in good 3-D Printing and Your Heart
Interventional cardiologist Vijay S. Iyer talks about how 3-D printer technology is helping in the treatment of patients with cardiac problems
August 2016 • Issue 22
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Expanded Role for Paramedics May Be Coming to Buffalo State bill calls for a larger role for emergency medical services responders Page 2
Page 16
Farmers, Fishermen, Foresters More Likely to Commit Suicide
Reddy Bikeshare Debuts in Buffalo
A 2,700-Mile Walk
Buffalo-area trio makes 2,700-mile cross-country walk for health — and loses dozens of pounds in the process
Peaches
Broccoli? Yes. Garlic? No question. But peaches? Read about surprising news about peaches. in SmartBite Page 11
Tips for Visiting a Memory Care Patient Follow a few tips to get the most of a visit with a memory care patient. Page 12
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EMS in Transition Emergency response teams in Buffalo may play more enhanced role By Ernst Lamothe Jr.
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he winds of change have hit almost every aspect of health care from hospital system mergers to more transparent costs for procedures for patients. The new way of thinking could soon hit emergency service responders. But while other states like Colorado and California are leading the charge in expanding emergency medical services, New York state lags behind with a bill that has been stalled for more than seven months. Community paramedicine is a new and evolving model of community-based health care in which paramedics function outside their customary emergency response and transport roles. Community paramedicine allows services provided by an emergency medical technician, an advanced emergency medical technician or paramedic to patients who do not require emergency medical transportation. It enables someone to get the care they need at home instead of simply having an expensive ambulance fee to drive them to an emergency room, where they will be charged for another fee for that service as well. If the bill passes, EMS will have a greater scope of services that include checking vital signs, blood pressure screening and monitoring, prescription drug compliance, changing wound dressing, stitching wounds, helping a recently discharged hospital patient reestablish themselves at home and medical reconciliation. It is all an effort to prevent the growing number of people who are using emergency departments as their primary care doctors. Rural/Metro Medical Services is Page 2
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a respected leader in the delivery of 911 emergency and non-emergency inter-facility ambulance transportation throughout Western New York. Headquartered in Buffalo, its team of more than 500 certified paramedics, EMTs and other support staff set the standards for medical transportation, patient care, safety and community service with a shared commitment to the patients they serve. Its coverage area includes 20 hospitals and more than 100 nursing home facilities, providing 911 emergency and non-emergency ambulance services in Erie and Niagara counties. “We propose to amend the public health law to explicitly allow EMS providers to operate in a wider variety of circumstances than they currently do,” said Hugh Chaplin, executive director of the New York Mobile Integrated Healthcare Association. “This legislation will help EMS in New York state to become more patient-centered, more adaptive to changes in health care and more integrated into the continuum of health care delivery and public health.” Reg Allen, chairman of the Monroe County-Livingston EMS Council, said he believes in community paramedicine. He said in the future, EMS services will have connections locally and regionally as forces in Buffalo, Rochester and Syracuse will begin working together like never before.
‘Just makes sense’ “There is no question in my mind that the opportunity to provide better service when we already have a ready and prepared paramedics force just makes sense,” said Allen. “Because once you call 9-1-1, ambulances
are required to take you to only a hospital That eliminates the ability for some of our trained people to take care of you either at your home or drive you to an urgent care, which would cost you less money than an emergency room. It just makes common sense and will increase quality care while reducing the total cost of health care, which is what we are striving to do.” Sean Burton, national manager of mobile integrated healthcare for American Medical Response, is familiar with the initiative by New York communities such as Syracuse and other Upstate cities for a push in utilizing paramedics in community settings and outreach. He understands the reason for that push, especially in rural settings, has been one of the reasons why the measure has slowly been gaining traction in Upstate cities. “I think this is one of the hottest topics right now in our industry,” said Burton. “We need to be locally driven and match the needs of our patients. When any community is dealing with a specific health care population, you can only manage that population if you have the appropriate resources.” Burton views a day sometime in the future when EMS services have an expanded role in helping patients receive the right resources and educating the public on the nec-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016
essary uses of emergency services. Any additional role would require advanced training for New York EMS departments. “We are not looking to increase the scope of practice without that necessary training,” said Burton. “The real focus in the state of care is actually including more medical providers like physician assistants and nurse practitioners into our emergency management systems.” For example, if the Canandaigua Emergency Service is called out to a home for someone who needs stitches, instead of transporting the individual to the hospital, taking up space in a room for an individual who comes in with a true emergency, the EMS responders can simply suture the patient right in their home. “Imagine being at home preparing dinner and you go to cut something like an orange and you slip and accidentally slice the palm of your hand and it’s bleeding pretty good,” said Ken Beers, chief of the Canandaigua Emergency Service. “You need some attention and you would normally call 9-1-1 or get inside your car and go to the emergency room. You may need only a couple of stitches and that requires you to go spend maybe six to eight hours in the emergency department. But with this new system that we hope gets approved, a specialized care paramedic can come directly to your house after you call 9-1-1, stitch it up, and connect you with antibiotics if you need it all while you are at home.” Another advantage is furthering access to communities that struggle to receive it. For nearly 75 million people living in rural areas of the United States, health care needs far outnumber health care options. These communities already include disproportionate number of elderly citizens, immigrants, impoverished families and those in poor health. “You have people who use the emergency room as their primary doctors. They come in for many things that are not necessary,” said Beers. “There is so much emergency department overcrowding that we hope this system will free them for more urgent needs.
Farmers, Fishermen, Foresters More Likely to Commit Suicide
CDC study shows workers in some occupations five times more like to commit suicide
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an the type of job you choose affect your risk of suicide? Possibly, according to a new U.S. report that found for certain occupations, the odds of suicide were significantly higher. From 2000 to 2012, the overall rates of suicide for people aged 16 and older rose 21 percent, the study found. That works out to an approximate increase from 13 to 16 suicides per every 100,000 people in the United States. But among farmers, fishers and foresters, the suicide rate was dramatically higher — at 85 suicides per 100,000 people. For males in those jobs, the rate was even greater. Their suicide rate was 90.5 suicides per 100,000, according to the report. “People working in certain occupations are at greater risk for suicide due to job isolation, a stressful work environment, trouble at work and home, lower income and education, and less access to mental health services,” said lead researcher Wendy LiKamWa McIntosh. She’s a health scientist at the U.S. Centers for Disease Control and Prevention. “Farmers have additional risk factors like social isolation and unwillingness to seek mental health services,” McIntosh said. The report also noted that farmers’ exposure to pesticides may affect their neurological system and contribute to depression. Other occupations that carried signifi-
cantly higher-than-normal rates of suicide included construction and extraction, with 53 suicides per 100,000; and installation, maintenance and repair with 48 suicides per 100,000, the study found. For construction workers, the report authors suggested that a lack of steady work, isolation and a fragmented community might play a role in their higher risk. The investigators theorized that people working in installation, maintenance and repair may have long-term exposure to solvents that could damage their neurological systems. That might contribute to memory loss and depression, the researchers suggested. Men working in fishing, forestry or farming had the highest rates of suicide for their gender. Among women, the highest rate was seen in those working in protective services, such as policing and firefighting. Their rate was 14 per 100,000. Men in the protective services field had a suicide rate of 34 per 100,000, the report noted. Physician Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, pointed out that “work is increasingly stressful.” People take their own lives “mostly because they are depressed,” he said. “We live in a 24-hour world, so it can be easy to feel overburdened, which can lead to depression,” Manevitz added.
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In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Publisher: Jamie Sandidge • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Tim Fenster, Ernst Lamothe Jr., Catherine Miller, Katie Coleman, Nancy Cardillo, Michael J. Biloni Advertising: Jamie Sandidge (585-317-1671), Donna Kimbrell (716-332-0640) • Layout & Design: Eric J. Stevens • Officer Assitance: Michelle Kingsley No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Simply Sweet of WNY in Williamsville is one of the stores in the area that offer a variety of gluten-free baked goods. It’s owned by Cindy Slomovitz, whose body cannot tolerate gluten. She used her passion for baking to turn out a range of gluten-free baked goods. Her business started in 2013.
Gluten-Free Diet: More Than a Fad By Tim Fenster
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he “gluten-free” label has more or less become ubiquitous in modern dining. We see it on all sorts of supermarket items, as little symbols on our favorite restaurants’ menus and in bakeries that deal exclusively in gluten-free goods. Gluten, or the lack thereof, has risen so high in our collective nutritional conscious that in many circles its regarded as a new fad diet for those without the severe, possibly fatal gluten intolerance condition known as celiac disease. But do people with healthy GI tracts have anything to gain from excluding the naturally-occurring
wheat and grain protein from their diets? Elaine Rothfus, an educational and nutritional counselor with the Williamsville-based Western New York Gluten-Free Diet Support Group, says probably not much. Rothus, who has been gluten-free for more than half a century, notes that the diet poses a lot of challenges. Gluten-free products are consistently more expensive than their traditionally-made counterparts. They’re not as available and sometimes don’t taste quite as good. And the diet tends to be low in many of the nutrients that are found in fortified pasta,
such as iron and vitamin B. “It’s not going to do them any harm but they have to be aware of the nutrients they aren’t getting,” Rothfus said. She also points out that gluten-free products are often higher in butter and sugar, to compensate for the lack of gluten, which helps hold baked goods together. “It’s not a weight loss diet,” she said. But that’s not to say that she sees no value in the diet for people without celiac disease. She notes that while two of her granddaughters have celiac disease, a third follows a gluten-free diet simply because it makes her feel better and suffer from fewer migraines. What’s more, a gluten-free diet may be the answer for people who have not been diagnosed with celiac disease but do experience persistent, severe digestive problems. Despite major advances in celiac disease awareness and diagnosing
(Rothfus considers herself very lucky to be diagnosed in the 1960s), most of those who suffer from the condition still wait years to be properly diagnosed. The reason is that the symptoms of celiac disease — bloating, gas, diarrhea, fatigue and indigestion, among others — vary, and are associated with dozens of other digestive disorders. Lack of diagnosis/treatment often results in persistent inflammation of the small intestine, and makes celiac patients more likely to contract cancer or diabetes. It also causes the villi in the small intestine — finger-like pieces of tissue that help absorb nutrients — to become totally flattened, often leading to malnutrition, weight loss, osteoporosis. “If it’s undiagnosed, our small intestines remain inflamed, and it could cause some serious complications,” Rothfus said. In addition, there are many others who do not have celiac disease but do have gluten sensitivity. They experience many of the same symptoms as a person with celiac, but without the autoimmune response that damages the villi in the small intestine. “The symptoms are identical between celiac disease and gluten sensitivity,” Rothfus said. While she welcomes the rise in celiac awareness and availability of gluten-free goods for making life on a gluten-free more manageable, she does have one concern about it being viewed mostly as a fad diet. Rothfus says that when someone with celiac eats at a restaurant, it’s not enough for their food to be gluten-free; it can’t come into contact with any kitchen utensil that has touched a product containing gluten. But if most people ordering the gluten-free option do not have celiac disease, servers and line cooks might start to take those special preparations less seriously. “We’re afraid servers will become nonchalant about it,” she said. For more information about celiac disease, gluten sensitivity and gluten free diets, contact the Western New York Gluten Free Diet Support Group at www.buffaloglutenfree.org.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016 ASSE 4x4 color 0613.indd 4
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Medical Errors: A Hidden Killer Study claims they’re the third leading cause of U.S. deaths, but CDC doesn’t track such data
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edical errors may be the third leading cause of death in the United States, a new study contends. Johns Hopkins University researchers analyzed eight years of U.S. data and concluded that more than 250,000 people died each year due to medical errors. If confirmed, that would make medical errors the third leading cause of death among Americans. Currently, respiratory disease, which kills about 150,000 people a year, is listed as the third leading cause of death by the U.S. Centers for Disease Control and Prevention. However, “incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” said Martin Makary, a professor of surgery at Baltimore-based Hopkins. The CDC’s data collection method does not classify medical errors separately on a death certificate, according to the study authors, who
called for changes to that criteria. “The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used,” Makary explained in a university news release. The Hopkins researchers examined four separate studies that analyzed medical death rate data from 2000 to 2008, including two that used data from federal agencies. Then, using hospital admission rates from 2013, the investigators extrapolated that information, and based on a total of over 35 million hospitalizations, more than 251,000 deaths stemmed from a medical error. That translates to 9.5 percent of all U.S. deaths each year, the study authors said. But the CDC data paints a different picture. The CDC statistics show that in 2013, over 611,000 people in the United States died of heart disease, nearly 585,000 died of cancer and about 150,000 died of chronic respira-
tory disease. “Top-ranked causes of death as reported by the CDC inform our country’s research funding and public health priorities,” Makary said. “Right now, cancer and heart disease
get a ton of attention, but since medical errors don’t appear on the list, the problem doesn’t get the funding and attention it deserves.” The findings were published May 3 in the BMJ (British Medical Journal).
Healthcare in a Minute By George W. Chapman
“Micro” Hospitals
Not that common yet in New York state, micro hospitals offer emergency care, surgery, lab and imaging services and are priced somewhere between urgent care centers and full scale hospitals. Micro-hospitals can treat more conditions than urgent care centers because they typically have about eight to 10 beds for observation and short stays. Most large hospital systems are establishing them in markets that cannot support a full scale hospital.
Hospital Affiliations
Most rural and smaller community hospitals are being encouraged to “affiliate” with larger hospital systems or face a slow lingering death in an increasingly competitive marketplace. Recently, Oneida Healthcare in Madison County announced an “affiliation” with the Bassett system, but Oneida retains its sovereign board and management. Without an actual merger, affiliations usually fail to achieve the necessary economies of scale when it comes to management, operating costs, market share and physician recruitment and retention. Without a total merger or full integration, most affiliations don’t last, have little to show and typically leave the smaller hospital worse off and in a poorer bargaining position.
Top Causes of Death in 2014
1) Heart disease, 23.4 percent (of all deaths). 2) cancer, 22.5 percent. 3) chronic lower respiratory disease, 5.6 percent. 4) accidents, 5.2 percent. 5) cerebrovascular disease, 5.1 percent. 6) Alzheimer’s, 3.6 percent. 7) diabetes mellitus, 2.9 percent. 8) flu and pneumonia, 2.1 percent. 9) nephritis, 1.8 percent, 10) suicide, 1.6 percent. The age-adjusted death rate of 725
deaths per 100,000 people is an alltime low.
Most Expensive Inpatient Conditions in 2015
Septicemia, $23.6 billion; osteoarthritis, $16.5 billion; live birth, $13.3 billion; complication from graft, implant or device, $12.4 billion; acute myocardial infarction, $12.1 billion. Three years ago the top five was the same but expenses related to septicemia (bacterial blood infection) was $3 billion less.
ACA Exchange Enrollment
As of March 31 about 11.1 million people purchased healthcare insurance on the exchange. 12.7 million people enrolled but 1.6 million lost coverage for failure to pay their premium. The 11.1 million is about 1 million more than the same time last year. The public exchanges remain an unpredictable and volatile market for some carriers. National insurers United and Humana are planning to pull out of the individual markets next year.
Inpatient OOP Costs Up
A study published in the Journal of American Medical Assn Internal Medicine magazine found that despite the reasonable annual increase in healthcare spending of 2.9 percent between 2009 and 2013, the out-ofpocket expenses for hospitalized consumers grew more than twice that rate. In order to keep premium costs down, employers have been shifting more of the cost of care to employees through higher deductibles and coinsurance. In the past, most of the out-of-pocket expenses were for non-inpatient visits and procedures. Since the vast majority of consumers
will not be hospitalized in any given year, most probably overlook hospital benefits and coverages when considering a plan.
Overall Spending Down, But...
According to the Robert Wood Johnson Foundation, the ACA can take some credit for slowing down the annual increase in healthcare spending. The study says we could spend $2.6 trillion less this decade (2010-19) than originally projected prior to the passage of the ACA in 2006. Analysts attribute some of the slowdown to the recession that began in 2008. Before the passage of the ACA, trustees of the Medicare hospital fund predicted they would run out of money by next year. The fund is now projected to stretch through 2028. The historic battles between insurance companies and providers must end if there are to be meaningful decreases in costs and increases in value or outcome. More than just collaboration, there must be aligned incentives among insurers, hospitals, physicians and drug manufacturers.
Huge Fraud Bust
Last month, more than 300 physicians, nurses and other professionals across 36 federal districts were arrested by the Medicare Fraud Strike Force. They are accused of bilking Medicare for over $900 million in false claims.
Data Breaches Costly
The average data breach costs an organization an average of almost $4 million per incident per a study sponsored by IBM. The cost of a hospital breach is about $355 per record up $100 from 2013. The study found that slow responses to a breach resulted in much more damage to an
August 2016 •
organization.
Advanced Practice Clinicians
The debate about increasing the scope of practice for nurse practitioners and physician assistants continues. Advocates for increasing their scope of practice point to advanced technology, low malpractice experience and the projected physician shortage. Those opposed believe increasing the scope of practice will result in more mistakes, more unnecessary care (tests) and poorer quality of care. The scope of practice varies by state. Many states — like New York — still require a formal relationship with a physician while other states allow them to practice relatively independently. The scope of practice debate often gets political. While the AMA tends to be against expanding the scope of practice, virtually none of my hospital or physician clients that employ advanced practitioners are opposed to expanding their roles. According to a recent study published in the Annals of Internal Medicine, advanced practitioners were no more likely to order unnecessary care (lab, X-ray, drugs) than physicians.
George W. Chapman is a healthcare consultant who works with hospitals and medical groups. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Meet
Your Doctor
By Chris Motola
Vijay S. Iyer, M.D. Interventional cardiologist talks about how 3-D printer technology is helping in the treatment of patients with cardiac problems
Study: Use of Chiropractic in the VA Rising Steeply
T
he use of chiropractic services in the Department of Veterans Affairs (VA) health care system has seen a steep rise over more than a decade, according to research published in the Journal of Manipulative and Physiological Therapeutics (JMPT), the official scientific journal of the American Chiropractic Association (ACA). The study’s authors, who analyzed VA national data collected between 2004 and 2015, discovered an increase of more than 800 percent in the number of patients receiving the services of doctors of chiropractic. While authors attribute the increase to a natural growth of the chiropractic service, which was only implemented on-site at the VA in 2004, they also suggest it may be attributed to the successful performance of VA chiropractors and the perceived value of their care, among other factors. “The fact that these services have expanded consistently and substantially beyond the minimum mandated level may suggest that some VA decision-makers perceive value in providing chiropractic care,” the study notes. Key findings from the study show that: • the annual number of patients seen in VA chiropractic clinics increased by 821 percent; • the annual number of chiropractic visits increased by 694 percent; • the total number of chiropractic clinics grew from 27 to 65 (9 percent annually); • the number of chiropractor employees rose from 13 to 86 (21 percent annually); and • female and younger patients received chiropractic care at VA clinics at a greater rate than the national VA outpatient population. “This demographic tendency is consistent with the cohort of veterans from the recent conflicts in Iraq and Afghanistan, which is known to have a high prevalence of musculoskeletal conditions,” the study authors note.
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Q: 3-D printing has been making some noise in the realm of prosthetics, but how does it affect cardiology? A: For our purposes, we’ve used it for procedural planning of complex procedures. But we’ve also used it to teach purposes and product demonstrations — for example 3-D printing a model of someone’s heart and showing how a device would interact with it. We’ve also used it for student training. But the most utilitarian use for it is for complex mitrovalve procedures with a trans-catheter approach. So we’d use 3-D printing to make sure we can actually implant the valve on that particular patient by the best means possible. For example, would a stiffer wire work better or a softer one? Q: How widely available is this tech? A: It’s not. It’s still expensive. The more complex 3-D printing you need to do, the more expensive it is. There are 3-D printers available that aren’t super-expensive, but for what we do, it can take up to two or three days to print. It’s not a trivial endeavor and it’s not necessarily something we can or even should do in every case. But the type of printing we’re doing isn’t widely available.
of tissue. With the multi-material printing that we do, we can really mimic the type of material you’re going to encounter. So if there’s calcium present, you can make the calcium harder than the surrounding tissue. Using the different materials is really key to procedural planning if you really want to get a sense for how a device is going to work in a particular individual. Virtual planning can never really get you to that level of accuracy. Q: Is it more useful for minimally invasive surgery or more traditional surgeries? A: We don’t really think of it from that perspective. Where it’s most useful is when you don’t know how a particular device will perform or be deployed in a new situation. Or, if there are procedural aspects, to how the device can be deployed to optimize it and minimize complications. I’m not sure how helpful it would be for open procedures unless you wanted to practice a repair and see how an instrument would work in that setting. The biggest benefit is with minimally invasive procedures. Q: Where do you see future applications of this technology going? Do you think we’ll be able to print the actual devices in the near future? A: Once the cost comes down and you’re able to print more complex things, theoretically you could individualize any number of procedures on levels we haven’t seen before. Where we have used it is primarily complex procedure planning. So if there’s a tiny catheter valve you want implanted and you have three different devices, instead of implanting the device, you can implant it on the model and get a sense of how it will perform on an individual patient.
Q: As far as accuracy goes, how does it compare to digital modeling? A: Computer modeling can never really model the feel
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016
A:
Q: So far what effect has it had on outcomes? There’s
very little data from a true, largescale study. In our limited use, we feel we have benefited greatly from being able to plan procedures and look at how the devices fit into that model. Q: Is this purely happening in cardiology right now? A: There’s been models made for other scenarios. Really, the potential is limited only by our imagination. As it becomes more widespread, physicians of different specialties will begin to get a sense of how they can use it. it?
Q: How often are you able to use
A: I have a case planned for, not this week, but the week after where we have complex mitrovalve case. We had the CAT scan this week. We’ve looked at the images [and] fed them into the printer. Monday and Tuesday we’ll look at the model and come up with a plan for next Wednesday. Q: Are you able to visualize structural flaws? Does it help with diagnoses? A: Potentially, but imaging capability is good enough now that we don’t really need to print out a model to see that. We’re mainly looking at interactions and trying to understand the benefits of therapies. Q: Does that require additional technicians or engineers? A: We have engineers who help us with the printing and modeling. Q: Cardiology seems like it’s on the forefront of medical technology in general. A: Cardiology has always been on the forefront of medical technology, especially minimally invasive procedures. Of course, research tends to go in the direction of the market, and there’s a large demand for cardiology due to the high rates of mortality from heart disease. It’s just a natural product of that, and some of the best and brightest working in cardiology.
Lifelines Name: Vijay S. Iyer Position: Associate professor at the department of medicine, Jacobs School of Medicine and Biomedical Sciences at UB; interventional cardiologist with UBMD Internal Medicine; and medical director of cardiac services at Buffalo General Medical Center. He also directs the Complex Valve clinic at BGMC and the Structural Heart Interventions Clinic at both BGMC and the Gates Vascular Institute. Hometown: Mumbai, India Education: Fellowship, interventional cardiology, University of Minnesota (2009); fellowship, cardiovascular disease, University at Buffalo (2006); postdoctoral fellow, division of cardiology, University at Buffalo (2003); PhD, pharmacology, Drexel University, Philadelphia (2001); medical degree, internal medicine, Grant Medical College, Maharashtra University Of Health Sciences (1995) Affiliations: Buffalo General Hospital; Erie County Medical Center Organizations: American College of Cardiology Family: Son, 12 Hobbies: Reading, traveling, watching movies
Jason Rogers, Chris Cooke, Joe Cooke, all from the Riverside area in Buffalo, as they arrived in Calfornia earlier this year. The trio embarked on a cross-country walk that took them through 12 states in 12 months. Their goal was to lose weight — and have some fun in the process.
A 2,700-Mile Walk Buffalo-area trio makes 2,700-mile cross-country walk for health — and loses dozens of pounds in the process
By Catherine Miller
A
t 478 pounds, Jason Rogers was at his all-time high weight during his 2013 physical. His doctor recommended gastric-bypass surgery. “There has to be an alternative,” thought Jason, who had struggled with weight and health-related issues most of his life. Jason was determined to do what he needed to do to stay out of the operating room. “I knew I needed to lose weight and I wanted to avoid the surgery,” stated Jason. “So I started walking.” Walking has long been proclaimed in the medical community to be a great low-impact means to improve heart health and assist in weight loss. But starting out at 478 pounds is no easy task. So, beginning in the fall of 2013, Jason enlisted longtime friend Chris Cooke as his walking partner, which worked well for both of them as Chris was tipping the scale at 340 pounds. They started walking around the neighborhood a few blocks at a time. The blocks turned to a mile, and those miles began to add up to nearly a 10-miles-a-day walk — and it was working. The pounds began to drop and the energy levels were increasing in these men that hail from the Riverside area of Buffalo. By early spring, Jason had lost just over 90 pounds and Chris had lost 15. They were feeling better than they had in a long time. One day, one of them suggested during a daily
journey, “Hey, wouldn’t it be cool to just keep walking, and walk to California?” The cross-country concept struck a chord in each of them and they started doing a bit of online searching into people that had walked across the country — what gear they used, the issues they came across and the funding that was needed. Before long, Chris’ brother Joe Cooke, weighing in at 218 pounds, was also incorporated into the plan. Although Jason and Chris thought of this as a unique way to lose weight, Joe’s interest held more of a “document the trip and see the country”
appeal. So with a few months of planning and a couple practices on how to pack the converted baby strollers that would carry their gear, and pitch unanchored tents that would become their nightly recluse from their hiking mates, they took to the road in May 2015. “We were unrealistic and unprepared for what we were about to encounter,” stated Joe. “I really thought my one pair of sneakers would last the duration of the trip.” It wasn’t just sneakers that were underestimated. Types of food that were viable, ability to order prescrip-
Walking on a New Mexico road on New Year's Day — just after winter storm Goliath hit the area. August 2016 •
tion medications to nearby pharmacies for their medical conditions, and what products they actually needed and which were dispensable were hot topics at the onset.
Overcoming obstacles
Even the availability to find dry, available places to set up tent at night proved more of a challenge than anticipated. After being instructed by law enforcement that tenting was unavailable anywhere in the Route 5 area of Buffalo, their first night was spent at a friend’s home in Lackawanna. The trio learned early on that the trip could be a bit more problematic than anticipated. Despite their unforeseen woes, the tenacious trio did not give up. That one pair of sneakers eventually turned into approximately a dozen pairs of Brooks sneakers for each of them. The guys were specific to the make of sneakers, having promptly learned how to avoid blisters by staying with the same brand. It wasn’t long before they could anticipate the township they would be in when their sneakers began to give way, and could order shoes via their cell phones and Internet so they could be delivered to the post office of the upcoming town just as they arrived. They continually turned to the Internet for guidance and found financial assistance on their Go Fund Me page that was set up to help sub-
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A 2,700-Mile Walk
Three men, 12 states in 12 months
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sidize the trip, and applicable advice on their “2700 Mile Rotund Challenge” Facebook page that they had initiated to get the word out about their adventure. “We could not have finished the trip without our Facebook group,” Joe said. “They helped us whenever we had issues. Many of them were military and ex-military and had great advice.” Some of the tips shared were to use duct tape on the “hot spots” of their feet to minimize blistering. When dehydration hit them, they were told to use the color of their urine to determine if they should drink more water — “yellow meant drink more; clear for you’re good for now,” Joe said. Relying heavily on the Facebook advice of those who know how to “make do” without much, the trio leaned on the guidance of hundreds of people that followed their travels.
Flocks of folks went out of their way to assist the walkers. A group near Witchita, Kan., invited the trio to their Halloween party and allowed them to spend the night in their warm facility. Traveling routes previously traveled by William H. Bonney, also known as Billy the Kid, the guys hit New Mexico during a raging snow storm that lasted from Christmas through the New Year, and despite the locals being upset by the power outages, the Riverside trio enjoyed the dry, unheated shelter afforded them by a few new friends. They were accustomed to not having electric, and the weeklong respite from walking could not have been better timed. “Our bodies had taken a beating,” admitted Chris. “We needed a break.”
Kind reception
While state after state seemed
to experience out-of-the-ordinary weather just as the trio walked into town, the three guys experienced out-of-the-ordinary kindness and gestures of goodwill from total strangers they met. Postmasters bent the rules to allow packages to be delivered for them; Facebook allies met up to offer warm food and supplies; and time after time residents along the way offered up their grassy yards for a night of “lawn camping,” where the guys would assure the owners that there would be “no litter, no staking and no camp fires.” It became their lawn camping motto. Finally, on April 23, the trio walked into Santa Monica Pier, Calif. They were greeted by a host of supporters who came out to wish them well at the end of the journey. Upon arrival back in Buffalo nearly a year later, Joe’s weight was generally unchanged. Chris dropped from 340 pounds prior to his walk-
ing routine to 304 pounds. Jason, the most drastic change, dropped from 478 pounds that day at his doctor’s office to 332 pounds upon his return to Buffalo. At 6’3”, that dropped Jason’s Body Mass Index from 59.7 BMI to 41.5 BMI — an over 30 percent decrease. The Riverside trio continues to walk, and being home, are trying to eat healthier as well, a task that proved difficult on the road. Jason’s resting heart rate is 68 beats per minute, signifying good cardiovascular fitness, and in the same range as his walking comrades. While the guys are adjusting back to life with a roof and bed, their trip is one that has forever changed their lives. Miles between Buffalo and the Pacific Ocean at Santa Monica Pier? 2,700. Total weight loss between three friends during the trip? 182 pounds. Funds needed to get from Buffalo to sunny California? $14,615. Dollars spent on Brooks sneakers during their trip? $3,700. Memories spread over 12 states in 12 months for three men in their 30s, who have now walked their way to a healthier future? Priceless.
Michael Galligano, CEO of Shared Mobility Inc., the Buffalo-based nonprofit that partnered with Independent Health to bring Reddy bikeshare to Buffalo. Galligano is shown with a group of other bikers during a July 21 press conference at Delaware Park in Buffalo.
Reddy Bikeshare Comes to Buffalo A total of 200 ‘social bicycles’ are now available to bikers through 30 ‘stations’ around Buffalo By Katie Coleman
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eddy bikeshare is finally here, expanding access to active transportation with 200 bicycles available for rent at more than 30 locations across Buffalo. Each bike, which officials call “social bicycles,” has solar-powered GPS systems, built-in locks, lights and bells. The program was launched with a press conference and inaugural ride July 21 at Delaware Park. “Reddy bikeshare is the best new way to explore the city of Buffalo,” Page 8
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said Jennifer White, Reddy bikeshare’s marketing and communications executive. “Nothing like this exists in Buffalo.” Technology on the bikes makes them easy to use, and they track the amount of calories burned, trip distance and duration, along with estimated reduction in carbon dioxide emissions, and saving costs from leaving your car behind. “It’s fun, affordable and a great way to stay active and healthy,” White said.
Reddy bikeshare is a bike share mobility program that has been made possible by a partnership between Independent Health and Shared Mobility Inc. It can be accessed by downloading the SoBi app to your phone, which is similar to Uber, but for bikes. The app system displays the geographic locations of select Reddy bikeshare stations where bikes can be reserved or you can just walk up to a bike and enter your account number on the bike’s keypad. You’ll have to create a four-digit PIN to unlock and begin riding. “I decided to live car-free over two years ago to adopt this new, completely liberating lifestyle,” White said. “I feel great; I’m more
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016
connected to the community I live and work in and I’m the happiest I’ve ever been. It’s not for everyone, but I do think this new program will allow folks to take less trips with their car and realize how fun it can be to exercise while you commute.” Locations for the bike stations include Delaware Park, Buffalo Museum of Science, RiverWorks, Canalside, Broadway Market, Allentown and Elmwood Village neighborhoods, and the Buffalo & Erie County Public Library. Bike stations will continue to expand, as more desired locations are determined. There will be free parking zones located on Elmwood Avenue, Allen Street, downtown on Main Street, Broadway market, Buffalo Museum of Science, Buffalo State College, and Canisius College. Reddy racks outside of free parking zones will cost riders 25 cents to park. Public bike racks within city limits will cost riders $2. Reddy bikeshare also provides a functional use for those who need transport to and from work. Short term, monthly passes are $8.50 to activate plus 6 cents per minute. Annual passes are $55 plus 1 cent per minute. Group passes are $20 per month plus six cents per minute, and allow four users to ride under one account. Independent Health members receive 20 percent off the annual pass membership rate. You must be 18 or older and have a credit card to participate. For more information and to purchase a membership pass, go online at www.reddybikeshare.com, or download the SoBi mobile app. Contact Jennifer White at jen@reddybikeshare.com or at 716-407-7474.
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Coming Home Alone: Put Out the Welcome Mat . . . For Yourself
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remember it well. I was in my 20s, just starting out and working for a small non-profit agency. I was asked to deliver a document to one of our board members, and I set out to find her house in one of Rochester’s older, gentrified neighborhoods. As I walked up the steps to Jane’s front porch, three things caught my eye: the fresh flowers in a hand-painted ceramic pitcher, the tasteful wreath on her door and a doormat that simply said, “All are welcome here.” A good feeling came over me. I announced my arrival by softly tapping the sweet little heart-shaped iron knocker on her front door. Then I waited. I stood on Jane’s porch feeling as if I had arrived at a special place — a place that held the promise of comfort and hospitality. When Jane answered the door and invited me in, I saw that she had brought the warmth of her front porch into her home. I walked into an oasis of rich earth tones, subtle lighting and artwork and objects from around the world that invited inspection. I just wanted to plop myself down into one of her overstuffed
tapestry chairs and savor the warm embrace of her home. And so it came as a big surprise to me when Jane told me she lived alone. I remember thinking: “What? This can’t be.” It just didn’t add up. I had assumed that a home this wonderful — a home this lovely and complete — could only be the home of a family or, at the very least, a couple. But no; this was Jane’s home. Her retreat. Her wonderful life. Little did I know that, years later, my experience on Jane’s front porch would stay with me and influence the way I decorate and furnish my home inside and out. Unbeknownst to her, she was a role model and, by example, showed me that a house can be a home, even when it’s occupied by only one person. When I moved into my own home after my divorce, I didn’t immediately follow Jane’s good example. I didn’t feel up to it. The walls stayed bare for far too long and I didn’t fully unpack for months. The worst part was coming home to a dark, empty house. In fact, it was so depressing, I often avoided going home after work and became a vagabond of sorts, working late or going
KIDS Corner Early Bedtime for Preschoolers, Healthier Weight Later? Getting shuteye by 8 p.m. appeared linked with lower obesity risk as teens, researchers say
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ending preschoolers off to bed early may bring them an unexpected benefit: less chance of obesity when they are teens. So suggests research that compared preschoolers who went to bed at 8 p.m. with same-age kids who had later bedtimes. A team at the Ohio State University College of Public Health found that a bedtime just one hour later seemed to double the likelihood that young children will be obese teens. “For parents, this reinforces the importance of establishing a bedtime
routine,” said the study’s lead author, Sarah Anderson, an associate professor of epidemiology. “It’s something concrete that families can do to lower their child’s risk.” She added that the earlier bedtime is also likely to benefit youngsters’ social and emotional development as well as their brain development. The study reviewed data on nearly 1,000 children who were part of a study that followed healthy babies born in 1991 at 10 U.S. locations.
to the mall until I had no choice but to pull into my driveway. I knew I had to make some changes and that’s when I recalled Jane’s front porch. Thinking back on that experience, I found the inspiration to make my own home inviting for the most important visitor of all: myself. I now take special care to create an environment — and especially a front porch — that warmly greets me on my return home. If returning home alone triggers feelings of loneliness and loss for you, you might consider making some changes yourself. Here’s what works for me: ■ Setting the stage. I want to feel welcome even before I set foot on my front porch. That’s why you’ll find flameless candles glowing in my windows all year long, not just during the holidays. Programmed with timers, the candles come on at dusk and their soft luminescence fills me with warmth and security as I approach my home after dark. ■ Making and keeping things nice. It’s no fun (in fact, it can be a real downer) to come home to a dirty front porch covered with cobwebs, peeling paint and dead leaves or lawn clippings. I’ve learned that lesson! I now hang a handmade artisan broom on my porch, and use it almost every day. And on a weekly basis, I clean the moths and “bug juice” off my porch lanterns, window sills and door frame. Stepping onto a nice, clean and uncluttered porch makes me feel good about myself. A sense of pride wells up in me before I even walk through the threshold. That little ego boost gets my evening off to a good
start. ■ Adding the inspiration. I see my porch as a blank canvas, and I’m the artist. I delight in making decorative changes that reflect the seasons, capture my taste, and stimulate the senses — small inspirational changes that make coming home a joy. The soft sound of wind chimes has an immediate soothing effect, my “Believe” wreath reminds me to have faith and my charming little chalkboard often sports messages from visiting friends and relatives. One friend recently wrote “Welcome Home, Gwenn.” His kind message is still there, and I enjoy this friendly greeting on a daily basis. I know that coming home alone can be a challenge, especially if you are accustomed to returning to a house filled with the hussle-bussle of family life. I also know that making “welcome” changes can ease the way into a new life and home. Roll out the welcome mat for yourself and discover all the good things that may arrive at your doorstep! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, N.Y. For information about her upcoming workshops or to invite Voelckers to speak, call 585-6247887 or email: gvoelckers@rochester. rr.com.
More Teens Show Evidence of Early Hearing Damage
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ew research into the ringing-ear condition known as tinnitus points to an alarming level of early hearing damage in young people who are exposed to loud music, prompting a warning from a leading Canadian researcher in the field. “It’s a growing problem and I think it’s going to get worse,” says Larry Roberts of McMaster’s department of psychology, neuroscience and behavior, the only Canadian author of a paper published in June in the journal Scientific Reports. “My personal view is that there is a major public health challenge coming down the road in terms of difficulties with hearing.” The researchers interviewed and performed detailed hearing tests on a group of 170 students between 11 and 17 years old, learning that almost all of them engage in “risky listening habits” — at parties, clubs
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and on personal listening devices — and that more than a quarter of them are already experiencing persistent tinnitus, a ringing or buzzing in the ears that more typically affects people over 50. Further testing of the same subjects — all students at the same school in São Paulo, Brazil — showed that even though they could still hear as well as their peers, those experiencing tinnitus were more likely to have a significantly reduced tolerance for loud noise, which is considered a sign of hidden damage to the nerves that are used in processing sound, damage that can foretell serious hearing impairment later in life. “The levels of sound exposure that are quite commonplace in our environment, particularly among youth, appear to be sufficient to produce hidden cochlear injuries.“ says Roberts. “The message is, ‘Protect your ears.’”
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SmartBites The skinny on healthy eating
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Surprising News About Peaches
’m always on the lookout for foods that may prevent or arrest cancer. Since mounting evidence shows that the foods we eat weigh heavily in the war against cancer, it just makes sense to consume as many of these foods as we can.
Never in my wildest dreams did I think that peaches — sweet, luscious, gorgeous peaches — would fall into that category. Broccoli? Yes. Garlic? No question. But peaches? Researchers at Texas A&M University, in concert with food scientist
Giuliana Noratto, say “yes,” especially when it comes to breast cancer. In a first-of-its-kind study, published online in the Journal of Nutritional Biochemistry, Noratto and her colleagues found that peach extracts drive breast cancer cells in mice to self-destruct, while leaving normal ones intact. Two powerful antioxidants found in peaches appear to be the frontline warriors. According to Noratto, we can get the same dose as the mice by eating two to three fresh peaches a day. Canned peaches, she said, don’t pack the same cancer-fighting punch. Of course, this is but one study and one team’s findings, but it certainly shows promise. On the nutrition front, peaches rock with healthy doses of fiber, vitamins C and A, niacin and potassium.
Most Americans Are Eating Better (No Kidding!)
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Helpful tips
Select peaches with a rich color and a sweet aroma. Ripe ones yield to gentle pressure. Avoid peaches that are overly soft or that have surface cuts and bruises. Slightly hard but mature peaches can be kept at room temperature until they ripen. To hasten ripening process, put peaches inside a closed paper bag and set on counter, out of direct sunlight.
Honey-Glazed Chicken with Peach Salsa Adapted from Bon Appetit 1 3/4 cups diced peaches (about 3 large) 1/4 cup diced red bell pepper 1/4 cup chopped green onions 3 tablespoons fresh lime juice, divided 2 tablespoons chopped fresh cilantro or mint 1 tablespoon minced seeded jalapeño chile
2 teaspoons minced peeled fresh ginger, divided 1 garlic clove, minced 2 tablespoons soy sauce 2 teaspoons sesame oil 4 chicken breasts 2 tablespoons honey Fresh cilantro or mint leaves Mix peaches, red bell pepper, green onions, 2 tablespoons lime juice, chopped cilantro or mint, jalapeño, 1 teaspoon ginger, and garlic in small bowl to blend. Season to taste with salt and pepper. (Salsa can be made 2 hours ahead. Cover and refrigerate.) Whisk soy sauce, sesame oil, and remaining 1 teaspoon ginger in medium bowl to blend. Add chicken and stir to coat. Marinate in refrigerator for 30 minutes, turning occasionally. Whisk honey and remaining 1 tablespoon lime juice in another small bowl. Preheat the grill to medium-high heat; lightly oil grill grate. Remove the chicken from marinade and place on grill. Grill the chicken until no longer pink inside, brushing occasionally with honey glaze, about six to eight minutes per side. Sprinkle chicken with cilantro or mint leaves and serve with peach salsa and (suggested) a side of brown rice. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
Now Pasta Is Good for Your Diet?
But government programs needed to improve overall diet for many, researchers say
ore than half of Americans were eating healthier in 2012 than they were in 1999, a new study finds. In fact, the percentage of adults with poor diets dropped from 56 percent to 46 percent during that period. By 2012, people ate more whole grains, fruit, nuts, seeds and fish while cutting back on sugar-sweetened drinks, the researchers found. "Many Americans are starting to pay attention to healthier diets. This is encouraging, and farmers, food manufacturers, retailers and restaurants should take notice," said lead researcher Dariush Mozaffarian. He is a physician who serves as dean of
Fiber keeps us regular and helps regulate cholesterol levels; vitamin C is a tissue-builder and immune-booster; vitamin A is essential for growth and healthy vision; niacin assists in the conversion of food to energy; and potassium helps control blood pressure. On the calorie front, peaches are remarkably low for such a sweet li’l thing: only 60 per medium peach. As for grams of sugar, peaches have fewer than an apple, more than an orange and about the same as a banana. Need a few more reasons to reach for a peach? Well, they’re delicious; they’re in season; and they’re awfully tasty with yogurt or vanilla ice cream.
the Tufts Friedman School of Nutrition Science and Policy in Boston. Despite these gains, the number of Americans eating an "ideal" diet increased only slightly, from 0.7 to about 1.5 percent, the investigators found. An ideal diet includes fruits, vegetables, fish, whole grains and less meat, salt and saturated fat. Moreover, disparities persisted in the quality of diet based on race or ethnicity, education and income. Among whites, those with a poor diet decreased from 54 percent to 43 percent. But little change was seen among blacks, Mexican-Americans and Hispanics, the findings showed.
Researchers link this Italian staple with lower BMI
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asta may have gotten a bad rap. New research suggests pasta — specifically noodles in this study — might actually help you lose weight. Moderate pasta consumption seems linked to lower chances of general and abdominal obesity, researchers found after analyzing data on thousands of Italians. "Our data show that enjoying pasta according to individuals' needs contributes to a healthy body mass index, lower waist circumference and better waist-hip ratio," said George Pounis, first author of the study. Previous research has touted the heart-healthy benefits of the Mediterranean diet, which is a way of eating rather than a specific meal plan. It emphasizes fruits, vegetables, grains, beans, peas and olive oil plus fish
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and poultry. However, little was known about how pasta — also a staple in the Mediterranean region — affected health, the researchers behind the new study said. This finding fills that gap, they believe. The results were published online July 4 in the journal Nutrition and Diabetes. "We have seen that consumption of pasta, contrary to what many think, is not associated with an increase in body weight, rather the opposite," Pounis added in a journal news release. Many people have shunned spaghetti, noodles and other types of pasta in recent years because of concerns they were fattening. The new study could potentially cause Americans and others to revise their views.
Golden Years
Great Gadgets for Aging Golfers
Gripping Aids
By Jim Miller
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here are actually a wide variety of nifty golf accessories and adaptive equipment that can help older golfers who struggle with injuries, arthritis or loss of mobility. Here are several products for different needs.
Bending Substitutes
The game of golf requires a lot of repetitive bending and stooping that comes with teeing up the ball, repairing divots, marking the ball on the green, retrieving a ball or tee on the ground, along with picking up a club, sand rake or flag stick off the ground. For teeing up the ball without bending over, consider one of the Northcroft Golf Tee-Up devices. These are long-handled tools (1.5 to 3 feet long) that have trigger-style handgrips and a jaw that holds the ball and tee for easy placement. They cost between $69 and $72 and are
available at NorthcroftGolf.com. For other tee-up solutions, see the Tee Pal ($55, TeePalPro.com) and Joe’s Original Backtee ($15, UprightGolf. com). NorthcroftGolf.com and UprightGolf.com also offer a variety of stoop-proof ball pickup accessories, divot repair and magnetic ball marker products ranging between $5 and $12. Or, if you just want a great all-around golf picker-upper, consider the Graball GrabAll Jaw — sold through Amazon.com for $10 for a package of two. It attaches to the handle end of your putter and chipper and is designed to pick up golf balls, flagsticks, putters and green side chippers.
To help alleviate your golf club gripping problem, there are specially designed golf gloves and grips that can make a big difference. The best gloves are the Bionic Golf Gloves (BionicGloves. com) that have extra padding in the palm and finger joints to improve grip. And the Power Glove (PowerGlove.com) that has a small strap attached to the glove that loops around the club grip to secure it in your hand. These run between $20 and $30. Another option is to get oversized grips installed on your clubs. This can make gripping the club easier and more comfortable, and are also very good at absorbing shock. Oversized grips are usually either one-sixteenth-inch or one-eighth-inch larger in diameter than a standard grip, and cost around $10 per grip. You can find these grips and have them installed at your local golf store or pro shop. Or, for a grip-and-glove combination fix, consider the Quantum Grip (QuantumGrip.com) that incorporates Velcro material recessed in the golf club grip and a companion golf glove that has mating Velcro material in the palm. Cost: $20 per grip, plus $35 per glove.
Vision Helper
If vision problems make finding the ball difficult, Chromax golf balls (ChromaxGolf.com) can make a big difference. These are reflective colored golf balls that make them appear larger and brighter. Cost: $10.50 for a three-pack.
Ergonomic Carts
There are also ergonomically designed golf carts that can help you transport your golf clubs around the course. If you like to walk, the Sun Mountain Sports Micro-Cart, V1 Sport Cart or Reflex Cart are great options. These are three and fourwheeled, lightweight push carts that that fold into a compact size for easy transport. Available at SunMountain. com for $200, $210 and $230. Or, for severe mobility loss, the SoloRider specialized electric golf cart (SoloRider.com) provides the ability to play from a seated or standing-but-supported position. Retailing for $9,450, plus a $550 shipping fee, this cart is lightweight and precisely balanced so it can be driven on tee boxes and greens without causing any damage. Federal ADA laws require that all publically owned golf courses allow them.
In the Market for an Adult Day Care Service? A By Jim Miller
dult day care services can be a great option for caregivers who work or for those who just need a break during the day. Here’s what you should know, along with some tips to help you find and choose one.
Adult Day Services
The business of adult day care services has grown rapidly in recent years. According to the National Adult Day Services Association, there are around 5,700 programs operating in the United States today. As the name implies, adult day care provides care for elderly seniors who cannot care for themselves at home. While services will vary from center to center, they typically provide personal care, meals and snacks, various activities and social interaction in a safe supportive environment. Additionally, many centers also provide health services such as medication management, various
therapies, exercise and transportation to and from the facility. Adult day care centers generally operate programs during normal business hours five days a week. However, some centers may offer services in the evenings and on weekends, too. Costs for care will vary as well, usually between $25 to more than $100 per day (the national average is $65/day), depending on where you live. Unfortunately, in most cases original Medicare (Part A and B) does not pay for adult day care, but some Medicare Advantage (Part C) plans, and many long-term care insurance policies do. But, most seniors or their families pay for care out-of-pocket. If your mom is lower income and can’t afford this, many states offer Medicaid waiver programs, and some have PACE programs that provide financial assistance. Contact your state Medicaid office (see Medicaid.gov) for more information.
The VA even provides adult day care to eligible veterans enrolled in their Medical Benefits Package. See VA.gov/geriatrics to learn more.
How to Choose
Your first step in shopping for an adult day center is to determine the kinds of services your mother and you need. After you do that, here are some tips to help you locate and choose a good provider. Start by contacting the county’s office for the aging (call 800-6771116 to get your local number) to get referrals to adult day service programs in your area. You can also search online at the National Adult Day Services Association (NADSA) website at NADSA.org/locator, or check your phone book yellow pages under “Adult Day Care” or “Senior Services.” Once you have a list of a few centers, call them to find out their eligibility criteria, if they offer the types of services your mother needs, if they
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are accepting new clients, their hours of operation, if they’re licensed and/ or registered with a state agency (this is not required in all states) and what they charge. After you identify a few good centers, go in for a visit. Find out about the staffing ratio (at least one staff member for every six participants is recommended) and what kind of training they have. While you’re there, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem friendly and knowledgeable? Also be sure to taste the food, and consider making an unannounced visit. To help you rate your visit, the NADSA offers a helpful checklist of questions to ask at NADSA.org — click on “Choosing a Center.” Then, after your visit, be sure to check their references. Get names and phone numbers of at least two or three families who have used the center you are considering and call them.
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Golden Years Tips for Visiting a Memory Care Patient By Deborah Jeanne Sergeant
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f your loved one lives in a memory care facility, visiting may seem intimidating. Perhaps you have visited before and the interaction did not go well. Or maybe you have not visited because you don’t know what to say or what to expect. Planning ahead can make your visit more enjoyable for both of you. Call the facility ahead of time to plan your visit for the time of day that your loved one typically feels at ease. Call the same day to see how your loved one is feeling that day so you can visit on a “good” day. Turning off the TV or radio can help the resident focus better, as can spending time in a place where he feels relaxed, such as his room or the garden. Set realistic expectations. “A lot of times, families have a prerequisite of how the person should be talking to them or how the conversation should go,” said Cheryl O’Brien, director of social services at Elderwood Senior Care in Buffalo. “It won’t be the normal conversation that goes back and forth,” she added. “It will be more one-sided. The person with memory deficits will struggle knowing what’s going on, depending on the stage. They don’t understand the vocabulary and who
you are. Each day is a new day.” Get on eye level and slowly and clearly introduce yourself so he won’t have to struggle for your name. People in the early stages of dementia realize that activities and relationships they once enjoyed are slipping away. Don’t try to keep your loved one up-to-date on what he’s missing, unless he asks for this information. It’s important to realize that especially in the mid to latter stages of dementia, people live in a different reality or think their stay is temporary. O’Brien at Elderwood Senior Care recalled a 107-year-old resident who believed her parents were coming for her. “I fibbed and said they were coming later,” O’Brien said. “One family brought in funeral cards to show that her parents and husband died. She began crying because to her, they all died that day. I have one woman who thinks her husband’s on a trip. He has passed away, but the family doesn’t think it will benefit her to know.” People with dementia may latch onto different eras of their past that still remain intact in their minds. But that can change.
Pictured from left are Cheryl O’Brien, director of social services at Elderwood at Amherst; resident Edith Sawicki and her daughter, Gail Bolster, discussing articles in the daily newspaper.
“You have to figure out how old they think they are the day you’re visiting,” said Terra DePasquale, a licensed practical nurse and memory care coordinator, Brompton Heights Assisted Living, Memory Care, and Independent Living in Williamsville. She said that people with dementia struggle to hold on to thoughts, so let him interrupt as needed before a thought escapes. Since many people with dementia oftentimes have difficulty expressing their thoughts and understanding speech, asking yes/ no questions helps them, along with using visual cues. Some memory care patients ask the same question repeatedly, but visitors must remain patient. “Having dementia is a form of brain failure,” DePasquale said. “They’re not attempting to agitate you by asking that question over and over. That part of their brain doesn’t work anymore.” Dementia causes some people to experience changes in personality. “Never argue or reason or confront them,” said Rachel Hughes, director of life enhancement at Mercy Nursing Facility at OLV in Buffalo.”Practice 100 percent forgiveness.” She recommends using a family photo album, listening to music the patient enjoys, or bring in an animal (call first). Talk about interests, current events or your surroundings, but don’t bring up any painful or embarrassing subjects. Hughes advises visitors of mid- to late-stage dementia patients to avoid asking questions, but instead to comment on the immediate surroundings in order to relate to them. Ashley Kasprzak, sales and operations specialist at Eden Heights of West Seneca in Buffalo, welcomes visitors to take part in on-site activities. “Most communities plan
A resident at Eden Heights of West Seneca in Buffalo looks through a photo album with a visitor. activities well in advance and promote them through social media,” she said. “There is no greater way to show you want to be a part of a loved one’s new life than participating in parties and entertainment with that person.” Sharing a simple game or craft project can also brighten your loved one’s day, as can visiting with pets or children. Ask in advance to make sure pets are okay, and only bring leashed, well mannered pets that are up-to-date on vaccinations.
Memory Loss: Normal or a Sign of Trouble?
Everyone experiences some forgetfulness, but the FDA explains when to be concerned
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ild memory lapses such as forgetting where you put your keys or reading glasses, though worrisome, are normal, experts say. But certain memory problems — such as putting your car keys in the fridge — may indicate a more serious issue. So, what kind of memory issue suggests the need for a medical assessment? Some examples include: memory loss that disrupts daily activities such as balancing a checkbook, maintainPage 12
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ing personal hygiene and driving; or frequent memory lapses such as regularly forgetting appointments or where you parked your car, the U.S. Food and Drug Administration (FDA) said in a news release. Other warning signs include forgetting whole conversations, forgetting the names of relatives or close friends, frequently repeating yourself, or asking the same questions in the same conversation. Another red flag is memory loss that’s getting worse over time. There are a number of things you
can do that might help reduce the risk of developing memory problems: keeping cholesterol and blood pressure levels low; not smoking and not drinking too much alcohol; eating a healthy diet; engaging in lots of social activity; and keeping your brain active by reading, writing, learning a new skill, playing games and gardening. There are a number of causes of memory loss, including medications; heavy drinking; stress; depression; head injury; infections such as HIV, tuberculosis, syphilis and herpes;
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016
thyroid problems; lack of quality sleep; and low levels of vitamins B1 and B12. Many of these causes can be helped with medical treatment, the FDA noted. “As part of the normal aging process, it can be harder for some people to recall some types of information, such as the names of individuals. Mild cognitive impairment, however, is a condition characterized by a memory deficit beyond that expected for age, but is not sufficient to impair day-to-day activities,” according to the news release.
Golden Years
Thursday, August 11 10 to Noon
Food: Good and Cheap
Experts offer seniors strategies on how to eat healthfully on a tight budget
Now Smoke FREE
By Deborah Jeanne Sergeant
I
f you’re a senior with a fixed income, it may seem difficult to eat a well-balanced diet. Food prices increase, but your grocery budget doesn’t. With some planning, you can eat healthfully. Local experts offered a few strategies to help stretch your dollars and find the most affordable nutritious food. Saving money on your overall grocery bill can help you better afford healthful foods, such as lean sources of protein and a variety of whole fruits, vegetables and grains. Purchase ingredients, not prepared foods, said Mary Jo Parker, certified dietitian nutritionist, who owns a self-named nutrition business based in Buffalo. She recommends purchasing chicken when it’s on sale “to prepare it ahead of time and freeze it or package it raw in individual pieces,” she said. If you have cooked the meat, all you need to do is take it out of the freezer and place it in the fridge the night before you plan to heat it and eat it. Choose inexpensive cuts of meat and slow cook or use a meat mallet to tenderize. Lentils and beans provide a good source of economical protein, plus fiber. Parker recommends rinsing canned beans to reduce the sodium content. The dietitian added that eggs and nut butters can also offer versatile and inexpensive sources of protein, especially if dental issues make meat difficult to chew. Cottage cheese and Greek yogurt also provide protein and calcium inexpensively. “Canned fish is pretty reasonable and a wonderful source of protein,” Parker said. “Tuna, salmon, sardines are very rich in heart-healthy omega-3 fat. For produce, she advises clients to shop at farmers’ markets for seasonal fruits and vegetables to help save money. But after summer, frozen foods can help trim costs. Since they’re flash frozen after harvest, they may retain more nutrients than fresh items shipped to the store several days after harvest. “Usually, when we’re talking about canned items, they tend to be higher in sodium and less nutrient dense,” Parker said. The processing reduces its nutrients. Tap into savvy shopping strategies, such as planning meals for the week around what’s on sale, and
comparing prices of generic items versus the price of a name-brand item on sale and/or with a coupon. Always compare the unit price, not the general price. Most stores indicate the price per weight or volume on the shelf tag in smaller print in a small orange or yellow square. That way you can know you truly have the best price. Cooking at home offers the highest nutrition and best savings since you’re in control of what goes into your meals and you’re not paying anyone else to cook for you.
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Research websites that can help you cook more economically, such as www.jsyfruitveggies.org, which features seasonal recipes; www. cookingmatters.org, to find recipes that focus on pantry staples; www. ewg.org/goodfood, for great tips for finding nutrient dense foods in each food group and www.leannebrown. com, which offers a free PDF copy of Good and Cheap a cookbook that can feed a person for $4 a day. The USDA’s site — www. whatscooking.fns.usda.gov — shows how much a particular recipe costs to make. Users can search for recipes based on numerous filters, too. Eating away from home can perk up a flagging appetite and provide a variety of foods with a different nutritional profile. Bob Angelino, site manager for Kenmore Senior Nutrition in Buffalo, agrees. “Would you rather eat alone or with someone else?” he asked. Instead of dining out at restaurants, consider joining community meals. Many churches host free meals or dish-to-pass meals open to the community and advertise them in the shopping flyers and newspapers. Angelino’s organization receives subsidized meals from Erie County to serve to seniors at lunch Monday through Friday for $3.50, although no one is turned away. Plus the center receives day-old baked goods for distribution to seniors to take home. If you need help to afford enough nutritious food to eat, food pantries operated by churches and other charitable organizations may help you. Erie County lists food pantries, senior dining services and grocery delivery services for seniors
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Call 685-4871 IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 13
Golden Years
Cataracts: What You Should Know
Condition can start affecting people as early as 40 By Nancy Cardillo
A
s we age, our bodies undergo many changes, including diminished eyesight. Presbyopia — the age-related eye condition that makes it more difficult to see very close — usually begins to appear around age 40. Cataracts are also very common, often showing up when people hit their 40s or 50s; however, at that point they are typically small and won’t affect vision. As people reach their 60s, however, cataracts can begin to steal people’s vision. By age 80, more than half of all Americans either have a cataract or have had cataract surgery, according to the National Eye Institute.
What exactly is a cataract?
Simply put, a cataract is a clouding of the eye’s lens — the transparent part of the eye that helps to focus light or images on the retina — that negatively affects vision. In a normal eye, light will pass through the lens to the light-sensitive tissue at the back of the eye known as the retina. Once light reaches the retina, it is changed into nerve signals that are sent to the brain.
The clearer the lens, the sharper the image. But if a cataract is clouding the lens, the image will be blurred. An eye’s lens is made up mostly of water and protein. As we age, the protein can clump, which clouds the lens and creates a cataract, which can grow and cloud more of the lens if not removed. A cataract can occur in either or both eyes. Some develop slowly over the years, with minimal visual changes; others develop rapidly over a few weeks or months.
What causes a cataract?
“Cataracts usually develop as part of the normal aging process,” says David P. Montesanti, a boardcertified surgeon at Eye Care & Vision Associates (ECVA), an ophthalmological practice with four offices in Western New York. “But they can also be caused by diabetes, eye injury, smoking, medications and even by prolonged unprotected exposure to the sun.” There are some things you can do to protect your vision, such as wearing sunglasses and a hat with a visor. If you smoke, stop. Eating
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David P. Montesanti, a board-certified surgeon with Eye Care & Vision Associates, uses an ophthalmoscope to examine a patient’s eyes. green, leafy vegetables, fruit and food with antioxidants can also help reduce your risk.
What are the symptoms of a cataract?
The most common symptoms of a cataract include cloudy or blurred vision; colors that seem faded; glare or light sensitivity; poor night vision; double vision or frequent prescription changes for your glasses or contacts. If you experience any of these symptoms, see your eye care professional, who can detect a cataract through a series of simple, painless tests.
How is a cataract treated?
The only real treatment for cataracts is surgical removal, one of the most common operations
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For a few days after surgery, your doctor may ask you to use eye drops to help healing and decrease the risk of infection. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs and do light household chores. “Patients can experience itching, discharge and mild discomfort after the surgery, as well as sensitivity to light and touch,” says Montesanti. “That typically disappears after just a few days.” In most cases, healing will be complete within four weeks and you’ll experience clear vision once again!
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performed in the United States today. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward. But, in about 10 percent of people, a thin membrane can form on the back of the implant. This can be removed simply and in just a few minutes with a laser. Once removed, a cataract cannot grow back. “There have been considerable advancements in cataract surgery,” says Montesanti. “Today, most cataract surgeries are done in an outpatient setting by ultrasound disruption of the lens, called phacoemulsification, with placement of a clear acrylic or silicone lens implant, called an intraocular lens. An IOL requires no care and becomes a permanent part of your eye, improving your vision. You will not feel or see the new lens.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016
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Golden Years
Turning the Big 6-0
Radio host, fitness trainer Robbie Raugh of Williamsville proves that age is simply no barrier By Michael J. Billoni
W
hen most of us see the “Big 6-0” birthday on the horizon, a great deal of anxiety may come over us. For Robbie Raugh, an international certified fitness trainer, registered nurse, radio host, health and fitness expert, wife and mother of two daughters, celebrating her 60th birthday recently was time for her to declare “60 is the new 40!” “I just hit a milestone of 60 years young and I cannot believe it,” says the resident of Williamsville and a devout Christian who hosts a Saturday morning radio show on WDCX 99.5 FM that also streams worldwide. Raugh has also regularly appeared on WKBW’s AM Buffalo with Linda Pellegrino for the past 20 years. “I am, however, living the reality that age is just a number if you take care of yourself every day. Getting older earns us benefits and we should eagerly embrace and celebrate them,” she explains during a conversation at her kitchen table as she sips water and munches on raw veggies. “While I look back nostalgically at my youth, I wouldn’t want to be 20 again today. I feel a sense of satisfaction, accomplishment, wisdom, joy and peace in my life today. I didn’t have that in those early days.” Raugh is a strong believer that “health is wealth” and as everyone gets older, we all must fight hard to stay healthy everyday by exercising, watching what we eat and getting plenty of rest. “God gives us a responsibility to take care of this mobile home or temporary earth suite, as I like to call it,” she explains. “This life is but a vapor — do we really want to spend it being sick and thick and tired? I don’t and the choice is yours.” To help you with that choice, Raugh has authored her first book: “The Raw Truth Recharge — 7 Truths to Health and Fitness.” Information about purchasing the book and workout DVDs she has produced are on her website at www. RobbieRaugh.com. The book can also be purchased locally or on Amazon.com and Barnesandnoble.com. Believing that our lifestyle and the choices we make each day matter in our overall health, Raugh wrote the book to show it is more than what we eat and how much we exercise that makes us well. “Although eating and exercising certainly helps, I have always counted my blessings — family, friends and my health. Now at 60, that is more important than ever
Robbie Raugh, an international certified fitness trainer, registered nurse, radio host, health and fitness expert, recently celebrated 60 years. “60 is the new 40,” she says. Next to her is Jon Summer, co host of AM Buffalo on WKBW-TV. before,” she said. “What really matters, and this is what my book is all about, is faith, family, food, fitness, detox, sleep and stress management. They are all vital to the health of our mind, body, soul and spirit. “We know that with age comes wisdom and experience, and I am looking at things differently these days,” she added. “I have always counted my blessings but even more so now. I feel I have a better sense of purpose in my life, and I am seeing God’s plan roll out for me every day. I have been blessed to do what I love and feel that it matters for most of my life. How can anything be more fun?”
and our health,” Jill and Erin wrote. “Yes, she is certified, qualified, and amazingly talented. More than that, she sincerely cares about people and wants them to prosper in every way. The Kellys would not be where we are today without Robbie’s love, guidance and prayers. Her book will
transform your life.” Neil Boron of WDCX Radio lost 52 pounds, reduced his body fat by 30 percent and trimmed eight inches off his waist in just four months following her program. “Robbie Raugh knows what she is talking about,” he says with pride. “If you do what she says, it will change your life. I have way more energy and I feel fantastic.” Raugh, a native of North Tonawanda, began teaching fitness classes when Bally’s Fitness Clubs came to town nearly 40 years ago. Her co-ed classes became so popular that ESPN filmed a segment calling it the largest indoor exercise class in America. She quickly climbed the ladder at Bally’s to become the international group exercise director, overseeing 5,000 instructors in 400 clubs. Today, she teaches classes at the BAC for Women locations locally where she offers free “Raw Truth Health” seminars and healthy eating classes as well as offering them for medical practices or through her own private practice. She also is going to host her signature co-ed outdoor, highenergy Raw NRG kickboxing classes for Outer Harbor Buffalo on the waterfront, as well as other locations this summer. Reflecting on being 60 and what she has experienced in her life, Raugh sits back, looks outside at her beautiful yard and says, “I will embrace the next decade with open arms. If today were my last day, I would not want to spend it thinking about the “what if’s — shoulda and coulda.” “My family and close friends all want to live, love and be happy and healthy every day.”
Significant impact
The testimonials about the success of Raugh’s teachings and programs are numerous, including one from Hall of Fame Quarterback Jim Kelly’s wife, Jill and their daughter, Erin. “It would be near impossible in a few sentences to describe the impact Robbie Raugh has had on our lives
Robbie Raugh, right, has also regularly appeared on WKBW’s AM Buffalo with Linda Pellegrino for the past 20 years.
August 2016 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
•
Page 15
Depression Not Uncommon Among Elderly
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Isolation, loss of friends and loved ones are some factors that contribute to depression among seniors, say experts By Deborah Jeanne Sergeant
B
ecoming a “grumpy old man” or a “crabby old lady” isn’t a natural part of the aging pro-
cess. Aging increases the likelihood for certain risk factors for depression; however, older people can reduce their chances of depression. And those with depression can find relief. As people grow older, several factors can increase their risk of depression. Psychiatrist Joseph J. Alessi, who practices in Buffalo, said that the many losses that older people typically experience increase their risk for depression. “They have losses in relationships, health, activities, and what they can do,” he said. “It’s different than with younger people. When these losses occur, they can last longer.” He added that depression can seriously affect seniors’ health, can cause insomnia and increased risk of cardiac disease. Wende Birtch, a licensed mental health counselor and holistic counselor practicing at Mindful Birtch Psychotherapy in Williamsville, listed isolation as “a big risk factor” because of the loss of friends and loved ones as their friends die and their adult children and grandchildren live elsewhere. Seniors may also experience loss of hobbies and employment, untreated pain and decreased independence. These factors would negatively affect people of any age, but are likelier in older adulthood, according to Birtch. Older people also may experience more directly age-related complications. Birtch said that among people 60 and older, decreasing serotonin levels create higher risk for depression. The brain’s serotonin helps regulate emotions and mood. Kathleen Calabrese, Ph.D, offers counseling in Buffalo. She encourages Calabrese Page 16
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seniors to obtain a blood test to check their vitamin D and vitamin B levels. “Many of the elderly, if not with a geriatrician, don’t realize they’re out of balance with the substances that support a sense of wellbeing,” she said. “Supplements are needed.” Prescription medication can cause a greater risk of depression if the patient takes two medications contraindicated for each other or at a dose exceeding an elderly person’s ability to metabolize it effectively. “Their system isn’t the same as the 21-year-old the drug is tested on,” Calabrese said. “The medication issue is critical.” Addressing environmental, emotional and biological needs can help people with depression. Wendy Baum, licensed clinical social worker practicing in Buffalo, said that said that talk therapy and medication or a combination of the two prove helpful for most people. She added that people who are mildly depressed may find relief through lifestyle modification, such as more aerobic exercise, eating better and finding positive ways to spend time. Many derive pleasure from volunteering, too. Don’t count on a primary care physician to spot depression, especially if the visit is about a different malaise. Shareen Fox, licensed mental health counselor at Blossom Mental Health Counseling, PLLC in Buffalo, said, “Many just go to their GPs and get blown off. ‘Oh, you’re old. What do you expect?’” But depression is not a normal part of aging. Fox said that partially because depression is mistakenly considered a weakness, a large number of seniors don’t mention their struggle to their primary care provider or a counselor and attempt self-medication with drugs or alcohol. A lack of geriatricians and geriatric counselors also leaves depression untreated among the elderly. “Like any disease, if it’s left untreated, it will get worse,” Fox said. Look for signs of depression such as persistent sadness, unexplained fatigue, losing interest in activities previously enjoyed, isolation, low self worth, contemplating death or suicide, lack of mental focus, feeling hopeless, anxiety, unexplained body aches, irritability, unexplained changes in weight, sleeping, grooming and eating patterns.
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The Social Ask Security Office
From the Social Security District Office
Social Security Has a Full Basket of Useful Offerings
W
ho doesn’t love sharing a summer picnic with friends and family? Whether you plan one for everyone on your block or a quiet afternoon for two, you’ll need to bring a basket full of delectable goodies. When you’re sharing dishes with loved ones, whether you’re at home or away, you’ll be sure to make everyone happy with a variety of treats. In the service of securing today and tomorrow, Social Security has a full picnic basket of services. Our table is ready to serve millions of Americans online, by phone and in person in our network of field offices. It’s easy to pick the method that’s best for you from the comfort of your home or on the go. The quality service you expect from us is easy, secure, and convenient to access when you go online. Signing up for a My Social Security account will give you a secure and efficient way to interact with us and accomplish various tasks, including estimating your future benefits or managing your current benefits. You can sign up for your own account at www.socialsecurity.gov/myaccount and join the more than 25 million Americans who already conduct business with us online using My Social Security. Another way you can contact us is toll-free at 1-800-772-1213 (TTY 1-800-325-0778). Of course, you can
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016
also use the field office locator at www.socialsecurity.gov/agency/ contact to find your local field office, where you can speak with a Social Security employee face-to-face. What true summer picnic is complete without ice cream? When it comes to great flavors, there’s vanilla, mint, chocolate chip, rocky road … who can choose just one? Likewise, Social Security offers all the different types of benefits you’ll need at any stage of your life. Social Security has retirement benefits and the tools to help you plan for your retirement and apply for benefits online. But that’s not all. We also provide disability benefits to individuals with medical conditions that prevent them from working. If the disabled individual has dependent family members, they can also receive payments. There are also survivors benefits for widows, widowers, and deceased workers’ dependent children. When you create your my Social Security account, you can view your Social Security Statement to see estimates of the future retirement, disability, and survivors benefits you and your family may be eligible to receive. It’s a great day for a picnic! Social Security is opening up its picnic basket to share our great services and benefits, and you’re invited! Visit www.socialsecurity.gov today, and we’ll save you a place.
in good Child Safety
May 2016 • Issue 19
With 4.5 million dog bites occuring annually in the US, parents with young kids are advised to be careful before bringing a dog in their home
By Jim Miller
Dear Savvy Senior,
Who is eligible for Social Security survivor benefits? My ex-husband died last year at the age of 59, and I would like to find out if me, or my two kids – ages 13 and 16 – that we had together are eligible for anything? Divorced Widow Dear Divorced,
If your ex-husband worked and paid Social Security taxes, both you and your kids may very well be eligible for survivor benefits, but you need to act quickly because benefits are generally retroactive only up to six months. Here’s what you should know. Under Social Security law, when a person who has worked and paid Social Security taxes dies, certain members of that person’s family may be eligible for survivor benefits including spouses, former spouses and dependents. Here’s a breakdown of who may be eligible. • Widow(er)’s and divorced widow(er)’s: Surviving spouses are eligible to collect a monthly survivor benefit as early as age 60 (50 if disabled). Divorced surviving spouses are also eligible at this same age, if you were married at least 10 years and did not remarry before age 60 (50 if disabled), unless the marriage ends. How much you’ll receive will depend on how much money (earnings that were subject to Social Security taxes) your spouse or ex-spouse made over their lifetime, and the age in which you apply for survivors benefits. If you wait until your full retirement age (which is 66 for people born in 1945-1956 and will gradually increase to age 67 for people born in 1962 or later), you’ll receive 100 of your deceased spouses or ex-spouses benefit amount. But if you apply between age 60 and your full retirement age, your benefit will be somewhere between 71.5 — 99 percent of their benefit. To find out what percentage you can get under full retirement age visit ssa.gov/survivorplan/survivorchartred.htm. There is, however, one exception. Surviving spouses and ex-spouses who are caring for a child (or chil-
dren) of the deceased worker, and they are under age 16 or disabled, are eligible to receive 75 percent of the worker’s benefit amount at any age.
4
Teenage girls now try alcohol before boys do, says study
• Dependent parents: Benefits can also be paid to dependent parent(s) who are age 62 and older. For parents to qualify as dependents, the deceased worker would have had to provide at least one-half of the parent’s financial support. But be aware that Social Security has limits on how much a family can receive in monthly survivors benefits — usually 150 to 180 percent of the workers benefit. You also need to know that in addition to survivor benefits, surviving spouses or children are also eligible to receive a one-time death benefit of $255.
Maximizing Strategies
Social Security also provides surviving spouses and ex-spouses some nice strategies that can help boost your benefits. For example, you could take a reduced survivor benefit at age 60, and could switch to your own retirement benefit based on your earnings — between 62 and 70 — if it offers a higher payment. Or, if you’re already receiving retirement benefits on your work record, you could switch to survivors benefits if it offers a higher payment. You cannot, however, receive both benefits. You also need to know that if you collect a survivor benefit while working, and are under full retirement age, your benefits may be reduced depending on your earnings. For more information, visit ssa. gov/survivorplan or call 800-7721213. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
Need to Know Now
Page 7
WHAT’S THE SKINNY ON APPLE CIDER VINEGAR?
Going on Vacation? A week’s vacation may leave many adults with a heavier midsection — extra weight that can hang around even six weeks post-vacation.
bfohealth.com
April 2016 • Issue 18
priceless
Buffalo & WNY’s Healthcare Newspaper
Online Breast Milk There has been an explosion of websites that buy and sell breast milk and traffic in those sites has continued to rise. Transactions have more than doubled in the past three years. And it’s not just moms buying it. But how Page 14 safe is buying breast milk online?
One Year, No Domestic Line Infections Violence
Beloved Buffalo Sabres broadcaster and throat cancer survivor Rick Jeanneret helping promote Relay to Life. See inside
The Revenge of Bedbugs They’ve grown thicker skin, which helps protect against pesticides and may explain why population is growing worldwide, scientists suggest
A Former Ballet Dancer Making a Difference Dancer Cynthia Pegado has performed in Belgium, Switzerland and Portugal. Now she is devoted to helping patients with Parkinson’s disease in Buffalo
Living Alone: Create Your Own Perfect Day!
Page 18
Page 20
Why You Should Fall for Mangoes
NYS Hospital Mergers Driving Up Prices A study by the conservative think tank, the Manhattan Institute, concludes that the 100-plus hospital mergers in NYS have served to only increase costs and decrease competition with no perceptible increase in quality. See “Health in a Minute” on page 5
Q&A with Christopher Kerr, M.D.
Mangoes, the world’s most popular fruit (who knew?), bring a wealth of powerful nutrients.
One in four women has been the victim of severe physical violence by an intimate partner, while one in seven men have experienced the same. Why this is still a problem and how local groups are trying to tackle it
5
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
in good
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Page 3
Reasons to Do Aquatic Therapy
Autism: Are Girls Being Overlooked for Screening?
Page 18
Farrell family from Tonawanda with their newborn at the Women & Children’s Hospital of Buffalo’s NICU. The unit recently celebrated one year without any central line infections.
The Surprising Benefits of Portobellos
Tai chi and other traditional Chinese exercises might reduce depression, improve quality of life for heart patients
Founder and managing partner of OB-GYN Associates of Western NY talks about growing a single-specialty group focused on women’s health April 2016 •
Page 1
Tai Chi Could Be a Healthy Move for Your Heart
Q&A with Carlos A. Santos, M.D.
This mushroom possesses such a unique and vast array of nutrients, it’s hard to know where to begin.
Hospice Buffalo chief medical director talks about the end-of-life experience and why we have the thoughts we do when we’re in final hours May 2016 •
• Unmarried children: Surviving unmarried children under age 18, or up to age 19 if they’re still attending high school, are eligible for survivor benefits, too. Benefits can also be paid to children at any age if they were disabled before age 22 and remain disabled. Both biological and adoptive children are eligible, as well as kids born out of wedlock. Dependent stepchildren and grandchildren may also qualify. Children’s benefits are 75 percent of the workers benefit.
Buffalo & WNY’s Healthcare Newspaper
STROKE Things You
Drinking
Who’s Eligible for Social Security Survivor Benefits?
bfohealth.com
in good
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 1
priceless
THE COMMISH March 2016 • Issue 17
No Reading Glasses Ephraim Atwal is one of the first eye doctors in NYS to use camera inlay to eliminate need for reading glasses. He shares his technique
MEN’S SPECIAL ISSUE
• More options to fight prostate cancer • Fat Dads = Fat Children
bfohealth.com
Buffalo & WNY’s Healthcare Newspaper
The Long Road to Get a New Kidney Paul Bloser is one of 100,791 people waiting for a lifesaving kidney transplant in the U.S. The median wait time to get the organ is 3.6 years. The 58-yearold shares his story
At 91, former President Jimmy Carter is the most famous cancer patient to benefit from a groundbreaking new treatment — immunotherapy
See story inside Page 9
Roswell doc: Therapy a ‘game-changer’
Page 5
Winter Gardening
First-Time Moms Are Getting Older in US
Frozen spheres developed by Connie Oswald Stofko, a local gardening expert. She talks about making your garden prettier — in the winter
Page 2
Page 11
Women’s pay lacks parity with men’s, according to experts
Twenty-eight percent of consumers in the U.S. are preparing ethnic foods more frequently than five years ago. Bowl of Thai is just an example. See story inside
Tax Filing for Retirees
Fat Dads = Fat Children
Living Alone: Making Choosing a Hospice the Best of 2016 Care Program
Buffalo & WNY’s Healthcare Newspaper
New Hope for Cancer Patients
Erie County Health Commissioner Gale Burstein: Happy to have opted for career in public health. Her major challenge: decrease opioidrelated deaths locally
11 Food Trends Yes, Women Make Less in Healthcare Industry, Too
bfohealth.com
February 2016 • Issue 16
The Commish
A recent study indicates that maternal health isn’t the only influence on childhood obesity. Having a father who is obese may increase the child’s chances of becoming obese as well Page 14
Oh Boy, Is Bok Choy Nutritious!
Water Quality: Buffalo is No Flint
But officials say lead in paint still poses a problem, especially in older houses
March 2016 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Telehealth Expected to Living Making Grow Alone: Exponentially
the Best 2016 “Healthcare in a of Minute” on p. 5
Beyond Genes–Keys to Healthful Aging URMC prof says in many ways we’re not growing older healthfully
Oysters
Pet Therapy For the past year, care providers at Sisters of Charity Hospitals have been treating patients in a new way — with smiling, tail wagging, certified therapy dogs. They count on 12 dogs that are ready to help
And it is loaded with an impressive array of nutrients, so loaded that the wellregarded World Health Organization considers bok choy to be one of their highest nutritionally ranked vegetables.
Maple Syrup Season Coming
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Is there any truth to their libidoboosting power? Read “SmartBites” column inside
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Half of Those with Glaucoma Don’t Know They Have it — Are You at Risk? February 2016 •
Special Olympics Project Unify has athletes who have disabilities competing alongside high school students who have no disabilities
New Guidelines New U.S. Dietary Guidelines: Boost Fruit and Veggie Intake, Limit Sugar and Salt
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Health News Comptroller Schroeder appointed to DAS board Buffalo Comptroller Mark Schroeder has been appointed a member of the board of directors at Deaf Access Services (DAS), a nonprofit organization that provides services for individuals and families in the deaf and hard of hearing communities Schroeder brought 25 years of private sector experience to Schroeder the comptroller’s office, in addition to a decade as an elected official, a role in which he earned a reputation as an independent, tireless voice for his constituents in the state capitol and county hall. Schroeder was recently recognized as the DAS 2016 Community Member of the Year. As an assembly member for the 142nd district, Schroeder continually supported the efforts of St. Mary’s School for the Deaf and Deaf Access Services in Albany. Schroeder also participated in deaf awareness week kickoff events and week-long activities for the past 20 years. “We are extremely pleased and grateful that Mark Schroeder has agreed to serve on the DAS board,” said DAS Executive Director Sharon L. Hanson. “He brings to our organization significant financial and governmental expertise as well as a history of community advocacy for vitally important services and organizations such as ours.” DAS provides services to deaf, hard of hearing, and late-deafened individuals who are experiencing obstacles with social services, health services, and financial and legal situations.
The BrightMatter Technology provides visualization of the brain surface, which is then overlapped on the location of the tumor, allowing for a safer retrieval route with fewer potential complications. The technology also allows for images of the physiology and brain function, something traditional MRI images do not show. "This technology allows surgeons to better identify eloquent brain pathways, in turn helping surgeons find the safest routes to remove brain lesions," said Levy. “This is especially useful for tumors located in areas of the brain that control motor and speech functions.” This is a collaborative effort by the GVI and surgeons affiliated with the University at Buffalo Neurosurgery and the Jacobs Institute to provide patients with the latest imaging technology.
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Students participate in ECMC intern program Buffalo Mayor Byron Brown speaks to Erie County Medical Center Corporation’s summer youth intern program interns during kickoff event held June 29. A total of 125 high school students participated in the four-week comprehensive self-development program for area high school students administered by the ECMC Foundation. Fifty percent of the participating students come from Buffalo Mayor Byron Brown’s
Buffalo Medical Group recently announced that nine cardiologists and a pulmonary medicine specialist have joined the group. The new cardiology providers are Reza Banifatemi, JoAnne Cobler, Richard Corbelli, Michael D’Angelo, Neil Dashkoff, Robert Gatewood Jr., Justine Krawczyk, Lisa Kozlowski, and Brian Riegel. The cardiologists join the group’s existing cardiology division that includes physicians Laura Ford-Mukkamala and Andrew Luisi, Jr. The pulmonologist joining BMG is Celestino (Sal) Pietrantoni, who joins BMG’s pulmonary and critical care medicine providers Nashat Rabadi and Sherif Sherif, both medical doctors. All of the new providers began practicing with Buffalo Medical Group in late May.
dermatology at Women & Children’s Hospital of Buffalo announced it’s expanding the hours it sees patients who need phototherapy. Phototherapy is a state-of-theart ultraviolet light therapy used to treat a wide variety of skin disorders, including eczema, psoriasis, vitiligo, pityriasis rosea and many others. The treatment has been offered since 2013. The department’s phototherapy treatment utilizes narrow-band ultraviolet B, which is considered the safest ultraviolet treatment. Treatments are brief, painless and are typically recommended two to three times a week. “We are so happy to be able to offer this safe and effective treatment to our patients,” said Ilene L. Rothman, chief of pediatric dermatology at Women & Children’s Hospital of Buffalo and clinical associate pro-
summer youth employment and internship program. “My annual summer youth employment and internship program has put thousands of young people from neighborhoods all Brown throughout our city to work and this opportunity at ECMC will provide these high school students with real-life health care workplace experience, where they’ll see firsthand the demands of a critically important work environment that has such an important impact on the lives of citizens,” Mayor Brown said.
BlueCross BlueShield’s Discount Program Goes Digital
Cardiologists, pulmonologist join BMG
WCHOB’s expands Gates Vascular first to use phototherapy program BrightMatter Technology The department of pediatric
The Gates Vascular Institute (GVI) it is the first hospital in New York state and in the Northeast region to successfully use Synaptive Medical’s BrightMatter Technology to remove a brain tumor, according to the institute. The state-of-the-art technology fuses high definition imaging, information and visualization of critical structures in the brain to support clinical decisions. Physician Elad Levy, medical director for neuroendovascular services at the GVI, co-director of Kaleida Health’s stroke center and chairman of neurosurgery at State University of New York at Buffalo, in conjunction with a multi-disciplinary team of specialists, successfully removed a high grade brain tumor using the DTI software to map the tumor’s motor fibers and outline the resection boundary.
fessor of pediatrics, University at Buffalo. “For those with severe eczema and extensive psoriasis who are in need of effective therapy beyond creams and ointments, phototherapy is a wonderful alternative to strong systemic medications.”
Relaunches as ‘Blue Discounts’ featuring over 100 offers
Blue sign at the entrance of the Buffalo Zoo indicates that the organization is one of the participants in the Blue Discount,” a free, value-added benefit offered to the health plan’s commercial members to encourage healthy living and activity. BlueCross BlueShield of Western New York’s signature member discount program is going digital, relaunching as Blue Discounts, featuring over 100 local and national offers. Blue Discounts is a free, value-added benefit, offered exclusively to the health plan’s commercial members to encourage healthy living and activity. It was developed in collaboration with local customer loyalty tech company, Loupe. The program is an evolution of the health plan’s signature Blue Box, which engaged members over 30,000 times at various locations throughout Western New York in 2015. The transition from physical card decks to a convenient, mobile-friendly website emerged from member feedback. “By introducing a digitally-friendly program, our members have easy access to discounts that
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016
encourage healthy living,” said David Busch, senior vice president, chief sales officer, BlueCross BlueShield of Western New York. “Blue Discounts not only delivers value to our members, but also supports our region’s health and economic vitality.” BlueCross BlueShield members can view over 100 healthy offers on a mobile-friendly website and simply show their member ID card at participating locations - with no limit on usage. Highlights of the program include offers at the region’s most popular restaurants, businesses, sports teams and cultural attractions including Anderson’s, the Buffalo Zoo and Canalside. A complete list of over 100 local and national offers can be found at bluediscountswny.com. Offers will also be displayed through signage at participating merchants and venues.
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Meet Your Provider
Buffalo Hearing & Speech Center
Practice offers innovative programs for children and adolescents At Buffalo Hearing & Speech Center (BHSC) three innovative, researchedbased programs were designed to improve reading, listening and communications skills for students of all ages. Leap Into Literacy
Would you like your child to become a great reader? Leap Into Literacy was developed by BHSC for children aged 3 to 5 years old. The program focuses on improving foundational skills including: listening, following directions, memory, phonological awareness, rhyming, alliteration, sound letter, correspondence, print knowledge, vocabulary and comprehension.
Social Communication Program
BHSC also offers a program designed to help children with peer interaction and communication. Language to Literacy The Social Communication Program is for children For children that may struggle with language aged 5 to 18 and focuses on improving: eye contact, and reading, BHSC’s Language To Literacy listening behaviors, interpreting facial expressions, program has been developed to improve reading body language, and tone of voice, starting and and comprehension skills in children aged 6 to 18. Specifically, this program improves skills including: maintaining conversations, turn taking, establishing and maintaining friendships, compromising and central auditory processing, following directions, cooperation skills, coping with transitions, and memory, organization, phonological awareness, changes in routine. vocabulary, comprehension, reading and spelling.
Buffalo Hearing & Speech Center improves the quality of life for adults, children and infants with communication disorders by delivering cutting edge diagnosis and treatment of hearing and speech impairments and related special education services. The first step for a family is to meet with a qualified instructor for an evaluation. For more information on BHSC and the many programs offered, call 716-885-8318, ext. 2289 and ask to speak with Steve Miller, director of special programs or visit askbhsc.org.
BHSC • 50 E. North St. • Buffalo NY 14203 • 716-885-8318 • askbhsc.org August 2016 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Summer Outings
Last in a three-part series
Boldt Castle in the 1000 Islands region. The place has undergone significant renovation recently.
Castles of Upstate Upstate has a surprisingly high number of castles — all open to the public By Deborah Jeanne Sergeant
Y
ou don’t have to cross the Atlantic to see castles this season. Upstate offers a few closer to home to appeal to your inner Royal.
Belhurst Castle in the Finger Lakes region.
• In the Mohawk Valley region, Beardslee Castle offers dining and event space. The Irish-style castle looks like a storybook creation. The castle’s murder mystery dinners and ghost stories seem apropos. But it’s also host to numerous weddings. Many nearby places of lodging can host overnight guests. (http://beardsleecastle.com; 123 Old State Road, Little Falls) • The New York State Military Museum displays artifacts pertaining to state history from the Revolutionary War to Desert Storm. It’s a great place to bring New York’s military history to life for the entire family. Admission is free. (http://dmna.ny.gov/historic; 61 Lake Avenue, Saratoga Springs)
Singer Castle in the 1000 Islands region.
• Singer Castle offers guided and self-guided tours to view its displays of antique furnishings, unique architecture and stately grounds. Since the 100-year-old castle is located on Dark Island, contact a tour boat service or use your own boat to visit. $14.25 for adults; $5.25 for children, plus the cost of transportation. (www.singercastle.com; Chippewa Bay) Page 20
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Augusr 2016
• Boldt Castle is accessible only by boat. Boldt Castle has undergone significant renovation recently. If you’ve visited before, it may be time to return. And if you’re never toured it, it’s a must-do for your summer trips list. View its decadent gardens, architecture and period appointments. $9 for adults; $9 for children 13+; $6 for children 6 to 12; free for children five and younger, plus the cost of transportation. (www.boldtcastle.com/visitorinfo; Heart Island, Alexandria Bay) • Belhurst Castle, offers a day spa, lodging, two restaurants, winery, meeting space and tours. Widely lauded for its romantic decor and atmosphere, reserve a trip to Belhurst as a couples getaway rather than a family trip. The day spa and onsite restaurants also make Belhurst a great venue for a girl’s day out or bachelorette party. Belhurst also hosts live music. See the website for the schedule. (www.belhurst.com, 4069 West Lake Road, Geneva) When visiting castles, remember that their exhibits likely hold significant historic value. Make sure photography is permitted before snapping away. Keep curious children back from exhibits to help preserve them for future visitors.