Health, sports & fitness 2017 composite

Healthy Hudson Valley FEBRUARY 23, 2017 • ULSTER PUBLISHING • HUDSONVALLEYONE.COM

Health, Sports & Fitness

Exercising to fit one's self

New team sports for grownups, signing up for summer's bounty, what babies need now, the health benefits of therapy and pets

23, 2017 2 | February Health, Sports & Fitness

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looking to find a group to play with. There’s also an official set of rules to help govern games.

As the second game of volleyball begins, one of the players looked over to where I sit perched on the bleachers. “Are you gonna play?” he asked.

I haven’t touched a volleyball since high school Physical Ed, and hadn’t planned on playing. “I don’t know how,” I said, a little embarrassed.

Judging by the expression on everyone’s face, it was plain that my lack of experience was in no way relevant.

Adult team sports WIKICOMMONS

Dodgeball is fast becoming the community winter group sport in many Hudson Valley towns. Large teams often include kids and oldsters, and the play is gentler we remember gym classes long ago to have been.

A substitute for gym class like you knew it could be

By Jodi LaMarco

A

dult recreational group sports have been around for a long time, but never in my own exercise routine. For the most part, I work out or hit the trail solo. I never voluntarily participated in team sports as a kid, let alone as an adult.

I decided to contact the unofficial organizer of Rosendale Volleyball to check out a game for myself. By the time I arrive at the Rondout Municipal Center, a game was already in full swing. After brief hellos, I climb atop a stack of bleachers nested against the wall of the gymnasium and took a

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look around. Each team consisted of half-a-dozen players ranging from 20-somethings to 70. The group is solidly male, except for a twelve-year-old girl.

Aside from the dearth of female players, the other thing I noticed was a marked absence of aggression. That’s not to say that everyone wasn’t wholly engrossed in the game. As the match progressed, there was much running, jumping and diving across the glossy wooden gym floor. What was most evident was a sense of eagerness and camaraderie rather than an unpleasantly competitive atmosphere. There was no cockiness, no pretense. Nobody was dressed to impress. It felt like everything that gym class wasn’t.

Adult recreational groups for sports like baseball, basketball and volleyball are common, but old childhood favorites such as kickball and dodgeball have become popular as well.

The World Adult Kickball Association began organizing kickball games in 1998, and its membership has been increasing ever since. WAKA kickball is just like the game you remember from elementary school (baseball diamond, red rubber ball), but with grownups and cheeky team names.

Their website, kickball.com, is a portal for those

I hopped down and walked onto the court, which was denoted by what looked like worn strips of blue painter’s tape. They told me a few rules. I muttered a prayer to the Volleyball gods, and we began.

Some people messed up, and others made good plays. I missed the ball a few times, and got it over the net in a series of lucky flails. The group was encouraging. I was having too much fun to notice whether I was performing well. The other players too seem a lot more pleased with a long volley than with scored points.

Standing around after the game, I asked the group what had drawn them to recreational volleyball. One player cited unpleasant experiences during gym class as his motive for seeking a supportive play environment. Another joked that volleyball allowed him to vent his deep inner rage.

“And it’s fun!” chimed in, drawing universal nods of agreement.

Still smiling from the rush of getting off my butt on a weeknight, I could understand why these folks kept coming back.

Interested in playing? Check them out at facebook.com/RosendaleVolleyball.

For my next experiment in recreational sports, I had planned to give Ultimate Frisbee a try, but the game had been derailed by a Sunday snowstorm.

Woodstock Ultimate Disc and Frisbee plays weekly at the Comeau property through the winter, and three times per week when daylight and weather allows. Even with the certainty of snow on the way, the group waited until the last possible moment to cancel. I suspect that in the end what really put the kibosh on the match were poor road conditions rather than an aversion to playing in eight inches of fresh powder.

In lieu of a match, I settled for a description of what I had missed over the phone. “Ultimate Frisbee is a full-field team sport similar to soccer,” explains Mark Bernard, who manages the group’s website, woodstockultimate.org. “The goal is to work the frisbee down the field, passing it from team member to team member across a goal line.

Officially, teams are seven on seven, but our minimum is three on three.”

Bernard was traumatized by high-school gym

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Goodbye, old-fashioned nurseries The face of birthing has radically changed

By Lisa Carroll

S

t. Peter’s Hospital in Albany, just an hour north of Kingston, was the first in the Capital Region to receive designation as a baby-friendly facility by Baby-Friendly USA, Inc. St. Peter’s is only one of only four such designees in Upstate New York. There are 17 BFHI-designated facilities in New York State.

That designation, according to Sandra Michael, MST, BSN, RN, SNT, CLC, manager of community Integration and lactation services for the women and children’s division at St. Peter’s Hospital, was long sought after. It took seven years to achieve, finally received in October 2016.

“It’s really a revamp of a number of things we’re doing,” Michael said. “It’s multifaceted, and a ton of work.”

Becoming baby-friendly means adhering to the ten steps required by the Baby Friendly Hospital Initiative (BFHI) developed in the 1990s through UNICEF, United Nations International Children’s Emergency Fund, and WHO, the World Health Organization. That’s no easy task. “It’s changing what has been practiced, and has a lot to do with culture,” Michael explained.

The steps to designation — to become more baby-and-mother-focused by promoting breastfeeding and mother/infant bonding — involves both education and facilities. The regimen, Michael said, include adhering to “rooming-in,” where mom and baby stay together for the duration of their hospital stay.

In years past, Michael said, hospital nurseries would be filled with babies. Nursing staff would typically give the baby its first bath, conduct staterequired physicals, and perform tests and vaccinations. Babies were often whisked away from their mothers moments after delivery.

As more hospitals and birthing centers become baby-friendly, nurseries are becoming a thing of the past. Though some facilities have closed

WIKICOMMONS

Breastfeeding is being promoted as much for the benefits of skin-on-skin contact as its physical sustenance. Some tired new moms still prefer the opportunity for relief that a nursery and a formula can provide. their baby nurseries, St. Peter’s, Michael said, has elected to keep its open. Some procedures like circumcisions and other medical procedures require observation, Michael said. Under normal circumstances, however, medical staff inform the family of the benefits of rooming-in. such as bonding, initiating breastfeeding and learning cues, before mothers are permitted to use the nursery.

The lack of nursery access as more facilities close this section of the maternity ward has been met with mixed emotions. Some suggest that new mothers may need time to heal or to sleep after a particularly stressful birth before caring for their newborn one-on-one.

“We treat patients as individuals, recognizing that some births are more traumatic,” Michael

said. The nursing staff at St. Peter’s maintains round-the-clock observation of moms, carefully watching and assisting as the new mom or veteran mom comes into her own.

While promotion of breast feeding is at the forefront of the BFHI, “it’s not all about it,” Michael said. Rooming-in and skin-to-skin contact — also known as kangaroo care — are encouraged, regardless of feeding style (be it breast-fed or bottle).

It’s during those first few hours, Michael explained, that moms learn the subtle feeding cues babies give off. Those early cues are lost in nurseries, where all the babies are roomed together and nurses feed — or return to their moms — based on a clock. When babies cry to be fed in the nursery,

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February 23, 2017 Health, Sports & Fitness

Ulster Publishing Co. Michael said, the baby first has to be calmed. In a private room with mom, Michael explained, the mom would witness earlier signs of baby’s distress and respond instinctually.

Following BFHI, and best practices developed

by American Association of Pediatrics, Michael said pacifiers are not introduced until breast feeding has been well developed. The use of pacifiers in bottle-fed babies, which can happen at any point, reduces the chances of sudden infant death syndrome.

The initiative, Michael said, has been implemented gradually over several years. Of particular note, she said, has been how quiet the maternity ward at St. Peters’ has now become. “It’s very rare to hear babies cry,” she said. “It’s very rare to see them in the nursery. It’s a very peaceful environment.”

Coming out of the initiative, Michael believes, is the empowerment of mom and dad in their health care. “Moms are making informed decisions on their labor, pre-natal care, the risks of formula,” she said.

Keeping the BFHI designation, Michael said, will require management and monitoring of the hospital’s progress, patient interviews and participation in an annual quality project demonstrating adherence to the BFHI policies.

According to conversations Michael has had with first-time patients and those coming back, the changes to St. Peter’s maternity have been positive. Of particular note, she said, moms have responded positively to the increased time they have with their newborns. Newborn screenings are all done in-room now, Michael said. Contact allows better regulation of the baby’s temperature, improved bonding between mother and baby, and positive changes as measured in the hormones and blood sugar of both. Interestingly, babies are not given their traditional baths until they are 24 hours old.

Every delivery is unique. If mom isn’t available, dad or a birthing partner can step in.

In 2016, over 2800 babies were born at St. Peter’s. Those babies are part of the 20.1% or 801,000 births occurring at 409 baby-friendly hospitals, according to Baby-Friendly, USA. That’s a huge statistical increase, the organization reports, compared to the 2.9% of such deliveries in 2007.

According to a Centers for Disease Control and Prevention (CDC) report in October 2015, only 289 of the 3300 maternity hospitals in the nation were designated baby-friendly. These statistics, however, don’t take into account hospitals and birthing facilities working towards designation.

Utilizing a majority of the steps outlined by the BFHI policy, the CDC reported that 29% of hospitals and birthing centers participated to some degree in 2007. That has increased to 37% in 2009, 43% in 2011, and 54% in 2013.

Many hospitals and birthing centers not participating in the BFHI practice similar methods.

“While we don’t participate in this particular initiative, our hospitals have strong quality measures in place to support breast feeding and en-

sure all of our mothers and newborns receive excellent quality care,” said public affairs manager Sarah Bradshaw-Colomello of Health Quest. “We warmly encourage new mothers to breastfeed, and to that end provide a variety of support services such as private consultations with boardcertified lactation consultants, breastfeeding equipment to rent, and monthly prenatal breastfeeding classes and support groups.”

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Vassar Brothers Hospital is taking part in a 20-month state breastfeeding quality collaborative. Hospital staff attend learning sessions and track quality data, with a goal of increasing breastfeeding. Northern Dutchess Hospital has a policy of family-centered cesarean birth, ”which initiates skin-to-skin contact and breastfeeding immediately after a cesarean delivery if the mother wishes,” Bradshaw-Colomello said.

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What to do to feel better Therapists: The best friend you’ll never lose until you don’t need them anymore

By Rebecca Wolff

L

ots of people are afraid of therapy. Lots of people rely on therapy. In between these poles are the curious and the confident — some who think someday they may like to be in therapy, some who think that they will never need therapy because they have friends to talk to — or that they would rather suffer alone than pay someone to listen to them.

Also in the mix are those who adore therapy for its luxurious emotional charge and those who are made deeply uncomfortable by the demands it makes that they articulate their lost and found emotions.

Therapy can go on for years, or can take ten visits paid for by the insurance company to resolve a situational depression or an anxiety disorder that can perhaps be medicated successfully. A therapist takes the long view of human development. The long view is increasingly hard to maintain, peering off into the middle distance of lifetimes while an insurance company breathes down the collar of your shirt and mandates clear goals and prescriptions to justify paying for the ten visits.

Psychotherapy was born more than a century ago in a highly charged environment of new thinking around how humans function, in relation to the self and to one another. Early concepts of psychology articulated a clearly defined structure of the self-within-the-self and the self-in-society. In the 1940s and 1950s popular culture began to assimilate and synthesize notions of self-improvement through therapeutic efforts (see Hitchcock’s Spellbound). By the 1970s a person was expected to be trying to get to know themselves, get in touch with their feelings, and generally make good on the assertion, attributable to Socrates, that the unexamined life was not worth living.

Fast-forward through the goal-oriented 1980s and 1990s and you find yourself in the crisis of this new century, in which social and economic inequality, addiction, violence, penurious self-interest and digital isolation substantiate the notion that everyone needs all the help they can get.

A person in need of emotional or psychological Many still think of psychology in terms of the support may be referred to a counselor, a social enigmatic inkblots of Rorschach tests, still worker, a psychologist and/or a psychiatrist to get one of the many means to allowing one to find the help they need. All of these people may be reways to feel better about meeting the stresses ferred to as a “therapist,” providing “therapy.” of our lives.

A therapist is, in the best of all possible worlds, carefully trained to know how to listen to a person in such a way that that person feels truly “seen.” In this case we feel seen, holy eyeballs on us, when we do not imagine that we need to be anything other than what we are in order to be loved. People in therapy often weep tears of joy when they Donaldson & Chiera RN, Family Health NP, PC feel this, perhaps for the first time. Writ large, a

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therapist can function as a stand-in for the rest of the human race and the social fabric it wears, in relation to their patient; a reified human corpus that treats the patient with decency and respect, and therefore reinforces the patient’s ability to return that favor.

In this case, listening becomes an active effort. The therapist is trained to listen carefully and with a fully engaged sense of advocacy. For the course of the therapy, the therapist becomes the patient’s advocate in the struggle for their own self-love and emotional well-being.

Whatever forces are working on that person to create discomfort, sadness, worry, compulsion, disassociation, and perhaps a general weakness or underdevelopment of the inner resources a person might need to draw upon in their lifelong struggle to meet the challenges provided by the world.

In a therapy session, the therapist acts strongly as a reinforceNS O M ment against those forces. The theraOM IC K pist, speaking crudely as well as in the most WI macro sense, has the patient’s back. As part of this back-getting, it is in the therapist’s purview to understand the ways in which the patient may be their own enemy, and to help them stop working against themselves, beating themselves up, and hating themselves.

Practically speaking, a therapist can help a person get over a very difficult time, such as we encounter periodically in work-love-law-moneyturmoil. Trouble happens to people, and a therapist is at that time a leg to stand on, a temporary extra member of the family — or other support network — which can often be inadequate, either because of its extreme lack of resemblance to the supportive loving family we all ideally should have but usually don’t, or because it can actually be difficult to show ourselves, in sum, to those to whom we are close.

What does a therapist actually do? A therapist listens and asks questions, in that order. A thera-

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WIKICOMMONS

Phrenology was a 19th-century method for charting the bumps and contours of one’s skull to determine personality and psychological tendencies. Various forms of therapy now help us face the challenges of our lives.

pist assesses the needs of the patient, which are sometimes a mixture of things, and makes interventions where necessary. A therapist gives the patient a rare opportunity to feel that they are being truly heard.

A good therapist provides a nonjudgmental space in which the person-in-need can make their best attempt to know themselves, that they can in turn know others better. A therapist listens so that the patient can feel seen.

Ears versus eyes: a mixed metaphor for the ways humans relate within the comfortable space of a therapy. A therapy, rather than a therapist, is a metaphorical space in which a human being tells another human being that what they need right now is to feel better, and that they will do what it takes to feel better, so that they can be better for the people around them. Ideally, a therapist prepares the person in need for their role helping others to feel better as well.

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Lining up your farm CSA members find that even their most unwelcome adventures can turn out to be positive experiences. Your interaction with the other members and with the farmers themselves, with the people who are producing your food and enjoying the same items on their tables, provides you a deeper connection to your community and the lands through which it sustains itself. Food sourced this way has much more goodness in it — on so many levels — than far-flung items sold by a corporate chain.

The ins and outs of obtaining and consuming local food

By Jennifer Brizzi

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e all know that fresh local ingredients are the tastiest and most nutritious, Limp, lthough CSAs vary a lot in out-of-season, three-week-old their structure, generally a full California kale is not going to be share costs several hundred dolas good to your taste buds, to your lars, payable as early in the season as poshealth, to the local economy or to sible so the farm can use it to cover the your carbon footprint as a vibrant season’s startup costs. Other options may head of the same brassica fresh include a half-share, in which you pick from a nearby field. up your goods every other week instead How to get the best stuff into of every week for considerably less. Most your kitchen can be accomplished farms encourage you to split your share a few different ways. You can wait with a friend if the amount of food prountil it’s in season and get it at a lovided is too much for you to cook in a cal farmstand or farmers’ market week. or from a grocery store that offers Some farms offer a payment schedule, local produce. You can dig a garden and some offer a sliding scale based on in the back yard or in a local comyour ability to pay. Some offer work hours PHOTOS FROM THE PUBLIC DOMAIN SITE PEXEL munity garden space, which is a lot to lower your membership cost, some reof work but very rewarding. You The trick to getting the most from community-supported agriculture (CAS) quire work-hours for membership. For can grow exactly what you want, is learning to be exible with one’s menus in order better to utilize the fresh others, work-hours are not an option. pouring your soul and time into food. In winter and early spring, a soup or stew is the heartiest meal for those Because farms offer a limited number your favorite vegetables and fruits working with CSA produce. These dishes are not only ďŹ lling, but can also of shares based on the quantity of what and dining sumptuously on them sustain us for an entire week. they estimate they will produce over the all season long. season, it’s best to sign up as soon as posOr you can take a different route. You can sign that are new and exotic to you and you have no sible. You may want to get that coveted spot in a up for a CSA. Farms that participate in Commuclue what to do with them. Or maybe you know highly rated CSA. nity Supported Agriculture have a partnership them all too well, always prepare them the same Although the weekly farm visits are a delightful with their members, a symbiotic relationship in old way, and they’ve worn out their welcome in part of being a CSA member, they’re not always your kitchen. Or your adventure can come from which the members help the farm get a jump-start convenient. Many farms do deliveries to pickup the risk you assume of the farm crops you get not on the season and in turn receive regular bounty spots away from the farm, around the Hudson performing as expected due to unpredicted vagafrom the farm.

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enerally the boxes or baskets or bags that you receive (often with choices available, like you can get more potatoes if you don’t like zucchini, etc.) are sparser in the beginning of the growing season, when there are only a handful of cool-season crops ready to harvest.

As the season picks up momentum, the bounty increases. There are more items and more of them.

Even for an obsessed cook like me, sometimes life gets in the way and it can be challenging to cook everything you get. But because everything is so fresh when you pick it up, it keeps much longer than your typical supermarket produce that hasn’t seen the field in a long time, from days to weeks.

But to get the full advantage of CSA membership, you can’t let stuff languish in your fridge forever. You need to be a cook at heart, or willing to learn to be one, to embrace how good and healthful food tastes when it’s locally sourced and freshly prepared. It helps to be open to new ideas, new ingredients, new ways of cooking things. You might taste ground cherries or kohlrabi for the first time and discover something new and wonderful. Or if you’ve always sautÊed something you might discover how amazing it can be simply steamed and tossed with a pat of coconut oil and pinch of sea salt.

Or if you’ve only boiled something, how amaz-

Vegetable CSA Farm Shares still available!

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February 23, 2017 Health, Sports & Fitness

Ulster Publishing Co. ing it is sautéed with garlic and olive oil. Or how fast you can make a whole meal if you mix that with pasta or rice and grated cheese or nutritional yeast. Many CSAs now include newsletters or recipes and ideas in another format to help you enjoy the bounty creatively.

Most CSAs are either certified organic or use only organic practices in the way they grow crops or raise animals, with a commitment to sustainability, non-toxic fertilizers and pest controls. In recent years CSAs have become more and more diverse in their offerings. What originally was just produce from the fields has expanded to orchard fruits, flowers, herbs — culinary and/or medicinal, mushrooms, maple syrup, honey, meats, cheeses, eggs, often as optional add-ons or included in the farm share, or sometimes available in the farm shop at the time of pick up.

There are winter shares for long-keepers, there are U-pick elements where many items you harvest yourself and can take as much as you want.

For me, the U-pick herbs, flowers and cherry tomatoes are a real highlight, for a steady supply of just the right amount of these items.

M

any farms offer community events, like harvest parties, dances, potluck dinners, classes, workshops and so forth.

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So it’s time to do some research before the shares get snapped up. Not every CSA is good for every person or family, so do the research to determine what’s best for you. Talk to any friends who are CSA members about which one they use and why.

Look at the Facebook page for the Hudson Valley CSA Coalition or go to http://hudsonvalleycsa. org/. At www.localharvest.org/csa/, you can punch in your zip code for a list (mine brought up 25 local CSAs).

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Contact the ones that look most appealing. Ask questions about the things that matter the most to you. Are they organic? How many members do they have? Do shares include items from other farms?

For the health of your body and that of the community, make an effort to consume local products as much as possible this year Go to farmstands, farmers’ markets. Grow your own if you can. And think seriously about joining a CSA.

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WIKICOMMONS

Pet people have a tendency to see the world in pet-related ways. The canine spirit is celebrated in this oft-imitated 1894 painting, The Poker Game, by Cassius Marcellus Coolidge, sold at auction in 2015 for $658,000.

Species specific Animals have a role in human health

By Elisabeth Henry

A

nimals affect my life in many ways. The loathsome weasel that dug its way into my henhouse, decapitated each of my many chickens, and then sucked out each one’s lifeblood one recent cold, winter’s night

had a very visceral affect on me. Said weasel is on notice. My girls will be avenged.

At one time I regarded naive pet owners with a snarky disdain that has now morphed into envy.

Perhaps it was always envy. My life with animals began with a flurry of activity and a vast cast of characters like that of a Super Bowl half-time show. We built our house in the mountains, and immediately populated it with dogs, rabbits, goats and horses. And children.

I was the little old lady who lived in a shoe. Only I lived in a house that kept on building. I had no time to nurture friendships with other adults.

Quiet moments with my animals was my respite.

However, their numbers and the myriad demands of motherhood, barn chores and token stabs at housewifery made me unlike that smiling, coiffured woman seated in the veterinary waiting room, stroking the fluffed and perfumed terrier

on her lap. I had an oversized Labrador in tow.

Or a bleeding sheep in the truck outside. Or a goat with a pro-lapsed uterus at home. Or a rabbit with one leg bitten off by a raccoon. Was it rabid?

My animals were my world. They repaid me by recognizing me. They nickered to me, they followed me, they let me hold their babies. They were loyal.

Once, after a particularly sweet-fueled holiday season, I arranged a disco party for my first-born daughter, then in fourth grade. We hired a DJ. I baked and baked. And sampled.

Around about 2 p.m., while the DJ played Cotton Eyed Joe for, like, the twentieth time, I began to experience pain in my gut. Maybe it was a kidney stone. I managed to politely trundle each reveler into their coats and the waiting arms of the parents who retrieved them, and then collapsed.

The pain was excruciating. I tried to hold off, but the cold sweats, my bloodless face, and the prospect of my little children marooned in the house with my corpse until my husband came home later that week, prompted my call to the rescue squad.

When they arrived, my ancient Labrador, my Boston Blacky, sat at the foot of my bed, a growl rumbling in his grizzled throat. Who were these strangers? One of them, someone we knew for many, many years, crouched in a squat in the door way, and called my boy to him. The dog crept toward him like a lion on the prowl, sniffed his outstretched hand, wagged his tail, retreated to the other side of the room, and sat. But watched.

I’ve no doubt he would have given his life for me. Years later, one of his progeny sired a litter, and one of those dogs almost died. She attacked a bear that attacked her owner. The bear swiped the dog’s side with its massive claws, sent the pooch spinning away, seriously wounded. The dog leapt up, its side a bleeding flap of skin, and attacked again. The bear left. The dog, and the owner, lived.

I

t’s not all blood and violence. Once, when pregnant for the third time, I waddled to my barn one lovely summer morning. I was checking for eggs in the henhouse. I noticed all my pregnant mama goats basking in the sun, in the grass, leaning against the barn wall. I sat down and rested my back among them. The sun got strong, its healing rays penetrated us, keeping us there, relaxed. The nannies chewed their cud. I sipped my tea. Our babies lolled about inside us. Heaven.

When “swimming with dolphins” was the subject of Nat/Geo specials, 20/20, and People Magazine, I interviewed the person who was, at that time, the world’s foremost expert on sharks, dolphins, rays, etc. Apparently he had the type of career, unlike mine, that one can retire from, because I searched for him now and he cannot be found. Anyway, he was very opposed to swimming with dolphins feeding sharks, etc. These behaviors affect the animals adversely.

I will go further and say that one can get the same feelings of wellbeing petting a dog, or a cat.

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February 23, 2017 Health, Sports & Fitness

Ulster Publishing Co. One just must find the right species. The caveat to that is, the species must not be wild.

My friend Missy Runyon is a wildlife rehabilitator. She has mounted a campaign which features her motto, “Let Wild Be Wild.” A conversation with her will convince even the most stubborn, sentimental crumb-dropper that any interaction with wildlife should be considered only after bothering to educate oneself. And one must never feed bears or coyotes or any species that will be shot as a nuisance by someone less enamored. See Missy’s website at FFF Wildlife Center.

I

suspect I am, at this point, a dog (See “Dogology” by T.C. Boyle). I adore my cats, but we are not the same. It’s like me with singers.

They know I cannot sing, as much as I admire and value the gift, and this puts a teensy-teensy wedge into deep camaraderie. Dogs, however, totally get me.

Which brings me to the subject of diseases which make one smell bad. One disease prevents the metabolic processing of a particular enzyme, so the afflicted smells like old fish. Then, there is that which happens when diabetics do not monitor their diet properly. These odorous facts, and others, are prompting scientists to use dogs to sniff out potential illness, or impending seizures, in humans.

I do not have those diseases. When stranger dogs sniff me, however, it is just like when people thumb their phones. At first it is fervent, and intense. But it’s temporary. It is as if the stranger dogs get all the news that fits, and then thinks of other things.

There are times, however, that my clothing is so freshly perfumed by animal contact that other humans back away. It is as if I do have a disease that makes me smell bad.

I am aware. For those who may wonder how to respond, I cite the reaction of the young veterinarian who was there when I dropped off the bat I captured in my house, lo those many years ago. I apologized for my boots, my jacket, my gloves. He smiled and said, “I know. I smell the barn.”

My species for slowing the pulse, calming the breath and soothing the soul is the horse. I love to ride, but I love equally to groom and stroke the gentle beast. I love to bury my face in the neck, and inhale. The aroma is not the more commonly known stank of spreaded fields. It is the perfume of sweet grass and fresh air.

Each horse is different. My mare Sealina had the prettiest scent. My old stallion’s scent is spicier, like tomato vine. My horses love to be groomed. In fact, this winter I had a little surgical episode and could not get down to the barn. My young mare was clearly peeved. Regular feeding and clean water is not enough, her averted face told me.

I

t is not enough to merely feed any animal.

They are, all of them, sentient beings indeed, with specific requirements. One of them is purpose.

Apparently the animal-rights people disagree.

Many of them remind me of the sculptor who visited my farm long ago. He had been commissioned to do a very large piece in stone. It was to be a Morgan horse.

He took a long time studying my grazing herd.

We walked among them and they let him stroke them. He was astonished at their eyes. It was as though, before this, horses were merely features of a landscape for him.

That’s what many “animal lovers” bring to my mind. People that know what an animal is, but do not understand what an animal is. My prayer is that those people pursue their passion right up to the point of epiphany.

One way to begin? Approach a horse and slow your breath. Feel your pulse slow, too. If the horse lets you, bring your nose to its nostrils. Breathe in its breath, and breathe out yours to him. This is how horses come to know each other. Be the horse.

Animals need purpose, and so do humans. However, the passage of time makes evident that we are perishable, this-worldly. That which makes us unwilling to rise at dawn, carry heavy buckets of water, and heave 50-pound bales of hay from here to there. It also makes us (me) more subject to lamentations and the rending of garments when, say, our gorgeous filly, the last we will breed, dies inexplicably, sickened at the new, nearby trainer’s barn.

These blows become harder to take. And so I loaded up my last show horse and sent her to the only trainer I will ever trust, five hours away. She will most likely become the super-successful show mount for a supple 18-year-old. I may get to be at the rail, quietly rooting for my winner.

I still have my 33-year-old stallion, who is toothless and skinny, but game. He is one of the reasons I sent her away. It is true, apparently, as my old vet claimed, that erectile dysfunction does not happen in horses. My stud broke out of his field to be with her, and nearly killed himself scrambling over a stone wall. That urge is, indeed, the last to go.

He will be buried here, in the field he has known since he was a weanling. I cannot predict when that will be. Experts have predicted his impending death for decades now. Both he and I get great pleasure thumbing our noses at the experts. We soldier on, one horse, three sheep, two cats, a doz-

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23, 2017 12 | February Health, Sports & Fitness

Ulster Publishing Co.

WIKICOMMONS

The 1962 Ken Kesey novel One Flew Over The Cuckoo’s Nest, made into an award-winning 1975 film of the same name, has become the cliche for mentalhealth assisted-living facilities.

Filling beds The continuing problems of mental-health assisted living

By Paul Smart

J

anice T is a career health worker who’s been employed by private mental-health assisted-living facilities for 40 years, a majority of them in the Hudson Valley. She first started reaching out to me last summer, saying she had stories to tell about the places she’d spent her life working in, but also lessons to impart about how to solve some of the problems she’s witnessed.

The most dramatic of Janice T’s stories have similarities with the Nurse Ratchet floor depicted in the book and film of One Flew Over The Cuckoo’s Nest. Mental-health treatment evolved from 19th-century jails and poor houses and 20thcentury asylums and state psychiatric hospitals.

Those stored away were seen as “mad” or “lunatic.”

A “deinstitutionalization” trend started in the 1940s. Former “patients” were at first let out on to the streets, and eventually into smaller often pri-

vate facilities. The 1970s Willowbrook case documenting gross negligence and abuse forced the closing of most New York state facilities.

“I had a degree in psychology and got into the field back when the good jobs were in locked psych units in hospitals, where they weren’t above using straightjackets as well as heavy medications,” Janice T noted. “I had one job with gang kids. It was like a rodeo getting them into restraints, when they turned violent. But I was young and in shape, too.”

Janice T. recalls the people she’d worked with: addicts, angry kids, guys who’d wander around with a book in hand thinking they were on the verge of going to college even though they’d lived nowhere but institutions. They’d finally get out, based on changing laws, but then they’d forget to take their meds and be returned through what our man called “the system’s revolving door.”

We asked Janice T how things were in mentalhealth assisted living these days. She talked about people being “lumped together,” with different ages and different issues treated similarly in local institutions. “’Filling beds is what we call it,” she said. “It’s a business like a hotel, subsidized by Medicaid and other programs. I’ve seen it where

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people want to leave a place, and by law they’re allowed to, but management doesn’t want their bed empty. So they’re discouraged. They tell them nothing can be done.”

These facilities range in size from 50 beds to several hundred around the Hudson Valley. The administrators say the facilities’ owners can’t do anything. “We call it the warehousing of our mentally ill for profit,” Janice T says. “I think about it as being like a dog pound.”

Federal laws, upgraded every few years but made ineffective by budget cuts, now have an ombudsman program in place to address issues.

But nothing seems to change, she says, once the reports are passed up yet again from the administrators to the facility owners.

Janice T. says she got into what she does because she’s always cared for those in need of help.

Things started when she was a kid and she had to deal with her father’s dementia.

She notes that there are good institutions out there, both private and state-run. But she worries about the clumping of various people without interest in their individual conditions. The general lack of funding beyond the basics leads to overtired minimum-wage workers working two to three jobs to get by. Even when someone like her has constructive ideas, there’s no way of implementing them.

Field trips get cancelled because there aren’t enough caretakers to make sure people don’t wander off. Group activities get frowned upon. The result? Everyone ends up in a common room watching television.

“Once a year inspectors come in from the state to look things over, but each facility’s administrators find out about it from other administrators beforehand so they can prepare,” Janice T says.

“They check the kitchens, the bathrooms, general housecleaning, and look at a log for activities. If someone doesn’t pass an item, the facility gets a warning, and if they don’t fix something in a cer-

February 23, 2017 Health, Sports & Fitness

Ulster Publishing Co. tain amount of time they have to pay a violation fee.�

The only times that Janice T has heard of a facility getting closed has been when widespread abuse occurs. That’s rare. Yet she notes that bed bugs have become a real problem everywhere she’s seen in recent years. “The owners try to JUST satisfy minimum state requirements so to avoid further ‘violations’,� she said. “And medications were not closely monitored and documented according to State regulations. This is a huge issue in many facilities and puts the residents at medical high risk.�

T

he bottom line for the private facilities at which she’s worked is money. Do residents have the proper Medicaid eligibility, or are they on disability, or might they even have private financing?

Facilities rarely allow their residents access to their own funds, using various excuses. “One resident I knew had paychecks coming in that he wanted to cash. They said no, that all has to go through us,� Janice T says. “The administrators then told everyone he was a troublemaker and to watch him.�

How could things be made better?

She talks about raising salaries and allowing unionization so employees can have more pride at their work. She speaks about creating more responsiveness between staff and administration, and most importantly administration and ownership. She favors greater oversight from state and federal authorities. Better training is necessary.

Most of all, she sees a need for more public funding for this largely-forgotten side of society. There needs to be more awareness that these problems persist. “You need to treat residents in terms of their

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special issues,� she says. “You can’t just dump meds into them and not expect to show up in the morning without there being an ambulance or the cops at the front door of this former hotel. You have to find ways to actually help them move closer to life and get beyond the ‘filling-beds’ idea.�

Have things changed at all for the good since the Cuckoo’s Nest days? “It’s always been bad,� Janice T replies. “But it remains our job, my job, to take care of people. As time passes, things get more expensive. We should know that by now and deal with these things accordingly. This is what I care for. It’s the fight I’ve been fighting for years, and will continue to fight for.�

| 13

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23, 2017 14 | February Health, Sports & Fitness

Ulster Publishing Co.

On exercising A dialogue between Violet Snow and Sparrow, two writers who are also a married couple.

S

parrow: “Use it or lose it,” my father says, and he just turned 98.

Admittedly, most of his “exercises” are mental. He reads The New York Times daily, studies Yiddish — which he taught himself to read 15 years ago — and spends a few hours a day playing chess with guys in Bulgaria on Yahoo. But mental exercises often require some physical exercise; Dad saunters from room to room with his trusty walker.

Violet: I know there are people who enjoy working out at a gym, but I’ve never had the determination to do more than three minutes on a rowing machine or stationary bike. I did take up running one summer and learned to conquer the initial angst so I could shift into the exhilaration of doing something that seems physically impossible. But I notice my running discipline lasted only a few months. Now I’m back to exercise that has actual pleasure built in.

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39

Violet: There are some drawbacks to aikido.

First, like joining a gym, it costs money — wellspent money, but if you’re poor you might want to seek out exercise that’s free. Second, the only way to practice is to attend scheduled classes. If I have to miss a class, I feel crappy unless I fill in

Sparrow: In 1993 I injured my back, for two reasons. I was leading a recreation group for autistic kids at the 92nd Street Y, and one child named Natalie constantly sat on the floor, refusing to move. Over and over, I lifted her back up.

Meanwhile, I was volunteering as the super of my building in the East Village, lugging bags of garbage out onto the curb.

Between these two lifestyle decisions, my back began to spasm. Numerous visits to the chiropractor had no effect. Then my brilliant friend Mindy suggested an osteopath named Guray on West 14th Street. He analyzed my problem and prescribed an antidote: a fencing position with bent knees and one arm lurching forward, as if holding a sword. “Whenever your back hurts, even if you’re in the middle of the street, stop and do this exercise,” Dr. Guray explained.

I followed his advice, and my back quickly healed. That’s when I learned an invaluable lesson: for each human distress, there is an alleviating exercise. The trick is discovering the secret

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Sparrow: My biggest exercise, no doubt, is walking — my main problem being my bunions.

(A bunion is a bony mass at the base of the big toe which makes walking painful.) When my feet touch natural earth, the bunions don’t hurt. It’s only stone or concrete which causes agony.

Occasionally I promenade barefoot in large circles around Phoenicia Park, and a couple years ago I discovered that our portable phone (not a cell phone) functions within 200 feet of the house, so I often pace back and forth on the road, particularly while speaking to our daughter.

with another form of exercise (preferably something free).

I do ten minutes of yoga at home a few times a week, and that’s free. Classes cost money, and they’re not as aerobic as aikido, but a good yoga class makes me feel great — loose and stretchy and calm. With lots of yoga studios in the Hudson Valley, there plenty of different teachers and schedules to choose from. I find it important not to compare myself to the hard-core yogis who can twist their bodies into positions that are impossible for ordinary mortals like me. As long as I stay in my own bubble, yoga is a fabulous form of exercise.

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Violet: At 45, I began to study the martial art of aikido. Throwing people across the floor is really fun, especially when you know they’re not really trying to hurt you, and you won’t hurt them because they’ve been trained to curl into a ball and roll away. Falling down and getting up over and over is not as much fun, but that’s the aerobic part, and without it I don’t get to do the throwing.

Also, aikido is social and interactive, and it’s like a puzzle, wherein I study the ever-deepening mysteries of moving from my center instead of using muscular effort to toss people around. And Woodstock Aikido’s head teacher is Harvey Konigsberg, one of the top-ranking Americans in the sport.

His students have gone on to found dojos (practice halls) in Kingston, New Paltz and Catskill.

WIKICOMMONS/PEXEL

As we age, we grow more limited and specialized in those exercises we can regularly undertake.

While one of our authors loves the rigors of aikido, the other finds walking rigorous.

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Sparrow: Physical exercising also may be practiced as an art. For example, as I walk throughout the house each day — and I attempt to walk as much as possible, in our doublewide trailer — I transform my foot-transport into a dance, whenever possible. I wave my arms, or do a whimsical flourish with my left leg.

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Violet: The best workout our area has to offer, in my opinion, is hiking. It doesn’t cost money, you can do it almost any time (weather and daylight permitting), and you get to be outdoors, breathing fresh air and drinking in the beauties of nature.

There’s also the possibility of euphoria, as in any form of exercise, but augmented by communion with sky, trees and earth. Years ago, when I spent a lot of time hiking to places where I would harvest medicinal herbs, those moments of bliss in the wild were frequent.

Sparrow: I don’t really have a job. I spend much of my day aimlessly writing essays like this one.

Therefore, a physical regimen becomes my daily “work.” When I finish it, I feel satisfied, as one does leaving the office at 5:15 p.m. Even though my occupation is purely illusory — a matter of stretching muscles — it feels more solid and practical than the rest of my life.

Violet: Since I became a journalist, I tend to get more out of gardening. There is a similar thrill involved in the earthy smells, hands in the dirt, a motherly sense of nurturing plants, plus the exercise of digging and weeding. And if I get an inspiration, I can run into the house and write up my thoughts. The downside, of course, is that gardening is strictly a warm-weather sport.

Sparrow: I went to the Women’s March in Washington, DC and woke up the next morning with palpably stronger legs. I felt like I could kick through a wall! Political engagement, I learned, provides an excellent physical workout.

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February 23, 2017 Health, Sports & Fitness

Ulster Publishing Co.

| 15

Health notes Gauging your insurance future Where does your health insurance stand for the coming year? If you receive coverage through an employer's carrier, you'll already know the rates for the coming year. But what about everyone who is receiving subsidies, some version of Medicaid, Medicare or other insurance caught in the crosshairs of the current debate over the future of the Affordable Care Act? Suffice it to say that there's more smoke than fire, for now, and that it's all quite complicated.

The best place we've found to chart where you stand is to go to the AARP interactive page "How the Health Care Law Works for You," which can be found at http://healthlawanswers.aarp.org.

The site is quite specific and very helpful.

Photo of Benedictine Hospital courtesy of Health Alliance of the Hudson Valley.

Flu season worse than usual

The Empire battle heats up!

Last summer's contract dispute between Empire BlueCross BlueShield and hospital operator HealthAlliance of the Hudson Valley saw Ulster County employees, along with staff at a number of key regional institutions, unable to use Kingston hospitals and a number of key health practitioners. The fight is still going on, and seems to be heating up. Ulster County executive Michael Hein threatened in a statement that he was ready to look into the shifting his county's health-insurance coverage as a means of pushing things to a conclusion. Complicating matters is the fact that the county government is contracted for its coverage with the Blues. HealthAlliance, now a subsidiary of Westchester Medical Center Health Network, won't comment because of ongoing litigation regarding the coverage lapse.

Family Practice WIKICOMMONS

Feeling a bit under the weather? The current flu season has been pegged by health authorities as one of the worst in years. We're just approaching that season's peak, too.

Ulster County figures show 421 confirmed cases of the flu in the 2016-17 season, as compared to 384 cases confirmed for the entire 2015-16 flu season and 292 the previous year. The U.S. Centers for Disease Control and Prevention says the flu season runs October 1 to April 30, with February the peak each year. The CDC estimates that only six of ten people receive flu shots year, while under half of patients report flu symptoms to doctors or hospitals. Stay well.

Political stress on the rise Last year saw many surveys looking at the stress levels the election were creating among citizens.

According to a new American Psychological Association's report based on polling from January, Stress in America: Coping with Change, two-thirds of Americans are still saying they're stressed about the future, including a majority of both Democrats and Republicans.

While nearly half (49 percent) surveyed said they were as stressed by the outcome of the presidential race as the race itself, 57 percent identified the current political climate as a very or somewhat

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that the overall average reported stress level of Americans rose from 4.8 to 5.1, on a scale where 1 means little or no stress and 10 a great deal of stress.

Stress levels rose with education levels, and for urban versus rural lifestyles. This was the tenth annual Stress in America report, and the first time major growth from political stress was recorded year to year.

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significant source of stress. Democrats said the election results were stressful to them, 72 percent, versus 26 percent for Republicans. Some 59 percent of Repubicans said the future of the nation was a significant source of stress for them, compared with 76 percent of Democrats.

Last fall, the APA found that 52 percent of Americans reported that the presidential election was a significant source of stress. The group noted

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Ulster Publishing Co.

Investing inYou. Expanding our Surgical Expertise.

HealthAlliance welcomes Michael Moscowitz, MD, general surgeon.

Leading the way in healthcare starts with bringing leading physicians and specialists here to care for you.

That’s why we’re pleased to announce that Dr. Michael Moscowitz has joined our growing surgical team at HealthAlliance. Dr. Moscowitz brings advanced care and surgical excellence to the Hudson Valley.

As a member of WMCHealth, HealthAlliance has access to the respected specialty expertise that only comes from the area’s largest and leading health network.

Dr. Michael Moscowitz. Another way we’re Investing in You and Advancing Care. Here.

For more information, call 845-338-4128 or visit hahv.org.

Westchester Medical Center Health Network includes: WESTCHESTER MEDICAL CENTER I MARIA FARERI CHILDREN’S HOSPITAL I BEHAVIORAL HEALTH CENTER MIDHUDSON REGIONAL HOSPITAL I GOOD SAMARITAN HOSPITAL I BON SECOURS COMMUNITY HOSPITAL I ST. ANTHONY COMMUNITY HOSPITAL HEALTHALLIANCE HOSPITAL: BROADWAY CAMPUS I HEALTHALLIANCE HOSPITAL: MARY’S AVENUE CAMPUS I MARGARETVILLE HOSPITAL