INSIDE Healthcare a guide to your healthcare services
Women’s Healthcare Issue
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% SATISFACTION
IN MATERNITY*
p. 3 — Heart Disease p. 9 — Lowest Infection Rate in Area p. 12 — Short-term Rehab
Oswego Health WINTER 2016
INSIDE HEALTHCARE A Publication of Oswego Health 110 W. Sixth St., NY 13126 315-349-5511 Chuck Gijanto President and CEO of Oswego Health Jeff Coakley VP for Communications & Government Affairs Jennifer Martin Director of Marketing Marion Ciciarelli Director of Public Relations Anne Raham Communications Coordinator Maureen Miceli Administrative Assistant Correspondence: Oswego Health Development and Community Relations 110 W. Sixth St. Oswego, NY 13126 dearoh@oswegohealth.org
©2016
facebook.com/oswegohealthcare for Oswego Health community news, events and medical information twitter.com/oswegohealth
oswegohealth.org for newsletters, medical information, provider listings and more Information in this issue comes from a range of medical experts. If you have any questions or concerns about specific content that may affect your health please contact your health care provider.
on the front cover —
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As a general surgeon at Oswego Hospital, I saw firsthand the exceptional care provided by the maternity center physicians and the staff and didn’t think twice about where we should have our baby. Everyone was helpful and caring, ensuring our precious moment was comfortable, smooth and so special.” Our cover features Oswego Health General Surgeon Jai Singh, MD and his wife, Pooja Fandan, whose baby was delivered Dec. 14th at Oswego Hospital. The couple’s new daughter, Shreya Singh, joins a brother, Aaryav at home. You can learn more about our maternity center by visiting oswegohealth/ healthybabies.org.
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Welcome to the 2016 Inside Healthcare “Women’s Issue” This issue of Inside Healthcare focuses on a variety of women’s health issues. We hope you find it informative and interesting. This magazine and other health information is always just a click away on our newly redesigned website, oswegohealth.org. Under the resources tab, our new site offers an online health library and the opportunity to sign up for several newsletters. These newsletters concentrate on women’s topics and can be delivered to your email address. Expectant mothers and fathers can also choose our free weekly Pregnancy e-newsletter. This e-newsletter follows you through the various stages of pregnancy, offering timely tips and articles and practical, interactive tools that can help take some of the worry out of this time in your life. The New Parent e-newsletter is designed especially for new parents. Once a month you will receive timely information related to the growth of your new child up to 3 years of age. *Press Ganey Standard Overall Large Peer Group Hospital June 2015-October 2015
inside — The mission of Oswego Health is to provide accessible, quality care and improve the health of residents in our community.
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Your Maternity Center and Oswego County OB-GYN Physicians
Going Home With Oswego Health Home Care after a Hospital Stay
Build a Relationship with Your Physician
Strong for Life
What Are the Risk Factors for Heart Disease?
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During February, Oswego Health strives to bring awareness to the No. 1 killer of women, heart disease, which causes one in three deaths each year. That’s approximately one woman every minute!
Some risk factors, such as age and family history of early heart disease, can’t be changed. For women, age becomes a risk factor at 55. After menopause, women are more apt to get heart disease, in part because their body’s production of estrogen drops. Women who have gone through early menopause, either naturally or because they have had a hysterectomy, are twice as likely to develop heart disease as women of the same age who have not yet gone through menopause.
Cardiology Services & Information
Symptoms of a Heart Attack for Women:(AHA) w Uncomfortable pressure, squeezing, fullness or pain in the center of your chest that lasts more than a few minutes, or goes away and comes back. w Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
oswegohealth.org/services/cardiology-services For more information on Cardiology, Cardiology Rehab at Lakeside Heart Center or Cardiopulmonary Services please go to our website. We all know that to be heart healthy , we should exercise 30 minutes each day, not smo ke or use tobacco products and eat healthy. But just wha t foods are heart healthy? Oswego Health’s Cardiolo gist Thomas Grady Jr., provides a list of 20 foods we should all eat for a healthier heart. (These foods are not listed in any particular order.) u Salmon & Tuna
w Shortness of breath, with or without chest discomfort. w Other signs such as breaking out in a cold sweat, nausea or lightheadedness. As with men, the most common heart attack symptom in women is chest pain or discomfort. But it’s important to note that women are more likely to experience the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.
Flaxseed u Oatmeal with berries such as blueberries, raspberries, blackberries and strawberries u Black and/or kidney beans u Almonds and walnut s-not the other nuts u Carrots, Spinach and Broccoli u
Risk factors are conditions or habits that make a person more likely to develop a disease. They can also increase the chances that an existing disease will get worse. Important risk factors for heart disease that you can do something about are: w High blood pressure w High blood cholesterol
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w Diabetes and pre-diabetes
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w Smoking
Sweet potatoes and Acorn Squash Red Bell Peppers and Tomatoes
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Asparagus
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Pomegranates
w Being physically inactive
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Oranges and Cantaloupe
w Having a family history of early heart disease
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w Being overweight
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w Having a history of pre-eclampsia during pregnancy w Unhealthy diet
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w Age (55 or older for women)
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Brown rice Red wine-in moderation (no more than one drink per day)
Dark chocolate-in moderation (cho ose 70% or higher cocoa content)
Good heart health means don’t smoke, limit alcohol consumption and embrace techniques that reduce stress such as exercise, meditation or yoga.
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Inside Healthcare WINTER 2016 — 3
We deliver healthy babies Outstanding patient satisfaction rate Samantha Hesse and her husband, Michael, welcomed their third baby named Liam in Oswego Hospital’s completely modern maternity center in October. The Hesse family was among the first to use the center’s new C-section recovery room, which offers a quicker bonding experience for the new family.
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Those first bonding moments are very special and important for both baby and the family,” said Kim Hyde, RN, and clinical director of the maternity center. “We are glad to be able to offer this to our moms and it’s yet another benefit of having a baby at our maternity center.
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Previously, women who underwent a C-section delivery fully recovered in the post-anesthesia unit. Now, following the birth and some initial assessments, both mother and baby will recover together in the new C-section room that features the comforts of home and state-of-the-art medical equipment, which is immediately available if needed. “For my first two deliveries, I felt out of the loop as everyone got to see the new baby before I did,” Samantha said. “However, this
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time with the new C-section recovery room I felt I was included in all those special first moments.” The C-section room is just one feature of the maternity center, which offers a comfortable and home-like environment alongside the latest technology, providing women with a safe and intimate birthing experience. Each of the five private labor/delivery/recovery rooms features a private bathroom with a large soaking tub. Laboring mothers have found these chest-high tubs helpful in moving along the labor process and with pain management. Another feature is the attractive wooden cabinets that conceal the medical equipment until it is needed. Once a woman delivers her baby, she will recover in one of the postpartum rooms, most of which are private and have their own bathrooms, complemented with a cheery, homelike atmosphere. The maternity center staff takes ownershp when making a new family’s the best experience possible. The Maternity Center enjoys a 98 percent patient satisfaction ranking among peer group hospitals, according to Press Ganey, which is the largest provider of healthcare satisfaction measurement data in the country.
A private labor and delivery room
Physician Partners
Daniel Coty, DO Daniel Coty, DO, is a board-certified obstetrician/gynecologist, who has been providing care at Oswego Hospital and Oswego County OB/GYN, P.C. since 1999.
We deliver healthy babies
Dr. Coty serves as Oswego Hospital’s chief of surgery. He earned his Doctor of Osteopathy Degree (DO) from the University of Medicine and Dentistry of New Jersey. Dr. Coty completed his residency training at BiCounty Community Hospital in Warren, Michigan. He earned his Bachelor of Science degree from William Paterson College in Wayne, NJ.
Raj Mahajan, M.D
One of our postpardum rooms
Oswego native Raj Mahajan, M.D. joined the medical staff of Oswego Hospital and the Oswego County OB-GYN, P.C. in 2008. Dr. Mahajan serves as Oswego Hospital’s chief of obstetrics/gynecology. Dr. Mahajan, who is board-certified in obstetrics and gynecology, earned his undergraduate and medical degrees from the University of Buffalo. He completed his residency in obstetrics and gynecology at the State University of New York at Buffalo Affiliated Hospitals.
Oswego Health Maternity Center oswegohealth.org/healthybabies For more information on our Maternity Center and women’s services please go to our website. Remember to sign up for our Pregnancy E-newsletter.
For a tour of the maternity center, please call 315-349-5572
Dr. Mahajan possesses extensive knowledge of urogynecology and assisting women with incontinence issues. In addition, he has experience in helping couples experiencing fertility problems. He also has undergone special training in ultrasound and is certified as a diagnostic medical sonographer.
Venkata Ramani Dasari, MD Dr. Dasari is also board-certified as an obstetrician/gynecologist. She joined the medical staff of Oswego Hospital and Oswego County OB-GYN, P.C. in 2011. Dr. Dasari completed her residency at St. John Hospital and Medical Center in Detroit, Mich. She attended medical school at Osmania Medical College in Hyderabad, India. Following medical school, she provided care in several hospitals in India and at a private practice. See page 7 for an interview with Dr. Dasari.
Inside Healthcare WINTER 2016 — 5
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Screening Tests Women Need
Screening tests can help catch diseases early, when they’re easier to treat. Illness isn’t the only reason to see a doctor. In fact, preventive care while you’re healthy can help reduce your risk of getting sick to begin with. Regular screenings can help you avoid some of the biggest threats to women’s health—including heart disease, cancer, stroke and diabetes. Screenings can also catch diseases in early stages, when treatment is often most effective. The following are conditions for which women should undergo the appropriate screening.
1. Blood pressure 2. Cholesterol 3. Cervical cancer 4. Breast cancer 5. Colorectal cancer 6. Osteoporosis 7. Diabetes 8. Depression 9. Skin cancer 10. Sexually transmitted infections (STIs)
To learn more about these recommendations, including the frequency and age to undergo the screening, please visit: oswegohealth.org.
Going Home After a Hospital Stay For patients about to be discharged from the hospital, going home can cause some anxiety. Ready to assist patients who need help at home with chronic disease management, wound care, intravenous antibiotic therapy or other health concern, is Oswego Health Home Care (OHHC). The home care agency has been assisting area residents with skilled nursing, rehabilitation and support services for more than 30 years.
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Our staff is highly skilled in teaching patients on how and when to take their prescribed medications, how to communicate with their physician and perhaps most important, how to manage their condition overall, all with a focus on well being.
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— Director of Patient Services Megan Hollister, RN, BSN. Staff members work under the direction of your physician and are available 24/7. To learn more about OHHC, call 598-1544 or visit: oswegohealth.org/services/home-care.
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Build a Relationship with Your Physician Building relationships with her patients is most important to Venkata Ramani Dasari, MD, a board certified obstetrician/ gynecologist, at Oswego Hospital and the Oswego County OB/ GYN medical practice. As an OB/GYN physician, she cares for women at some of their most memorable and private moments, as she not only delivers newborns, but also provides well-woman healthcare and performs surgery for those with reproductive health issues. Delivering babies, is of course, a favorite aspect of her profession. “Our facility is modern, and it provides privacy to our patients and their families,” she said. She also has high praise for the staff.
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The nursing care is one of the best,” Dr. Dasari said. “And the patient care is really great. The nursing staff is just awesome.
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Each year more than 500 babies are born in Oswego Hospital’s maternity center. The center provides a comfortable and technologically-advanced facility for families to welcome their newborns. There are private labor and delivery rooms with their own bathrooms, which feature large soaking tubs and other comfortable amenities. Women can recover in postpartum rooms, most of which are private. There is an on-site international lactation specialist to assist with breast feeding, as well as neonatal nurse practitioners and a full complement of registered nurses. To learn more about the board-certified OB/GYN physicians, see the bios on page 5.
Oswego Health Maternity Center oswegohealth.org/services/maternity-center or for OB-GYN Services
Dr. Dasari’s Health tips for Women p See your physician annually for clinical breast and pelvic exams. Don’t skip a visit just because it’s not the year for a Pap smear. p As you age and your monthly cycle changes, please see your physician. p Adopt a healthy lifestyle, eat a balanced diet, exercise regularly, and do not smoke.
Dr. Dasari’s Tips For Pregnant Women and New Mothers p Don’t smoke. p Ask your physician regarding flu and Tdap vaccines. They protect not only you, but also your baby the first few months. p She strongly advocates breastfeeding. It can reduce the risk for breast cancer too.
ocobgyn.net
Inside Healthcare WINTER 2016 — 7
Back on her feet after surgery and feeling better than ever!
arrhythmias or other issues. The specialized equipment can also trend data for physicians to review with their patients. Keeping a watchful eye on the technology as June exercises are registered nurses who have undergone specialized training. Complementing June’s rehab regimen, are 10 educational sessions, which she says are very helpful in providing tips on a variety of topics, from understanding medications, risk factors, nutrition and the anatomy of the heart. June Tryon at Lakeside Heart Center
After undergoing heart valve surgery this past summer, June Tryon, 77, of Oswego, said that the programs offered at Oswego Health’s Lakeside Heart Center have not only given her life back, but also are providing her the tools to stay healthy. “The program has been tremendous,” June said. “After my surgery, I felt weak. Then slowly, but surely, I made progress and now feel back to normal. I am now able to do things that I wasn’t able to prior to my surgery.” Lakeside Heart Center, located at 177 W. Fourth St., offers care to those who have experienced a cardiac event. The program is accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), signifying the facility offers the highest standards for cardiac rehabilitation. At Lakeside, June is taking part in a 36-session program to improve her heart health. Three times a week, she visits the Center for an hour, where she utilizes three pieces of exercise equipment as part of her individualized rehab program. Throughout her exercise program, June’s blood pressure and heart rate are monitored continuously by state-of-the-art telemetry equipment, which immediately alerts staff of any
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Oswego Health Cardiologist Thomas Grady, Jr., says that he refers most of his patients to the program. “One of the most important things a patient can do after a cardiovascular event is to take part in a cardio fitness program, such as the one offered at Lakeside,” he said. According to Dr. Grady, the program offers three important aspects of heart health improvement, including cardiac fitness, education about the disease, how participants can make better health decisions, and lastly emotional fitness, which fosters support among those who have undergone a cardiac event. Along with offering a program to those who have experienced a cardiac event, Lakeside also has a adult fitness program.
Community members interested in learning more about the Lakeside Heart Center can call 343-1378 or visit us online at
Lakeside Heart Center oswegohealth.org/services/cardiology-services/ Lakeside Heart Center cardiac-rehabilitation-services An Affiliate of Oswego Health
Lowest Infection Rate in Area Ensuring Oswego Hospital maintains its low rate of hospitalacquired conditions are the dynamic germ-fighting duo Kathryn Pagliaroli, director of clinical quality and patient safety and Terri Hammill, director of infection prevention and environmental services. Late last year, the hospital was recognized for having the best hospital- acquired condition (HAC) score in the region. A Medicare study, released Dec. 10th, revealed that two Syracuse hospitals had worse scores, which resulted in financial penalties. While Pagliaroli and Hammill are among those leading the charge to eliminate hospital-acquired conditions at Oswego Hospital, they are quick to credit the entire staff, as well as Oswego Health Chief Medical Officer Renato Mandanas, MD, and Bruce Krolikowski, director of central services. “Patient safety is paramount at Oswego Hospital and it takes everyone’s participation, from our environmental services staff, to the pharmacy and of course all our physicians, nurses and other clinical staff members,” said Pagliaroli.
Kathryn Pagliaroli, at left, and Terri Hammill
This is the second year in a row that Oswego Hospital has been recognized by Medicare for having an infection rate lower than the Syracuse hospitals.
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each hospital a score from 1 to 10, with one being the best. The report covered the years 2011-2014. Hospitals with high hospital-acquired condition rates are penalized and can have their Medicare reimbursement rate reduced by one percent.
Community members need to know that their Acquired Score care hospital is providing a Hospital higher levelConditions of quality Crouse 9 compared to other hospitals in the region and that they St. Joseph's 7.75 receive the care they deserve close to home. Cayugacan Medical Center 7.25 —University Dr. Mandanas Upstate Hospital said 6.5
Hospital local
Along with this Medicare report, other initiatives to improve care include:
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p Excellus’ Bordering on Zero initiative assisted with the hospital nearly eliminating its incidence of pressure ulcers, also known as bedsores in 18 months.
Cortland Regional Medical Center 4.25 The Medicare Auburn Communityreport Hospitalmeasures a hospital’s 4.12rates associated with a Oneida Healthcare Center 4 central-line associated bloodstream infection, catheter-associated Oswego 3 urinaryHospital tract infection and surgical site infections. Medicare gives
p Excellus’ Falling Star has assisted the 164-bed community hospital reduce its patient falls. p Staff members from environmental services, the pharmacy and nursing collaborated on a program that has significantly reduced the hospital’s Clostridium difficile infection rate.
Hospital Acquired Conditions Scores Oswego Hospital
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p New York Partnership for Patients, a state initiative to engage hospital staff on the importance of quality care.
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Auburn Community Hospital
4.12
Cortland Regional Medical Center
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Upstate University Hospital
Over 6.75 Incurs a Penalty
6.5
Cayuga Medical Center
For more information please go to: http:// www.oswegohealth.org/about-us/qualitycare.
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Inside Healthcare WINTER 2016 — 9
As women, we can expect our bodies to change over time. During our 20s, 30s, 40s, 50s, 60s and beyond, you’ll be making health choices. The healthier you are, the better you’ll feel, and the more you’ll enjoy all that life has to offer. This article gives you a look backward and a look forward. Remember this really is the first day of the rest of your life.
Joan Newell, MD
Dr. Newell is a member of the Port City Family Practice in Oswego and is an advocate for women’s health.
In Your 20s and 30s Healthy habits. Now is the time to establish healthy habits. Don’t smoke and do avoid second-hand smoke. If you drink alcohol, do so in moderation, and never drive after drinking. Don’t drink any alcohol if you are or might be pregnant. Eat a healthy diet to reduce your risk for many cancers and heart disease and to help with weight management. Incorporate physical activity in your daily routine, making it a lifelong habit. Use sunscreens to protect against ultraviolet rays that can age your skin and cause cancer. Preventive health care may add years to your life. Going to the doctor. Starting at age 21 you should be getting Pap tests for cervical cancer. Reproductive health. It’s important to discuss birth control options and how to protect yourself from sexually transmitted diseases with your doctor. Nutrition. Reducing the amount of fat you eat and increasing your intake of fruits, vegetables and whole grains can help reduce your risk of heart disease, stroke and cancer. The amount of bone you build and strengthen now through diet and exercise will directly affect your risk for osteoporosis later. Be sure to incorporate vitamin D into your diet, which also helps bone health. Include calcium-rich foods, such as dairy products, salmon and leafy green vegetables in your diet. Boost your intake of folic acid before becoming pregnant; it helps reduce the risk of some birth defects.
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In Your 40s Healthy habits.You’re no longer building bone mass, you’re slowly losing it. Your metabolism has also probably slowed down. A low-fat diet, weight-bearing exercise and physical activity can help reduce weight gain. Also, those suntans of your youth may start catching up with you. Check your skin regularly for signs of skin cancer. Going to the doctor. Talk to your doctor about diabetes testing if you have any risk factors. Type II diabetes occurs most often after 40 and rarely has symptoms in the early stages. Your doctor may recommend a mammogram every one to two years in your 40s. You might consider a bone density test before menopause to use as a baseline. Reproductive health. Your 40s can be like going through puberty in reverse as your reproductive organs slow down. The years when menopauserelated changes begin are called perimenopause, and when you may have irregular periods, hot flashes, fatigue, mood swings and sleep disturbances for a few months to six years- or longer. Nutrition. Continue a diet high in fruits, vegetables, and whole grains including sources of folic acid and calcium. Reduce fats in your diet to protect against heart disease, stroke and cancer. You might consider adding soy to your diet; it may help decrease hot flashes and other menopausal symptoms and prevent osteoporosis.
Healthy at 50 Healthy habits. As you age, your skin becomes thinner, drier and more fragile, so use sunscreen, wash with mild soaps, and use a moisturizer if your skin is dry. Don’t smoke, and drink plenty of water. Also, examine your skin once a month; skin cancer accounts for half of all malignancies in the U.S. Going to the doctor. Regular checkups and tests are even more important as you grow older as they allow you to catch problems at earlier, more treatable stages. Begin colon cancer tests at age 50. Your risk of breast cancer increases as you age; having mammograms is crucial.
Reproductive health. The average age of menopause, when your periods stop completely, is 51, but it can happen between the ages of 40 and 55. For smokers, menopause may occur at an earlier age. You are past menopause when you have not had a period for 12 consecutive months.
How Much Vitamin D Do You Need? Women and Men Under age 71
600 international units (IU) daily
Age 72 and older
800 IU daily
Nutrition. As you age and your risk for heart disease and cancer increases, a low-fat diet rich in vegetables, fruits and whole grains becomes even more important. Also, because your body has less muscle, it burns calories more slowly. Eat in moderation to help control your weight.
And on into Your 60s Healthy habits. Because of longer life expectancies, most women can expect to spend some of their later years alone. Women who become socially isolated are three times more likely to die from various cancers. It’s important to continue current interests and to look for new ones. Don’t forget to continue to exercise and eat a balanced diet to slow down bone loss. Begin bone density screenings at age 65. Going to the doctor. At age 65, you should get a pneumonia shot. You may want to talk with your doctor about common problems, often resulting from hormone losses, such as urinary incontinence, sleep problems and memory loss. If you’re feeling depressed as a result of the changes in your life or of coping with losses, don’t be afraid to talk with your doctor. Be sure to include regular visits to the eye doctor for a vision test and screening for glaucoma and cataracts. Your risk of breast cancer increases as you age; having mammograms is crucial. Consider getting the shingles vaccine and the Tdap vaccine to prevent the spread of whooping cough to babies. Reproductive health. While birth control is no longer an issue, remember to continue to protect yourself against sexually transmitted diseases. Nutrition. As you age, you may lose your appetite, so be sure to continue to eat a complete, healthy diet. Talk to your doctor about taking a multivitamin/mineral supplement to ensure you’re getting all the necessary nutrients. As you age, you should also consider completing a healthcare proxy and other advance directives to inform family members of your wishes in the event you cannot make medical decisions for yourself.
How Much Calcium Do You Need? The amount of calcium you need every day depends on your age and sex. Women Age 50 & younger
1,000 mg daily
Age 51 & older
1,200 mg* daily Men
Age 70 & younger
1,000 mg daily
Age 71 & older
1,200 mg* daily
Strong for life
Inside Healthcare WINTER 2016 — 11
Oswego Health 110 West Sixth St. Oswego, NY 13126
FREE Mammograms
Oswego Health continues to partner with State Senator Patty Ritchie to offer free mammograms and clinical breast examinations to women who meet certain criteria. Women over the age of 40 who have not had the screenings in the past three years are eligible. Appointments are necessary and can be made by calling Carin at 349-5513.
Short-term Rehab at the Manor New software installed at The Manor at Seneca Hill is helping those with swallowing disorders or dysphagia. Synchrony, a virtual reality-assisted biofeedback system, allows participants to visualize swallowing activities in real time. This capability helps The Manor’s Speech Language Pathologist Melissa Beatrice evaluate the quality of a swallow to guide therapeutic intervention, while monitoring treatment progress. The system also enables patients to participate in fun, game-like interactive activities, which help keep them motivated and interested in their rehabilitation. Melissa said she is seeing impressive results since Synchrony was installed. “It’s been incredible,” she said. “This fun, interactive program is very motivating and is providing these individuals with a better quality of life.
According to Melissa , the very visual program further provides better patient documentation, offers patient specific data and allows the patient to see their own improvement. Melissa added that she has been pleased that her patients with dementia are also seeing positive results using the software. Most of Melissa’s patients use the software for 45 minutes three times per week. One of her patients with more challenging symptoms was able to have her feeding tube removed and with her improved quality of life, was able to return home. Community members can see the new program in action by visiting: http://www.oswegohealth.org/ services/rehabilitation-services/speech-therapy/