healthy fatty acid that is able to (1) interact with mood-related molecules inside the brain, (2) help promote the production of serotonin — the “feel-good” brain chemical, and (3) provide anti-inflammatory actions that may help relieve depression. Foods with the highest amount of omega-3s include oily fish (such as mackerel, salmon, sardines, tuna and herring), flax seeds, chia seeds, walnuts and soybeans.

Boost your serotonin levels An important neurotransmitter, serotonin communicates “happy” messages to your brain. Basically, the more serotonin circulating in your bloodstream, the better your mood. But higher blood serotonin levels — which can result from eating foods rich in the amino acid tryptophan — is but a piece of the feel-good puzzle. Tryptophan must cross into the brain to help serotonin work its magic, a crossing that is greatly facilitated by the consumption of carbohydrates. While any carb will do, experts recommend smart carbs, like whole grains, fruits, vegetables and legumes for their additional health benefits. Foods rich in tryptophan include poultry, eggs, oily fish, tofu, cheese, seeds and nuts. Also, too little folic acid in our diets can cause lower levels of serotonin in our brains. Some experts suggest that eating folate-rich foods — like asparagus, spinach, beans and lentils — may help some people who suffer from depression.

Get enough vitamin D Vitamin D is known as the

Naturally produced by the nervous system, endorphins are chemicals that act as a pain reliever and happiness booster. The wellknown “runner’s high,” for example, is due to an increase in endorphin levels after vigorous exercise. Certain foods can also boost endorphin levels. Although no food products contain whole endorphins for easy consumption, several foods contain high levels of the nutrients needed for boosting your brain’s endorphin production and encouraging its release. Chocolate-lovers, are you sitting down? Dark chocolate, with at least 70% cocoa solids, tops the list! Experts say it could be because of the antioxidants found in dark chocolate. Me? I’ll go with taste! Other foods that may influence the release of this “happy hormone” include strawberries, oranges, nuts, seeds, and anything spicy.

Move to a Mediterranean diet A lifestyle rather than merely a diet, the Mediterranean diet is associated with getting regular exercise, eating with family and friends, and practicing a balanced, healthy eating pattern that includes most, if not all, of the nutrients linked to easing or preventing depression. It’s also the diet that for the third year in a row has been named the best diet overall in the “U.S. News & World Report” annual rankings. The foundation of the diet is plant-based, not meat-based, and is built around daily consumption of vegetables, fruits, whole grains, and healthy fats (i.e., olive oil, nuts); weekly intake of fish, poultry, beans and eggs; moderate portions of dairy products; and limited intake of red meat. Red wine, in moderation, is also part of this highly recommended diet. As we all know, improving our mood by eating certain foods won’t happen overnight. But by moving away from junk food and toward foods that research has linked to better mental health, perhaps we stand a better chance of waking up on the right side of the bed! Anne Palumbo is the author of SmartBites column, published in this newspaper every issue.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Heart Month ed,” Sharma said.

LOVE YOUR HEART 10 Things to Improve Heart Health By Deborah Jeanne Sergeant

he American Heart Association lists three major risks for heart disease that you can’t alter: increasing age, gender (men have greater risk than women and tend to have attacks earlier in life), and heredity (those with heart disease in their family or who are of black, Mexican, American Indian, native Hawaiian and some Asian descent). While these can’t change, you can mitigate your risk with lifestyle. Here are 10 tips from local health providers:

1.Avoid tobacco.

“Quit smoking,” said Gaurav Sharma, cardiologist with Sands Constellation Heart Institute.

2.Get regular physical activity.

“Get 150 minutes per week of moderate aerobic activity or 75 minutes of vigorous activity per week,” Sharma said, “but any amount is

beneficial. If you are mostly sedentary, even 15 minutes of walking daily has tremendous health benefit. You don’t have to become a marathoner. Consider a Fit Bit or another way to count your steps. Women should work up to 7,000 steps and men to 10,000.

3.De-stress.

“Find ways to relieve stress: exercise, mindfulness-spirituality, spending time with family and friends and be with nature and away from the chaos of daily city-urban-suburban life,” Sharma said.

4.Limit alcohol.

“If you don’t drink, don’t start,” Sharma said. “If you do drink, drink in moderation, which is one to two drinks per day for a woman and two to three drinks per day for a man at most, knowing that the more you drink, the higher your risk of cancer and heart arrhythmias, specifically atrial

fibrillation. Don’t binge drink.”

5.Control your weight.

“Healthy body weight is a body mass index of less than 25 as a goal for most, and less than 23 for Asians. If you are over this number, try to achieve at least 5% body loss in the next 6 months. This amount has significant health benefit.”

6.Keep regular check-ups.

“Go see your primary physician on a regular basis to understand and manage your risk factors for heart disease,” Sharma said.

7.Keep your dental visits.

“Poor dental health correlates with poor heart health,” Sharma said.

8.Watch your numbers.

“Make sure your blood pressure is controlled with the above lifestyle measures and medications as need-

“I set long-term goals for clients to have a fasting glucose below 90, HDL cholesterol above 50 for females, and above 40 for males, emphasize healthy blood pressure (below 120/80), and triglycerides under 150.,” said Heather Carrera, doctor of clinical nutrition at the office of Lesley James, MD in Pittsford.

9.Trim your middle.

“Clients’ goals include to have a waist circumference of less than 35 inches for females and less than 40 inches for males,” Carrera said.

10.Eat a healthful diet.

“This means a predominately whole plant food diet with minimal if any processed food (processed meat, re fined grains, sugars) and less animal product, especially red and processed meat,” Sharma said. “To reduce cardiovascular risk factors, I recommend a diet plan that supports Gaurav healthy blood sugar called the cardiometabolic food plan from the Institute for Functional Medicine, which is loosely based on the Mediterranean diet but with certain therapeutic foods emphasized,” Carrera said.

Can You Actually Die from a ‘Broken Heart’? By Katie Coleman

ebruary is American Heart Month and a good time to consider your heart health, both physical and emotional. Traumatic life events, stress and grief can affect the human body in so many ways — such as sleep problems, fatigue, inflammation and weakened immunity — but in extreme instances of physical or emotional stress, our hearts can temporarily “break.” The condition is called takotsubo cardiomyopathy, also known as broken heart syndrome or stress cardiomyopathy, and was first described in Japan in 1990. Together, takotsubo means octopus trap in Japanese and was coined to describe the shape of the heart’s left ventricle when present with the condition. Although not fully understood, some experts think the flood of hormones produced during a stressful situation, is what affects the heart. It can happen when people or pets die, during medical treatments, after a job loss or other overwhelming stressors. Mohan Madhusudanan is a cardiology specialist at Trinity Medical WNY in Buffalo who has treated a Page 14

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handful of patients with broken heart syndrome. “One of my patients was very close with her sister and the sister passed away. She came in with shortness of breath and chest pain, and I thought she was having a heart attack. We did everything for her and found no blockages. That’s when we realized this could be broken heart syndrome,” Madhusudanan said. When someone’s heart “breaks,” the left ventricle, which is the heart’s main pumping chamber, weakens or balloons and stresses the heart. It’s a condition that is usually temporary and complications mimic those of a heart attack (without any clogging of the arteries), causing chest pain and shortness of breath. “Patients may have low heart function and it may not be normal. They may be in heart failure, so we tend to provide the treatment based on what’s needed at that time,” Madhusudanan said. “It’s something you can easily miss if you’re not paying attention. In medical literature, we say this is a diagnosis exclusion: You have to exclude other findings before you can say it’s broken heart syndrome,” Madhusudanan said.

More research needed “A lot more research needs to happen. It’s very hard to diagnose. If you take all the people who present with heart attack symptoms, only 1% to 2% have it and you can easily miss it if you don’t pay attention or follow up,” Madhusudanan said. The New England Journal of Medicine published a study in 2015 in which 1,750 patients with takotsubo cardiomyopathy were studied. Of those patients, 89.8% were women at an average age of 66. Physical triggers were more common than emotional triggers. “It predominately affects elderly women and is often preceded by an emotional or physical trigger, but the condition has also been reported with no evident trigger,” the study stated.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

There are certain exams and tests to rule out a heart attack and determine if someone has broken heart syndrome: an electrocardiogram, which measures the heart’s electrical activity; an echocardiogram, which produces an image of the heart; and a coronary angiogram, which gives doctors a detailed look at patients’ blood vessels. Because symptoms do mimic that of a heart attack, Madhusudanan if you suspect you have broken heart syndrome, you should call 911.

‘Heart Healthy’: Is It Hype or Helpful?

Many products have big labels proclaiming they are ‘heart healthy’ — but are they? By Deborah Jeanne Sergeant

eart Healthy: You’ve seen it on products from breakfast cereal to snack foods. Many products proclaim this status with a bright, red heart on the package to drive the message home. But is that claim accurate or just clever marketing to push consumers to buy certain brands? “Consumers should not assume that all products labeled ‘heart healthy’ are truly helpful in improving heart health,” said Simone Bailey-Brown, a cardiologist with Sands-Constellation Heart Institute in Rochester. “It is important to read the list of ingredients on these products carefully and to review the nutritional facts which companies are legally required to disclose on their labels.” Bailey-Brown advised sticking with whole, plant-based foods like fruits, vegetables, nuts and legumes to support heart health and avoiding processed carbohydrates and items high in saturated fat, sodium and added sugars. To find these good foods — and skip the less Brown healthful options — UR Medicine cardiologist Jeffrey Bruckel tells patients to shop the store’s perimeter. Generally, that’s the area lacking pre-packaged foods and providing more healthful items like produce. “There’s no regulation about what gets the ‘heart healthy’ label or not,” Bruckel said. “Food should look like it came off the plant or animal. The least processed, the better it is for your health.” The “magic Bruckel food” that’s supposed to be heart healthy sporadically comes into vogue, such as red wine; however, Bruckel isn’t con-

vinced that’s conclusive. “A moderate level of alcohol is probably fine, but a high level isn’t fine,” he added. Heather Carrera, doctor of clinical nutrition at the office of Lesley James, MD in Pittsford, tells her patients to skip the claims on the front of the package and go straight to the nutrition facts. “It’s even better to avoid foods that have labels, packages and boxes at all,” she said. But for those in a container, she limits grams of added sugar at 25 per day, since these can cause inflammation and contribute to weight gain. “I also help educate people about all the different names sugar can go by: barley malt, corn syrup, dextrose, honey, maltodextrin and sucrose, just to name a few,” Carrera said. Avoiding trans fats and Carrera hydrogenated fats also promotes heart health. These are found in many processed foods and snacks. Choosing white meat or leaner cuts of red meat and sources that are naturally less fatty such as grass-fed meat and venison and bison can help reduce fat intake. But a moderate amount of naturally occurring fat found in nuts, seeds, olive oil and fatty fishes can promote heart health. In addition to eating these healthful fats, Carrera recommends drinking two cups of hawthorn tea, including celery, garlic and pomegranate in the diets, adding cinnamon for improved blood sugar control, increasing intake of antioxidant and phytonutrient rich produce, like berries, and eating beets for improved circulation. She added that depending upon the person’s health status, some supplements may also prove helpful. Along with diet, other lifestyle factors contribute to heart health. Anyone concerned about heart health should discuss the topic with a healthcare provider. February 2020 •

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New Medication for Migraines By Deborah Jeanne Sergeant

f you suffer from migraine headaches, a new medication recently approved by the FDA may offer help. Ubrelvy (ubrogepant) tablets are indicated for treatment migraine with or without aura, a visual effect concurring with many migraines. Unlike preventive migraine medication, patients prescribed to take ubrogepant can take it upon onset of a migraine as needed. Ubrogepant represents the first drug in the class of oral calcitonin gene-related peptide receptor antagonists that the FDA has approved for treating acute migraine. The FDA announced ubrogepant’s approval Dec. 23. Dashrath Dulal, pharmacist at Alexander Pharmacy in Rochester, said that this class of medication is becoming popular as a class since its mechanism is different. Many other migraine medications constrict blood vessels, which can contribute to higher risk of stroke and heart attack, unlike the oral calcitonin class. Though Dulal hasn’t seen demand at his pharmacy for the medication yet since it is so new, he said, “It will be interesting to see how people will respond to it. It may be

something for people who have no other choices may try it. It’s something that’s an alternative for people. Something like this might be a good try for them.” Having many options available can provide better therapies for people who cannot tolerate or do not wish to experience unwanted side effects of their migraine medication. Physician Melissa Rayhill is a clinical assistant professor of neurology in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. A neurologist with UBMD Neurology, Rayhill specializes in patients suffering from headaches, migraines and post-traumatic headaches. She said that other medications in the same class as ubrogepant are in current development. “There are additional new classes of medications that have been recently approved for the treatment of migraine in the last two years, including lasmiditan, the first of the new ‘ditan’ class for symptomatic attack management and CGRP monoclonal antibodies for migraine prevention (erenumab, fremanezumab, and galcanezumab),” she said. While it seems there’s a lot of migraine medication available for people with migraine, Rayhill said that offering more options benefits

medications metabolized by the liver should avoid taking ubrogepant, as well as those with liver disease and women who are pregnant or breastfeeding. Participants in two randomized, controlled trials reported nausea, drowsiness, and dry mouth as the most common side effects.

Migraine at Glance

patients. “Not all patients respond to treatments in the same way, so having a new class of medication available to our patients is a big deal,” Rayhill said. “We need better treatments for the millions of patients suffering with migraine in this country alone.” She said that ubrogepant blocks the activity of pain-transmitting protein. When a patient feels a migraine coming on, taking the medication decreases the inflammatory response caused by the protein. That can stop the migraine. People who take certain other

According to the Migraine Research Foundation based New York City, migraine affects 39 million men, women and children in the U.S. and 1 billion worldwide. • Migraine is the third most prevalent illness in the world. • Nearly one in four U.S. households includes someone with migraine. • Twelve percent of the population — including children — suffers from migraine. • Eighteen percent of American women, 6% of men, and 10% of children experience migraines. • Migraine is most common between the ages of 18 and 44. • Migraine tends to run in families. About 90% of migraine sufferers have a family history of migraine. • Migraine is the 6th most disabling illness in the world. • Every 10 seconds, someone in the U.S. goes to the emergency room complaining of head pain, and approximately 1.2 million visits are for acute migraine attacks.

Prices of MS Medications Keep Soaring

he cost of essential medications for multiple sclerosis have nearly tripled this decade, despite the release of the first generic MS drug, a new study shows. The 2015 release of glatiramer acetate — the generic version of Copaxone — did nothing to halt skyrocketing prices for MS medications, said lead researcher Daniel Hartung. He›s an associate professor of pharmacy with Oregon State University, in Portland. “Overall, there were very minimal effects on the price of all the other medications in the class,” Hartung said. “They continued to escalate at about the rate they had before.” Medicaid spending on 15 MS drugs increased from $453

million to just over $1.3 billion between 2011 and 2017, Hartung and his colleagues found. Even after adjusting for average rebate amounts paid to the Medicaid program, spending still more than doubled from $278 million to $600 million per year, the data showed. The spending increase can’t be blamed solely on the expansion of Medicaid under the Affordable Care Act, either. The cost of MS drugs doubled from $2 per Medicaid enrollee to a little more than $4 per enrollee during the seven years of the study, Hartung said. These drugs are essential for checking the progression of MS, a debilitating disease of the brain and spinal cord that affects nearly 1

million people in the United States, experts say. According to Bari Talente, executive vice president of advocacy for the National Multiple Sclerosis Society, “The best thing people can do is to get on a disease-modifying treatment early, as soon as possible after their diagnosis, and stay on treatment continuously. Anything that interrupts treatment opens someone up to a relapse that they may not recover from.” Unfortunately, two of every five people living with MS have had to alter the use of their medications to cope with rising drug costs, according to a recent survey sponsored by the society. “That can be anything from go-

How to Be a Super Conqueror in Life By William Stanley Ferris

here we were standing in surgery with three surgeons, four nurses and a sedated patient lying on the operating table. As a new medical device sales representative, I stood there when suddenly my manager left to receive a call. All eyes turned to me as direction was needed to operate the device that assisted in surgery. The nerves were felt but the training kicked in. Everything went smoothly as the surgery finished successfully without a hitch. That was 25 years ago and my perspective has grown signifi-

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cantly since becoming a chiropractor in 2001. Both sides are pretty clear. Side one is referred to as allopathic medicine (drugs and surgery) and side two is known as complementary and holistic (namely chiropractic, acupuncture, massage, etc.). While drugs and surgery have their place, so does holistic approaches to health, wellness and pain relief. I believe there are three main areas that when addressed will help to reduce and even avoid a majority of our healthcare problems. The three foundational keys to optimal wellness while hopefully

avoiding costly doctor visits are, in my opinion, the following: 1. Proper BIA (Body Impedance Analysis) which is a measurement of lean body mass (muscle) to adipose tissue (fat). There is an optimal number range for this. We must endeavor to dial this number in. 2. A strong gastrointestinal system. I call it a titanium gut. A 5R program works great here. Remove unhealthy organisms, replace, reinoculated, regenerate, and retain healthy bacteria. 3. A strong musculoskeletal system through proper spinal alignment, stretching and flexibility. This will greatly

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

ing with a medication that is not the one they prefer, to people skipping doses or delaying doses to make their prescription last longer,” Talente said. “It opens that person up to potential detrimental effects.” The new study was published online Jan. 15 in the journal Neurology.

reduce nerve entrapments that are both painful and unhealthy. These three simple principles will honor your body and pay homage to your mother who knew best when she said “an ounce of prevention is worth a pound of cure.” William Stanley Ferris is a doctor of chiropractic with specialization in functional medicine. He is the president and founder of Modern Chiropractic & Pain Relief and New York Weight Loss in Victor. Call 585-398-1201 or visit www.modernchiropractic.com

New Minimum Purchase Age for Tobacco Expected to Reduce Youth Use by Deborah Jeanne Sergeant

ccess to tobacco just became more difficult for youth. New York increased its minimum purchase age for buying tobacco from 18 to 21 in November. President Trump signed into law a new nationwide minimum age of 21 as part of an amendment to the Federal Food, Drug, and Cosmetic Act, beginning Jan. 1. The law includes cigars, cigarettes and e-cigarettes. The increased minimum age should offer a number of benefits, according to area experts. “Keeping it out of the hands of younger patients is definitely important for their health,” said physician Kathy Grisanti, president and owner of Pediatric Urgent Care in Rochester and Buffalo. “There certainly will be children who will get their hands on it no matter what the age, but it will deter some young adults.” Many 18-year-olds still attend high school and therefore have lots of exposure to younger teens. Since many young adults leave home around age 21, those who smoke take their tobacco habit with them — away from younger siblings and their visiting friends. “The evidence base indicates this is a very good move,” said Deborah Ossip, leader of the URMC smoking research program. “States or municipalities have done this before. Where it’s enforced, there’s good compliance among retailers and there’s a reduction in tobacco use among youth, especially 15- to 17-year-olds. It’s easier for 18-year-olds or 19-yearolds to pass as 21, but it’s tougher for those 15 to 17.” She added that the higher minimum age also puts more distance between youth and tobacco products,

an important factor since teen brains are more susceptible to nicotine addiction than adult brains. Ossip said that about 95% of adult smokers begin before they turn 21 and 80% start before age 18. Those statistics mirror electronic cigarettes, commonly called e-cigs, vapes, or JUULs. (JUUL is a popular brand name.) The numbers speak to the ease at which teens can become addicted to nicotine. “Forty to seventy-five percent of underage youth say they got their tobacco from a social source,” Ossip said. “If you’re underage, you’re likely to know someone who can get it.” “Raising the age to 21 is an evidence-based approach and making flavors less available are very positive movements,” she said. The Institute of Medicine reported in 2015 that increasing the tobacco sale age to 21 would reduce smoking by 12%; reduce smoking related deaths by 10%; cause 223,000 fewer premature deaths and 50,000 fewer lung cancer deaths; and prevent 4.2

February 2020 •

million years of life lost because of tobacco use. “E-cigarette smoking patterns have replaced cigarette smoking and we have no reason to believe the effects wouldn’t be the same,” Ossip said. Ossip views the raised minimum age as complementary to the FDA crackdown on mint and fruit flavored vaping liquids which research shows particularly attract youth. The 2019 National Youth Tobacco Survey (NYTS) indicates that more than 5 million U.S. middle and high school students are current e-cigarette users. Most of these say they usually use cartridge products. “Making these products less attractive at the same time the law makes it less available is a good combination for reducing the number of teens who will start using,” Ossip said.

Enforcing a national minimum age prevents youth from traveling to neighboring states with lower minimum ages to acquire tobacco products. The only caveat Ossip sees is the possibility of young people equating tobacco use as an adult activity on the same level as alcohol use, which has the same minimum purchase age. Ossip doesn’t want teens to look at tobacco use as a similar rite of passage. She believes that a carefully phrased message against tobacco use can help teens understand that the habit is harmful for the health on many levels. Anyone who wants to quit nicotine has many free resources. For e-cigarettes, text: ditchjuul to 88709. For any nicotine product, access it through the NYS Quitline at 866-NYQUITS or www.nysmokefree.com.

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New Study Reports Alarming Surge in E-Scooter Accidents

lectric scooter accidents are sending droves to emergency rooms — especially young adults, a new study finds. As e-scooters’ popularity has exploded, so have injuries — skyrocketing 222% between 2014 and 2018 to more than 39,000. Hospital admissions also soared — 365% to nearly 3,300. Head injuries made up about a third of the injuries, twice the rate seen in bicycle accidents, researchers said. Men suffered about two-thirds of the injuries. Most riders hurt for the first time were between 18 and 34 years old, researchers found. “E-scooters are a fast and convenient form of transportation and help to lessen traffic congestion, especially in dense, high-traffic areas,” said senior author Benjamin Breyer, a urologist at the University of California, San Francisco. “But we’re very concerned about the significant increase in injuries and hospital admissions that we documented, particularly during the last year, and especially with young people, where the proportion of hospital admissions increased 354%,” he added in a university news release.

Health officials nationwide are alarmed by the number of fractures, dislocations and head injuries showing up in trauma centers from e-scooter accidents, researchers noted. A likely reason: Few regulations for e-scooter use exist, particularly about the need to wear a helmet. Only 2% to 5% of injured riders wore helmets, the study found. Researchers think mandatory helmet use would dramatically reduce the number of head injuries from e-scooter accidents. For the study, they reviewed data from a nationwide injury reporting system. Between 2014 and 2018, almost 40,000 injuries from powered scooters were reported nationwide, the study found. The accident rate more than tripled over that period — from six per 100,000 people in 2014 to 19 in 2018. The most common injuries were fractures (27%); Scrapes and bruises (23%); and cuts (14%). In all, 78% of injuries happened in cities. The report was published online Jan. 8 in the journal JAMA Surgery.

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ike the mighty grizzly bear that hibernates in winter, many people spend more time sleeping during this cold, dark season, a new survey reveals. According to the American Academy of Sleep Medicine (AASM), 34% of Americans say they sleep more in winter, compared with 10% who claim they sleep less during this time of year. In summer, these numbers are turned around, with 36% saying they sleep less and 9% saying they sleep more than usual. “The shorter days during the winter create a great, natural opportunity to spend more time sleeping,” physician Kelly Carden, president of the AASM, said in an academy news release. “Getting quality sleep of adequate duration can improve physical and mental health, overall performance and mitigate safety risks,” she added. Here are some tips for getting a good night’s sleep regardless of the season:

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

• Set a bedtime that allows you to get enough sleep. • Avoid screens and electronics before bed. Exposure to light at night can disrupt the sleep cycle. • Avoid caffeine after lunch and alcohol near bedtime — both can disrupt sleep. • Relax before bed, by taking a warm bath, drinking tea, journaling or meditating. • Make your bedroom comfortable. It should be cave-like — quiet, dark and a little cool. • If you have sleep problems, see your doctor.

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Director of Behavioral Health and community services at Baden Street Settlement Interview by Mike Costanza

ounded in 1901, the Baden Street Settlement, Inc. has become pillar of northeast Rochester. Its six facilities house eight departments that offer 41 programs. Those in its service area can turn to Baden Street for assistance with a host of problems, including the need for child care, treatment for substance abuse or help with finding a place to stay. Its 137 employees serve about 10,000 adults and children a year, including those whose first language is Spanish. Most of the nonprofit’s current $5.9 million budget consists of funds from the United Way of Greater Rochester and private donations. In Good Health spoke to Mary DeSantis, Baden Street’s director of behavioral health and community services, about the nonprofit’s mission and services. Q. What is Baden Street’s mission today? A. Improve the quality of life for adults, children and families, pursue the elimination of the causes of poverty, and reduce the level of negative social problems associated with being poor and socially disadvantaged. We do what we do because we care for our community, which is why we’ve been here for so long. Q. Which of Baden Street’s departments is the busiest? A. First and foremost is our emergency and family assistance service. Last year, they had 4,000 individuals who were served, and 1,200 families. Q. What kinds of services does that department provide? A. The focus there is preventing homelessness. When clients come for service, they are oftentimes in some form of crisis, so there’s crisis management. If they are homeless, need to obtain an apartment and need assistance with a security deposit, we can assist them with those. We can also assist with the first month’s rent. Do they need placement in a shelter? Are they facing an eviction? There is also a need for connectivity with the appropriate services, whether in-house or in the community. On top of addressing an immediate need, we also provide some counseling on budgets and education on different local systems and resources — perhaps it might be on navigating through the Department of Social Services. There is a food pantry there as well, and a clothing room that also has small household items. Q. The Dr. George C. Simmons Counseling & Support Center offers substance

February 2020 •

By Appointment Only,

No Walk-Ins

abuse treatment programs. What do they entail? A. It’s an addictions outpatient treatment facility for adults that offers group therapy and individual therapy. It’s OASAS (New York State Office of Addiction Services and Supports) approved. We also offer medication-assisted treatment. Q. What are some of the services that you offer to parents and children? A. We have the Alvin Wesley Child Development Center, which works with children at 6 weeks old through the age of 12. We offer UPK (universal pre-kindergarten) and EPK (early pre-kindergarten) classes. That is in collaboration with the Rochester City School District. We offer transportation to and from for those classrooms. We also collaborate with the Rochester Hearing & Speech Center to do testing of toddlers, and then we have community providers who provide for children that need occupational and speech therapy. Q. Residents of other parts of Monroe County can make use of some of Baden Street’s services, but most them are designed to aid those living in northeast Rochester. Why is that? A. It is the poorest area in the city of Rochester. The annual income of the folks that we serve, the majority is under $15,000, or below the poverty level. Q. What makes Baden Street different from other nonprofits that serve Monroe County’s low-income residents and families? A. One of the things that makes Baden Street unique is the fact that we are in the community, in the back yard of those we serve. All of our locations are within a few miles of 152 Baden St., which is our admin building. Another unique piece is that 65% of the employees that work here live in the same community that we serve. We are an agency folks are used to. They know that we can always help them. Q. What challenges does Baden Street face these days? A. Our buildings are old. Maintaining them is our largest expense. In addition, many or our services are Medicaid reimbursable. There has been reduction in reimbursement rates across the board. The other thing is workforce. Workforce has been difficult to maintain across-theboard because of the regulatory requirements of some of our positions. Some require master’s degrees, or at least associate’s degrees, and there is a shortage of those personnel.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

Golden Years

IRS Creates New Tax Form for Seniors By Jim Miller

he Internal Revenue Service (IRS) has created a new federal income-tax form specifically designed for senior taxpayers, age 65 and older, that should make filing a little easier this year, particularly those who don’t file electronically. Here’s what you should know.

Form 1040-SR

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Created by the 2018 Bipartisan Budget Act, the new two-page simplified federal income tax form is called the 1040-SR. Similar in style to the old 1040-EZ form that the IRS discontinued last year, the new 1040SR has larger print and better color contrast that makes it easier to read. In addition, it also includes a chart to help older taxpayers calculate their standard deduction, which may help ensure that fewer seniors neglect to take the additional standard deduction that they are entitled to. For 2019, the additional deduction for those 65 or older or the blind is $1,300. The 1040-SR form also has specific lines for retirement income streams such as Social Security benefits, IRA distributions, pensions and annuities, along with earned income from work

wages and tips. And, it allows a child tax credit for seniors who are still taking care of a dependent child or grandchild. You can also report capital gains and losses, as well as interest and dividends on this new form. Any of the tax schedules available to those using the standard form 1040 may also be used with the 1040-SR. You should also know that the 1040-SR doesn’t put a limit on interest, dividends, or capital gains, nor does it cap overall income like the old 1040-EZ form did. But, if you have to itemize because of state and local taxes or charitable giving, then you will not be able to use the new Form 1040-SR.

Paper Filing Advantage

Seniors who use tax-preparation software to file their taxes will be able to generate a 1040-SR, but the new form will provide the most significant benefit to taxpayers who still fill out and file their returns on paper. Last year, about 88% of the 153 million individual federal tax returns filed to the IRS were filed electronically. About 5% were prepared using tax software, then printed out and mailed to the agency, while about 7 percent were prepared on paper.

To use the new 1040-SR tax form for the 2019 filing year, taxpayers, including both spouses if filing jointly, must be at least age 65 before Jan. 1, 2020. You also don’t have to be retired to use the form — older workers can use it too. But early retirees (younger than 65) cannot use 1040-SR. To see the 2019 new 1040-SR form, go to IRS.gov/pub/irs-pdf/ f1040s.pdf.

Tax Preparation Help

If you need help filing your tax returns this year, consider contacting the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit IRS. treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 4,800 sites nationwide. To locate an AARP Tax-Aide site call 888-2277669 or visit AARP.org/findtaxhelp. You don’t have to be an AARP member to use this service.

Readings by

Food Assistance Programs Can Help Seniors in Need

Appointments Only

Less than 40% of those eligible take advantage of some benefits to which they are entitled

Yvonne

585-216-5519

ytriassi@gmail.com

By Jim Miller

illions of older Americans struggle with food costs — according to a recent study by Feeding America, 5.5 million U.S. seniors age 60 and older are food insecure. Fortunately, there are several programs that may be able to help. Here’s what you should know.

SNAP Benefits

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While there are millions of seniors who are eligible for food stamps, less than 40% actually take advantage of this benefit. Food stamps are now referred to as the Supplemental Nutrition Assistance Program, or SNAP. For seniors to get SNAP, their net income must be under the 100% federal poverty guidelines. So, households that have at least one person age 60 and older, or disabled, their net monthly income must be less than $1,041 per month for an individual or $1,410 for a family of two. Households receiving TANF or SSI are also eligible. Net income is figured by taking gross income minus allowable deductions including a standard monthly deduction, medical expenses that exceed $35 per month out-ofpocket, and shelter expenses (rent or mortgage payments, taxes and utility costs) that exceeds half of the house-

hold’s income. In addition to the net income requirement, a few states also require that a senior’s assets be below $3,500, not counting their home, retirement or pension plans, income from SSI or TANF, and vehicle (this varies by state). Most states, however, have much higher asset limits or they don’t count assets at all when determining eligibility. To apply, seniors or an authorized representative will need to fill out a state application form, which can be done at the local SNAP office or, it can be mailed or faxed in. In many states it can be completed online. If eligible, benefits will be provided on a plastic card that’s used like a debit card and accepted at most grocery stores. The average SNAP benefit for 60-and-older households is around $125 per month. To learn more or apply, contact your local SNAP office – call 800-2215689 for contact information or visit fns.usda.gov/snap. Locally, check https://otda.ny.gov/programs/ snap/

Other Programs

In addition to SNAP, there are other federal programs that can help low-income seniors, aged 60 and older, like the Commodity Supplemental Food Program (CSFP) and the Senior

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

Farmers’ Market Nutrition Program (SFMNP). The CSFP (see fns.usda.gov/ csfp) is a program that provides supplemental food packages to seniors with income limits at or below the 130% poverty line. And the SFMNP (fns.usda.gov/ sfmnp) provides seniors coupons that can be exchanged for fresh fruits and vegetables at farmers’ markets, roadside stands and community supported agriculture programs in select locations throughout the U.S. To be eligible, your aunt’s income must be below the 185 percent poverty level. There are also many Feeding America network food banks that host “Senior Grocery Programs” that provide free groceries to older adults, no strings attached. Contact your local food bank (see feedingamerica. org/find-your-local-foodbank) to find out if a program is available nearby. In addition to the food assistance programs, there are also various financial assistance programs that may help pay for medications, health care, utilities and more. To locate these programs, and learn how to apply for them, go to BenefitsCheckUp.org. Jim Miller is the author of Savvy Senior column, published every month in this paper.

By Jim Miller

How to Choose the Right Hospital for You Dear Savvy Senior, I need to get a hip replacement, and want to find a good, safe hospital to have it done in. What resources can you recommend for evaluating hospitals? I don’t currently have a doctor. Shopping Around

Dear Shopping, Most people spend more time shopping for a kitchen appliance or flat-screen TV than choosing a hospital. But selecting the right one can be as important as the doctor you choose. Here are some tips and resources to help you research the hospitals in your area.

Hospital Shopping While you may not always have the opportunity to choose your hospital, especially in the case of an emergency, having a planned procedure can offer you a variety of choices. When shopping for a hospital, the most important criteria is to choose one that has a strong department in treating your area of need. A facility that excels in coronary bypass surgery, for example, may not be the best choice for a hip replacement. Research shows that patients tend to have better results when they’re treated in hospitals that have extensive experience with their specific condition. In order to choose a hospital that’s best for you, it is important to discuss your concerns and alternatives with the doctor who is treating you. Some doctors may be affiliated with several hospitals from which you can choose. Or, if you’ve yet to select a doctor, finding a top hospital that has expertise with your condition can help you determine which physician to actually choose. Another important reason to do some research is the all too frequent occurrence of hospital infections, which kill around 75,000 people in the U.S. each year. So, checking your hospital’s infection rates and cleanliness procedures is also a smart move.

Free Researching Tools There are a number of free online

resources that can help you evaluate and compare hospitals in your area, including: • Medicare’s Hospital Compare (Medicare.gov/HospitalCompare): Operated by the Centers for Medicare and Medicaid Services, this tool has data on more than 4,000 U.S. hospitals. • Why Not The Best (WhyNotTheBest.org): Created by the Commonwealth Fund, this is a private foundation that provides performance data on all U.S. hospitals. • The Leapfrog Group (LeapfrogGroup.org): This national, nonprofit organization grades more than 2,000 U.S. hospitals on quality and safety. These websites use publicly available data to rate hospitals on various measures of performance like death rates from serious conditions such as heart failure and pneumonia, frequency of hospital-acquired infections, patient satisfaction and more. On these websites, you plug in your location to find hospitals in your area. You can then check to see how well or poorly each hospital manages patients in various conditions. Two other good sites that can help you choose a good facility include U.S. News & World Report (USNews.com/best-hospitals) and Healthgrades (Healthgrades.com). U.S News & World Report is an online publication that publishes a hospital ranking in 17 medical specialties like cancer, orthopedics and urology, and rates common procedures and conditions, such as heart bypass surgery, hip and knee replacement and COPD. They also rank hospitals regionally within states and major metro areas. And Healthgrades, which is a private for-profit organization, provides free hospital ratings on patient safety and medical procedures, and scores hospitals using a 5-star scale. They also provide comprehensive information on most U.S. doctors including their education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records, office locations and insurance plans.

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. February 2020 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 21

Ask St. Ann’s

Why Should Seniors See a Geriatrician? By Brian Heppard, MD

re you ready to live a long life? Choosing the right health care provider for your age can

help. Just as pediatricians specialize in the growth and development of newborns through young adulthood, geriatricians help the elderly with age-related frailty and impairment maintain their best quality of life. Serving as both the primary care provider and specialist, geriatricians focus on the prevention and treatment of disability and disease in older age. They provide family-centered care and work with a team of providers to address the medical, emotional, mental health and spiritual needs of patients and their family caregivers. Also, shared decision making around healthy aging, advanced care planning, and end-of-life care provide everyone with peace of mind.

Adapting to change, managing stress and bouncing back from illness becomes more challenging with age because of fewer physical, cognitive and social reserves. Trips to multiple specialists and invasive medical treatments often only complicate matters more. Comfort with the complexity and ambiguity surrounding most eldercare situations requires geriatric expertise. By considering the patient’s age, values and current conditions, geriatricians help sort out the situation and find the best solution. Also, unlike mainstream primary care providers, geriatricians understand the differences between each level of care in senior living settings. Working within the regulations that govern nursing homes and assisted living facilities, they’re able to access the resources necessary to make a

positive impact on an elder’s health in these environments. St. Ann’s Community embraces geriatric care as a complement to its continuum of care philosophy. What matters most to their residents, they say, is symptom control that enables them to function as long as possible with dignity, purpose and importance. A few practices from days gone by help these physicians provide the best outcomes possible: • Care Coordination — Transitions can leave families and patients feeling lost. The geriatrician understands what’s going on and how it affects the big picture. The doctor reviews medications, helps interpret directions and guides patients and families through the next steps of a loved one’s care while safeguarding the advanced directives in place. • Quality Time — A 30-minute appointment every quarter is common practice for geriatricians, giving ample time to examine your loved one and consult with you and healthcare staff. The frequency picks up after an acute health event like hospitalization until the person’s stabilized. • House Calls — Best of all, geriatricians provide care at home. Mobile X-ray and laboratory services bring phlebotomy and diagnostic testing there, too.

• Support for Caregivers — Having one doctor oversee medical issues frees family and friends to handle the many other responsibilities that come with caring for a loved one, including taking time for themselves. To find a geriatrician, ask your loved one’s current primary care doctor for a referral. You might also find a local geriatrician through the Monroe County Medical Society website at www.mcms.org.

Brian Heppard is a medical doctor and certified medical director at St. Ann’s Community and Pillar Medical Associates, PC, a geriatrics practice providing outpatient care for seniors in assisted living and independent living. He is boardcertified in family medicine, geriatrics, and hospice and palliative care. To learn more, visit www.pillarmedical.com.

Want a Long, Healthy Old Age? A Healthy Middle Age Helps

M America Woefully Unprepared to Deal with Its Aging Population By George Chapman

he New York Times recently ran an article on the pending healthcare crisis facing the country as we age. There is no easy solution as several factors contribute, but it’s time to acknowledge and discuss the issue. Our birthrate is at a record low, continuing a steady decline since the 2008 recession. At the same time, 10,000 baby boomers are retiring every day and they are living longer. In 10 years — by 2030 — the population of the prime caregivers (in the 45-65 age bracket) will increase by just 1% a year, while the population of over 80 will increase by an astounding 80%. To compound the approaching dilemma, once you reach 85 your chances of developing Alzheimer’s is 14 times higher than when you’re 65 to 70. Page 22

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Most of the help received by the elderly, 83%, is provided by relatives or neighbors — without compensation — and two thirds of the caregivers are women. According to the National Institute on Retirement Security, the median savings of people in middle age is just $15,000. It is estimated that people over 65 withdrew $22 billion from their savings to cover for what Medicare doesn’t. And Medicare does not cover long term care. It is human nature to kick the can down the road, ignore reality and avoid uncomfortable debate. Pending crises aren’t really addressed until they are smack in front of us. 2030 is just around the corner. George Chapman is the author of Healthcare in a Minute column, published every issue in In Good Health.

iddle-aged Americans who are exercising and eating right, give yourselves a pat on the back: Your efforts will pay off, new research shows. A study involving more than 110,000 people finds that a healthy lifestyle in middle age appeared to help folks live longer lives free of major diseases. Researchers at the Harvard T.H. Chan School of Public Health said that many prior studies have made the connection between healthy living and reductions in a person’s odds for cancer, heart disease and other ills. However, “few studies have looked at the effects of lifestyle factors on life expectancy free from such diseases,” lead researcher Yanping Li, a senior research scientist in nutrition, said in a Harvard news release. To see if a healthier middle age

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

could lead to a long, disease-free old age, Li and her team tracked health data on U.S. nurses and other health professionals, more than 73,000 women and more than 38,000 men. Each participant was given a “healthy lifestyle score,” ranging from 0 to 5, with 5 indicating the healthiest lifestyle. The score was based on the person’s adherence to five low-risk lifestyle factors: never smoking, maintaining a healthy weight, getting at least 30 minutes of daily physical activity, moderate alcohol intake, and a having a good-quality diet. The participants were assessed regularly over a period of more than 20 years. The research team adjusted their results for factors such as the person’s age, ethnicity and family medical history. The study found that a woman aged 50 years of age could expect 24 more years of life that was free from cancer, heart disease and diabetes if she had none of the healthy lifestyle factors on that list of five. But that same woman could expect another decade of healthy life — 34 years — if she had four or five of those healthy factors, the researchers said. Among men, life expectancy free of any of the three major diseases was 24 years for those with no low-risk lifestyle factors and 31 years for those with four or five low-risk lifestyle factors. Men who smoked heavily (15 or more cigarettes a day) and obese men and women had the lowest rates (75% or less) of disease-free life expectancy at age 50, the study found. The study was published Jan. 8 in the BMJ.

Dimitri House: Food, Shelter for Everyone Rochester nonprofit about to expand services it provides to homeless people thanks to a $1.3 million grant By Christine Green

ohn Mills of Rochester knows what it’s like to be homeless. He also knows what it’s like to come out the other side and thrive, and that is why he volunteers his time with Dimitri House in Rochester. Dimitri House is a nonprofit organization that assists those in need with food, shelter and other important services. The facility on North Union opened in 1985 and is named after Dimitri Mamczur, a homeless gentleman who died after being struck by a car. Three days a week Dimitri House offers a drop-in lunch program for anyone who would like to join them. From 1:30 to 4:30 p.m. Tuesday, Wednesday and Thursday lunch is served to “anybody who walks in the door — from the truly homeless individual to indeed people who have gotten employment, even the guys next door at the garage come over and have lunch with us sometimes,” said Laurie Jones-Prizel the executive director of Dimitri House. They offer nutritious, filling meals that are prepared by a host of volunteers in the kitchen. Those looking for food to take home can also make use of the Dimitri House food pantry. Families and individuals from zip codes 14604, 14605, 14607 and 14609 can take home groceries every 30 days. Jones-Prizel noted that it isn’t only the homeless or unemployed making use of the food pantry or lunch program. She is seeing a large number of working poor, too. In addition to providing food to those who need it, Dimitri House also offers a winter men’s shelter. They have seven beds with clean, fresh sheets for their clients. Those staying at the shelter can also launder their clothes, take showers and partake in breakfast and light supper. The shelter portion of Dimitri House opens in November and runs through mid-April. The time men stay at the house varies depending on individual situations. The organization’s fourth program is Dimitri Affordable Safe Housing or DASH. “We provide security deposits to chronically homeless individuals who are getting their first apartments,” said Jones-Prizel. Dimitri House recognizes that securing deposits and rent when moving into a new apartment can be extremely difficult for those with very little income. The DASH program gives them a leg up and offers support during this critical life transition.

they have a dedicated group of volunteers with some regulars having donated their time for over 20 years. Mills, the Rochester resident who once was a homeless, is a regular volunteer. He can often be found working the night shift at the shelter and enjoys working with their overnight guests. “I love it and it’s giving back,” he said. Jones-Prizel noted that Mills is

Laurie Jones-Prizel (left), Dimitri House’s executive director, and volunteer Elizabeth Spreng.

a valued volunteer because he can connect with the men who stay at the house. “He has a great relationship with the guys. He gets it more than I’m ever going to because he has been there and done it.” Even though Mills enjoys volunteering overnight, he can’t do it alone. This time of year they need more night time volunteers at the

Grace Granata is program coordinator at Dimitri House.

How to Help Dimitri House If you would like to donate items for Dimitri House, consider donating men’s socks, gently used coats and new underwear. Mittens, gloves, and hats are always welcome, too. Dimitri House also accepts donations of bed linens and blankets, travel size toiletries, and toe and hand warmers. If you would like to help with food for the pantry or the lunch kitchen, consider giving Dimitri House gift cards instead of actual groceries. Dimitri House can always use more volunteer help and opportunities to lend a hand abound. If you would like to donate your time to Dimitri House visit dimitri-house.org or call their office at 585-3251796. Community members looking for support can use this same number or drop-in for lunch from 1:30 to 4:30 p.m., Tuesday, Wednesday, and Thursday.

A Community of Volunteers The many Dimitri House programs couldn’t run without the help of volunteers. Jones-Prizel said that

shelter. “It’s a wonderful opportunity to meet the folks and where they come from,” said Jones-Prizel. Volunteers also cook, organize and distribute groceries from the food pantry, and work in the office, among many other duties. Last year Steve Witte saw a call for executive board volunteers for Dimitri House on LinkedIn. As he learned more about what the organization did, he knew it would be a good match for him. “I wanted to do something to feed my soul more than just making money,” Witte said about choosing to volunteer for the board. He now helps out with the operations and marketing committees, attends monthly board meetings, and finds local resources to help Dimitri House better serve the community. Elizabeth Spreng has volunteered at Dimitri House for the last seven years. She answers the phones in the office. When asked why she is dedicated to helping out at Dimitri House she said, “I like the idea of helping homeless people, and I love answering the phone and talking to people.” Dimitri House continues to evolve and recently received a $1.3 million grant from the Homeless Housing and Assistance Corporation (HHAC) and the New York State (NYS) Office of Temporary and Disability Assistance (OTDA). They will use the funding to renovate another building on the property into six one-bedroom apartments for chronically homeless men and women. There is a bright future ahead for Dimitri House and Jones-Prizel is proud to be a part of their expansion and growth. “Absolutely love the job. We’re small but mighty.”

John Mills of Rochester was once homeless. Today he volunteers at Dimitri House February 2020 •

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H ealth News Rochester General achieves Magnet status again Rochester General Hospital, an affiliate of Rochester Regional Health, attained Magnet recognition again in December. The American Nurses Credentialing Center’s Magnet Recognition Program distinguishes health care organizations that meet rigorous standards for nursing excellence. This credential is the highest national honor for professional nursing practice. Receiving Magnet recognition for the fourth time is a great achievement for Rochester General Hospital as it continues to proudly belong to the global community of Magnet-recognized organizations. Just 461 U.S. health care organizations out of over 6,300 U.S. hospitals have achieved Magnet recognition. “Magnet recognition is a tremendous honor and reflects our commitment to delivering the highest quality of care to this community,” said Kristin Opett, chief nursing officer for Rochester General Hospital. “To earn Magnet recognition once was a great accomplishment and an incredible source of pride for our nurses. Our repeated achievement of this credential underscores the foundation of excellence and values that drive our entire staff to strive harder each day to meet the health care needs of the people we serve.” Research demonstrates that Magnet recognition provides specific benefits to health care organizations and their communities, such as: • Higher patient satisfaction with nurse communication, availability of help and receipt of discharge information. • Lower risk of 30-day mortality and lower failure to rescue rates.

• Higher job satisfaction among nurses. • Lower nurse reports of intentions to leave their positions. Magnet recognition is the gold standard for nursing excellence and is a factor when the public judges health care organizations. U.S. News & World Report’s annual showcase of “America’s Best Hospitals” includes Magnet recognition in its ranking criteria for quality of inpatient care. “We’re a better organization today because of the Magnet recognition we first achieved 15 years ago,” said Opett. “Magnet recognition raised the bar for patient care and inspired every member of our team to achieve excellence every day. It is this commitment to providing our community with high-quality care that helped us become a Magnet-recognized organization, and it’s why we continue to pursue and maintain Magnet recognition.”

Trillium earns LGBTQ ‘Equality Leader’ designation Rating a top score in the nation, Trillium Health has been recognized by the Human Rights Campaign Foundation as an LGBTQ Health Care Equality Leader. Nationwide, 680 healthcare institutions took the survey for the 12th annual Healthcare Equality Index (HEI), and Trillium Health was among 406 to garner a top score of 100. Human Rights Campaign scores healthcare facilities on policies and practices dedicated to the equitable treatment and inclusion of their LGBTQ patients, visitors and employees. “From our founding day, the core of our mission has been to support and innovate for the LBGTQ commu-

Serving Monroe and Ontario Counties A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations. In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Christine Green, Katie Coleman, Mike Costanza, Katie DeTar, Brian Heppard, MD • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office manager: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

Reach Thousands of Health-Conscious Readers Advertise with In Good Health — Rochester’s Healthcare Newspaper. editor@GVhealthnews.com Page 24

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nity, so it’s always gratifying to rate with the top institutions in the country that do this work,” said Andrea DeMeo, president and CEO of Trillium Health. “The number one reason we can celebrate this achievement is that every member of our staff is dedicated to delivering our services in the best ways possible. Our people make it happen, and that’s why we’re successful,” DeMeo stated. The 12th edition of the HEI assesses participants on four criteria: non-discrimination and staff training, patient services and support, employee benefits and policies, and patient and community.

Lifetime Care named as a ‘Top Agency’ Lifetime Care Home Health Care and Hospice has been named a “Top Agency of the 2019 HomeCare Elite,” a recognition of the top-performing home health agencies in the United States. For 14 years, HomeCare Elite has annually identified the top 25% of Medicare-certified agencies and highlighted the top 100 and top 500 agencies overall. Lifetime Care, which is part of Roches-

ter Regional Health, has received this recognition 12 of the 14 years. The ranking is developed by ABILITY Network, a leading information technology company helping providers and payers simplify the administrative and clinical complexities of healthcare. It is sponsored by DecisionHealth, part of the H3.Group. “We’re pleased to recognize Lifetime Care for exemplifying best practice in patient care,” said Christine Lang, senior director for ABILITY Network. “Lifetime Care’s home health professionals have demonstrated exceptional commitment to care quality and the patient experience.” Nancy Horn, vice president of clinical operations/administrator at Lifetime Care, credits the agency’s skilled professionals and mission-driven services with the agency’s ability to achieve recognition as one of the HomeCare Elite. “As a not-for-profit organization, we are dedicated to building an extraordinary, passionate and diverse team, committed to delivering the highest level of care possible for our patients and families,” said Horn. Lifetime Care serves 33,000 patients in home and home-like settings in the Rochester and Finger Lakes region including the counties of Monroe, Wayne, Seneca, Cayuga, Yates, Schuyler, Ontario and Livingston. Primary in-home services include skilled nursing, rehabilitation therapies, medical social work, infu-

Lifespan Gets Award for Excellence in Program Innovation

he 2019 Award for Excellence in Program Innovation, given by the Archstone Foundation and the Aging & Public Health Section of the American Public Health Association, recognizes Lifespan’s Community Care Connections service as a “best practice model in care for older adults.” Community Care Connections integrates Lifespan’s services for older adults with medical systems of care to reduce unnecessary ED visits and hospitalizations among people 60 and older. As evaluated by the New York Academy of Medicine, ED visits among 1,225 patients decreased by 28% 90-days post service, hospitalizations decreased by 29% and observation stays decreased by 23%. The service accepts referrals from health care organizations for patients who struggle with medical adherence, have multiple illnesses, difficulty navigating healthcare, a history of missed appointments, low health literacy and/or no caregiver or stressed caregiver. Lifespan’s social workers visit with patients and/or caregivers to assess needs and link them to supportive services. In a new role, Lifespan’s healthcare coordinators, LPN nurses, help patients schedule appointments and transportation, attend appointments with patients,

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2020

conduct medication reconciliation in homes and provide health education. Community Care Connections social workers and nurses communicate findings and progress to the referring medical organizations. The evaluation also identifies which community service connections make the greatest difference in decreasing ED use and hospitalizations. The analysis showed that in addition to Lifespan’s in-home care management, linking older adults to bill paying, home delivered meals, transportation, health management workshops and minor home modifications helped reduce medical utilization. “We’ve always believed that integrating services, like Lifespan’s, with medical providers would enhance care for older adults. Why? Because it’s vital for physicians and other providers to know what’s influencing a person’s health outside of the healthcare door. Do they have enough money to pay for prescriptions? Do they have a reliable caregiver? Do they have transportation for appointments? Where are they living? Do they understand their diagnoses? These are the factors we uncover with our assessments and home visits,” notes Ann Marie Cook, president/ CEO of Lifespan.

H ealth News sion therapies and home health aide services. In the counties of Monroe, Wayne and Seneca, Lifetime Care provides comprehensive hospice care in the home, at skilled nursing facilities, and at the Hildebrandt Hospice Care Center.

Highland recognizes employee for 60 years of service Highland Hospital employees gathered to celebrate Patient Relations Coordinator Dorothy “Dottie” Haelen for achieving 60 years of service. Haelen began her career as a registered nurse at Highland Hospital Jan. 14, 1960, after graduating from the Highland Hospital School of Nursing. Haelen has cared for patients in various roles, including staff nurse, head nurse and nurse supervisor. In her current role as Highland’s patient relations coordinator, she continues to have an important role in patient care. Haelen is Highland Hospital’s longest-tenured employee. “Dottie is a role model of patient and family centered care. Her dedication, compassion, and focus on our patients is remarkable,” said Highland COO Cindy Becker. One of the highest honors bestowed to a Highland Hospital nurse — the Dorothy Haelen Lifetime Achievement Award — is named after her. This award is given to an individual who provides consistent support to the department of nursing’s efforts to improve practice and achieve goals that reflect excellence in patient care. It was named in honor of Haelen for her outstanding support and contributions. “I feel privileged that I have been able to work here for so long,” said Haelen. “Knowing how many people have placed their trust in me has been very rewarding.”

NYCC and Bridge Back to Life Center Announce Partnership New York Chiropractic College (NYCC) recently announced a clinical partnership with Bridge Back to Life Center, Inc., a NYS Office of Addiction Services and Supports (OASAS) site. Since 1988, Bridge Back to Life has provided treatment to individuals recovering from addiction, as well as education and support to their families and significant others. Now, through an innovative new partnership, NYCC clinicians and students will provide beneficial services and treatment to current clients of the outpatient addiction and counseling center, with the goal of reducing pain

Thompson Dedicates Time Capsule in New Addition After wrapping up its Associate Annual Giving Campaign, the F.F. Thompson Foundation recently invited UR Medicine Thompson Health staff members who designated their donations for the new Sands-Constellation Intensive Care Unit and Pulmonary Medicine Clinic to the dedication of a time capsule to be placed in a wall of the new addition. Having collectively donated more than $17,000 toward the project, the staff members were invited by UR Medicine Thompson Health President/CEO Michael F. Stapleton, Jr. to add their signatures to a letter for those who open the capsule in 2070. “It’s exciting for us to know the capsule will one day be opened by those who follow in our footsteps, providing health care to residents of the Finger Lakes region,” Stapleton said during his remarks, adding, “We will never meet them or some of us won’t but my hope is when the capsule is opened 50 years from now, Thompson remains a thriving, vital piece of the community.” In addition to the letter from Stapleton, other items in the time capsule included recent Thompson publications, recent issues of local and national newspapers, a photo book, 2019 currency, renderings of the new addition, assorted Thompson items and items related to the capital campaign, which currently stands at $11.8 million of its $12 million goal. The new, 12-bed ICU and the Pulmonary Medicine Clinic are slated to open in March of 2020, and a plaque will mark the spot where the capsule is located. and improving overall health and wellness. “NYCC and Bridge Back to Life are entering into a collaborative partnership using evidence-based practices to deliver chiropractic and provide resources to help people achieve optimal health,” said Wendy Maneri, NYCC associate dean of chiropractic clinical education and health centers. “We also pride ourselves on delivering alternative solutions to drugs and surgery, which is especially important within the recovery community.” NYCC clinicians started treating patients at Bridge Back to Life in early December 2019, and a full student rotation began in January. “I truly believe that this agreement with the college will serve as a national model for drug rehabilitation centers throughout the country,” said medical director at Bridge Back to Life, Russell Surasky, neurologist and addiction medicine specialist. NYCC offers more than 20 clinical partnerships, providing students with important hands-on practice at sites such as community health centers (such as NYCC-run Health Centers in Levittown, Depew and Seneca Falls) and Veterans’ Administration (VA) hospitals. February 2020 •

During a recent dedication ceremony, Jim Ufholz of purchasing at UR Medicine Thompson Health and Rosalind giroux of the operating Room look over some of the items for a time capsule to be placed in the wall of a new addition and opened at the hospital in 2070.

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Medicare 101 seminars every month! Free one-on-one consultations. Learn more! lifespanrochester.org 585-287-6413. A service of Lifespan’s Health Insurance Information Counseling & Assistance Program (HIICAP).

No person shall be denied benefits or subjected to discrimination under any program or activity receiving Federal Assistance on grounds of race, color, sex, religion, national origin, disability, or marital status. This program is funded by participants’ contributions, U.S. Administration on Aging, N.Y. State Office for the Aging, N.Y. State Department of Health, Monroe County Dept. of Human Services / Office for the Aging.

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