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Healthy Hudson Valley OCTOBER 22, 2015

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ULSTER PUBLISHING

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HEALTHYHV.COM

Healthy Body & Mind

Mind and body

The growing joys of running, health insurance scares, and the pleasurable work of staying healthy

22, 2015 2 | October Healthy Body & Mind ate how to proceed with the company’s smallgroup policies in the new year, based on Health Republic’s continuing financial results, and be able to suggest up to 16 new insurance plans at some point in November.

Health briefs

New medical coding Happenings at Health Republic Health Republic Insurance, which was offering the cheapest insurance coverage for many throughout the region this past year, announced last month that it won’t offer plans in 2016 and is winding down operations. The decision came after the federal government announced it would pay only 12.6 percent of what is owed to insurers under the “risk corridor” program. All current Health Republic individual and small group policies, which together number nearly 210,000, “re-

main in full effect through the end of 2015,” the health insurer announced. “Since our inception in 2013, Health Republic designed and priced all our plans in reliance upon the risk sharing guarantees of the Affordable Care Act,” the insurer continued. “This has placed us in a difficult financial position that could jeopardize our members and partners. As a result, we believe the most ethical step is for Health Republic to refrain from entering the market in 2016 and begin an orderly wind down of business.” The State Health Department expects to evalu-

Living your life to the maximum

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Join us for a welcoming day of entertaining and helpful sessions. Price includes a continental breakfast, buffet lunch and friendship.

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October 1 was the day when the nation’s physicians and hospitals were mandated to start using a massive new coding system necessary to their getting paid for insurance claims. Previously, U.S. health providers used a system of roughly 14,000 codes to designate a diagnosis, for reimbursement purposes and in medical databases. The new updated system has about 68,000 codes, the better to capture the details from a patient’s chart and provide interchangeable information for health providers in other nations around the globe, which have all used the new codes for at least a decade now. The federal government says the long-awaited change should help health officials better track quality of care, spot early-warning signs of a brewing outbreak, or look for illness or injury trends. Under the tenth edition of the International Classification of Diseases, there are codes that flag novel strains of flu, for example, and even Ebola and its cousins, as well as the various forms of concussion suffered from sports. With medical care gone digital, more precise diagnosis codes could allow researchers, even doctors themselves, to get a closer look at trends in one office or the entire country. A spike in repeat visits for strep throat, for example, might indicate a more worrisome strain is spreading. This kind of data also is used by insurers and other organizations to help determine quality of care. Though CMS can’t estimate how many health providers are ready for the switch, officials think most large practices and hospitals are. The agency is intensifying its focus on smaller doctors’ offices, said Dr. Mandy Cohen, CMS chief of staff. Private insurers told Congress months ago that they were ready, and that they too are focusing on small pro-

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October 22, 2015 Healthy Body & Mind

Vaccination calendar Local flu-vaccination clinics are underway, and in Ulster County upcoming sessions include a stop at the Trudy Resnick Farber Center on Canal Street in Ellenville next Tuesday, October 27 from 10 to 11:30 a.m.; from 10 to 11 a.m. at the Woodstock Rescue Squad next Thursday, October 29; at the Rosendale Rec Center on Route 32 on Friday, November 6 from 10 to 11 a.m.; from 10:30 to 11:30 a.m. on Monday, November 9 at the Wallkill Fire Department; on November 18 at the Senior Center in Lake Katrine from 10 to 11 a.m.; and from 10:30 to 11:30 a.m. at the Shandaken Town Hall on November 20. The Centers for Disease Control (CDC) recommends annual vaccinations for everyone six months of age and older. For information, call the Ulster County Department of Health Flu Hotline at 340-3093.

PHOTO COURTESY OF ULSTER COUNTY

Ulster County Executive Mike Hein, currently seeking reelection, demonstrated the ease with which flu shots can be given these days at a recent inoculation clinic held in the Town of Hurley.

viders. CMS has also promised some flexibility in the first year of assessing claims.

Medicare shopping period open The Medicare open enrollment period where people with Medicare can shop for a Medicare Advantage (MA) or Prescription Drug Plan (PDP) for 2016 is now open through December 7. “Health needs can change in a year, so it is important for people with Medicare to use this time to check to see if they are getting the best price and best quality plan available,” said CMS acting administrator Andy Slavitt. “Even if you are happy with your current coverage, take the time to investigate all of your options and determine if a better option is available. You might be surprised to find a higher-quality, lower-cost plan in your area.” For 2016, Medicare beneficiaries will have access to more plans with high-star quality ratings at stable or lower costs. The average basic Medicare PDP premium in 2016 will remain stable at $32.50 per month while the average MA premium will decrease to an average of $32.91. In addition, approximately 49 percent of 2016 MA plans and 41 percent of PDPs earned four stars or higher in their 2016 overall star rating. Beneficiaries can visit Medicare.gov to search for a plan. If Medicare beneficiaries feel their current coverage will meet their needs for 2016, they do not need to do anything. Those with original Medicare are eligible to shop for a health or drug plan; or, individuals with a MA health plan may use the Open Enrollment period to switch to original Medicare. Call 1-800-633-4227) for aroundthe-clock assistance to find out more about coverage options or review the “2016 Medicare & You” handbook accessible online at www.medicare.gov/pubs/pdf/10050.pdf.

New handicapped emblem New York businesses have two disabled icons to choose from. A year ago, the state passed legisla-

tion okaying a new icon which removed the word “handicapped” and showed a more active person in a wheelchair. There have since been reports of confusion, with some saying that displaying the new icon violates the Americans for Disabilities Act, which still requires the old icon (despite similar legislation approving new icons in several cities) and claiming displaying the old staid icon violates state law. No one’s litigated yet, possibly because few know about the icon change as yet. “New York is again leading the way by being the first state in the nation to update our outdated handicap signs with a more active, engaging symbol,” state senator David Carlucci said at the time of the new law’s passage, and icon’s acceptance, last November. “Working together we will continue to be a shining example for disability rights throughout the country.” The old symbol, the result of a competition won in 1968 by Danish student Susanne Koefoed, featured a headless, inactive body in a wheelchair with arms extended outward. It was later modified with the addition of a head and incorporated by the International Organization for Standardization. The new update is by Sara Hendren, a professor of design at Franklin W. Olin College of Engineering who first made the more active icons as a form of guerilla art.

Kudos to Northern Dutchess

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HealthQuest’s Northern Dutchess was named “Best Regional Hospital” for the Hudson Valley and Poughkeepsie-Newburgh-Middletown metro area, ranking sixteenth in the state. “This award speaks to our commitment to provide quality care, which will continue into the future as we open a $47 million state-of-the-art building in early 2016,” said Denise George, president of the hospital. To earn the new distinction, Northern Dutchess received a rating of high-performing in two of the five medical specialties in the Best Hospitals for Common Care ratings: knee replacement and hip replacement. The others areas of care were heart bypass surgery, heart failure and chronic obstructive pulmonary disease. In other news, the state health department recently approved a certificate of need for Vassar Brothers Medical Center to construct a 696,000-square foot, seven-story inpatient pavilion on its grounds in Poughkeepsie. The new building will have 264 private patient rooms and 30 critical-care rooms, and include an emergency department/trauma center with 66 treatment rooms, parking for ambulances and the public, new operating rooms, a cafeteria and a conference center. Groundbreaking for the project, expected to cost $466 million, is planned for July 2016, and the new building is due to open in January 2019. Funding for the project is coming from private hospital funds and hospital bonds, and the Foundation for Vassar Brothers Medical Center will conduct a fundraising campaign to help support the project.

Advances for podiatrists Having foot problems and ready to try more than a new pair of shoes? Extracorporeal shockwave therapy is a noninvasive method that uses high-energy acoustic pressure waves to treat various musculoskeletal conditions by working on the body’s tissues. It’s being used to treat conditions such as degenerated tendons (Achilles tendonitis), heel pain (plantar fasciitis) and tennis elbow (lateral epicondylitis). According to podiatrist Dr. Bryan Kolber of New Paltz, a noninvasive probe is applied to the skin and an electrical charge creates an energy wave that is focused on the area of concern as a means to induce healing. Patients typically bear weight on the treated foot after treatment but are advised to reduce the level of physical activity for one to two weeks. Complications are infrequent but people who have poor sensation (neuropathy) or hypersensitivity in the target area should not have this procedure. Open sores should also be avoided. Shock-wave therapy is not used in patients with heart conditions or a history of seizures, and should not be used during pregnancy. The American Orthopaedic Foot & Ankle Society (AOFAS) has full information on the procedure. Check for local podiatrists and insurers for coverage.

Living your life COURTESY OF NORTHERN DUTCHESS HOSPITAL

Just as it does for colleges, U.S. News & World Report lists regional hospital leaders each year.

Our contributors this issue...

Also of interest and coming up is Jewish Family Services of Ulster County’s eighth annual Circles of Caring conference on Friday, November 6 at the Best Western Hotel in Kingston from 8 a.m. to 4 p.m. The focus this year is “Living your Life to the Maximum,” and the event includes breakfast and lunch. For more information or to register call 338-2980 or visit www.jfsulster.com.

Men, Hit Below the Belt? Jennifer Brizzi writes on food and health for newspapers, magazines and books, and does recipe development, cooking demonstrations and teaching. Her website is www.jenniferbrizzi.com. Lisa Carroll is a busy mama to two little girls, a wife and a reporter for the Shawangunk Journal. She resides in a quaint upstate village with her family, a cat and a goldfish called Purply. Matthew D’Onofrio is an up-and-coming writer currently studying at SUNY New Paltz with experience and interest in entertainment and the way people communicate and share with one another. Dante Kanter has been a Woodstock resident for 14 of his 16 years, and has received multiple awards for his poetry and short stories. He has attended the Iowa Young Writer’s Studio and the

New England Young Writer’s Conference. Kellie McGuire is a former teacher and current journalist, as well as a running enthusiast and publisher of the online Peak Magazine. Laura Nathanson, MS-MHC, is a primary therapist at the Renfrew Center in Old Greenwich, CT and a resident of the Hudson Valley, and before that the Catskills, for decades. Christopher Rowley is a science fiction and fantasy author and resident of the Hudson Valley since 1992. He is a local journalist and author of the new book, “The Shared Origins of Football, Rugby, and Soccer.” Milo Smart is getting ready to turn ten. A student at the Albany Free School, he is the son of this issue’s editor, Paul Smart. He lives in Catskill and dreams of getting even more pets.

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22, 2015 4 | October Healthy Body & Mind

PHOTO COURTESY OF WIKICOMMONS

We all need someone to listen to our woes, and the ability to access and talk about them. A key to modern life, and an antidote for many to the anxieties and stress of work and home, are regular therapy sessions, more often than not covered by most insurance plans.

Notes from a novice therapist Following one’s caring into the professional world By Laura Nathanson

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hen I was a teacher and someone asked me what I did at a party, the response I used to give tended to be a pitying look, which usually was the end of the conversation. Now that I’m a therapist (mental health counselor) I often get the response, “That’s so great. I”ve always wanted to do that, too.” I came to being a therapist after two other careers, in documentary filmmaking and teaching. In retrospect, it was always what I had wanted to do. I had obstacles to overcome, mostly my own thoughts. I sought to understand us strange humans, to know more about why people did the things they did, their motivations, feelings, thoughts and behaviors. I felt people’s pain, and wanted to know how/if it could be alleviated. I guess I wanted to be the person who I wished was there for me in troubled times. Now I understand therapy’s goal is not so much alleviating suffering, but leaning into it rather than away from it, for it is part of life.

I also had to overcome my (mostly) psychological, ambivalent and negative thoughts about psychology which had prevented me from pursuing it for many decades: It was too late in my life, it didn’t pay well, was it a real job? Wasn’t it just listening to people, which I did anyway? A barrier for me was that psychology isn’t a hard science. There is so much in it that depends, aside from learning the theoretical and evidence-based underpinnings of psychology and mental health treatment, upon intuition, being fully present, and intangibles referred to as “unconditional positive regard.” However, all my life experience has proven valuable to the practice. The perspective one gets just from having lived a long time is hard to come by another way. Compassion grows through life as we focus more on what we have in common rather than on our differences. What I appreciate about being a therapist is that every person is unique, so it is always different and new; there is old and daily new research to read, controversies to explore. And the similarities one finds in people over and over also gives one a sense of our fundamental commonality and humanity. It is a daily reminder of the suffering that everyone feels but seldom shows or expresses to others. Being a therapist has made me more compassionate and more attuned to the common and often difficult experience of simply being hu-

man What also can be difficult about being a therapist is that there is often no obvious “cured” state, as contrasted to when a cancer doesn’t return or a broken leg is set. But it is that mysterious and vague inner world that is so fascinating and challenging to behold and work with. The deep connection of souls meeting naked, unbared (that somehow is made easier by the limitation set by the client/therapist relationship and the hour, as well as the common, focused purpose), is a gift. A gift and a burden. As many have said, you can only plant the seed. Not everyone is ready for treatment, and a lot of acceptance is involved on the part of the client as well as the therapist. That is itself sometimes hard to accept. Daily feelings of success and failure can plague the novice therapist, as well I am sure as the seasoned one. It is only human. The finality when a client leaves, with that reallife connection gone, is also sometimes difficult. My clients feel like my children, my parents, my peers, and yet they are not. Ours is an artificial relationship, yet more real than many. My understanding is that with every “disorder” there are always compensatory extraordinary qualities, and these are as important to focus on as the disorder making a client’s life dysfunctional. The idea of “normal” ceases to exist. There are just variations in individuals of degree. What a relief this is to know. We can only deal with the state of our current knowledge. Especially when it comes to the science of the brain and our understanding of consciousness, the theories and techniques we use today are likely to be proven inadequate or mistaken in the future. We can only work with what

October 22, 2015 Healthy Body & Mind we know now. This is hardly reassuring, and is sometimes frightening. Are we doing harm when we set out to help? This concern can plague a therapist, and it is helps keep us ever vigilant, questioning, critical and balanced. We live in a consumer world. Computers bring us non-stop entertainment of questionable value that can often harm us. When so much information and products are coming at us every moment, we are bombarded by advertising suggesting the ideal goals of wealth, possessions, thinness and youth. Therapy for me is a practice where I can go with my clients into very private and internal sacred spaces. Silence, the spaces between words and thoughts, listening, reflecting and instinct come into play, an important part of healing, and selfdiscovery. The first step is cutting off the distorted information coming at us, finding our internal true and higher self. My experience working with women with eating disorders, people who are constantly taking in the falsehoods of advertising as truths, who are so disconnected from themselves and others in a real way, reinforces for me how the constant subliminal barrage of commands from advertising and media cause invisible and unrealistic expectations, and does violence to our psyches. Real therapy can provide a return to a world that has no commercial value. It helps us be free from the corporate dictates (pharmaceuticals aside) of most businesses. It can be a purposeful and meanCLAIRVOYANT

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ingful return to -- or creation of a better place -where people are re-connected with themselves and others in a direct, non-virtual way. without TV, Facebook encounters, texting, and computer interaction. Perhaps that is why so many people are drawn to therapy now. My neighbor, an elderly survivor of the Holo-

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caust, lost her family and fiancé and never married. She is an incredibly upbeat person. She once told me in her thick German accent, “We all have a story. We all come with a package.” Being aware of and questioning the stories we tell, the narratives of our life, is part of the therapeutic process. And so I listen.

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22, 2015 6 | October Healthy Body & Mind

The sick day For parents, having a plan is important By Lisa Carroll

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have to admit it. I am a stickler for rules. Something either is or isn’t. I try to avoid the gray areas as much as possible. But you know what? When it comes down to deciding whether my child should go to school feeling lousy or not, as a parent I find myself right smack dab in a gray area. Last week, my younger daughter, Sammie, wasn’t feeling well. It was nothing major — some tummy trouble — but the thought crossed my mind to keep her from school, just in case things got worse. She insisted on going. It was, after all, her day to sit in the purple chair as ‘star of the week’ in her pre-k class. She went to school, sat in her chair, and came home all in one piece. My older daughter, Shelby, runs a high fever with the drop of a hat. She could sneeze once and get a 102-degree fever. Keeping up with school-aged children and their health, especially during cold and flu season, is a challenge. According to the Centers for Disease Control and Prevention, flu “is very unpredictable and can vary in different parts of the country and from season to season.” Most seasonal flu activity occurs between October and May. Flu activity most commonly peaks in the United States between December and February. As parents, we’ve all been there. We’re settling into bed, reflecting on that day’s activities. Tomorrow’s long to-do list is churning in our minds. There are work responsibilities, family things, meals to cook, laundry to do. It’s a packed schedule. From the darkness, a small voice quivers. “Mommy. Daddy. I don’t feel good.” The coughing starts, then the retching. If you are anything like me, you have to move in one swift motion. Out of bed, find a bucket. Set a plan for the following day into motion. I’m lucky. The type of work I do, it’s okay if I show up in my pajamas, ready to work, following a long night of couch surfing with a sick child. Most school districts — although it is not mandated by the state — have guidelines that parents should follow in determining whether their child goes to school sick or not. For instance, according to the Kingston school district website, children with fevers over 100 degrees within a 24-hour window without fever-reducing meds or who have experienced vomiting or diarrhea within that same 24 hours are requested to stay home. According to Tom Dunn, communications representative for the state education department’s Office of Student Support Services, is up to the public school districts to establish guidelines at their discretion. “There are no state-level policies that provide

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Sick days are fine for kids, but another thing altogether for working parents. direct guidance to parents on when a student is too sick to attend school, as it is up to the local level school district to develop such a policy,” Dunn said. That’s a whole lot of gray area. Typically, since I’m the one with the more fluid profession in the household, the responsibility for child care generally falls in my lap. That doesn’t make it any less stressful for me. As a reporter and freelance writer, I am responsible for making calls and writing stories. But my doing so makes it a whole lot easier for my husband, a teacher. In our house, I generally follow the fever/bodily fluids test to determine whether my youngster is going to stay home for the day. If the fever is high, or if we’re seeing more breakfast outside their body than in it, they stay home. I treat them like most other moms would. I institute the BRAT diet (one rich in bananas, rice, applesauce and toast), which settles upset stomach and medication if necessary. If all else fails I call my mom or the girls’ pediatrician. As a work-from-home mother, a child-care plan isn’t a high priority for me. For many others, though, it’s a survival necessity, especially when a child’s sudden illness throws a monkey wrench into the juggling act. Having a well-thought-out childcare plan set in motion before your child gets sick and you have to take time off from work, could make a big difference in stress level for you. Kerry Wolfeil, program director at Child Care Connections (CCC), a childcare resource and referral agency serving Columbia, Greene and Ulster counties, offered several tips for parents finding themselves without options. “While some programs do offer care for mildly to moderately ill children, typically most don’t,” Wolfeil said. An emergency or an illness isn’t the best time to find suitable childcare. Most childcare providers, Wolfeil explained, require health release forms and other documen-

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tation before caring for a child. These can take a while to provide. Instead, she explained, parents or guardians could speak with a CCC representative. Within minutes of answering a few questions, a parent will have a list of referred childcare providers in the area. Similarly, families could search the CCC database of providers and speak with office staff via email and have a list generated. Having a plan before a child gets sick, misses school and requires childcare can alleviate some of the stress parents feel. “Having children become ill is one of the biggest reasons for parents missing work and can be very stressful,” Wolfeil said. Over past year, CCC has served over 290 clients and over 434 children in Ulster County. Wolfeil was quick to point out that financing doesn’t come into play, except when the CCC representative feels the family may be eligible for childcare subsidies through social services. In that case, the worker will refer the family there for further information. Of course, staying healthy in the first place wards off much of the illness-related stress. For parents of school-aged children, the CDC offers a variety of tips for keeping germs at bay: including, practicing good hygiene such as washing hands and discarding used tissues and reminding little ones to cover their mouths and noses when they cough or sneeze. And rest…get plenty of good old-fashion rest.

Home Hudson Valley Fall Home Improvement Editorial EDITOR:

Paul Smart LAYOUT: Joe Morgan CONTRIBUTORS: Jennifer Brizzi, Lisa Carroll, Matthew D’Onofrio, Dante Kanter, Kellie McGuire, Laura Nathanson, Christopher Rowley, Milo Smart COVER: Joe Morgan, Paul Smart, Leonardo Da Vinci & the Miracle of Science Ulster Publishing PUBLISHER:

Geddy Sveikauskas Joe Morgan ADVERTISING DIRECTOR: Genia Wickwire DISPLAY ADS: Lynn Coraza, Pam Courselle, Pamela Geskie, Elizabeth Jackson, Ralph Longendyke, Sue Rogers, Linda Saccoman PRODUCTION MANAGER: Joe Morgan PRODUCTION: Josh Gilligan, Rick Holland CLASSIFIED ADS: Amy Murphy, Tobi Watson CIRCULATION: Dominic Labate CHIEF INFORMATION OFFICER:

Healthy Body & Mind is an annual publication produced by Ulster Publishing. It is distributed in the company’s four weekly newspapers and separately at select locations, reaching an estimated readership of over 50,000. Its website is www.healthyhv.com. For more info on upcoming special sections, including how to place an ad, call 845-334-8200, fax 845-334-8202 or email: info@ ulsterpublishing.com.

October 22, 2015 Healthy Body & Mind

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The evil empire of online gaming?

IMAGE COURTESY OF MINECRAFT

Ever had a kid in the house addicted to his tablet? Such cases allow one a glimpse into the educational side of gaming these days, including the various skills needed by something like Minecraft, or whatever’s got the kid’s attention 24/7.

It turns out there are many beneďŹ ts in multiplayer worlds

and inducing a variety of emotions. Back then, we experienced the simple thrill of scoring on an opponent in Pong in 1972 or getting foolishly frustrated over a bad hand in Solitaire in 1990. Today, we are juggling themes of American ex-

By Matthew D’Onofrio

Are You Ready to Take Control of Your Health and

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y chest pounded with anxiety as I soared downwards from the sky above. I had goose bumps from the fear of not knowing what threat lay beneath the clouds. The fire that ignited in my heart was fueled by my determination to save the beautiful damsel in distress waiting for me at the end of my intense adventure. This is how I felt before entering the final battle with the evil Demise in the video game The Legend of Zelda: Skyward Sword, one of my favorite video games of all time. I felt as if I was in Link’s shoes, or boots. Invented roughly in the 1950s, video games have come a long way in impacting our demeanor

ceptionalism, manifest destiny and multiverse after embarking on a bewildering journey in a video game with exceptional storytelling and suspense, BioShockInfinite. Or, we are presented with the brutal decision of whether deliberately to shoot at

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22, 2015 8 | October Healthy Body & Mind hundreds of innocent civilians at an airport in an undercover mission in Modern Warfare 2. This rush of emotions we confront when playing a video game is becoming more complex as video games get, well, more complex as well. Some 155 million Americans are playing video games, and 42 percent play for three or more hours per week, according to a 2015 study by the Entertainment Software Association. What might this mean?

D

r. Glenn Geher, chair of the department of psychology and director of the Evolutionary Studies Program at SUNY New Paltz, describes video games’ impact on the human psyche as an evolutionary mismatch. The conditions at hand don’t match ancestral conditions. In order to attain what they desired and needed, our ancestors had to venture into the unknown empty-handed and face their fears head-on. But we’re not empty-handed today. We have these screens at our fingertips with the ability to simulate any situation and challenge any behaviors. Although perhaps unnatural, this new phenomenon isn’t necessarily a bad thing. Geher says it could go either way. In his article titled, “How Minecraft Actually Builds Social Skills,” published by Psychology Today, Geher talks about his elevenyear-old son’s addiction to the multiplayer, sandbox game Minecraft. Geher points out the game’s potential as a tool for developing social bonds and learning social skills such as leadership. “Good video games capitalize on and exploit our psychological systems,” said Geher. “However, so do cigarettes, alcohol, porn and McDonald’s. We have evolved to enjoy these fake worlds and be affected by them emotionally and behaviorally. I think we have to be wary of something that teeters on the border between beneficial and dangerous.” Although these virtual worlds may be fake, the way they make us feel is all too real. For example, take Second Life, a game-like online virtual world without the typical game objectives and conflicts. The concept is simple: the player creates whoever he or she wishes to be and lives another life in a virtual reality the way that player sees fit.

IMAGE COURTESY OF NINTENDO

The Legend of Zelda: Skyward Sword, our author’s favorite online game of the moment, is all about rising levels of stress... and accomplishment. Psychologists are now discovering that when played with others virtually or side-by-side, such things serve a purpose as a socializing tool.

S

UNY New Paltz students Amanda E. Guitar and Daniel J. Glass were able to use Second Life to create virtual situations to test Nesse and Ellsworth’s 2009 Model of Emotions for Situations that Arise in Goal Pursuit, which basically suggests that emotions are triggered by whether a situation poses a threat or opportunity, whether a domain of the situation is physical or social, and whether the outcome of the situation will be a success or a failure. These virtual situations ranged from physical ones, such as a situation designed to threaten the subject’s personal safety via the task of completing

a hazardous obstacle course, to social ones, such as a situation where subjects were risking being ostracized via a challenge to either make enough friends or be exiled. The results depended on things like whether the emotion was despair from falling off an obstacle course into a pitch-black pit or embarrassment from getting exiled due to an undisclosed random selection at the end of the social challenge. The study concluded that software like Second Life effectively elicited emotional responses. Perhaps the multiplayer component of Second Life contributes largely to the emotions players convey, which can also be seen in the massively multiplayer role playing game World of Warcraft. In that game players chat, complete tasks, and perform certain activities with one or more people. Emotions come more naturally when one is actively talking to teammates, especially after one does something stupid or is left exulting from revenge following defeat from the enemy.

L

ike WORLD OF WARCRAFT, similar interactions with others can be seen in mobile games such as Trivia Crack and Candy Crush Saga. Whether you are gloating your superior knowledge

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October 22, 2015 Healthy Body & Mind to a friend or mocking your buddy after topping his high score, we react to multiplayer video games in a way practically identical to how we react to realworld multiplayer games like chess or dominoes. The non-multiplayer mobile game Flappy Bird was infamous for causing widespread rage and insanity with its simple yet unforgiving mechanics. Creator Dong Nguyen decided to remove the game from the App Store and Google Play Store to rid the world of the addictive evil Flappy Bird had caused. “I am sorry, Flappy Bird users, 22 hours from now I will take Flappy Bird down. I cannot take this any more,” tweeted Nguyen on February 8, 2014. Although Flappy Bird is a bizarre case, many games get a bad reputation for allegedly influencing negative behavior, such as the handful of realworld murders and other crimes by young people linked back to the Grand Theft Auto franchise. Video games have the power to hit us right in our feelings and produce a spectrum of emotions. That effect differs for each player. The good or evil influence people feel video games bring about remains subjective. It is foolish to ignore the many uses video games have spawned in the world today and will continue to forge in the future. Anybody up for a round of Mario Kart?

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22, 2015 10 | October Healthy Body & Mind

Ridge running Long-distance motion increases in the Hudson Valley By Kellie McGuire

T

he Shawangunk Ridge Trail traverses a ridge line from High Point, New Jersey, where its unique geology and biology begins, for 74 miles to Rosendale, where the ridge ends. This was the second year of the SRT Run, which race directors Ken Posner and Todd Jennings of Shawangunk Adventures created as a challenge for runners to emulate the self-reliance of our forebears, whether settlers or native, and to celebrate the preservation of the Shawangunks. This year’s run, held the third weekend in September, was composed of 74-, 50-, 32-, and 20mile divisions. The longest one started in New Jersey on Friday night. The 50-miler began in Wurtsboro Saturday morning, the 32-miler at Sam’s Point, and the 20-mile race headed off from Peter’s Kill, a part of Minnewaska, overlapping with the other races as everyone headed through the Mohonk Preserve towards a spectacular view of the Rondout Creek from the Wallkill Valley Land Trust’s trestle bridge in Rosendale. “This is an important trail in our back yard

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unning in the Gunks, as well as in much of the rest of the Hudson Valley and Catskills, has become a widespread activity. There have been running events around the area and along the ridge for years. The Kingston Classic, a road-and-trail run, started in early 1980s. Shawangunk Runners Club has been around nearly as long. The Wurtsboro Mountain 30K has been going on for a decade. The Josh Feld, After the Leaves, and Run Like the Wind events are now longstanding running events in the Shawangunks. New Paltz and Kingston both hold a Turkey Trot on Thanksgiving. There is a popular Ulster Corps’ Zombie Run, the Pfalz Point Trail Challenge, and a Father’s Day half-marathon on the rail-trail in New Paltz, plus innumerable 5ks. But it’s the ultra-length trail runs that are really gaining popularity these days. An ultra-marathon is any length over 26.2 miles, and most consider the shortest ultra a 50K (31ish miles) run. According the Runner’s World Magazine, the number of ultra-marathons has doubled in the past decade. In the past few years the Mohonk Preserve added a Rock the Ridge 50-mile fundraising run. Shawangunk Adventures LLC, race directors for Rock the Ridge, put on the Shawangunk Ridge Trail Run for the past two years and in 2015 added the Ellenville Mountain Running Festival, as well as a long Catskills event. When I began running about three years ago, I quickly discovered, much to my dismay, that I’m

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marking. Runners must carry as much food as they will need to keep themselves moving for up to 32 hours, and they must also carry water filters to ensure what they get from streams is safe. And yes, several runners did get lost this year and last. But all found their way back on trail using maps.

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October 22, 2015 Healthy Body & Mind not very fast. But I have endurance. The allure to me of distance running was quickly evident. Now, suiting up with my hydration pack and fuel and heading out in any weather to spend four hours on a training run is, to my mind, a wellspent day. Some days I listen to music or an audio book while I run. Sometimes, I run with a partner or my mountain cur. Other days I just head out into the quiet beauty of the mountains, leaving my concerns at the car, and run. Humans are designed to move. Whether it’s walking or running, we are meant to be moving most of the day, not sitting at a desk. And while I still write for a living, there are clear physical health benefits of my new sport, such as stronger muscles and an improved cardiovascular system, more endurance, and better sleep. I run off my stress and I gain a sense of accomplishment from setting a goal, training for it, and reaching it. Plus conversations can get pretty deep on a four- or eight-hour run. My running partners and I know each other very well. Every now and then I get the chance to run with a friend who is new to running. There is always the apology at the start: “I’m not very fast. I can’t go that far.� And my answer is always the same. “We’re running together. People did it for me when I was new and I’ll stick with you now. That’s the way it works. We don’t leave other runners behind�. Except on race day.

A

aron Stedny, who was in first place until the check-in near Peter’s Kill about 30 miles into the race, at one point was told someone was ahead of him -- only to find out later that runner, from western New York, had gone off-trail for an hour. “It was dark and I didn’t count on that. I didn’t do a head lamp,� Stedny later recounted. “The first mile and half was on the road. It was about 6:25 by the time I got on the SRT and by then I could see the rocks on the trail.� Like many who raced, he had met Ken Posner on the trail a few weeks earlier for a training run, which gave him a sense of what he’d be dealing with. “I got off-trail in one early section and I had to bushwhack for about ten feet. Some people had camped out and they were screaming and yelling when I came through,� Stedny said. “I got on top of that ridge and a sea of clouds lay on the valley. It was cool and breezy; I was running with a smile on my face and I just enjoyed myself and tried to save up for the later part of the race. Part of the fun of a long run like that is that you have no clue where anyone else is.� Paul Fost of Westchester did the whole 74 miles

of the SRT this year after trying but failing the big achievement in 2014. He said he’d twice run Rock the Ridge, the 50-mile endurance challenge to raise money for the Mohonk Preserve, to get in shape for the SRT. “I thought, ‘I did the 50 I can do 74. It’s half again the effort.’ But effort increases more after that kind of mileage,� Fost said, noting how all but one person dropped out from the bigger race in its first year. He hired a trainer for the bigger event this time. “The guy I ran with, Raymond Russell, had done the 32 last year so he knew the last half and I knew the first half. I thought we wouldn’t get lost but we veered off from the trail. We start to bushwhack and saw some lights getting closer and it turned out to be other runners who had gotten more lost than we did.�

T

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conversations we have on a long run. The way my yoga pants feel after taking off my sweaty running clothes. Seeing a hill and knowing I can run up it, no problem. Knowing that my former fast time is now my slow time. Recovery days. That moment when my muscles warm up and I flow. My thighs (for the first time in my adult life). The knowledge that I can run in any weather. Running in the fog. My calves. The support and encouragement I’m getting from friends and family. Being able to eat two days’ worth of calories after a long run day. Really long runs. Speed work. The shower after running in the cold. Running in the sun. The anticipation of race day. Being part of an elite community. My abs. The scenery in Gunks where I train. Self-esteem gained through not giving up. Runner’s high.

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22, 2015 12 | October Healthy Body & Mind

PHOTOS BY PAUL SMART

Pets like Minnie, Speedy the Turtle, and CP (seen with her own pet bear, “Baby”), have served as a means of teaching kids caring and responsibility, as well as the means to deal with mortality, for eons now.

What my pets mean to me Paul Smart’s nine-yearold tells it like it is By Milo Smart

I

have had pets my whole life. The first pet I remember is Teddy. He was the type of cat who liked to relax, sit around, let us pet her and catch mice. I really loved Teddy. He made me feel disgusting and good. Disgusting because of the mice he caught every week and good because he never tried to hurt me. He let me pet him. Later Teddy got sick and died. That was very sad because I was there. I also had goldfish, but they kept dying. We threw their bodies in the woods. I cried every time. It was very sad, but my mom and dad said I learned a lot from that, just like when Teddy died. Now I have four pets. They are Berry, Minnie, C.P. and Speedy. Speedy is a shy turtle who lives in water and likes to climb. He is very shy. We got Speedy when I was six, about 2012. I named the turtle Speedy because when we got it it climbed out of the box and took off really fast. We are not sure whether Speedy is a boy or girl. I don’t know how Speedy makes me feel. I was very excited when I got it. Now Speedy’s just there in its tank, and occasionally I look over and see Speedy swimming or climbing. That makes me feel good. Berry is our dog. She’s very hairy. She’s small and black. She’s the type of dog who likes dogs but will bark at them when she feels jealous. Her favorite things are her family, my stuffed animals, food, chewing plastic toys, and making a mess. She likes to sleep on our beds. In the morning she wakes us

John M. Carroll

The author with his dog Berry, as seen on the day the two first met each other at the start of Channukah, 2014. up really tired and stretches out and yawns. I am in charge of feeding her two times a day. She also likes to lick our kitty’s plates and beg for our food. She loves to go in the car, especially when my mom or dad pick me up from school, and she wishes she could play soccer with me. Berry makes me feel happy and safe. I love to cuddle with her. Sometimes she gets too excited when we all wrestle. C.P. is our youngest kitty. Her real name is Cutie Pie. She’s a black and brown cat and very furry. We got her when our friend Lynn found her in a barn after she was chased by a fox. She was very very little and could fit in my arms with some space. Her favorite thing is a stuffed white bear that we call Baby that she sucks on and purrs, and we have to keep Berry from eating (my mom has had to fix Baby up many times). My favorite thing about C.P. is that she likes adventures, although she did

get lost once so she doesn’t go too far and is really happy to get home with us and her Baby. She makes me feel good. My other cat is Minnie. We got her when we were in New York City and my friend Zora asked if we wanted a cat, showed us a picture of a very cute kitten. We said yes. We met somebody in a parking lot and Minnie started screaming and scratched my dad right across the face. Then we drove her home and she was really cute until C.P. showed up. She hissed C.P. a lot, and still does. But not as much. Minnie’s favorite thing is breakfast and dinner when she jumps up on the counter and tries eating the food before it hits the plate. She meows a lot. She makes me feel good because she’s really pretty and really soft and she’s part of my family. All my pets are good. I love my pets. They make me feel good and safe. They are part of my family.

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October 22, 2015 Healthy Body & Mind

| 13

Hurricanes and hospitals A teenager’s view of what drives our health concerns

time surrounded by recent parents, sad, distant, and ghostly, all in danger of losing their children,. The walls were bland, the hallways clean and mechanical. My parents were only allowed to touch me wearing gloves through the hole in my incubator. My father recalls coming in one day to see an African women who he’d met before crumpled onto the ground, screaming into the floor. A doctor at her side was consoling her. She was wide and short. Her husband, tall and rail-thin, stood behind her. He stared at the wall opposite him intently, but when my father walked by him he turned and looked him in the eyes. “Good afternoon, sir.” He said. Calmly. Formally. The words have stuck with my father for years. After a week’s stay, my mother was released from the hospital on the same day that Hurricane Floyd hit New York City. Wind gusts exceeding 50 miles an hour tore through the city, blowing billboards, pieces of buildings, construction sites, and New Yorkers down the street. Two people were killed. My parents were stranded in Brooklyn, with half of Manhattan between them and the hospital where I was. My mother braved the storm regardless, taking the subway and staying underground for as long as possible, walking against the wind in the final two block stretch to St. Luke’s Roosevelt, watching as ply wood barreled across sidewalks like tumbleweed. In the following week, my father had his appendix removed, I was sent a tapestry from a Buddhist monk in Tibet, the storm subsided, and I was deemed fit to return home. By some strange miracle, I suffered no long-term effects from my infection. With their son finally home and well, my parents both collapsed from the weight of all their waiting, and my babysitter fell ill for the next month. Knowing that they and I had gone through hell and returned safely, my parents decided to name me Dante.

By Dante Kanter

“

T

he worst thing about hospitals is the waiting,” said a young emergency room doctor with a strong jaw as he withdrew my cerebrospinal fluid through a needle sunk two inches into my

lower back. I’d had a high fever for more than three days, and I was up the previous night stumbling between fever dreams in which I was a coke dealer running from an NYPD drug bust and vomiting into the toilet of my upstairs bathroom. The worst possible outcome of my condition was a diagnosis of spinal meningitis and a two-week stay at the Albany Children’s Hospital. It turned out that what I had was a combination of scarlet fever and Lyme disease, both treatable with antibiotics. I was in the emergency room for six hours, enough time for me to recognize that the young doctor was right. Iin a hospital, what can end up being more painful than any sickness is the slow and tedious passing of time. This meningitis scare was the most danger I had been in fourteen years, but there was a time when I was in far more. I spent the two weeks following my birth in the neo-natal wing of St. Luke’s-Roosevelt hospital, sick with listeriosis caused by an infected shipment of D’Artagnan Inc.’s foie gras that my mother purchased at Whole Foods. The waiting meant nothing to me then , since I was new to the world and unadjusted to the laws of the universe, which includes such things as the passage of time. But it was more than enough waiting for my parents, who had recently gone through the pain, anxiety and satisfaction of becoming parents only to have their prince at risk of dying. Prior to the pregnancy, my parents were recently married painters living in the then-tough Brooklyn neighborhood Dumbo, in a loft overlooking the part of the dirty East River that was rumored to be where the Mafia dumped their dead bodies. My mother, born in Oregon and raised in her family’s grand hotel on the Mexican border in an Arizona mining town full of bikers and psychics, has eyes like mine. They close when smiling to make room for apple cheeks. My father, raised in suburban New Jersey by an Italian Catholic and Eastern European Jew, spent his middle-school years in love with Captain Kirk and Jim Morrison. He is well-read and scholarly and has a bend in the tip of his nose from when it was bitten off by a lapdog. They decided to have a child, they told me, after seeing my mother’s 19-year-old niece caught in the throes of single motherhood after being abandoned by her boyfriend whose name is lost to time and who the family now calls “Spudboy.” He had been given this nickname because of his smell: fry grease from the kitchens of McDonalds, where he worked. If this grandniece could raise a child and survive, my parents figured, surely they could as well. My mother was seven months pregnant and expecting to give birth in eight weeks when she was summoned to the Montclair Art Museum to repair one of her wax paintings. A curious child on a school trip had sunk his nails into it leaving four neat vertical lines down the length of the canvas. While my mother was in the museum applying another layer of translucent wax, she had a specific craving for foie gras, a dish highly criticized by animal-rights organizations as amoral because it is made by the force feeding of geese and the later dissection of the goose’s liver. She went to the Whole Foods across the street and bought D’Artagnan’s foie gras from a contaminated shipment which was later recalled. A statement was released noting that the infection could cause “sometimes fatal infections in those with weak immune systems -- infants, the frail or elderly, and persons with chronic disease.”

PHOTO BY MARK THOMAS KANTER

The author with his mother, after finally making it home from the hospital. A week after her trip to Montclair, after much screaming from both my mother and father, and reckless and panicked driving along I-87 south, my mother was sitting on the floor of the waiting room demanding immediate care. I was born at St. Luke’s Roosevelt Hospital on West 59th street by C-section. The doctors knew immediately that something was wrong, and after my mother held me briefly I was taken away to be inspected. They found the bacteria, which had bored through my mother’s placenta, and decided that both my mother and I would stay at the hospital until I recovered. The days that followed were stressful. My grandparents on my father’s side, unclear of the god my parents believed in and anxious to worship the one would help me the most, sent a rogues’ gallery of religious figures to my hospital room. Rabbis, Catholics, Protestants all came to my door asking to pray for either my survival or for a prime spot in the afterlife. my mother kicked them all out. She decided that there was going to be no stewing in my tragedy or thinking about my death. My parents believed that their faith in my survival would help my odds. The neonatal wing itself was surreal and nightmarish. My mother and father spent most of their

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22, 2015 14 | October Healthy Body & Mind

The affordable-care experiment Things are changing and will continue to change By Chris Rowley

H

ealth insurance premiums are going up. In many cases they’re going up a lot. At the same time, health insurance policies are becoming harder than ever to understand, even if you’re wise to medical industry jargon. Does anyone really know what they’re covered for, and for how much? This was not how the Affordable Care Actt was supposed to operate, at least according to its supporters back in 2010. Since it was more ore than 1000 pages long and only passed by razorzorthin margins after months of trench warfaree in derCongress, how much did any of is actually understand it? ases, After the first couple of years of small increases, Family Practice

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relatively big hikes in premiums have returned. For 2016, insurers in the New York State market sought an average 10.4% rate increase in the individual market. For the small-group market, they asked for 14.4%. They got an average 7.1% increase in the individual premiums and 9.8% in the small-group market. For one Ulster County zip code, 26 plans were available on the New York State Health Insurance website for the current year, 2015. Eleven of those, including all the least costly, were from Health

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ULSTER GASTROENTEROLOGY Dr. Reham El-Shaer is pleased to inform you that she is starting her own gastroenterology practice. Dr. El-Shaer is a highly respected Board certiďŹ ed Gastroenterologist dedicated to the prevention, diagnosis, treatment and management of digestive disease. Ulster Gastroenterology offers the cutting edge and coordinated top quality care of patients. Dr. El-Shaer is looking forward to caring for her patients with any digestive issues they might have and she is willing to take care of young patients at least 14 years old and above. Our staff will always be available to help you with any questions.

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erhaps it might help if we measured the overall beast. Healthcare in the US produces a constellation of uncomfortable facts, mingled with a few stellar data points. We spend about $3 trillion on healthcare, or about 18 per cent of our GDP. The average in the rest of the world’s advanced economies is about nine per cent. Eighty percent of the money is spent on the part of the population that is elderly, sick and/or dying in hospital. Our country is a spectacular outlier in healthcare. Of the 40 or so sovereign nations that maintain healthcare systems (places like Belgium, Britain and Switzerland), the United States is the only one that does not operate a universal system for coverage. Ours is a selective system that leaves out millions of people. About 62 percent of personal bankruptcies in this country are caused by unpayable medical bills. American life expectancy, pegged at 78.4 years at birth, today ranks 50th in the world and 27th of the 34 OECD countries. Of the high-income countries in 2013, the United States led or was second in obesity prevalance, in infant mortality, in heart and lung disease and in sexually transmitted diseases. Americans who reach age 75, however, tend to live longer than their counterparts anywhere else. Furthermore, Americans, who are screened more frequently for cancer than in other nations, survive cancer at better rates than most Europeans. This country remains the powerhouse in medical innovation, too, with almost 90 percent of recent technologies and drugs originating in America. Still, Americans are charged, on average, between 40 and 50 percent more for drugs than Canadians or Europeans, because in the U.S. the government and its agencies neither control nor negotiate drug prices.Â

John H. Grant, lcsw-r

Arms Arms Acres Acresisisaa162-bed 1 -bedresidential residenalcoholism and substance abuse tial alcoholism and substance treatment facility situated on a abuse treatment facility beautiful 54-acre wooded site situated on a beautiful in Carmel. 54-acre wooded site in Carmel. The treatment program is The treatment program is multimultidisciplinary in scope and disciplinary in scope and individindividualized in approach. Our ualized in approach. Our inpatient inpatient programs consist programs consist of detoxificaof detoxiďŹ cation, Medicated tion, assessment, rehabilitation, Assisted Treatment, assessment, and family support. rehabilitation, and family support.

Republic, Rep a non-profit cooperative that is being wound wou down by the state. It appears to have underestimated dere the costs of insuring individual New Yorkers in the health market. Yor The remaining plans available came from j just a handful of insurers, Empire Blue Cross, United Health Care, and one plan from Emblem-health, an HMO plan called Emblemhealth Gold. All these plans were considerably more expensive than those of Health Republic, with punishing deductibles of as much as $6000 in certain bronze plans and situations. We will not know until the end of this month what plans will be available for us in 2016. We can be sure that they will be more expensive, and may carry even higher deductibles, co-insurance costs and co-pays for drugs ib an services. and The Th rates for individuals are still half what they were wer before the health-market exchange went i 2014. As with so much of the debate over up in heal healthcare in America and the ACA, nothing is quite quit black or white. The self-employed were once heav discriminated against in American health heavily i insurance. That has now ended, but the question of whether American healthcare is affordable is still unanswered.Â

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October 22, 2015 Healthy Body & Mind

PHOTO CARE OF WIKICOMMONS

The signing of the Patient Protection and Affordable Care Act by President Obama and Congressional leaders in the White House, March 23, 2010. The smaller person present is “11 year old health care activist” Marcelas Owens.

T

he big point to remember is that things are changing and will continue to change. In New York State, 2.1 million people enrolled in public plans after passage of the ACA. The great majority of them, 1.7 million, joined Medicaid, the federally funded program for the poor. About 415,000 joined private plans. Of these 83,000 joined Health Republic. In Ulster County, 2839 of the 4939 total enrolled in Health Republic. Plans and process for 2016 must be available to consumers by the end of October. December 15 is the big date to remember. That’s your last day to enroll in a new plan, or change your plan for 2016 if you want coverage to continue starting January 1. January 15 is the last day to enroll to have coverage that begins February 1. January 31 is the last day of open enrollment, and such enrollment will start on March 1. If you choose not to enroll, you will pay the higher of these two amounts: either 2.5% of your annual household income, or $695 per person in your household, with children under 18 assessed at $347.50. This penalty maxes out for families at $2085. You may be exempt, if for instance the lowestcost coverage you can find either in the market or through your job takes more than 8.05% of your household income. You are also exempt if your income is lower than the level required to file a tax return ($10,150 for a W2 in 2014.) You’re also exempt if you’re in prison, or of you’re an American citizen living outside the USA. There are a number of hardship exemptions,

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form without agreement from the drug companies, hospitals, the medical-industrial complex in general. They face no real cost constraints. Exorbitant bills, opaque paperwork, a maze of confusing options, plans and payment channels all combine to leave the consumer helpless unless he or she puts in hours of intensive research. And even then, the facts received may not be accurate! And thus what Obamacare is achieving is an overall increase in the numbers of those insured, with a hefty slice of that from the ranks of new Medicaid beneficiaries. But this is coming at a cost to the working poor and the middle class, who find themselves facing costly premiums married to deductibles of several thousand dollars that effectively freeze them out of medical care. They have insurance, but they can’t afford to go to a doctor, or have a procedure. Backgrounding that problem is another. While healthcare costs have soared over the past fifty years, by as much as 800% in some estimates, wages for most US workers have stagnated. Indeed, their purchasing power is pretty much exactly what it was in 1960. Back then, US workers could afford health care, such as it was without MRI scans, and a host of other technological advances. The medical industry, secure within an opaque market structure, protected from serious reform and cost control by its lobbying power in Washington, has simply improved its position, in the process pricing out the American working class. Now the middle classes are about to feel the same pinch. Meanwhile, at the other end of the spectrum, United Health Group, the largest health insurer reported $10.3 billion in profits for 2014, on revenues of $130.5 billion, up 7% on the year. United’s share price on March 23, 2010, when President Obama signed the ACA was $30.40. Since then, United’s shares have risen to a nice, fat $119, outpacing the overall stock market by a considerable margin.

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| 15

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22, 2015 16 | October Healthy Body & Mind

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