IGH Rochester #186 February

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PRICELESS

Golden Years

GVHEALTHNEWS.COM

FEBRUARY 2021 • ISSUE 186

Special Issue

n Aging in Place: More accidents happen in the bathroom than any other room in the house. How seniors can make their bathrooms safer. n What Caregivers Should Know About Medicare: Having a working knowledge of Medicare can help them take full advantage of the coverage and services it provides n Acupuncture: Does it work and is it covered by Medicare? n Food Insecurity: Many seniors across the country (and in our region) are not certain if they will have food tomorrow. n Hearing Loss: What are the signs? n Heart Month: Post-heart attack. What is typical for patients after they’ve survived a heart attack?

Urgent Care, ER or a Visit to Primary Care Doctor? Where to Go When You Need Quick Medical Help P. 9

Drug Makers Raise Prices on 500 Prescription Drugs

Flu Cases in NYS Dramatically Down

Surprising Benefits of Rye Bread P. 11

Medical Minute: Debunking Vaccine Myths

Also: ‘I’ve Already Had COVID-19, Do I Need the Vaccine?’


U.S. Cancer Death Rates I Keep Falling: Report

mproved lung cancer treatment is a major reason for the 31% decline in cancer death rates in the United States between 1991 and 2018, including a record 2.4% decrease from 2017 to 2018, the American Cancer Society says. How the COVID-19 pandemic will affect this downward trend is unknown, the society noted. “The impact of COVID-19 on cancer diagnoses and outcomes at the population level will be unknown for several years because of the time necessary for data collection, compilation, quality control and dissemination,” according to the report’s lead author, Rebecca Siegel. “We anticipate that disruptions in access to cancer care in 2020 will lead to downstream increases in advanced-stage diagnoses that may impede progress in reducing cancer mortality rates in the years to come,” she said in a cancer society news release. The American Cancer Society said about 3.2 million cancer deaths were prevented from 1991 through 2018 due to declines in smoking, earlier detection, and improvements in treatment that led to long-term decreases in deaths from the four leading cancers: lung, breast, colon and prostate. Lung cancer is the most common cause of cancer death, causing more deaths than breast, prostate and colon cancers combined. While there’s been slow progress against breast, prostate and colon cancers in recent years, declines in lung cancer death rates grew from

Decline boosted by fewer lung cancer deaths, says study

LET’S MOVE FORWARD

SAFELY.

Right now, it’s easy to focus on all the things we can’t do. But what if we all focused on the things we can do? We can learn more about testing and vaccines. We can protect ourselves and others by continuing to wear a mask. We can show support for essential workers and local businesses. We can stay home and safely connect with the people who matter to us. Explore what you can do at

ExcellusBCBS.com/CanDo

A nonprofit independent licensee of the Blue Cross Blue Shield Association

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021

2.4% a year during 2009 to 2013 to 5% a year during 2014 to 2018. Lung cancer accounted for nearly half (46%) of the overall decline in cancer deaths in the past five years, driving the record single-year drop of 2.4% from 2017 to 2018 for the second year in a row, according to the cancer society’s new report on cancer statistics, which was published Jan. 12 in CA: A Cancer Journal for Clinicians. The report also appears in Cancer Facts & Figures 2021. Recent large reductions in lung cancer deaths reflect better treatment for the most common subtype of the disease — non-small cell lung cancer (NSCLC). Two-year survival for NSCLC increased from 34% among patients diagnosed in 2009 to 2010 to 42% among those diagnosed in 2015 to 2016, including gains of 5% to 6% for every stage of diagnosis. Two-year survival for small cell lung cancer remained at 14% to 15% over that time period. In 2021, nearly 1.9 million new cancer cases will be diagnosed in the United States and there will be over 608,000 cancer deaths, the cancer society estimated. However, that prediction is based on 2017-2018 data and doesn’t account for the potential effects of the COVID-19 pandemic. The report also said that cancer is the leading cause of death in Hispanics, Asian Americans and Alaska Natives. In addition, the five-year survival rate for all cancers combined that were diagnosed from 2010 through 2016 was 68% in white patients and 63% in Black patients.


auggie 1. vera 99. Life is about looking back and moving forward. Life is a mix of the years ahead of us and the years behind. As we commemorate 100 years, Jewish Senior Life is learning from a long history of leadership in senior care and looking ahead to a new century committed to the personal safety and well-being of our residents. To experience the difference at Jewish Senior Life, call 585-427-7760. All photos safely taken prior to COVID-19 pandemic.

February 2021 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Ryan P. Lydon, M.D.

On Waitlist Rochester General doctor offers new option of treatment for patients who suffer from deep for Liver venous obstruction Transplants, in allowing us to make the measureQ: You’ve been working with a new Women Die More treatment ments that allow us to put in propfor deep venous obstruction. erly sized stents. If you undersize What is deep venous obstruction? them, they can take off and wind up Basically the veins in your Often Than Men legs,A:which recirculate the blood back where you don’t want them. So we

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railty may explain why women awaiting a liver transplant are more likely than men to become too sick for a transplant or die before transplantation, a new study suggests. Exercise and a healthier diet may help narrow that gender gap, researchers say. For the study, researchers followed more than 1,400 patients with cirrhosis awaiting a liver transplant from nine U.S. transplant centers. About 40% were women. The men, aged 49 to 63, were more likely to have chronic hepatitis C and alcoholic liver disease. The women, aged 50 to 63, were more likely to have non-alcoholic fatty liver disease and autoimmune cholestatic liver disease. Both groups had similar levels of disease severity. However, the women were significantly frailer than the men, the researchers noted. “This is the first time that frailty has been identified and quantified as a risk factor among women with cirrhosis who are waiting for liver transplants,” said lead study author Jennifer Lai, a general and transplant hepatologist at the University of California, San Francisco. “The importance of this finding is that this gender gap can potentially be mitigated through early interventions as basic as providing adequate caloric and protein intake and engaging in regular exercise. Clinicians can advise women on diet and exercise interventions that build strength,” she said in a university news release. Why women were frailer was not explored, but it is generally attributed to physical inactivity, chronic liver failure and poor diet, Lai said. The women had a 36% greater risk of being too sick for a transplant or dying before one was available. In all, frailty accounted for 13% of the gender gap, the researchers said. “The waitlist mortality gender gap has persisted for 15 years across the entire U.S. liver transplant system and will continue to persist if it is not recognized,” Lai said. “Now that it has been recognized, it can be addressed.” The study was published Dec. 30 in JAMA Surgery.

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to the heart to be re-oxygenated, all come together into one vein in the groin, which then goes up through the pelvis, and joins the other side around the level of the bellybutton and brings everything up to the heart. Patients can get [deep venous obstruction] for a variety of reasons, ranging from scar tissue from prior pelvic, abdominal or lumbar spine surgeries or problems like tumors, uterine fibroids and similar extrinsic problems that put pressure on the veins. You can also have intrinsic blockage inside the veins from a blood cot or scarring from a cleared clot. So these people may have had swelling in one leg for many years and we had no idea why. They’re told to elevate their leg, wear compression stockings. Most primary care doctors had no idea this was a thing, so the patients lived their lives like this, with swelling in one or both legs for many, many years. We didn’t really have answers until recently. Q: How is this condition treated? A: We’d been doing procedures for this specific problem for right around five years. That began with the introduction of a technology called IBIS, which is an ultrasound that goes over wires that you put through those veins, and it gives you a real time view of the inside of veins. It lets you see where compression is happening, how bad the compression is. It lets you take measurements to determine what you’re going to do about the problem. Are you going to balloon it open? Most of the time these things need stents to keep things open. So this changed the game

started doing this five year ago. We started using stents that were good. They did the job, but maybe weren’t the best in terms of deployment. They didn’t always land exactly where you wanted them to. They also weren’t very flexible. As you can imagine, some patients require stenting over the hip joint or right in the crease of the groin. Some of these patients are still relatively young and active, so we needed a stent that wasn’t going to migrate, wasn’t going to move after deployment, wasn’t going to fracture and was flexible. So that’s what this new stent [Medtronic Abre venous self-expanding stent system] that we just started using offers: no migration, no fracturing, but enough flexibility to use in younger, healthy patients. Q: Generally speaking, is this a condition that affects younger patients? A: The bulk of the patients I see with this condition are women of childbearing age or older. A lot of this just has to do with the design evolution of the female body. The hips and the abdomen are designed to promote childbearing. That’s just from a pure anatomic standpoint. Anyone can have their appendix out, or have had colon surgery that caused compression on these veins. So it tends to be women of childbearing age or older, but anybody who has had any abdominal or lumbar spine surgery can end up with swelling in their legs. It doesn’t discriminate. Q: How are the outcomes of this surgery? A: The outcomes are out-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021

standing. It’s kind of variable based on the cause of the swelling, whether they’ve had a blood clot in the past, or if there’s extrinsic compression. Patients who have swelling from extrinsic sources usually end with greater than 50% improvement in the swelling of that leg. Some end up with complete resolution of the swelling. For many of these patients, even a 5% improvement would be a major quality of life improvement. Even if we’re able to just get them to the point where they can get compression stockings on, that’s a huge win and will help them do the things they want to do. Q: Is it inpatient or outpatient surgery? A: It’s done in the hospital just because that’s where I have the resources to do the procedure, but it is an outpatient procedure. They show up about an hour before the procedure. The procedure itself takes 30 or 40 minutes. Then they stay another hour, and then they go home. Q: Do the effects last? Or do you need to correct them down the road? Or is it too early to know? A: With this specific new stent it’s too early to know. But with the older stents it depends on the initial cause. Overall durability is very good. We do see the patients in follow-up about once a year to make sure everything is intact. For the vast majority of people the durability isn’t an issue. If they do need anything else done, it can usually be in the same minimally invasive way, whether it’s extending a stent or maybe balloon on the inside of the stent. It’s usually not a big deal. Q: Do patients usually have to keep using compression stockings afterwards? A: I usually tell patients they need to stay in compression for at least six weeks after the procedure. After that it’s kind of a discussion between them and myself at my office to see how the leg is doing, to scale it back to a couple times a week. It differs for every patient. Q: Rochester was one of the first sites in the country to get this new stent procedure. Do you see it getting widely adopted? A: It already has, even in the month or two since we started doing them. It’s going to spread. The results are so good. Once they see how good these devices are, and coming from a reputable company like Medtronic, I think it’ll get widely adopted and become the new standard of care.

Lifelines Name: Ryan Patrick Lydon, M.D. Position: Vascular surgeon at Rochester Regional Health Specialty: Specializes in aortic dissection, thoracic aortic aneurysm, abdominal aortic aneurysm, carotid artery disease, and limb salvage. Hometown: East Amherst, NY Education and training: St. George’s School of Medicine (medical degree); Morristown Memorial Hospital, Albany Medical College Affiliations: Rochester Regional Health Organizations: Society for Vascular Surgery; Society for Clinical Vascular Surgery; American Board of Surgery; American Medical Association Family: Wife (Erica), daughter (Sophia) Hobbies: Golf


Flu Cases in NYS Dramatically Down

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Excellus reports 2,046 lab-confirmed cases of influenza in NYS as of January compared to 32,848 cases last year in the same period

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he prevalence of flu in New York state is way down compared to this time last year, according to an analysis of health tracking data by Excellus BlueCross BlueShield. Contributing factors include a closer match between the genetic make-up of this year’s influenza virus and the vaccine, a majority of the adult population supporting vaccination, and the intense safety protocols being practiced in order to limit the spread of COVID-19. As of Jan. 2, there were 2,046 laboratory-confirmed cases of influenza, 357 patients hospitalized, and no pediatric influenza deaths. At this time last year, the state reported 32,848 laboratory-confirmed cases of influenza, 5,694 patients hospitalized, and one pediatric influenza death. “We have a proven threepronged approach to challenging the flu virus: We have a flu vaccine that’s safe and effective and widely available, we have buy-in from much of the public to get the flu vaccine, and we have everyone practicing common-sense behaviors that can reduce the spread of a virus,” said Excellus BCBS Senior Medical Director for Clinical Services Nicholas Massa. “The success of this approach in reducing the impact of this year’s flu virus is the template for reducing the impact of COVID-19,” said the

physician. The exact timing and duration of flu seasons can vary, but influenza activity often begins to increase in October, peaks between December and February, and can last as late as May. The U.S. Centers for Disease Control and Prevention (CDC) reports 192.5 million doses of this year’s flu vaccine have been distributed nationally, to date (as of Jan. 1), compared to 174.2 million doses in total for the 2019-2020 flu season. “Each year brings a new formulation for the flu vaccine to reflect the different strains that are expected, so it’s important for everyone to get the flu vaccine each year,” said Massa. New York state reports influenza A and B are circulating this season. “And as we’ve learned this year, there’s more to practicing personal responsibility than simply coughing into your elbow. We need to wear masks, practice social distancing, and wash our hands effectively and often to protect ourselves and others.” Last year, 22,000 Americans died from the flu and flu-related complications and 405,000 were hospitalized, according to the CDC. A 2020 survey of 2,000 Upstate New York adults commissioned by Excellus BCBS and conducted by One Research found 60% of adults believe it is important to get a flu vaccine.

Drug Makers Raise Prices on 500 Prescription Drugs

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ith the new year comes another round of prescription drug price hikes. The data comes from 46brooklyn Research, a nonprofit company that aims to improve access to drug pricing information. AbbVie, Bristol Myers Squibb, GlaxoSmithKline, Pfizer and other major pharmaceutical companies are raising their prices by a median of 4.6%, the nonprofit said. In all, more than 500 drugs will cost more this year, the data shows. Drug prices are higher in the United States than in other developed countries, where governments typically negotiate with manufacturers to control costs. GlaxoSmithKline raised the price on 34 of its drug brands on Jan. 1, company spokesperson Lyndsay Meyer said in an interview. “Compared to last year, we’ve taken fewer list price increases and we didn’t raise the list price of 18 products across our portfolio,” Meyer noted. Pfizer officials said that its prices rose about 1%. “This modest increase is necessary to support investments that allow us to continue to discover new medicines and deliver those break-

throughs to the patients who need them,” a company spokeswoman said. Bristol Myers Squibb “responsibly balances pricing its medicines so high-risk innovation is rewarded while providing access and affordability support for its patients,” the company said in a statement. the company sells the lung cancer treatment Opdivo, which is expected to rise 2% in price, and the arthritis drug Orencia, which is looking at a 5% jump, CBS News said. Other drugs expected to see price hikes include: • The pain medication Zipsor, by 10% • The anti-epileptic treatment Sabril, by 10% • The Crohn’s disease drug Humira, by 7% • The heart attack treatment Kengreal, by 6% • The diabetic nerve damage treatment Lyrica, by 5% • The smoking cessation drug Chantix, by 3% February 2021 •

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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. © 2021 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., By Kim Petrone (M.D.) • 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

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Solo Travel:

‘You Had Me at Hello’

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ho doesn’t remember one of the most romantic lines ever spoken in a movie: “You had me at hello” from the 1996 film “Jerry Maguire.” In one of the film’s most memorable scenes, Tom Cruise’s title character pours out his heart to his on-screen wife, played by Renee Zellweger, and asks her for a second chance. Zellweger stops Cruise mid-sentence and tearfully says “You had me at hello,” after which they fall into each other’s arms, destined for a long and happy reunion. I watched the movie clip on YouTube this morning and it brought a tear to my eye. I’m a softy at heart. But, what in the world does this have to do with solo travel? For me, travel — like a captivating romance — holds intrigue, excitement and the promise of profound, life-changing moments. When I took my first stroll by myself in the Luxembourg Gardens in Paris, I could easily have exclaimed, “You had me at bonjour!” But those were the good ol’ days, when we could move easily throughout our lives and the world. Sadly, the pandemic brought travel to a near standstill in 2020, keeping most

of us hunkered down at home for most of the year. Because it may still be months before we can safely travel again (even with the roll-out of the vaccines), people are busy doing the next best thing: They are joyfully plotting, planning and preparing their future vacations and visits with loved ones. Goodbye Netflix; hello TripAdvisor! Now’s the perfect time to compile your bucket list of destinations near and far. And while you’re at it, consider including a solo dream trip in your planning. Why do I have such a love affair with solo travel? Let me count the ways: n You call the shots — When you travel alone, you are free to see and do whatever you like. Your decisions and itinerary are your own. And when it’s just you, you are reminded of who you are, what you enjoy doing the most, and what you like least. When you travel with other people, their interests may be at odds with yours. And precious time can be consumed with the inevitable negotiations that come with trying to satisfy everyone’s needs and desires. Traveling alone allows you to follow your heart and own path.

s d i K Corner

Youth Vaping Triples Odds for Adult Smoking

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aping may not be a way for kids to avoid the smoking habit, after all. A new study finds that teens who start vaping are three times more likely to smoke cigarettes in adulthood than those who never started with electronic cigarettes. Although the number of teens who start smoking cigarettes in high school has declined, vaping has soared. From 2016 to 2019, the number of cigarette smokers among U.S. high school seniors dropped from 28% to 22%, but e-cigarette use increased from 39% to 46%, the researchers found. Page 6

“The rapid rise in e-cigarette experimentation among the youth of our country appears to mean that we will have a whole new generation of cigarette smokers along with all the health consequences that follow,” said lead researcher John Pierce. He’s a professor emeritus in the department of family medicine and public health at the University of California, San Diego. “There is an urgent need to reconsider the policies on e-cigarettes and at least hold them to the same standards as the cigarette companies, such as restricting their right

n You make new friends more easily — I’ve discovered this time and time again. When I’m on my own, other travelers and “locals” are more likely to strike up a conversation with me or extend an invitation to join them. I’ve met some of the nicest, most interesting people this way. When traveling with friends and family, we tend to stay focused on each other and lose the chance to meet people we might otherwise have met. That could be a missed opportunity, especially if you are single and hoping to meet someone new. n You can release your adventurous spirit — By yourself (with no one watching), you may be willing to take more risks — maybe zip-lining, bungee jumping, or swimming with dolphins. I’ve never been that adventurous, but I have sampled some pretty exotic food, wrestled Old Paint into submission on a horse trail, and held on for dear life while rafting down the Colorado River. n Likewise, you can find some heavenly time to yourself — On your own and with fewer distractions, the opportunity for a tranquil, soul-soothing retreat is within your grasp. Whenever I travel, I like to build in time to myself to relax and recharge my batteries. Solo travel makes guilt-free “me” time possible. Want to sleep in till noon, find splendid solitude in a secret garden or enjoy your own company and a nightcap at the end of the day? Go for it, because you can. n You learn a new language faster — Je peux en témoigner! (I can vouch for that!). When traveling alone in France, I was forced to make sense of the language. It was either that or go hungry. Without a traveling companion to talk with or to aid in translation, I had to fend for myself. While I am far from fluent in French, I can at least order a croque-monsieur — a hot ham and cheese sandwich. Want to learn a

language more quickly? Travel solo. n You build your confidence and sense of independence — Even a small jaunt can boost your self-confidence. All the decisions are yours, including your budget. You decide how to get where you’re going, where to stay, and how much to spend on transportation, food, accommodations and things to do. In no time, you’ll discover your own resourcefulness, ability to solve problems, and capacity to spend some time alone. Those are invaluable, lifelong lessons. Solo travel is ripe with opportunities for self-discovery, growth and joy. Start dreaming today. When the travel advisories are lifted, you’ll be ready. Pack your bags, and with no reservations (pun intended), set out on your journey with a spring in your step and unbridled anticipation for all the hidden treasures that await. I’m already contemplating a vacation with just “me, myself and I” when the time is right. It might be a weekend away for a change of pace or a great big adventure for a jolt to the senses. Lately, I’ve been pouring over travel guides for Austin, Texas. I have a sneaking suspicion that the “Live Music Capital of the World” will — you guessed it — have me at howdy!

to advertise to our teens,” Pierce said. For the study, the investigators collected data on nearly 16,000 people in the United States, aged 12 to 24. Nearly two-thirds had tried at least one tobacco product, and almost one-third tried five or more tobacco products, of which e-cigarettes and cigarettes were the most popular, the findings showed. Each additional product tried increased the users’ odds of becoming a daily cigarette smoker, as did trying tobacco before age 18, according to the report published online Jan. 11 in the journal Pediatrics. Physician Pamela Ling is interim director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. She said, “This is a problem because the tobacco companies are continuing to produce more new tobacco products every year.”

E-cigarettes and other new tobacco products gained popularity because people think of them as safer alternatives to cigarettes, explained Ling, who was not involved in the study. But this study shows that in the hands of young people, e-cigarettes lead to harm. “Some young people may think they are decreasing their risk because they smoke a little, vape a little, chew a little, but may not use any single product very much. But this poly-tobacco use behavior increases risk to end up a daily smoker,” Ling said. Pierce noted that there are a number of people who advocate e-cigarettes as a way of reducing the harm caused by cigarettes. These people have assumed that young people who start using e-cigarettes will become dependent on them to get their nicotine.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021

NOTE: As of this writing, the CDC and other health experts and institutions advise staying at home as the pandemic surges. 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 Gwenn to speak, visit www. aloneandcontent.com


First-Time Mom at 40 By Deborah Jeanne Sergeant

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hree years ago, having a baby was probably the last thing on Rachael Tachco’s mind. The Rochester resident and her husband, Nick Tachco, had a busy, happy life together. The couple had known each other since age 8 and had been married 16 years. When Tachco’s brother died from drug addiction, they began to stop to think about the meaning of life. “We had a lot of time under our

belts,” Tachco said. “That mixed with sorrowful stuff made us think about our full throttle living and seeing if we can have a baby.” Unlike most women her age, Tachco became pregnant right away at age 40. And like any woman at this age, her healthcare providers followed her closely. “We got checked out all the time,” she said. “I’m an anxious, high-energy person.” She felt eager to make sure the

baby was doing well and underwent any test or scan offered. She also connected with a doula from Beautiful Birth Choices, which serves the Rochester area. Doulas offer birth education and support to help mothers before, during and after birthing. “I leaned into mindfulness and all of the doula work,”Tachco said. “Because of my brother’s issues with substances, I wanted a medication-free birth if I didn’t have to have medication.” She credits her classes with her doula, along with having a birth plan with making her birthing experience very easy. She was able to have a natural labor without pain medication at Highland Hospital when she brought Corrina Suzanne into the world. Adjusting to having a baby in their lives was another change for the couple. Tachco said that career-wise, becoming a mom at 40 was easier than if she had been younger. “I’d been established in my career so long,” she said. “I found ways to make it work.” She thinks if she had been a less experienced professional trying to tackle both new motherhood and a new career, she would have had a harder time. Tachco said her family’s willingness to provide childcare has helped her and her husband continue to work and have some personal time. She has found that having Corrina has helped her better relate to people. “I was always a civically engaged person, a civil servant,” Tachco said. “Having the baby has made me more passionate to help people who are underserved. Everyone is some-

one’s child. I couldn’t have understood that as deeply without being a mom.” She also thinks that as a more mature mom, she possesses much more patience than she would have had for Corrina if she were younger. Tachco has also met many new friends through her experience. While all her friends her own age have teenagers by now, she has made additional friends through the Beautiful Birth Choices support groups, like Breastfeeding Café. “I’m 10 years older on average than most, but it’s a sweet, sweet place to meet and have community,” she said. What she feels she did miss as an older mom is the energy level she had in her 20s. Despite this, “We say all the time it’s the most wonderful thing to happen to us,” Tachco said. “We’d had lots of fun and had never tried for a baby. It has brought a lot of joy to us to see the world through a child’s eyes. She’s hilarious and loves dancing. She’s not a fan of gray days, but when it’s snowing, she’ll go outside. We just got kittens to add to the mayhem.” She encourages anyone who does not have children to consider becoming parents. “I feel like our life has only become enriched,” Tachco said. “I’m more tired than I’ve ever been, but more joyful. “Having this sweet baby put the world into Technicolor. I thought I had a colorful full life before but it’s a heart explosion to have a baby. It’s the sweetest thing ever. I’m so thankful that we were able to have a baby.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Medical Minute: Debunking Vaccine Myths

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accine. The word conjures up a host of emotions, from relief and hope to skepticism and even fear. In truth, says physician Patrick Gavigan, a pediatric infectious disease physician at Penn State Children’s Hospital, vaccines are among the most heavily studied of all medical interventions, and the evidence shows they are safe and extremely effective. Many once-daunting diseases, such as measles, meningitis and pneumonia, have been combatted successfully with childhood vaccinations. Most parents readily accept the vaccine schedule and bring their children for well-child visits expecting the vaccines will be given, Gavigan said. Those who hesitate often want clarification on things they have heard about vaccine safety or additives. Doctors understand there is misinformation and are happy to set the record straight. “Most people with reservations about vaccines come to us with pretty good questions and are just looking for advice,” Gavigan said. Here are a few of the most common myths about vaccines and reassuring truths. n Vaccines can make you sick and cause the illness they’re supposed to prevent. The truth: Vaccines contain inactive viruses or components of the virus or bacteria and cannot cause infection in people with normally functioning immune systems. “Common side effects, such as fever or pain at

the injection site, that people often mistake for illness are the immune system’s response to the components and actually show the body is building immunity to the virus or bacteria,” Gavigan said. (People with compromised immune systems should consult their physician before taking any live virus vaccines.) n Vaccines contain toxic ingredients. The truth: Mercury and thimerosal, a mercury-containing organic compound, are no longer used in childhood vaccines or in many other vaccines. Safety data shows, however, that there was no increased risk of harm even when these compounds were present, Gavigan said.

n The choice not to vaccinate affects only my child, or only me. The truth: Vaccines protect the person who gets vaccinated and build herd immunity by decreasing the prevalence of the virus to such low levels that people who are unable to get vaccinated or who don’t fully respond to the vaccine also are protected. A certain percentage of the population must be vaccinated to attain herd immunity, so a decision against vaccination affects the whole group, Gavigan said. n Natural immunity is better than vaccine-acquired immunity. The truth: While it may be true that someone who naturally catches a virus has longer-term immunity, the

risks and consequences from actually getting sick with the infection far outweigh any value that may come from having the virus itself. “And with COVID-19, we don’t know that immunity from getting the infection is any better than the vaccine,” Gavigan said. n It’s best to space out vaccines and even delay the COVID-19 vaccine until the pandemic is over. The Truth: All of the data on a standard schedule for vaccines has shown them to be very safe. “Any time you space out vaccines, there’s a big risk that you’re providing additional time when you can contract the disease,” Gavigan said. In addition, getting multiple vaccines at the same time doesn’t diminish your immune system’s response to them, and there’s no need to worry that your body can’t withstand multiple vaccinations in short order. “The amount of antigen, or virus protein, in the vaccine is much lower than what you would encounter if you got the infection,” Gavigan said. The COVID-19 vaccine has been developed and approved in short order, which makes people understandably concerned about its safety, Gavigan said. “However, the data has been thoroughly looked at in tens of thousands of people involved in the studies, and the rates of adverse effects were exceedingly low,” he said. “This vaccine looks to be as safe and effective as we could hope for.” The Medical Minute is a health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff. It’s distributed by Newswise.com

Telehealth Now Mainstream as Insurers and State Expand Access to Care Excellus BCBS reports 2.2 million telehealth claims in 2020 vs. 28,529 in 2019

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omprehensive telehealth legislation was an area of focus in New York state Gov. Andrew Cuomo’s 11th State of the State Address. “The COVID-19 pandemic laid bare the inequities in our healthcare system and showed that telehealth

is a critical tool to expand access and lower costs for low-income communities, especially for behavioral health support,” said Cuomo, as he took executive action to expand access to remote care. Telehealth is when a patient and a provider communicate by audio,

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video or text messaging. “The number of telehealth visits soared in 2020 as a result of the COVID-19 pandemic,” said physician Stephen H. Cohen, senior vice president and chief medical officer at Excellus BlueCross BlueShield. The insurer processed 2.2 million telehealth claims in 2020, compared to 28,529 in 2019. Behavioral health services, including care for mental health and substance use issues, accounted for 43% of telehealth claims in 2020, compared to 25% in 2019. Most adults in Upstate New York (77%) have heard of telehealth though less than a third have used it, according to a survey commissioned in late 2020 by Excellus BCBS. Of those adults who reported using telehealth, 90% did so since the outbreak of COVID-19. Additional survey findings: The primary reason telehealth is currently used: n Required to use because of COVID-19 – 59% n Convenience – 40% n Preferred to use because of COVID-19 – 34% n Cost of visit – 8% The most important features of

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021

telehealth: n Ability to obtain prescriptions (79%) n Avoid in-person visits (69%) n Cost of visit (58%) Excellus BCBS spent $102 million in 2020 to expand telehealth coverage to all members and waive any member cost-share responsibility for telehealth services, regardless of the medical issue. The insurer increased provider reimbursement rates to help replace some of the revenue lost due to the decline in in-office patient visits. The health plan’s provider relations team trained more than 500 health care providers in the use of telehealth technology. “When seeing a health care provider in person isn’t possible, or preferable, telehealth offers an effective alternative,” said Cohen. “Telehealth is here to stay, and our health plan will continue develop and support ways to increase access to this innovative way to get care.”


Urgent Care, ER or a Visit to Primary Care Doctor? Where to go when you need quick medical help By Deborah Jeanne Sergeant

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rgent care centers have helped decrease the load on emergency rooms. According to a 2018 study published by JAMA International Medicine, ER visits dropped by 36% between 2008 and 2015 and during the same time period, visits to urgent care facilities and telemedicine increased by 140%. Shifting to urgent care and telemedicine can help reserve ER personnel and resources for the direst cases. Knowing the difference between what is treatable at the primary care physician (PCP), urgent care or ER can continue to improve those numbers. Physician Scott Allan, medical director at Rochester Regional Health Immediate Care, said that people with symptoms of common colds, sinus infection and bronchitis do not need to rush out to the urgent care. “They should wait to see their Allan primary care provider,” Allan said. While waiting for a few days to get a PCP appointment is uncomfortable, some cases of these illnesses improve by then without profession-

al care anyway. For most otherwise healthy people, rest and hydration at home can hasten healing. Allan said that some patients ask providers for antibiotics to treat a minor illness and complain when they do not receive them — even though the medication will not help. Other urgent care visitors are people who lack a PCP. Their issue may not be very urgent; however, without a regular care provider, they turn to urgent care for help with routine issues or chronic health problems. Still, Allan is glad when these patients visit urgent care. “It is rewarding to talk with someone who’s completely outside the system and get them included,” Allan said. “They have follow-up and someone who manages their chronic issues like blood pressure management or diabetes management that need monitoring.” Ongoing treatment by a primary care physician would suit them better as they would see the same provider instead of whoever happens to be at the urgent care. Allan said that some people turn to urgent care because their illness or injury is not life, limb or function threatening enough for the emergency room, yet the availability of their primary care physician cannot accommodate them. Understandably, few people want to wait several days for relief. February 2021 •

Urgent care facilities typically use the same equipment as PCPs, plus have access to X-ray and other tools related to acute issues. But for issues like chest pain, suspected stroke or heart attack or a complicated fracture or burn, the ER is the right place to go. Emergency medicine physician Bohdan M. Klymochko, cares for patients at UR Medicine urgent care locations. He said that calling a PCP can help determine where to go for treatment. “Urgent care is a great option for prompt evaluation and treatment of concerns such as minor lacerations that may require sutures, sprains or strains, minor Klymochko fractures, fever, rash, skin infectionsand abscess, UTI [urinary track infection], cough, sore throat, ear pain, vomiting or diarrhea,” Klymochko said. “There are also several rapid and send-off lab tests that can be done in the urgent care setting, as well as X-ray imaging capabilities, which can aid in diagnosis and treatment.” Any condition perceived as life threatening should be evaluated at the emergency department, including profuse bleeding, chest pain or concern for heart attack, difficulty breathing, seizures, suspected stroke, severe burns, abdominal pain, blood clot or deep vein thrombosis, anaphylaxis, drug overdose, significant head trauma, pregnancy complications, knife or gunshot wounds or large bone fractures. Like Allan, he does not recommend using urgent care or the ER for managing chronic conditions. The primary care physician “can provide you with the proper continuity of care,” Klymochko said. “If you’re having trouble deciding whether or not you need an urgent care, do not hesitate to reach out to your primary care doctor so that they can help direct you to the appropriate place.”

Do not rush to any provider if you exhibit any of the following symptoms of COVID-19 listed by the Centers for Disease Control and Prevention: Most common symptoms include: • Fever • Dry cough • Tiredness Less common symptoms: • Aches and pains • Sore throat • Diarrhea • Conjunctivitis • Headache • Loss of taste or smell • A rash on skin, or discoloration of fingers or toes Serious symptoms: • Difficulty breathing or shortness of breath • Chest pain or pressure • Loss of speech or movement Seek immediate medical attention if you have serious symptoms. Always call before visiting your doctor or health facility.

‘I’ve Already Had COVID-19, Do I Need the Vaccine?’

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olks who’ve gotten through a COVID-19 infection might naturally question whether they need to get a coronavirus vaccination when their turn comes. Experts say they really need the shot anyway, because even after having COVID-19 they might be vulnerable to reinfection. “We’re encouraging people if they meet the other criteria to get immunized because we don’t know how long either natural immunity or vaccine immunity lasts,” said physician Chris Beyrer, a professor of public health and human rights at Johns Hopkins Bloomberg School of Public Health in Baltimore. All previously known coronaviruses are notorious for promoting short-lived immunity in humans, he said. “Unfortunately, with other coronaviruses typically the immunity you have — like if you get a common cold coronavirus — usually only lasts about a year and a half to two years and then you’re vulnerable again,” Beyrer said. This is because the body uses a relatively simple strategy to fight off common cold coronaviruses, and this strategy does not appear to make a lasting impression on immune system memory, said physician Greg Poland, director of the Vaccine Research Group at the Mayo Clinic in Rochester, Minn. As such, he said there’s a chance people who had asymptomatic or mild cases of COVID-19 did not build up any lasting immunity. “Particularly for people who have milder cases, it may be that they don’t have immunity for very long,” Beyrer said. “So we still think it’s a good idea to get immunized.”

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Gambling:

Addiction Is Easy to Hide Expert dreads when online mobile gambling will be legal in New York by the end of 2021 By Deborah Jeanne Sergeant

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ambling is a profitable industry. In 2018 alone, Americans spent $306.5 billion just online and $161.24 billion through poker, casinos, sports betting, horseracing, lottery, daily fantasy sports (DFS) and bingo, according to industry website www.casino.org. It’s likely those numbers may shift in an unexpected way once numbers are available for 2020. For some, it may seem a harmless pastime. For others, gambling takes over. People described as “pathologic gamblers” by Jim Maney, executive director of New York Council on Problem Gambling in Albany, just don’t stop, even when they know they will face extremely negative consequences. “Alcoholics want to keep drinking; gamblers want to keep gambling,” he said. For Maney, “it’s not just about the winning. The risk is the excitement piece. The finances are how they keep score.” Also, like alcohol addiction, gambling addiction begins with social involvement. It evolves from there. “When they cross over, they start having problems,” Maney said.

These could include having little time left for family, lying about missing money, obsessively following sporting events upon which they’re wagering, and significant financial loss. “They have to decide if they’re going to continue, go back to social gambling or continue as a problem gambler. Then they become a compulsive gambler. They can’t stop. We want people to stay non-gamblers.” Maney said that multiple factors related to the pandemic could both positively and negatively affect

gambling. Some have experienced downtime from work, which could mean more time to gamble, and financial stress which may lead to more or to less gambling. While the casinos were closed, people may have turned to online gambling, which is always available. “For seniors, they probably slowed their gambling because there’s no buses going to the casinos or other establishments,” Maney said. “Anxiety and depression triggers things differently in different people. We’ve seen cases of people able to control it more or others unable to control it.” He dreads when online mobile gambling will be legal in New York by the end of 2021. “Anytime there’s more expansion or availability, there will be more problems,” he said. The pandemic has helped more people gain access to treatment from counselors through remote sessions. For people who feel stigma about receiving help, Maney said that it is easier receiving treatment from home via the internet. Maney said that people from all demographics and economic levels can become compulsive gamblers. Jeff Footer, clinical services manager of the Restart Substance Abuse Program at Catholic Family Center in Rochester, said that people with substance abuse disorders may switch to gambling. “It’s triggering the same part of their brain as a substance,” Footer said. “It gives them a high. It’s not just winning the money. It’s the winning. They have won $2,000 but they spend $8,000. It’s as devastating as any other addiction but easier to hide until they’re evicted. That’s when

their family finds out.”

Some can hide for years Recognizing the need for treatment represents a big barrier to receiving care. Gambling addiction is much easier to hide and difficult to admit because it does not directly cause car accidents or overdoses. Those addicted to gambling can still function well for the most part; however, as the addiction progresses, their lives begin to fall apart. “The denial is so much higher,” Footer said. “Some can hide it for years. They look good and still have a job. The stress gets overwhelming and the suicide rate is so high.” Treating gambling addiction is much like treating substance abuse. Sara Hopkins, licensed clinical social worker and director of outpatient adult mental health services for Rochester Regional Health Behavioral Health, said that gamblers can help to receive assistance from a trusted person, a self-help group or a professional who understands addiction and compulsive behavior. “That can help a person recover and make desired changes in their lives,” she said. “Becoming knowledgeable about problem gambling is an important step in making changes and long-term recovery.” Support groups may take a 12step approach, like that of substance abuse support groups. A therapist may also help their patients develop coping skills to better ways to deal with anxiety and the urge to gamble, along with creating short-term and long-term goals. Those seeking help may call the Substance Abuse and Mental Health Services Administration national helpline at 1-800-662-HELP (4357).

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021


SmartBites

The skinny on healthy eating

Surprising Benefits of Rye Bread

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asteless, white Wonder bread was not the only bread I consumed during my growing years. Our family also ate a lot of rye bread: dark pumpernickel, marbled rye and traditional light rye. My German father insisted on it; and, over time, I grew to love the taste and texture. Since then, and with each pass-

ing year — years marked by disturbingly high cholesterol counts or worrisome digestive issues or tightening waistbands — my fondness for rye has only intensified. Why rye? Earthy, dense, chewy rye? Like other whole grains with the germ, endosperm and bran intact, unprocessed rye rocks with a variety of nutrients and health benefits.

Rye is a terrific source of fiber, ranging from about 2 grams to 6 grams per slice, depending on the kind of rye bread consumed. Many of our health problems — from heart disease to certain cancers, Type 2 diabetes to obesity — stem from too little dietary fiber, which is why leading institutions, like the American Heart Association, recommend we consume at least 25 to 30 grams of fiber a day. Whole-grain rye bread can help meet that goal. Blood sugar control is important for everyone, especially people with diabetes or at risk for developing Type 2 diabetes; and rye bread — thanks to its unique concentration of fiber, manganese, and phenolics (powerful antioxidants) — aids how we process sugar. Working together, these important nutrients help stabilize blood sugar levels by slowing both the release and absorption of sugar and insulin into the bloodstream. Adding whole grains like rye bread to your diet may reduce the risk of heart disease, according to studies at the Harvard School of Public Health. Multiple factors — from its cholesterol-lowering fiber to its aid in weight control (since whole grains make you feel full longer) to its inflammation-busting plant compounds — all contribute to healthier hearts.

Avocado Rye Toast with Egg, Tomato, and Sriracha Mayo

Sriracha Mayo 2 tablespoons light mayo ¼ cup plain low-fat Greek yogurt 1-2 teaspoons Sriracha sauce (or hot sauce of choice) 1 tablespoon lime or lemon juice salt and pepper to taste Lightly mash avocado with lime juice, salt, and pepper. Set aside. Whisk Sriracha mayo ingredients together in small bowl. Cook eggs any way you like. Toast rye bread. Spread Sriracha mayo (if using) over the toast, then top with avocado mash, tomato slices, and cooked egg. Lightly sprinkle with salt and pepper, if needed.

Helpful tips If possible, seek authentic rye bread from local bakers. If buying from store, read labels carefully: the first ingredient should say rye flour or rye meal, whether you buy light, dark or marbled rye. True pumpernickel, one of the healthier ryes, is made entirely from coarsely ground whole rye grains. For those who prefer a more lightly flavored rye, Pepperidge Farm makes a “Whole Grain Seeded Rye Bread” with a blend of whole wheat and whole grain rye flours.

Anne Palumbo is a lifestyle colum-

nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Serves 2

2 slices rye bread 1 avocado 1-2 teaspoons lime or lemon juice salt and pepper to taste 2 eggs 8 thin slices Roma tomato

AHA News: The Best Foods for Brain Health

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t’s easy to see the connection between an unhealthy diet and an expanding waistline. The connection between food and brain health can be harder to get your mind around. But experts agree. Eating right is essential for brain health. “Of all the organs in our body, the brain is the one most easily damaged by a poor diet,” said physician Lisa Mosconi, director of the Women’s Brain Initiative and an associate professor of neuroscience in neurology and radiology at Weill Cornell Medicine and NewYork-Presbyterian Hospital. “From its very architecture to its ability to perform, every aspect of the brain calls for proper food.” Mosconi, who has written books about the science of food and the brain, said many people have misconceptions about what “proper food” might be. One of the biggest fallacies she’s been hearing lately is the idea that a very high-fat diet is somehow helpful to the brain. “This is not what most research shows,” she said. Dietary supplements are another area where people get misled, said physaician Kristine Yaffe, professor of psychiatry, neurology and epidemiology at the University of California-San Francisco. Except when someone is deficient in a specific

nutrient, vitamin supplements don’t seem to improve brain health, she said. Similarly, supplements that contain omega-3 fatty acids and fish oil have gotten a lot of attention. But while they might help certain heart patients when prescribed by a physician, research has not confirmed benefits for brain health. “There have been a number of trials, and they haven’t borne out,” said Yaffe, who was a co-author on a 2017 American Heart Association advisory on brain health. So, what does work? “We still have a lot to learn about that,” Yaffe said. But certain foods do seem to help when they’re part of an entire dietary pattern. And that diet looks similar to the ones physicians recommend for heart health. A Mediterranean-style diet — heavy in fruits, vegetables, fish and nuts — lowers stroke risk in women and may lead to better cognitive ability in old age, studies have found. A 2018 study Mosconi led estimated it provided 1.5 to 3.5 years of protection against the development of biomarkers for Alzheimer’s disease. Another science-backed eating plan that limits red meat, sodium and added sugars and sweets, called DASH (dietary approaches to stop hypertenFebruary 2021 •

sion), may reduce stroke risk. Mosconi highlighted some nutrients — antioxidants, such as vitamin C, vitamin E and beta-carotene, and anti-inflammatory B vitamins and omega-3 fatty acids — that she said are important for the health of neurons. But neither Yaffe nor Mosconi is a fan of singling out something as the perfect brain food. “I don’t believe in ‘superfoods,’ or that any one food or food group is key to brain health,” Mosconi said. And not that there’s anything wrong with blueberries, Yaffe said, but “you wouldn’t want to be thinking, ‘If I only eat blueberries, that’s going to do it.’” It’s also important to think of foods that are potentially harmful to brain health, Mosconi said. Saturated fat, especially from animal sources, is associated with a higher risk of cardiovascular disease, she said. And some research also shows it increases the risk of cognitive problems. “When we eat a fatty, sugary meal and experience symptoms like sluggishness, brain fog and drowsiness — these symptoms originate not in the stomach but in the brain,” Mosconi said. And the effects aren’t necessarily temporary. Research indicates a poor diet

may cause the loss of key structural and functional elements in the brain, she said, along with “a higher vulnerability to brain aging and dementia.” A 2018 report from the Global Council on Brain Health, an independent group convened by the AARP, noted that foods and diets that are good for heart health are also good for brain health. Yaffe, a member of that brain health council, said the mechanisms of the brain are complex, but it stands to reason that “if you’re eating a dietary pattern that is heart-healthy, it’s probably also healthy (for) the vessels in the brain.” She acknowledged that some people have a hard time seeing the connections between brain health and their diet – or with other activities such as smoking, sleep and exercise. Mosconi, also a member of the AARP brain health council, put it this way: “Day after day, the foods we eat are broken down into nutrients, taken up into the bloodstream, and carried up into the brain. Once there, they replenish depleted storage, activate cellular reactions and, finally, become the very fabric of our brains. “Consider that the next time you reach for a brownie. Its ingredients will actually become part of your brain.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 11


Is It OK to Exercise When You’re Sick?

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f you are sick and plan to exercise this cold and flu season, experts say to use your head — and recognize the body’s warnings signs. It’s especially important to

take precautions this winter during the COVID-19 pandemic. Consulting a doctor always is a good idea if there are any questions about symptoms or whether to quarantine or

isolate. But in general, physical activity isn’t necessarily a no-no for a milder illness like a simple head cold. “The typical rule of thumb that a lot of practitioners and exercise physiologists like to stick to is that if symptoms are above the neck, it’s OK to get out there and do some exercise,” said Amanda Paluch, assistant professor at the School of Public Health and Health Sciences at the University of Massachusetts Amherst. Think a runny nose or light headache, though it might be wise to ease up from the typical routine, she said. “Maybe just going out for a walk instead of a vigorous run,” Paluch said. “You can still see benefits even with this lower intensity. Just getting out there could actually help you feel a little better.” Symptoms below the neck like chest congestion or upset stomach typically are signs to avoid exercise. Never exercise when you have a fever, regardless of whether it’s related to the flu, COVID-19 or another virus, said physician Felipe Lobelo, an associate professor at

Emory University’s Rollins School of Public Health. Recently updated guidance from the Centers for Disease Control and Prevention recommend that people diagnosed with COVID-19, with or without symptoms, generally should isolate for at least 10 days after the onset of symptoms or after a positive test. So, that means no exercising during that time, too, Lobelo said. Even after that 10-day period, he said people should wait another week before resuming exercise. And the return to exercise after recovering should be gradual. “You probably will feel deconditioned because of some bed rest and much lower levels of activity, on top of any lingering effects of COVID if you had a cough, fatigue or shortness of breath.” It’s important, Lobelo added, to notify your doctor if symptoms don’t improve gradually with exercise or if new symptoms like chest pain, shortness of breath or extreme fatigue develop during physical activity.

Cold Weather Exercise Could Burn More Fat

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f you want to burn fat this winter, take your exercise outdoors, researchers say. A Canadian study suggests that vigorous exercise in cold weather may burn more fat than working out indoors. Regular physical activity speeds metabolism and helps regulate fat in the blood (lipids), and high-intensity training is better for burning fat than moderate-intensity exercise, the researchers said. Temperature also

plays a role in metabolism during exercise. In the study, a group of moderately fit, overweight adults participated in two high-intensity exercise sessions. In both, they completed 10 one-minute cycling sprints at 90% effort. A 90-second recovery period of cycling at 30% effort followed each sprint. In one session, the temperature was about 70 F. (“thermoneutral”). In the other session, it was 32 F.

During both sessions, the researchers measured participants’ skin temperature, core body temperature, heart rate and the amount of oxygen delivered to the large thigh muscle. “The present study found that high-intensity exercise in the cold increased lipid oxidation by 358% during the exercise bout in comparison to high-intensity exercise in a thermoneutral environment,” according to the report published online

recently in the Journal of Applied Physiology. Longer-term metabolic responses after eating a high-fat meal did not change substantially after the cold condition, the researchers noted in a news release from the American Physiological Society. The lead researcher was Stephanie Munten of the School of Human Kinetics at Laurentian University in Sudbury, Ontario, Canada.

cial impact on psychological wellbeing. Being outdoors provides opportunities to escape from the stresses of being confined at home, maintain social relationships with others, and engage in physical activity – all of which can improve mental health. “Our findings have practical

health policy implications. Given that further lockdown restrictions have now become necessary in the UK, public health messages that promote getting some fresh air instead of staying indoors and staring at our screens could really help to lift people’s mood this winter.”

Heading Outdoors Keeps Lockdown Blues at Bay Study finds time spent outdoors is associated with higher levels of happiness

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new study has found that spending time outdoors and switching off our devices is associated with higher levels of happiness during a period of COVID-19 restrictions. Previous academic studies have indicated how being outdoors, particularly in green spaces, can improve mental health by promoting more positive body image, and lowering levels of depression and anxiety. Jointly led by academics from Anglia Ruskin University (ARU) in the UK, the Karl Landsteiner University of Health Sciences in Austria, and Perdana University in Malaysia, this new research examined how levels of happiness during a national lockdown were affected by being outdoors, the amount of daily screen time (use of TV, computer and smartphone) and feelings of loneliness. Using an experience sampling method (ESM), the researchers measured levels of happiness amongst a group of 286 adults three times a day, at random intervals, over a 21-day period. This allowed the participants to provide data in real-time rather Page 12

than retrospectively, helping to avoid recall biases. The research, published in the Journal of Happiness Studies, was carried out in April 2020, when the Austrian participants were allowed to leave their homes only for specific activities, which included exercise. It found that levels of happiness were higher when participants were outdoors rather than indoors. In addition, more daily screen time and higher levels of loneliness were both associated with lower levels of happiness. The impact of loneliness on happiness was also weaker when participants were outdoors. Co-lead author Viren Swami, professor of social psychology at Anglia Ruskin University, said: “While lockdowns can help slow down the transmission of COVID-19, research has also shown that prolonged periods of lockdown take their toll on mental health. “Our results are important in this context because they show that being able to spend time outdoors under conditions of lockdown has a benefi-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021


In 2020 alone, the 37 employees of Rochester Regional Health Foundations raised about $20 million.

Q A &

with Kelly McCormick-Sullivan New president of Rochester Regional Health Foundations talks about new position, the organization’s mission and her fundraising efforts during the pandemic

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By Mike Costanza

elly McCormick-Sullivan, the new president of Rochester Regional Health Foundations, has taken the nonprofit’s helm at a time when the coronavirus pandemic limits its ability to fundraise. The organization, which is Rochester Regional Health’s charitable arm, helps bring in the money that finances the health care giant’s operations. Those being cared for at about 150 facilities across the Finger Lakes region, including Rochester General Hospital, Unity Hospital in Greece and Clifton Springs Hospital & Clinic in Ontario County, benefit from the nonprofit’s work. In 2020 alone, the 37 employees of Rochester Regional Health Foundations raised about $20 million. In Good Health spoke to McCormick-Sullivan, who started her job on Nov. 30, asking her about her background, the organization she heads and the difficulties of fundraising in this climate. To those challenges, the Rochester resident brings the knowledge and experience she gained in a variety of high-level positions in the field of health care, including that of resident and CEO of Ronald McDonald House Charities of Rochester, NY. Q. What is RRHF’s mission? A. Getting out into the communi-

ty and building the generous support of individuals, families, companies and foundations to help Rochester Regional Health achieve its mission of enhancing lives and preserving health. At the end of the day, it comes down to relationships and connecting people with the amazing work that’s happening within health care. Q. You spent about 10 years in the corporate and academic worlds before entering the field of nonprofit health care. Why did you make the switch? A. I grew up in a household of people who were on the front lines of health care, and it was something that I always wanted to do. My mom was a registered OR (operating room) nurse and my dad was the president and CEO of Unity Hospital for 35 years. When he started, it was actually part of Park Ridge [Park Ridge Hospital, now named Unity Hospital, which subsequently became part of Rochester Regional Health]. Q. Before taking your current position, you were president and CEO of Ronald McDonald House Charities of Rochester, NY for about three-and-a-half years. Can you tell the readers of one of your accomplishments while with that role? A. We were able to demonstrate to the healthcare community both at Rochester Regional and at the [UniFebruary 2021 •

versity of Rochester] Medical Center that the programming that Ronald McDonald House provides impacts the quality of care. It decreases the cost of care and it improves the family experience. Q. You then took RRHF’s helm. What was that like for you? A. In a sense, it was like coming home. My dad was the president and CEO at Unity, and I have a strong connection to the health system because of that. It’s always been my goal to work in some capacity supporting not just Unity, but the entire health system. Q. What kinds of challenges has the coronavirus pandemic posed for you, and for RRHF? A. Starting any new job is always a challenge in and of itself, coming up to speed and just the learning curve. It’s also difficult to do fundraising during a pandemic, but yet it’s never been more important. The health system needs philanthropic support. Q. Can you tell us some of the difficulties that you and your staff are encountering because of the need to stay safe from the virus? A. You can’t be out meeting one-on-one with donors. I’m a firm believer that fundraising is all about relationships, but it’s challenging to try and do that over the phone or in Zoom. It’s just not the same as being in person. A lot of the fundraising events have also had to be canceled. Despite that, Rochester Regional Health Foundations is running fundraising campaigns, including the COVID-19 Support Fund. The campaign has brought in about $375,000 since it began in the spring. The funds support the greatest needs of patients with COVID-19, as well as frontline teams and researchers as they work to combat — and help end — this worldwide health crisis. Q. Are there other ways in which you plan to take on the challenges posed by coronavirus? A. I like to look at it for every challenge there’s an opportunity, and that’s how we’re going to charge into 2021. The opportunity is to use the time, where maybe we can’t be doing the things that we’d like to be doing in person, to make sure that when it is safe to do so, were going to be ready to hit the ground running. So, it’s a great opportunity to build strategy, to build our plans, to think about how we want to be really creative and donor-centric when it’s safe to do so. Q. You were born and raised in Fairport, and now live in Rochester with your husband and three children. What do you like to do when not at work? A. We love to travel, but this is making it so hard. We also do downhill skiing. Q. I understand that you and your family are also longtime “Jeopardy!” fans. A. We watch it every night together. I think tonight (Jan. 8) is Alex’s last night. We’re very sad. Note: Alex Trebek, host of the popular game show since 1984, died on Nov. 8 after a bout with pancreatic cancer. His last show aired on Jan. 8.

You don’t have to Youhearing don’t have face loss to alone. face hearing loss alone. The Rochester Chapter of the

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Why Visit a Hearing Specialist? Expert says some people with hearing loss won’t admit the problem and wait years to look for treatment By Deborah Jeanne Sergeant

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pecialists in the ears and hearing care for not only the actual function of hearing but may also deal with other issues and concerns such balance. Audiologists are one example. “Most audiologists have a clinical doctorate degree and are experts in the field of hearing health and balance disorders,” said Gregory Horton, audiologist and administrator at Rochester Hearing & Speech Center. “They are working to improve quality of life issues related to ear-related concerns.” He listed reasons for seeing an audiologist to include suspected difficulty or change of hearing, tinnitus (known as “ringing in the ears”), balance disorders or vertigo, ear pain or sustained ear pressure, discharge or drainage from the ears, or impacted ear wax. Numerous conditions can affect hearing. “Sometimes hearing loss can be related to other medical concerns and an audiologist may be the first health care provider to suspect this issue,” Horton said. “Once these conditions are suspected, a referral to an ear specialist (otolaryngologist) would be recommended for an additional evaluation.” Sarah Lookabaugh, otolaryngologist with Rochester Regional Health, said that seeking professional help is warranted “if you notice progressive or sudden change in hearing, especially sudden. That makes us think that something is going on that we

could treat and potentially restore the hearing.” She added that if hearing is different side to side, constant ringing, buzzing or humming, or any trouble understanding what people say. “If you have a history of a lot of ear infections. A lot of time if it’s swimmer’s ear or a middle ear infection, it can lead to scarring which can potentially affect your hearing as well,” Lookabaugh said. Having these and other hearing concerns checked out can help identify if the problem is treatable. Diminished hearing may not mean a hearing aid is the answer. Sometimes, the cause is temporary or treatable. In some cases, a hearing aid may present the best way to solve the problem. “A lot of patients we can manage with doing simple things like going to another room to talk face to face, or having the speaker not turn away while talking,” Lookabaugh said. “It’s not a guarantee you’ll get a hearing aid. Also, it doesn’t hurt to have an exam.” Unfortunately, those whose hearing gradually diminishes don’t notice or don’t want to admit the problem for a long time. The loss occurs so slowly that many people might not notice. What draws many people to seek treatment for hearing loss is “someone living with them or a kindly friend can’t tolerate it anymore that they need the television so loud,

constantly repeating and they get frustrated,” said Michelle Gross, a resident of Brighton and member of the Hearing Loss Association of America Rochester Chapter. “For people with progressive hearing loss, it’s easy to deny. You can make the television louder and it helps but you’re blasting out your spouse and children. Many deny hearing loss for seven years,” Gross said. While a primary care provider may offer adequate hearing screening to recommend further testing, Gross said some rely upon less than scientific testing like whispering instead of using instruments. “Tests where they talk with you aren’t that good because it’s a oneon-one situation and they’re facing you and the room is quiet,” Gross said. “Everything is ideal.” That situation is far from the everyday situations where ambient sounds make it even tougher to hear. Delaying treatment only makes it harder to treat. For those best treated with hearing aids, the performance and capabilities over instruments of even a decade ago has dramatically improved. Salvatore Tuttobene, board-certified hearing instruments specialist

with Clear Choice Hearing and Balance in Rochester, said that some people assume that hearing aids are the same as their parents’ or grandparents’ aids from decades ago, when clunky, behind-the-ear aids were the only styles available. “Modern hearing instruments are tiny,” he said. “Their Bluetooth capability allows them to stream television and the phone. Most people are flabbergasted when we tell them about these features. They can’t believe how much the tech has advanced in a short period of time.” Horton said that it is never too late to begin protecting what hearing remains. People routinely exposed to loud sound should plan ahead with the proper hearing protection devices. “Hearing loss is often a quality-of-life issue and when people experience changes to their hearing, they may find that they start to withdraw from interactions with friends, family and loved ones,” he said. Audiologists can help patients find the right solution for the individual, such as musician, hunter, construction worker, firefighter and factory worker. These individuals need to hear some sounds but must also block the damaging sounds.

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CALENDAR of

HEALTH EVENTS

Hearing loss group schedules virtual meetings

Thanks to its technology team, Hearing Loss Association of America (HLAA) Rochester Chapter will offer virtual programs in February for anyone interested in hearing loss. All use the Zoom platform. Preregistration is required by visiting the HLAA website at http://hearinglossrochester.org All programs are free and in real time. As well, closed captioning is an option for all participants. Programs for February are: • Noon, Feb. 2. “How We Hear and Why We Don’t.” presented by physician Elise dePapp. She will demonstrate the three-part anatomy of the ear and the detailed structure of the cochlea, the inner ear and brain pathways and auditory centers for understanding sounds. dePapp graduated from Sweet Briar College and earned her MD degree

at the University of Rochester. She is a retired pathologist who became interested in the pathology of hearing loss. • 10 a.m., Feb. 9. Hearing Other People’s Experiences (HOPE). Prospective, new or experienced hearing aid users can share their experiences, questions, and hearing loss journeys in an informal virtual round table discussion facilitated by Joe Kozelsky, a retired audiologist and hearing aid user. Real hearing aid users discuss real problems and concerns. • 10 a.m., Feb 18. Virtual ALD Demo center. HLAA-Rochester Technology Team. This is a continuing orientation to the online “Virtual Demo Center” website. It is a review of selected assistive listening devices, captioning-capable and amplified telephones, signaling-alerting devices and smart phone Apps related to hearing enhancement and gives the opportunity for the presenters to answer questions from those joining the Zoom meeting.

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What Causes Your Hearing Loss By Deborah Jeanne Sergeant

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ne out of eight people in the U.S, aged 12 or older has hearing loss in both ears, according to the National Institutes of Health, Up to 2% of adults 45 to 54 have disabling hearing loss. The percentage rises to 8.5% for the age group of 55 to 64. Almost 25% of those 65 to 74 have disabling hearing loss and half of those 75 and older have disabling hearing loss. “One of the myths of hearing loss is that we all lose our hearing with age,” said Gregory Horton, audiologist and administrator at Rochester Hearing & Speech Center. “Although hearing loss does affect a greater percentage of the population with each decade of life, age alone is not a predictor for hearing loss.” While some hearing loss is genetic, many cases are because of preventable causes. Horton said that noise exposure is a cause of hearing loss that can be avoided. Although most people think of very loud sounds as causing hearing damage, “in reality, excessive noise of all levels can cause serious, permanent hearing loss,” Horton said. “An extremely loud noise like a gunshot can cause hearing loss after just a few moments of exposure, while sustained lower-level noise can create the same amount of loss over time.” Salvatore Tuttobene, board-certified hearing instruments specialist with Clear Choice Hearing and Balance in Rochester, said that prolonged exposure to moderately loud sound is the type most people do not think about.

“People should limit their exposure and wear hearing protection when using equipment like snowblowers, lawn mowers and weed whackers,” Tuttobene said. “Or listening to loud music — that can cause damage. That noise exposure may not affect them until down the road. We’re seeing more and more people in their 40s and 50s who worked in skilled trades like roofers and around heavy machinery.” He described a typically hearing loss for a middle-aged or older farmer as occurring more dominantly on the left side. “When using controls on the tractor, they turn to the right so the left is exposed to the stacks,” he said. Many farm owners and other home-based business owners may remain unaware of safety guidelines or choose to ignore them because unlike a larger, more public business, there is no OSHA oversight. Hobbies that could cause hearing damage include those involving musical instruments, woodworking equipment and firearms. While headsets can be perfectly safe to use, their prolonged use at high volume can cause hearing damage. Michelle Gross, a resident of Brighton and member of the Hearing Loss Association of America Rochester Chapter, said that as a rule, people using a headset can test its volume safety by removing it and allowing it to play. “Hold it straight in front of you and see if you can hear it,” Gross said. “If you can, it’s too loud. For children, there are decibel limiting headsets. Even if the person puts February 2021 •

Snow blowers with an average sound level of about 80 to 85 decibels can potentially harm your hearing after two consecutive hours of exposure, according to the Centers for Disease Control and Prevention. Other noises that can cause hearing loss include firecrackers, sirens and other loud sounds. it on full volume, it won’t let them listen to it any louder. The time is another factor. If you listen to 80 decibels. for eight to 10 hours, you still may have a problem. The parent should break up the time into intervals.” In addition to noise-induced injuries, medical conditions and some prescription medication may contribute to hearing loss. Sarah Lookabaugh, otolaryngologist with Rochester Regional Health, said that some antibiotics, very high doses of aspirin taken daily, some anti-malarial drugs, Viagra, and chemotherapy can cause hearing damage. “Talk with your medical provider if you are concerned,” Lookabaugh said. She added that some head injuries, multiple sclerosis and some autoimmune diseases can cause hearing loss. “One we see not infrequently is a vestibular vestroma,” Lookagaugh said. “That grows on the balance nerve, which is also the hearing

nerve. It can cause nerve-related hearing loss.” She encouraged use of helmets to protect against head trauma when riding bicycles, all-terrain vehicles, horses and any other activity where it is warranted. Hearing protection devices, such as muffs and ear plugs, worn when engaging in activities that involve acute or continuous sounds. Lookagaugh said that starts around 80 decibels for eight hours or more per day; however, the time allowance decreases as the decibels increase. Not using protection against the continuous sounds that are too loud tends to result in hearing loss that manifests later in life. Lookagaugh said that for that reason, people don’t tend to take it seriously. They also do not realize why hearing loss is important. “Hearing loss makes a huge impact on their lives and limits their ability to communicate,” Lookagaugh said. “It can result in stress, poor self-esteem and is associated with a decline in memory and cognition.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Golden Years

U.S. Life Expectancy Rose in 2019, But 2020 Reversed That Trend

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efore the COVID-19 pandemic hit, life expectancy in the United States rose in 2019 for the second year in a row, according to two new federal government reports. But don’t expect that good news to be repeated in 2020. The impact of COVID-19 and other ills are projected to boost the death rate by 15% to exceed 3 million deaths for the first time in U.S. history, according to the Associated Press. COVID-19 has already killed more than 400,000 Americans. According to the AP, preliminary data suggest a year-end total for 2020 of more than 3.2 million U.S. deaths. That would be a new record and represent 400,000 more deaths than were recorded for 2019. The news agency noted that the rise from 2019 to 2020 marks the

biggest such jump since 1918-1919, when deaths soared due a combination of fatalities from World War I and the Spanish Flu pandemic. That remains the record period for any one-year uptick in American deaths, with fatalities rising by 46%, the AP reported. This year’s big rise in death comes after a welcome rise in Americans’ life expectancy during 2019, according to new data for last year, issued in December by the U.S. Centers for Disease Control and Prevention. The agency reported a record number of deaths nationwide in 2019 — 2,854,838, up 15,633 from 2018, which is expected as population rises. But life expectancy actually rose by 0.1 year, so that the average American had a life expectancy in

2019 of 78.8 years. Put another way, the age-adjusted death rate fell from 723.6 deaths per 100,000 population in 2018 to 715.2 in 2019. For 2019, the reports from the CDC’s National Center for Health Statistics showed that • Heart disease remained the No. 1 killer, claiming 659,041 lives • Cancer came in second with 599,601 deaths, and • Accidents/unintentional inju-

Food Insecurity: Nearly 200,000 People Affected in WNY According to Feeding America, nearly 200,000 people in a 10-county Western New York area (Monroe County included) can experience by food insecurity. Seniors are particularly affected By Deborah Jeanne Sergeant

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hile many people have figured out ways to get what they need and do what they need to do during the pandemic, some older adults still feel the effects of food access challenges because of COVID-19. Within the 10 counties comprising the Western New York through Monroe County area, Feeding America’s annual “map the meal gap” shows a 10.9% food-insecurity rate, which affects more than 136,000 people. The organization estimates that figure will rise to 15.7%, affecting almost 200,000 individuals. While many businesses and organizations have opened since last year’s quarantine period and the supply chains have become re-established, many older adults are still understandably hesitant to go near crowds, even if that means avoiding the grocery store. The frailty of older age, along with the age-related conditions many older adults experience, makes them more vulnerable to illnesses such as COVID-19. Staying away from crowds represents one strategy to limit exposure; however, it also makes obtaining food difficult. “In March, April, May and into the summer, the calls kept coming — hundreds every day,” said Mary Rose McBride, vice president of marketing and communications at Lifespan. Page 16

“Unable to leave the house and with food pantries closed, older adults’ food insecurity was obvious, and perhaps for the first time, highly visible. One caller said, ‘I only have one sleeve of Ritz crackers.’ Many, many others said they had only enough food for one day.” She added that Lifespan is still fulfilling requests for food through FoodLink (https://foodlinkny.org), which provides the food, and Medical Motors, which delivers twice a week, to the tune of 300 boxes a month. Lifespan is also delivering meals to older adults who would ordinarily attend the Wolk Older Adult Café for meals. Linda Tucker, registered dietitian and nutrition manager at ElderONE, an affiliate of Rochester Regional Health System, said that the pandemic has exacerbated food insecurity for older adults. “A lot of seniors that were previously going to senior centers to get meals, most of those are closed,” she said. She added that some have begun offering grab-and-go meals and home delivered food. “Meals On Wheels has increased,” Tucker said. “Since the pandemic, there are 200 more clients per month, equaling 10,000 more home delivered meals per month by the Monroe County Home Delivered

Meals program.” She added that Wayne County is delivering about 1,500 more meals per month than prior to the pandemic. Some organizations like this have switched from daily meals to weekly deliveries of frozen meals. The program also struggles because many of their drivers are older adults who feel concern about going out into the community; however, Tucker said that some young people on furlough from their jobs have stepped up to help.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021

ries totaled 173,040 deaths. In some good news, suicides fell from 48,344 in 2018 to 47,511 in 2019, and the suicide rate also declined, from 14.2 per 100,000 in 2018 to 13.9 in 2019. According to the American Federation for Suicide Prevention (AFSP), that’s the first decline in the suicide rate in two decades. For more information on life expectancy, visit www.cdc.gov/nchs/ fastats/life-expectancy.htm

Although most older adults saw no change to their income, they may live with relatives who are out of work or struggling with fewer hours. That means less money to spend on food. FoodLink’s mobile food pantry supplies conventional food pantries for anyone in need of help. Since March, the organization has served 120,000 drive-through meals; 700,000 meals from the Community Kitchen and has maintained 36 curbside markets to help vulnerable people access affordable food. Other organizations such as churches and senior centers have organized grab-and-go meals. “Anything congregant is still canceled,” Tucker said. “At ElderOne, we are starting to have folks come back, but it’s only 10 or less, not the 60 to 70 participants we normally saw among our three centers. Each is open only a couple days a week.” Limiting numbers helps prevent the spread of COVID-19 but it also limits the reach of such efforts in providing healthful meals. South Wedge Food Program, offered by the ROC SALT Center (www.rocsaltcenter.org/southwedgefoodprogram), offers market hours and food delivery once a month. ROC SALT is part of the Presbytery of Genesee Valley. The center also provides personal care items and pet items. Tucker has worked in meal delivery before, and likes that South Wedge offers pet items. “We’d hear about people sharing their meals with their pets because they could not get pet food,” she said. The City of Rochester’s Senior Meal Delivery Restaurant Grant Program involves 25 area restaurants that delivers three free meals a week to seniors in need. To participate, those 60-plus need to call 211.


Golden Years

Transportation, Income Affects Senior Food Insecurity By Deborah Jeanne Sergeant

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ood nutrition supports good health; however, for some older adults — including in the Rochester area — obtaining sufficient healthful food is challenging. According to USDA data gathered in 2018, more than 37 million Americans were food insecure. Of those, 5.3 million are seniors. “Food insecurity is a problem for seniors,” said Linda Tucker, registered dietitian and nutrition manager at ElderONE, an affiliate of Rochester Regional Health System. “They have definite reduced intake of nutrients they need. That can negatively affect their health. It is associated with increased prevalence of health problems, like congestive heart failure, diabetes, heart attack, asthma, hypertension, depression and it can also limit activities of daily living.” Subsisting on an unbalanced diet of mostly pre-packaged foods only worsens existing health problems and can cause new ones. The problem of senior food insecurity is local. Mary Rose McBride, vice president of marketing and communications for Lifespan, said

that “too many” older adults “have one day of food in their kitchens. The need has been startling.” For some older adults, the barrier to food is transportation or mobility. They may not drive anymore or may drive only locally. Driving to a full-service grocery store may require driving on busier streets. For others, navigating a large store is hard because of issues like balance, stamina, COPD, recent surgery or illness or arthritis. While ordering delivered groceries online seems an easy solution, it is not as readily embraced by some older adults. McBride said that Lifespan has provided information and how-to videos on its website to assist people in using food ordering or delivery services (www.lifespan-roch.org/ lifespan-covid19). Some accept Supplemental Nutrition Assistance Program (SNAP) benefits but charge a fee for delivery that SNAP does not cover. Ordering shelf-stable food through Amazon Prime or Walmart. com, for example, may help people

unable to lug around heavy groceries. Paring down the shopping list to just the fresh foods may make grocery shopping easier. Prime and Walmart offer free delivery for members ordering $35 or more. Not all food items in Walmart are available through the site. Amazon allows customers to set up regular shipments (choose “subscribe”), so a customer can automatically receive orders of frequently used goods without having to go online to order them. Ordering shipments may require a higher number of items, such as fourpack of soup instead of a single can. Some pharmacies that provide delivery do not mind adding to the order a few other items the store sells. That could help an older adult stay stocked up. A growing number of grocery stores provide curbside pick-up for those who have transportation but struggle with store navigation. This service may incur a fee. In addition to its regular bus stop routes, Regional Transit Service (RTS, https://myrts.com) provides bus rides on demand to persons of any age who call 48 to 24 hours in advance of when they want to travel. On a first-come, first-served basis, the ride costs seniors about $1.50 each way. An additional fee is charged for extra stops. The drivers do not assist people carrying packages or helping them onto the bus or to the door. Dial-A-Ride serves Genesee, Livingston, Ontario, Orleans, Seneca, Wayne, and Wyoming counties; On Demand serves Monroe County. Some communities offer scheduled senior rides or routes to help older adults access places to shop or keep appointments. Organization such as Catholic Family Center (www.cfcrochester.org) offers shopping transportation and, if needed, assistance, for a fee-based upon income. For people who do not cook, staying well fed is challenging. Many restaurants deliver; however, until recent times, the selection

was limited. Apps such as Grubhub and DoorDash deliver food from many restaurants; however, they charge a fee. For anyone with budgetary concerns, it is not a viable option. In general, many restaurants’ foods contain higher levels of fat and sodium than recommended for good health. Home meal delivery, food pantries, mobile food pantries and senior lunch grab-and-go sites are sources of inexpensive or free food for older adults. Home health assistance can also make mealtime easier for older adults who are no longer safe cooking at home. “If you don’t have food and you need help, you can call for help,” said Tucker of ElderONE. “The person who answers the phone can direct you to places where you might be able to get food.” She recommends the 211 general information line or New York Connects, 1-800-342-9871. “Calling either of those would really give the person options as to where they might go if they’re in need of food or want to apply for food stamps or need help with grocery shopping,” Tucker said. Asking a younger friend or relative, a civic or religious organization or a neighbor for assistance can make a big difference in eating well and eating poorly. It could be as simple as, “Could you give me a ride to the store the next time you’re going? I don’t drive into the city anymore.” Or asking, “Since you said you were going to the store, would you mind picking up a few things?” Perhaps offering to set up an Amazon subscription or a meal delivery plan would help an older adult. “It is hard to ask for help,” Tucker said. “We run into this because we help people who don’t have food and won’t ask their kids to help them.” For further resources, call SNAP, 1-800-692-7462; NY Connects/Lifespan, 585-325-2800; or 211.

“Our research suggests that physical activity may impact cognition in part through its effects on small vessels in the brain,” Palta said in a journal news release. “This

study adds to the body of evidence showing that exercise with moderate-to-vigorous intensity is important for maintaining thinking skills throughout your lifetime.”

Get Fit in Middle Age to Boost Your Aging Brain

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oderate-to-vigorous physical activity in middle age and beyond might help keep your brain healthy, a new study suggests. “Our study suggests that getting at least an hour and 15 minutes of moderate-to-vigorous-intensity physical activity once a week or more during midlife may be important throughout your lifetime for promoting brain health and preserving the actual structure of your brain,” said study author Priya Palta, an epidemiologist at Columbia University Irving Medical Center in New York City. “In particular, engaging in more than 2.5 hours of physical activity per week in middle age was associated with fewer signs of brain disease,” she said. For the study, published online Jan. 6 in the journal Neurology, Palta’s team collected data on more

than 1,600 people (average age: 53) who had five physical exams over 25 years and rated their weekly activity levels. Participants also had brain scans at the end of the study to measure their gray and white brain matter and areas of injury or disease in the brain. While the researchers only found a correlation, those participants who didn’t do moderate-to-vigorous intensity physical activity in midlife had 47% greater odds, on average, of developing small areas of brain damage compared to people who engaged in high levels of moderate-to-vigorous intensity physical activity. Higher activity levels were also associated with more intact white matter. White matter is tissue composed of nerve fibers that link different areas of the brain. February 2021 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 17


Golden Years

Post-Heart Attack Rehab Saves Lives By Deborah Jeanne Sergeant

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ardiac rehabilitation can help patients who have experienced a heart attack reduce their risk of experiencing another heart attack and other cardiac events. While a mainstream practice now, promoting these programs began in the 1970s. They were not widespread until the mid-2000s. Before this point, post-heart attack patients were told to rest and avoid performing hard work. Return to anything close to their pre-heart attack life? Forget about it. Treating patients after a heart attack “is so different than what it used to be,” said physician Seth Jacobson, director of the cardiac rehabilitation program at University of Rochester Medical Center. “We spend a lot of time taking care of our patients and advising them what to do after a major lifechanging events. The medical improvements from 30 years ago compared with now is night and day.” Jacobson said that after a heart attack, patients learn what happened to them and why — along with what they can do to lower the chances of it happening again. As an active participant in their own healthcare, patients learn about the changes they can make to get better. All that information can be a little overwhelming, so Jacobson recommends that patients bring along a helper to provide a second set of ears and take notes. Most patients will receive up to five medications, some long-term and others short-term, to perform tasks like lowering cholesterol,

controlling blood pressure, prevent blood from coagulating, and more. These medications allow the heart to recover and help the patient get vital numbers under control. “This isn’t an antibiotic where you take a pill seven days and you’re done,” Jacobson said. Patients also will plan follow-ups with a cardiologist and primary care physician to monitor their health. Other risk factors to work on can include smoking cessation and weight loss. The plan for rehabilitation also includes teaching patients how to safely become fitter, improve their diet, and enhance their emotional health. It is not a matter of a shortterm fix but lifestyle modification to gain and maintain wellness. As a result of their new lifestyle, patients may experience reduced need for medication, prevent future hospital admissions, become stronger, lose weight and better manage stress. “We want you to not only survive but thrive and get back to the level you were before,” Jacobson said. “We rehab people back to their condition before and better. We can improve their endurance and confidence. “We also screen for depression. That happens in one-quarter of those who have a heart attack. We think that people who have symptoms of depression are more likely to have a heart attack. It’s really something that should not be ignored. Depression factors into cardiac disease and leads to worse outcomes afterwards.”

Aging in Place More accidents and injuries happen in the bathroom than any other room in the house. How seniors can make their bathrooms safer and easier to use By Jim Miller

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ecause more accidents and injuries happen in the bathroom than any other room in the house, this is a very important room to modify, especially for seniors with mobility or balance problems. Depending on your parents’ needs and budget, here are some simple tips and product recommendations that can make their bathroom safer and easier to use. • Floor: To avoid slipping, a simple fix is to get non-skid bath rugs for the floors. Or if you want to put in a new floor get slip-resistant tiles, rubber or vinyl flooring, or install wall-to-wall carpeting. • Lights: Good lighting is also very important, so install the high-

Page 18

est wattage bulbs allowed for the bathroom fixtures and get a plug-in nightlight that automatically turns on when the room gets dark. • Bathtub/shower: To make bathing safer, purchase a rubber suction-grip mat, or put down adhesive nonskid tape on the tub/shower floor. And have a carpenter install grab bars in and around the tub/ shower for support. If your parents use a shower curtain, install a screw or bolt-mounted curtain rod, versus a tension-mounted rod, so that if she loses her balance and grabs the shower curtain the rod won’t spring loose. For easier access and safer bathing, consider getting a shower

Patients also meet with a dietitian to plan how to eat better and with an exercise physiologist for help in learning how to exercise. Cardiac rehabilitation lasts 36 sessions. Patients go twice weekly. Those who follow through with cardiac rehab reduce their risk of another significant cardiac event by 25% to 50%. Insurance covers the rehabilitation with co-pays and those with Medicaid or Medicare pay very few fees. Jacobson said that since the rehabilitation is so important, his organization works with people who struggle to cover the co-pays. Social workers can help arrange transportation for those who lack it. Despite its importance, most patients do not follow through with cardiac rehab. Jacobson estimated only 20% to 25% of those eligible participate. “Some patients don’t feel like going,” Jacobson said. “Some of it is because their doctors don’t recommend it strongly enough.” Simone Bailey-Brown, cardiologist with Rochester Regional Health, said that if patients do not receive the recommendation for cardiac rehab at the hospital, then they should when they meet with their cardiologist. “Cardiac rehabilitation is a very important program for patients who

have survived a heart attack,” Bailey-Brown said. She also said that for some patients, work restrictions may be required; however, that depends upon the nature of their work, the severity of the heart attack, and their condition after the heart attack. Jonathan Rodriguez, a cardiologist with Geneva General Cardiology Associates, considers cardiac rehabilitation as part of preventive cardiology. “Cardiac rehab helps to foster healthy lifestyle choices during a time when patients may be reluctant or afraid to do so,” he said. “This is in a safe environment, usually under the guidance of experienced registered nurses.” Insurance usually covers cardiac rehab for chronic heart disease such as coronary artery disease or chronic systolic heart failure and patients who have had a heart procedure or surgery. “Cardiac rehab has become a multidisciplinary tool to help patients optimize their risk factors to lead healthy lives,” Rodriguez said. “The future of cardiac rehab lies in expanding the indications for cardiac rehab to diastolic heart failure and those patients considered high risk for adverse cardiac outcomes.”

or bathtub chair so your parents can bathe from a seated position. In addition, you should also have a handheld, adjustable-height showerhead installed that makes chair bathing easier. If your mom or dad has the budget for it, another good option is to install a curb-less shower or a walk-in-bathtub. Curb-less showers have no threshold to step over, and come with a built-in seat, grab bars, slip resistant floors and an adjustable handheld showerhead. While walkin tubs have a door in front that provides a much lower threshold to step over than a standard tub. They also have a built-in seat, handrails and a slip resistant bottom, and some have therapeutic features like whirlpool water jets or bubble massage air jets. Curb-less showers and walk-intubs run anywhere between $2,500 and $10,000 installed. • Toilet: Most standard toilets are around 15 inches high and can be an issue for taller seniors with arthritis, back, hip or knee problems. If your mom has trouble getting on or off the toilet, a simple solution is to purchase a raised toilet seat that clamps to the toilet bowl, and/or purchase toilet safety rails that sit on each side of the seat for support. Or you can install a new ADA compliant

“comfort height” toilet that is 16 to 19 inches high. • Faucets: If your mom or dad has twist handles on the sink, bathtub or shower faucets, consider replacing them with lever handle faucets or with a touch, motion or digital smart faucet. They’re easier to operate, especially if she has hand arthritis or gripping problems. Also note that it only takes 130-degree water to scald someone, so turn the hot water heater down to 120 degrees. • Doorway: If your mom or dad needs a wider bathroom entrance to accommodate a walker or wheelchair, an inexpensive solution is to install some swing clear offset hinges on the door which will expand the doorway an additional two inches. • Emergency assistance: As a safety precaution, you should also consider purchasing a voice-enabled medical alert system like Get Safe (GetSafe.com) for her bathroom. This device would let her call for help by simple voice command, or by pushing a button or pulling a cord. You can find all of these suggested products at either medical supply stores, pharmacies, big-box stores, home improvement stores, hardware and plumbing supply stores, as well as online.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021


5

Golden Years

Things You Need to Know About Alzheimer’s Disease

By Ernst Lamothe Jr.

A

lzheimer’s disease occurs when changes in the brain methodically stunt and slow down memory and cognitive thinking. It’s associate with those in their senior years and it often worsens with time. Alzheimer’s disease is the most common cause of dementia, a continuous decline in thinking, behavioral and social skills that disrupts a person’s ability to function independently. “Someone who has moderate to severe Alzheimer’s disease can see their quality of life decrease drastically,” according to physician Ciandra D’Souza, assistant professor in the department of medicine at University of Rochester Medical Center. “They may get frustrated with not being able to remember common occurrences in their lives and it can affect their ability to live independently.”

1.

Symptoms One of the key indicators of Alzheimer’s is memory loss. While we all have moments of forgetfulness, what makes this different is the recurring aspects along with the sudden decrease of short-term memory. “You will find someone repeating the same sentences over and over again or not realizing in one conversation that they are telling the same

story repeatedly,” said D’Souza, who is also board-certified in internal medicine. “Also, when someone forgets the name of family members, familiar places or has problems finding the correct words for a situation, it can be a sign that the symptoms are worsening.” This disease kills 2. Alzheimer’s Disease is the sixth leading cause of death in

the United States, according to the National Institute of Aging. More than five million Americans are living with the disease. By 2050, the number is projected to rise to nearly 14 million. “People are dying from this disease,” said D’Souza. “We cannot understate the seriousness of what someone goes through who has Alzheimer’s.” Support is essential 3. Because Alzheimer’s targets the memory of an individual,

it can cause layers of difficulties for those battling through it. That is why it is important to have a close support system. “Oftentimes, family is going to be the first people who notice cognitive changes,” said D’Souza. “They are going to notice the changes in speech, memory and overall behavior.” Another reason she touts family as essential is because once someone

receives the diagnosis, they will need people around them for encouragement and overall help, especially if the disease progresses rapidly. “It really does take a village, and support is one of the best ways you can help your family and friends,” said D’Souza. “Many times people just feel lonely and isolated.” Alzheimer’s is not just a 4. part of aging Medical officials believe one of

the reasons that Alzheimer’s gets diagnosed later than it should is because people just see memory loss as part of getting older. They equate it in the same manner as arthritis, back pain or diminished eyesight. “The problem is that it often isn’t until it is too late that someone comes in to see a doctor and tell them what is happening. They will say they are fine and they won’t mention that they are having memory lapses,” said D’Souza. “Sometimes it is because of stubbornness or thinking it is associated with getting older so they don’t see it as a problem. Yes, you may not remember things as quickly as you used to when you get older, but that is in a different category than having a severe cognitive disease.” Possible blood test 5. For years, medical experts have been hoping to find new

ways to predict someone’s propensity to getting Alzheimer’s. Recently,

Acupuncture: Does It Work and Is It Covered by Medicare?

M

any studies over the years — funded by the National Institutes of Health — have found acupuncture to be very effective in easing pain and can help with a variety of other ailments too. Here’s what you should know.

Acupuncture Treatment

First used in China more than 2,000 years ago, acupuncture has become increasingly popular in the United States over the past decade. While acupuncture isn’t a cureall treatment, it is a safe, drug-free option for relieving many different types of pain, including low back pain, neck pain, osteoarthritis, migraine headaches, fibromyalgia, postoperative pain, tennis elbow, carpel tunnel syndrome, dental pain and more. Studies have also shown that it can be helpful in treating asthma, depression, digestive disorders, menopause symptoms like hot flashes, and nausea caused by chemotherapy or anesthesia. Exactly how or why acupuncture works isn’t fully understood, but it’s based on the traditional Eastern theory that vital energy flows through

pathways in the body, and when any of these pathways get blocked, pain and illness result. Acupuncture unblocks the pathways to restore health. However, today most Western practitioners believe that acupuncture works because it stimulates the nerves causing the release of endorphins, which are the body’s natural painkiller hormones. It’s also shown to increase blood circulation, decrease inflammation and stimulate the immune system.

What to Expect

During acupuncture, practitioners stimulate specific points on the body by inserting thin needles through the skin. The needles are solid, sterile and disposable (used only once), and as thin as a cat’s whisker. The number of needles used for each treatment can vary anywhere from a few, up to a dozen or more. And where the needles are actually stuck depends on the condition being treated, but they are typically inserted about a quarter-inch to one-inch deep and are left in place for about 20 minutes. After placement, the needles are sometimes twirled or manipulated, or stimulated with elecFebruary 2021 •

tricity or heat. You may feel a brief, sharp sensation when the needle is inserted, but generally it’s not painful. Once the needle is in place, however, you may feel a tingling sensation, numbness, mild pressure or warmth. How many treatments you’ll need will depend on the severity of your condition — 12 treatments done weekly or biweekly is very common. It’s also important to know that acupuncture can be used in conjunction with other conventional medical treatments, or by itself.

Cost and Coverage

Physician Ciandra D’Souza, assistant professor in the department of medicine at University of Rochester Medical Center. researchers found that a combination of brain PET scans and spinal fluid tests can help discover the disease as early as two decades before it occurs. While that doesn’t mean anything is reversible, when early detection occurs it can help treatment. Experts say the new discovery could lead to testing of new drugs and creative treatment options. “Right now it is important for people to know that there is no definite cure for Alzheimer’s disease,” said D’Souza. “But that doesn’t mean there are not ways to slow down the progression. This test is an example of how we can work with the philosophy of early detection to educate and put a plan together for the disease.” ture sessions in 90 days for patients with chronic lower back pain. Eight additional sessions can be added if patients show improvement. But in order to receive Medicare coverage, you must use a licensed acupuncturist who is supervised by a medical doctor, physician assistant or nurse practitioner trained in acupuncture, who will need to process the acupuncture claim. Currently, licensed acupuncturists can’t directly bill Medicare. To find an acupuncturist in your area ask your doctor for a referral, or you can do a search online. Two good resources are the National Certification Commission for Acupuncture and Oriental Medicine (nccaom.org), and the American Academy of Medical Acupuncturists (medicalacupuncture.org), which offers a directory of MDs and DOs who are certified to practice acupuncture.

The cost per treatment typically runs anywhere from $40 to $150, depending on where you are in the country and what style of treatment you are receiving. Today, an increasing number of private insurance plans, including some Medicare Advantage plans, and policies provided by employers offer some type of acupuncture coverage. You’ll also be happy to know that in January 2020, the Centers for Medicare and Medicaid Services announced that original Medicare will now cover up to 12 acupuncIN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 19


Ask St. Ann’s

COVID-19 Vaccines: Another Line of Defense Against Coronavirus

A

fter months of anticipation, COVID-19 vaccines with 90–95% efficacy rates are available to help save lives and bring hope to the world. Receiving this added layer of protection against COVID-19 is essential in achieving the herd immunity necessary to end the pandemic. The development of the Pfizer and Moderna COVID-19 vaccines and Emergency Use Authorization by the Food and Drug Administration happened in record time because the vaccines use Messenger RNA (mRNA) technology, which scientists worldwide have been researching for 30 years. Unlike traditional vaccines that contain the weakened virus, such as polio and measles vaccines of your youth, mRNA vaccines contain the “recipe” for the spike protein from COVID-19 — a critical piece of its protein coat. After receiving the vaccine, the body makes antibodies to this protein, and markedly reduces the chance you will get sick from the virus. So, rest assured that these vaccines cannot give you COVID-19. The only reason you would have COVID-19 symptoms or test positive after being vaccinated is that you already had the infection and didn’t know it. Should you get vaccinated? YES! For the vaccines to be effective, you must receive two doses administered three to four weeks apart. You’ll develop protection — meaning there are enough antibodies in your system to help your body fight COVID-19 effectively and potentially prevent it altogether — approximately two weeks after your second injection. A small percentage of people may experience short-term discomfort for about 24 hours after each dose of the vaccine, such as a headache, muscle pains, fatigue, chills, fever and pain at the injection site. If you do, don’t worry — this is your body’s immune system creating antibodies to fight off the virus, which is good news. Don’t let the experience deter you from getting both doses for full protection! Even if you had COVID-19 and have antibodies, it’s wise to get vaccinated for protection against future infections. The Centers for Disease Control and Prevention (CDC) recommends waiting 90 days after your infection to be vaccinated. You should also hold off if you are currently ill with a fever or have an active COVID-19 infection. Individuals prone to allergic reactions to injectable medications or polyethylene glycol should also consult their doctor to determine if they should obtain the vaccine.

Page 20

Ask The Social

By Kim Petrone. M.D

‘Rest assured that these vaccines cannot give you COVID-19. The only reason you would have COVID-19 symptoms or test positive after being vaccinated is that you already had the infection and didn’t know it.’ Protect yourself and others. Until the vaccine is widespread, it’s not safe to assume that those around you have been vaccinated, too. And because scientists are still learning about COVID-19, it’s unclear if people can still transmit the disease to others, even after being vaccinated. With these factors in the mix, the best way to keep everyone as safe as possible is to continue social distancing, wearing masks, and practicing frequent hand hygiene. The medical team at St. Ann’s Community has begun vaccinating healthcare staff and elders in its long-term care communities, per the recommendations from the CDC and the New York State Department of Health. Only time will tell how long protection from the new COVID-19 vaccines will last. While no vaccine is perfect, it’s safe to say that this vaccine will be crucial in ending this pandemic. Now’s the time to err on the side of science when making health care decisions. You can find the latest COVID-19 vaccine information at www.cdc.gov. Kim Petrone, MD, is the Medical Director at St. Ann’s Community. She is board-certified in internal medicine and geriatrics. Contact her at kpetrone@ mystanns.com or visit www.stannscommunity.com.

Security Office

From the Social Security District Office

Hearings With the Social Security Administration During COVID-19

I

n March 2020, we temporarily closed all of our Social Security Hearing Offices due to the coronavirus pandemic and are not offering in-person hearings. During the office closures, we are providing two flexible, safe and secure hearing options: either a telephone hearing or our new option of an online video hearing. Additional information on both of these hearing options is available here: www.ssa.gov/appeals/hearing_options.html What are “online video hearings”? Online video hearings are a secure way to conduct hearings over the internet, using a free platform called Microsoft Teams. You and your representative, if you have one, can attend the online video hearing safely and securely from any private place with a secure internet connection using a camera-enabled smartphone, tablet or computer. Like our telephone hearings option, the online video hearings option is not mandatory. We will conduct online video hearings the same way we conduct telephone and in-person

Q&A Q: I worked for the last 10 years and I now have my 40 credits. Does this mean that I get the maximum Social Security retirement benefit? A: Probably not. The 40 credits are the minimum number you need to qualify for retirement benefits. However, we do not base your benefit amount on those credits; it’s based on your earnings over a lifetime of work. To learn more about how you earn Social Security credits and how they work, read or listen to our publication How You Earn Credits, available at www.socialsecurity.gov/ pubs. Q: I’m expecting a baby this June. What do I need to do to get a Social Security number for my baby? A: Apply for a number at the hospital when you apply for your baby’s birth certificate. The state agency that issues birth certificates will share your child’s information with us and we will mail the Social Security card to you. You can learn more about the Social Security number and card by reading our online publication “Social Security Numbers for Children”, available at www.socialsecurity.gov/ pubs. Q: Someone stole my Social Security number, and it’s being used repeat-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021

hearings. During the hearing, the administrative law judge (ALJ) will swear in all hearing participants and listen to your testimony. You will see the ALJ and representative, if one has been appointed. Other participants, such as vocational or medical experts and interpreters, will join by phone. What are the technology requirements to participate in an online video hearing? You and an appointed representative, if applicable, must have access to email and a personal computer, laptop, Android or Apple tablet or mobile device with a secure and private, high-speed Wi-Fi or cellular data connection. The device must have a camera, microphone, and speakers. If using a mobile device, you must download the free Microsoft Teams application. We will send you a link to a user guide that explains how to access and use Microsoft Teams before the date of an online video hearing. Please read our publication Online Video Hearings at the Social Security Administration at www. ssa.gov/pubs/EN-70-10284.pdf for additional information. A short video about online video hearings is available at www.ssa.gov/appeals/ hearing_video.html.

edly. Does Social Security issue new Social Security numbers to victims of repeated identity theft? A: Identity theft is one of the fastest growing crimes in America, so you aren’t alone. If you’ve done all you can to identify and fix the problem, including contacting the Federal Trade Commission (FTC), but someone is still using your number, Social Security may assign you a new number. If you decide to apply for a new number, you’ll need to prove your identity, age, and U.S. citizenship or immigration status. You’ll also need to provide evidence you’re having ongoing problems because of the misuse of your current Social Security number. You can read more about identity theft at www.socialsecurity.gov/pubs. Q: What is the earliest age I can begin receiving Social Security retirement benefits? A: The earliest age you can begin receiving Social Security retirement benefits is age 62. If you decide to receive benefits before your full retirement age, which for most people is age 66 or 67, you will receive a reduced benefit. Keep in mind you will not be able to receive Medicare coverage until age 65, even if you decide to retire at an earlier age. For more information, go to www. socialsecurity.gov/retire.


DO YOU HAVE DRY EYES?

By Jim Miller

What Caregivers Should Know About Medicare Dear Savvy Senior, I am the caregiver for my 81-year-old mother, who recently fell and broke her hip, and have a lot of questions about how original Medicare works and what it covers. Where can I get some help understanding this program?

Overwhelmed Caregiver

Dear Caregiver,

Excellent question! Having a working knowledge of Medicare can help you take full advantage of the coverage and services it provides to ensure your mom receives the best care possible. Here’s what you should know.

Medicare Assistance

A good starting point to get familiar with Medicare is the official “Medicare & You” handbook that overviews the program. It’s mailed to all beneficiaries every fall and provides an up-to-date description of all services and benefits. You can also see it online at Medicare.gov/medicare-and-you. If you have a particular question, you can call and visit with a Medicare customer service representative at 800-633-4227. Medicare also works closely with State Health Insurance Assistance Programs (SHIP) to provide free health insurance counseling. To find a SHIP counselor in your area visit ShiptaCenter.org or call 877-839-2675. Caregivers also find Medicare’s secure website — MyMedicare.gov — especially useful. After setting up a personal account for your mom, you can view the details of her coverage, track recent health care claims and keep up to date on the preventive services she qualifies for.

Compare Tools

Medicare can also help you locate the right health care providers for your mother. At Medicare. gov/care-compare you can find and compare doctors, hospitals, home health agencies, dialysis facilities, inpatient rehab facilities, long-term care hospitals and nursing homes in your mom’s area.

What Medicare Covers

Medicare can reduce many outof-pocket medical expenses your mom incurs, but it doesn’t cover everything. Understanding what Medicare does and doesn’t cover can save you time and spare you frustration when navigating the caregiving maze. Here are some key points for caregivers: Besides basic hospital and physician services (which includes telehealth services) and optional

prescription drug benefits, Medicare covers home health care too. To qualify, your mom must be homebound, under a physician’s care and in need of part-time skilled nursing care or rehabilitative services like physical therapy. Medicare also helps pay for oxygen, catheters and other medical supplies that a doctor prescribes for home use. The same is true for medically necessary equipment like oxygen machines, wheelchairs and walkers. In addition, Medicare covers skilled care in a nursing home for limited periods — up to 100 days — following hospital stays. But it doesn’t cover long-term stays. Patients who need custodial care (room and board) must pay out of pocket unless they’re eligible for Medicaid or have private long-term care insurance. Medicare pays for hospice care too, for someone with a terminal illness whose doctor expects to live six months or less. The hospice benefit also includes brief periods of respite care at a hospice facility, hospital or nursing home to give the patient’s caregivers an occasional rest. Besides long-term nursing home stays, original Medicare typically doesn’t cover regular dental care or dentures, regular eye exams or eyeglasses, and hearing exams and hearing aids. Likewise, it won’t pay for nonemergency ambulance trips unless a doctor certifies they’re medically necessary. To find out what Medicare covers, visit Medicare.gov/coverage and type in the test, item or service you have questions about, or download the Medicare “What’s covered” app in either the App Store or Google Play.

Financial Assistance

If your mom lives on a limited income, you should check whether she qualifies for help with prescription drug costs or with other Medicare-related premiums, deductibles and copayments. For help with drug costs, visit SSA.gov/prescriptionhelp or contact Social Security at 800-772-1213 and ask about the “Extra Help Program.” For help with other Medicare costs, go to Medicare.gov or call 800-6334227 and ask about the “Medicare Savings Programs.” Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. February 2021 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2021


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