IGH Rochester Issue 138

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in good Meet Your Doctor

February 2017 • Issue 138

GVhealthnews.com

New medical director at Lifetime Care Hospice, physician Miyeon Oh, talks about palliative care, hospice care and making end-of-life patients as comfortable as possible

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Rochester’s Healthcare Newspaper

Golden Years Special

Doctor Still Practicing, at Age 89

Valentine’s Day

Melvin Dyster, a physician in Western New York, has been practicing medicine since 1954. “I love it,” the 89-year-old doctor says. He sees patients most days of the week

Can You Really Die of Broken Heart?

p. 15

Low Back Pain

What’s the source — and what to do about it

1.3 Million U.S. Adults Identify as Transgender

Nurses: No. 1

For the 15th year in a row, nurses are the No. 1 most trusted professionals. See Healthcare in a Minute, page 9

Delicata Squash

This great-for-you veggie is known for its soft texture, its scrumptious flavor (similar to sweet potatoes), its tender skin (edible!) and its bounty of health benefits. Read more in SmartBites.

Cancer at Age 33 How a Rochester woman takes on incredible odds p. 21 against cancer

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US Life Expectancy Decreases

Americans who were born in 2015 expected have shorter lives. See what had caused this trend and why experts are worried about it.

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1.3 Million U.S. Adults Identify as Transgender

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ne of the first comprehensive surveys on the subject estimates that about 1.3 million American adults currently identify as transgender. The new data is based on answers to a 2014 U.S. government survey of more than 151,000 adults conducted across 19 states. Transgender people identify with or express a gender identity that differs from the gender they were born with. Researchers say that 0.53 percent of respondents — about one in every 189 U.S. adults — answered “yes” to the question, “Do you consider yourself to be transgender?” Transgender individuals were

more likely to identify as male-tofemale (0.28 percent of adults surveyed) than female-to-male (0.16 percent), the study found. “The transgender population is a racially diverse population present across U.S. communities,” concluded a team led by physician Halley Crissman of the University of Michigan. Transgender adults were more likely to be nonwhite than white, the survey found. Many transgender people face economic hardship. The study found that 26 percent lived below the poverty line, compared to 15.5 percent of non-transgendered respondents. Transgender people were also less

likely to have attended college, the researchers said. These inequalities “have negative implications for the health of the transgender population,” Crissman’s team said. However, in other respects, transgender people’s lives were similar to those of other Americans. About half of both transgender and non-trans-

Cardiology Still a Man’s Field, Survey Finds Women less likely to choose that specialty, and they report more discrimination than males

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ost cardiologists in the United States are men, and many female cardiologists report discrimination in the workplace, a new survey finds. “We need to increase the diversity of our workforce, and find ways to recruit higher numbers of women and underrepresented minorities,” said survey senior author, physician Claire Duvernoy, chairwoman of the Women in Cardiology Council at

the American College of Cardiology (ACC). The council conducted the survey. “We must work to change the culture that allows this to occur in our field,” Duvernoy added. The poll included more than 1,300 male and almost 1,000 female cardiologists. The findings revealed that the percentage of women reporting workplace discrimination fell from 71 percent to 65 percent in

the past 20 years, but that rate is still three times higher than it is among men. Women were more likely to report discrimination related to gender and parenting, while men were more likely to report racial and religious discrimination, the investigators found. Women are still much less likely to choose cardiology than other medical specialties. In 2013, women

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

February 2017

gender people were married, for example, and they had roughly the same levels of employment. The researchers stressed that many transgendered people may not have answered “yes” to the survey question out of privacy concerns or stigma, so the numbers reported may still be an “underestimation.” Still, any accurate representation of what the study authors call this “marginalized” population should further efforts to help improve the lives of transgender Americans, they said. The challenges many transgender people face mean that many need “support for tackling factors deterring [them] from continuing education, including harassment and discrimination,” Crissman’s team said. The findings were published online Dec. 20 in the American Journal of Public Health.

accounted for 13 percent of cardiologists, compared with more than 35 percent of internists, more than 30 percent of hematologists/oncologists, 18 percent of general surgeons and more than 50 percent of obstetricians gynecologists. The survey also found a significant increase in the number of cardiologists older than 60 compared with a decade or two ago. Also, the proportion of cardiologists in private practice fell from 73 percent in 1996 to 23 percent. The findings were published Dec. 21 in the Journal of the American College of Cardiology.


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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Request either or both of our free booklets from our website www.AlbrightBuild.com

Feb. 20

March 28

Lifespan is looking for five people aged 70 or older to honor at its 21st Celebration of Aging luncheon at noon, Thursday, March 30, at the Floreano Riverside Convention Center. The organization encourages nominations from the public. Honorees are role models for how they are taking on the opportunities of longer life. They lead fulfilling lives no matter what their age or life challenges. Nominations are due by Feb. 20. Just visit www.lifespan-roch.org/celebration-of-aging-2 Lifespan gives the Second Half Hero Awards in memory of one of our founders, Eli Rudin. In 2016, 1,600 people attended the Celebration of Aging. Guest speaker this year is zookeeper Jack Hanna. Hanna is the director emeritus of the Columbus Zoo and Aquarium. He was director of the zoo from 1978 to 1992, and is viewed as largely responsible for elevating its quality and reputation.

The New Fibromyalgia Support Group is sponsoring a workshop that will highlight traditional Chinese medicine and acupuncture and how they help keep the body healthy. A practitioner will also discuss working with traditional Chinese herbs and medicinal plants to help improve the everyday life of those who suffer from fibromyalgia. This workshop will give attendants, especially those suffering chronic pain, the modalities and tools to better work through the stress of it all. The workshop will take place from 6 to 8:30 p.m., Tuesday, March 28, in the meeting room at Westside YMCA, located at 920 Elmgrove Road in Gates. The meeting is free and open to the public. No need to be a YMCA member to participate. Classes are small and registration is needed. Register with a voicemail by calling 585-752-1562. Leave your name and details.

Lifespan seeking ‘Second Half Hero’ honorees

James W. Albright, CAPS, GMB, CGR, CGP 5205 Johnson Hill Drive, Canandaigua, NY 14424 Cell (5850 230-4280; Fax(585) 396- 5879 albright1.j.s@gmail.com www.AlbrightBuild.com

Fibromyalgia group to discuss Chinese medicine

Red Cross Issues an Emergency Call for Blood and Platelet Donations

What if you could choose?

5 Days or 45 Days

The American Red Cross has a severe winter blood shortage and is issuing an emergency call for blood and platelet donors to make a donation appointment now and help save patient lives. Hectic holiday schedules for many regular blood donors contributed to about 37,000 fewer donations in November and December than what was needed. Snowstorms and severe weather have also impacted donations. Nearly 100 blood drives were forced to cancel in December, resulting in more than 3,100 blood donations going uncollected. “Blood and platelet donations are critically needed in the coming days so that patients can continue to receive the lifesaving treatments they are counting on,” said James Love, executive director of the American Red Cross Rochester Chapter. “We encourage donors to invite a family member or friend to donate with them to help meet patient needs. Right now, blood

and platelet donations are being distributed to hospitals faster than they are coming in.”

How to help

Find a blood donation opportunity and schedule an appointment to donate by using the free Blood Donor App, visiting redcrossblood.org or calling 1-800-RED CROSS (1-800-7332767). The Red Cross is extending hours at many donation sites for more donors to give blood or platelets. Overall, the Red Cross has added nearly 200 hours to blood donation centers and community blood drives across the country over the next few weeks. Donation appointments and completion of a RapidPass online health history questionnaire are encouraged to help speed up the donation process. “In about an hour, you can help save someone’s life. This simple act can have a profound impact on another human being,” said Love.

Veterans encouraged to submit artwork

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

The Canandaigua VA Medical Center is asking veterans who receive care from a VA medical center or community-based outpatient clinic, to share their creative abilities by participating in the 2017 National Veterans Creative Arts Competition. Art categories include fine art such as painting, drawing, sculpture and photography; applied art that includes ceramics, carving, needlework and leatherwork; and craft kits such as string art, fabric art and wood building. Veterans should call Hank RieFebruary 2017

gel, recreation therapy supervisor at 585-393-7371 for an entry application and how to submit their art work. The competition is an annual event that provides veterans receiving VA health care the opportunity to participate in creative self-expression in art, creative writing, dance, drama and music as part of their therapy, and to gain recognition for these artistic accomplishments. Artwork by veterans will be on display to the public at the Canandaigua VA Medical Center March 8


Call 585-670-0020 or go online to schedule at riddlewellness.com

“After suffering a major injury and 8 1/2 months of physical therapy, cortisone shots, and even surgery I was worse off and in more pain than ever. My insurance company had even cut me off. Within 20 minutes of walking through the door of an ARP clinic I was swinging the club full speed with no pain.” - Chris Loughney Pro Golfer

February 2017 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Miyeon Oh, M.D. New medical director at Lifetime Care Hospice talks about palliative care, hospice care and how she and her staff try to make end-of-life patients as comfortable as possible Q: I understand you have a background in infectious diseases? How did you transition into hospice? A: Yes, I did internal medicine and infectious diseases, and I took care of HIV patients for a while. I think it played a role. At the time, the folks with HIV weren’t doing as well. They were very ill and many died. So it did help develop my interest in end-of-life care.

to care for the patient should they become a hospice patient. But palliative care patients aren’t necessarily terminally ill. They might be newly diagnosed with cancer, be living at home. And they may recover or many years later become hospice patients. Q: Hospice seems to differ from most other

Q: You’ve been with Lifetime Care for a while now. What made you want to step into the medical director position? A: I came here two and a half years ago. I’ve been in the field of hospice since 2000. I wanted to take the medical director position to be more available to the patients and our staff who are providing hospice care. Q: What’s the difference between palliative and hospice care? A: We have palliative care and hospice care. Palliative care is a broader term. So when we say “palliative care,” it’s detached from any prognosis. Hospice care specifically refers to the care given to terminally ill folks. It’s not only for patients, but we also include family and caregivers. So we have both palliative care and hospice, but I’m the medical director for hospice specifically. Our nurses who take care of palliative care patients will continue

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

specialties in that the goal isn’t to cure the patient, but to maximize the quality of the end of their lives. How does that change your approach from an administrative perspective? A: For patients who are recommended to have hospice services, they have to have run out of medical treatment options. While we can’t either hasten or prolong death, there’s a lot that we actually can do. While they’re alive, we’ll help them live as well as possible. We provide not only medical care, but support them emotionally and spiritually and try to help them live fully day by day. So it’s very different than most specialties, but I find it very gratifying to help them find meaning at this stage that could be very depressing. A lot of our patients, though they are very seriously ill, may feel well and use it as a time for closure. So it’s very different in the sense that death isn’t just medical, but personal. Q: Since your staff has to be around death so much, how do you deal with the psychological and emotional needs of your personnel? How do you help them to avoid burning out? A: That’s a very good question. The burnout rate, as you might expect, is rather high. You end up encountering your own mortality when you work with the dying, and they have to move from one death to another. A lot of times they don’t have time to process the deaths of patients they may have developed a bond with. They might not have

February 2017

In the News Physician Miyeon Oh has recently named medical director at Lifetime Care Hospice. She is responsible for the clinical oversight of the hospice program delivered to residents of Monroe, Wayne and Seneca counties, both in home and home-like settings. Previously she was the associate medical director at the organization.

time to talk about that. So we give support to staff. We have a self-care program for our staff. Every Tuesday we have mindfulness sessions in the morning. They can talk to our counselors if they need to. I encourage my staff to talk to me if they ever need to talk about one of their patients or their feelings. A lot of times they feel like they’ve failed the patient, so it’s very important to share their feelings. I try to make myself available to talk to. Q: How do you assist the families of your patients? A: Every patient gets assessed for emotional needs and spiritual needs. They’re assigned to a social worker and have access to pastoral care and grievance counselors. So it’s a part of our assessment. It’s not uncommon to have patients to make use of all those, as well as volunteer services like massage therapy and pet therapy. It’s a very comprehensive approach. We use a team approach, so each patient has an interdisciplinary team working with them. Q: What are the primary challenges you hope to tackle as director? A: My guiding light is that I want to give the kind of care I’d like to receive. When I see my patients, I see myself and my family. I want to be proud of my work and my agency. So that’s my guiding light. So I want to work on communication between staff, patients, and family as well as between coworkers. So that’s the mark I want to make. I want to be able to recommend my agency to my loved ones. Q: How do you divide your time between your practice and administrative duties now? A: I think it would be 50 percent seeing patients, 50 percent administrative.

Lifelines Name: Miyeon Oh, M.D. Position: Medical director at Lifetime Care Hospice Hometown: Seoul, South Korea Education: Inha University College of Medicine (1992) Affiliations: University of Rochester system Organizations: American Academy of Hospice and Palliative Medicine; Hospice and Palliative Care Association of NYS; National Hospice and Palliative Care Organization Family: Husband, three daughters Hobbies: Running, walking, gardening, enjoying nature


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February 2017 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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US Life Expectancy Decreases Americans who were born in 2015 expected have shorter lives By Deborah Jeanne Sergeant

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ecently released data from pursuits such as exercise and stress National Center for Health Sta- reduction. It also contributes to tistics shows that life expectan- substance abuse, as does untreated cy for a person born in 2015 is down mental health issues. from 78.9 years to 78.8 years. Michael Merrill, internal medWhile that may not seem like a icine physician with Rochester large decrease, the fact that medical Regional Health, thinks that the advances are not outpacing death evidence points to “social determirates for the first time in a decade nants of health. We think of ourselves causes medical experts some conin America as individuals, but we cerns — and a hard look at why are part of larger social groups and we’re dying. systems, and they affect how Sara Otis, health healthy we are. Think of and wellness coordiwhat happens when somenator for Lifespan in one in a family gets very Rochester, pointed sick, or gets laid off: other out that rising rates people in the family of obesity play a big start suffering, too. The role in longevity. same thing happens in “It raises risk of a larger scale in neighhigh blood presborhoods, and in larger sure, which leads regions.” to wear and tear on Socio-economic facblood vessels and the tors can make a differheart and leads to ence as to whether or plaque,” she said. not people have ac“The heart has cess to nutritious to work much food, health edharder.” ucation, means Elevated to exercise cholesterol in and alleviate the blood also stress. taxes blood “We are vessels and the all in this heart. Obesity together, also raises the but we risk of diadon’t betes, which take care brings poof each tentially fatal other well,” complications. Merrill said. Otis added “Those with that stress can resources also contribute —for examto ill health. ple, jobs and “We live money — in a frenzied can protect Life expectancy for babies born in 2015 society,” themselves has decreased — a first in a generation she said. to an ex“It’s hard for people to stay current tent by exercising, and eating well, and present. People can stay overand doing all the right preventive whelmed pressured.” medicine things. But as long as the In addition to stress’ direct system we live in has such profound harmful effects on the cardiovascular problems, it will affect longevity on system, busyness edges out healthful average.”

How to Increase Your Chances to Live Longer To improve your healthy longevity, local experts offer a few tips: • “Making small changes in the dayto-day can have a big impact. • Get out and be with people. Don’t stay isolated; feel connected. It’s been shown to play a huge impact in people’s health.” Sara Otis, health and wellness coordinator for Lifespan in Rochester • “This is certainly a home away from home for lots of folks. They come for lunch and lots of activities. • “We have inter-generational activities. They get to work with the youth on a variety of activities. Some will read to them or do a craft activity. They feel more part of the community.” Shelly Gorino, senior center coordinator at Henrietta Senior Center in Rochester • “Check out your local community centers, and libraries. There are often affordable or free programs that will keep you active, and by revisiting favorite programs or trying something new, you keep things interesting for yourself. • “I think it is important to follow the advice of the trusted advisers in your life. • “Balance your diet. • “As people get older, health conditions can complicate life, but I have been lucky enough to meet people who really focus on the positive in their life, and by doing so, they radiate good energy that draws others to them. • “It’s always worth trying to be positive. If you plan to live a long life, it would preferably be a happy one.” Emily Kelsey, senior citizen program coordinator at Brookside Community Center, Brighton

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

February 2017

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Group: Rochester Hospitals May Lose Up to $1.4 Billion if ACA is Repealed

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he Rochester Regional Healthcare Advocates is opposed to the repeal of the Affordable Care Act without an immediate and meaningful replacement because it could financially damage hospitals in the Rochester area and reduce access to coverage for thousands of New Yorkers. “We need to protect Upstate New York hospitals from potentially damaging cuts,” said Travis Heider, president and CEO of Rochester Regional Healthcare Advocates. “Many hospitals in New York are already financially vulnerable. New York’s average hospital operating margin of 1.3 percent is the second worst in the nation, far below the national average of 6.4 percent. Repealing the Affordable Care Act without an immediate replacement would seriously harm many hospitals, including hospitals in the Greater Rochester area.” In addition to providing needed

care 24/7, Rochester hospitals are a major force in the local economy. Hospitals in the Greater Rochester Region deliver care to 6.4 million patients, generate over $7.2 billion in economic activity, produce over $807 million in tax dollars for local economies, provide $469 million in care for the underserved and are responsible for more than 53,000 jobs. According to the Healthcare Association of New York State, repeal of ACA would cost Greater Rochester Hospitals up to $1.4 billion over the next 10 years. “Hospitals and health systems across New York state are making strides in transforming care delivery to reduce costs while improving care quality. This transformation requires substantial investment, long-term commitment, reconfiguration of care delivery, and accepting risk and responsibility for healthcare in entire communities,” said Amy Pollard,

president and CEO of UR Medicine/ Noyes Health and chairwoman of the Rochester Regional Healthcare Advocates. “A repeal of the ACA without replacement would pull the rug out from under all of us.” A repeal of ACA in whole or in part should only be pursued if replacement is simultaneous and meaningful: for patients in the form of affordable, robust, and continuous health coverage at least as expansive as under ACA for the state of New York, according to the group.

“The Rochester Regional Healthcare Advocates stands with the Greater New York Hospital Association and Healthcare Association of New York and urges Washington to avoid actions that could compromise New York hospitals,” said Heider. For more information about RRHA’s position on this matter, contact Mary Beth Walker at 585-2738186 or email mwalker@seagatealliance.com. Or visit www.rochesterregionalhealthcare.org.

Healthcare in a Minute By George W. Chapman

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Most Trusted Profession

or the 15th year in a row, nurses are the No. 1 most trusted professionals, according to Gallup’s annual poll that ranks the honesty and ethical standards of various professionals. Healthcare providers took four of the top five spots. Following nurses are: No. 2 pharmacists, No. 3 physicians, No. 4 engineers, No. 5 dentists. Also ranking high were teachers and police officers.

2016: Some Good Health News

Colon cancer, dementia and heart disease started declining in developed countries. Since 1990, the number of women dying due to pregnancy or childbirth has declined by half. Public smoking bans have improved health in 21 countries and the number of US smokers has declines by 8.6 million since 2005. Harvard scientists are honing in on an antibiotic discovery that could help remedy the growing antibiotic resistance crisis. Homelessness has decreased in the US by 35 percent over the last 10 years. Teenage pregnancies have declined in the US for the 24th year in a row. Large oil spills declined from an average of 25 per year in the 1970s to just two a year now. Charitable donations were at an all-time high, again led by Warren Buffet at $2.9 billion and Bill Gates at $5 billion.

Hospital Mergers

In recent months, both the Federal Trade Commission and the Department of Justice have increasingly intervened to thwart or block

hospital mergers. While one can only speculate what President Trump will do, there is a history of support for antitrust enforcement in healthcare from both parties. The fear is that mergers have tended to drive up costs whether in the same or separate markets. A potential merger between Catholic Health Initiatives and Dignity Health this year would create the nation’s largest system by revenue. The number of Catholic-owned or affiliated hospitals has grown by 22 percent since 2001, resulting in control of 17 percent of acute care beds in the US.

States Ranked by Health

United Health Foundation just released its America’s Health Rankings. It takes into consideration 34 measures of behaviors, community, environment, policies and clinical data like smoking, obesity, substance abuse, cardiovascular disease, etc. The five healthiest states are: No. 1 Hawaii, (five years in a row) No. 2 Massachusetts, No. 3 Connecticut, No. 4 Minnesota, No. 5 Vermont. The five unhealthiest states are: No. 50 Mississippi, No. 49 Louisiana, No. 48 Arkansas, No. 47 Alabama, No. 46 Oklahoma. It should be noted four of the five worst states are in the southeast. NYS ranked No. 13.

Choose Hospital Wisely

A study published in the academic journal “Public Library of Science” (PLOS One) found that patients cared for in the “worst” hospitals were three times more likely to die and 13 times more likely to have complications than if cared for in one of the “best” hospitals. 22 million February 2017 •

admissions were studied, using 24 measures of medical outcomes. Researchers found significant differences among hospitals. Under terms of the agreement, in order to get hospitals to participate, the identity of the hospitals were kept confidential. In general, hospitals that treated high volumes of certain conditions fared better than those with low volumes. Most patients have little information about the differences between hospitals. The study raised the obvious question of why don’t we have broader outcomes measurement and transparency around performance available to the public.

Cost of Drugs for Seniors

The AARP Public Policy Institute reports that the price of drugs used most commonly by seniors rose more than 130 times the rate of inflation between 2006 and 2015. The average senior takes four or five different drugs every month which comes to about $26,000 annually if taking only brand name drugs. The median annual income for seniors is about $24,000. While Medicare covers some of the cost through part D, these price increases drive up Medicare premiums and the senior’s copays. Many believe congress should use the purchasing power of Medicare and Medicaid to negotiate drug prices with big pharma in order to contain spiraling drug costs.

Ontario, Canada, Healthcare

Bill 41, or The Patients First Act, is creating more controversy than our ACA because it impacts all citizens. Proponents argue it will streamline and integrate healthcare. Oppo-

nents argue it does nothing to help over-worked physicians and reduce waitlists for services (it can be several months to two years to see some specialists) and only serves to add to the already expensive and redundant bureaucracy. Unlike the US, Canada actually has “unemployed” physicians. The government controls access and expenses by restricting the number of physicians available in each of the provinces. Many of the “unemployed” physicians end up working here in the US. Once there is an “opening,” many return to Canada. On the flip side, compared to the US, the cost of care in Ontario is relatively cheap. We average about $10,000 per person in the US. The budget for 14 million people in Ontario is $50 billion. That comes to just $3,571 per person. While we are spending way too much, and with modest results, it seems that Ontario can afford to put some more physicians to work which would take some pressure off current providers and reduce the ridiculous wait lists for care. Physicians in Ontario have dubbed the bill “Bureaucracy First, Patients Last Act.” George W. Chapman is a healthcare consultant who works with hospitals and medical groups. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@ gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

How Content Are You? A Quiz

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erriam-Webster defines contentment as “the state of being happy and satisfied.” This dictionary definition of contentment sounds like a nice way to feel, doesn’t it? Oh, if we could just snap our fingers and be happy with who we are and what we have. Wouldn’t life be grand?! I’ve had the privilege of meeting and talking with a lot of women and men who live alone, and our conversations often turn to the subject of contentment: how to find it, how to keep it and how to find it again once it’s been lost. Those on their own often feel a

lack of something in their lives, and many have trouble letting go of a craving for things to be different. I know. I’ve “been there.” For years, after my divorce, I had trouble seeing the good in myself and in my life. But with time, intention and practice, I was able to stop yearning for what I didn’t have and to start appreciating what existed right in front of me. It all began with taking a hard look at myself. It was an important first step, and I created the quiz below to help you assess where you are on your own road to contentment.

How Content Are You? Circle the choice that best answers the questions below: 1. What do you admire most about yourself? If asked, how many positive personal qualities come immediately to mind? A. Five or more B. One to four C. Nothing really comes to mind

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2. How would you describe your home? A. Very “me” — I’ve made it my own! B. It’s fine. I keep meaning to redecorate, but just haven’t gotten around to it C. It’s a place to sleep 3. The past is the past. How would you describe your success in letting go of old ways of thinking and of negative thoughts or behaviors that keep you anchored in the past? A. I live in the present; it’s full steam ahead! B. I still go “back there” from time to time C. I can’t let go, I obsess about the past 4. Could you imagine planning a trip by yourself and traveling alone to a favorite destination? A. In a heartbeat! B. Maybe someday C. I can’t imagine that 5. Does the thought of going alone to a cafe for a cup of coffee or grabbing a bite to eat in a local restaurant feels perfectly comfortable, even enjoyable? A. I do it all the time B. Occasionally, but I’m not at ease C. I’m just not ready 6. Are your health and fitness priorities for you? Do you exercise, get enough sleep, and stay on top of health screenings? A. Of course B. I know I should, but I don’t always take care of myself C. I’m too preoccupied to think about my health 7. How often do you reward or pamper yourself by taking some time just for you or by purchasing that little something special you’ve had your eye on? A. As often as I can! B. Sometimes, but I tend to put others’ needs first C. I can’t remember the last time I pampered myself

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8. Have you let go of the idea that you need a spouse to be happy and have a good life? A. Absolutely B. Mostly C. No. I feel I need a spouse (or significant other) to be content

To See how you ranked turn to page 18 Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, NY. For information about her Living Alone workshops or to invite Gwenn to speak, call 585-624-7887 or email: gvoelckers@ rochester.rr.com. Page 10

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

Webster • Rochester Call Today: 1-855-270-1583

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Low Back Pain:

What’s the Source? By Dustin Maracle

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f you’re like 80 percent of all Americans, you have at one point or another suffered from back pain in your life. Lower back pain can come at a variety of ages and for a variety of reasons. Sprains and Strains The back is a very complex structure consisting of muscles, ligaments, tendons, neural tissue, bones, fluids, discs and other connective tissue that all function together to provide support and stability. Sprains and strains in the lower back are a common cause of pain and usually localized in the lower back and associated tissue. Flexing, twisting, pulling and straining these soft tissues can cause one of these injuries. A strain is defined as a when a lumbar muscle is pulled or stretched beyond its ability, and a tear results, causing damage to the muscle fibers. A sprain, on the other hand, occurs when a lumbar ligament is pulled or stretched farther than it can anatomically give, resulting in a tear of these tough, connective tissue structures. Both of these injuries can create acute lower back pain with localized inflammation and, if untreated, chronic pain from scar tissue and instability. Disc Injuries There are many terms used to describe a lumbar disc injury, such as disc protrusion, disc bulge, disc herniation, slipped disc and many others. While the exact diagnosis is different for all and terminology changes between specialists, the exact injury involves a change to the fluid filled disc that separates the lumbar vertebrae. These injuries can cause immediate inflammation and localized pain, and in more severe cases nerve pain that migrates into the buttock and down the lower extremity, usually only on one side. These injuries are most often caused by repetitive flexion and twisting movements, causing the disc itself to migrate posteriorly, and often occur between 20-50 years old.

Arthritis, Degeneration and Stenosis Another common cause of lower back pain is age-related. Many patients come to our clinics with complaints of generalized pain in their lower backs, which gradually worsens over time and becomes more severe. As we age, the fluid in the discs that separate our vertebrae diminishes as a result of gravity, activity and degeneration. As a result, there is less space between the joints and more compression on the supporting tissues and bones. Pain and symptoms in these cases can be worse in the mornings and when “first getting moving” as a result of the cartilage that protects the ends of these joints wearing away over time. Movement and exercise are key to help alleviate the pains associated with degeneration. Each and every individual case of lower back pain is different and unique. No one case is the same and all patients are treated differently depending on the exact case and diagnosis. Physical therapists are able to properly diagnose the source of the back pain through examination, and help guide patients to recovery in many cases, without having to resort to surgery. As all cases are different, some individuals will need more treatment (X-rays, MRI, epidural injections, surgery). Speak to your physical therapist to see if you can avoid more costs and issues, and let them initiate you on your road to recovery. Dustin Maracle graduated from the University at Buffalo with a doctorate in physical therapy and works at Lattimore Physical Therapy & Sports Rehabilitation Network in Rochester, where he is co-owner and clinical director. To contact him, call 585-582-1330 or email him at dustinmaracledpt@gmail.com.

SERVING MONROE AND ONTARIO COUNTIES in good A monthly newspaper published

Health Rochester–GV Healthcare Newspaper

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. © 2017 by Local News, Inc. All rights reserved. 154 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Jessica Gaspar, Diane Kane (M.D), Dustin Maracle Colleen M. Farrell, Eva Briggs (M.D) • Advertising: Anne Westcott, Debra Kells • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler 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.

February 2017 •

18 CONVENIENT LOCATIONS IN MONROE AND LIVINGSTON COUNTIES

Close to Where You Work or Live

Early Morning and Late Evening Hours for Your Convenience LATTIMORE PHYSICAL THERAPY NETWORK AVON PHYSICAL THERAPY 490 Collins Street Avon, NY 14414 Phone: 226-2480 Fax: 226-2494 Co-Clinical director: Jon Gerenski, DPT Co-Clinical director: Leslie Summers, PTA Owner: Mario Melidona, PT DANSVILLE PHYSICAL THERAPY 40 Village Plaza Dansville, NY 14437 Phone: 335-2456 Fax: 335-3494 Owner: Matt Marino, MS, PT

LATTIMORE OF IRONDEQUOIT PT 1299 Portland Ave Suite 10 Rochester, NY 14621 Phone: 286-9200 Fax: 286-9203 Clinical Director: Lindsey Yu, DPT, LMT LATTIMORE PHYSICAL THERAPY AND SPORTS REHABILITATION 1655 Elmwood Ave Suite 130 Rochester, NY 14620 Phone: 442-9110 Fax: 442-9049 Clinical Director: Erin Tobin, PT, DPT

LATTIMORE OF FAIRPORT PT 59 Perinton Hills Shopping Ctr Fairport, NY 14450 Phone: 385-0444 Fax: 385-0442 Clinical Director: Matthew Stoutenburg, MS, PT, CSCS

LATTIMORE PHYSICAL THERAPY (Land and/or pool based therapy) 383 White Spruce Blvd Rochester, NY 14623 Phone: 442-6067 Fax: 442-6073 Clinical Director / Owner: Andrew Chatt, DPT, OCS Owner: Cynthia Shuman, MS, PT, ATC

LATTIMORE OF GATES-CHILI PT 5 Fisher Road Rochester, NY 14624 Phone: 247-0270 Fax: 247-0294 Clinical Director: Jeff McGiven, PT

NORTH GREECE PHYSICAL THERAPY 515 Long Pond Road Rochester, NY 14612 Phone: 227-2310 Fax: 227-2312 Owner: Tim Anne, MS, PT, MLD-CDT

LATTIMORE OF GENESEO PT 4577 Morgan View Road Geneseo, NY 14454 Phone: 243-9150 Fax: 243-4814 Clinical Director: Johanna Kaufman, DPT

PIANO WORKS PHYSICAL THERAPY 349 W. Commercial St. Ste. 1275 East Rochester, NY 14445 Owner: Leah Gerenski, DPT, OCS

LATTIMORE OF GRPT 2000 Empire Blvd. Building 2 Webster, NY 14580 Phone: 671-1030 Fax: 671-1991 Clinical Director: Melissa Graham, DPT, OCS

PITTSFORD MENDON PT 20 Assembly Dr. Suite 101 PO Box 212 Mendon, NY 14506 Phone: 582-1330 Fax: 582-2537 Clinical Director: Dustin Maracle, PT, DPT, MS, SCS, COMT,CSCS

LATTIMORE OF GREATER PITTSFORD PT 40 State Street Pittsford, NY 14534 Phone: 387-7180 Fax: 387-7182 Clinical Director: Adam Ellis, DPT

RUSH HENRIETTA PT 60 Finn Road Suite C Henrietta, NY 14467 Phone: 444-0040 Fax: 444-0052 Clinical Director: Karen Shufelt, DPT, CHT

HILTON PHYSICAL THERAPY 1026 Hilton Parma Corners Rd. Suite 1, PO Box 131 Hilton, NY 14468 Owner: Matt Landon, DPT HONEOYE FALLS LIMA PT 58 North Main Street Suite 200 Honeoye Falls, NY 14472 Owner: David Monsees, MS, PT

LATTIMORE OF SPENCERPORT PT 37 N. Union Street Spencerport, NY 14559 (585)349-2860 Fax (585)349-2995 Clinical Director: Russell Manalastas, DPT, SCS, COMT, CSCS LATTIMORE OF WEBSTER PT 1130 Crosspointe Lane, Suite 6 Webster, NY 14580 Phone: 347-4990 Fax: 347-4993 Owner: Adam Frank, MS, PT

www.lattimorept.com IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 11


SmartBites

Delicata Squash with Quinoa Stuffing

The skinny on healthy eating

Delicious, Nutritious Delicata Winter Squash

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f you haven’t tried delicata squash — an oblong-shaped winter squash with yellow-colored skin and green stripes — steer your shopping cart to the produce aisle. This great-for-you veggie is known for its soft texture (unlike other winter squashes, it can be easily sliced and chopped), its scrumptious flavor (similar to sweet potatoes), its tender skin (edible!) and its bounty of health benefits. On the vitamin front, the delicata, with its orange-yellow flesh, is a vitamin A superstar, providing nearly all of our daily needs in one cup. A nutrient we can’t live without, vitamin A is essential for growth, healthy skin, vision and a well-oiled immune system. Delicata also packs an impressive vitamin C punch. Immune-boosting vitamin C helps the body maintain healthy tissues, heal wounds in a timely manner, and neutralize cell-damaging free radicals that can sow the seeds for disease. Many studies have linked winter squash — delicata included — to a lower risk of certain cancers. Their fiber (perhaps more with delicata because you can eat the skin) and abundant carotenoids help shuttle out inflammatory and potentially cancer-causing substances from the body. Those looking to lose or main-

tain weight will appreciate delicata’s health cred: half a squash delivers a scant 30-40 calories and is super low in saturated fat, cholesterol and sodium. Moreover, delicata’s slow-digesting fiber helps us feel fuller longer, so we’re not as inclined to reach for those chips. And while delicata squash, like all winter squash, has more carbs than your average vegetable, recent research has made it clear that all starch is not the same: there are “nature-made” good carbs that get absorbed more slowly into our systems and then there are “refined” bad carbs that zip through us lickety-split. Thankfully, delicata is full of good carbs and all the benefits they reap: more stable blood sugar levels, longer-lasting energy, improved digestion and fiber-driven heart protection.

Helpful tips:

Select squashes that feel firm, especially near the stem ends, and that feel heavy for their size. Steer clear of those with blemishes or soft spots. Store delicata squash in a cool, dark, well-ventilated area for up to one month. Delicata may be cooked whole, split lengthwise, or sliced. As mentioned, the nutrient-rich skin is edible, so you can leave it on.

Adapted from EatingWell.com Serves 4

2 small delicata squash (12-14 ounces each), halved lengthwise and seeded ¼ teaspoon salt ¼ teaspoon ground pepper 2½ tablespoons olive oil, divided 1 cup water ½ cup quinoa 1½ cups chopped leek (about 2 large), white and light green parts only 1 teaspoon dried thyme 1 teaspoon dried parsley ⅓ cup dried cranberries ⅓ cup coarsely chopped pecans, toasted salt and pepper to taste Preheat oven to 400 degrees. Line a baking sheet with parchment paper. Halve the delicata lengthwise and carefully scoop out the seeds to make four long “boats.” If the boats are too wobbly, take a very thin slice off the bottom so they’ll sit flat. Brush cut tops with olive oil (1 tablespoon for all 4), season with salt and pepper, and arrange cut-side up on the prepared pan. Bake until they are soft and just starting to char a little, about 25 minutes. Remove from oven and reduce temperature to 350 degrees. While squash is baking, prepare stuffing. Combine 1 cup water and quinoa in a small saucepan and bring to a boil over medium heat. Cover, reduce heat to a simmer and cook until the quinoa is tender, about 15 minutes. Remove from heat, fluff with fork and let stand, covered, for 10 minutes. Transfer to medium bowl.

Heat 1½ tablespoons olive oil in a medium skillet over medium heat. Add leek and cook, stirring constantly, until the leek is tender and edges are slightly browned—about 8 minutes. Add the leeks, thyme, parsley, cranberries, pecans, and salt and pepper to bowl of quinoa and stir well. Spoon the quinoa mixture into the squash halves, packing as needed. Bake at 350 degrees until the stuffing is heated through, about 15 minutes. Tasty tip: Seeds may be washed and roasted.

Anne Palumbo is a lifestyle columnist, 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.

Food for a Healthy Heart

Three experts talk about the best food you can eat to protect your heart By Deborah Jeanne Sergeant

C

oncerned about heart disease? What you eat can make a difference regarding your risk. Along with other lifestyle factors, diet can raise or lower your changes of heart disease. We spoke with three experts who offer some suggestions.

Sara Otis, health and wellness coordinator at Lifespan, Rochester: • “Avocados have monounsaturated fat, which is the good fat that lowers the LDL, the bad cholesterol Page 12

and increases HDL, the good cholesterol. You can have it on toast or in salads. • “I also like berries in yogurt. They have vitamin C, fiber and potassium. They lower LDL and raise HDL and contain antioxidants. • “Some studies have shown lowfat dairy may lower blood pressure. It’s a delicious way to incorporate berries. You can add nuts like almonds that protect against heart disease and have the good unsaturated fat, fiber and omega-3 fatty acids. • “Salmon also has omega-3 fatty acids, which are good for reducing triglycerides in the blood. They have vitamin E, which reduces plaque in arteries.

Molly Ranney, registered dietitian in private practice in Victor: • “The more meatless you can go, the better. It’s good for your heart because it reduces your intake of saturated fat. • “Eat sources of fat like the Mediterranean sources of fat: plant-based fats like olives, nuts and seeds. • “Consume dairy in moderation. Think to add dairy in your diet more as an accent, like a bit of parmesan cheese, but don’t cover everything in cheese. • “Go with more natural foods. I’m not a fan of everything that’s processed. • “Choosing whole foods is the priority over low-fat and fat free foods. Fat adds flavor. Research is showing that since we went low-fat and no-fat, obesity rates have climbed dramatically. Fat hasn’t made us fat. Many low-fat and no-fat foods are full of sugar. I’d rather use a full-fat product and use less. Yogurt: go full fat. • “The best medicine you could possibly have is at the end of your fork. You’re choosing your health. The more fresh fruits and vegetables and whole grains you put in your diet, the better. You can reverse heart disease, even if you have established plaque in your arteries.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

February 2017

Erin Burch, registered dietitian and owner of Erin Burch Nutrition in Buffalo: • “Avoid eating a lot of processed foods and junk foods, diet drink and juices. Sugar is a big contributor to diabetes and heart disease. • “Limit hydrogenated fats in processed oil, shortening and margarine. I recommend avocado oil and coconut oil. They’re non-oxidized oils which limit inflammation. It’s an inflammatory disease process more than clogging up our arteries with fat. • “Eat lean animal protein: fish, turkey, chicken and lean cuts of lamb and red meat. Eat nuts and beans. Lean proteins are very important for blood sugar balance. • “Eat protein with every meal to avoid sudden increase in blood sugar spikes which is important even if you’re not a diabetic. • “Try to eat every three to four hours, about five to six small meals per day. • “Fiber is important in general for heart health. Good sources are whole grains, like quinoa and oatmeal, beans, fruits and vegetables with their skins, nuts and seeds. They help lower cholesterol and risk of heart disease.”


Parenting By Jessica Gaspar

This Little Boy is a Blessing

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very day I remind myself that today is a blessing. Since Timmy was born just more than a year ago, I didn’t fully realize just how fast time goes. Now, newborn pictures of Timmy show up in my Facebook memories page and I get to reminisce about those early days with him — how he’d snuggle up on my chest after a bottle and move his head to just over my heart. I liked to think he wanted to hear my heartbeat. From about the middle to end of January to midMarch, Timmy cried almost every night. After he had his pyloromyotomy in March, the crying stopped. Truthfully, I think the crying was due to the discomfort associated with the pyloric stenosis he had. But, boy, those nights were tough. A year later, he’ll give me a kiss on the lips when I ask for one. He’ll snuggle me just before bed, sucking the middle two fingers on his left hand, and holding my hand with his free hand. Most days, he’s pure joy — all laughs and smiles and energy. Some days are hard, especially after working a 12-hour shift. I pick him up from the babysitter, rush home, eat a quick dinner, and then try to get him to bed so I can shower and do the same. His brilliant smile when he sees me for the first time at the end of the day makes up for so much of the stress. There were a couple of days back at the end of September and early October that were particularly difficult. We lost water in our house, and I stayed on my grandmother’s couch for a week. Timmy slept in his pack-and-play. I had very little sleep all week, but I still had to work at my full-time job. I was on a deadline for a freelance story, and my patience was put to the test. I called one of my friends who has 2-year-old twin girls and works from home. I wanted to know how she did it all, and she told me she had bad days too. I cried and cried wondering how I was going to get through that moment, but I did it. Looking back, none of that stuff seems to even matter. The work got

done, and we both survived! What matters the most to me is Timmy’s smiles and laughs. If I can be the one to make him laugh, even better. I’ll spend 10 or 15 minutes on the floor playing with him at a time. At some point, he’ll take a nap or go to sleep, and then I can get done what I need to do. Not everything has to be done right this minute. I have trouble remembering that! Growing fast At his 1-year wellness check on Jan. 9, Timmy weighed 21 pounds 12.5 ounces and measured 31.5 inches long. My buddy is getting so big! He’s been walking on his own, albeit just a few steps at a time, since about mid-December. He loves to play. He pushes his trucks and cars across the floor. As of mid-January, Timmy has six teeth. He cut his first tooth when he was 6 months old. The American Dental Association recommends babies see a dentist by at least age 1, so Timmy saw his dentist, Dr. Cheryl Kelley, on Jan. 30 for his first dental checkup. He brushes his teeth twice a day. He loves his Elmo toothbrush! His birthday fell on Friday, Jan. 6. My sister-in-law took Timmy and his cousin Carson to the Ontario Play and Café in Chili for an hour of fun. It’s an indoor playground of sorts for children of all ages. There’s a water and sensory play area, a table of kinetic sand, slides and swings and small cars kids can drive around. Then we went to Tully’s in Henrietta for lunch. They were kind enough to bring Timmy a birthday sundae. (We also went to Tully’s for lunch on Carson’s birthday back in May, so we decided this would become a birthday tradition of sorts.) I had a small gathering at my house on Sunday, Jan. 8 for his party. I had family and close friends over for lunch and cake and ice cream. He had so much fun! He fell asleep around 5:30 that night, woke up once around 7, but then was out for the night and slept until 8 o’clock the next morning. He was tuckered out! I love these days.

Excellus to Make $90,000 in Community Health Awards Available to Nonprofits Nonprofit organizations in the Rochester region are encouraged to apply for grants. Deadline is Fe. 17 Nonprofit organizations can apply for Excellus BlueCross BlueShield Community Health Award grants that add up to a total of $90,000, which the company has allocated to help fund health and wellness programs in Upstate New York. Nonprofit, 501(c)(3) organizations in Excellus BlueCross BlueShield’s

31-county Upstate New York region are invited to apply for an award of up to $4,000 each. The award can be used for programs that have clear goals to improve the health or health care of a specific population. Programs that improve the health status of the community, reduce the incidence of specific February 2017 •

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diseases, promote health education and further overall wellness will be considered. The deadline to submit an application to be considered for an Excellus BlueCross BlueShield Community Health Award is Friday, Feb. 17. To access additional information and the online application, go to www.excellusbcbs.com/wps/portal/xl/our/ compinfo/corp-giving. The application period will close on Feb. 17. Awards will be announced in March. “The company’s Community Health Awards demonstrate a corporate commitment to support local organizations that share our mission as a nonprofit health plan,” said Holly Snow, director, community health

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engagement, Excellus BlueCross BlueShield. “These awards complement our existing grants and sponsorships with agencies that work to enhance quality of life, including health status, in Upstate New York.” Last year, eight Rochester region organizations were selected from more than 185 submitted applications in the 31-county Upstate New York region. The winning Rochester region organizations were: NAMI Rochester; Huntington Study Group, Rochester; Focus on the Children, Caledonia; Rochester Childfirst Network, Rochester; Geneva Reads, Geneva; Refugees Helping Refugees, Rochester; Nativity Preparatory Academy, Rochester; and Cobblestone Arts Center, Farmington.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 13


Golden Years

5

Things You Should Know About Healthy Aging

By Ernst Lamothe Jr.

L

iving a long life is not the sole goal in life. What’s the purpose of beating back Father Time if you don’t have your health? The good news is that Americans are living longer lives. The bad news is that they are not actually living better lives. “Adults are living longer lives than previous generations, but there are things older adults need to keep in mind to ensure they’re staying healthy and happy,” said geriatrician William Hall, UR Medicine senior health expert. “Keeping your mind and body active are keys to a long, satisfying life.” Hall, who was the first geriatric specialist to be elected to the AARP’s board of directors, gives five tips to slow down the aging process. Exercise your brain. Research shows that putting your memory to the test can alter your brain chemistry, fostering new cell growth that improves memory and thinking. So, give your brain a workout. “Do puzzles like crosswords and Sudoku, read books, and exercise your brain like you exercise your body,” said Hall. “Learning a new language offers enormous po-

1.

tential for stimulating cognition and memory.” Keep active for fitness. When it comes to your body, keeping active is essential as we age. Even 20 minutes of activity a day, three times per week, provides benefits. Thirty minutes every day is even better. “Activity like light housework and yard work, walking, and low-impact exercise like swimming are good choices,” said Hall. “You can try a new sport such as golf or tennis, and get the added benefit of learning new skills.” Hall believes if you have physical limitations, consider working with a physical therapist or athletic training to adopt some adapted exercises that can help prevent injury or discomfort when you work out. “While we tend to think of frailty as a risk for older people, a growing concern is the number of older adults who are carrying excess weight,” added Hall. “Extra pounds are a health risk for your heart and add a burden to aging joints. If you need help reducing weight, work with your physician or a licensed nutritionist to take weight off safely.”

2.

3.

Stay socially engaged Depression is a true and treatable medical condition, not a normal part of aging. However older adults are at an increased risk for experiencing depression. If you are concerned about a loved one, offer to go with him or her to see a health care provider to be diagnosed and treated. We know that about 80 percent of older adults have at least one chronic health condition, and 50 percent have two or more, according to the Centers for Disease Control. Depression is more common in people who also have other illnesses such as heart disease or cancer. “Loneliness is a common health issue for older adults, since staying socially engaged is more challenging as we get older,” said Hall. “Stay connected with family and friends with in-person visits, telephone calls, email or Skype. You have to seek out in-person connections with friends via mall walks, going out for coffee and joining clubs.” Fill your dance card A few weeks of salsa dance classes can seriously increase an older adult’s strength and balance, according to a study published in the journal Gerontology. “Take up ballroom dancing for an exercise that has it all: aerobics,

4.

Help for Seniors with Bladder Control Problems More than half of women and 30 percent of men aged 65 and older are affected by problem

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ncontinence is very common in older adults. According to the CDC, more than half of women and 30 percent of men aged 65 and older are affected by it. Fortunately, there are a wide variety of treatment options that can help, as well as a number of absorbent pads or underwear you could use for leakage protection. Here’s what you should know. See a doctor If you leak unexpectedly (also known as stress incontinence) or sometimes have such a strong urge to urinate (urge incontinence) that you fear you won’t make it to a bathroom in time, your first step is to make an appointment with your primary care doctor or see a gynecologist, urologist, or urogynecologist. A doctor can determine if a medication side effect or a condition like diabetes or a urinary-tract infection Page 14

might be causing urine leakage. They can also set you up with a treatment plan. Depending on the reason or the type on incontinence you have, here are some common treatment options. Non-drug therapies There are a number of exercises, bladder training techniques and lifestyle strategies that should be the first line of treatment. Kegel exercises (repeatedly tightening and relaxing the muscles that stop urine flow to strengthen them) are especially helpful for women with stress incontinence, or leaking when they laugh, cough, sneeze, lift heavy objects or exercise. Bladder training involves keeping a diary of urination and accidents, then slowly increasing the time between bathroom visits. It’s most effective for those with urge incontinence. There are also a number of lifestyle strategies that can help, such

as cutting down on caffeinated and alcoholic drinks, which cause the kidneys to produce more urine. Getting sufficient fiber in your diet to keep yourself regular, because constipation can contribute to incontinence. Losing weight if appropriate, because excess weight puts pressure on the abdomen and bladder, and being overweight can also lead to Type 2 diabetes, which causes damage to the nerves that control the bladder. And if you smoke, quit. Smoking leads to excess coughing which can cause urine leakage. Medications Several drugs are approved for urge incontinence (or overactive bladder), such as prescription mirabegron (Myrbetriq), oxybutynin (Ditropan XL and generic), solifenacin (Vesicare), and tolterodine (Detrol and generic). While drug treatments are effective for many people, you also need

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

February 2017

balance, strength, music and even romance. Ballroom dancing provides both exercise and socialization that older adults need and enjoy,” said Hall. Sort out your sleep Many of us have trouble getting — or staying — asleep as we get older. This can leave you feeling tired and grumpy. Along with the physical changes that occur as we get older, changes to our sleep patterns are a part of the normal aging process. As people age they tend to have a harder time falling asleep and more trouble staying asleep than when they were younger. Avoid insomnia by cutting down on daytime naps, establishing a bedtime routine and going to bed at the same time each night. Try a warm drink such as chamomile tea or hot milk before you go to bed.

5.

to know that more than half of those who take incontinence drugs stop within six months because of side effects including constipation, drowsiness, dry mouth, blurry vision and dizziness. Injections of Botox into the bladder muscle are also approved for this condition and may reduce the urge to urinate. This is usually prescribed to people only if other first-line medications haven’t been successful. Medications should only be considered for those who continue to have bothersome symptoms despite having tried lifestyle changes and therapy exercises. Electrical stimulation Mild electric shocks to nerves in the lower back or the pelvic area can stimulate and strengthen muscles that are involved in urination. This can help with both urge and stress incontinence, but it requires multiple treatments over many weeks. Surgery Several surgical procedures are available for stress incontinence. The most common is sling surgery, where strips of synthetic mesh are implanted to support the urethra. This surgery is very effective in most patients, but should be a last resort. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. He writes the column “Savvy Senior” published in this newspaper.


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Melvin Dyster, a physician in Western New York, has been practicing medicine since 1954. “I love it,” he says

By Deborah Jeanne Sergeant

W

hile many in the health field retire early for a variety of reasons, some practitioners continue working long after the standard retirement age. One of them is Melvin Dyster, board certified family practice physician at Niagara Family Medicine. Now age 89, Dyster has been practicing medicine since 1954 because, “I love it,” he said simply. After he completed medical school in 1952, he served full-time in the US Army for two years, then passed the board examination in family medicine. He continued to serve in the military training doctors and practicing. He retired from service as a colonel and continued to practice family medicine. A few years ago, Dyster transitioned into what he calls “semi-retirement” but he still sees patients Tuesdays and Thursdays, works with residents Mondays and Wednesdays and makes house calls to see patients on Fridays. “I could have retired 26 years ago but I like it,” Dyster said. Passing on medical expertise is yet important to Dyster. “I still spend half my time teaching young doctors how to be family doctors,” he said. “It’s important they’re doing it for the patients. “I tell residents, ‘You’re probably higher IQ than most the people you see. The good Lord gave that to you to help people, not to make money.” His perspective on the medical industry has remained constant; however, many changes in medical practice have disappointed Dyster. He feels that the government and insurance companies have eroded the

doctor/patient relationship. When he sends patients to specialists, they cannot always get the care he recommends because their insurance won’t pay for it. “I’m so disgusted so many others put their noses in medicine to make money and, as doctors, we are just trying to make patients better. I’d like to go back to the old days when I’d make only house calls and people would go get a tin from the cupboard and say, ‘How much is that?’” He feels that at present, insurance companies hold too much control over the choices physicians and patients make. He would like to have care decisions in the hands of families and their doctors. Dyster is big on families, both in his medical practice and personally. He and his wife, Mary, had 10 children — all who graduated college — and 18 grandchildren. A few of his children work in the medical industry. Dyster described wife Mary as “a pretty little Irish girl” he noticed while he was working his way through college. Mary, a student nurse at the time, asked him to help her with her work. That turned into his invitation to dinner. “She was the only girl I dated twice,” Dyster said. Mary died 19 years ago. She, too, was active in the medical field, working as a nurse and also mentoring others. The Mary C. Dyster Women’s Pavilion at Niagara Falls Memorial Medical Center was named for her. In his spare time, Dyster enjoys operating a radio as an amateur and he has a pet bird. But he has described medicine as “one of the two loves of my life” with Mary as the other. February 2017 •

“I just enjoy working with people,” Dyster said. “On a day off, I work on the computer but I don’t get feedback from a computer. It’s so gratifying to work with people and help them feel better.” He likes to hear patients say when they see him out and about, “There’s my doctor.” He even gives patients his cell phone number but asks that they don’t call between 8 and 8:30 when he’s at church every morning. Dyster said that no one abuses the privilege and that patients feel better just knowing they can call. “That’s the doctor/ patient relationship.” Dyster advises medical students to go into family medicine in locations where they’re needed, not in a large city. Dyster recently had a physical and was told he can work until he’s 95. He attributes his personal longevity to eschewing tobacco, limiting his alcohol to a glass of red wine twice weekly and “I try not to cuss and swear,” he added. “I enjoy people, particularly children. I love kids. I’m so lucky that God gave me this opportunity to help people.” In an era when many physicians retire early, he has continued practicing because he has remained patient-focused, despite the changes in the medical industry. “If you keep that in mind, you can swallow a lot of junk to help patients,” he said. “I take care of people as they come. I don’t worry about ordering more tests or visits to get paid more. The pay you get is from the gratitude of the patients. You can’t buy that.”

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Fall Prevention Saves Lives Slippery bathroom falls — among many other falls among older seniors — send more than 200 older seniors to hospital every year in New York state.

How important is it to prevent a fall? Two older New Yorkers die every day because of a fall, and 223 end up in the emergency room. By Deborah Jeanne Sergeant

W

ant to live a long, independent, healthy life? Stay on your feet. According to the New York State Department of Health, two older New Yorkers die every day because of a fall, and 223 end up in the emergency room. Among adults 65 and older who are hospitalized due to a fall, 60 percent end up in a nursing home or rehabilitation center, 11 percent suffer a traumatic brain injury, and 27 percent experience a hip fracture. Sadly, the number of fall-related injuries is growing among older New Yorkers. The NYS Department of Health reports that from between 2000 and 2012, the number of fall-related hospitalizations grew from 42,567 per year to 53,270 and deaths increased from 746 annually to 1,059.

Ask St. Annʼs

9

Tips for a HeartHealthy Diet

By Diane Kane, MD

F

or someone with heart disease, diet is a big deal. Along with other healthy habits like regular exercise, the right diet can slow or even partially reverse the narrowing of the heart’s arteries and help prevent further complications. You can help a loved one who has heart disease by adopting a diet that limits LDL (‘’bad’’) cholesterol, lowers blood pressure and blood sugar, and helps with weight loss. Here are nine tips for a heart healthy diet: Serve more vegetables, fruits, whole grains and beans. Just about everyone would benefit from eating more plant-based foods. They’re rich in fiber and other nutrients, and they can taste great in a salad, as a side dish, or as an entree. But watch that you don’t use too much fat or cheese when you prepare them.

1.

Page 16

Falls occur because of internal factors and environmental factors. While you can’t eliminate every risk factor, you can nix quite a few of them. Dylan Mariah, registered yoga teacher with a self-named practice in Pittsford, thinks that practicing yoga can help decrease instances of falls since the practice helps people become more aware of how their bodies move. “Sometimes, seniors are at risk for falls because of how they walk,” Mariah said. “Their gait changes with chronic health problems and pain. Yoga can help them improve alignment.” Betty Perkins-Carpenter, Ph.D., runs http://howtopreventfalls.com and is president of Senior Fitness, Inc. in Penfield. The octogenarian has spent 50 years in the field of health care. She highly recommends that seniors stretch in bed before rising to reduce the risk of falling.

She offers clients tips such as counting stair steps to maintain awareness as they use staircases, and staying in place a moment while sneezing. “If you feel dizzy, pick out a spot straight ahead and stare at it without blinking and it will stop your dizziness,” Perkins-Carpenter said. She encourages clients to join an exercise class or to exercise at home to build confidence and balance. She’s also a big fan of building more strength by walking, participating in tai chi, and walking in a pool. She believes that doing so helps tap into latent “muscle memory” formed when younger. “Ninety percent of us can do more than what they think we can,” Perkins-Carpenter said. She advises building better balance by performing lifting up a knee while holding onto a stable structure, like the kitchen countertop, and looking straight ahead. Once a level of proficiency is gained, letting go to “play piano” on the counter top is the next step until the person can let go altogether while raising a leg. Environmental changes can also reduce fall risk. Jim Albright, 71 and owner of Albright Remodeling in Canandaigua, is a certified aging-inplace specialist. He said that many people live in homes that are poorly equipped for their needs. Many improvements cost little and don’t require professionals. For example, use the brightest light bulbs permitted for a socket to improve visibility. Use night lights. Paint the edges of steps with reflective paint. Eliminate clutter, skidding throw rugs, extension cords and other trip hazards. Wear non-skid, well-fitting shoes. If stairs have become unmanageable, choose a chair lift or live on one level of the home. If you lack a bedroom on the first floor, or need

2.

Choose fat calories wisely by: • Limiting saturated fat (found in animal products). • Avoiding artificial trans fats and partially hydrogenated oils. • Choosing oils that are high in monounsaturated fat (such as olive and peanut oil) or polyunsaturated fat (such as soybean, corn, and sunflower oils) for cooking or baking. Serve a variety of protein-rich foods. Balance meals with lean meat, fish, and vegetable sources of protein such as soy. Limit cholesterol. Cholesterol in foods, found in red meat and high-fat dairy products, can raise blood cholesterol levels, especially in high-risk people. Serve the right kind of carbs. Include foods like brown rice, oatmeal, quinoa and sweet potatoes to add fiber and help control blood sugar levels. Avoid sugary foods.

3. 4. 5.

to move the washer and dryer up from the basement, the expense of the remodeling may be worth it if that spares you from a fall-related injury. Small differences in floor height may cause falls. Albright uses ramps at one inch per foot of rise to make the difference more gradual. The bathroom represents a typical location for falls since they often present damp, slippery flooring. Stepping in and out of the tub, raising or lowering to use the toilet and forgoing corrective eyewear while bathing all contribute to bathroom falls. Since bathrooms usually have hard flooring and several hard surfaces in a small area, many people who fall in the bathroom suffer grievous injuries. Grab bars, walk-in tubs, curb-less showers and raised toilets all provide aging-in-place options that reduce falls. “We don’t do sliding shower doors because people grab for the shower door and it’s a disaster,” Albright said.” Weighted shower curtains work fine for keeping water in curbless showers. In addition to these renovations, Albright often installs additional outlets so seniors don’t have to trip over a tangle of extension cords. Deciding on all of these choices can seem overwhelming, so Albright recommends that clients discuss their needs with a physical therapist and a social worker. Many of these professionals will perform home assessments, which can prove invaluable in finding areas of home improvement that can prevent falls. “I look at where they will be five years down the road,” Albright said. By then, a client may need a walker for support or a wheelchair for mobility. That’s why Albright sticks with 34-inch door openings. He also hangs bathroom doors to swing out in case a client experiences a fall near the door. If the door swings inward, the client can block access to the room.

• Two servings of rice or pasta are the size of a tennis ball.

6.

Eat regularly. This helps someone with heart disease control blood sugar, burn fat more efficiently, and regulate cholesterol levels. Cut back on salt. Too much salt is bad for blood pressure. Instead, use herbs, spices, or condiments to flavor your foods. Encourage hydration by drinking water. Staying hydrated makes you feel energetic and less hungry. Encourage your loved one to drink 32 to 64 ounces (about one to two liters) of water daily, unless their doctor has told them to limit fluids. Keep serving sizes in check. Try using smaller plates. Check food labels for serving sizes to have a better understanding of how much you should eat. Some guidelines: • One ounce of cheese is the size of a pair of dice. • A serving of meat or tofu is the size of a deck of cards.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

7. 8.

9.

February 2017

Focus on the Positive Eating right doesn’t have to mean changing your whole diet and eliminating anything really appetizing. If you can help your loved one follow some of the tips listed here, you’ll go a long way toward helping them get healthier. The best strategy: Focus on what the person with heart disease is allowed to eat, not just what’s off-limits. Research shows that adding heart-saving foods is just as important as cutting back on others. Diane Kane, MD, is chief medical officer at St. Ann’s Community. She is board certified in internal medicine, geriatrics, and hospice and palliative medicine and has been involved in senior care for 29 years. Contact her at dkane@stannscommunity.com or visit www.stannscommunity.com.


Golden Years Experts: Yoga Benefits Seniors

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Practice helps support good bone health, balance, mobility, they say By Deborah Jeanne Sergeant

Y

oga may seem like an activity for lithe, young women; however, many seniors are finding that yoga benefits them in many ways, regardless of the state of their health. Most seniors notice that their flexibility decreases as they age. While it may not initially bother them much, its cumulative effect can hamper activities of daily living eventually. “This can affect us in many ways from impaired driving to back pain and arthritis,” said Mary Roat, health and wellness coordinator at The Village at Unity. “Keeping limber, though, can be easier than we think. Gentle yoga moves help to increase the flexibility in our muscles helping to keep us limber and more balanced.” She also recommends yoga to help support good bone health, as it is weight-bearing exercise. Chair yoga can help people with mobility and balance issues get more movement into their days, according to Molly Ranney, certified yoga teacher in private practice at Breathe in Pittsford. She said that quite a few older clients find that yoga helps them improve balance, build bone and manage hormone levels. “It’s something everyone can do until their last breath,” Ranney said. “You can’t say that with a lot of activities. Step aerobics, running and downhill skiing: there comes a point where not everyone can still do them. That’s not so with yoga.” Dylan Mariah, registered yoga teacher with a self-named practice in Pittsford, said that yoga benefits seniors with increased range of motion and more strength, balance and stamina. She also thinks that it can help decrease instances of falls since it can help seniors improve their posture and gait. “More important of any of that is the effect on the mind and emotions,” Mariah said. “It helps people to increase their ability to concentrate and let go of distractions and worries.” She added that yoga can help people disrupt the cycle of negative feelings and gain better control of their mood. Depression strikes many older people as they ruminate on losses and regrets. Anxiety can also take hold as they consider their future, especially if they fear losing control of their independence. In addition to the emotional stress caused by depression and anxiety, these affect physical health as well. Mariah believes practicing yoga, particularly its meditation aspect, can help.

“The meditation is a powerful stress reducer and promotes self-awareness of one’s attitudes,” Mariah said. “The breathing practices are like powerful medicine for cardiovascular problems. A lot of people find their blood pressure comes down. Those with stress relate illnesses find those improve.” She added that many seniors find camaraderie when practicing yoga in a group with other seniors, a factor that can make pursuing exercise both more fun and easier to stick with.

How to Choose the Right Yoga Class • “One-on-one practice is helpful for beginners. It’s nice to have someone home in on what’s important to you. • “Choose a class that’s well taught and not too big. • “There are opportunities to be gentle and stay within your comfort zone. We don’t do highly complex and difficult poses for beginners, but that doesn’t mean that seniors can’t do those poses. • “For folks who are starting yoga, it takes time to develop skill, strength and flexibility, so you can start with a beginner class. • “Safety is primary at a senior yoga class. A mixed level class will be different from senior yoga. You might have a senior yoga where people are down on the floor, but many Mariah offer chair options doing the postures and the meditation and breathing and the standing portion while holding onto the chair. There’s lots of support for making it work for you.” Source: Dylan Mariah, registered yoga teacher with a self-named practice in Pittsford.

February 2017 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 17


Live Alone & Thrive

The Social Ask Security Office

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Continued from page 10

From the Social Security District Office

Your Scorecard

Give yourself: 3 points for each answer in column A 2 points for each answer in column B 1 point for each answer in column C

2017 Brings Changes to ‘Full Retirement Age’

8 points

Contentment may feel elusive at the moment – beyond your grasp. But it can be found. You may benefit from talking with a professional or your pastor. Help and encouragement might also be found in grief support groups and other gatherings that offer emotional support.

9-16 points

You experience feelings of contentment, but you know there’s more to be found. Continue to stretch yourself. Reach out to others. And “try on” healthy pursuits outside your comfort zone. Success and achievement breed contentment. You might also find inspiration and a needed “jump start” in workshops, classes and lectures devoted to personal growth and development.

16+ points

What you have is precious. Being content with yourself opens up all kinds of possibilities. It enables you to feel peace and joy, whether you are alone or with others. It is an invaluable inner springboard on which you can launch all things imaginable! How did you do? What did your score reveal? I’d love to hear your story. Please share it with me by email: gvoelckers@rochester.rr.com

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Page 18

E

very worker’s dream is having a secure retirement to enjoy the fruits of their labor. Social Security is here to help you secure today and tomorrow. Part of that commitment is ensuring you have the most up-to-date information when you make your retirement decisions. “Full retirement age” refers to the age when a person can claim their Social Security benefits without any reduction, even if they are still working part or full time. In other words, you don’t actually need to retire from your work to claim your full benefits. Also note that waiting until you’re 70, if you can, will bring you a higher monthly benefit. The choices you make will affect any benefit your spouse or children can receive on your record, too. If you claim benefits early, it will reduce their potential benefit as well as yours. As the bells rang in a new year, they also rang in changes in 2017 for people considering claiming Social Security retirement benefits. For people who attain age 62 in 2017 (i.e., those born between Jan. 2, 1955 and Jan. 1, 1956), full retirement age is 66 and two months. Full retirement age was age 65 for many years. However, due to a law passed by Congress in 1983, it has been gradually increasing, beginning with people born in 1938 or later, until it reaches 67 for people born after 1959. You can learn more about the full retirement age and find out how to look up your own at www.socialsecurity.gov/planners/retire/retirechart.html. There are some things you should remember when you’re thinking about retirement. You may start receiving Social Security benefits as early as age 62

Q: I found out that my daughter submitted incorrect information about my resources when she completed my Application for Help with Medicare Prescription Drug Plan Costs. How can I get my application changed now to show the correct amount? A: You can call 1-800-772-1213 (TTY: 1-800-325-0778) and let us know. We will match information on your application with data from other federal agencies. If there is a discrepancy that requires verification, we will contact you. For additional information about Medicare prescription drug plans or enrollment periods, visit www.medicare.gov or call 1-800-633-4227.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

February 2017

or as late as age 70. The longer you wait, the higher your monthly benefit will be. Your monthly benefits will be reduced permanently if you start them any time before full retirement age. For example, if you start receiving benefits in 2017 at age 62, your monthly benefit amount will be reduced permanently by about 26 percent. On the other hand, if you wait to start receiving your benefits until after your full retirement age, then your monthly benefits will be permanently increased. The amount of this increase is two-thirds of 1 percent for each month — or 8 percent for each year — that you delay receiving them until you reach age 70. If you decide to receive benefits before you reach full retirement age, you should also understand how continuing to work can affect your benefits. We may withhold or reduce your benefits if your annual earnings exceed a certain amount. However, every month we withhold or reduce increases your future benefits. That’s because at your full retirement age we will recalculate your benefit amount to give you credit for the months in which we reduced or withheld benefits due to your excess earnings. In effect, it’s as if you hadn’t filed for those months. You can learn more at www.socialsecurity.gov/ planners/retire/whileworking.html. If you pass away, your retirement date can affect the benefit amount your surviving loved ones receive. If you started receiving retirement benefits before full retirement age, we cannot pay the full amount to your survivors. Their benefit amount will be based on your reduced benefits. You can learn more by visiting our Retirement Planner at www. socialsecurity.gov/planners/retire.

Q: How do I know if I meet the eligibility requirements to get Social Security disability benefits? A: To qualify for Social Security disability benefits, you must have worked long enough in jobs covered by Social Security (usually 10 years). You must also have a medical condition that meets Social Security’s strict definition of disability. We consider an adult disabled under our rules if he or she has a medical condition, or combination of medical conditions, that are expected to last for at least one year or result in death, and that prevent the performance of any type of work. If you think you may be eligible to receive disability benefits and would like to apply, you can use our online application at www.socialsecurity.gov/applyfordisability


Is Your Medicine Safe at Home? Only YOU Can Secure Your Rx!

MONITOR– count your medication regularly

By Jim Miller

Tax Help for Caregiver of Elderly Parents Dear Savvy Senior, Are caregiving expenses tax deductible? I provide a lot of financial support to my elderly mother and would like to find out if I can write any of it off on my taxes. Supporting Son Dear Supporting, There are actually several tax deductions and credits available to adult children who help look after their aging parents or other relatives. Here are your options along with the IRS requirements to help you determine if you’re eligible to receive them.

Dependency Deduction

If you’re paying for more than 50 percent of your mom’s living costs (housing, food, utilities, medical and dental care, transportation and other necessities), and her 2016 gross income (not counting her Social Security benefits) was under $4,050, you can claim your mom as a dependent on your tax return, and reduce your taxable income by $4,050. Also note that your mom doesn’t have to live with you to qualify as a dependent, as long as her income was under $4,050 and you provided more than half her financial support. If your mother does live with you, you can include a percentage of your mortgage, utilities and other expenses in calculating how much you contribute to her support. IRS Publication 501 (see irs.gov/pub/irs-pdf/ p501.pdf) has a worksheet that can help you with this. To receive this, or other IRS publications or forms via mail, call 800-829-3676.

Shared Support

If you share the financial responsibility for your mom with other siblings, you may be eligible for the IRS multiple-support declaration. Here’s how this works. If one sibling is providing more than half the parent’s financial support, only that sibling can claim the parent. But if each sibling provides less than 50 percent support, but their combined assistance exceeds half the parent’s support. In that case, any sibling who provides more than 10 percent can

claim the parent as a dependent. But only one sibling can claim the tax break in any given year. Siblings can rotate the tax break, with one claiming the parent one year, and another the next. The sibling who claims the parent as a dependent will need to fill out IRS Form 2120 (irs.gov/pub/ irs-pdf/f2120.pdf) and file it with his or her tax return.

SECURE– lock up any medication you do not want anyone to access

DISPOSE– drop off any

unwanted/unused and expired medication to your local disposal site For more information, call the Substance Abuse Prevention Coalition of Ontario County at (585) 396-4554 or visit us at substanceabusepreventioncoalitionofontariocounty.com.

Medical Deductions

If you can’t claim your mom as a dependent, you may still get a tax break for helping pay her medical costs. The IRS lets taxpayers deduct money spent on a parent’s health care and qualified long-term care services, even if the parent doesn’t qualify as a dependent. To claim this deduction, you still must provide more than half your mom’s support, but your mom doesn’t have to be under the $4,050 income test. And the deduction is limited to medical, dental and longterm care expenses that exceed 10 percent (or 7.5 percent if you’re 65 by Dec. 31, 2016) of your adjusted gross income. You can include your own medical expenses in calculating the total. See the IRS publication 502 (irs.gov/pub/irs-pdf/p502.pdf) for details.

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Dependent Care Credit

If you’re paying for in-home care or adult day care for your mom so you are free to work, you may also be able to claim the Dependent Care Tax Credit, regardless of whether or not your mom qualifies as a dependent on your tax return. This credit can cut up to $1,050 off your tax bill for the year. In order to claim it, you must fill out IRS Form 2441 (irs.gov/ pub/irs-pdf/f2441.pdf) when you file your federal return.

Check Your State

In addition to the federal tax breaks, more than 20 states offer tax credits and deductions for caregivers on state income taxes too. Check with your state tax agency to see what’s available. For links to state tax agencies see taxadmin.org/state-taxagencies.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. February 2017 •

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Page 19


Primary care from your

living room chair. “It’s the idea of old-fashioned medicine, the doctor making house calls to those who have difficulty getting to an office… I get to be on a personal level with my patients.”

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My Turn

H E A LT H A S S E S S M E N T S

|

C A R E C O O R D I N AT I O N

|

M E D I C AT I O N R E V I E W

By Eva Briggs

Can You Really Die of Broken Heart? Valentine’s Day, love, broken heart

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alentine’s Day is approaching, and thoughts turn to love and also to broken hearts. Can you really die from a broken heart? Yes, and the condition has a name: Takotsubo cardiomyopathy (TCM). The name comes from the Japanese term for octopus trap, because the affected heart assumes the shape of a tako tsubo. If you are curious to see how octopus are trapped and eaten, you can check out this website: http://tinyurl.com/hvuele8. TCM symptoms resemble those of a heart attack. Patients have chest pain and often shortness of breath. Other common symptoms are palpitations, nausea, vomiting, fainting or shock. But unlike a heart attack, blocked arteries don’t cause TCM. Two-thirds of TCM patients have a preceding physical or mental stress. While heart attacks occur most often in the early morning, TCM is more likely to happen in the afternoon. TCM patients are less likely to have traditional cardiac risk factors of high blood pressure, elevated cholesterol, diabetes, smoking, or a positive family history for heart attacks. The stress that causes TCM can be psychological, such as the death Page 20

of a loved one, bad news, legal problems or even positive stress like winning the lottery. Physical stresses include motor vehicle accidents, a newly diagnosed serious illness, worsening of a chronic illness, a stay in the ICU, and surgery. There are four criteria used to diagnose TCM. First, there must be evidence that muscle of the heart’s main pumping chamber, the left ventricle, isn’t moving and contracting properly. Second, the coronary arteries are not blocked. Third, new changes occur in the EKG. And fourth, the symptoms are not due to myocarditis (infection of the heart muscle) or pheochromocytoma (a rare tumor of the adrenal gland.) Post-menopausal women are the most likely to develop TCM. Nearly 90 percent of TCM patients are female. Although the average age is 67, even children and young adults can be affected. Asians and Caucasians are the ethnic groups with the highest incidence. Exactly how stress causes TCM is unclear. One likely theory supports a response to catecholamines; the stress related to “fight or flight” hormones epinephrine, norepinephrine and dopamine. They’re released in response to a mental or physical shock.

These hormones may trigger heart blood vessels to spasm. The hormones may stun the heart muscle, or cause microscopic areas of heart muscle cell death. Healthy heart muscle gets 90 percent of its energy from fat. But when stressed, as during TCM, the heart shifts toward using glucose for fuel. Glucose isn’t as efficient. Evidence implicating catecholamines includes elevated levels of these hormones in the blood of TCM patients compared to levels in heart attack patients. The part of the heart muscle involved in TCM corresponds to the areas that typically contain the highest levels of catecholamines. Scientists can give TCM to rats by physically stressing them. Pretreating the rats with medicines that block catecholamines (alpha blockers and beta blockers) protects them from TCM. Because the symptoms are the same as the symptoms of a heart attack caused by coronary artery blockages, the same kinds of tests are used to make the diagnosis: an EKG, blood tests looking for substances released by injured heart muscle, echocardiogram (a sound wave picture of the heart) and angiography (images of the heart arteries). And the treatment

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

February 2017

involves the same medicines used to treat heart attacks. But since blocked arteries don’t cause TCM, it doesn’t require stents or bypass surgery. Fortunately the prognosis is good. 95 percent of TCM patients fully recover in four to eight weeks. It doesn’t usually happen again, recurring in only 1.5 percent of patients per year. There is a 1 percent risk of death. So this Valentine’s day, don’t go breaking anyone’s heart.

Eva Briggs is a medical doctor who works various healthcare centers in the Syracuse region.


Phases of a cancer battle: Colleen M. Farrell of Rochester developed cancer at age 33. At one point doctors were skeptical of her recovery. Finally, thanks to a new treatment based on immunotherapy, she has recovered. “My medical team uses the word “miracle” to describe me,” she writes. “I am not cured, but I am better. I am so grateful.” Photos show Farell after she developed a painful rash on her face during chemotherapy. The middle photo shows her last summer after being rushed to the hospital’s intensive care unit after bleeding problems; the photo on the right shows Farrell recently getting immunotherapy at Wilmot Cancer Institute.

Cancer at Age 33 Rochester woman takes on incredible odds against cancer By Colleen M. Farrell

I

guess it’s arrogant to think cancer won’t happen to you. Why shouldn’t it, really, when it sadly happens to so many? Cancer is an equal opportunity illness. You can do as much as you want to prevent it, but it still tries to take things away from you like a thief in the night. I was 33 when I got diagnosed with stage IV cancer. Part of dealing with it involved coming to terms with what I could and could not control. I couldn’t change how invasive or painful my rectal tumor was. I couldn’t change the side effects of medication. But I could set the tone for how I would handle this disease. I am no stranger to health adversity. At 19, I developed ulcerative colitis. The chronic illness alters the lining of your colon, making it ripe for cancer. At 28, I had my colon removed after I developed precancerous changes. I always knew cancer remained a threat but my surgeon assured me it was a very small one. Two years ago, after months of feeling unwell and four surgeries to curtail a rectal abscess, I learned I had inoperable cancer. It’s never good, but mine was really bad. Cancer is a big fat jerk. Just hearing the word and my name in the same sentence induced panic. It took several weeks for my brain to process what was happening. For just

about my entire adulthood, while my peers discussed their latest bad dates or career decisions or apartment searches, I was dealing with serious illness. This time, it was the most serious of all. I wanted to live a normal life. I wanted children. I felt under attack from this uninvited houseguest. All I could do was wait and see if chemotherapy, then radiation, helped tame the beast. Meanwhile, family and friends rallied and organized a benefit to help offset my medical expenses. I’d find flowers and books and food on my doorstep. Someone who knew someone who knew someone who knew me donated $5 or sent a kind note. I remain humbled by the cocoon which people — some of whom I don’t even know — formed around me. “Irish Strong” is our mantra. Just when my tumor seemed operable, I found out that the cancer had spread to my liver and both lungs. I went from fighting an uphill battle to fighting a nearly impossible one. When I saw no effect after a second round of chemotherapy, my oncologist suggested immunotherapy. If it didn’t help, he said I likely only had a few months. Cancer is a sneaky rat.

Therapy switch

This past spring, I started immunotherapy. Amazingly, it has February 2017 •

helped; my medical team uses the word “miracle” to describe me. I am not cured, but I am better. I am so grateful. In the months after my cancer diagnosis, I had to work hard at thinking about anything else. Cancer dominated my headlines. It pushed me to my breaking point and then asked me to give more. Slowly, I reminded myself that it didn’t need to take up all of my mental energy. But, it continued to dominate how others thought of me. Whenever a friend talks about a lousy boyfriend or bad day at work, she does so apologetically. “You have so much more going on than my stupid problems,” is the typical refrain. “I don’t own the corner on pity,” I reply. Frankly, I know my loved ones mean well, but I don’t want to be treated like “Colleen” and “cancer” are synonymous. I am still the person I was before, just with a few more physical and emotional scars. My parents, sister and boyfriend still yell at me when I talk too much, still laugh at my jokes — and groan at some, too — and still tease me mercilessly. Being reminded that the word “cancer” isn’t stamped on my forehead allows me to feel normal again. Cancer doesn’t define me anymore than being a brunette does. It’s just another part of me. Make no mistake; this isn’t me

embracing cancer like I learned to embrace my freckles. I’d like to evict this bloodsucker once and for all. Perhaps it is because of the nature of my work — I have been in journalism for over a decade — that I’ve been haunted by the “why.” Why do I have cancer? Why do I have to go through this? That question doesn’t have an answer. Indeed, it’s something out of my control. It grates on me, but I have to accept that. It’s a work in progress. My faith helps get me through. Recently, I told a friend how lucky I feel. This statement came after three massive bleeding episodes this summer that almost cost me my life. “Well, I don’t know if I’d use that word to describe you,” she said, chuckling. “You seem pretty unlucky. Whatever you did in a past life must have been pretty bad!” I laughed, too, and explained. I am upright on the right side of the grass. I have defied medical experts’ expectations. I made it through some very dark and painful times. I’ve known love. I’ve learned how loved I am. I’ve experienced some states of grace that people who live to 99 don’t reach. I’m very lucky. For more on my journey, visit http://colleenfarrellwrites.blogspot. com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 21


Health News Highland anesthesiology team has new leadership Physician Steven M. Finkelstein has been appointed as Highland Hospital’s next chief of anesthesiology replacing physician Gregory Previte, who served in that position for the past three years. Finkelstein is currently an associate professor of clinical anesthesiology at the University of Rochester’s School of Medicine and Dentistry after starting as a senior instructor of anesthesiology in 2000. He has been the resident education director for Highland Hospital since 2008. He is a graduate of the University at Buffalo / SUNY School of Medicine & Biomedical Sciences and is board-certified by the American Board of Anesthesiologists. In addition, physician David Lyons has been appointed chief sedation officer. He was a DeKiewet Summer Research Fellow at the University of Rochester before receiving his medical degree from Stony Brook Health Science Center. Lyons is also board-certified by the American Board of Anesthesiologists and currently serves as the chief sedation officer at URMC. “Dr. Finkelstein and Dr. Lyons are distinguished physician leaders

Page 22

who are committed to the Highland tradition of providing excellent patient and family centered care,” said physician Bilal Ahmed, associate chief of medicine for Highland Hospital.

Highland doctor to lead AHA’s rehab council The American Hospital Association (AHA) has announced that physician Daniel Mendelson will be chairman of the AHA’s Section for Long-Term Care and Rehabilitation Council. Mendelson is the associate chief of medicine and director of palliative care for Highland Hospital. The council comprises CEOs and senior executives from the nation’s leading hospitals representing Mendelson rehabilitation, acute long-term care, skilled nursing, home health and continuing care services. As chairman, Mendelson will lead the section’s council on public policy issues of concern to post-acute

and continuing care providers and AHA member service strategies. Mendelson helped establish UR Medicine Geriatrics Group, which provides primary medical care at several nursing homes and assisted living facilities; he has served as the group’s associate medical director as well as medical director of several nursing homes. He co-founded and continues to co-direct the Geriatric Fracture Center at Highland Hospital and lectures worldwide about topics related to fragility fractures and co-management. He is the founder of the Palliative Care Consultation Service at Highland Hospital and was one of the first certified palliative care physicians in the U.S. Mendelson is the William and Sheila Konar Family Professor of Geriatrics, Palliative Medicine, and Person-Centered Care in the Division of Geriatrics at the UR School of Medicine & Dentistry. A graduate of Rochester Institute of Technology in chemistry, Mendelson received his master’s degree in biophysics and his medical degree from the University of Rochester where he also completed his residency in internal medicine and a fellowship in geriatrics.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

February 2017

Waterloo Reality Check youth makes presentation Waterloo Reality Check members participated in the Seneca County Youth Summit at the Waterloo Holiday Inn recently. Reality Check members educated middle school youth about the dangers of tobacco exposure. Youth attending the summit shared experiences with and asked questions of the youth leaders throughout the sessions. Waterloo High School Reality Check Youth presenting at the summit included David McCarthy, Kim Page and Ashley Smith. Reality Check is a statewide program that provides youth opportunities to learn and practice leadership and advocacy skills. In addition to attending weekly meetings, Waterloo Reality Check Youth has attended statewide events, summits, and Legislative Day in Albany where they met with state Sen. Nozzolio. “Reality Check Youth members use their leadership skills to create a tobacco-free generation by educating those younger than them and community leaders about the importance of reducing youths’ exposure to tobacco.” said Penny Gugino, one of the coordinators. For more information about Reality Check, call 585-484-1503.


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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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You’re the boss. Where you go for rehab is strictly up to you. If you have a surgery scheduled, you can preplan your stay with us and eliminate last-minute decisions—and disappointments. Call 585-697-6565. Or visit www.StAnnsCommunity.com Wegman Transitional Care Center

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Page 24

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

February 2017


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