IGH Rochester #179 July 20 by In Good Health: Rochester's Healthcare Newspaper

PRICELESS

JULY 2020 • ISSUE 179

GVHEALTHNEWS.COM

Important health numbers you absolutely need to know about To maintain good health, it’s all in the numbers that measure key indicators of health. We talk to local experts who discuss what those numbers are and how we can get them to normal levels. P. 12

Transplant Uptick at Strong Memorial Chief of transplantation at Strong Memorial, Dr. Roberto HernandezAlexandro says his team performed 26 life-saving transplants through coronavirus pandemic months

Picky Eaters

Special Women’s Health issue inside

Emotional Abuse: Women Are Often the Target Also inside

n Rochester Center for Sexual Wellness holds grand opening in Penfield n Love during lockdown: Survey shows how couples have coped

For many kids, picky eating isn’t just a phase, study finds

Little Raspberries Score Big on Many Fronts

More Young Americans Abstaining From Sex P. 13

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More Young Americans Are Going Without Sex

ex, and lots of it, has long been the primary preoccupation of young adults, but more of them are now going months and years without any intimate encounters. New research shows that one of three men between the ages of 18 to 24 have not had any sex during the past year, putting to rest all the talk of the “hookup culture.” Men and women aged 25 to 34 in the United States also reported an increase in sexual inactivity and a decrease in sexual frequency during the past two decades, the researchers found. “In the age of Tinder, young people are actually having less sex, not more,” said Jean Twenge, a professor of psychology at San Diego State

University. Analyzing national survey data, researchers found that sexual inactivity increased from 19% to 31% among men 18 to 24 between 2000 and 2018. They defined sexual inactivity as no sex at all for a year or more. Among those aged 25 to 34, sexual inactivity doubled among men (7% to 14%) and nearly doubled among women (7% to 13%) during the same two decades, the researchers reported. Many who remain sexually active are having sex less often, the findings also showed. Fewer people are having sex at least weekly, particularly those with one sexual partner. The report was published online June 12 in JAMA Network Open.

“It is important to distinguish between a decrease in sexual frequency among those who are sexually active and an increase in those who do not have sex at all,” said lead researcher Peter Ueda, a physician-researcher at the Karolinska Institute in Sweden. “While the mean sexual frequency among those who were sexually active may reflect their priorities and preferences, sexual inactivity may reflect an absence of sexually intimate relationships, with substantially different implications for public health and society,” Ueda said. Technology and society appear to be colliding in a way that dramatically affects young adults’ interest in sex, said Twenge, who wrote an editorial accompanying the new study.

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

Even though kids are entering puberty earlier, they are taking longer to grow into adulthood, Twenge said. It’s not just about sex. These young adults also are taking longer to begin working, start dating, move out of their parents’ home, settle into a career, live with a partner, have kids or buy houses, Twenge said. The generation coming up after millennials, which Twenge calls “iGen,” aren’t even that motivated to hang out with friends, she said. “iGen does those things significantly less than previous generations did at the same age,” Twenge said, noting that young adults these days would rather check out social media, play video games or text their pals. “They’re choosing to spend their leisure time communicating using their phones instead of face-to-face,” Twenge continued. “When people aren’t face-to-face, they’re probably going to have less sex.” All told, young adults now might decide that bingeing Netflix or posting on Instagram is more enjoyable than seeking a sexual partner, Twenge said. “There are just more things to do at 10 p.m. than there used to be,” Twenge explained. Even when people are together, they’re allowing their smartphones to interfere with their chemistry, Twenge added. Many people on dates are guilty of “phubbing” -- pulling out their phone and snubbing the person they’re with, Twenge said. “What happens to face-to-face interactions when the phones come up? Not surprisingly, it just doesn’t go as well. It’s not as emotionally close,” Twenge said.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Roberto HernandezAlejandro, MD Coronavirus May Be Seasonal After All

ere’s a glimmer of hope about the new coronavirus: New research finds it appears to follow a seasonal pattern that is similar to the flu. Scientists found that all cities/regions with large COVID-19 outbreaks have similar winter climates, with an average temperature of 41 to 52 degrees Fahrenheit, average humidity levels of 47% to 79%, and are located within a latitude band of 30 to 50 N. This includes Wuhan, China; South Korea; Japan; Iran; Northern Italy; Seattle; and northern California. The findings also suggest that U.S. mid-Atlantic states may be at risk, as well as New England, according to researchers at the Institute of Human Virology (IHV) at the University of Maryland School of Medicine (UMSOM) and the Global Virus Network (GVN). “Based on what we have documented so far, it appears that the virus has a harder time spreading between people in warmer, tropical climates,” said study leader Mohammad Sajadi, an associate professor of medicine at UMSOM, physician-scientist at IHV, and a member of GVN. The researchers used weather data from the previous few months, as well as typical weather patterns from last year, to predict community spread of COVID-19 within the next few weeks. The next step is to determine if weather and climate forecasts could make the predictions more reliable. Study co-author Anthony Amoroso said, “I think what is important is that this is a testable hypothesis.” Amoroso is an associate professor of medicine at UMSOM and chief of clinical care programs for IHV. “If it holds true, it could be very helpful for health system preparation, surveillance and containment efforts,” he added in an institute news release. The study was published online June 11 in JAMA Network Open.

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Chief of transplantation at Strong: He and his team perform 26 life-saving transplants through coronavirus pandemic months Q: COVID-19 has had a major impact on medical procedures this year. You, however, have been performing some of the riskiest procedures during this time— solid organ transplants. What’s that been like? A: It was around mid-March that the hospital started making some changes in procedure because of the pandemic — internal changes and modifications. As you probably know, one of the biggest recommendations from the state was to stop elective surgeries. However, there are essential surgeries that we still have to do. I wear two hats where I work. The first is transplantation. I am the chief of abdominal transplantation at the University of Rochester, and am personally involved with liver transplants, which is a life-saving procedure for patients with liver failure. We can’t put that on hold; we don’t know if they’ll have another chance. Q: And your other role? A: The other area I work is with liver cancer, not necessarily related to transplant, but these patients need surgery and if we wait or hold for months, it might spread to other organs and be too late to operate and give them a better quality of life and chance at survival. Q: How did you resolve the need to perform these procedures with the risks from COVID? A: There were a lot of conversations with the institution, and we were able to implement and continue to implement. That moment in March and April, there were a lot of things we didn’t know about the virus. There are still a lot of things we don’t know, but we know more than we did. As you may know, with transplantation you need more than just a surgeon — there’s a huge team surrounding the patient, a lot of different specialties involved. So we

were able to set up and get the necessary PPE to do these operations. They implemented a plan to set up an area where patients with COVID would be placed and kept isolated, and non-COVID areas in the ICUs free of COVID. There were a lot of structural changes in the building. It’s been working well. Q: How did that turn out? A: Interestingly, I have to say that our practice in Rochester has been pretty strong — kidney, liver, and heart transplantation — but since March 17, we have been extremely busy, especially in liver transplantation. We’ve had 26 [transplants] since then. You would expect a decrease in donations, and that’s happened in a lot of other cities, but in Rochester we’ve been lucky in being able to get organs. We’ve more than doubled our number of liver transplants in a short period of time. Q: Has your team been able to stay healthy? A: We’ve been following guidelines to avoid getting infected. No one on our team has tested positive yet despite working in this environment and how busy we’ve been in the operating room. Q: Have you worked on any patients with COVID? A: I do have an interesting story that’s worth mentioning. We had a very sick patient who was transferred from the Southern Tier. This patient needed an urgent liver transplant, within 72 hours or they were likely to pass away. We did a proper workup on the patient while the patient was on the urgent

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

wait list. The patient was very lucky and got a very good organ donor. It was a difficult operation and took about nine hours. Twenty-four hours later, the patient started moving his arms and opening his eyes. Three or four days after the operation, the patient was communicating with his family on social media, but he started having some respiratory issues, shortness of breath. The patient turned out to be COVID-positive. When the patient was transferred, he was COVID-negative according to the test. Whether the first test was a false negative or whether the patient acquired the virus within our hospital, we don’t know, but we moved quickly to isolate the patient, who needed to go back on ventilation shortly after coming off it from the surgery. And transplantation patients are on immunosupressants, so the prognosis was not good. The risk of mortality, according to the New England Journal of Medicine is high — there’s a mortality rate of 40% for patients who have COVID around the time of surgery. And this wasn’t a simple surgery, it was a liver transplant. When you factor in the risks from that, you’re probably looking at closer to 75-80% [mortality rate]. On top of this, we know the virus creates clots, so the patient needed anticoagulation medication, but this is after surgery where you put a lot of veins and arteries together. So there’s a lot of bleeding, and the patient had needed multiple transfusions. So after you factor that in, you’re looking, according to statistics, at a mortality rate approaching or even higher than 100%. The patient’s doing phenomenal. He’s back home, walking, enjoying life with his family. The reason I wanted to share this is because we, as surgeons, healthcare workers, we live around this virus. There’s a lot of things we can do. We need to be conscious that these things can happen, but when we work together, we can achieve good results. Despite all those risk factors, we have a beautiful story at the end. Q: Is the virus a complicating factor for patients who have had transplantations in the past? A: We also have some patients who received kidney or liver transplants from months or years ago who were infected. The vast majority of these cases were managed at home, and they were able to clear the virus like any other patient who contracted the virus. A handful required treatment in the hospital and were treated successfully.

Lifelines Name: Roberto Hernandez-Alejandro Position: Chief of transplantation and liver cancer surgery at Strong Memorial Hospital Hometown: Mexico City, Mexico Education: Universidad de La Salle Affiliations: Strong Memorial Hospital; Western University (London, Ontario) Organizations: International Liver Transplant Society; Americas HepatoPancreato-Billiary Foundation (AHPB); American Society of Transplant Surgeons; United Network for Organ Sharing Family: Wife (Ximena); Children (Julia, 18; Victoria, 17; Paulino, 13) Hobbies: Travel; supporting children’s sports; reading; exercise; watching and feeding birds

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Dreams Dashed

Finding your ‘happily ever after’ on your own

met Susan several years ago, when she attended one of my Alone and Content workshops. Below, she plaintively recalls the raw feelings she experienced following her divorce:

“I opted to end my unhappy marriage and initiate a divorce about three years ago. Since then, I’ve been on my own. It wasn’t easy back then. I was surprised to discover that many married friends no longer wanted to socialize with me, fearing I might be a threat and attract the interest of their husbands. Plus, I made my daughter the singular focus in my life, and lost contact with people. Over time, I developed the attitude that I had nothing to offer and slid into a minor depression. Finances were another issue. I had stayed home to take care of my daughter but, after my split, found it necessary to get a job to make ends meet.” Susan, like many divorced women and men, found herself bewildered and fearful of the future after her marriage ended. For many, the experience of having a marriage of many years unravel is not unlike becoming the victim of an unwelcome catastrophe.

No matter what, and even though more people are waiting longer to walk down the aisle, most still hold onto the dream of “happily ever after.” That dream is powerful. Letting go of it can seem next to impossible. I know it was for me. While getting and being divorced can feel overwhelming, most everyone presses on and, lo and behold, eventually experiences a change in attitude and perspective that ultimately enriches their lives and opens up possibilities — possibilities they couldn’t have imagined when they were in the throes of loss. Susan continued: “It’s taken me a long time to get it together. I went back to college and graduated with an advanced degree in nursing. It kept me busy, but now my daughter is preparing to leave for college. Life will be very different (and a lot quieter) without her here, so I am being proactive. I’m walking with friends (six feet apart) and I’m an active member of Meetup.com (now virtual), the social networking program that gives members safe ways to find and connect with others who share common interests — things such as hiking, reading, food, pets, pho-

tography, hobbies, etc. I also make a point of staying in touch with my colleagues at work, through email and Zoom meetings. And, I’m no longer waiting for an invitation; I’m initiating the contacts, which people appreciate. It feels good! Attending Gwenn’s workshop was the jump-start I needed to get moving. Listening to others made me realize that we were all struggling with similar issues. I no longer felt so alone and benefited from hearing how others have dealt with their challenges. When the workshop was over, I made several small, but meaningful changes at home. I now create a nice place-setting for dinner and put fresh flowers on my kitchen counter to welcome myself home. I cleaned up the clutter on my desk and am practicing meditation most mornings (it’s a work in progress). I am also planning a solo travel adventure abroad, when it’s safe to lift off. That’s a huge leap for me!” While few women and men consciously decide to live singly, more and more are finding themselves on their own in midlife. The good news? Like Susan, they are making healthy choices and finding joy on their own. While she acknowledges that there are trade-offs to being single, she has created a life that meets her needs and supports her new dreams:

Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women, and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com

“It seems to be part of a child’s disposition.” Nor do the findings mean that parents cannot do anything about picky eating, she stressed. The study merely followed families to see what happened naturally — and did not test any intervention to change kids’ habits. What does seem clear is that mealtime ultimatums do not help. In this study, mothers of picky eaters reported more efforts to control what their child consumed — including limits on sugary, fatty foods. (When kids are high on the finicky scale, Pesch noted, they often stick to those types of foods.) Despite those battles, children’s fussiness held strong. In fact, coercion is probably

destined to fail, according to Nancy Zucker, director of the Duke Center for Eating Disorders at Duke University in Durham, N.C. Zucker, who wrote an editorial published with the study, pointed to one of its key findings. Based on mothers’ responses to a standard questionnaire, the pickiest eaters also tended to be emotionally reactive in general. And those kids will not respond well to dinner-table demands — “It won’t work,” Zucker said. “These children will just shut down.” She agreed that the findings suggest picky eating is a trait. “These kids may be more harm-avoidant,” Zucker said. “And when you think about it, eating is breaking a barrier — allowing something into your body. These children hold back when everyone else is running to the food.” So what can parents do? Zucker said that making meals a pleasant experience may at least brighten children’s moods around food. And that could, at some point, ease their boundaries. Including kids in shopping and meal preparation, Zucker said, is one way to make it more enjoyable for them. Pesch agreed, adding that simple exposure may help, too. That is, keep making varied meals for the family so that the picky eater gets used to the sights and smells. “But keep it low-pressure,” Pesch said. “Don’t try to force them to ‘clean their plates.’ “

For Many Kids, Picky Eating Isn’t Just a Phase, Study Finds

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limited culinary repertoire. Still, researchers saw bright spots in the findings, published May 26 in the journal Pediatrics. For one, there were no signs that picky eaters were underweight. And the fact that the fussiness seems to be a trait — and not a failure on the parents’ part — might bring some solace. “It can be very stressful for parents to deal with a picky eater,” noted senior researcher Megan Pesch, a pediatrician at the University of Michigan’s C.S. Mott Children’s Hospital in Ann Arbor. But if parents think they did something wrong to cause it, she added, these findings suggest otherwise. “It’s not your fault,” Pesch said.

On her own, Susan has fashioned a life that works well for her. You can, too. Being single can give you the time you need (and deserve!) to sustain a diverse and interesting network of friends, to go new places, to pursue your professional or personal aspirations, and to experience adventures yet to be imagined. My advice? Don’t close yourself off from people. It’s easy to stay home (especially these days), to dig a hole and furnish it — but that’s a big mistake. Be curious, Be courageous. Research things to do and show up. Go ... even if it means going alone. Who knows what you might discover on the corner of happy and delight?!

“After my divorce, I had this dreaded thought that I would be alone for the rest of my life. I identified with Whistler’s Mother, in her dowdy dress and dour expression. I now realize that just because I choose to live alone does not mean that I am alone: Fact is, I’m surrounded by family and friends who love me.

s d i K Corner

or parents hoping their “picky” eater will grow out of it, a new study may be unwelcome news. Researchers found that choosy 4-year-olds were still turning their noses up at many foods at age 9 — suggesting their finicky eating is more of a trait than a phase. The study, which followed over 300 children, found three patterns: The majority were consistently middle-of-the-road when it came to food fussiness — sometimes shunning unfamiliar cuisine, but remaining relatively open to trying new foods. A sizable minority (29%) consistently ate everything their parents offered up. Then there was the picky 14%. From age 4 to 9, they routinely refused new foods and maintained a

I am no longer frantically, desperately seeking a new relationship or the next big thing to ignite excitement in my life. I am content to spend time either at home alone or socializing safely with small groups of dear friends. I’ve even gone on a few ‘virtual’ dates. As I’ve come into my own, I now know that I am fully responsible for making positive changes in my life. That realization is empowering. I’m engaged with others and am having fun and feeling like my old self again for the first time in a very long time.”

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

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Healthcare in a Minute By George W. Chapman

Use of Telehealth Surges: From 10% in 2019 to 46% in April

o one could have predicted that a pandemic would be the catalyst or “black swan” event for telehealth. Up until the pandemic, telehealth was infrequently used. It was approximately 10% of a typical provider’s schedule in 2019. In April 2020, it had ballooned to 46%. Industry experts are predicting that telehealth could be $250 billion a year in spending post-pandemic. Both providers and consumers are adapting to the new reality. According to a recent consumer survey by McKinsey & Company, 75% of respondents are highly or moderately likely to use telehealth services. Seventy-five percent of respondents who recently received services via telehealth were satisfied. Up until the pandemic, providers were somewhat reluctant to incorporate telehealth into their business models, primarily due to poor reimbursement from insurers. Telehealth was used mostly to reach isolated, rural or homebound patients. Because of the pandemic, Medicare began to reimburse providers for a telehealth visit the same as an office visit. Most commercial carriers followed suit. The big question is whether or not Medicare will continue improved telehealth reimbursement beyond the pandemic. The longer this pandemic lasts, the further the horse is out of the barn. Medicare would certainly face a backlash from both providers and consumers who have adapted to this delivery of care option. Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma sounds like she is hedging her bets, though, when she said that while telehealth is getting us through this pandemic, it won’t replace the “gold standard” of in-person care.

AHA Addresses Racism The pandemic has dispropor-

tionally impacted people of color. It has exposed the systemic racism in public health. Rick Pollack, CEO of the American Hospital Association, recently addressed the problem. “As places of healing, hospitals have an important role to play in the wellbeing of their communities. As we’ve seen in the pandemic, communities of color have been disproportionately affected, both in infection rates and economic impact. The AHA’s vision is of a society of healthy communities, where all individuals reach their highest potential for health … to achieve that vision, we must address racial, ethnic and cultural inequities, including those in health care, that are everyday realities for far too many individuals. While progress has been made, we have so much more work to do.”

COVID19 Vaccine

Dr. Tony Fauci is the nation’s leading expert on infectious disease. July 2020 •

As director of the National Institute of Allergy and Infectious Diseases, or NIAID, Fauci is cautiously optimistic about the development of a vaccine by bio tech firm Moderna. However, he believes the vaccine will not be a one and done solution and will most likely require boosters. Once a vaccine is approved for use, the question remains what will be its durability. It could be six months or a year or two. (It should be noted: Moderna is not the only bio tech firm developing a vaccine.) There has been much confusion over wearing masks. Fauci emphasized the three basics of mitigation are still the most effective at slowing the spread of the virus: frequent hand washing, social distancing and masks in public. The latter all the more important when inside. Meanwhile, in anticipation of a vaccine, the federal government has begun stockpiling 400 million syringes by December.

What We Know So Far

A recent article in the New York Times gave a summary. 1) We will be dealing with this pandemic for a long time. 2) Masks mitigate the spread. 3) Our public health infrastructure needs an update if not an overhaul. 4) The pandemic is hugely expensive: testing, treatment, PPE, lost wages, mitigation, etc. 5) We can’t count on herd immunity to protect us. 6) There are far more symptoms than expected or experienced. 7) We can worry less about surface transmission of the virus. It is mostly person to person. 8) We can worry less about a mutating virus. 9) Warm weather will not defeat the virus. Estimates of the cost of the virus to insurance companies, (commercial, Medicare Advantage and Medicaid) are modeled or based on infection rates. A population infection rate of 10% puts cost estimates around

$30 billion while an infection rate of 60% could cause costs to skyrocket toward $500 billion.

Reopening Healthcare

The pandemic forced hospitals and physician offices to close to non-emergent care. The cancellation of elective surgeries and routine office visits have put most providers in dire financial straits. Most have resorted to furloughing or laying off staff as bottom lines flounder. In April, CMS issued guidelines for providers to open up again for normal business. Basically, “non-emergent, non-COVID care (NCC) should be offered to patients, as clinically appropriate, in localities or facilities that have the resources to provide such care, as well as the ability to quickly respond to a surge in COVID-19 cases, if necessary. Decisions should be consistent with federal, state and local orders, and CDC guidance and made in collaboration with state and local public health authorities. Careful planning is required to safely deliver in-person care to patients requiring NCC, and all aspects of care must be considered.” If you have been putting off care, you are encouraged to contact your provider and resume your treatment or address your health concerns. 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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Dental Care

Early Orthodontics Can Shorten Treatment By Deborah Jeanne Sergeant

rthodontic braces may seem like a treatment for teens, but the American Association of Orthodontists recommends a screening — and possible treatment — to start by age 7. Instead of waiting for the permanent teeth to come in, orthodontists would rather treat children to prevent or minimize future issues. The molars are the first permanent teeth to come in, around age 6. At that point, orthodontists can tell if they’re likely to cause crowing problems, or if it’s a wait-and-see case. “Things can be done that are bone-related in the way bones grow, like a crossbite,” said Deb New, orthodontist at New Smiles Orthodontics in Rochester. “In order to correct this, we’d want to place an expander.” Early intervention can reduce the duration and possibly the need for braces later. Though there’s no guarantee a child will never need braces, “it makes a bigger problem into a smaller problem,” New said. Orthodontists monitor the bone and tooth development, spacing and placement and use appliances such as expanders in the mouth as needed to attain and keep the space children need for their permanent teeth. As

more teeth come in, the treatment plan adjusts. “Teeth come in in different stages of growth and development,” New said. “This is important for guidance and helping parents to choose when to choose the appropriate appliance.” But New added that an orthodontic screening doesn’t necessarily mean braces are needed. Most providers offer free evaluation screenings. Orthodontist Steven Hietanen at Orthodontists Associates of Western New York said that he has treated between 3,400 and 4,000 children with expanders. Many of his referrals come from dentists. Some parents bring in their children because they see crowding. Others are concerned about other functional issues. “Oral expansion can help with improvement with breathing dysfunction the child has,” Hietanen said as an example. Some children with breathing problems may have their adenoids removed as they may cause obstruction. Hietanen said that a 2019 study by the American Association of Orthodontists states that children who have breathing issues treated only with adenoidectomy experienced a 50% success rate compared with 95%

success for those treated with adenoidectomy along with expansion. “The size and shape of the upper jaw can affect how the lower jaw will develop,” Hietanen said. He referenced a University of Michigan study which suggested that of children treated with an expansion at age eight,92% show spontaneous correction of a class 2 overbite. “In the untreated control group, there’s a 6% spontaneous improvement,” he said. Some children with speech issues also benefit from orthodontic intervention. It’s all about identifying children who could benefit from early intervention and using the treatment to improve their future growth and

development instead of trying to fix a problem once it’s fully manifested. “If a child was born with hip dysplasia, they’d take that baby prior learning to walk and put him in a brace to straighten the hip out,” Hietanen said. “They wouldn’t wait until he was walking. Why would we do any different in dentistry?” Since their bones aren’t as mature at 8 as 14, the force exerted by the appliances isn’t as great. Some orthodontists use removable appliances for early treatment; others, including Hietanen, prefer fixed appliances to better ensure compliance. He said that younger children are often more eager to please their parents and take better care of their appliances.

Should You Worry If Baby Teeth Get Cavities? By Deborah Jeanne Sergeant

t may seem of little consequence if baby teeth get cavities since they’re just going to fall out to make room for permanent teeth. But orthodontists place a good deal of value on keeping a child’s original teeth healthy. “We want to maintain baby teeth,” said Deb New, orthodontist at New Smiles Orthodontics in Rochester. “As teeth grow, they go where there’s space. If they lose a baby tooth prematurely, it can cause teeth to move where there’s space.” It may not be the most ideal space. Orthodontist New calls baby teeth “space maintainers” because as a tiny tooth falls out, the neighboring baby teeth still in place help prevent the permanent tooth coming in from going askew. For some teeth, the baby teeth help provide an even bigger space for permanent teeth. “Second molars, one of the last baby teeth to erupt, are wider front to back than the permanent tooth that will grow in,” New offered as an example. “That’s why we like to maintain these teeth,” she said. Orthodontist Steven Hietanen with Orthodontists Associates of Page 8

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Western New York, said that baby teeth also help in developing the arches to the proper size. Baby teeth lost too early can mean the tongue is in a different, unnatural position. “Space loss can occur and subsequent crowding will raise the risk for extractions for the future in orthodontics,” he said. As many as 10% of the general population is missing permanent teeth, meaning that an expected permanent tooth never comes in. “Sometimes, when permanent teeth are missing, we elect to save baby teeth as their replacement,” Hietanen said. “If no one has taken X-rays to ensure they have all their permanent teeth and makes the assumption the baby tooth will just fall out and you find out there’s no tooth under there, it’s a miscalculation.” Hietanen said sometimes he has a new patient as old as 14 who then learns teeth are missing. Proper oral hygiene can help children keep their baby teeth for as long as they’re needed. Leaving it up to the children is likely not the best strategy. New encourages parents to monitor brushing with fluoride toothpaste — at least twice dai-

ly — for two minutes each session. Daily flossing is also important, as it removes plaque before it has the chance to harden onto the teeth. The child’s dentist can provide help in teaching proper technique. As recommended, a fluoride dental rinse can help improve oral health, especially for children who live in cities that don’t add fluoride to the drinking water. Children can be seen by their dentist early to get acquainted, become accustomed to dental examina-

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

tions and develop a relationship of trust. Parents should also set a good example of keeping up with their own home care and scheduled dental visits. “We don’t like kids to be fearful of going to the dentist,” New said. “In our office prior to COVID, we have games and contests to keep it fun. We want to make the experience as fun as possible.” Dental cleanings and exams twice a year or more often if recommended can also prevent problems.

Things You Need to Know About Pediatric Dental Care

“You want to have kids avoid gummy bears, jelly beans and fruit roll ups,” says chairman of URMC’s division of pediatric dentistry By Ernst Lamothe Jr.

avities are one of the most common chronic childhood diseases in the United States. About one in five children aged 5 to 11 years have at least one untreated decayed tooth, while one in seven adolescents aged 12 to 19 years have at least one untreated decayed tooth, according to the Centers for Disease Control and Prevention. Often this occurs because tooth care was not as vigorously done during their younger stages of life. “The importance of oral health simply cannot be underestimated,” said dentist Sean McLaren, chairman of pediatric dentistry at University of Rochester Medical Center. McLaren offers five tips to early tooth care.

Early maintenance Many parents believe their role in their child’s oral care begins when beginnings of the first tooth start appearing. However, there is work to be done before. A few simple routines after the first feeding and before they go to sleep can help wash out food, sugar and any bacteria that begins when they eat solid foods. “You want to start practicing good oral care before the first tooth arrives. Use a wet washcloth and clean around the gums two to three times a day so your baby can get

used to brushing,” said McLaren, who is also a board-certified pediatric dentist. “Once the first tooth starts to erupt, usually six months in, is when you want to start introducing toothpaste.”

Fluoride use Fluoride varnish can prevent about 33% of cavities in baby’s teeth, according to the CDC. Children living in communities with fluoridated tap water have fewer cavities than children whose water does not contain fluoride. Fluoride in water is the most efficient way to prevent one of the most common childhood diseases; tooth decay. The American Dental Association estimated 51 million school hours and 164 million work hours are lost each year due to dental-related illness. Some fluoride is also naturally present in groundwater and the oceans. “Fluoride is often recognized as one of the top measures for tooth decay prevention,” said McLaren. “You should brush your child’s teeth twice a day with fluoride toothpaste. Fluoride in water is truly a public health benefit.”

Wear a mouthguard Without a mouth guard, there is potential for a collision that could cause teeth to be broken, knocked out or chipped.

Healthly diet Eating the wrong foods continues to be a risk factor for heart disease and stroke. But making incorrect choices with your diet also has a ripple effect with your oral health. “You want to make sure you are careful with sugar, sticky food and dried fruit because they stick to your teeth, cause tooth decay and cavities. You want to have kids avoid gummy bears, jelly beans and fruit roll ups,” added McLaren. “Stay away from juices with a lot of sugar or even chocolate milk. You can’t go wrong with water.” monitoring is in place to detect and respond to an outbreak at the school. “It’s not a question of if, it’s a question of when there will be an outbreak, because there will be outbreaks. We know that. We can expect and plan for it,” said Dimitri Christakis, director of the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute.

Will Schools Reopen This Fall? What Will That Look Like? he boisterous bustle of students jostling down crowded hallways to reach lockers and classrooms has long served as one of the most powerful memories of high school life for many. Those loud, happy throngs might now belong to a bygone era, thanks to COVID-19. Schools planning to reopen in the fall are weighing what’s called the “pod” approach, in which middle and high school students remain isolated with their peers in the same classroom all day, said Dan Domenech, executive director of The School Superintendents Association. The traditional between-class hallway jam “really is conducive to infection, as opposed to isolating them in the same room for the whole day,” Domenech said. It’s one of many ways that schools might operate differently in the days of COVID-19, if infection

Tooth protection may also aid in preventing immediate or future expensive dental care. “We see a lot of dental injuries with kids that play contact sports,” said McLaren. “You have people being elbowed in sports where there is constant action. You can either get a custom mouth guard or a generic one that protects your teeth.” McLaren adds that a mouthguard is useful for more than just your teeth. “A guard can protect your bottom jaw from colliding with your top jaw and lessen the force of the blow. That has been known to decrease concussions since the top jaw is not moving upward in the mouth and affecting the brain.”

Most kids not vulnerable

rates in their communities even allow them to reopen next school year. The U.S. Centers for Disease Control and Prevention recommends that middle and high schools consider adopting the elementary school model, in which “high school kids remain in the same room and the teachers move around,” Domenech said. Staggered school hours would make sure hallways remain relatively empty as students enter and leave the building. There’s even talk of keeping the cafeterias closed and serving the kids lunch in their classroom “pod,” so they remain in the classroom nearly all the school day. A CDC checklist holds that schools should feel safe reopening if COVID-19 outbreaks are contained in their communities; teachers and students have been drilled on the importance of hand hygiene, face masks and social distancing; and ongoing July 2020 •

Parents should feel reassured about their child’s safety in going back to school, said Christakis. “If a child gets COVID, there’s a one in 1,000 chance that they will be hospitalized with it, and there is a one in 100,000 chance they will die from it,” Christakis said. “Those are long odds, as they say. Your child’s risk of getting hit by lightning over the course of their lifetime is one in 15,000, to give some perspective.” Precautions put in place at schools to prevent outbreaks are instead designed to protect adults -teachers, parents and family members, Christakis explained. “We know children themselves are at very low risk of getting sick with COVID. We don’t know how big a risk they pose to pass COVID on to either teachers or family members,” Christakis said. “It’s unfortunate we don’t know that, because that would make our decision-mak-

Dentist Sean McLaren is the chairman of pediatric dentistry at University of Rochester Medical Center.

Visit your doctor and floss Regular visits to your dentist for teeth cleanings every six months can help early detection of potential problems. Experts want people to floss once a day when they are young and continue that into adulthood. It prevents food and other particles from being trapped within the barriers. Make sure to floss between and around each tooth. Gently hook the floss like a C around the tooth. Slide the floss up and down and around all tooth surfaces, even the hard-to-reach back molars. Avoid snapping the floss between teeth. “Visiting your dentist will also help you clear up any myths. My mom used to tell me she had soft teeth which is pretty rare for someone. Cavity is the main bacteria that erodes teeth,” said McLaren. “You can have some heredity problems when it comes to your teeth so you want to be aware of your family history.” ing a lot easier. We don’t know how contagious they actually are.” The CDC recommends that schools reopen with plans to routinely clean and disinfect surfaces and objects that are frequently touched, stagger arrival and dismissal times for students, avoiding mixing students in common areas, and increasing the space between desks. Time-honored traditions like “Career Day” likely will fall by the wayside, as schools are being encouraged to limit all non-essential visitors. It also could be some time before kids attend group events that promote school spirit, such as student assemblies, school sports, student concerts and dances. The CDC is asking schools to reconsider any event that would bring kids in close contact with each other. Parents also should be ready for the school to be closed at a moment’s notice, in the event of an outbreak. The CDC recommends students and most staff be sent home at least two to five days upon finding a confirmed case at a school, so health officials can perform contact tracing and staff can disinfect areas used by the infected person. All these changes are going to take place amid ongoing turmoil at schools related to both the COVID-19 pandemic and its effect on the economy, Domenech said.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

signed to help those who have Down syndrome improve muscle tone? A. We have a signature program called GigiFIT for different age levels and abilities. The program is a physical therapy-based program that was scientifically designed to specifically target the low muscle tone and strengthen the muscle tone of individuals with Down syndrome. We also have some recreational programs and a gym, and we open the Playhouse on our open-play days for families.

Excellus Responds to Pandemic with $162M for the Community’s Health Care

xcellus BlueCross BlueShield expects to spend at least $162 million on its comprehensive response to the COVID-19 pandemic. The health plan is funneling more than $1 million worth of grants for testing supplies and personal protective equipment to Upstate New York hospitals and area health care workers. It is also working with regional business groups to help employers and their employees return to work. “No one has faced a public health crisis like COVID-19 in the almost 90 years that our health plan has provided coverage in Upstate New York,” said Christopher C. Booth, president and CEO of Excellus BlueCross BlueShield. “This crisis requires a strong and comprehensive response to assure our members are able to receive the care they need and to help assure the system will survive. The pandemic significantly impacted the economy, sickened tens of thousands of people and continues to threaten Upstate health care.” With the state’s stay-at-home order and the suspension of elective medical procedures, Excellus BCBS expanded access to telehealth, trained physician offices how to use it, and increased the reimbursement to providers for these services. This allowed many local provider practices to continue to see patients using remote technology and replace lost in-office revenue. That expanded coverage and the increased reimbursement associated will cost at least $80 million in 2020. The health plan will absorb a $12 million reduction in Medicaid rates from the state this year, rather than pass it on to providers. Restoring some Medicare fees for providers that had been cut at the federal level added an additional $6 million in cost this year. For members, Excellus BCBS absorbed the cost of member outof-pocket expenses for the diagnosis and treatment of COVID-19, medically appropriate testing, as well as absorbing the member cost share for all telehealth visits. These steps are adding about $9 million in cost this year. The $162 million in unbudgeted spending is being funded through the health plan’s reserves. The comprehensive response is in addition to $192 million in cash advances the health plan had extended to most of the 70 Upstate hospitals in its network prior to the pandemic outbreak. “Our priority in this crisis continues to be taking care of the customer and making sure members have access to the care they need,” Booth said. “We are starting to see an increase in claims from the pent-up demand for elective procedures and routine care that may have been put off during the quarantine. We are also still bracing for a possible second wave in COVID-19 related costs later this year. We hope it doesn’t come. We must be prepared if it does and we are ready.”

Page 10

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Q. Does Gigi’s offer services for the families of those who have the syndrome? A. We offer lots of parent support groups. They [parents] discuss everything from education to living independently, to just the daily struggles of learning, and the best ways for them [participants] to learn. We also have a group of family members who have their own children with Down syndrome who are a huge resource for us to reach out on a more personal level to families that are facing any type of need for support.

Q A &

with Amy Shulman Site Coordinator for GiGi’s Playhouse Rochester A different kind of playhouse — helping those with Down syndrome By Mike Costanza

hicago-based GiGi’s Playhouse helps those who have been diagnosed with Down syndrome and their families cope with the syndrome’s effects. Amy Shulman, site coordinator for GiGi’s Playhouse Rochester, spoke to In Good Health about the nonprofit, and the services it offers locally. Q. What is Gigi’s Playhouse? A. We are a nonprofit Down syndrome achievement center that provides free therapeutic and purposeful programming to individuals of all ages who have Down syndrome — we call them “participants” — and their families. We have families that contact us if they end up getting a prenatal diagnosis. We start working with them at that point, and we see them throughout the participant’s life. In the Rochester Playhouse, we service over 400 families. Q. What is Down syndrome, and what are its effects? A. Down syndrome is a genet-

ic disorder. The individual is born with an extra copy of the 21st chromosome, which causes them global intellectual developmental delays. Q. Could someone with Down syndrome work as a computer programmer? A. Absolutely they could. It would take additional effort, probably. Perhaps even assistance — an aide — or they may just need more time than the average individual to achieve whatever they’re trying to achieve. Most of our individuals probably won’t drive. Q. How does Gigi’s Playhouse help its charges prepare for life? A. We offer one-to-one-tutoring in speech, math and literacy for all age groups, from ages 4 on up throughout adulthood. We also offer them independent life skills and socialization programs, and the chance to work one-to-one with our speech and language pathologists. Q. What GiGi’s programs are de-

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

Q. How has New York state PAUSE and its restrictions affected the Gigi’s Playhouse’s operations? A. COVID-19 hit everyone hard, and it especially hit our organization hard. We are not an essential service, unfortunately. Currently [as of midJune], we have no in-person programing or play programs. No one comes into the premises. Q. What has GiGi’s done to continue serving its participants? A. Our national office in Chicago set out when the world shut down on March 13. In five days, they were able to launch all of our programs virtually on a GoToMeeting [online meeting] platform. We now offer over 250 on-demand and live programs online daily. Q. Does GiGi’s charge for its services? A. What we do at the playhouse is offered free. We are 100% funded by local donations, and grants from local businesses, and we are 99% run by volunteers. We only have three employees. Q. Has the shutdown affected your fundraising programs? A. On March 14 was supposed to be The Red Carpet Affair Gala, our largest fundraiser of the year. We had over 500 attendees registered, and we had to cancel that event. Q. You held the Step To Accept Challenge on June 6. What was it? A. It was a fundraiser for all 60 Playhouses and startups across the US and Mexico. It’s a virtual walk, bike and run challenge. All the Playhouses raised over $1 million through registrations and donations. Q. Monroe County is currently in phase two of Gov. Andrew Cuomo’s plan for restarting the state’s economy. When do you think Gigi’s Playhouse will open? A. We don’t foresee being able to reopen probably until the fall. That would be mainly because the individuals that come to our Playhouse fall under very, very, very high risk. Having Down syndrome makes them very susceptible to any illness. n For more information about GiGi’s Playhouse Rochester, go to: https://gigisplayhouse.org/rocheste

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

Numbers to Follow for Good Health

o maintain good health, it’s all in the numbers that measure key indicators of health. These include blood pressure, cholesterol, minutes of activity per week, sleep, weight, blood glucose (if diabetic) and waist size. By Deborah Jeanne Sergeant

Tahir said that high cholesterol can indicate inflammation in the body, which has been linked to multiple conditions, such as autoimmune disorders, cancers, heart disease, and dementias.

Physician Az Tahir, who practices holistic medicine in Rochester, said that blood pressure is one of the vital signs because it’s associated with stroke and heart attack. “When blood pressure goes up, it affects the circulation,” Tahir said. Blood pressure should be less than 120/80. “Blood pressure is the silent killer,” said physician Michael Dlugosz, with High Gate Medical Group in Williamsville. “It doesn’t have symptoms until it causes a heart attack or stroke. You want to prevent it when you’re not symptomatic.” That’s why periodically checking it is so important.

Cholesterol and Triglycerides

The LDL (“bad”) cholesterol should be under 160 and HDL (“good” cholesterol) over 40 and triglycerides under 150 for generally healthy people Dlugosz starts checking cholesterol for men at age 35 and women at 45 because men have more cardiovascular risk. But he cautioned that anyone with risk factors should start at about 20 years old if they’re overweight, smoke or have hypertension. “There’s been a dynamic shift following the numbers,” Dlugosz said. “Those are screening tests, not a perfect look into your body chemistry. It’s as good as we can get but still not great. If there’s a history of stroke or heart attack, we don’t focus on the numbers, but if you’re adequately treated with a cholesterol medication.” Once a diabetic patient turns 40, Dlugosz automatically prescribes a cholesterol medication because their heavier, stickier cholesterol more readily adheres to the walls of blood vessels. Even if their cholesterol is under control, that risk factor of stickiness is enough to validate mediation. Page 12

Blood Pressure — ‘The Silent Killer’

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Minutes of Exercise Per Week

To maintain weight, a person needs 150 minutes of moderate exercise weekly or 75 minutes of vigorous exercise. “When you’re talking about what’s moderate, I look at heart rates,” Dlugosz said. To find the target heart rate, subtract your age from 220. Moderate intensity exercise should be between 64% and 76% of the target heart rate. Vigorous exercise should be between 77% and 93% of the target heart rate, according to the Centers for Disease Control and Prevention. “That’s when you’re maximally active,” Dlugosz said. “Everyone’s will be a little different based on age and physical fitness.”

Weight

Most health care providers use the body mass index to determine a patient’s ideal, healthy weight; however, the body composition can make a difference. A very muscular body builder may have a higher BMI than a lighter but less fit person. “A number of studies have shown that being overweight is tied to heart disease, diabetes, fatty liver and other very serious health concerns,” Tahir said. “If it’s on the belly or the person has a pear shape, it’s riskier. Many people think of it for appearance, but treating it can reverse many disease processes.” In general, Dlugosz said that a BMI between 20 to 25 is ideal. For most people, less than 20 is underweight. Between 25 and 30 is overweight, over 30 is obese and over 40 is morbidly obese. BMI calculators are available online such as at www. nhlbi.nih.gov/health/educational/ lose_wt/BMI/bmicalc.htm. Dlugosz helps patients who need to lose weight to set small goals, such as losing a small amount of weight between visits, improving their food choices and increasing the number of minutes they exercise. “Those small steps go a long way and they often come back very satisfied if they lose more than their goal,” he said. “We don’t want them to leave feeling overwhelmed.

Hours of Sleep

Most experts agree that between seven to nine hours of nightly sleep are recommended, and more for children. “It helps emotionally and physically,” Dlugosz said. “The more sleep deprived you are, the more in a state of stress you are.”

A1C Blood Sugar Test

Diabetics should have their A1C blood test reading under 7 “to help prevent eye and

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

kidney problems and neuropathy,” Dlugosz said. Pre-diabetes is identified between 5.5 and 6.6. In general, the A1C is administered annually for those who have prediabetes; biennially for those with type 2 diabetes who don’t use insulin and have their blood sugar level within their target range; and quarterly for Type 1 or Type 2 diabetics. “People can check it at home and not just diabetics,” Tahir said. “People who are not diabetic should check it once in a while.”

Waist Circumference.

More than just for vanity, waist circumference can indicate weight gain that has been linked with cardiovascular disease. “If I see a person that has central obesity in the belly, that’s when I focus more on circumference and changes in inches,” Dlugosz said.

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Little Raspberries Score Big on This!

hen it comes to a food’s nutritive profile, unexpected discoveries (good or bad) intrigue me. Pale cauliflower high in vitamin C? Who knew? Fibrous celery low in fiber? Didn’t see that one. Rich avocados full of healthy fats? More toast, please! So you can only imagine my delight when I discovered that raspberries — sweet, little raspberries — rock with more fiber than any other fruit: 8 big grams per cup. Since we need between 25 to 30 grams of fiber a day, that’s about a third of our daily needs. A vital nutrient, fiber promotes regularity, lowers cholesterol levels, helps control blood sugar levels, and may even help us live longer by reducing the risk of dying from cardiovascular disease and many cancers. Another discovery? Luscious raspberries are surprisingly low in sugar: only 5 grams per cup (about a teaspoon of sugar). As a comparison, one medium apple has about 20 grams. Equally low in carbs, raspberries are an excellent choice for anyone who wants to minimize their overall sugar and carb intake. Raspberries, like most berries, are full of antioxidants — health-protective compounds that have been tied to lower rates of heart disease, cancer, diabetes, obesity and other chronic diseases. These same antioxidants also help toreduce inflammation, a known trigger of premature aging. On top of everything, a particular type of antioxidant found only in red berries is so strongly associated with brain health and delayed cognitive decline that weekly consumption of berries is highly recommended by many leading health organizations. On the vitamin front, raspberries dish up a healthy dose of vitamin C: about 50% of our daily needs in just one serving. Essential for the growth and repair of tissue body-wide, vitamin C helps to increase the production of infection-fighting white blood cells, which is why many of us turn to vitamin C during cold and flu season and are seeking it now. Those looking to lose or maintain weight will appreciate raspberries’ nutrition stats: only 64 calories per cup and no fat, cholesterol or sodium. What’s more, raspberries’

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Fresh raspberries are highly perishable; use as soon as possible after purchasing or picking to ensure the best flavor and appearance. Choose berries that are ripe, plump and firm. Wash gently and pat dry right before eating or cooking. If not using right away, refrigerate unwashed raspberries in a shallow, covered container on a paper towel for up to 3 days. Be sure to toss any spoiled or moldy berries so they will not contaminate the others.

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Spinach, Goat Cheese and Raspberry Salad Adapted from Cooking Light Serves 2-4

2 tablespoons extra-virgin olive oil 5 teaspoons balsamic vinegar ½ teaspoon honey ¼ teaspoon Kosher salt (or more) ¼ teaspoon coarse black pepper 1 clove garlic, minced ¼ cup chopped red onion (optional) 1 (5-ounce) bag baby spinach (or more) 1 cup raspberries ½ cup chopped walnuts, toasted ¼ cup (or more) crumbled goat cheese or feta Combine first 6 ingredients in a small bowl; blend with a whisk. Combine onion, spinach, berries and walnuts in a large bowl. Drizzle dressing over the salad; toss gently. Top with crumbled cheese and serve.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

Emotional Abuse; Women Are Often the Target

Women’s Health

By Deborah Jeanne Sergeant

ne in four women and one in seven men will be victims of at least one incident of severe physical violence by an intimate partner — not a stranger — in their lifetime, According to the Centers for Disease Control and Prevention. Many people do not realize that emotional abuse often precedes physical abuse. Emotional abuse is far different than a spat between partners. “There can be a lot of disagreements, but those are over the natural course of any relationship,” said Eric Schantz, licensed mental health counselor in private practice in Pittsford. Emotional abuse is a repeated pattern of coercion and control using manipulation. Every person occasionally acts snappish or hurtful. Emotional abuse is when a partner gains dominance through consistent use of intimidation, bullying, cruelty, name-calling and humiliating. Gaslighting is yet another tactic of abuse. With gaslighting, the abuser contradicts the victim’s memory of the past to cause the victim to doubt the memory of past comments or events for the purpose of undermining confidence and others’ trust. (“You’re forgetful — as always.” or “That’s crazy; it’s not what happened at all.” Or “You must have misheard me; that’s not what I said.”) According to experts, using gaslighting helps the abuser “rewrite” the past to gain the upper hand by downplaying their offenses, appearing as victims and presenting the true victim as a wrongdoer. Schantz said that oftentimes, the abuser is an active substance addict or has a personality disorder such as psychopath, pathological narcissist, or borderline personality disorder. It’s ineffective to compare interactions with an abuser like this with

Signs a Woman Is Experiencing Abuse The US Department of Health’s Office of Women’s Health lists the following signs of experiencing emotional or verbal abuse if someone: • Wants to know what you’re doing all the time and wants you to be in constant contact • Demands passwords to things like your phone, email, and social media and shows other signs of digital abuse, like repeated unwanted calls/texts; harassment on social media; pressure to send

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interactions within a normal relationship. Anne Graham, licensed mental health counselor in private practice in Rochester, said that for the most part, victims are women, who “tend to see their value as being in a relationship with a man.” Women also tend to be won over by words rather than waiting for action. “A lot of women think they’re in love relationships which are not love relationships. They want to be with a guy and be in a family.” This vulnerability generally makes women easier targets for abusive men. Initially, they’re treated very well. In fact, abusers sweep them off their feet in a whirlwind romance. It’s like a storybook. The victim feels so lucky and dazzled by how attentive and thoughtful he is. He lavishes her with gifts and flattery. It feels like the love of a lifetime. He slowly begins to exert more and more control over the victim and usually under the guise of “protecting” or “helping” her. He isolates her nude or private pictures (called “sexting”); using texts or social media to check up on you, insult you, or control whom you can see or be friends with; and demanding that you reply right away to texts, emails, and calls • Acts very jealous, including constantly accusing you of cheating • Prevents or discourages you from seeing friends or family • Tries to stop you from going to work or school • Gets angry in a way that is frightening to you • Controls all your finances or how you spend your money • Stops you from seeing a doctor

from friends and relatives that would spot any problems or support her if she considered leaving. Abusers do this by eroding her trust in others and even accusing them of wrongdoing to drive a wedge in her other relationships. If the emotional abuse begins to lose effectiveness in controlling her, that’s when physical violence usually begins. By this point, she is so emotionally (and likely financially) dependent upon him that leaving is extremely difficult. On average, it takes a woman seven attempts to successfully leave. Ironically, safety is one of the reasons it’s hard to leave. Many abusers threaten harm to the victim’s originating family, children or property, or even themselves. “If there’s any chance of physical danger, they need to be extremely careful,” Graham said. “If it’s emotional abuse, if you’re unhappy, you have to decide do you want to do anything about it. If you want to do something about it, you have to fig• Humiliates you in front of others • Calls you insulting names (such as “stupid,” “disgusting,” “worthless,” “whore,” or “fat”) • Threatens to hurt you, people you care about, or pets • Threatens to call the authorities to report you for wrongdoing • Threatens to harm himself or herself when upset with you • Says things like, “If I can’t have you, then no one can” • Decides things for you that you should decide (like what to wear or eat) In addition, more subtle signs the victim may experience include: • You experience non-specific

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

ure out what are your options? You need to build a support system.” That may include repairing relationships that the abuser has damaged and seeking help with a trained counselor. Well-meaning friends who want to “patch things up” between them likely will make things worse. The abuser is very likely to retaliate against her in private. He cannot see that he’s done anything wrong and will blame her for “causing problems” in the relationship. Hoping the abuser will change, staying for the children’s sake or thinking that couple’s therapy will help are all reasons victims stay. But abuse is not a marriage problem; it’s one-sided. Schantz said that batterer counseling is usually done under a court mandate or other outside motivator, such as the wife threatening to report his behavior. He added that the batterer usually won’t finish or else won’t apply the information to himself, believing it’s the partner who’s the problem in the relationship. He added that the chance that someone with a personality disorder will change are “about zero.” Anger management classes won’t help, either since anger doesn’t cause the problem. Goodtherapy.com states, “Research shows that men who are abusive often lash out at their partners or spouses with the intent of enforcing what they believe to be their rights, but that they are generally able to keep from reacting in an abusive manner when individuals other than their wives or children do not meet their expectations. This behavior is rooted in logic, demonstrating rationalization that makes it less likely that battering behavior stems from a mental illness, although it may in some cases.” Most of the time, leaving the relationship is the only option when abusers have a personality disorder. Among those who are chemical dependent, only those who are willing to complete rehabilitation have hope of stopping battering. “A person getting sober means their ego deflates,” he said. “They have humility and can do acts of love and service. They can have fellowship and know there’s a higher power of some sort. That’s very humbling and I do see rays of sunlight. I have had clients who’ve had alcoholic partners and when they get sober, they stay together.”

dread of spouse’s return when you’re apart. • You cannot count on him to stick up for you or support reasonable emotional needs. • He will not take your thoughts or ideas seriously. • He teases you in ways you do not like even though you have asked him not to. • He speaks disrespectfully of groups with which you identify to draw you into a conflict and then blames you for “starting a fight.” • He has low regard for your emotions and little capacity to understand them.

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Page 15

Women’s Health

Charcoal Masks Cleanse, Tighten Skin By Deborah Jeanne Sergeant

ctivated charcoal masks have become a popular facial treatment, available both at spas and over the counter at stores. “A charcoal mask is detoxifying and can help people who suffer from blemishes and acne,” said Therese Oaks, aesthetician at Luxe Spa in Rochester. “It is tightening and can be clarifying for sure.” Users apply a warm towel to the face to open pores. Next, they apply the charcoal mask to the skin with ei-

Elizabeth Flaherty, owner of The Mask Room in Webster

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ther clean fingertips or a brush, keeping care to avoid the eyes, eyebrows, mouth, hairline and inside the nose. Once they’re done applying the mask, the user then allows it to dry for 10 to 15 minutes before removing it. Depending upon the type of mask used, they may peel it off and clean off any leftover bits with a wet washcloth or clean it off entirely with a wet washcloth. A charcoal mask may also be used in problem areas that are prone to excess oil. The masks can pull hair during the process of mask removal. Elizabeth Flaherty, owner of The Mask Room in Webster is a licensed aesthetician and has used charcoal masks for years, among the other types of masks she offers. “It’s been pretty popular in the dermatology world,” she said. “Charcoal masks basically balance the sebum and oil in your skin. They’re typically used for acne-prone and oily skin. “Charcoal has a boding agent to it so it’s used for quite a few things. They bond with most substances quite well. That’s why they’re great for detoxifying. Normally, they have an exfoliation property to them as well.” For this reason, charcoal masks are not recommended for dry skin. Oddly, many people aren’t accurate in understanding their skin’s issues, according to Flaherty. “People with oily skin may have dehydrated skin as well,” Flaherty

said. “They may have skin flaking off and skill have acne. A lot of people confuse dry skin with dehydrated skin.” This is why seeking help from a skin care professional can help determine what’s going on and what products can help keep the skin clear without blemishes or flaking. Flaherty said that the charcoal masks available at stores tend to have more of a glue-like consistency, which can make them peel right off. Especially if they are overused, they can cause irritation. “If you’re overusing them, you can take out too much oil or leave

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

your skin un-hydrated so you have more dry skin than oily,” Flaherty explained. “If you use it too much your body thinks, now I need to make more oil. You could end up with more oil coming out of you.” As for how often is often enough, that depends upon many factors, such as skin type, age and hormone levels. It may be as often as weekly initially and then every month thereafter. “Charcoal masks are great for your skin,” Flaherty said. “If overused, it can peel off some of your skin, so you could end up with some redness.”

Women’s Health

Rochester Center for Sexual Wellness Opens in Penfield By Deborah Jeanne Sergeant

any issues involving intimate relationships, gender and menopause overlap and also represent some of the most sensitive health concerns patients encounter. That’s why physician Pebble Kranz founded Rochester Center for Sexual Wellness (RCSW) in 2017, which offers an array of services under one roof and in a collaborative fashion. The practice recently announced an expansion — it’s moving from a one consultation room in Brighton into a larger facility in Penfield, which includes four consultation rooms, a group room and an exam room. “Sexual function touches all aspects of a person’s wellbeing and the treatment of sexual concerns requires knowledge and skills spanning medical, mental health and relational approaches,” Kranz said. “We felt our community needed a multidisciplinary center to help people meet their wellness goals.” While urologists, gynecologists, mental health therapists and others can address the various pieces of these issues, Kranz believes that by developing an integrative team to address the complex facets of patients facing intimacy issues, patients can receive more comprehensive and efficient care. “They’re wonderful providers who look at the whole person,” Kranz said, “but when there’s a sexual concern, there’s a bio-psycho-social approach that is really critical for evaluating sexual concerns. They have to do with more than the one square foot of the body, but emotions, private thoughts and oftentimes, they have to do with values and cultural beliefs. It relies on an approach to the whole person and not just the body.” Housing a multi-disciplinary team in one building also makes it

easier for patients who need a combination of treatments, such as mental health therapy and medical approaches. Instead of referring patients to providers in other locations, Pebble Kranz care providers at RCSW can send patients just down the hall. Not all the providers at RCSW accept insurance; however, “We work with clients about payment if that’s a problem for them,” Kranz said. She hopes to expand RCSW’s services to include related fields such as pelvic floor physical therapy, which can help with issues such as pain during intercourse, constipation, chronic lower abdominal pain and continence. Because so few providers offer the type of care RCSW provides, Kranz said that the office serves patients from a two hours’ drive away. “There’s a big access issue,” she said. “I don’t know of anywhere in the Northeast US, outside of New York City, that that’s providing this kind of integrated collaborative care for sexual issues. It’s pretty rare even in major metro areas, particularly a center that is addressing the needs of people of all genders. “We hope to be a resource for people here. We want people to feel like there are resources and solutions to their concerns that are often very tender and difficult to talk about. And we also want people to know that there are a lot more kinds of solutions than they might imagine, medical solutions and therapy solutions.

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Love During Lockdown: Survey Shows How Couples Have Coped

s U.S. states issued stay-athome orders in March and April, one of many questions was how couples would fare under lockdown together. Now a new survey offers an initial snapshot: some more arguments, regular declarations of love, and a good dose of same-old, same-old. The survey included close to 2,300 U.S. adults who were living with their partner when the pandemic hit — forcing most to hunker down at home. For some couples, the extra together time caused friction: One-quarter of respondents admitted to more arguments with their partner. However, about as many claimed to be squabbling less than usual, while the remaining half were maintaining their status quo. Many couples were holding

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

steady when it came to sex, as well. Two-thirds of respondents said they were having sex with their partner at their normal frequency -- which, on average, worked out to the awkward statistic of 2.5 times per week. Some people — 16% — were having sex less often than their norm, but even more (28%) said their sex lives had heated up since lockdown. Researchers said it’s no surprise that U.S. couples are having a range of experiences. Much depends on what their relationships were like before lockdown, and what their present circumstances are like — a cramped apartment versus a spacious home, or financial security versus insecurity. “For couples who were already in a strained relationship, this probably created even more strain,” said lead researcher David Frederick, an associate professor of health psychology at Chapman University in Orange, Calif. And yes, he said, there’s a distinct possibility that strain will lead to breakups — as research into other traumatic events, like the 9/11 attacks, has found. “A disaster or pandemic can push some couples to become more stressed and argue more, leading them to break up,” Frederick said. “It can also make them question if this is the relationship they want to spend their life in.” Jacqueline Olds, a psychiatrist at McLean Hospital in Boston, agreed that some people have likely been rethinking their lives and plans for the future. In lockdown, she said, “you can’t distract yourself in the ways you used to.” To the extent that people use that time to self-reflect, Olds said, some might decide their current relationship is not what they want. That’s one side of things. Most couples surveyed, however, reported no big changes in their relationship, or said they were arguing less, or having sex more often. And overall, 84% said they and their partner exchanged an “I love you” at least three times a week. Almost two-thirds were snuggling and cuddling that often. “For some couples,” Frederick said, “the safer-at-home order was a positive shock to the system. It allowed them to spend more time together and to become more emotionally and physically intimate.” So for them, the current moves toward reopening may actually be an issue as the old routines and distractions return.

By Jim Miller

How to Make the Most of Your Telehealth Appointment Dear Savvy Senior, I manage a large doctor’s clinic that treats hundreds of seniors each month. We are moving to more telehealth visits to help keep our patients safe at home during the coronavirus pandemic, but this new way of seeing a doctor is befuddling to many of our elder patients. Can you write a column educating patients on how to prepare for a telehealth appointment? Regular Reader

Dear Reader, I’d be happy to help! To help keep patients safe and at home during the coronavirus crisis more and more doctors and other health care providers are turning to telehealth (a.k.a. telemedicine) appointments, which are remote e-visits using a digital communication device like a smartphone, tablet or computer. Although telehealth has been around for a few years now, recent updates to regulations and a surge in demand has made it the easiest way to get many different types of medical care. Most telehealth appointments today tend to be primary care or follow-up visits that can assess symptoms or check on people who have had a medical procedure. Telehealth also works well for some specialties like dermatology or mental health care (counseling/therapy) services.

What to Expect The first step is to call your doctor’s office to find out whether telemedicine visits are available and whether you will need to set up an account or install special software on your computer, phone or tablet. Until recently, doctors were required to conduct telehealth visits through platforms such as Doxy, Thera-Link or MyChart that were compliant with the Health Insurance Portability and Accountability Act — or HIPAA. But some of those requirements have been relaxed in the current crisis, so many providers are using popular apps such as FaceTime, Skype and Zoom to conduct visits. Once you know what technology

you will be using, get familiar with it. You don’t want to spend the first 10 minutes of your visit trying to figure out how to unmute the audio. For older patients that aren’t familiar or comfortable with technology, ask a relative or friend with a smartphone, tablet or laptop to assist you. Take the time to clarify the purpose of the televisit before it begins. Prioritize a written list of three or four issues you want to discuss with your doctor and make a list of the medicines you’re taking, along with the dosages. Also, have relevant medical devices or logs on hand, such as a penlight or smartphone flashlight for viewing a sore throat, a blood-pressure cuff and thermometer (or recent readings), blood-sugar logs if you’re diabetic or a food log if you have gastrointestinal problems. If you’ve received medical care at different places, such as an urgent care facility or another doctor’s office, have your latest medical records with you during the telemedicine visit. Wear loose clothing that will allow you to show your medical provider what is concerning you. The length of the appointment may depend on the problem. A routine visit could be very quick, while others, such as a physical-therapy appointment, may last as long as a session at a clinic. Waiting rooms are sometimes replaced by virtual waiting rooms. Before the visit ends, make sure you know the follow-up plan. Do you need to schedule an in-office visit, fill a prescription or get a referral to a specialist? Right now, Medicare and Medicaid are covering the cost of telehealth visits (see medicare.gov/coverage/ telehealth for details), and most private insurers are following suit. If, however, you don’t have a primary care physician or need urgent care, you can get help through virtual health care service like Doctor on Demand (doctorondemand.com) or TeleDoc (teladoc.com). These services currently do not accept original Medicare, but they may be covered by private insurers including some Medicare Advantage plans — be sure you check.

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. July 2020 •

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Ask St. Ann’s

Healthcare Workers Need Our Care, Too. By Michelle Dwyer and Victoria Bournival

In a recent survey conducted by mental health provider Ginger, which was published in Forbes.com on April 20, 69% of employees said the coronavirus is the most stressful time of their career, and 88% said they had experienced moderate to extreme stress over the past four to six weeks. To remove any stigma about asking for help, encourage self-care practices and make resources available. Promote telemedicine visits to help employees access mental health counseling services at their convenience and in the privacy of their own homes. Consider offering pastoral care for soul support. The team at St. Ann’s Community disseminates daily affirmations and has an opendoor policy for staff. Collaborate with a success coach through the Employer Resource Network (ERN) in Rochester to help employees navigate systems and find solutions to many personal or professional issues. Coaches can assist with childcare needs, transportation, stress management, conflict on the job, finances and professional growth opportunities.

Overall well-being Working in healthcare today Page 20

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From the Social Security District Office

Communicate clearly and often

Prioritize mental health

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Qualifying for Supplemental Security Income With Social Security

ealthcare workers caring for COVID-19 patients and protecting vulnerable seniors give their all to our community. Caring for the mental health and overall well-being of these workers must be an employer’s top priority. Here are ways employers can support and encourage workers to seek help when they need it most.

Information and guidance about COVID-19 changes quickly, even in a day. Open communications channels ensure workers understand expectations and can ask questions to provide the best outcomes. St. Ann’s Community updates its 1,200+ workforce through emails, phone calls, video chats, social media and blogs. Daily check-ins also ensure everyone is up to date with current in-house facts and changing regulations. Monthly, the CEO and leadership team greet employees at the start of each shift to check-in, distribute employee updates, provide healthy treats, and give thanks for their service. Delivering top-notch care under pandemic conditions isn’t easy. Acknowledge when people go above and beyond the call of duty to boost morale and build community. Create a social media platform to encourage employees to share acts of kindness, accomplishments and stories. Offering a branded apparel item is also a great way to show appreciation.

Ask The Social

leaves people with less time to tend to their home life. Take some items off their to-do lists to make their lives easier. If possible, offer on-site COVID-19 testing so frontline employees can meet state testing mandates without additional time and travel. Connect those who test positive with support. Supply healthy meals and snacks and sell at-cost grocery staples at the workplace to eliminate the need for employees to go to crowded stores and risk exposure. Implement a casual dress policy to encourage a more relaxed environment. Train ancillary and non-clinical workers to serve as resident service technicians and nursing assistants to assist healthcare teams with patient care such as feeding, dressing, and toileting. “We’re all in this together” only rings true for employees when employers follow up with compassionate, consistent actions that support the best outcomes for all. It’s the least we can do for those who give so much to others. If you’re a healthcare worker looking for more information on ways to cope during the pandemic, visit the Centers for Disease Control and Prevention’s website (cdc.gov).

e pay monthly Supplemental Security Income (SSI) to people with disabilities who have low income and few resources, and people who are age 65 or older without disabilities who meet the financial limits. Income is money you receive, such as wages, Social Security benefits and pensions. Income also includes things like food and shelter. The amount of income you can receive each month and still get SSI depends partly on where you live. Resources are things you own, including real estate, bank accounts, cash, stocks and bonds, which we count in deciding if you qualify for SSI. You may be able to get SSI if your resources are worth $2,000 or less. A couple may be able to get SSI if they have resources worth $3,000 or less. If you own property that you are trying to sell, you may be able to get SSI while trying to sell it. We will not count economic

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Michelle Dwyer is director of human resources for St. Ann’s Community. Contact her at mdwyer@MyStAnns. com or 585-6976395.

Victoria Bournival is employee experience and organizational development specialist for St. Ann’s Community. Contact her at 585-697-6510 or vbournival@ mystanns.com. Learn more about St. Ann’s Community in Rochester at www. stannscommunity. com, or apply for jobs at www. stannsjobs.com.

impact payments, also known as coronavirus stimulus payments or CARES Act payments, as income for SSI. These payments will also not count as resources for 12 months. You can read more about qualifying for SSI at www.ssa.gov/pubs/EN-0511000.pdf. If you’re an adult with a disability intending to file for both SSI and Social Security Disability Insurance, you can apply online for both benefits at the same time if you: • Are between the ages of 18 and 65; • Have never been married; • Aren’t blind, • Are a U.S. citizen residing in one of the 50 states, District of Columbia, or the Northern Mariana Islands; and • Haven’t applied for or received SSI benefits in the past. We’re here for you. You can find more information at www.ssa.gov/ benefits.

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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. © 2020 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, Mike Costanza, Ernst Lamothe Jr., Wade S. Norwood, Michelle Dwyer, Victoria Bournival, Art Mason • 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.

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

H ealth News Celestial Dental installs innovative air purification system In an effort to ensure that adults and children have a safe place to come for emergency dental care in light of COVID-19, Celestial Dental became the first practice in Monroe County to install one of the most advanced medical-grade air purification systems in midMarch, according to a news release issued by the practice. The system, used globally in hospitals and other medical settings to sterilize indoor air, eliminates viruses much smaller than and structurally similar to the coronavirus. Celestial Dental is open for sameday, evening or weekend real-time emergency dental care in a medically-safe, clean air environment. The system filters the air every two to three minutes in examination rooms and every half hour in the office. “If someone has a broken or cracked tooth, severe pain and sensitivity, difficulty swallowing or breathing, or an inability to eat or chew, access to immediate emergency dental care is crucial,” said dentist Antonio Calascibetta, owner of Celestial Dental. “In addition to the air purification system, we are following surgical-level sanitization procedures and safe distancing protocols aligned with the CDC and American Dental Association (ADA) guidelines with regard to COVID-19.” If prospective patients have a fever or are exhibiting symptoms of the illness, they are encouraged to stay home. Phone consultations are available for patients who are ill to alleviate pain in the short-term. Pa-

tients are pre-screened upon arrival outside the building to ensure that they and their family members are fever-free and without symptoms for at least the last 24 hours. “We are committed to keeping our patients and staff safe not only during this challenging time, but every single day,” said Calascibetta. “Our air purification systems will stay in our office permanently beyond the pandemic.” According to the practice, since mid-March, Celestial Dental has donated more than $15,000 in emergency dental treatment in the form of free exams and X-rays. At age 29, Calascibetta is the youngest dentist owning a private practice in Monroe County.

Friendly Senior Living website wins award

Friendly Senior Living’s website, www.friendlyseniorliving. org, has been recognized as a bronze award winner in the 22nd annual Digital Health Awards competition, which honors the world’s best digital health resources. A panel of nearly 30 experts in digital health media served as judges, selecting winners in 60 categories from more than 300 entries. “Friendly Senior Living is thrilled to be honored among the best digital health resources,” says Glen Cooper, president and chief executive officer of Friendly Senior Living. “Our website is a very valuable tool for consumers as they explore housing, services and care options for seniors. The goal is to provide consumers with the best possible online experience as part of their decision-making process.” The website features user-friendly navigation; information about Friendly Senior Living’s independent living, assisted living and nursing home communities; photos; and virtual tours. The site is also mobile-responsive and ADA compliant.

Members of The Finger Lakes Chapter Knights of Columbus delivering breakfast pizzas and subs to St. Ann’s Community.

Knights of Columbus Recognizes Healthcare Heroes at St. Ann’s Community

he Finger Lakes Chapter Knights of Columbus has been recognizing healthcare heroes working at local nursing homes as part of an organization-wide effort for appreciating frontline workers and supporting local businesses. Most recently, the Knights of Columbus decided to recognize the healthcare heroes working at St. Ann’s Community. The Knights of Columbus came armed with breakfast pizzas and DiBella’s sub trays for all employees at St. Ann’s Community at Chapel Oaks located in Irondequoit, St. Ann’s Community at Cherry Ridge located in Webster,

Elder Abuse in a COVID-19 World By Art Mason

ocial isolation is a known risk factor for elder abuse. What have many older adults been doing the last few months? Isolating due to the COVID-19 health crisis. With little social interaction, limited access to supportive family and friends, and limited opportunities for informal observation, the risk of abuse, in its many forms, increases dramatically. Many of us, at some point in our lives, will become more isolated due to illness or frailty, and we will be at greater risk of isolation, neglect, and abuse. After all, if we don’t interact regularly with friends, neighbors and loved ones, who will notice if we experience abuse or neglect — and who will help us recover and get support when we need it? Elder abuse exists in every com-

munity and every neighborhood, rich and poor, even in “nice” families. Elder abuse occurs more often in people’s homes than in nursing homes. Adult children and grandchildren are often abusers. Sometimes it’s an acquaintance or caregiver. At the Upstate Elder Abuse Center at Lifespan, we strive to break the silence about elder abuse, a hidden problem that affects as many as one in 13 older adults in New York state. We know elder abuse is hidden because just one in 23 instances is ever reported. We also know that the most prevalent form of abuse is financial exploitation by people who know the older adult. Scams also target older adults with false cures, illegitimate charities and fraudulent emails. They are a constant threat which exploits our parents, grandparents and friends. Elder abuse is an injustice that July 2020 •

erodes older people’s safety and dignity by subjecting them to verbal or physical abuse, neglect, financial exploitation or sexual assault. Working toward a truly just society means eradicating elder abuse in all forms. In fact, New York state needs comprehensive, mandatory reporting laws about elder abuse. It is the only state in the country without mandated reporting of elder abuse occurring outside of nursing homes. We ask for more conversation on how we can better protect our older victims and raise awareness about this hidden, growing problem. We can create a more just society by building a stronger social structure for older people; a structure which includes increased awareness to prevent abuse, intervention to stop abuse and public policy advocacy to break the silence that surrounds elder abuse and financial exploitation.

and St. Ann’s Community at The Greens located in LeRoy. Employees at all three locations were appreciative of the kind gesture and enjoyed the delicious food. “We are truly grateful for the show of support from the Knights of Columbus for our healthcare heroes,” said Michael E. McRae, president and CEO of St. Ann’s Community. “Our team has been working extraordinarily hard throughout the pandemic, and we know they enjoyed this much deserved treat. Thank you again to the Finger Lakes Chapter Knights of Columbus for the generosity and recognition of our frontline workers.”

The Upstate Elder Abuse Center at Lifespan provides information, guidance and intervention services in Monroe and nine other counties including Genesee, Livingston, Ontario, Orleans, Seneca, Schuyler, Wayne, Wyoming and Yates.

Art Mason is the director of the Upstate Elder Abuse Center at Lifespan. He holds a licensed master social worker degree.

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LIFE CHANGING MEDICINE, MOVING MEDICINE FORWARD Page 22

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

Many Kidney Failure Patients Regret Starting Dialysis

ore than one in five adults getting dialysis for kidney failure are sorry they started it, a new study finds. Patients who began treatment to make their doctors or family members happy are least pleased with the decision, researchers reported. On the other hand, patients who said they’d discussed life expectancy with their doctors and those with a living will were less likely to second-guess their decision. Having a frank discussion with a kidney specialist to learn how dialysis can affect your life can make a difference in your satisfaction, the authors said. The study, led by physician Fahad Saeed, from the University of Rochester Medical Center in Rochester, and Paul Duberstein, of the Rutgers School of Public Health in New Brunswick, New Jersey, used survey responses from nearly 400 dialysis patients in the Cleveland area. Twenty-one percent of the patients said they regretted starting dialysis. The report was published online June 4 in the Clinical Journal of the American Society of Nephrology. Saeed recommended three strategies to mitigate regret in patients with kidney failure. “The public should be educated about alternatives to dialysis, such as conservative management or active medical management without dialysis,” he said in a journal news release. In addition, nephrologists should give patients and family members detailed information about life expectancy and quality of life with and without dialysis to help patients and family members decide whether to start the treatment. Lastly, “patients should talk with their doctors about their life expectancy and complete a living will,” Saeed said.

If you think something is wrong with this picture, you should see what’s happening in stores. That’s where tobacco companies spend more than half a million dollars every day here in New York State on promotions where kids can see them. And the more kids see tobacco, the more likely they are to start smoking.

The average age for a new smoker is

Sales of Johnson’s Baby Powder Halted in U.S., Canada Lawsuits claiming that talc-based Johnson’s Baby Powder has caused cancer have led to a plunge in sales in the United States and Canada, so Johnson & Johnson said in May it is ending sales of the product in those two countries. The company said the talc-based powder is safe and will still be sold in other countries, the Associated Press reported. About 19,400 lawsuits have been launched against the company alleging that J&J’s talcum powder caused ovarian cancer or mesothelioma, a cancer that affects the lungs and other organs. To date, J&J has won 12 cases, lost 15, and there have been seven mistrials. All of the lost cases have either been overturned on appeal or are still being appealed, the AP reported.

YEARS OLD.

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In Good Health, Rochester’s Healthcare Newspaper

Call 585-421-8109 to advertise. Read every month by nearly 100,000 health-conscious people www.GVhealthnews.com • editor@GVhealthnews.com July 2020 •

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Do what you love. Even if it’s nothing at all. That’s the joy of living at St. Ann’s Community at Chapel Oaks. We consider you one of the most important people on earth. You should have nothing to worry about except choosing today’s group activity, outing or dining option. Or maybe just enjoy quiet time for yourself in spacious, beautifully maintained surroundings with 24-hour security. Choosing Chapel Oaks means you don’t pay an entrance fee, only a low, monthly service fee for all your amenities. You also have complimentary transportation for appointments and activities, and access to higher levels of care if you ever need it. • Luxury 1- and 2- Bedroom Apartments • Wellness Center & Pool • Multiple Dining Venues

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St. Ann’s Community at Chapel Oaks 1500 Portland Avenue l Rochester, NY 14621 l 585-697-6606

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