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MARCH 2022 • ISSUE 199
KIDS’ HEALTH Special Issue
Children have been through an awful lot in the past two years: online classes; social isolation; constant stress from family finances, work and school changes; plenty of negative news media coverage; ever-shifting COVID-19 protocols; and fear of the virus itself. For kids and teens, it’s been hard to go back to the conventional way of doing things STORY ON P. 14.
‘FUNCTIONAL MEDICINE’ Physician who practices in Henrietta, Azhar Tahir, discusses how ‘functional medicine’ can treat and even revert some conditions. P. 4
FIVE THINGS TO KNOW ABOUT COLON CANCER We spoke to UR Medicine’s Tanya Bruckel, gastrologist and assistant professor of medicine. P. 9
LIVE ALONE: ‘BEWARE THE IDES OF MARCH’...OR NOT!
The No Surprises Act Protects Patients From Unexpected Medical Bills Patients can more knowledgeably weigh their options and make informed choices. P. 10
Humans’ Sense of Smell May Be Getting Duller
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new study that tested volunteers’ perceptions of various smells — including underarm odor — adds to growing evidence that people’s sense of smell is declining, little by little. “Genome-wide scans identified novel genetic variants associated with odor perception, providing support for the hypothesis,” the researchers said in a news release from the journal PLOS Genetics. The study was published there Feb. 3. Individuals experience smells differently, and the same scent may be pleasant, too intense or undetectable to various people. By combining differences in scent perception and people’s genetics, scientists can identify the role of various scent receptors. In this study, researchers in the United States and China analyzed the genomes of 1,000 Han Chinese people. They were looking for genetic variations associated with how individuals perceived 10 scents. The investigators then repeated the experiment for six odors in an ethnically diverse group of 364 people. From these experiments, they pinpointed two new scent receptors — one that detects a synthetic musk used in fragrances and another for a compound in body odor. Study participants had different versions of the receptor genes for musk and underarm odor, and those variations affected how they perceived the scents. These findings and previous
research show that people with ancestral versions of the brain’s scent receptors tend to find the corresponding odor more intense. Ancestral versions are those shared with non-human primates, the team explained. The researchers, led by Joel Mainland of the Monell Chemical Senses Center in Philadelphia and Sijia Wang of the Chinese Academy of Sciences in Shanghai, said it all supports the theory that our sense of smell has weakened over time due to gene changes. This study also confirmed three reported links between genes for scent receptors and specific odors. Those earlier studies included primarily Caucasian participants. The new findings from East Asian and diverse groups suggest that genetics underlying the ability to detect odors are constant across people of different backgrounds.
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Page 2 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2022
health care right at home. The Physician House Calls program provides a convenient way for you to get high-quality care in the comfort of your own home. For over 10 years, our medical team has provided one-on-one medical assessments, medication review, and care coordination. We’ll work with you to develop a comprehensive care plan that will give you and your family peace of mind. Available to individuals 65 years and older.
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March 2022 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 3
Meet
Your Doctor
By Chris Motola
Azhar Tahir, M.D. Physician who practices in Henrietta discusses how ‘functional medicine’ can treat and even revert some conditions
Almost All Americans Are Now Within 1 Hour of Good Stroke Care
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ine in 10 Americans now live within an hour of lifesaving stroke care, researchers say. That’s up from about 80% a decade ago, due to an increase in hospitals with specialized staff, tools and resources, as well as expanded use of telestroke services that use the internet to link small and rural hospitals with stroke specialists in large facilities. “Investments in improving stroke systems of care have been successful, and we are seeing improved access to stroke expertise and improved health care for patients who are remote from centers of expertise, so it’s a message of hope,” said study lead author, physician Kori Zachrison, an associate professor of emergency medicine at Massachusetts General Hospital and Harvard Medical School in Boston. The analysis of 2019 and 2020 national data showed that 91% of the U.S. population can reach an acute stroke ready hospital or center within an hour by ambulance. That rises to 96% if telestroke-capable emergency departments are included. “There is a narrow window of time for delivering disability-reducing stroke treatments,” Zachrison said in a meeting news release. “Improving poststroke outcomes for patients depends on a patient’s ability to access that care,” she said. “With increased implementation of telestroke, optimal stroke care has been made possible for an estimated 96% of the U.S. population, which is remarkable, considering the geographic span of our country.” The findings were presented at a conference of the American Stroke Association, held in New Orleans and virtually, Feb. 8-11.
Q: What’s the difference between integrative and functional medicine? A: Integrative medicine is a new and very successful thing that has been spreading quickly. The definition would be the best of scientifically proven modern Western medicine along with safe and centuries-used Eastern medicine. Functional medicine came out of the Cleveland Clinic and is becoming more and more popular with doctors and patients because of its success. Functional medicine says we shouldn’t focus just on the symptoms. It says we should try to find out — if we can — the cause of the symptoms. Q: Can you give me an example of how functional medicine would approach a symptom? A: So if somebody has a migraine or a bad headache, we wouldn’t just stop at treating the symptom, the headache. We would try to find out the cause of the headaches. Functional medicine also focuses a lot on the gut and gut health. Gut health can be the cause of many diseases. Functional medicine uses, I believe it’s called, a functional approach. So if you have a heart attack, the approach isn’t just concerned with the heart being damaged. If you’ve had a heart attack, the whole body is sick. So they wouldn’t just focus on the heart and circulatory system. There could be some genetic weakness, some environmental toxin, stress, PTSD. There could be hidden causes. And this could also apply to something like Alzheimer’s. In Western medicine, there’s currently no treatment for Alzheimer’s. You can Google it. Q: And by “treatment” in this case, I assume you don’t mean treating symptoms? A: There are ways to
improve quality of life, but there’s no treatment. But with functional medicine—there’s an M.D. from the University of California, Dale Bredesen; he’s actually shown that you can reverse Alzheimer’s. And there can be many hidden causes of Alzheimer’s, including genetic weakness, environmental toxins, inflammation or any combination of those things. So we’d check for these things and take proactive measures. That’s the functional medicine approach. Q: How successful have these approaches have been in your practice? A: My practice and my success have been to keeping up with the latest on these things. But also, my success comes from focusing on prevention. We don’t wait for the cancer to come in. We don’t wait for a heart attack. We take a preventive approach. We look at food, lifestyles and genetic factors so that we can prevent the cancers, the heart attacks. And the other part of that is even if we can’t prevent it we try to make sure we get a really early diagnosis. Q: How do you go about that given limited time with each patient? A: I try to encourage patients to be proactive. For example, I’ll encourage patients to monitor their own blood pressure in addition to the times we see them every three, six, 12 months. It makes it easier for us to see early warning signs and reverse it if we need to. And I encourage them every month to do a self-examination. You’ll check yourself from head to toe in the bathroom, examine your skin,
Page 4 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2022
the inside of your mouth. Females will palpate their breasts, males will examine their testes. If they observe anything new they can write it down and report it to me if it’s concerning. Many things, like skin lesions, can also go away from month to month, but something like a melanoma won’t. But this helps us make early diagnoses. And if you have an early diagnosis, there are a lot less complications to deal with. Q: What’s a common disease you’ve gotten better results treating this way? A: Type 2 diabetes. That can be reversed. Even Type 1 management can be improved significantly. High blood pressure can be reversed. Cholesterol can be lowered. Even if there’s a genetic weakness, you can get better results. We try to make treatments as natural and as comfortable as possible. Our basics start with food, of course, but also breathing exercises, regular exercises. Sometimes we give supplements. Sometimes it’s difficult to get all the necessary nutrition from food. And if we do have to give a treatment, we try to make sure it’s safe and scientifically proven and ideally not a lifelong thing. Q: How did you become interested in these approaches? A: Many years ago I met and spoke to Andrew Weil, who is the father of integrative medicine, after attending one of his lectures and reading his books. I had some ongoing health issues myself. I applied his principles to myself and got amazing results. I started applying it with my patients and they started seeing wonderful results as well. So that was the starting point. Now I try to continuously try to learn, because not every modality is appropriate for every patient. I tend to combine things is varying proportions, everything from medication, to exercise, to gut health, brain exercises, to mediation and breathing. I think everyone should know about all these things, but different individuals will need different things in different proportions. Q: You’ve also studied a lot of specialties in the mainstream sense. Do you consider yourself any particular specialty? A: Basically I was trained in internal medicine initially then did pediatrics training in Dublin. I also did OB-GYN training in Ireland. I also have some educational experience working at Sloan Kettering Cancer Hospital. I’ve also been trained and keep up to date in functional medicine and integrative medicine.
Lifelines
Name: Azhar Tahir, M.D. Position: Internal medicine, integrative medicine and functional medicine physician at Dr. Tahir MD Internal Medicine Holistic, Natural And Functional Approach In Henrietta and Syracuse. Hometown: Lahore, Pakistan Education: University of Cairo; University College Dublin School of Medicine Organizations: Member of American Medical Association; American College of Physicians Family: Wife, five children Hobbies: Reading, music, gardening
CALLING ALL NURSES -
Deadly Type of Stroke Increasing in Young and Middle-Aged
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ew cases of a debilitating and often deadly type of stroke that causes bleeding in the brain have been increasing in the U.S., growing at an even faster rate among younger to middle-aged adults than older ones, new research shows. The findings show an 11% increase over the past decade and a half in intracerebral hemorrhage strokes, referred to as ICH strokes. “From a public health perspective, these results are troubling and indicate risk factors are not being well managed in young adults in the U.S.,” said physician Karen Furie, chief of neurology at Rhode Island Hospital and chairwoman of the department of neurology at Brown University’s Warren Alpert Medical School in Providence. Furie was not involved in the research. “Earlier onset of this disease is very alarming and indicates we need to be more aggressive with primary prevention,” she said. ICH strokes occur when blood vessels in the brain rupture and bleed. They are the second most common type, accounting for 10%-15% of the estimated 795,000 strokes each year in the U.S. Globally in 2020, 18.9 million people had an intracerebral hemorrhage, according to the AHA’s most
recent heart and stroke statistics report. They are more deadly and more likely to cause long-term disability than other types of stroke. Smaller previous studies have reached conflicting conclusions about whether the rate of ICH has been rising or falling in the U.S. In the new study, researchers found an 11% increase in the rate of ICH among U.S. adults over the 15-year study period. ICH increased at a faster rate for adults under age 65 compared to those 75 and older. The rate of increase also varied by region, climbing faster in the South, West and Midwest than it did in the Northeast. ICH stroke rates were 43% higher for men than women. Among those who had ICH strokes, the percentage of people who had high blood pressure also rose, from 74.5% to 86.4% over the study period. High blood pressure is a major risk factor for an ICH stroke, as is increasing age. The findings are alarming, Furie said, because they suggest blood pressure is so poorly controlled among younger adults that they risk losing the most productive years of their lives. “ICH occurs after decades of vascular damage from unmanaged high blood pressure,” she said. “It’s terrible that this is occurring.”
Mary Cariola Center
What's in your medicine cabinet?
Mental health, autism, integrative medicine... Don’t miss the next issue of In Good Health
SERVING MONROE AND ONTARIO COUNTIES A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations. In Good Health is published 12 times a year by Local News, Inc. © 2022 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com
Editor & Publisher: Wagner Dotto Writers: Deborah J. Sergeant, Chris Motola, George Chapman, Gwenn Voelcker, Anne Palumbo, Ernst Lamothe Jr., Mike Costanza, Lynette M Loomis Advertising: Anne Westcott, Linda Covington • Layout & Design: Joey Sweener • Office Manager: Kate Honebein 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.
March 2022 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 5
Nonprofits Encouraged to Apply for Excellus BCBS Community Health Awards Deadline to apply for 50 awards is March 17
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onprofit organizations in the region can apply for Excellus BlueCross BlueShield Community Health Awards that the company is offering to help fund health and wellness programs in Upstate New York. The application period closes Thursday, March 17. There will be up to 50 awards available with award funding up to $5,000 each. “As a nonprofit health plan, our mission is to provide access to affordable health care and continually work to improve the health and health care of the residents in the communities we serve,” said Melissa Gardner, executive vice president and chief oop-
ulation health engagement officer at Excellus BlueCross BlueShield. “The company’s community health awards are an opportunity to help support organizations in our community that share our mission of improving access to care and advancing specific health outcomes.” All nonprofit, 501(c)(3) organizations in Excellus BlueCross BlueShield’s Utica region are invited to apply for an award. Funding is intended to support programs that improve individual and population health and reduce ethnic and racial disparities by impacting: • Economic Stability — Food availability and security and healthcare
workforce development. • Education Access and Quality — Early childhood education and development, enrollment in higher education, high school graduation, and language and literacy. • Social and Community Support — Caregiver, youth mentorship, and reintegration. • Healthcare Access and Quality — Access to health care, access to primary care, health literacy (health education), and healthcare provider pipeline programs. • Neighborhood and Built Environment — Neighborhood crime and violence (including Domestic Violence & bullying), availability & quality of
housing, and access to transportation. • Racial, Ethnic and Cultural Competency — Educational initiatives to address bias, and discrimination & racialized medicine. Funding requests can also support programs that focus on community needs and impact quality gap closures in behavioral health, women’s health, chronic condition management, preventative care, well-child visits, osteoporosis and fall prevention. “This is just one way we are continuing to advance health equity, and foster our mission in its entirety, to help people lead healthier more secure lives by working together,” said physician Gina Cuyler, vice president of health equity and community investments at Excellus BlueCross BlueShield. For additional information and the online application, go to www. excellusbcbs.com.
Healthcare in a Minute
By George W. Chapman
Physician Burnout at Worst Levels in Decades
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t no time in the past several decades has physician burnout and stress been worse. A recent survey of 13,000 physicians, published by Medscape 2022, revealed one in four (26%) physicians describes themselves as “unhappy” versus just one in 10 (9%) prior to the pandemic. The unhappiness percentage is much higher among hospital-based physicians. The two-year-old, and counting, pandemic has taken its toll on physician relationships at work and
Telehealth Extended In January 2020, at the beginning on the pandemic, Congress declared a public health epidemic, which directed more funding to physicians and hospitals. It was scheduled to expire January 2022. Thankfully, it has been extended through April 16, 2022. What this means, primarily for consumers, is the continuing financial, operational and philosophical support for telemedicine. The pandemic has significantly accelerated the use, acceptance and effectiveness of telemedicine which, prior to the pandemic, was largely underutilized primarily because of payment issues with Medicare and commercial insurers. The PHE authorized Medicare to pay physicians the same for virtual visits as in-person visits. Commercial payers followed suit. Telemedicine has increased or improved access to care for millions of senior, infirmed, disabled, incapacitated consumers as well as those living in rural and remote areas. As an example, United Health Group saw its telemedicine visits soar from 1.2 million in 2019 to a staggering 34 million in 2020. An HHS study found that telehealth
at home. Many physicians indicated they will either retire early or reduce hours, which will only exacerbate the looming physician shortage. The burnout is attributed to staffing shortages, longer and stress-packed hours, the spike in patient deaths and non-ompliant, demanding and outright ungrateful patients. Last December, six large Ohio healthcare systems, including the Cleveland Clinic, ran ads in local papers stating, simply, “HELP.” (See Help Wanted! below)
usage ran between 21% and 28% among various demographic subgroups. Understandably, the usage rate among the uninsured was only 9%. Somewhat surprisingly, the usage rate among technology-savvy 1824 year olds was only 18%. However, when they used telehealth, 73% of them used video. Income was a major determinant as 69% of households over $100,000 income incorporated telemedicine into their care.
Healthcare System Clogged The combination of higher acuity (and length of stay) of COVID-19 patients with system-wide staffing shortages has clogged or delayed hospital discharges to nursing homes, home care agencies and even hospices. On the front end, when a hospital can’t discharge patients on a timely basis, it backs up the emergency department. Consequently, waiting times increase, ambulances are stacked up in the parking lot and ED hallways are jammed with patients on gurneys waiting for a bed. On the back end, with nursing homes, home care agencies and hospices facing their own staffing shortages, their ability to safely accept a
discharge and relieve the pressure on hospitals is severely curtailed. According to a poll of 14,000 skilled nursing facilities by the American Healthcare Association, 58% are facing severe staffing shortages. SNFs have lost 234,000 employees or 15% of their workforce since the pandemic. At the same time, hospital discharges to SNFs, primarily due to COVID-19, have increased 32%. Discharges to home health care agencies have increased 42% and discharges to hospices have increased 15%. According to the Kaiser Family Foundation, more than 200,000 SNF residents and employees died from COVID-19. Your patience, understanding and cooperation will go a long way with stressed out staff and your treatment.
mary care physicians and 43% cited need for specialists. Adding to the list of concerns were: patient safety, behavioral health and addiction, government mandates, access to services, patient satisfaction, physician and hospital relations, technology, population health management and reorganization. It will take more expertise and a lot more cash than your average hospital has to reimagine and reorganize how care is delivered. Unless there is some sort of leveling of the playing field, for profit corporations with plenty of expertise and cash (like CVS, Walmart, Amazon, etc.) will gradually dominate the industry within the next decade.
It Takes a Shark
President Biden has resurrected the Cancer Moonshot Campaign, which aims to reduce the cancer death rate by 50% in 25 years. While COVID-19 has claimed 800,000 lives the past two years, cancer continues to claim 1.2 million lives every year. Biden has directed more funding to the National Cancer Institute and the National Institutes for Health. Industry analysts estimate close to 10 million cancer screenings have been delayed during the pandemic. The Community Oncology Alliance has continually emphasized the fact that regular cancer screenings are inextricably linked to health disparities such as income, insurance, race, access to care and education. Two cancer screenings that have been proven to be both clinically and financially effective are mammography and colonoscopies.
While the ubiquitous drug lobby has ramped up its efforts to prevent congress from fairly negotiating prices (versus “setting” prices per their misleading ads), billionaire philanthropist Mark Cuban of TV’s “Shark Tank” has started his own on-line generic drug pharmacy called “Mark Cuban Cost Plus Drug Company.” There are currently 100 generic drugs on his formulary. Several popular generic drugs are offered at around half the price of the competition. Unlike typical pharmaceutical industry practices, he has vowed to be totally transparent. In general, prices are based on the manufacturer’s price plus a flat 15% fee. He has eliminated the middle man. It will be on a cash-only basis to keep out predatory pharmacy benefit managers.
Help Wanted! For the first time, hospital CEOs cited staffing shortages as their No. 1 priority and concern. Perennial front runner finances fell to second place. Three-hundred ten hospital CEOs responded to the most recent survey conducted by the American College of Healthcare Executives. Ninety-four percent of them cited need for RNs, 85% cited need for therapists, 45% cited need for pri-
Page 6 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2022
Cancer Prevention Campaign
George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
Q. What kinds of anti-poverty initiatives has SEAC undertaken? A. We do a lot of organizational drives—we try to do one a quarter. We’re currently getting ready to launch one for the Marvelous Minds Academy, which has an emergency day care service that serves anyone in Rochester. We’re gathering supplies that they’re in need of—they need diapers and stuff of that nature. We’re going to have a drop-off [box] at our location, and then we’re trying to set up several other drop-off sites where people could drop off these needed goods. We’ll gather them all up and we’ll deliver them to Marvelous Minds. Its helping individuals who need to continue to get to work even emergencies arise. The other thing we do is we make monetary contributions to agencies. We have sponsored Center for Youth’s The Nook, a food pantry for youth who are receiving services. We have twice made a monetary donation of $100 each.
Q A
Q. Can you give us an example of how SEAC has served the educational needs of local children? A. I created four annual scholarships benefiting youth who are at the Center for Youth who are interested in entering into vocational or trade programs. Each scholarship is for $250. It’s not a lot…but it is for an individual to use not just for tuition or books. Let’s say their car breaks down, and their car is what gets them to school. They could use that $250 for an emergency car repair. The program is overseen by the Center for Youth.
&
with
Mike Evans
New executive director at South East Area Coalition talks about helping Rochester’s neighborhoods for over 50 years
S
By Mike Costanza
ince it was created in 1968, the South East Area Coalition (SEAC) has supported and advocated for the people, organizations and businesses that call southeast Rochester home. Though it has only one full-time and three part-time employees, the nonprofit offers a number of programs that help fight poverty, support youths who are in vocational training, assist businesses and in other ways aid the 14 neighborhoods it serves. With a current budget of just $157,000, SEAC covers an area that stretches roughly from the Town of Brighton’s border northwest to Rochester’s Neighborhood of the Arts, and from Lucien Morin Park southwest to Strong Memorial Hospital. The nonprofit recently moved from a 500-square-foot office on Rochester’s East Avenue to
1,500-square-foot quarters on University Avenue. Mike Evans, SEAC’s newest executive director, took the nonprofit’s helm in October of 2020. In Good Health spoke to him about his agency and its services. ——— Q. SEAC’s website lists four areas of focus. Can you tell us about them? A. When I started, I started to bring in four areas of focus, or four pillars. Our four pillars are anti-poverty initiatives and advocacy, childhood health, safety and education, neighborhood preservation and community development, and supporting our local merchants and vendors.
Q. How has SEAC sought to advance neighborhood and community development? A. We try to attend, as often as we can, the neighborhood associations meetings. We offer help to them, be it through giving them access to tools we might have at the time, or funding through our community engagement funds, or connecting them with needed services. In addition, if a neighborhood association wants it or needs it, we provide fiduciary services. We would hold their funds in a secure bank in our fiduciary account monitored by our bookkeeper. Someone who wants to make a donation, say to the Highland Park Neighborhood Association, could do so and have the benefit of a tax write-off. Q. How has SEAC supported southeast Rochester businesses? A. We offer our services as fidu-
ciary to business associations, if that is a service that they need. We have also helped provide limited liability insurance coverage for events both for neighborhood associations that we’re in fiduciary relationships with, as well as merchants’ associations. If businesses have jobs open, we’ll post them on our website and on our social media. I also attend many merchants’ associations’ monthly meetings just so I can hear about the businesses—maybe there’s an issue an outside perspective can help. Last December, I created a small initiative called “ROCing the Takeout.” Anyone who shopped at a locally owned eatery that was not a franchise or fast food outlet could send me a picture of the receipt in an email with their mailing address. I then mailed them a $5 check as a thank you for supporting local. We sent out roughly $125 in $5 checks as thank yous. Businesses were really appreciative. Here’s an agency willing to spend a little bit of money as a thank you for people supporting them. Q. SEAC created the Tool Shed program, a kind of tool lending library for Rochester residents, about eight years ago, then ended it. Why are you restarting the program? A. I started hearing…people talking about the frustrations of needing to do repairs on their home or their cars, or wanting to remodel something or whatever, but they didn’t have the tools and didn’t want to buy them. For $25 a year, a person can rent up to five tools at a time for up to five days. The idea of this is that regardless of your income, you should have the ability to repair your vehicle, to grow your own food in your yard, to repair your home. This is a way to do that. Q. What challenges does SEAC face in the coming year? A. Like many nonprofits, funding. We have to spend quite a bit of time fundraising. Number two is we’re a small agency, so I really try to make sure that my staff knows that they’re appreciated, and that I know they go the extra mile. I want them to be respected, I want them to be appreciated and I don’t want them to burn out. The final one is just getting the word out—letting people know that we’re here, that some of the programs that we do exist. For more information on the SEAC, go to https://seacrochester. org/
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
‘Beware the Ides of March’ ... or Not!
I
n William Shakespeare’s “Julius Caesar,” a soothsayer warns Caesar to “Beware the Ides of March.” That immortal phrase portends gloom and doom. It has also given the month of March, a rather wearisome month to begin with, a bad rap. Will this cold, rainy weather ever end? Will tender tree buds ever appear? Will we ever grill out again? If March is stretching out in front of you as a big, dreary void to fill, you are not alone. For many, a prolonged winter wonderland is not so wonderful when cabin fever sets in. Anxiety and restlessness can make unwelcome visits. You might feel yourself spiraling down, questioning the past and second-guessing your future dreams. And that’s when you could be tempted to grab for the TV remote, a pint of Ben and Jerry’s, and head for the couch — or worse — for bed. Sounds familiar? I can remember many nights after my divorce, coming home after work to an empty apartment with hours on my hands and a heavy heart. The prospect of a long, lonely evening or weekend ahead was almost unbearable. After far too many nights on the couch, way too much TV, I had finally had enough. Both wanting and needing to make better use of my “me time,” I made some intentional changes to reduce my stress and restore my energy. Today, I am thoroughly com-
fortable spending time by myself and have come to enjoy my own company. In fact, it’s not unusual for me to pass on an invitation to go out in favor of spending a nice quiet evening at home — relaxing or fully engaged in something I love to do. If you are challenged by time alone this time of year, consider getting back to basics this March by following the “Three Rs” below: Reading, ‘Riting, and ‘Rithmatic.
Reading When is the last time you read a good book? In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely evening for those who live alone. While I’m reluctant to credit the pandemic with anything positive, I did discover a silver lining: Sheltering in place kick-started a reading binge for me that has yet to subside. Reading “by ear” has become my preferred medium. I listen to audiobooks in my car, on my walks, while exercising, and when doing mundane tasks. Folding laundry comes to mind. Beyond the convenience of audiobooks, a good narrator can bring the text to life. When I listen to my books, I experience a more intimate and emotional connection to the
characters and a deeper understanding of the story. Audiobooks have reinvigorated my love for reading. Whether you enjoy reading a book in your hands, on your laptop, or through your earbuds, I’m confident you will feel less alone. Don’t know where to start? Ask a friend for a book suggestion or make a selection from The New York Time’s best-seller list. My most recent favorite is “The Midnight Library” by Matt Haig. Snuggle up in a comfy, well-lit place and let a good book introduce you to new people, new places, and new ideas as we transition from winter to spring.
‘Riting I have found that putting pen to paper often lends clarity to the issues I face as a single woman. When I put things down in words, I can better organize my thoughts and embrace life’s challenges with less apprehension and more objectivity. While I don’t keep a diary or journal, I am a tried-and-true list maker. Almost nothing gives me more satisfaction than checking things off my list — from paying bills to practicing meditation to returning emails. I’m also a believer in capturing on paper the pros and cons of bigger life decisions, such as ending a longterm relationship, moving across the country to be closer to loved ones or to buying a new versus a used car. These bigger, more profound decisions often trigger emotions and fears that can intrude on clear thinking. One helpful resource I have discovered is the “3-minute Positivity Journal” by bestselling author Kristen Butler. In her book, Kristen maintains that a daily habit of physically writing out our thoughts, feelings, intentions, reflections, goals and wins can change your life. Excepted from the book jacket: “Each entry is quick, yet powerful —
only three minutes in the morning and three minutes in the evening — to keep you on track with your mindset, health and goals.” I encourage you to check it out. March won’t be so bad after all!
‘Rithmatic Yes, arithmetic. Math is all about patterns and relationships. And relationships are key to our happiness as we get older. But don’t take my word for it. In the Harvard “Study of Adult Development,” one of the world’s longest studies of adult life and health, researchers uncovered a surprising finding: That our relationships and how happy we are in our relationships have a powerful influence on our health. This is according to Robert Waldinger, director of the study and professor of psychiatry at Harvard Medical School. The study revealed that close relationships, more than money or fame, are what keep people happy throughout their lives. My readers have heard me say this many times: Mastering the art of living alone is not about mastering the art of isolation. It is about mastering the art of engagement and connection with yourself and with others. Our journey to contentment is one we make with companions. Relationships are what bring purpose and meaning to our lives. So, hug those dear to you and embrace the month of March — doldrums, slush, Ides and all! Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com
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Page 8 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2022
5 C
Things You Should Know About Colon Cancer By Ernst Lamothe Jr.
olorectal cancer occurs when there is growth of cancerous cells in the colon. Your colon is a tube-like structure, the main part of the large intestine. It connects to the small intestine, which removes water, a few nutrients and electrolytes from partially digested food. The American Cancer Society estimates that about one in 25 women and one in 23 men develops colorectal cancer during their lifetime. “One of the main reasons why I chose gastroenterology is because I can see many conditions that preventative care can make an incredible difference in outcomes. Colon cancer is one of the best examples,” said physician Tanya Bruckel, assistant professor of medicine and gastrologist at UR Medicine. With colon cancer being the third most commonly diagnosed cancer in the United States, Bruckel talks about five aspects of colorectal cancer and prevention that you need to know.
1.Get screenings
In 2021, there were about 150,000 colon and rectal cancers. “While those figures may seem high, the incident rate numbers have dropped since the concept of screening occurred,” said Bruckel. “Everything that we know is that colon cancer is one of the most preventable cancers. Because it begins with non-cancerous polyps, it can
be easier to remove these growths before they become cancerous. We are seeing colon cancer in younger people.”
2.Get a colonoscopy
A colonoscopy is an exam used to detect changes or abnormalities in the large intestine colon and rectum. “The procedure involves us taking a camera to look for these polyps and take them out. In order for us to be successful, you have to complete bowel preparation by taking a liquid laxative to cleanse your colon of any stool. Most patients do receive some type of sedative during the procedure so they are comfortable and do not experience any great pain. The majority of patients don’t remember anything,” she added. When it comes to determining when your next colonoscopy can occur, it is often a conversation with your physician after the results. “After you have your first colonoscopy, then that is when you can meet with your physician for recommendations,” she said. “The determination will be made from a combination of factors such as your risk profile which will determine if you receive it every five to 10 years.”
3.Stages of Cancer
Colorectal cancer grows from stage 0, which is the earliest stage to stage 4, the most advanced.
guideline 4.Colonoscopy changes
In May 2021, the U.S. Preventive Services Task Force issued new recommendations for colorectal cancer starting at an earlier age. “We used to recommend that general screenings would happen at age 50. But various gastrologist societies have recently changed the recommendation to age 45,” said Bruckel. The recommended age was lowered from 50 to 45 because colorectal cancer cases are on the rise among young and middle-aged people. Deaths of people under age 55
Deadly Colon Cancers Increasing in Younger Americans
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At stage 0, the abnormal cells are only in the inner lining of the colon or rectum. At stage 1, the cancer grows through the inner lining and reaches the muscle layer of the colon or rectum. At stage 2, the cancer grows through the wall of the colon or rectum but won’t spread into nearby tissue or lymph nodes. At stage 3, the cancer will move to the lymph nodes but not to other parts of the body. At stage 4 the final stage, the cancer will spread to other major organs, such as the liver or lungs. People with stage 1 and stage 2 colon cancer may experience symptoms like constipation, diarrhea, change in stool color or shape, blood in stool, bleeding from rectum, excessive gas, abdominal cramps and abdominal pain. Some people with colon cancer may not even experience any symptoms in the earlier stage which makes it even more difficult to predict the condition. But, the symptoms are noticeable in stages 3 and 4 such as excessive fatigue, weakness, weight loss, vomiting, and feeling like your bowel is not completely empty. “There are treatments at all different stages where you may have to bring in cancer surgeons and expert oncologists,” she added. “But we all know that there are more options and better outcomes the earlier it is detected.”
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et another study is chipping away at the idea that colon and rectal cancers are diseases of older age: In the past couple decades, Americans younger than 40 have shown the steepest rise in advanced cases of these cancers. The research adds to evidence of a disturbing, and not yet completely understood, increase in early-onset colon cancer. The absolute numbers remain low, but since the 1990s, the rate of colon cancer among Americans younger than 50 has more than doubled, according to the U.S. National Cancer Institute. What’s more, those cancers are often detected late — in part because young adults do not routinely undergo colon cancer screening. That screening has traditionally started at age 50 for average-risk people, though the threshold was recently lowered to age 45. In the new study, researchers
Physician Tanya Bruckel, assistant professor of medicine and gastrologist at UR Medicine. increased 1% per year from 2008 to 2017, even though overall colorectal cancer rates have dropped.
5.It affects women too
Sometimes there has been confusion on if both genders are supposed to get colonoscopies because people mix up colons and prostates. The colon is part of your large intestine and your GI tract that turns your food into stool. The prostate is more of a male reproductive organ. While it lies in proximity to the colon, they should not be grouped together. “Like it or not, men and women are in this together. We both need colonoscopies,” said Bruckel. In addition, she said family history could play a large role in early detection cases. “If you know your mom, dad, siblings or grandparents had colon cancer, it is important to let your physician know. There are times where we recommend people having colonoscopies at age 30 in those cases,” said Bruckel.
found that Americans in their 20s and 30s are seeing the steepest rise in distant-stage colon cancer — later-stage tumors that have spread to other sites in the body. Between 2000 and 2016, their rates rose by 57% to 66%: Among people in their 20s, late-stage cases increased from 0.21 per 100,000 to 0.33 per 100,000; for people in their 30s, cases rose from 1.14 per 100,000 to 1.9 per 100,000. Delayed detection probably plays a big role in why young adults are often diagnosed with advanced disease, said senior researcher, physician Jordan Karlitz, chief of the gastrointestinal division at Denver Health Medical Center. The new findings, published recently in the journal Cancer Epidemiology, Biomarkers & Prevention, are based on figures from a U.S. federal cancer registry. There were nearly 104,000 Americans ages 20 to 54 who developed colorectal adenocarcinoma between 2000 and 2016. When it came to colon cancer specifically, people in their 30s showed the steepest increase in late-stage cancers over time, at 49%. Meanwhile, those in their 20s had the sharpest rise in advanced rectal cancer, 133%.
March 2022 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 9
The No Surprises Act Protects Patients From Unexpected Medical Bills Crowdfunding for Medical Costs Almost Always Fails
Y
ou have almost certainly seen the pleas while scrolling through social media: Called crowdfunding, folks try to raise money to pay for their sick loved one’s mounting medical bills. But new research shows these grassroots campaigns rarely raise enough money to make a difference. According to GoFundMe, which corners over 90% of the U.S. crowdfunding market, more than one-third of its fundraisers are for medical needs. Crowdfunding for medical bills has often been talked of as an “ad-hoc” safety net — a place for the uninsured or underinsured to turn to in times of need. But the new findings, published Feb. 3 in the American Journal of Public Health, reveal a different reality. People dealing with medical debt are often facing “astronomical” costs, explained lead researcher Nora Kenworthy, an associate professor at the University of Washington, Bothell. So, even a crowdfunding campaign that goes relatively well may still fall far short of getting people out from under medical bills. The investigators found over 437,000 fundraisers listed for medical needs between 2016 and 2020. Altogether, those campaigns raised an impressive-sounding $2 billion. But campaigns varied wildly in their success: The top performer raised $2.4 million, from over 70,000 donors, while 16% of all campaigns raised nothing. When campaigns made money, they typically had modest success, pulling in a median of $1,100 in 2020. And across all study years, almost 90% of campaigns failed to meet their goals; half reached 25%, while one-third raised half of what they’d hoped. Who was most successful at fundraising? The people who already had some advantages. The study found that more campaigns were launched in U.S. states with the highest rates of medical debt and lowest rates of insured residents. Yet, those same campaigns earned the least. A look at the data by income found a similar pattern: Campaigns in the one-fifth of U.S. ZIP codes with the highest incomes raked in a total of $152 million in 2020. That compared with $70 million in the one-fifth of ZIP codes with the lowest incomes.
Patients can more knowledgeably weigh their options and make informed choices By Deborah Jeanne Sergeant
H
ave you ever received an unexpected medical bill weeks after you arrive home from the hospital? Or feel sticker shock when the tab for the specialist is much higher than you imagined it would be? That should seldom happen again, thanks to the No Surprises Act (H.R.3630). It is part of the Consolidated Appropriations Act, 2021, which passed with bipartisan support in Congress and was signed by President Trump. The law took effect Jan. 1, 2022. The Congressional Budget Office estimates that the act will lower health insurance premiums by between 0.5% and 1%, which can amount to a savings to taxpayers of $17 billion over the next decade. Consumers should save about twice as much between the savings on health insurance premiums and cost sharing for out-of-network expenses. The No Surprises Act applies to commercial insurance, since programs like Medicare and Medicaid already have this kind of protection built in. The one big exception is ground ambulances. Providers and facilities outside the patient’s commercial insurance network cannot bill patients above the in-network cost sharing amounts for emergency facilities and services; post-stabilization care until they can be transferred to an in-network facility; air transportation; services ordered by an in-network facility. The exception is if the provider offers notification of the billing and obtains the patient’s written consent more than 72 hours before the service is delivered. But services such as emergency medicine, anesthesiology, pathology, radiology, neonatology and diagnostic testing are not included, as patients normally cannot give consent. “Unfortunately, the healthcare consumer has been disadvantaged for decades,” said Robin Flaherty, president of Benefit Link, LLC, a Rochester firm that advises employers and employees on healthcare benefits and author of the chapter “Healthcare’s Great Transformation” in the new book Life and Death Decisions in the C Suite, availRobin Flaherty able on Amazon.com. “It has to do with whether you’ve had an opportunity to feel it. If you’re healthy and not heavily using your health insurance, you feel your premiums, but don’t experience the costs of using your health insurance or risks associated with being out of network.” She believes that the No Surprises Act represents a big step towards better transparency in healthcare because it offers important information that can affect how patients receive
The No Surprises Act establishes new federal protections against surprise medical bills that take effect in 2022. Surprise medical bills arise when insured consumers inadvertently receive care from out-ofnetwork hospitals, doctors, or other providers they did not choose. care and how the care will affect their finances. Instead of blindly plunging forward into costly healthcare options, patients can more knowledgeably weigh their options and make informed choices more favorable to their financial situation. Flaherty likens the scenario to purchasing a car without paying upfront and then receiving bills over the next several months from the manufacturers of the gas tank, steering wheel, carburetor, seats and all the other parts. “That’s not how people shop, but we accept it in healthcare,” she said. Now with the No Surprises Act, patients without health insurance can know what to expect. Any good faith estimates they receive that are $400 or more higher may be contested within 120 days of the date on the bill. Flaherty stressed the importance of the No Surprises Act to family finances. “Sixty-two percent of all bankruptcies in the US are related to medical debt and 60% of medical bankruptcies happen to patients with private insurance,” she said. “Prior to this law, if you were unconscious, not notified or otherwise unable to approve an out of network provider, you were on your own to deal with the financial fallout. Now there are
Page 10 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2022
guardrails to protect you when you can’t protect yourself in the moment. This law, coupled with other recent transparency laws, makes it a great time for the health care consumer.” Caitlin Donovan, senior director of the Patient Advocate Foundation in Hampton, Virginia, said that price transparency will help reduce the cost of care, though it will not solve the problem of the high cost of care. “Healthcare is forever unexpected,” Donovan said. “Building in more certainty is better for patients and caregivers.” She said that one loophole in the No Surprises Act is ground-based ambulance services, which are quite complex. Depending upon the municipality, the ambulance service may be within or without the patient’s insurance network. “I’ve seen people with $1,500 ambulance bills, or horror stories of people trying to take a Uber to the hospital,” Donovan said. “You don’t have a lot of power over who 911 will send.” But, once the ambulance parks at the hospital, the rest of the patient care will no longer be subject to surprise billing. Donovan said that since the No Surprises Act is so new, many healthcare consumers do not know they should receive advanced notice of out-of-network bills. “They need to know it’s out there, so they don’t get bamboozled by a bad actor,” she said. “Your insurance company and provider should let you know if that bill is covered by the No Surprises Act. Look over your explanation of benefits. That should be where you’re made aware you’re covered. Once you’re to the point of a bad actor who’s not following the law, it becomes your responsibility to stick up for your rights.” Unfortunately, about half of medical bills have mistakes in them. Donovan said that when her son was born two years ago, her bill had an extra $650 on it. It took her eight months to get the money back. On average, it takes her case managers about 20 phone calls to resolve issues such as this. “It’s easy to be cynical and say that’s why the system is set up that way, that they hope you give up,” she added.
Meet Your Provider
In Truth Mental Health Counseling What You May Want to Know About Therapy but Are Afraid to Ask A Q&A with Nicki Ditch, licensed mental health counselor
Q: What goes through a therapist’s mind at the end of the session?
A: We consider how brave our clients are. We might take a moment to clear our mind so that we can be fully present for the next client and we may even need a moment to cry. We may find ourselves feeling a bit frustrated and need to work to remind ourselves that our clients will do the healthier thing when they have more insight and are fully ready to make the change. We work to determine how we could have handled things better or reassure ourselves that we did a good enough job that day. After all, therapists are human too.
Q: What should I do when I disagree with my therapist but I’m hesitant to say something?
A: Therapy is a microcosm of the real world. If we are in therapy long enough, we will eventually behave in
therapy as we do outside of therapy. If you are asking this question, my guess is that you struggle to express your disagreements in your life and it’s important to work to understand why and how to overcome that. Try telling your therapist, “I struggle to speak up when I disagree with you.”
Q: How do therapists stay neutral during sessions?
A: We are often not “neutral.” We are human and we have our own reactions and there are times when asserting a “side” makes sense, but we remind ourselves that unless someone’s safety is at risk, it’s best to help the client come to their own realizations.
Q: How do you help someone through something you’ve never experienced?
A: Empathy (the ability and willingness to work to feel WITH another person) cultivates healing even more than having had a similar experience. I work to understand the
Nicki Ditch is a licensed mental health counselor (LMHC) and the owner of In Truth Mental Health Counseling in Webster. experiences as fully as possible by asking curious questions. I search my own memories of times when I’ve felt similarly to connect with the clients in the most genuine way possible. Once I feel the memory in my body, I check my experience with the client. If I am not yet on the mark, I ask them to say more about their experience until I get it right. Understanding cultivates empathy and empathy cultivates connection. Healing takes place in that sacred space of feeling deeply understood and connected.
triggered and overwhelmed by sessions does exist. Therapists need not be fully healed from their own hurts, but they must be working through them in their own therapy and supervision, especially if it is affecting their ability to be therapeutic. It can become detrimental to the client’s therapy if a therapist takes something personally or assumes he knows how the client feels based on his own experiences rather than working to understand the client’s experience.
Q: Can having had the same experiences be detrimental to the client’s therapy?
A: Yes, usually when I feel attuned to the client’s profound hurt or when a client has had a “breakthrough.”
A: The risk of the therapist being
Q: Do you ever cry in sessions?
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Foot Pain and Footwear Poorly fitting shoes can cause problems By Lynette M Loomis
M
ost of us take our feet for granted… until they start to hurt. In 2021, the College of Podiatry reported that of 2,000 adults surveyed, one-third of men and nearly half of women admitted to having purchased shoes that didn’t exactly fit. The research shows that improperly fitting shoes can result hammertoes, deformities and bunion growth. Poorly fitting shoes can also contribute to things like headaches and back pain. “This is so true,” said Mort Nace III, owner of Medved Running & Walking Outfitters in Rochester. “We hear that all the time, from people who haven’t had their feet measured in years, sometimes decades. ‘I’ve never worn that size...’ Shoes worn small contribute to several issues, including bunions, bruised toenails and hammer toes. Feet swell, the more active we are, or with more time on feet. A proper fit will allow room for that swelling.” So, what kinds of foot issues are we, our friends, runners, and people who stand all day at work, experiencing? Nace says plantar fasciitis is the issue most frequently seen by his staff and it is one of the most common causes of heel pain. Mayo Clinic describes it as an inflammation of a thick band of tissue that runs across the bottom of each foot connecting the heel bone to the toes. “We see quite a lot of that among all of our communities,” he said. “Morton’s neuroma is another common malady.” Harvard Medical School defines a Morton’s neuroma as swelling along a nerve in the foot that carries sensations from the toes. Once swelling begins, the nearby bones and ligaments put pressure on the nerve,
causing more irritation. Nace said runners often suffer from shin splints and stress injuries, but both can be helped with the proper footwear and keeping footwear current. “If a runner is in the right shoe and size, we typically see shoes last 400-500 miles,” he said. “We explain to our customers that the midsole (the foam in the middle of the shoe that absorbs the impact) breaks down first, not the outsole (tread). “Walkers can sometimes assume ‘because they are just walking they can get away with wearing just about anything, until the shoes are well beyond their life. Those shoes are often worn most of the day for our customers too, making it even more critical we get both the shoe and fit right. Our older customers who walk frequently are often surprised to learn that their feet are both longer and wider than they understood. Both gravity and time affect feet. Years of life has caused their feet to flatten and widen. We surprise our customers every day with this conversation!” The process used is not guesswork or a quick glance at the foot. First, they measure both feet on the Brannock device. According to Nace, “This is also an opportunity to inspect the feet as well start the conversation about injury history, what workouts look like currently, and what is the primary use for their footwear.” “The next step is to scan our customers’ feet on our Aetrex scanner. The scanner surrounds the feet with cameras and the floor of the scanner uses pressure mapping to give us a lot of information-data to use as we work on ‘shrinking the wall’ (we have hundreds of shoes...),” he explained. “We can then determine what category of footwear we feel makes the most sense for the
This is the Aetrex scanner, available a Medved Running & Walking Outfitters in Rochester. The foot is surrounded by several cameras taking measurements of foot length and width, arch length and height, instep, foot volume. The green space uses pressure mapping to tell us how weight is distributed. “Using the information gained from the scan, the suggested insert allows us to better customize the shoe’s interior,” says store owner Mort Nace III. customer. The scanner will also make an insert recommendation; we’ve found inserts have a huge impact on the comfort of all kinds of footwear. Using the information gained from the scan, the suggested insert allows us to better customize the shoe’s interior. We also can order a 3D custom orthotic using the customer’s scan as well!” “Lastly, it’s important that we watch our customers move. For our running customers we use a treadmill to do a gait analysis; we want to see what’s happening on impact through the gait cycle. For our walking customers we will watch them take strides on our track. Yes,
Page 12 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2022
we have a track inside the shop for testing footwear,” he said. Using all that information and observations the staff determines a group of shoes they believe to be most appropriate. Running shoes are sold by foot type (yes, running shoes are perfectly appropriate for walking). For example, someone with flat feet is likely looking at a different group of shoes than someone with high arches. The staff will bring out three to six pairs from the group they’ve chosen and then see what feels and fits best. “There’s no best shoe,” Nace said. “Let’s see what feels best.”
SmartBites
The skinny on healthy eating Prune’s Other Benefits May Surprise You By Anne Palumbo
S
hould we pity the poor prune? It’s shriveled, wrinkled and puckered. It’s best known for relieving constipation. It’s granny’s favorite fruit. It’s never in restaurants but always in nursing homes. And its sexy makeover — from dowdy prune to provocative dried plum — never gained enough traction to stick. But, no, we should not pity the humble prune. We should take a cue from granny and get to know this delicious dried fruit even better! Boasting an impressive array of nutrients — over 15 different vitamins and minerals — a prune’s health benefits go way beyond the bathroom. Ready for some surprises? Prunes are great for bones. Yes, bones! Current studies suggest that simply eating a serving of five prunes a day may help slow and prevent bone loss. While it’s not entirely clear why prunes promote bone health, this mighty dried fruit has many properties to consider: good amounts of vitamin K and potassium (both vital for strong bones), a wealth of antioxidants that may protect bones from cell damage, and the potential to increase certain hormones that are involved in bone formation. No wonder Granny’s doing the Rumba with Gramps into the wee hours!
Another startling perk from this toothsome dried plum? Prunes benefit heart health. Their fiber helps lower cholesterol; their powerful antioxidants keep inflammation at bay; and their potassium helps lower blood pressure and ease tension in the walls of blood vessels. Indeed, a trifecta of nutrients to help keep our tickers tocking longer. Lastly, prunes are good for guts in more ways than one. While the insoluble fiber in prunes promotes regular bowel movements, the soluble fiber helps to moderate digestion and absorb nutrients from our food. What’s more, prunes contain sorbitol — an ingredient known to have a laxative effect — which can increase stool frequency. Feeling blocked-up and sluggish? Passing stools as hard as golf balls? You know what to reach for! An average serving of four prunes has 90 calories, 3 grams of fiber, and no fat, cholesterol or sodium. Final surprise? A recent study found that people who snacked on prunes felt less hungry and ate fewer calories overall than people who ate other foods.
Helpful tips Look for prunes that have no added sugars and are preservative-free. Tightly reseal opened packages and store in a cool, dry place. Prunes do not need to be refrigerated. If you’re not used to eating prunes or other fiber-rich foods, you may want to start slow with one to two prunes a day and slowly work your way up.
½ teaspoon Dijon mustard ½ teaspoon salt ¼ teaspoon coarse black pepper 1-2 tablespoons water to thin, as needed Make the salad Rinse the quinoa (to remove bitterness) and drain well. Combine the rinsed quinoa and water in a saucepan. Bring the mixture to a boil over medium-high heat, then decrease the heat to low to maintain a gentle simmer. Cook until the quinoa has absorbed all the water, about 15 to 20 minutes. Remove the pot from heat, cover, and let quinoa steam for 5 minutes. Transfer the quinoa to a medium bowl and fluff with a fork. Cut the peppers into small chunks, finely chop the parsley, and cut the prunes into quarters. Drizzle vinaigrette over fluffed quinoa and mix well. Add the peppers, parsley, prunes, lemon zest, lemon juice and slivered almonds and gently mix again. Adjust seasonings and serve. Make the vinaigrette
Quinoa Salad with Chopped Prunes and Prune Vinaigrette
Adapted from californiaprunes.org Serves 4-6 For the salad: ¾ cup quinoa 1½ cups water ½ cup chopped red pepper ½ cup chopped yellow pepper ¼ cup parsley, finely chopped 5 prunes, zest from 1 lemon 1-2 tablespoons lemon juice ½ cup slivered almonds, toasted
While quinoa is cooking, make the vinaigrette. Cut prunes in half and put in a small pan with ½ cup water. Bring to a boil and then decrease the heat to low to maintain a gentle simmer. Simmer, uncovered, for around 10 minutes until the water is almost gone. Stir occasionally while prunes are cooking. Remove from heat and transfer to a small food processor. Add oil, balsamic vinegar, Dijon mustard, salt and pepper and blend until fairly smooth. Add 1 to 2 tablespoons water to get a pourable thickness.
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
For the vinaigrette: 4 prunes ½ cup water 2 tablespoons olive oil 1 tablespoon balsamic vinegar
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March 2022 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 13
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KIDS & TEENS
For kids and teens, it’s been hard to go back to the conventional way of doing things. By Deborah Jeanne Sergeant
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hildren have been through an such as how to make friends with awful lot in the past two years: someone new, settle small squabbles online classes; social isolation; with children they do not know or few in-person social outlets and develop understanding with someHair Replacement Specialists interactions; constant stressRochester’s from one from a different background. family finances, work and school Oftentimes, these situations occur changes; plenty of negative news me- on the playground, while waiting dia coverage; ever-shifting COVID-19 in line or during other incidental, protocols; and fear of the virus itself. unplanned times during a school day. These factors can all contribute to “Teachers are doing their absoa host of issues for children, includlute best but without some of those ing stunted social skills, developmen- skills, kids won’t emotionally be tal delays, learning issues, anxiety where they should be,” Chenenko and depression. said. “They won’t have those social Especially for younger children skills because of the pandemic.” who do not remember life before While the isolation may have felt COVID-19, “I don’t know if we can like a godsend to more introverted know for sure what the long-term children, isolation prevents them outcome will be,” said Brittany from becoming as social as they Chenenko, who has a master’s in could be. education and is a permit-holding For older children who are home licensed mental health counselor by themselves more, the lack of strucScheduleEmotional your complimentary, confidential loss evaluation at Cleveland Health in ture in their hair school day followed by Geneseo. of returning to in-person today and see how easy itthe is toshock be yourself again! The acute issues presenting at classes has been challenging. her practice include young children “It’s been hard to go back to the with social issues. They struggle to conventional way of doing things,” understand sharing, taking turns Chenenko said. “They had a year Financing. Onsite servicebecause and repairs. where they didn’t have to do it that andAffordable resolving minor conflict Restoring hair 1425 Jefferson Rd., Saginaw Plaza, 2nd floor those serendipitous interactions they way. Not knowing what will happen Restoring Rochester, NY 14623 at • 272-7320 would experience school do not next will cause stressconfidence in teens and happen duringinZoom and Facetime middle schoolers.” We specialize both permanent and non-permanent techniques, gradual hair replacement, and “playdates” arrangedWewith theirtopical pre- hair loss treatments In addition to life system integration. can provide and laser hair lessons, rejuvenation.chilCOVID-19 friends. lessons are less than Check out Virtual Reality Hair Replacementdren’s for menacademic & women at Baldness.com. Children have missed life lessons ideal for most children. As children
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exhibit different learning styles, some are more hands-on, others prefer the explanation inherent to a lecture, still more like reading over doing or hearing, virtual learning has hamstrung teachers to instruct in fewer styles than they could in the classroom. While the struggles of the past two years have certainly made typical development more difficult, Cheneko does see a few positives, such as the display of resilience from so many children as they figure out how to make life work. “This will serve them very well in the future,” she said. She advises parents to ask their children how they are feeling. A chart of angry, sad, ill and happy faces may help very young children. “Children need to know that it’s appropriate to have feelings,” she said. She added that parents should help their children find appropriate, healthy ways to cope, such as practicing mindfulness. Matt Devine, doctor of osteopathic medicine at Highland Family Medicine, reminds parents to continue to expand on their children’s social and physical interaction, an element largely missing from their lives in the past two years. “We’ve spent a lot of time as
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physicians saying, ‘Don’t use your devices a certain period of the day; but we can’t advise that as we have had no other choices,” he said. “As we come out of this, I’d like to get back to that discussion of limiting that technology time.” He fears that long-term implications of the pandemic could be less fit and healthy children if they become accustomed to sedentary life. Instead, he encourages parents to get their children involved in physical activities they enjoy, whether an organized sport or outdoor play time riding bikes, climbing on playground equipment or playing tag. The academic gaps concern many parents. However, they should keep in mind that this factor is universal. Nearly all children are expected to have some degree of lag in their schooling. So an amount of remedial work is normal. Parents can use the summer to help make up for lost time. Bringing home more library books, engaging in educational outings such as to places like museums, open houses and cultural points of interest and using educational media such as games, documentaries and puzzles can help children feel better prepared for the next school year. Psychologist Christina McCann, Ph.D., in private practice in Rochester, tells parents to mitigate this effect by asking the school district as to what in the curriculum will address these gaps for both academic and social issues. “School has the biggest access to the child’s peer groups,” she said. “Maybe parents can support or look to the school districts to see what in the curriculum can address these gaps. “Parents can also encourage an anxious child to start having more social contacts with friends.” It may feel easier to shield anxious children from this distress by allowing them to continue holing up at home. “In the end, that can worsen the situation,” McCann added. Gently re-introducing social activities to anxious children will better prepare children for long-term social success.
HEALTH EVENTS
Hearing Loss Association Announces New Programs Hearing Loss Association of America (HLAA) Rochester Chapter offers several virtual programs in March: • Noon, Tuesday, March 1. “Ask the Audiologists,” featuring audiologists Carly Alicea and Peter Hart, who will field audience questions about audiograms, hearing aids, deafness, tinnitus or whatever subjects you bring up. • 10 a.m. Tuesday, March 2. “Hearing Other People’s Experiences,” featuring Joseph Kozelsky, a retired audiologist and hearing aid user. Real hearing aid users discuss real problems and concerns. • 10 a.m. Thursday, March 24. Virtual ALD Demo center. HLAA-Roch-
Page 14 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2022
ester technology team. This is a continuing orientation to the online “Virtual Demo Center” website. It is a review of selected assistive listening devices, captioning-capable and amplified telephones, signaling-alerting devices and smart phone APP’s related to hearing enhancement and gives the opportunity for the presenters to answer questions from those joining the Zoom meeting. • 8 p.m. Tuesday, March 22. “Hear Together,” a new virtual support group designed as a safe community for connecting parents and caregivers of Deaf/hard of hearing children. To register, contact Kristinbslp@gmail. com For more information visit www. hearinglossrochester.org or telephone 585 266 7890.
KIDS & TEENS
Top 10 Issues Teens Face Today From poor sleeping habits to isolation and poor body image, teens face a host of challenges now By Deborah Jeanne Sergeant
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n addition to the normal issues teenagers face, the pandemic has added an additional layer of stressors and pressure. Area experts weighed in on what they believe are the top issues of young people. 1. Maturity level.
“They have not been in the social spaces they normally are,” said Mathew John Devine, doctor of osteopathic medicine at Highland Family Medicine. “The school setting and other settings help nurture and create this. We’ve had to pause this. There are high school juniors with the mindset of a freshman or sophomore. They haven’t matured more because of isolation. There haven’t been the coaches and teachers involved in their lives.”
5. Anxiety. 2. Bullying. “I am concerned about social media and the things teens post on things like Tik Tok,” Devine said. “They need to be aware that these are things that follow you and can harm others. People say things they would not say face to face.” 3. Sedentary living. “Teens aren’t as active and health conscious,” Devine said. “They have not been involved in physical activity like they used to be. Their lives are more virtual.”
“Anxiety has always been a challenge for teens as they go through developmental changes,” said Rodrick Davis, a pediatrician at Portland Pediatric Group in Rochester. “We throw in now the huge changes going into COVID-19 as that affects their life at home with parents and being home more, and the fact that a lot of their social interaction has changed from in-person to social interaction has led to a huge increase of the amount of anxiety.”
they’re on,” Davis said. “You need to know who they’re on with. You need to be checking in with them to know who they’re on with. You want to be careful when talking with your teen. Try not to focus on how they look like, ‘It looks like you’re putting on weight.’ Focus on leading by example instead of saying, ‘I need to go on diet.’ It sets a bad example. Parents who go to the gym and exercise a few times a week and eat a healthful diet set a good example.”
diet should be fruits and vegetables, whole grain and healthful proteins. Focus on whole foods and make sure the majority is healthful, so they don’t have to feel bad splurging once a week.”
8. Isolation. “For the past two years, they’re at home alone more,” Davis said.
4. Poor sleeping habits. “Oftentimes, this can go astray outside of a normal routine,” Devine said. “This is not healthy. They need eight to 10 hours of sleep per night.”
10. Focusing on weight.
6. Depression. “Recently, we’re seeing depression more,” Davis said. “We’re seeing it affecting three times as many girls as boys. We aren’t sure why.” 7. Body image. “You need to monitor the social media they are using and what
9. Dietary habits. “Let adolescents know everything is OK in moderation, not, ‘Don’t have pizza; it’s bad for you,’” Davis said. “You can’t draw their attention to it every time they make a bad choice. The majority of their
“Weight is just a random, one-minute representation of what a body weighs and not an indication of health,” Davis said. “Focus on eating a healthful diet and moving throughout the day. If you start early helping them recognize that instead of focusing on what the scale says. They should focus on healthy habits. Focus on just eating healthy diet and just moving throughout the day. Parents need to verbally recognize to their children the positive traits about a person, not focusing on body image.”
March 2022 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 15
KIDS & TEENS
Family, Pandemic Stress Having Affect on Kids Children should be made aware stressors aren’t their fault and they aren’t responsible for trying to fix it By Deborah Jeanne Sergeant
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tress is a part of life, whether it is acute stress, such as a car accident, or chronic stress, such as completing daily tasks on time. Stress can be unpleasant, like the aforementioned car accident and even enjoyable, such as planning a surprise party, bringing home a new
baby or receiving a promotion. The pandemic has brought nearly ubiquitous stress and nearly all of it is difficult stress. Regardless of the cause, stress affects children negatively. “Teens are absorbing a lot of it, especially the politicizing of the pandemic,” said Brittany Chenenko, who has a master’s in education and
is a permit-holding licensed mental health counselor with Employee of Cleveland Emotional Health in Geneseo. Chenenko added that other hot-button issues, from climate change to identity issues to pandemic protocols have become highly polarized and political. She heard from colleagues that even children as young as middle schoolers have become much more aware of politics than previous generations, to the point where political strife may represent the hallmark of the current generation. “Nearly everything they’re bringing into the room is politicized, which is polarizing,” Chenenko said. “There’s not a lot that isn’t black and white. You can’t be in the middle.” To mitigate the stress in the household, parents need to make their children feel free to share their thoughts, which can lead to brainstorming ways to feel more in control. “If climate change is freaking them out and they feel the government isn’t listening, they can’t vote yet, but they can get involved in a litter clean-up, recycling drive to give them a feeling of participating and helping in what they’re worried about,” Chenenko said. “There will be times those kids will feel like this won’t change the world. But reinforce that they’re making small changes now and as they get older, they can make bigger and bigger ones. They are contributing to what they believe in.” By finding healthy ways to control things, teens have lower risk for turning to unhealthy ways to feel in control, like drugs, alcohol and self-harm. But children should also be made aware that stressors are not their fault and that they are not responsible for trying to fix it, especially family and political problems. Exposure to excessive news can ramp up stress in the household. Christina McCann, Ph.D., a psychol-
ogist in private practice in Rochester, advises limiting exposure. “For younger kids, you would protect them more from information,” she said. “Older kids will have questions. Adolescents may be self-focused and not know what’s going on. Let yourself be a resource for whatever is going on.” Turning inward can also help families manage. “Have some protected time where the family comes together and hangs out, whether snuggling on the couch, device-free time, as that’s been problematic before and it’s now on steroids,” McCann said. “It’s healthy for families to get away from phones and tablets. Play board games together. Have a family; go for a walk after dinner. Get outside.” Especially if one child is struggling and needs extra attention, take time to give one-on-one attention to the other children, too. Acknowledge their strong points. To manage day-to-day stress, it helps for parents to remain open to talk about what is going on in their children’s lives. “Have an open forum and give them the opportunity to hear where they are coming from,” said Mathew John Devine, doctor of osteopathic medicine with Highland Family Medicine. Further resources at school, community counselors or places of worship can help as well. Teens may also need reminders that no family is perfect, but families continue to work on their relationships. Parents should also talk about how they feel, even when they feel stressed. “People feel like they have to hide that when in fact, I have people share with me in a private setting,” Devine said. “Nine out of 10 or maybe 10 out of 10 have significant stress going on.” It is not giving up feeling “OK with stress being a part of life, focusing on what you have to be thankful for. That’s vital,” Devine added.
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KIDS & TEENS
Poor Body Image Affects Teens’ Mental Health Body image in particular for females has always been an ongoing problem By Deborah Jeanne Sergeant
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eens who view their body image negatively experience an increased risk of low self-esteem, depression, nutrition and growth issues, eating disorders and having a higher body mass index of 30 or higher, according to the Mayo Clinic. Some may try to control their weight by smoking diet pills, taking supplements to increase muscle mass or change their appearance through cosmetic procedures. Oftentimes, teens base their ideal body image on what they see in the media—only now instead of just movies, magazines and television, teens can access media anytime, anywhere. “It is a similar problem we’ve had in the past but more accessible,” said Mathew Devine, doctor of osteopathic medicine with Highland Family Medicine. “It’s hard to get away from and hard to shelter our kids from some of these things that are there.” Via social media, anyone has the ability to post and see unrealistic images and videos that portray perfect lives. The software used to improve posts is ubiquitous. Unfortunately, young people tend to view these posts as reality and the ideal to
which they should aspire, whether that’s a svelte figure, chiseled abs or high cheekbones. “Body image in particular for females has always been an ongoing problem and continues to be a problem,” Devine said. “It goes back to those people’s lives are not perfect. They can snapshot or do an appearance of that but no one’s life is perfect and has it all figured out.” Devine encourages parents to have their children take breaks from social media and to spend more of
their down time engaging in activities that build their confidence. Accomplishing goals allows teens to develop a sense of worth outside of their physical appearance. Building meaningful relationships, both familial and among friends, can help teens’ self-image, too. Leading by example is how Rodrick Davis, pediatrician at Portland Pediatric Group in Rochester wants more parents to help their children develop a healthy body image. “If parents are careful to not
judge by body size and to recognize that people have different looks and are built differently, that helps,” he said. “Start early on to help them recognize that not everything is within the normal range. If she’s 15, it may be too late. When they’re younger is the ideal time to start.” Parents should praise their children for their character and other traits beyond appearance. Modeling healthy behavior can also help children develop a better body image. For example, complaining about one’s weight, going on extreme diets, calling food “bad” or “good” or making derogatory comments about appearance can contribute to body image issues. Instead, parents should emphasize improving health, such as exercising regularly and eating a healthful, balanced diet. Regular exercise does not have to be a gymbased regimen but can include enjoyable physical activities and sports. No foods are “bad” or “good,” but a healthful diet focuses on plenty of fruits and vegetables, whole grains, lean sources of protein, dairy and a few healthful fats, but with minimal processed foods. In addition, a pediatrician can discuss healthy body weight during a well-child visit.
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March 2022 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 17
Addiction
In-Patient Care Only Part of Substance Use Recovery By Deborah Jeanne Sergeant
F
or a patient struggling with a substance use problem, a stay in an in-patient facility may represent only part of the recovery process. Joel Yager, senior director of clinical services at Huther Doyle, a nonprofit agency that provides addiction rehabilitation programs and services in Rochester, said that many people outside the field do not understand this aspect of substance
use treatment. “Inpatient stays, for a lot of cases, are used inappropriately,” Yager said. “Families believe that inpatient is the end-all, be-all. It is really only to stabilize the individual. The follow-up is the important part.” For most patients, the journey toward wellness has only begun once their two to three weeks of inpatient care has ended. In some cases, a stay at a residency for three to four months may be in order and then treatment as an outpatient or at a
halfway house for weeks afterwards. Yager said that for many patients, their stay at an inpatient facility is not only about their health but offers a break for their families. “People are so tired,” he said. “They’ve been through so much. That inpatient stay becomes a break for them, too. They want to breathe for a while and get a good night’s sleep. It’s not always the most appropriate care.” Before any of treatment begins, the patient must be ready to change and accept treatment. Yager said that if the patient does not believe a problem exists, change cannot happen. “Families spend all this money to convince them they have a problem; it doesn’t work,” Yager said. “It only works if the person truly wants the help and wants to make the changes. There’s no magic cure to it. It’s based on the fact that the person truly wants to get well.” Unfortunately, this may take several years and attempts at completing a treatment program and the patient’s insurance coverage may not cover the necessary amount of treatment. Yager said that limitations in coverage for inpatient stays have developed because this portion of the treatment plan by itself is the least effective for lasting change. While patients have a safe place to stay, eat wholesome food and see a counselor, “it has the worst success rate unless there’s follow-up.” At $3,000 to $4,000 a day, it is not cost effective to keep patients in such a program for months or even several weeks. For motivated patients with the right supports, that level of care is not even necessary. Most insurers do not cover inpatient care unless lower levels of care have not been tried first. During in-patient stays, patients develop a plan for their follow-up treatment to increase their chances of success. This can include finding housing, a local therapist, group meetings and a
sponsor. For patients forced to go to inpatient treatment by a family member or judge, treatment likely will not progress to success. Yager said that preparing for discharge is important because patients must eventually go back to the world where they used substances. If they do not enact changes in themselves first, they will likely begin using again. A year ago, Huther Doyle began a mobile practice to aid homeless people, many of whom are medically compromised. “They’ll never go to a treatment facility or hospital, so we bring everything out to them,” Yager said. As with patients at Huther Doyle, the patients at Cazenovia Recovery in Buffalo also develop a discharge plan and receive referrals before they leave in-patient treatment. “As soon as they come, we ask about their plans after discharge and how can we support those plans,” said Edward Cichon, director of marketing and communications for Cazenovia Recovery. “They have a structure set up for referrals and they feel supported and empowered so they make good choices when they leave us.” This includes to referrals to an outpatient provider and housing. While dictating what patients should do next may seem a good idea, Cazenovia Recovery has found that working with patients to develop their plans works better than telling them what to do next in their recovery process. A sense of support and community is also necessary for patients’ success. That is why Cazenovia works with patients’ families. “Family involvement is huge,” said Angela Angora, director of reintegration. “By having family members come in, we can have expectations about when this person can leave.”
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Approaching 65? Here’s What to Know About Enrolling in Medicare Dear Savvy Senior, Can you give me a brief rundown of Medicare’s enrollment choices along with when and how to sign-up? — Approaching 65
Dear Approaching, The rules and timetables for Medicare enrollment can be confusing to many new retirees, so it’s smart to plan ahead. Here’s a simplified rundown of what to know. First, a quick review. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people, and Part B which covers doctor’s visits and other medical services, and costs $170.10 per month for most enrollees in 2021. When to Enroll: Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later. You can enroll any time during the “initial enrollment period,” which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. It’s best to enroll three months before your birth month to ensure your coverage starts when you turn 65. If you happen to miss the seven-month sign-up window for Medicare Part B, you’ll have to wait until the next “general enrollment period” which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You’ll also incur a 10% penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium. You can sign up for premium-free Part A, at any time with no penalty. Working Exceptions: Special rules apply if you’re eligible for Medicare and still on the job. If you have health insurance coverage through your employer or your spouse’s employer, and the company has 20 or more employees, you have a “special enrollment period” in which you can sign up. This means that you can delay enrolling in Medicare Part B and are not subject to the 10% late-enrollment penalty as long as you sign up within eight months of losing that coverage. Drug Coverage: Be aware that original Medicare does not cover prescription medications, so if you
don’t have credible drug coverage from an employer or union, you’ll need to buy a Part D drug plan from a private insurance company (see Medicare.gov/plan-compare) during your initial enrollment if you want coverage. If you don’t, you’ll incur a premium penalty — 1% of the average national premium ($33 in 2022) for every month you don’t have coverage — if you enroll later.
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Supplemental Coverage: If you choose original Medicare, it’s also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles. See Medicare.gov/medigap-supplemental-insurance-plans to shop and compare policies. All-In-One Plans: Instead of getting original Medicare, plus a Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan instead (see Medicare.gov/ plan-compare) that covers everything in one plan. Nearly half of all new Medicare enrollees are signing up for Advantage plans. These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper premiums, but their deductibles and co-pays are usually higher. Many of these plans also provide coverage for extra services not offered by original Medicare like dental, hearing and vision coverage along with gym fitness memberships, and most plans include prescription drug coverage too. How to Enroll: If you’re already receiving your Social Security benefits before 65, you will automatically be enrolled in Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have work coverage that qualifies you for late enrollment. If you’re not receiving Social Security, you’ll need to enroll either online at SSA.gov/medicare or over the phone at 800-772-1213. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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March 2022 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 19
Ask St. Ann’s
By Jeff Brunner
Smaller Gatherings Allow for More Meaningful Engagement
O
ne of the things we value most as humans is the ability to connect with others, to have meaningful interactions with those around us. It’s what makes us truly human. For many of us, that ability took a big hit at the height of the pandemic when isolation was our default mode. That was especially true for older adults. In skilled nursing communities, we had to devise new ways to keep our residents engaged while at the same time keeping them safe. As a result, the situation has led to opportunities for even greater and more meaningful engagement than ever before. Prior to the pandemic, it was common for us to gather many residents together in a large room for entertainment, games and parties. Having a hundred or more residents in one location was not uncommon. Once the pandemic hit, such gatherings ceased. In their place came smaller, more personalized get-togethers for small groups of residents and even one-to-one engagement with staff. For example, I meet regularly with a resident of St. Ann’s Home to help him write letters to his nephew in Michigan who’s become his pen pal. There are also residents with whom I sit and play cards one-on-one, giving us time to chat and hear what’s on each other’s minds. Similarly, my colleagues continue to meet individually with our residents to help them make Zoom calls to family members. While this practice began out of necessity during lockdown and families can now visit in person, many keep the Zoom relationship going. I know of a woman at St. Ann’s who continues to have calls with her granddaughter in California; she loves the face-to-face contact and has built a close relationship with a cherished but far-away relative. Research shows that for older adults, staying engaged in enjoyable activities supports their physical and mental health. Further, when elders have a say in what’s happening around them, the effects can be even greater. Small-group engagement makes this possible. With a group of six or eight residents, my colleagues and I can listen more closely to what each says as they direct us in supporting their choices. We planted apple trees on the St. Ann’s campus after it was suggested by a fifth floor resident who was an apple farmer; this has led to excursions, when weather permits, to observe the growth of the trees and await apple-picking time. Small
‘All of us look forward to the time when we can again hold parties in the auditorium and Sunday socials in the lobby. But we know that more intimate, personalized engagement is good for our residents and their quality of life, so it’s an idea whose time has come.’ groups also rotate in taking care of the raised-bed vegetable gardens on campus, a treasured activity for those who loved caring for their own gardens. Many skilled nursing communities began transitioning to smaller, more personalized engagement well before the pandemic, the benefits to our residents having been well documented. The newly renovated living space at St. Ann’s Home, for example, has a maximum of 15 residents sharing a “household,” the space in which most of their daily living takes place. Residents in each household are familiar with their neighbors, which means they’re more comfortable and more inclined to actively participate. When we get together as a group, the feeling is similar to meeting friends for coffee: intimate, low key, and pleasant. Small groups also make spontaneity possible. I can visit with a household and ask, “What do you want to do today? Uno, tabletop bowling or something else?” It’s fun for the residents (and for me!) and puts the choice in their hands. It also wouldn’t work with a large group, the point being that we are focusing on the integrity of the group rather than the size. All of us look forward to the time when we can again hold parties in the auditorium and Sunday socials in the lobby. But we know that more intimate, personalized engagement is good for our residents and their quality of life, so it’s an idea whose time has come.
Jeff Brunner is a life enrichment advocate at St. Ann’s Home. You can reach him at jbrunner@ mystanns.com.
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e are required to periodically conduct continuing disability reviews for beneficiaries with disabilities. This process requires that beneficiaries complete a continuing disability review packet, that we mail to beneficiaries, to help us update information about their medical conditions and recent treatments. Additionally, we offer an online option for beneficiaries to complete the disability update report form and provide any supporting documents about their medical treatment or work activities. We designed this form with convenience in mind — and to save you time. You can access the online
Q&A
Q: I want to apply for Medicare Part B (medical insurance) this year. When is the deadline to apply? A: If you didn’t sign up for Medicare Part B (medical insurance) when you first became eligible for Medicare, you have an opportunity to apply during the general enrollment period, which runs from Jan. 1 through March 31 each year. If you miss the deadline, you may have to wait until next year to apply. Medicare Part B covers some medical expenses not covered by Medicare Part A (hospital insurance), such as doctors’ fees, outpatient hospital visits and other medical supplies. You can learn more by reading Medicare at www.ssa. gov/pubs/10043.html. Q: I lost my Medicare card. How can I get replacement? A: The easiest and newest way to get a replacement Medicare card is by using your my Social Security account. Go to www.ssa.gov/myaccount for more information on how to create an account. You also can get a replacement Medicare card by calling us toll-free at 1-800-772-1213 (TTY 1-800-325-0778). Keep your card in a safe place. You don’t want anyone getting hold of your Social Security number. They could steal your identity. Q: My child is disabled, but when I applied for SSI, I was told that my child was ineligible because my spouse and I earned too much money? Why does our income make my child ineligible? A: If a child is living with either their natural or adopted parents, then some of the income that the parents earn deems to the child. We use these amounts to determine whether or not your child meets the non-medical requirements for SSI. For more information, visit www.ssa.gov/ssi/
Page 20 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2022
form at www.ssa.gov/ssa455-onlineform. (Use either Microsoft Edge or Google Chrome for the best online experience.) When you complete your continuing disability review, you will need your Social Security number, current address and phone number, and a valid email address to complete the form. Also, you must have received a request for an updated disability report in the mail. Once you “Click to Sign,” you will receive an email from echosign. com asking you to confirm your digital signature. Check your junk folder if you don’t receive it within a few minutes. If your signature isn’t complete your form won’t be processed. Please be sure to let your friends and loved ones know about this new online option. spotlights/spot-deeming.htm. Q: I saw a poster that advised people 65 or over with limited income and resources to apply for Supplemental Security Income (SSI). Next month I’ll turn 65, and I thought I’d be eligible for SSI. I planned to apply until my neighbor told me I probably would be turned down because I have children who could help support me. Is this true? A: Whether your children are capable of helping to support you does not affect your eligibility. SSI eligibility depends solely on your income and resources (the things you own). If you have low income and few resources, you may be able to get SSI. However, if you are receiving support from your children or from anyone living inside or outside of your home, it may affect your eligibility or the amount you can receive. Support includes any food or shelter that is given to you, or is received by you because someone else pays for it. Learn more about SSI at www.ssa. gov/ssi. Q: I have been collecting disability benefits for a few years, but I’m getting healthy enough to work again. Can I return to work while getting Social Security disability benefits? A: Yes, you can return to work while receiving Social Security disability benefits. We have special rules to help you get back to work without lowering your initial benefits. You may be able to have a trial work period for nine months to test whether you can work. If you get disability benefits and your condition improves or you return to work, you must report these changes to us. Call us at 1-800-772-1213 (TTY 1-800-3250778) or contact your local Social Security office. You can find your local office by visiting www.ssa.gov/ locator.
Health News Excellus BCBS Awards Hospitals $30 Million for Quality Improvements
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hirty-one Upstate New York hospitals and health centers earned a combined $30 million in quality improvement payments from Excellus BlueCross BlueShield last year as part of the nonprofit health insurer’s hospital performance incentive program. Since 2005, Excellus BCBS has paid out more than $371.2 million in quality improvement incentives. “It’s part of our mission to ensure that all in our communities have equitable access to high quality health care,” said Melissa Gardner,
Rochester Regional has new medical director for gynecologic oncology Rochester Regional Health announced the appointment of physician Sajeena Geevarghese as executive medical director for gynecologic oncology. Geevarghese was expected to join the health system Feb. 28 and assume this newly created position in partnership with the gynecologic oncology operational team to lead strategic, clinical and operational priorities. Geevarghese A native of Chattanooga, Tennessee, Geevarghese comes to RRH from the University of Rochester Medical
Local Businesses Launch a Geriatric Care Management Service
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hree local businesses, with decades of experience in eldercare, have launched a new geriatric care management company dedicated to serving the growing population older adults and their caregivers in Monroe, Wayne, Ontario, Yates, Seneca and northeastern Livingston counties. Lifespan of Greater Rochester Inc., Touching Hearts at Home, and Entrusted Care have formed Together in Caring LLC to provide comprehensive, private pay care management for challenges such as medical crises, health care coordination, home care, residential transitions, and social and mental health. “Our approach is very personalized. As our company name indicates, we form a partnership with our clients to achieve the highest quality of life as they define it,” said Mark McDermott, CEO of Touching Hearts at Home
executive vice president, chief population health engagement officer at Excellus BCBS. “The foundation for achieving that is a collaborative relationship with our local hospital and physician partners.” Nine hospitals in the Rochester region participated in this program in 2021, sharing $14.6 million in quality improvement incentive payments. Participating hospitals are Clifton Springs Hospital & Clinic, Highland Hospital, Newark-Wayne Community Hospital, Noyes Memorial Hospital, Rochester General Hospital, Strong Memorial Hospital, Thompson Health, United Memorial Medical Center and Unity Hospital. “In 2021, Excellus BCBS’s hospital performance incentive program evaluated participating hospitals on
projects that are in alignment with and responsive to the ever-changing health care environment,” said physician Stephen Cohen, senior vice president and corporate medical director at Excellus BCBS. “Although COVID is still a dominant issue for the hospitals, the best evidence that this collaboration is a success is that our partners are able to maintain focus on continuous quality improvement.” Areas targeted for improvement in 2021 included: • Clinical Processes of Care — Focused on improvements in follow-up after hospitalization, diabetes, chronic obstructive pulmonary disease (COPD), surgical care, and other measures unique to each participating hospital
• Patient Safety — Centered on reductions in hospital-acquired infections, readmissions, and other adverse events or errors that affect patient care • Patient Satisfaction — Used the hospital consumer assessment of healthcare providers and systems survey, which is a national, standardized, publicly reported survey of patients’ perspectives of hospital care In addition to meeting required clinical and patient safety measures in 2021, other nationally endorsed measures and target outcomes were jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, the Institute for Healthcare Improvement, and others.
Center (URMC), where she served as associate professor and director of medical education for gynecologic oncology. In addition to her full-time surgical and clinical caseload, Geevarghese’s responsibilities at URMC included overseeing the resident and medical student education programs for the division of gynecologic oncology. One of the region’s top robotics surgeons, she was awarded the 2021 CREOG National Faculty Award for Excellence in Resident Education. Geevarghese received her medical degree from Johns Hopkins University School of Medicine, and completed residency at Washington University in St. Louis, and her fellowship at the University of Minnesota.
nursing for F.F. Thompson Hospital in Canandaigua. Nguyen, who lives in Canandaigua, obtained her bachelor’s in nursing from St. John Fisher College in Rochester and her master’s in nursing from St. Xavier University in Chicago. She is a board-certified emergency nurse and certified trans plant nurse who holds nurse executive certification from the American Nurses Association. Prior to joining UR Medicine Thompson Health as a nurse leader Stephanie Nguyen in late 2020, Nguyen was the patient care director for the solid organ transplant program at Columbia University’s New York-Presbyterian Hospital in Manhattan, where she had previously been a nursing administrator and emergency department charge nurse. At Thompson, Nguyen oversees a staff of more than 40 nurses and nearly 30 patient care technicians in the 24-bed emergency department. “Stephanie has been a valued member of our team for over a year now and, having come to us with previous experience at the director level, has tremendous leadership skills as well as exceptional clinical skills,” said Vice President of Patient Care Services and Chief Nursing Officer Hazel Robertshaw.
said Sady Alvarado-Fischer, corporate director of diversity, equity and inclusion for Excellus BCBS. “As a queer woman, I am especially proud to work for an organization who is committed to creating an environment where our employees and members can choose to be out, and have their identities affirmed and celebrated.” The CEI rates companies on detailed criteria falling under four central pillars: non-discrimination policies across business entities; equitable benefits for LGBTQ+ workers and their families; supporting an inclusive culture; and corporate social responsibility. The full report is available online at www.hrc.org/cei.
Thompson Hospital has new director of emergency nursing Stephanie L. Nguyen was recently named director of emergency and Together in Caring. Together in Caring is a joint venture separate from Lifespan’s operations as the long-standing nonprofit leader in assistance for older adults and their caregivers. “This partnership expands geriatric care options for older adults whose needs are acute, long-term and best served in a private pay context. This service supplements and complements, rather than replaces or detracts from, the broad range of programs and services currently provided by Lifespan,” said Lifespan’s president/ CEO Ann Marie Cook. “By participating in the ownership of Together in Caring we are now contributing in an additional way to help adults in our area navigate the challenges of older age.” Kathy Jacobs, president of Together in Caring noted, “Navigating care options in our community can be overwhelming, particularly in a crisis. Hiring experienced professionals who see the whole picture and provide coordination can reduce stress leading to better decisions.”
Excellus BCBS Recognized for LGBTQ+ inclusion Excellus BlueCross BlueShield has received a score of 90% out of 100 on the Human Rights Campaign Foundation’s 2022 Corporate Equality Index, the nation’s foremost benchmarking survey and report measuring corporate policies and practices related to LGBTQ+ workplace equality. Excellus BCBS joins the ranks of 1,271 major U.S. businesses that were also ranked in the 2022 CEI. “We’re proud to be recognized for our inclusive policies and practices related to LGBTQ+ inclusion,”
UR School of Nursing, URMC extend free tuition program The University of Rochester School of Nursing, in partnership with nursing practice at the University of Rochester Medical Center (URMC), has extended a free tuition program for UR nurses for another two years. The UR School of Nursing Tuition Grant supplements UR employee tuition benefits to provide 100% tuition coverage in select bachelor’s, master’s, and post-master’s programs. Open to eligible University of Rochester employees, the grant is available for new students in the following programs: • RN to BS program (BS), • Clinical Nurse Leader (MS, Post-MS, RN to BS to MS entry points) • Nursing Education (MS, Post-MS, and RN to BS to MS entry points) • Leadership in Health Care Systems (MS and RN to BS to MS entry points) The grant was first implemented in 2019 as a pilot program but was slated to end later this year. The extension will cover new students who matriculate and begin their degree program no later than the summer 2024 semester. More than 500 URMC nurses and health care professionals have enrolled and benefitted from the grant since its inception. (continued on page 23)
March 2022 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 21
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Health News (continued from page 231
Grant to help Compeer increase mental health access Compeer Rochester, a local mental health organization, recently received an $85,000 grant from the Mother Cabrini Health Foundation to expand its veteran services programming to families. The effects of the COVID-19 pandemic forced veterans back into periods of isolation and many were without adequate technology at home or skills needed to participate in the Zoom sessions that were offered to continue supporting those with mental health challenges. As a result, participation in the program decreased and there were many veterans who struggled with their mental health and PTSD issues simply from the lack of social connection. With support from its latest grant, Compeer will continue and extend its CompeerCORPS programming and services to veterans’ families and further its reach throughout the community creating a more substantial impact of its mental health and wellness initiatives. The grant will allow the organization to hire two part-time workers for its intake and engagement services roles, fund the person responsible for coordinating its Vets Driving Vets initiative, and help create activity-based and
client enrichment programs. This is the third year Compeer Rochester receives funds from Mother Cabrini Health Foundation. The foundation recently provided $140 million to organizations and programs addressing the health-related needs of underserved communities across New York state.
DePaul selected to receive more than $100K in grants DePaul, a Rochester-based nonprofit that provides a range of services to the community, has announced it has received two grants. • Mother Cabrini Health Foundation selected DePaul Adult Care Communities, Inc. as a 2022 grantee. The $90,500 grant it received will be used to support the ongoing cost of technology engagement programs at DePaul’s five senior living communities in New York. Funds will be used to maintain the operational and subscription costs associated with Eversound wireless headphones, Rendever virtual reality headsets, and iN2L, a content-driven engagement technology, all of which was purchased with the support from the Mother Cabrini Health Foundation in 2021. Seniors at Glenwell in Cheektowaga, Heritage Manor of Lockport, Westwood Commons in North Chili, Wheatfield Commons in North Tonawanda, and Woodcrest Commons in Henrietta have been leaping
into the 21st century thanks to the technology purchased with these grants. “DePaul recognizes the importance of providing the tools, support and activities that allow seniors to age in place,” said Stacie Major, DePaul’s regional director of operations for DePaul’s Adult Care Communities. “The use of the new technology has proven to be successful as residents are more engaged with the outside world in many different ways, but yet in the comfort of their own home. Seniors have been able to engage with family and friends, even if they couldn’t see them face to face,” Major said. The Mother Cabrini Health Foundation is a private, nonprofit organization whose mission is to improve the health and well-being of New Yorkers, bolster the health outcomes of vulnerable communities, eliminate barriers to care, and bridge gaps in health services. Named after a tireless advocate for immigrants, children, and the poor, the Mother Cabrini Health Foundation funds programs and initiatives across New York state that either provide direct healthcare services or address the social determinants of health. “As we look back at the compounding crises of the last few years, the health-related needs of vulnerable communities have only grown. Our grantees have demonstrated tremendous resilience, creativity, and dedication to serving those in need,
especially as the COVID-19 pandemic continues to have such detrimental impact,” said Alfred F. Kelly, Jr., chairman and chief executive officer of Visa and chairman of the Mother Cabrini Health Foundation board. • ESL Charitable Foundation has awarded a $26,863 grant to enhance DePaul’s WorkGuide Supported Employment Program. DePaul’s WorkGuide Program has decades of experience providing vocational support to individuals with mental, developmental or physical disabilities seeking assistance with gainful employment in Monroe County. Along with the financial benefits and self-sufficiency, employment also assists individuals in gaining a sense of purpose and fulfillment, and a sense of pride in themselves and their work. WorkGuide assists in building a sense of community between employers and employees while also fostering respect and support for individuals with disabilities. In 2021, WorkGuide served over 500 people ages 16 and older who fall below the poverty line in Monroe County. WorkGuide encourages many people, including employers, service providers, policymakers and the public at large, to dispense with the false notion that people with disabilities are not capable of successfully working in community-based employment settings.
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