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AUGUST 2021 • ISSUE 82
BACK TO SCHOOL SPECIAL ISSUE ✓ REMOTE LEARNING is hurting students academically and emotionally ✓ BULLYING IS BACK as in-person school returns; we discuss what to do about it ✓ BACK-TO-SCHOOL ANXIETY has skyrocketed. What can parents do to help their kids? ✓ AUTISM: Back to school for kids on the autism spectrum brings challenges
Starts on p. 12
MEET YOUR DOCTOR Matthew Cavagnaro, Buffalo Medical Group’s sports-loving orthopedic surgeon, finds satisfaction in helping patients get moving again. p. 4
NAT’L HEALTH SURVEY COMING TO ERIE COUNTY The nation’s mobile health survey is traveling to 15 counties, including Erie, to learn about the health of the U.S. population p. 6
300 DONATIONS, 38 GALLONS, 50 YEARS Lancaster resident celebrates 300 blood donations made over the past half-century. p. 5
Living to Age 130: New Study Projects It Could Happen HExperiencing ow long can a human live? New research predicts there’s a chance that someone in the world will celebrate a 130th birthday in this century. There’s been a steady rise in the number of people living beyond 100
years in recent decades, with up to nearly half a million worldwide, researchers noted. The world’s oldest known person was Jeanne Calment of France, who was 122 when she died in 1997. Currently, the world’s oldest person is
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118-year-old Kane Tanaka of Japan. Some experts believe that disease and basic cell deterioration limit human life span, but others believe there is no ceiling. University of Washington researchers used statistical modeling
to determine potential maximum life spans this century. “People are fascinated by the extremes of humanity, whether it’s going to the moon, how fast someone can run in the Olympics, or even how long someone can live,” said study author Michael Pearce, a doctoral student in statistics. “With this work, we quantify how likely we believe it is that some individual will reach various extreme ages this century,” he said in a university news release. Pearce and his colleagues concluded that by 2100, it’s nearly 100% likely that the current known record of 122 years will be broken. There’s a 99% probability that someone will live to 124, a 68% chance of someone making it to 127, and a 13% likelihood that a person will reach 130. It’s extremely unlikely that a person will live to 135 this century, according to the study published June 30 in the journal Demographic Research. While there are increasing numbers of long-lived people, the authors noted that the death rate flattens after a certain age, which means that a 110-year-old and a 114-year-old have about the same chances of living another year. “It doesn’t matter how old they are, once they reach 110, they still die at the same rate,” said study co-author Adrian Raftery, a professor of sociology and of statistics. “They’ve gotten past all the various things life throws at you, such as disease. They die for reasons that are somewhat independent of what affects younger people,” he explained in the release. “This is a very select group of very robust people.”
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
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Get on Track. Stay on Track. Even Before Pandemic, OneThird of U.S. Adults Went Without Dental Care Millions of American adults haven’t seen a dentist in at least a year, a new U.S. government health survey reveals
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n 2019, before the coronavirus pandemic made dental visits difficult, a third of adults under 65 hadn’t had a dental exam or cleaning in the past 12 months, according to the report from the U.S. Centers for Disease Control and Prevention. And the problem was worse in rural America, the National Health Interview Survey showed. The authors suspect the reason is easy to explain. “It was beyond the scope of study, but we kind of assumed there are fewer health care providers in the rural areas, compared to urban areas, so there’s less access to dental care in rural areas,” said study co-author Robin Cohen, a statistician at CDC’s National Center for Health Statistics. Income and race also underpin the results, Cohen said. The survey found: • In 2019, 65.5% of U.S. adults saw a dentist in the past 12 months. • More adults in urban areas than rural areas saw a dentist (67% versus 58%). • In both cities and rural areas, women were more likely than men to have visited a dentist in the past 12 months. • In urban areas, white adults (70%) were more likely than Hispanic
adults (59%) or Black adults (62%) to have seen a dentist. • In rural areas, white adults (59%) were more likely than Hispanic adults (46%) to have had a dental visit. As income increased, so did the odds of seeing a dentist. And that was true in both rural and urban areas. Jane Grover is director of the Council on Advocacy for Access and Prevention at the American Dental Association in Chicago. She said staffing shortages are a key contributor to access issues in rural America. “They may not have the staffing that many urban areas have — I’m talking about the number of dental assistants and dental hygienists,” Grover said. Cost is another barrier to care, Grover said. Low-cost clinics can help in urban settings, and some clinics charge on a sliding scale based on patients’ ability to pay. In rural areas, these clinics can be few and far between. Grover said more needs to be done to make dental care available to folks who can’t afford it, no matter where they live. This includes involving dental students who can help provide services at little or no cost.
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Meet
Your Doctor
By Chris Motola
Matthew Cavagnaro, M.D.
Buffalo Medical Group’s sports-loving orthopedic surgeon finds satisfaction in helping patients get moving again
U.S. COVID Vaccine Rollout Saved 279,000 Lives: Study
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OVID-19 vaccines have prevented at least 279,000 deaths and 1.25 million hospitalizations in the United States, but the Delta variant poses a significant threat to that progress, researchers say. “The vaccines have been strikingly successful in reducing the spread of the virus and saving hundreds of thousands of lives in the United States alone,» said study author Alison Galvani, director of the Center for Infectious Disease Modeling and Analysis at the Yale School of Public Health. “Yet until a greater majority of Americans are vaccinated, many more people could still die from this virus,” she said in a Yale news release. “The danger is not over. Now is not the time to let down our guard.” Galvani and her team analyzed data from Oct. 1, 2020 through July 1 and found that more than 328 million COVID-19 vaccine doses were given during that time, and that 67% of adults received at least one dose. If only half as many shots had been administered there would have been more than 120,000 additional deaths and 450,000 additional hospitalizations, according to the researchers. It also found that the number of COVID-19 cases plummeted from more than 300,000 a day at the pandemic›s peak in January to less than 20,000 a day in mid-June. However, the progress made with the national vaccination program could be quickly reversed by the highly transmissible Delta variant if it triggers a spike of new cases among the millions of people who haven’t been vaccinated, the researchers warned. The study was published July 7 by the Commonwealth Fund, a nonprofit organization that focuses on health care issues.
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Q. You specialize in sports-related injuries. What can people do to reduce their chances of suffering a sports-related injury? A. I get this question a lot. Especially as people become older, it becomes more important to stretch. Kids and teenagers can often do anything without risking serious injury, but the older you get the less limber you are. For a lot of people who exercise most of their lives, it becomes that much more important to stretch. I also believe in not over-stressing the body in any one particular way. A lot of people say they run six days a week. That’s not a good idea. I’m one for diversifying your exercise routine so that you’re evening out the stress on your body. It leads to less risk of developing a problem. Q. What types of employment cause orthopedic injuries? A. Typically, those are occupational hazards like repetitive use or from poor ergonomics. That can apply to any job, even desk work if you don’t have a good ergonomic setup, like carpal tunnel. People with more labor-intensive jobs, they have to be conscious of how they’re lifting and how frequently they’re lifting. A lot of workplaces have training, but it’s important to think about ergonomics. A lot of people go to work every day just trying to find a way to get through the day but if you’re not doing it right it will eventually catch up to you. Q. You also specialize in hip arthritis, and all ligamentous and meniscal knee injuries, and knee arthritis. What can people do to reduce their chances of other types of orthopedic injuries? A. The weekend warrior who doesn’t participate in sports consistently but randomly will go play basketball with friends — their body isn’t in shape to handle those stressors. Those are the athletes who often get injured. Be consistent so you keep yourself in good cardiovascular health and stay
strong. If you have a more consistent program than sporadic, you’re more likely to avoid acute injury. Q. How can people reduce their risk of joint wear? A. The most important thing about joint wear is keeping your weight under control. Carrying excessive weight leads to more likely development of arthritis and if you have arthritis, you will experience faster progression of that problem. For those with known joint problems, especially arthritis, avoid higher level impact exercises can also slow progression. I’m often advocating things like swimming, biking or elliptical machines. They’re generally less likely to lead to worsening of the problem. For those otherwise healthy, thin and don’t have health problems, some evidence suggests running is not bad for those people. Q. What factors play into a successful orthopedic surgery? A. From a general standpoint, you have to have the correct indication for surgery. A lot of times we don’t consider surgery unless someone has tried dedicated, conservative management and they’re still not happy where they are. After surgery, it’s important to stay within the limitation the surgeon places on you. For example, if the recommendation is to stay in a sling or limit weight-bearing exercise. It’s important to abide by these things or it can fail. Most of these orthopedic procedures require physical therapy to get motion and strength back. It’s important to follow through on that or it can lead to other problems or a poor result. Any surgery, if you don’t work on getting
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
the motion back, you can end up with stiffness. You can get scar tissue as a natural response to surgery. A lot of surgeries, you lose strength in that limb for a while. It takes time to get that back. Q. Many people had to delay non-necessary surgery because of COVID-19, causing back-ups at some surgical facilities. Has your practice experienced this? A. Yes. It was tough for a lot of people for a long time because they were in pain waiting for their surgery. Although there are some more strict protocols, we’ve gone back to a full go. Q. How close are you to catching up? A. We finally started to catch up and get people what they need. It was tough for a while. Q. Why did you become interested in orthopedic surgery? A. I always liked the idea of doing something procedural where I’d be using my hands. I explored a lot of surgical subspecialties and orthopedics allowed me to treat athletes and people with joint issues. I’ve always been interested in sports. The idea of taking care of people with something functional was appealing. Q. Why do you like working at Buffalo Medical Group? A. It’s multispecialty. That creates an environment where our patients feel it’s a lot easier to navigate through the specialists on their care team. We’re integrated on the same electronic medical record. It eases their stress when their records will be on the system for their doctor to look at. We’ve developed a really good patient portal so we can communicate over email and messaging. It makes communication easier. A lot of people are anxious when they call their doctor’s office and are on hold. For those who take the time to learn it, they love it. Q. What are your professional goals? A. I want to be someone who provides top-notch care over a long period of time. I’m always thinking about that. This job can be physically and mentally demanding. I want to be available so I’m trying to keep myself driven, sharp and in shape so I can handle this for years to come. Q. What do you like most about living in Buffalo? A. I love Buffalo. I could have really worked anywhere. My wife is from Philly and wasn’t thrilled about moving to Buffalo, but I always wanted to be here when I finished my training. I love the four seasons and the people from Buffalo. There’s so much to do here and it’s a hidden gem. A lot of people don’t know how great of a place this is.
Lifelines
Name: Matthew Cavagnaro, M.D. Position: Orthopedic surgeon at Kaleida Health’s Buffalo Medical Group Hometown: East Amherst Now lives in: Buffalo Education: University at Buffalo Jacobs School of Medicine and Biomedical Sciences Special training: Orthopedic Surgery Residency at Thomas Jefferson University Hospital, Philadelphia Family: Wife (Patti-Anne), three sons Hobbies: Golf, exercise and hockey.
300 Blood Donations
Lancaster resident celebrates 300th blood donations made over the past half-century. “I do it to help someone in need,” he says By Daniel Meyer
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ene Baran has been giving the gift of life for more than 50 years, yet the Lancaster resident says he believes that he is the one who has been repeatedly rewarded over the past five decades. “For me, giving blood and doing something for another person is such a rewarding experience,” Baran said. “I have always enjoyed doing this and I am actually quite thankful that I still can.” The 70-year-old Baran recently celebrated a major milestone when he donated blood for the 300th time, an occasion that marked a half-century of volunteerism that has included donations of whole blood, plasma and platelets. “I have never had any difficulty or suffered from any complications from donating,” Baran said. “I always say that if something comes relatively easy to you then you shouldn’t mind doing it on a regular basis.”
It all began at Fort Gordon, Georgia Baran first donated blood in 1970 at the age of 19. Serving as a U.S. Army basic trainee at Fort Gordon, Georgia, a drill sergeant was seeking volunteers to donate and enticed potential blood donors with something that Baran said was too attractive to ignore. “He told those of us willing to roll up our sleeve that we could then lay around in our bunks for the rest of that day,” Baran said. “For a day off, I figured that I’d give it a shot.” At the time, Baran didn’t fully recognize the important role he played in assisting someone else in need. “I mean, I was 19 and I honestly don’t think I gave it that much thought after that day off was over and done with,” Baran said. “It wasn’t until later in life when I was working that I began to comprehend how important it is for people to volunteer and stick to a regular donation schedule.”
Gene Baran of Lancaster recently celebrated his 300th blood donation. “I do it to help someone in need,” Baran says. “I am eligible to donate blood once every 28 days and I mostly stick to that throughout the year. It is my way of giving back to the community and making a difference in a small way.”
Red Cross regular, Roswell Park supporter While working for the New York State Department of Transportation, Baran volunteered to donate as part of a mobile blood drive that took place at his workplace. It was with that donation that Baran began a longstanding relationship with the American Red Cross. “A very supportive employer helped me to realize after that donation at work that I can make a difference and with that it became a way of life,” Baran said. “My donations just became all part of my regular routine and I have been very fortunate to be able to avoid any serious illnesses or injuries that would have thrown me off my schedule of regular appointments to donate.” Baran, who retired 11 years ago, has also donated platelets and whole blood at Roswell Park, special occasion volunteer efforts that he dedicat-
Gene Baran, wearing a red shirt, was honored by the American Red Cross for his consistent blood donations. ed toward cancer patients he knew. “Roswell Park is great with the free parking perk and it feels especially good knowing you are directly helping people who are battling some form of cancer,” Baran said. As someone who has AB-positive blood, his blood donations are limited in use to approximately 3% of the U.S. population but remain important contributions to the cause. The American Red Cross estimates a little more than one-third of the country’s population is eligible to give blood or platelets, with less than 5% of the nation’s total population taking the time to donate blood at least once a year.
Why give? Why not? Baran, who has donated nearly 38 gallons of blood, is a passive advocate for the American Red Cross and ConnectLife, meaning he passionately supports their efforts and encourages others to consider donating blood. But he never pressures anyone to make an appointment, choosing instead to follow one of his longtime approaches to life. “I let my actions speak for themselves,” Baran said. I’m actually the only person in my family who is a regular donor and that’s fine. If someone wants to speak with me about my donation schedule I’m
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Plaque recognizing Gene Baran as a top blood donor. happy to talk with them, but I am not someone who is going to lecture or ramble on about it.” Baran believes he should never take for granted his ability to stay healthy, including recently as a retiree. “I do it to help someone in need,” Baran said. “I am eligible to donate blood once every 28 days and I mostly stick to that throughout the year. It is my way of giving back to the community and making a difference in a small way. I look forward to continuing this because I do think we should all give back in some fashion. The donation of blood is an excellent way to do that.”
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National Health Survey Coming to Erie County NHANES, the nation’s mobile health survey, is traveling to 15 counties to learn about the health of the U.S. population
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he National Health and Nutrition Examination Survey (NHANES), the most comprehensive survey of the health and nutritional status of the U.S. population is coming to Erie County beginning on Aug. 16. Erie County is one of 15 counties selected by the Centers for Disease Control and Prevention (CDC) to be part of this initiative. Each year, only 5,000 residents across the nation have the chance to participate in NHANES, conducted by the National Center for Health Statistics (NCHS), part of the CDC. “NHANES serves as the nation’s ‘health check-up,’ by going into
communities to collect health information throughout the country,” said Brian C. Moyer, Ph.D., director of the National Center for Health Statistics (NCHS). “The survey provides a wealth of important data about many of the major health and nutritional issues affecting the country.” “The information collected by NHANES gives valuable, critical insights into local and national health trends,” said Erie County Commissioner of Health Gale Burstein. “Erie County residents who are selected for this project should feel confident that the answers they provide will be used to advance the important work
done by public health agencies to promote better health outcomes for all.” Since 1960, NHANES has had a prominent role in improving the health of all people living in the U.S. NHANES data address critical health concerns such as obesity, diabetes, and cardiovascular disease. Public health officials, legislators, and physicians use this information to develop sound health policies, direct and design health programs and services, and expand the health knowledge for the nation. NHANES data are also used to produce national references and standardized growth charts used by pediatricians across the country. NHANES collects a broad range of data that impact the everyday lives of everyone in the country, regardless of age. The survey addresses everything from air quality, to vaccinations and the low-fat and “light” foods found in grocery stores. Now more than ever, collecting timely information on the status of the nation’s health is critical. A NHANES team of health professionals, nutritionists and health technicians is heading toward Erie County and wants everyone
who has been selected for the survey to participate. Residents will have an invitation-only opportunity to participate in NHANES. Addresses are randomly sampled within Erie County. By selecting participants this way, when combining data from all counties visited this year, NHANES data can represent the U.S. population. Households will be sent one or more letters inviting them to be part of NHANES by completing a brief online questionnaire to see if anyone is eligible to participate in their home. Anyone eligible will be contacted by an NHANES representative to set up a telephone health interview at a convenient time, followed by a health examination that takes place in the NHANES mobile examination center. While no medical care is provided directly in the mobile examination center, each participant receives a report on physical findings, along with an explanation from survey medical staff. All information collected in the survey is kept confidential and privacy is protected by law.
drastically reduced unnecessary ED use. However, in many rural areas, the hospital ED is often the ONLY alternative for non-emergent care after 5 o’clock, on weekends and holidays.
seniors and to get the best bang for the buck. The priorities in no particular order are: 1. Make Medicare more affordable. In 2017, the average senior spent $5,800 out of pocket or a staggering 36% of the average Social Security check. 2. Pay for vision, hearing aids and dental. (It should be noted several Advantage plans do offer some coverage here. 3. Support family care givers. 4. Strengthen long-term care. 5. Help people age in place. 6. ASK seniors what they need. 7. Focus on prevention, no matter how old someone is. 8. Study and invest in social determinants of health.
Healthcare in a Minute
By George W. Chapman
Hospital Pricing: Uninsured Charged a Lot More for Same Services
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he recent requirement for hospitals to post their prices for 300 “shoppable” services, discussed here in earlier columns, has revealed uninsured consumers are charged far more than insured consumers. (They always have been). A recent survey of 1,550 hospitals by the Wall Street Journal revealed that uninsured patients were billed 3.6 times the negotiated rate with Medicare Advantage plans. Using their purchasing power, insurance companies typically negotiate volume based discounted prices with hospitals. In the past, the largest carriers in a market would often insert “favored nation” claus-
es in their contracts, which meant should the hospital offer a deeper discount to a competitor; the favored carriers would automatically get the same discount. Clearly an individual cannot negotiate a volume-based discount like carriers do, but it doesn’t necessarily mean they have to be charged the highest price. In the past, hospitals feared that if they offered a deep discount to an uninsured indigent patient, it would trigger the favored nation clause. That no longer being an issue. Hospitals today are far more willing to discuss and negotiate fees in advance.
Impact of Vaccines: 279,000 Lives Saved
Ban on Surprise ED bills
A study by the Commonwealth Fund and the Yale Center for Infectious Disease Modeling and Analysis estimates the vaccine rollout has prevented around 1.25 million hospitalizations and 279,000 deaths. The study looked at what would have happened without the 328 million doses being delivered. An Aetna Foundation study found healthier communities tend to have far less vaccine hesitancy among residents. Traditionally less healthy states, clustered in the southeast part of the country, also have the lowest vaccination rates and highest hesitancy rates. In June, unvaccinated people accounted for 99% of deaths due to the virus. The CDC wants to get more vaccines to family medicine practices as they are highly trusted by the vaccine hesitant.
Part of the Affordable Care Act is a “no surprise” provision. It prohibits insurers from retroactively denying emergency department claims for services considered not emergent. These denials virtually stick an ED with unexpected collection issues and the consumer with unexpected out of pocket bills. Insurers claim retroactive denials serve as incentives for their members to receive, what they deem to be primary or urgent care, in less costly settings like a physician office, health center or urgent care facility. Most EDs do triage non-emergent patients to their “fast tracks,” but the bills are still much higher than they would be if care was delivered at a physician’s office or urgent care facility. The rapid expansion of urgent care facilities with their extended hours of operation has
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Demand to Decrease Healthcare analytics firm Trillant is predicting demand for healthcare services will flatten out or even decline post pandemic. That coupled with an increase in suppliers of services from industry upstarts like Amazon, Walmart and various drug chains means that an industry that has avoided the inevitability of supply and demand, is in for a rude awakening. Does this mean there will actually be real price competition? Trillant is basing their predictions on 70 billion claims for 309 million visits. Telehealth is already down 37% from pandemic highs. Annual surgical services growth, hospital bread and butter, is now projected to be in the 1% to 2% range versus historical 3% range. Overall, demand will be down. Population shifts to states with lower taxes like Texas, Florida and Idaho will cause demand to increase there but be offset by demand decreases in states losing population like New York, California and Pennsylvania.
Where Should We Invest? An article by Judith Graham in Kaiser Health News questioned our healthcare spending versus benefits. The recent approval of the Alzheimer’s drug Aduhelm by the FDA inspired the article. $56 billion was invested in the drug with questionable efficacy. It may help one to two million people diagnosed with Alzheimer’s. Not to cast aspersions on the drug, is that prudent spending, mostly by Medicare, when looking at bang for the buck for seniors? Graham queried several physicians asking where they would invest $56 billion to improve care for our
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
Push for Home Dialysis Reform Thirty-seven million Americans suffer from kidney disease; 550,000 of them require dialysis. Having to travel to a kidney dialysis center three times a week is a tremendous emotional, logistical, time, transportation, access and quality of life burden, especially is rural areas. Several industry players including home dialysis machine manufacturers, the National Kidney Foundation and the American Society for Nephrology are lobbying congress to remove antiquated or outmoded federal regulations that make it hard for patients to get home dialysis. The coalition’s goals are to modernize conditions for coverage, empower patients and provide a better quality of life.
George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
Fewer Doctors Go Into Private Medical Practices Experts say some don’t want the hassle of running a private practice, prefer a steady paycheck By Deborah Jeanne Sergeant
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n American Medical Association survey of 3,500 doctors reveals that 49% are in private practice, a decrease from 54% in private practice in 2018. A few different factors play into this shift from the doctor working at a privately owned and operated practice to working at a facility owned by a hospital system, national chain such as CVS or Walmart or a federally funded clinic. “We’ve seen a huge transformation in healthcare,” said Jennifer M. Carlson, licensed master social worker and director of clinical development at Sheridan Medical Group, a primary care facility in Tonawanda and Grand Island. “Some are changes we believe are much for the better, mostly in terms of the way we are thinking in prevention instead of reactive medicine, treating diseases rather than helping people manage their health to prevent diseases that are preventable.” Carlson’s practice has survived and even grown by building partnerships with both employee and non-employee providers in the community to offer care within Sheridan Medical’s walls and some at outside offices. “Patients see themselves as consumers and want convenience,” Carlson said. This arrangement allows each provider to autonomously participate in offer complete care. While preventing problems is less expensive than treating them, Sheridan also treats patients and receives the same reimbursement, which is not nearly as inexpensive. “In some cases, we get paid $2.25 a month per person,” Carlson said. “For that, we are required to manage a diabetic who is trying to manage a lifelong weight problem, peripheral neuropathy, eye complications and renal problems. We are being very, very powerfully forced to provide annual physicals to every single person covered under a healthcare plan. If we don’t meet these measures, we lose money. There’s not a whole lot of evidence to suggest that an annual physical produces optimal outcomes for young and presumed well people.” It also does not make sense for people with chronic health issues and constant health monitoring to come
Jennifer M. Carlson, licensed master social worker and director of clinical development at Sheridan Medical Group, a primary care facility in Tonawanda and Grand Island. in for a separate visit for a physical. “The physicians are not being allowed to exercise their enormous amount of experience, training, knowledge and acumen on this decision,” Carlson said. “The insurance companies are controlling all this and don’t have the acumen to make this decision.” This kind of aggravation in the healthcare field drives away physicians. John Lopez, practice administrator for a general surgery group, Surgical Associates of Western New York, also believes that many independent physicians are leaving private practice because they struggle to staff their practices. A new surgeon out of medical school wants a salary of $400,000. “At this point, they don’t have a lot of experience and have no patient base,” Lopez said. “Their ability to make money seeing patients and paying for themselves is very difficult and burdensome for a smaller practice.” Another reason for the decrease in private practices is that fewer newly minted doctors can operate their own facility. As the cost of entrepreneurship has increased in many ways, including labor, real estate and supplies, the cost of medical malpractice insurance has also increased. Many new physicians are joining hospital systems to work as a hospitalist or at another facility to avoid footing this expense. According to Arthur J. Gallagher & Co., a medical
malpractice insurance brokerage in Houston, the average annual cost of the insurance is $75,000 for a family practice physician in New York State. Although medical malpractice insurance is not required, most physicians want it to avoid financial ruin in case of litigation. The additional rules added by changes such as the institution of electronic medical records have proven too onerous. Instead of spending most of their time caring for patients, they find that recordkeeping and documentation devours much of their day. “Every day I come across new regulations from state and fed entities that are raising costs of doing business,” Lopez said. “We would appreciate a little understanding from state and federal government about running a small business. The regulatory burden and maintaining staff with all the laws and regulations around people and financial systems is overly burdensome for any small business. It gets worse every year. I could spend 40 hours a week drafting policies and procedures on everything they want us to do.” He offered as one example an OSHA citing his surgical office— chockablock with medical supplies— because the practice lacked a first aid kit. Managing the “business side” of the practice challenges many physicians. According to the Harvard Business Review, “most doctors in the U.S. aren’t taught management skills in medical school. And they receive little on-the-job training to develop skills such as how to allocate short- and long-term resources, how to provide developmental feedback, or how to effectively handle conflict–leadership skills needed to run a vibrant business.” Lopez said that although on paper it may seem that the larger scale of a health system would lower healthcare costs, the increase in bureaucracy builds more cost into delivering healthcare which is passed along to consumers in health insurance premiums. “Ever since this trend emerged, the costs of healthcare have been rising,” Lopez said. He would like to see parity laws for payor negotiation and malpractice insurance rates.
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Starting a medical practice, like any other small business, does not guarantee success. Many providers struggle financially for years as they build their independent medical practice, all while trying to pay off their onerous student loans. “There’s an economic certainty getting a paycheck every two weeks that’s attractive,” said Ken Schoetz, vice president of Health Care Association of Western and Central New York, (HAWCNY), which includes Buffalo General Medical Center, Roswell Park Comprehensive Cancer Center, Kenmore Mercy Hospital, Mercy Hospital of Buffalo, Kaleida Health, Millard Fillmore Suburban Hospital and Erie County Medical Center among its members. One of the challenges of working independently is the difficulty in negotiating sufficient reimbursement from payors. Larger organizations’ volume enables them to obtain better reimbursement from drug manufacturers and insurers, just as a big box store orders goods from manufacturers at a much higher volume than a small store and can receive volume discounts on the items. “It’s more beneficial to the physician than the hospital as scale moves the entire economy, including health care,” Schoetz said. “Better pricing benefits the provider and the patient.” The physician has a few personal “costs” by working for a larger health system, including the sacrifice of some freedom. Unlike the entrepreneurial model of the independent practice, the physician is not the boss. “You’re not running your practice the way you might want to,” Schoetz said. “You have to follow the hospital’s rules and use their technology, which you might not like. They may say to start the day at 8, not 10.” Physicians also have less say over who works under them. They also cannot determine their own salary, compared with if they start a practice and manage it well. Patients may also experience a few drawbacks. Perception is a big one. “Sometimes, I think that anything that’s big, whether it’s AT&T or Wegman’s or Ford Motor Company, there can be some impersonality,” Schoetz said. “People still like the idea of a provider knowing who they are. They want a close, personal relationship. Doctors who go into these arrangements try to keep these relationships.” But the health care system may be able to provide a better level of care with the additional physicians on staff than without them. With more physicians, they can expand capacity to treat more patients, which can improve their finances and offer more specialized care. Patients needing multiple specialists may also enjoy a “one-stopshop” experience versus traveling from office to office. “Anytime a provider can reduce costs and by having the economic scale of a larger facility, patients benefit in terms of cost and the care they would receive,” Schoetz said. He added that this is a trend he does not foresee going away in the short-term or long-term. “There will be differences from what it used to be,” he said. “The hope is, you will get better care and make hospitals better able to withstand the challenges. The ultimate outcome will be better patient care.”
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D’Youville’s New Health Professions Hub
College builds a facility that will help students, community and employers By Jana Eisenberg
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ith its recently completed Health Professions Hub, in a brand-new building on its West Side campus, D’Youville College has come up with a win-winwin solution to address multiple, commonly known issues. In a nutshell, the Hub is “an education, training, and community health center embedded in Buffalo’s West Side where students, medical professionals, and community members can come together.” Eighty percent of D’Youville students train for careers in healthcare. The Hub, the school’s first outward-facing structure, is set up to be an all-encompassing and accessible community health center, a unique training facility for students and an already-proven feeder for Western New York employers. Initially funded with a lead gift from New York’s Higher Education Capital Matching Grant Program, the Hub, which officially opened in June, is on its way to fulfilling D’Youville’s mission of building healthy, thriving communities. The college describes the Hub as “the future of healthcare.” In 2019-20, New York state deemed construction of the facility as “critical” and fast-tracked funding for the project so that it could open in time to be a pandemic resource. The Hub is a 58,751 square foot, stateof-the-art facility anchored by the Sisters Health Center at D’Youville, a primary care clinic operated by Catholic Health. With its location on the first floor, it offers a physical entry point to additional services throughout the building. The need for such a facility is so acute partly because the neighborhoods surrounding D’Youville have for decades been inadequately Page 8
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Maria Orellana, the primary care physician at Sisters Health Center at D’Youville. Photo provided
Adam Grupka is the Health Professions Hub’s director of healthcare and education. Photo provided
serviced as far as healthcare and other basic needs; the populations face barriers in the traditional healthcare milieu. Many individuals are un- or underemployed and without health insurance. Additionally, there’s a large segment of “new Americans”— refugees and immigrants—facing additional language and culture barriers. Other elements within the Hub designed to create a “one-stop shop for healthcare, health, and wellness” for the community, as well as a unique training facility for students, include a full-service pharmacy, a demonstration kitchen and café, a health and wellness center featuring occupational and physical therapy and chiropractic services, an interprofessional education and simulation center, high-tech classrooms, meeting rooms, open workspaces, and an event center and community engagement space. Adam Grupka is the Hub’s director of healthcare and education; his other titles at D’Youville include assistant vice president for academic affairs, and clinical assistant profes-
sor in the physician assistant department. He agrees that the intertwined goals of the Hub are critical. “The building is intentionally designed to be inviting to the community,” he said. “The West Side is a ‘healthcare desert,’ so this is an opportunity for its residents to receive quality, inclusive primary care.” “The pharmacy is also on the first floor,” he continued. “During patient appointments, pharmacists come in and discuss their medications with them; they can leave the clinic with a months’ worth of their medication, or we will deliver them if need be. And when they’re here for primary care, we can also provide immediate access to or appointments for things like physical and occupational therapy, and nutritional guidance and education. These types of integrated services, long missing in this area, will improve health care outcomes, and decrease hospital readmissions, for example.” Maria Orellana, the primary care physician at Sisters Health Center at D’Youville, is also excited about
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
offering integrated care to people in the community, as well as giving D’Youville students a headstart in observing and participating in actual healthcare while they’re still in school. As a Spanish speaker and a firm believer in seeing the patient beyond their medical record, Orellana said that finding out what patients need, instead of just telling them, is important. “We really want to overcome language and cultural barriers, to teach people how to lead healthier lives,” she said. Working with patients who have chronic and ongoing conditions, like obesity and diabetes, is one of her specialties. “We can offer help beyond their basic medical appointment. We have a kitchen and dietitians with free classes to improve patients’ ability to manage their own health and health programs; we’ll talk about cooking healthier meals, including to how to shop, what to look for on food labels. We are set up for all of that.” She also agrees that making it easier to get everything at one place makes all kinds of sense for the community. “Having the clinic, the pharmacy, the lab, occupational and physical therapy, etc.—patients don’t have to go anywhere else, and that means we have less of a chance of losing them in follow-up,” she said. Chris Nentarz, director of Thrive Wellness and Rehabilitation Center within the Hub, is also enthusiastic about the facility’s opportunities for both patients and students. “The model of care that students can engage and get experience with through the Hub is going to be great. They are our practitioners of the future, and evidence shows that early touches with this model help create more mindful practitioners,” Nentarz said. “Simply having a lot of knowledge isn’t enough anymore; medical practitioners need to be culturally competent, and learn to work interprofessionally, in teams.” Professions that students study for at D’Youville include traditional nursing, nurse practitioner, physician’s assistant, medical assistant, physical and occupational therapist, and pharmacist. And they will all get the chance to be a part of the teams meeting with and treating patients in D’Youville’s exciting new Health Professions Hub. “Students will be active in every facet of the Hub, from the student-run free clinic to working in the demo kitchen, running courses, doing work-study and internships in the pharmacy and other areas,” said Grupka. “Students will rotate throughout the entire building, and be able to work in an interprofessional approach. In the simulation center, there are six rooms where we will educate both health professionals for today and for the future.” “Healthcare needs to become less of a transactional process, and more transformational,” summed up Nentarz. “Healthcare and wellness are not a destination, but a journey. There are good, better and best paths for each individual. That’s a key principle of the D’Youville system, and there’s no better place than academia to address and work to redesign how things are done. We can research, pay attention, and work to create a new model that provides true gains for everyone. The systems must be better—we need a common language, goals and skill sets so that we can meet the needs of patients in a different way.”
Jenna Schifferle is a writer from Tonawanda. She’s running toward her goal of 2,021 miles this year, with a mission to do 30 miles for her 30th birthday.
Writer on the Run By Jenna Schifferle
jenna.schifferle@gmail.com
My 30 Miles for 30 Years Journey W hen my alarm sounded at 5 a.m., I forgot it was my birthday. I groaned as I hit snooze and shook the sleepiness from my eyes. The fatigue-induced calm quickly turned to determination as I remembered the task at hand: 30 miles for 30 years. I slipped into my running shoes, grabbed a quick breakfast and headed out the door. The world had begun to wake as the sun snuck over the horizon. Before me, the streets glowed with the morning rays, not a soul but me to disturb anything. Moisture collected in the air around me, as the humidity built. I knew it would eventually downpour, but that wouldn’t stop me. My watch read 5:45 a.m. as I took the first step of my journey and settled into a slow, comfortable pace. I planned to head toward Buffalo for five miles down the bike path before turning and heading back. If I had extra time before work, I’d do a loop or two around Tonawanda to complete between 10 and 15 miles. That afternoon, I’d do five to 10 more. The final leg of my 30-mile journey would wrap up with 10 miles the next morning. Thirty miles
in 30 hours for 30 years — I still love the symmetry of it. I made my way toward Buffalo, plucking a small piece of paper from my pocket at the first mile marker, then a different piece of paper at each mile marker that followed. The week before, I’d written a list of achievements and goals — 30 to be exact. My list comprised an even split of accomplishments I prided myself upon over the last three decades and dreams for the three decades ahead. In those early miles, I reflected on all I’d done to date: publishing poems and short stories, completing a rough draft of a manuscript, finding a passion for volunteering at the hospital, falling in love, creating a home, building a beautiful life. As the miles rolled, I found myself floating on gratitude. I ended up taking that loop around Tonawanda, and the skies held out long enough for me to clock 14 total miles before the storm. Later that evening, I met my “run friend,” Alex, at Outer Harbor. We cruised along the water’s edge and caught up on life. I ran stronger than I thought I would after that morning’s effort and found the second leg passed by with ease. That, I suppose,
is the power of good conversation. Afterward, my fiancé and I celebrated with a low-key dinner at a vegan restaurant called Big Mood. (Delicious food and friendly people made it a place I would 10 out of 10 recommend to everyone.) Admittedly, I hit the hay early to rise at the crack of dawn and clock the last of my 30-miler. I slept like I was hibernating, and when I woke up, I felt a bear-sized anger. Everything hurt — my shoulders, my neck, the arches of my feet. Despite my body protesting, I pushed through and got ready. My childhood best friend and her partner, Will, showed up around 7:30 a.m., and we hit the road by 8. This time, we headed toward Pendleton where I grew up. At the end of the journey, there would be a pool, shower, and breakfast at my favorite diner — the Country Cottage. We just had to run there. I needed to take it easy, so we decided to walk a bit between each mile to ease the stress of the run. This proved to be beneficial as we made our way down the bike path next to the canal in Tonawanda, down Old Falls Boulevard, and headed to Bear Ridge Road. We ran strong through
Local Providers Seek to Increase Health Literacy, Improve Outcomes For Communities Improving health literacy would improve health outcomes for many people By Julie Halm
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t is not so uncommon for a person to walk into their doctor’s office and nod their head as they are being given instructions or information which they do not fully understand. Many people are too embarrassed to simply say, “I’m not sure I fully get that. Can you explain it further?” In other cases, language barriers may prevent someone from having all of the medical information which they need from their doctor, pharmacist, or any other medical professional involved in their care. This lack of health literacy can lead to major issues. To solve the problem, one organization is looking not to the patients, but rather, to better inform the medical community itself. The Call to Action Health Literacy Trainer Program, which is funded by the Health Foundation for Western and Central New York, has chosen 11 organizations to participate in this year’s cohort, including the Buffalo Prenatal-Perinatal Network. According to the program’s website, the initiative is for professionals in healthcare and community-based organizations and includes a total of 10 training sessions in professional health literacy competencies and universal precaution strategies. The trainees then become the trainers,
AnnMarie Correa is the program manager for the Health Families Buffalo Program, through the Buffalo PrenatalPerinatal Network. going back to their organizations and meeting training criteria with their own personnel by Dec. 31. AnnMarie Correa, program manager for the Health Families Buffalo Program, through the Buffalo Prenatal-Perinatal Network, was chosen to take part in the 21 hours of training and then return with what she will have learned to teach members of her own organization. Correa, who has begun the courses, said there is great value in providers learning this information because it is not infrequent that
patients they work with are not fully comprehending what they need to know and medical professionals may not even be aware. “It’s eye opening,” she said. “It’s showing that sometimes we’re talking to families and it sounds right to us, and we’re explaining things, but it’s not clear to them.” Correa said she understands on a personal level, how intimidating it can be to simply say, “I don’t understand,” in order to avoid embarrassment. “Sometimes you get kind of scared to ask the questions,” she said. “So it’s incumbent upon that professional to make sure that the people that they’re treating are really understanding.” According to Correa, improving health literacy in this way would improve health outcomes for many people, including minimizing instances in which patients are taking medications but not doing so correctly, causing further health complications. While the issue of health literacy is not one that is just cropping up, Correa noted that as with so many other disparities, the pandemic has only served to exacerbate this issue. The Buffalo Prenatal-Perinatal Network works with individuals across many communities throughout Western New York. She said that
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the halfway point, but ached by mile 7. Christa had ‘90s music blaring on her phone, and we did our best to distract ourselves by singing out loud. We took in the water and stopped for photos in front of a towering concrete T-Rex. Instead of worrying about pace, we let ourselves enjoy one another’s company. Slowly, surely, we inched toward the 10-mile marker. At 9.5 miles, elation carried me home, and I threw my hands up in triumph. I’d done it with a little help from my dearest friends, and it felt empowering. That moment brought a renewed sense of accomplishment and gratitude for everything in my life over the past 30 years and for all the possibilities over the next 30. It was the perfect way to celebrate, and breakfast never tasted so good. Now onward to new adventures! trust in the medical community, or a lack thereof, is one barrier that has long existed, particularly in more vulnerable populations. “It’s not like it’s unjustified. There have been populations who have been forced to try this or that medication which has led to distrust,” she said. That distrust, according to Correa, has led to a lack of communication between the medical community and members of some communities which they serve. “I don’t blame these communities and these individuals. I blame our lack of communication with them,” she added. “I’m hoping that this education will help us to build a bridge and help build trust, especially with individuals who are vulnerable and really need the extra attention.” In addition to building trust and better health, increasing health literacy can also have positive overall financial implications, according to the Buffalo Prenatal Perinatal Network. “Helping community members increase their capacity to obtain, communicate, process and understand health information is a significant way to decrease healthcare costs and hospitalizations,” said Denise Herkey-Jarosch, development administrator at the Buffalo Prenatal Perinatal Network. For Correa, even with 26 years’ of professional experience under her belt, she said the information she has begun to receive is thought-provoking, and she is excited to bring it back to her team. For more information on the Buffalo Perinatal-Prenatal Network, visit https://bppn.org/.
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5-minute Workout Lowers Blood Pressure as Much as Exercise, Drugs ‘Strength training for breathing muscles’ holds promise for host of health benefits
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orking out just five minutes daily via a practice described as “strength training for your breathing muscles” lowers blood pressure and improves some measures of vascular health as well as, or even more than, aerobic exercise or medication, new University of Colorado Boulder research shows.
The study, published June 29 in the Journal of the American Heart Association, provides the strongest evidence yet that the ultra-time-efficient maneuver known as high-resistance inspiratory muscle strength training (IMST) could play a key role in helping aging adults fend off cardiovascular disease — the nation’s leading killer. In the United States alone, 65%
of adults over age 50 have above-normal blood pressure — putting them at greater risk of heart attack or stroke. Yet fewer than 40% meet recommended aerobic exercise guidelines. “There are a lot of lifestyle strategies that we know can help people maintain cardiovascular health as they age. But the reality is, they take a lot of time and effort and can be expensive and hard for some people to access,” said lead author Daniel Craighead, an assistant research professor in the department of integrative physiology. “IMST can be done in five minutes in your own home while you watch TV.” Developed in the 1980s as a way to help critically ill respiratory
Health Career
Medical Scheduler: Helping Patients to Schedule Visits By Deborah Jeanne Sergeant
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he medical scheduler is non-clinical role that includes direct contact with both patients and providers, forming a vital link between those giving and receiving healthcare. While not requiring any education beyond a high school diploma, this job can offer a means of getting into the administrative side of healthcare. Page 10
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Schedulers do more than make appointments. “They explain how the scheduling works, how to prepare for the appointment and—if it helps—what to wear and if should they have eaten,” said Toni Haugen, licensed acupuncturist with Queen City Health and Wellness in Buffalo. “When people come to see us, they’ve been in excruciating pain and are rightfully ner-
disease patients strengthen their diaphragm and other inspiratory (breathing) muscles, IMST involves inhaling vigorously through a handheld device which provides resistance. Imagine sucking hard through a tube that sucks back. Initially, when prescribing it for breathing disorders, doctors recommended a 30-minute-per-day regimen at low resistance. But in recent years, Craighead and colleagues have been testing whether a more time-efficient protocol — 30 inhalations per day at high resistance, six days per week—could also reap cardiovascular, cognitive and sports performance improvements. For the new study, they recruited 36 otherwise healthy adults aged 50 to 79 with above normal systolic blood pressure (120 millimeters of mercury or higher). Half did high-resistance IMST for six weeks and half did a placebo protocol in which the resistance was much lower. After six weeks, the IMST group saw their systolic blood pressure (the top number) dip nine points on average, a reduction which generally exceeds that achieved by walking 30 minutes a day five days a week. That decline is also equal to the effects of
some blood pressure-lowering drug regimens. Even six weeks after they quit doing IMST, the IMST group maintained most of that improvement. “We found that not only is it more time-efficient than traditional exercise programs, the benefits may be longer lasting,” Craighead said. The treatment group also saw a 45% improvement in vascular endothelial function, or the ability for arteries to expand upon stimulation, and a significant increase in levels of nitric oxide, a molecule key for dilating arteries and preventing plaque buildup. Nitric oxide levels naturally decline with age. Markers of inflammation and oxidative stress, which can also boost heart attack risk, were significantly lower after people did IMST. And, remarkably, those in the IMST group completed 95% of the sessions. “We have identified a novel form of therapy that lowers blood pressure without giving people pharmacological compounds and with much higher adherence than aerobic exercise,” said senior author Doug Seals, a distinguished professor of integrative physiology. “That’s noteworthy.”
vous about coming in. I believe it’s our job as an office to really prepare them for how the appointment.” Schedulers also help the office’s providers and other personnel function better. These offices can be busy places. “Medical schedulers play an integral role to keep patient flow on track and the practice running efficiently,” said Maureen Bisaccio, director of Adecco Medical & Science for Upstate New York. “By relieving doctors and nursing staff from certain responsibilities, it allows them to focus on providing more hands-on patient care.” Schedulers may also schedule home visits from some types of providers and schedule transportation to visits. This happens over the phone and sometimes in person, so a good candidate for a medical scheduler position should have good people skills and phone skills. Since medical offices use technology to keep all their visits organized, a medical scheduler should also possess proficiency in Microsoft Office and be capable of learning any practice-specific software. “Medical schedulers often work in a fast-paced environment,” Bisaccio said. “An ideal candidate will be detail-oriented, organized and have the ability to multi-task in a busy practice. Other soft skills include someone who has excellent communication skills and is professional and personable. As in any medical environment, there’s also an element of compassion and patience necessary to provide best-in-class service to patients.” A medical facility can be a stressful and busy environment. For this reason, Farah Roman, director of staffing services for RBA Staffing in Rochester, said that a good medical scheduler should have organizational skills. “It should be someone who can take ownership, has the ambition to troubleshoot and prioritize and reprioritize as the day goes on,” she said. “You have to work under pressure as you make changes to the schedule and meet the needs of the patient,
provider and other staff.” Smaller practices may require a medical scheduler to perform more secretarial duties, such as filing, reception, and managing the office. Larger facilities may silo the worker as only a scheduler. A successful medical scheduler may have a number of opportunities for advancement in a few different environments. Working as a medical scheduler can offer exposure to many facets of the medical office. “I’ve had schedulers move up to be a secretary for a few of our providers,” said Meg Steffan, customer service and scheduling manager at UBMD Orthopedics & Sports Medicine in Buffalo. “You’ve got to be thinking quickly when on the phone with patients. All of our doctors treat different body parts in orthopedics.” She started out as a scheduler and worked in that role seven years. While some medical offices have added online scheduling, Peter Holdsworth, operations manager with UBMD Orthopedics & Sports Medicine in Buffalo, does not see medical scheduling as an endangered career choice. “We do not see it as becoming more automated,” he said. “We’ve talked about online scheduling and we’re close to enabling that; however, we’re finding that there’s no substitute for the human interaction and the knowledge that an experienced scheduler can bring to the table. Everyone assumes online is easier, but the variety of questions about insurance, locations. Yes, we could build a logical hierarchy but it’s not easier or faster. A human on the phone may be the fastest.” Some people prefer making their medical appointments with a person rather than an online calendar. Some people have questions that require a phone conversation. Many medical offices believe that the customer service offered by a medical scheduler cannot be replicated through a website. The Bureau of Labor Statistics states that the annual mean wage for a medical scheduler in the Buffalo area is $38,350.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
SmartBites By Anne Palumbo
The skinny on healthy eating
4 Reasons to Eat More Blueberries
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hen it comes to superfoods—foods that abound with compounds considered especially beneficial to a person’s health—blueberries always make the top 10 list. What gives blueberries this nutritional edge? And why should we eat more of this powerhouse fruit? Let’s take a look at four good reasons.
1. Longevity Promoters Research shows that blueberries may have one of the highest antioxidant levels of all common fruits and vegetables. Antioxidants protect your body by neutralizing free radicals, which are unstable molecules that can damage cells and contribute to aging and diseases, such as Alzheimer’s, cancer, and diabetes. Although free radicals are naturally produced by the body, lifestyle factors—such as smoking, alcohol, fried foods—can accelerate their production, resulting in an unhealthy balance.
2. Brain Boosters Blueberries, which teem with flavonoids, a particular plant compound with powerful antioxidant and anti-inflammatory properties,
appear to reduce cognitive decline in the elderly, according to research published in Annals of Neurology. The study suggests that cognitive aging could be delayed by up to 2.5 years in older adults who consumed greater amounts of this nutrient-dense berry. Studies have also found that blueberries may improve a person’s short-term memory and motor coordination.
3. Blood Pressure Reducers Concerned about high blood pressure? Eating just one cup of blueberries a week may cut your risk of developing hypertension, a major risk factor for heart disease. Anthocyanins—the pigments that give red, purple and blue fruits and vegetables their rich coloring—seem to protect against high blood pressure, says a recent study published in the American Journal of Clinical Nutrition. While there is no cure for hypertension, making lifestyle changes—such as eating more berries—may lower your risk of heart disease, stroke, kidney disease and more.
4. Bone Builders Blueberries contain a unique mix
of minerals and vitamins that contribute to bone health, most notably vitamins C and K and the mineral manganese. While vitamin C is essential to the formation of collagen (the foundation that bone mineralization relies on), vitamin K helps to make various proteins that are needed for the building of bones. Manganese may help promote strong, dense bones when combined with calcium and vitamin D.
Healthy Blueberry Parfait with Granola 1 cup blueberries, washed and dried 1 cup plain Greek yogurt (or yogurt of choice) ½ cup granola Spoon ½ cup yogurt in the bottom of a glass and smooth the top. Add ¼ cup granola and ½ cup blueberries. Repeat the layers and eat right away, or chill in fridge until ready to eat.
Helpful tips Shake the blueberry container before purchase, noticing whether the berries move freely: if they do not, this may indicate that they are old, soft, or spoiled. Before storing, remove any crushed or moldy berries to prevent the rest from spoiling. Place in covered container and store in refrigerator for five to seven days. Don’t wash blueberries until right before eating as washing removes the bloom that protects the berries’ skin from degradation.
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
Whole Grains Every Day: Key to Your Health and Waistline
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hole grains can help older adults maintain a thinner waist, lower blood pressure and lower blood sugar, new research suggests. Just three servings a day may do the trick, the authors said. One serving is a slice of wholegrain bread, a half-cup of rolled oat cereal, or a half-cup of brown rice. Researchers noted that their study — partially funded by the General Mills Bell Institute of Health and Nutrition — doesn’t prove that whole grains are protective, only that there appears to be a link between them and waist size, blood pressure and blood sugar. “These are all risk factors that can contribute to the development of heart disease if not maintained at healthy levels,” said study co-author Nicola McKeown of the nutritional epidemiology team at Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging in Boston. The researchers used data from a health study of residents in Framingham, Massachusetts, which started in 1948. They looked at health outcomes linked to whole and refined grains in the diets of more than 3,100 participants. Data was collected every four years over a median follow-up of 18 years. (Median means half were followed longer, half for less time.) The new study compared changes in five heart disease risk factors — blood pressure, blood sugar, cholesterol, triglycerides and waist size
— with reported intake of whole grains. Researchers examined effects of eating less than a half-serving to three or more a day. The upshot: People who ate few whole gains gained an inch around the waist every four years — compared to a half-inch among those who ate the most whole grains. Participants who ate fewer whole grains also saw bigger increases in blood pressure and blood sugar than those who ate the most whole grains. While whole grain intake was also associated with improvements in blood levels of HDL, or good, cholesterol, as well as triglycerides, the
findings were not significant, researchers added. For waist size, blood pressure and blood sugar, the greatest benefit came from having three to four servings of whole grains a day. Most whole grains came from whole wheat breads and ready-to-eat cereals. Refined grains were mostly pasta and white bread. McKeon said whole grains probably help prevent adverse changes in risk factors studied in several ways, but the mechanisms aren’t yet known. “For instance, in terms of helping prevent gain in body fat, the benefits
August 2021 •
may be related to the fiber in whole grains, which can help to prevent post-meal blood sugar spikes, help us to feel full so that we might eat a little less, or even feed our healthy gut microbes,» she said. Other nutrients found in whole grains, such as magnesium, may help with maintaining healthy blood sugar levels and blood pressure. “And then we have the many phytochemicals found in whole grains that may act alone or in synergy with other nutrients to help maintain our health as we age,” McKeon said. “This is still a very active area of research.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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BACK TO SCHOOL ‘Anxiety is the No. 1 mental illness that children are dealing with right now. It’s common.’ Stacy Salamone, family psychologist in Cheektowaga.
Dealing with Back-toSchool Anxiety: What Can Parents Do?
Start preparing a couple weeks beforehand to make heading back to school stress-free By Deborah Jeanne Sergeant
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ost children feel excitement and perhaps nervousness about their first day back at school after summer break. For the 2021-2022 school year, COVID-19 may bring more changes—and, for some, concerns. But what indicates garden-variety jitters compared with anxiety that warrants help? Area experts weighed in. “Anxiety is the No. 1 mental illness that children are dealing with right now,” said Stacy Salamone, family psychologist in Cheektowaga. “It’s common. Young children will typically romanticize their anxiety:
stomachache, headaches or general avoidance of school. The parents should be concerned if they see patterns of that occurring. They’re missing school because of these symptoms. That’s how younger children present. Older children have a greater capacity to be more verbal.” Older children may say they do not want to go back or excessively plan their return. Striking a good balance between planning and obsessing can help children feel prepared, yet flexible if things go differently than they anticipated. “Be mindful of any type of worrying symptoms and mood related
Youth Vaping Rates Decline But one in five U.S. teens still uses e-cigs
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lthough the number of teens who use e-cigarettes has dropped significantly, new research suggests that vaping
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rates are still too high. “This study underscores that flavored e-cigarettes, especially JUUL, have caused the epidemic of youth
Jacobs School of Medicine to it,” Salamone said. “If & Biomedical Sciences, they’re worried and anxrecommends getting ious about school, there back to a regular bedtime may be some depression if and mealtime at least it’s a situation that’s diffitwo weeks before school cult to overcome or that’s begins. It may also help to not going away.” do a trial run. She encourages par“Do some practices,” ents to try to talk about Adragna said. “If the their children’s anxiety child is anxious about the with them to help gauge first day of high school how serious it is. But it is or middle school and a more helpful to ask creMichael Adragna new building, drive to the ative questions, not “How school a couple times. Go inside, if was your day?” Instead, ask, “What possible. That takes a lot of the preswas the best thing that happened at school today?” This can help children sure off the first day.” Some children feel anxious about focus on the positives. having new teachers. Adragna said “If you get into a pattern, they’ll that meeting the teacher can help. look for it and be more mindful Review the school website to about the positives,” Salamone said. view photos of the teachers, grounds But this approach is best when and the school’s theme for the year. teamed with, “What was challengAdragna suggested connecting ing” and then reaffirming the child’s with a teacher, aide or school social self-confidence with something like, worker to let them know this child “That was difficult. It sounds like may need additional attention. you were brave and I’m proud of “The kid should know there’s how you handled that.” someone there who could keep an “A lot of parents try to solve their problems and they want to help eye on them, too,” Adragna said. “In general, the best way to work them,” Salamone said. “That’s not what older kids are looking for. They through our fears is to face them with the appropriate amount of supwant validation and empathy more port. Avoidance is generally not the than, ‘Fix this for me.’” Summertime often represents for answer. Going to school in spite of anxiety one day makes it easier to go children a period of greater freedom, the next day.” relaxed schedules and more time to Anxiety that prevents the child play. While this much-needed break from eating, sleeping or other routine can help them recharge for learning daily activities for a period of time in September, it also means that they may indicate that professional help are out of synch for the schooltime is warranted, as well as an inability schedule. To combat this effect, phyto calm down with distractions or sician Michael S. Adragna, clinical comforting supports. assistant professor of psychiatry in the department of psychiatry at UB’s e-cigarette use and nicotine addiction in the U.S. and shows why the [U.S. Food and Drug Administration] and other policymakers must act now to eliminate all flavored e-cigarettes,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids. To get around bans on e-cigarettes sold to kids, there was a dramatic shift to fruity-flavored disposable e-cigarettes, such as Puff Bar, and pre-filled menthol cartridge products, which were left on the market by loopholes in U.S. Food and Drug Administration regulations, he said. “It’s alarming that over 7% of high school e-cigarette users wrote in Puff Bar as their usual brand, although it was not named in the survey,” Myers said. For the study, researchers from the U.S. Centers for Disease Control and Prevention surveyed more than 14,500 middle and high school students about their use of e-cigarettes. In 2019, 27.5% of high school students and 10.5% of middle school students said they used e-cigarettes. In 2020, those numbers dropped to 20% of high school students and 5% of middle school students. The
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
preferred brand of e-cigarettes was JUUL, which was used by 25% of high school vapers and 35% of middle school students. Most users got their e-cigarettes from a friend (57% of high school students and 59% of middle school students), reported the researchers, who were led by Teresa Wang, from the CDC’s Office on Smoking and Health. Flavored e-cigarettes were preferred by far among by both high school and middle school students (85% of high schoolers and 74% of middle schoolers). Fruit-flavored e-cigarettes were the most popular, followed by mint-flavored e-cigarettes. Also, many students switched to disposable and refillable e-cigarettes, the researchers noted. “The evidence is clear that as long as any flavored e-cigarettes remain on the market, we will not end this youth epidemic,” Myers said. “The FDA must act to clear the market of all flavored e-cigarettes. And it should reject JUUL’s application to keep selling its products, given the unquestionable evidence that JUUL drove the youth e-cigarette epidemic and remains highly popular with kids.”
BACK TO SCHOOL
Remote Learning Hurt High School Students Academically, Emotionally
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here were academic, social and emotional consequences for U.S. high school students who attended classes remotely during the COVID-19 pandemic, new re-
search shows. The study included more than 6,500 students in Orange County Public Schools in Florida, who were surveyed in October 2020, when two-
School Is Back, and So Is Bullying
Responding like a bully only makes two bullies By Deborah Jeanne Sergeant
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he National Education Association estimates that 160,000 children miss school each day because they fear bullying from other students. Beginning in 2012, the New York State Education Department has required all public schools to file reports on incidents of bullying, harassment, intimidation or menacing. The state defines bullying and harassment as creating “hostile environments through threats, intimidation or abuse, including cyberbullying.” Some children fear reprisal at school if they tell their parents about a bullying situation at school. But the effects of bullying may manifest as signs parents can spot at home. “Sometimes it’s a stomachache first thing in the morning and they’re fine on weekends,” said physician Kathleen Grisanti, president and medical director of Pediatric and Adolescent Urgent Care of WNY with local practices in Williamsville and Orchard Park. “We suggest parents keep an eye on the timing. It could be something or someone at school they want to avoid.” Children may also try to explain injuries, lack of interest in activities or missing or damaged possessions as bullying progresses. Bullying behavior commonly stems from issues the bully experiences at home because of parental neglect, abuse or mistreatment. Chil-
dren often bully as a means of acting out to get attention or as a misguided attempt at building their ego. “When you look at the kid who’s the bully, they have some pretty horrible stories,” said Stacy Salamone psychologist based in Cheektowaga. “I recommend treating a bully with compassion and trying to understand why. Is it because they’re bullied at home and they want some even negative attention? You should feel bad for this kid if he’s bullying and not trying to make friends; he’s having a hard time.” By attempting to understand the bully, the victim can respond in a way that won’t exacerbate the situation. She encourages parents to teach their children to not feed into bullying and to use words to express that they do not like what the bully is saying or doing. Responding like the bully only makes two bullies. Asking bullies why they are acting this way, responding with humor or walking away can represent ways to respond to bullies. “I’d still involve an authority figure so if they have something going on at home, someone may need to check it out,” Salamone said. “I’m concerned about the bully if they’re showing aggression and it’s reinforced at home.” She also encourages parents to “model that empathy and compassion. That’s the best way to be proactive about these difficulties. Empathy is, ‘Wow, I understand why you’re
thirds were attending school remotely and one-third were attending in person. On a 100-point scale, in-person students scored higher than remote students on social well-being (77.2 vs 74.8), emotional well-being (57.4 vs 55.7) and academic well-being (78.4 vs 77.3). This “thriving gap” was consistent across gender, race/ethnicity and socioeconomic status, according to the study published online July 13 in the journal Educational Researcher. “Notably, the thriving gap was larger among students in 10th through 12th grades than it was among ninth graders,” study co-author Laurence Steinberg, a professor at Temple University in Philadelphia, said in a journal news release. While the differences between the two groups of students aren’t large, even small effects are significant when they impact millions of people, the researchers explained. “Many news stories have reported on individual stories of teenagers who have suffered from anxiety, depression and other mental health challenges during the pandemic,” said study author Angela Duckworth, a professor at the University of Pennsylvania and the feeling this way, as if it were happening to me.’ The attempt to search for a deeper understanding and identify with how they’re feeling.” Bullies need to learn to solve problems in a way that is not aggressive. Social skills like taking turns, losing a game or making friends may be lacking. While other children cannot be expected to fill in these gaps, becoming aware of why the bully may act out can be helpful in responding in more constructive ways. “We want them to be proactive and encourage pro-social behavior,” Salamone said. “It’s two people who are being helped essentially. Let’s confront bullies and help them.” She likes the quote from Dr. Martin Luther King, Jr.: “Returning hate for hate multiplies hate, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that. Hate multiplies hate, violence multiplies violence, and toughness multiplies toughness in a descending spiral of destruction.” Some children bully because they are anxious about social settings. It is easier to assure a dominant social status by force than to risk it by playing nice. Extending friendship to these children may cause their tough kid facade to crumble. When strategies like these do not work, or if a situation is immediately violent, children need to know that they should let a teacher, coach or school counselor know right away and tell their parents at home. Many children feel uncomfortable sharing about bullying outside their home; however, telling a school official about the bullying is usually necessary to resolve it. If this does not help the situation and it continues for a long time, children may need mental health treatment because of the stress and anxiety it causes.
August 2021 •
founder and CEO of Character Lab. “This study gives some of the first empirical evidence of how learning remotely has affected adolescent well-being,” Duckworth added. Social well-being was assessed by asking the students about fitting in at school, whether there was an adult in their school who could offer support or advice, and whether there was an adult in their school who always wanted them to do their best. For emotional well-being, the teens were asked how often they felt happy, relaxed and sad, and how they felt overall about their life. For academic well-being, the students were asked how interesting they found their classes, how important they felt it was for them to do well in their classes, and how confident they were that they could succeed in their classes if they tried. “As policymakers gear up for national tutoring and remediation programs — which we agree are urgent priorities — we must recognize that our nation’s students are not just lagging as performers, they are suffering as people,” Duckworth said. “Meeting their intrinsic psychological needs — for social connection, for positive emotion, and authentic intellectual engagement — is a challenge that cannot wait,” she added.
Coping with Bullying Stopbullying.gov offers a few tips to help bystanders deescalate a bullying situation: • Question the bullying behavior. Simple things like changing the subject or questioning the behavior can shift the focus. • Use humor to say something funny and redirect the conversation. • There is strength in numbers, too! Bystanders can intervene as a group to show there are several people who don’t agree with the bullying. • Walk with the person who is the target of bullying to help diffuse potential bullying interactions. • Reach out privately to check in with the person who was bullied to let them know you do not agree with it and that you care. It makes a difference.
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BACK TO SCHOOL
What Dentists Want Parents To Do Adults can help promote good dental health among children By Deborah Jeanne Sergeant
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n a sense, dentists treating children see two patients with each visit: the child and the accompanying parent. While the dentists treat the child, the parent receives dental education to improve home care. Several issues consistently come up during these visits. Amanda Dotterman, dental hygienist at Advanced Dental, PC, in Niagara Falls, wants parents to watch their children’s snacking more closely. While avoiding sugary snacks makes sense, noshing on Goldfish crackers or Cheerios all day is not a great idea, either. “Goldfish and Cheerios break down into sugars,” Dotterman said. “If they’re snacking on this all day, it’s an acid attack on their teeth. Fruits, vegetables and things that aren’t carbs are better. Even with sugar, it’s better to do it all at once so your teeth have a time buffer to re-miner-
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alize.” Parents should offer one portion for five minutes. If it is not finished, the remainder of the portion should be taken away. For children who frequently claim they are hungry, parents should remain strict about eating times. Many times, it is just boredom or thirst instead of hunger. It takes about 30 minutes for saliva to reduce the acid in the mouth. However, a drink of water can help. Dotterman also cautions parents about allowing children to sip beverages all day (unless it is water). “Especially for young children, keep sugary drinks to a minimum,” she said. That includes natural sources of sugar, such as unsweetened fruit juice. While more healthful than sugar-sweetened beverages like juice cocktail, sports drinks and energy
drinks, it still contains acid that breakdown the teeth. “Keep it to four ounces of juice per day, maximum, all at once or at mealtimes is better,” Dotterman said. “Water is the best choice.” She also reminds many parents to have their children wear a mouthguard for sports beyond just football and lacrosse. A collision with other players, equipment like the net or ball, or falling during play can endanger teeth. “If you forget to grab the mouthguard, one from the drugstore is OK for a day or two,” she said. “Longterm, you want a custom one that your dentist can make you. That is the best. The ones from the drugstore are softer than the one your dentist would make. “If anything ever happens and a tooth falls out, put it in a glass of milk and run to the dentist.”
Children can use a face shield on their sports helmet if applicable. One aspect of home care that many parents overlook is flossing. Stuffing large hands into tiny mouths is challenging. However, Dotterman said that using floss picks may make it easier. “Once the teeth in the back are touching, you want to start flossing, whether a parent is helping or a parent is supervising,” she added. In addition, children should begin seeing the dentist by 1 year of age. That is the most important aspect of improving children’s oral health, according to Peter DeMarco, dentist, professor and head of the department of dental lab technology at SUNY Erie in Orchard Park. Dentists can help children and parents learn proper home care, which DeMarco said starts with brushing. “It’s very important to start brushing the child’s teeth as soon as the first tooth comes in,” he said. “The parents should brush the child’s teeth with fluoride toothpaste the size of a grain of rice until age 3. From ages 3 through 6, use a peasized amount.” Parents should help their children brush until age 7 or when their manual dexterity is sufficient to do a good job. Otherwise, it is easy for children to miss spots. “A lot of people don’t realize that your first adult teeth come in around age 6,” DeMarco said. “It’s a molar that is never replaced. Parents should not ignore the health of baby teeth. If there’s a cavity, it can damage the underlying adult tooth.” Around age 6 or so, children may be capable of brushing their own teeth; however, their parents should always supervise. Tiffany Jadoo, board-certified pediatric dentist with Winning Smiles in Amherst, advises patients to brush at least twice per day. Ideally, they should brush three times daily. “Brushing after lunch is good as well. However, most children are not able to do so at school,” Jadoo said. “Rinsing the mouth with water can help reduce the bacteria load after lunch. Drink water throughout the day. It helps wash whatever you’re eating off your teeth.” Brushing before bedtime is also important, as well as flossing at that time since saliva flow lessens at night.
RE-PACK THE BACK PACK: HOW TO HELP YOUR KIDS HAVE A GREAT SCHOOL YEAR
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Local experts share their advice on how to help you and your kids get back into a routine that will support their success and mental wellness.
Reach health-conscious readers all across the region. Advertise with In Good Health. Low rates, wide distribution. All month long.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
For advertising information: editor@BFOhealth.com
BACK TO SCHOOL
Back to School for Kids on the Autism Spectrum Be patient and realistic. It could get overwhelming for the parents and the child By Deborah Jeanne Sergeant
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any children feel excited about going back to school. But for some children on the autism spectrum, the thought of returning to school feels overwhelming. Routine helps many children with autism thrive. The tumultuous 2020-2021 school year was anything but predictable. In addition to typical first-day jitters, children on the autism spectrum may feel particularly uncertain as they begin the new school year. “At the core of autism is a desire for routines and difficulties with socialization,” said physician Michael Adragna, from UBMD Psychiatry. “Both of those have been enormously challenging in the past year.” He advises parents to develop a
social story to help their children on the spectrum create some predictability. “Kids who have more of a classic autism and are in a more specialized education setting have difficulty with long conversations about feelings but learn well with pictures and visual aids,” Adragna said. Parents and children can create a unique social story with four to six illustrations about going back to school, including when to get up, riding the bus, going to class, eating lunch, and completing the school day. He added that it can also help to visit the school with the children and meet the teachers before school starts. Whether on or off the spectrum, children feed into their parents’ emo-
CALENDAR of
HEALTH EVENTS
Thru August–September
Narcan Virtual Training Schedule for August, September The Erie County Department of Health and the Erie County Opiate Epidemic Task Force are sponsoring trainings to recognize the signs of an opioid overdose and use Narcan (naloxone) to reverse an opioid overdose.
It started in July but it will continue in August and September. Virtual trainings are offered in a one-hour format as “Lunch and Learns” for individuals who would participate during a lunch break, and also in a 90-minute format. Participants who provide a mailing address will receive a free Narcan kit after the training is complete. Participants will need a computer with Internet access or a smart phone with the ability to access WebEx. The schedule is as follows: Aug. 3 from noon to 1 p.m.; Aug.
tional state. For this reason, Adragna cautions parents to remain calm and reassuring. When it’s time to drop children off, goodbyes should be brief. Teachers know how to distract children and draw them away from focusing on their nervousness. It is better to leave instead of linger. By helping children move out of their comfort zone, parents can help children grow emotionally. While Mary Brzustowicz likes using visual supports, as a family navigator with AutismUp in Rochester, she realizes that some children who are very rigid thinkers may balk if they arrive at their classroom to find a blue desk and the photos showed a green desk. “That’s where a cartoon desk is helpful,” she said. Going from lax summer bedtimes to school night bedtimes should not happen overnight. Brzustowicz said that beginning the transition three weeks in advance of school’s start can help ensure children are well-rested for school. Parents are experts in their own children, so Brzustowicz encourages them to stay in contact with the school to share learning strategies that work. “We always recommend for 7 from 9 to 10:30 a.m.; Sept 15 from 1 to 2 p.m. and Sept. 18 from 9 to 10:30 a.m. Register for virtual or in-person trainings at www.erie.gov/opioidtrainings. • Text for Narcan: 716-225-5473 • Request an emergency Narcan box for your business: 716-858-7695 • Buffalo & Erie County Addiction Hotline: 716-831-7007.
Aug. 6
Facebook live event focuses on the latest in orthopedic treatments Catholic Health is hosting a special Facebook Live event, “What’s Poppin’? The Latest in Orthopedic Treatments,” from noon to 1 p.m., Friday, Aug. 6, featuring a panel of local orthopedic specialists.
August 2021 •
parents is to print out a page about your child,” she said. “What are their preferred things, strengths and weaknesses? Preferred topics? When perhaps the classroom teacher sees your child is getting the wiggles, maybe incorporate a Thomas the Train illustration into the math lesson. It can deescalate them. If the parent doesn’t share that, the teacher won’t know that.” Parents should also remain open to the school’s feedback and try to share regularly through a folder, emails or whatever means is easiest Lawana Jones for both the parent and school personnel. By keeping a dated log of communication, parents can better track trends and know who said what and when they said it. “The boat goes much better if we’re rowing in the same direction,” Brzustowicz said. “We need to be willing to work as a team. Keep all your communication respectful. Sometimes, the parent, yours truly included, needs to be open to what the school is saying, too.” A child’s special needs adds challenges to the already enormous undertaking of being a parent. Lawana Jones, president and CEO of The Autism Council of Rochester, reminds parents to care for themselves. “Focus on what’s going right day by day,” she said. “Find an activity you can do that’s calming. Parents need to remember they’re doing the best they can do.” Staying in touch with how the child feels also helps parents know they’re doing. Jones suggested using a communication board to convey feelings and concerns. By showing “I feel sad” or “I feel afraid” on the board, children who struggle verbally can still express how their school experience is going. “Be patient and realistic,” Jones said. “It could get overwhelming for the parents and the child. We need a level of grace, including for the teachers and administration. It really needs to be a partnership.” Tune in as physicians Andrew O’Hara from Buffalo Medical Group (Orchard Park), David Pula from Excelsior Orthopaedics (Amherst & Orchard Park), and Thaddeus Szarzanowicz from Trinity Medical WNY (Williamsville & Hamburg), come together to discuss common sports and overuse injuries and how to treat them; non-surgical treatment options for joint pain such as injection-based therapies and physical therapy; relief options for arthritis; and the latest surgical techniques for hip, shoulder, and knee replacement. They’ll also be ready to answer your questions, live, from Seneca One Tower. Follow Catholic Health on Facebook at facebook.com/catholichealth to receive a notification when it’s time to join. If you have a question for our physicians, send it to us in advance through the event listing at chsbuffalo.org/events or submit it via chat during the event.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Ask The Social
Security Office
Atrial Fibrillation: Take Your Fluttering Heart Beat Seriously By Kimberly Blaker
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ften, when we think of heart conditions, we associate them with age. Although atrial fibrillation (AFib) is found more often in those over age 60, it can affect people of all ages, even children. Two million Americans are affected by this serious condition, which increases the risk of health complications, including heart attack and stroke.
What is AFib, and what causes it? AFib makes the heart beat rapidly and irregularly. It commonly feels like a fluttering of the heart. According to the Mayo Clinic, “During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart.” AFib, also known as arrhythmia, is not deadly in and of itself but is nonetheless a serious condition. It increases the risk of heart failure or can be the result of a serious underlying health problem. There are several causes associated with AFib. It can be genetic or may be caused by one of several heart-related diseases, previous heart surgery, sleep apnea, lung disease, infection or an overactive thyroid. Caffeine, heavy alcohol use, street drugs and certain medications can also cause AFib.
What are the symptoms, and how is it diagnosed? The most common symptom of AFib is a fluttering heartbeat or palpitations. Other symptoms also sometimes accompany the condition, such as: • fatigue • dizziness • thumping in the chest • anxiety • shortness of breath • feeling faint or confused • sweating
• chest pain or pressure In the event of chest pain or pressure, you should treat it as a medical emergency because it could indicate a heart attack. If you do experience symptoms AFib, diagnosis is painless and relatively simple. Your doctor will perform a physical examination and an electrocardiogram. A patient-activated cardiac event recorder can also help with the diagnosis.
Types of AFib and treatment There are four types of AFib, although one form can progress into another. • Paroxysmal AFib is intermittent and can last for just a few seconds or up to a week. Symptoms may range from none to severe. Either way, this form of AFib goes away on its own within a week or less. • Persistent AFib doesn’t go away on its own. It lasts until it’s treated with either medication or electric shock. For those at high risk of a stroke or if there’s another known cause of the AFib, physicians will treat the source of the irregular heartbeat as well. • Longstanding persistent AFib doesn’t respond to the above typical treatments. So several forms of minimally invasive catheter ablation are usually considered. For this procedure, you’ll be given something to relax you and a local anesthetic to numb the groin or neck area where the catheter will be inserted. • Finally, permanent AFib occurs when longstanding persistent AFib is unresponsive to treatment. If treatment has been ineffective, your doctor might decide to discontinue the treatment. This form of AFib is associated with an increased risk of a heart attack and can also impact the quality of your life. So whatever the form of AFib, take the condition seriously. If you experience symptoms, seek medical attention without delay.
Reach health-conscious readers all across the region. Advertise with In Good Health. Low rates, wide distribution. All month long. For advertising information: editor@BFOhealth.com
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From the Social Security District Office
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What Did You Earn at Your First Job?
ver wonder what you earned the year you worked your first job? Or perhaps any other year you worked? We can tell you. Your earnings history is a record of your progress toward your future Social Security benefits. We keep track of your earnings so we can pay you the benefits you’ve earned over your lifetime. This is why reviewing your Social Security earnings record is so important. While it’s your employer’s responsibility to provide accurate earnings information to us, you should still review your earnings history and inform us of any errors or omissions. This is so you get credit for the contributions you’ve made through payroll taxes. You’re the only person who can look at your lifetime earnings record and verify that it’s complete and correct. If an employer didn’t properly report even just one year of your earnings to us, your future benefit payments could
Q&A
Q: I got an email that says it’s from Social Security, but I’m not so sure. They want me to reply with my Social Security number, date of birth, and mother’s maiden name for “verification.” Did it really come from Social Security? A: No. Social Security will not send you an email asking you to share your personal information, such as your Social Security number, date of birth or other private information. Beware of such scams — they’re after your information so they can use it for their own benefit. When in doubt, or if you have any questions about correspondence you receive from Social Security, contact your local Social Security office or call us at 1-800-772-1213 (TTY 1-800325-0778) to see whether we really need any information from you. Q: My same-sex partner and I recently married. Will we qualify for Social Security benefits? A: You may be eligible to apply for Social Security benefits. Many factors affect your eligibility for benefits, including how long you worked and your age. Social Security is now processing more claims in which entitlement or eligibility is affected by a same-sex relationship. We encourage you to apply for benefits right away, even if you aren’t sure you’re eligible. Applying now will protect you against the loss of any potential
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
be less than they should be. Over the course of a lifetime, that could cost you tens of thousands of dollars in retirement or other benefits to which you are entitled. It’s important to identify and report errors as soon as possible. As time passes, you may no longer have easy access to past tax documents. Also, some employers may no longer exist or be able to provide past payroll information. The easiest way to verify your earnings record is to visit www.ssa. gov/myaccount and set up or sign in to your personal my Social Security account. You should review each year of listed earnings carefully and confirm them using your own records, such as W-2s and tax returns. You can find out how to correct your Social Security earnings record by reading our publication How to Correct Your Social Security Earnings Record at www.ssa.gov/pubs/EN05-10081.pdf. Let your friends and family know they can access important information like this any time at www. ssa.gov and do much of their business with us online.
benefits. You can apply safely and securely at www.ssa.gov/applyonline. Learn more about Social Security for same-sex couples by visiting www. ssa.gov/same-sexcouples. Q: I heard there is a Social Security video available in American Sign Language (ASL). Where can I find it? A: Yes, it’s true. The video is called “Social Security, SSI and Medicare: What You Need to Know About These Vital Programs.” The video is available in ASL and it presents important information about our programs. You can watch the video now at www.ssa.gov/multimedia/video/ asl. The video is a part of our larger collection of on-demand videos and webinars available at www.ssa.gov/ webinars and at www.YouTube.com. Q: I run a bed and breakfast. By this time every year, I am tired of all the paperwork involved with filing taxes. Is there an easier way for small businesses to file W-2s for their employees? A: Absolutely. If you are a small business owner or entrepreneur, you should check out Social Security’s Business Services Online (BSO) website. There, you can file your employees’ W-2s and W-2cs electronically and print out the W-2s to provide paper copies to your employees. You also can verify the Social Security numbers of your employees. Our online services are easy to use, fast, and secure. Visit our BSO page at www. ssa.gov/bso.
and occurs when the throat muscles relax during sleep, blocking the airway. While anyone can have it, sleep apnea is most common in people who are overweight, male, middle-aged and older. For women, the risk increases after menopause. The symptoms include loud snoring (however not everyone who snores has apnea), long pauses of breathing, gasping or choking during sleep and daytime drowsiness. But because most of these symptoms happen during sleep, most people don’t recognize them. It’s usually the person they’re sleeping with who notices it.
By Jim Miller
The Hidden Dangers of Sleep Apnea Dear Savvy Senior, How can you know when someone has sleep apnea? My husband has become such a terrible snorer that he wakes himself up at night, and he keeps me up too. Tired Teri
Dear Teri, If your husband is a loud snorer who wakes himself up during sleep, he probably needs to be tested for sleep apnea, a dangerous disorder that affects more than 22 million Americans, but often goes undiagnosed.
Diagnosing Sleep Apnea
Sleep apnea is a disorder that causes a person to stop breathing during sleep, hundreds of times during the night, for 10 seconds or more at a time. Left untreated, it can cause extreme daytime sleepiness, as well as a host of serious health conditions like high blood pressure, heart attack, stroke, diabetes and dementia. In fact, it’s estimated that every year, around 38,000 Americans die in their sleep from a heart attack or stroke because of sleep apnea. But the good new s is that sleep apnea is very treatable and most insurance companies, including Medicare, cover it.
Who Has It? There are three types of sleep apnea: obstructive, central and mixed. Of the three, obstructive sleep apnea (or OSA) is by far the most common
To help you get a handle on your husband’s problem, the American Sleep Apnea Association has several diagnostic tests he can take at SleepApnea.org/treat — click on “Test Yourself.” If the screening indicates that he may have sleep apnea, make an appointment with his doctor or a sleep specialist who will probably recommend an overnight diagnostic sleep test called polysomnography, which can take place at a sleep center lab (see SleepEducation.com), or at home using a portable device.
Smoking can increase the amount of inflammation and fluid retention in the upper airway. And alcohol and sleeping pills can relax the muscles in the back of his throat, interfering with breathing. Addressing these issues, if necessary, is usually the first line of treatment. If that doesn’t do the trick, mild cases of sleep apnea may respond to oral devices that fit into the mouth like a removable mouth guard or retainer. These devices work by positioning the lower jaw slightly forward to keep the airway open during sleep. Another noninvasive treatment option to consider is the new FDA approved eXciteOSA device (eXciteOSA.com). This treats sleep apnea and snoring by improving tongue muscle function by delivering electrical stimulation to the tongue through a mouthpiece that’s worn for just 20 minutes during the day. If none of these options work, the most effective and commonly prescribed treatment for OBA is a continuous positive airway pressure (CPAP) device. This involves sleeping with a snorkel-like mask that’s hooked up to a machine that gently blows air up the nose to keep the passages open. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
Treatment Options Your husband is at greater risk for sleep apnea if he’s overweight, smokes or consumes excessive amounts of alcohol. Excess weight, especially around the neck, puts pressure on the airway, which can cause it to collapse.
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Health News ECMC named among top hospitals for inclusivity
a confidence in the work Roswell Park does and the hope Roswell Park’s discovery brings to families confronting COVID and cancer.”
Erie County Medical Center has been named among the top 50 hospitals in the United States for racial inclusivity. The Lown Hospital Index has developed the first ranking to examine the racial inclusivity of over 3,200 hospitals in the country to assess their success at serving the people of color living in their communities. Founded in 1973 by Nobel Peace Prize winner Bernard Lown, developer of the defibrillator and cardioverter, the Lown Institute, based in Boston, advances civic leadership, accountability, and value in health care. The institute believes a radically better system of health is possible and generates bold ideas to that aim. The Lown Hospitals Index, a signature project of the Institute, is the first hospital ranking focused on civic leadership and includes measures like inclusivity by race, avoidance of overuse, and pay equity. “ECMC continues to prioritize racial diversity, equity and inclusion, both in the care of our patients and the composition of our workforce. This national ranking by the prestigious Lown Institute is gratifying and affirms our focus on strengthening ECMC’s leadership in programs and policies that promote racial equity and inclusivity,” said Thomas J. Quatroche Jr., Ph.D., ECMC president and CEO. “In 2018, we formally created the office of diversity, equity and inclusion within our institution, reporting directly to the office of the CEO to ensure the comprehensive development and implementation of programs and initiatives to benefit our diverse workforce. In addition, we are proud of our foundational support of the community-based African-American Health Equity Task Force, reinforcing ECMC’s commitment to initiatives that contribute to a more equitable, inclusive and healthy community,” said Quatroche Jr.
Batavia hospital receives largest donation in its history
Roswell Park teams draw more than $34 M in grants Even as the COVID-19 pandemic took hold, Roswell Park Comprehensive Cancer Center scientists continued to draw support for their innovative research proposals, garnering more than $34 million in competitive grants from government agencies and private funders. These recent grants fund efforts to improve outcomes for patients with some of the most challenging cancer types — including triple-negative breast cancer, pancreatic cancer and head and neck cancers — and to advance what we know about the impact of COVID-19 in cancer patients. “The scope and significance of the research being conducted right here at Roswell Park Comprehensive Cancer Center cannot be understated,” says Congressman Brian Higgins, co-chairman of the U.S. House of Representatives Cancer Caucus. “The federal government invests in promising science and scientists. The magnitude of these grants represents Page 18
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United Memorial Medical Center (UMMC) in Batavia has been gifted the largest donation in its history of more than 100 years. Marian Ransom, who lived in LeRoy, left her entire estate of more than $1.2 million to the hospital upon her death last year. In her honor and her generous contribution, the second floor medical wing at UMMC has been renamed the “Marian Ransom Medical Unit”. “It’s contributions like Marian’s that make such a profound impact on the community,” said Dan Ireland, president of United Memorial Medical Center. “We are beyond grateful for Marian’s contributions and what it will mean for the hospital, our patients and the community. With the support of her donation, we’ll be renovating the intensive care unit (ICU), which will also have a significant impact on the newly named Marian Ransom Medical Unit.” The ICU project is still in the early stages of development, but when complete will improve patient, visitor access and flow to both the ICU and the MarMarian Ransom ian Ransom Medical Unit. The ICU will get a new waiting area and greeting area and also, clinical support spaces for both units. “Marian desired to make a difference at the end of her life and so bequeathed her entire estate of more than $1.2 million to United Memorial Medical Center,” said Michael T. Welsh, Ransom’s attorney. “This humble and philosophical woman has left a legacy which will benefit so many of our citizens for years to come.” UMMC is part of the Rochester
Regional Health, based in Rochester.
Give 716 fundraiser to benefit ECMC
The ECMC Foundation has introduced Give 716, a collaborative effort between the Buffalo Bills Foundation and Buffalo Sabres Foundation by using their collective resources to benefit nonprofit organizations in Western New York. ECMC, along with Kaleida Health, is the official healthcare sponsor of the Buffalo Bills. The Give 716 donation campaign was established in response to the unprecedented challenges and a critical gap in the services that local nonprofits faced last year as a result of the pandemic. The goal of Give 716 is to unite Bills and Sabres fans with the Western New York community in “an epic day of giving.” Other objectives of Give 716 are to establish greater awareness and develop deeper, more meaningful connections between nonprofits that provide vital supporting services to the Western New York community. “ECMC has always been there for our community, and over the past 18 months our dedicated caregivers have stood tall on the frontline of the COVID-19 pandemic,” said Thomas J. Quatroche Jr., Ph.D., president & CEO of ECMC Corp. “From compassionate care of COVID patients at the bedside to providing tens of thousands of vaccines to keep our community safe, ECMC continues to be there for Western New York each and every day. Give 716 is an opportunity for Bills and Sabres fans and others to express their appreciation in recognition of our frontline heroes
who have consistently stepped up to care for our family members, friends and neighbors.” Through Aug. 16, ECMC is offering a special thank-you opportunity for Give 716 donors who choose ECMC Foundation as their charity of choice for their donation; one donor will receive a pair of Buffalo Bills 50yard line season tickets at Highmark Stadium, two additional donors will each receive a pair of single game tickets. Participants in Give 716 can donate with the opportunity to receive Buffalo Bills tickets by visiting www. ecmc.edu and clicking on the Give 716 button at the top of the home page.
BCBS employees donate to Boys & Girls Club Highmark Blue Cross Blue Shield of Western New York employees collected nearly 1,000 back-to-school supplies for local organization Boys & Girls Club of Buffalo. The local health plan has long supported the organization’s annual “2 Pack a BackPack Challenge.” This year, Highmark Blue Cross Blue Shield’s back-to-school-supplies drive was hosted virtually using YouGiveGoods, making it convenient for employees to visit the site to purchase an assortment of needed school supplies. Donated items are shipped directly to the Boys & Girls Clubs of Buffalo and then distributed to local families in need. “The Boys & Girls Clubs of Buffalo is grateful for the exceptional support we received from Highmark Blue Cross Blue Shield of Western New York employees! We know it truly takes a village and their team came through in a big way for all our members,” said Deanna Rusek, director of grants and communications, Boys & Girls Clubs of Buffalo. “Now, hundreds of kids will hit the ground running well-prepared for the next school year.” This support is in addition to Highmark Blue Cross Blue Shield employees recent $80,000 donation to 16 local organizations recovering from the COVID-19 pandemic. Employees also sent thousands of healthy snack-packs and meals to those serving on the frontlines of the pandemic.
Health at the Fair
Breastfeeding, baby changing station and COVID-19 vaccine at Niagara County Fair
The Niagara County Department of Health is providing a breastfeeding and baby changing station at the Niagara County Fair again this year. The fair will take place Aug. 4 – 9. “Providing a cool and quiet space for breastfeeding mothers and babies, as well as an accessible changing area for all parents and children, supports the health and wellbeing of our community,” said Public Health Director Daniel J. Stapleton. The breastfeeding station has a temperature-controlled refrigerator for mothers to store breastmilk, a sink for washing hands, power out-
lets for expressing breastmilk and air conditioning. A dual changing station is available to all families, separate from the private breastfeeding area. Mothers are welcome to nurse their children under the shade of our blue trailer, and we encourage the public to visit the station to learn more about the many benefits of breastfeeding for both mother and baby. This year the fair will offer COVID-19 vaccination each day. Single dose Johnson & Johnson will be available for individuals 18 years of age and older; two-dose Pfizer will be available for individuals 12 years of age and older. Individuals
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021
receiving Pfizer will be scheduled for their second dose after the first dose. “Although we encourage people to visit our website to register in advance, walk-ins are welcome,” said Tracy Fricano Chalmers, director of public health planning and emergency preparedness. “We are hoping that fairgoers will take advantage of this convenient opportunity to get vaccinated and protect themselves, their family, and their community,” Ms. Fricano Chalmers added. Registration links are available via the Vaccination clinic schedule can be found at www.niagaracounty. com/health/Vaccine.
Health News
Physicians Amanda Hassinger and Alberto Monegro with their very first lab patient at the sleep center.
New Accreditation For UBMD Pediatrics’ Sleep Medicine Center The UBMD Pediatrics Sleep Medicine Center has received accreditation from the American Academy of Sleep Medicine (AASM), making it Western New York’s only pediatric-dedicated sleep center with this accreditation. According to the AASM, the accreditation signifies the center has reached “the gold standard by which the medical community and the public evaluate sleep medicine facilities. Achieving AASM accreditation demonstrates a sleep medicine provider’s commitment to high-quality, patient-centered care through adherence to these standards.” Physicians Amanda Hassinger and Alberto Monegro spearheaded the development of the division and its center. Hassinger came into the center full time after being inspired during her time as part of UBMD Pediatrics’ critical care team. “While working in the pediatric intensive care unit, I saw the effects poor sleep and other sleep disorders were having on the patients and their
families,” Hassinger said. “I knew sleep interventions could be helpful to avoid these situations and other complications, creating a positive impact on their overall health.” Hassinger, a board-certified pediatrician and critical care physician, began a fellowship in sleep medicine with the goal of bringing this new specialty service into the area for the children of Western New York. After receiving her third board certification, Hassinger helped launch the center’s sleep lab on July 9, 2020. “For UBMD Pediatrics, the launch and accreditation of this sleep center was a long-waited dream come true that will help improve the care of children in WNY,” said Geovanny Perez, MD, division chief of pulmonology and sleep medicine at UBMD Pediatrics and the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. “Our center takes a holistic approach to sleep problems and collaborates with different subspecialties to provide the best treatment approach.” Monegro said, “When people hear ‘sleep study,’ they may be concerned about what it involves, but we try to make the experience as easy and comfortable as possible for both the patients and family members.” According to Perez, “Sleep is an essential building block for children’s
mental and physical health. Insufficient sleep can lead to irritability, lack of focus, learning and behavioral problems. Prolonged sleep issues may indicate an underlying physical or emotional problem that should be evaluated by a medical professional.” Hassinger, a mother of three, personally knows the toll sleep interruptions can have on not only the children but the family overall. “If one child is not sleeping well, or barely sleeping at all, the entire family’s sleep is disturbed,” Hassinger said. “It can have an awful consequence for the whole family and lead to other health concerns. Our family-centered focus ensures the development of a care plan that best addresses medical needs while also maximizing wellness and quality of life. A key aspect of sleeping better involves education and support, both of which are key parts of the services we provide.” With the opening of the center and lab, the team set its eyes on not only caring for patients, but becoming nationally accredited and expanding its sleep lab and service lines. All of which have now been accomplished. Just this summer, the sleep medicine lab grew from two beds to four beds, allowing the team to double the amount of sleep studies being performed and accommodate the growing demand in the area. “This makes an incredible difference in what we’re able to do for families,” said Steven Lipshultz, MD, president of UBMD Pediatrics and A. Conger Goodyear Professor and chair of the department in the Jacobs School. “We’re able to see our patients sooner, develop a treatment plan and help our patients and their families start experiencing a better quality of life.” The center’s team cares for patients from birth through young adulthood, treating a broad range of sleep disorders and managing the effects other complex conditions can have on a patient’s sleep, such as achondroplasia, Down syndrome, muscular dystrophy and scoliosis. “A key advantage of our program is having two sleep medicine physicians with an intensive care background, which allows us to
perform complex studies, including for children on home mechanical ventilation or with complex airway diseases,” Perez said. Seeing a UBMD Pediatrics’ sleep medicine specialist starts with an appointment at one of its two outpatient locations: the Conventus medical office building on the downtown Buffalo Niagara Medical Campus or the University Commons plaza in Amherst. After an assessment and conversation with a pediatric sleep medicine physician, either a treatment plan will be developed or some tests may be recommended, including a sleep study, before creating the plan. The UBMD Pediatrics’ sleep medicine lab, run in partnership with Sleep & Wellness Centers of WNY, involves an overnight stay at the lab that is attended by a certified sleep technologist using sophisticated software, with a monitoring and integrated video system. Sensors are placed in different areas of the body to monitor neurologic activity, body movement, breathing and both oxygen and carbon dioxide levels. Monegro noted, “Not everyone of our patients would needs a sleep lab test. In our initial meeting with patients, we spend a lot of time assessing what underlying sleep issues there may be, and, together with the family, formulate a personalized diagnostic and treatment plan that is right for them. We don’t automatically send everyone for a sleep study.” In addition to Hassinger and Monegro, the care team includes sleep technologists, respiratory therapists, nurses and other clinical staff members. Monegro, a critical care and sleep medicine specialist with UBMD Pediatrics, also provides care with UBMD Internal Medicine. Both Hassinger and Monegro are faculty members at the Jacobs School. For more information, including a list of common sleep disorders treated, please visit ubmdpediatrics.com or contact the UBMD Pediatrics Sleep Medicine Center at 716.323.0370.
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Our dedicated frontline heroes are here for you.
©2020 ECMC
Our ECMC family is incredibly grateful for the doctors, nurses, specialists, and staff who are working tirelessly to care for our community with undeterred dedication. Amid the challenges of the pandemic, you are fighting COVID-19 head-on. Even when we’re through this chapter, your courage and sacrifices will always inspire our community.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2021