in good New Doc in Town
Emese Zsiros, a new gynecologic oncologist at Roswell, talks about cancer immunotherapy and other experimental treatment for gynecologic cancers
Crunch Time for PTs
Physicial therapists’ double trouble: higher co-pays for patients, lower reimbursement for PTs
Buffalo & WNY’s Healthcare Newspaper
November 2014 • Issue 1
‘How I lost 40 pounds’ Newspaper reporter shares his experience trying to lose weight
The Momentum Continues
The Buffalo Niagara Medical Campus continues to grow in size and scope
Buffalo Wellness Organization started by Philip Haberstro marks 25th anniversary
priceless
Teen Driving Vehicle crashes still the leading cause of death among teenagers Page 8
Humble rutabaga rocks with nutrition Find out why rutabaga is the star of this month’s SmartBites column November 2014 •
Gary Band
Living With Diabetes
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Interviews with three people in the area —including the retired FBI investigative analyst Don Becker — who share their experience dealing with diabetes. Page 9
Bill to cover equipment and supplies for ostomies signed into law. It takes effect Jan. 1
Rolfing — is it something you should do? Hamburg certificate rolfer thinks so
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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More than 2.5 million people ended up in the ER in 2012
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h s a r C s e i r Inju
ore than 2.5 million people went to the emergency department (ED) — and nearly 200,000 of them were hospitalized — because of motor vehicle crash injuries in 2012, according to the latest Vital Signs report by the Centers for Disease Control and Prevention. Lifetime medical costs for these crash injuries totaled $18 billion. This includes approximately $8 billion for those who were treated in the ED and released and $10 billion for those who were hospitalized. Lifetime work lost because of 2012 crash injuries cost an estimated $33 billion. “In 2012, nearly 7,000 people went to the emergency department every day due to car crash injuries,” said CDC Principal Deputy Director Ileana Arias. “Motor vehicle crash injuries occur all too frequently and have health and economic costs for individuals, the health care system, and society. We need to do more to keep people safe and reduce crash injuries and medical costs.” Key findings include:
• On average, each crash-related ED visit costs about $3,300 and each hospitalization costs about $57,000 over a person’s lifetime. • More than 75 percent of costs occur during the first 18 months following the crash injury. • Teens and young adults (15-29 years old) are at especially high risk for motor vehicle crash injuries, accounting for nearly 1 million crash injuries in 2012 (38 percent of all crash injuries that year). • One-third of adults older than 80 years old who were injured in car crashes were hospitalized — the highest of any age group. • There were almost 400,000 fewer ED visits and 5,700 fewer hospitalizations from motor vehicle crash injuries in 2012 compared to 2002. This equals $1.7 billion in avoided lifetime medical costs and $2.3 billion in avoided work loss costs.
See related story in Kids Corner, page 8.
Complications from Anesthesia Drop by More Than Half in Four Years
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nesthesia-related complications decreased by more than half in four years, according to the Anesthesia Quality Institute’s (AQI) National Anesthesia Clinical Outcomes Registry (NACOR) of more than 3.2 million anesthesia cases. While the overall mortality rate
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held steady between 2010 and 2013 (at .03 percent, or three deaths per 10,000 surgeries or procedures involving anesthesia), the percentage of adverse events related to anesthesia decreased from 11.8 percent to 4.8 percent of procedures during that time period. The most common minor complication was
postoperative nausea and vomiting (35.53 percent), while the most common major complication was medication error (11.71 percent). “Our goal was to determine the nature and incidence of surgical complications at the national level and to identify their risk factors,” said physician
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • November 2014
Jeana E. Havidich at Dartmouth-Hitchcock Medical Center, Lebanon, N.H. “Previous studies examined adverse events for specific surgical procedures, types of anesthesia or patient populations. This is the first time we’ve been able to look at such a large amount of data on a national level.”
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November 2014 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Meet
My Take
Your Doctor
By George W. Chapman
Do Hospital Mergers Drive Up Costs? They are happening all around us, but we are faced with a conundrum. On one hand, in order to survive, many hospitals are merging. Smaller hospitals have little purchasing power, cannot justify providing certain expensive services, and face an increasingly difficult time recruiting, retaining and paying physicians. Larger multi-hospital systems should be able to reduce costs, provide more services and retain physicians. On the other hand, mergers reduce or outright eliminate competition. Since hospitals are still in a predominately fee-forservice/volume environment, several studies show mergers have resulted in price increases, (not to be confused with cost increases), as any merged hospitals take advantage of their new found market dominance and raise prices. For this reason the FTC must approve and then monitor mergers. It remains to be seen what will happen to hospital prices once providers are paid based on outcome/performance versus volume.
Healthcare Costs to Escalate Again
The non-partisan Office of the Actuary at Center for Medicaid and Medicare Services (CMS) is predicting healthcare spending will once again begin to escalate this year. Healthcare spending will account for 19-20 percent of our economy by 2023. It was 17.2 percent in 2012. The dire prediction comes after a few years of relatively modest increases of 4 percent. The report, published in Health Affairs, predicts an average annual increase of 6 percent a year from 2015 through 2023. Contributing factors are increased coverage under the Affordable Care Act, an aging population and overall economic growth. The “good” news is the experts are not calling for a return to the double-digit increases of the ‘80s and ‘90s. Much of the growth in spending will come from CMS, which now covers 100 million people.
Nurses Needed
According to the American Nurses Association, we will need another 1.1 million nurses by 2022 as 20 percent of existing nurses are eligible to or set to retire soon. Several other countries are predicting nurse shortages as well.
US Hospitals Lead Costs
This goes right along with our world leading highest per capita spending on healthcare ($8,000-plus). According to a study published in Health Affairs, 25 percent of hospital costs are for administration, more than twice that of in Canada and other countries. However, in defense of US hospitals, many of the other countries in the study, like Canada, have a single payer system, which makes running a hospital far easier when you have to deal with only one set of benefits, one fee schedule and one set of rules and regulations. US hospitals must deal with myriads of payers, which results in dealing with myriads of benefits, fee schedules and rules. Page 4
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By Chris Motola
Emese Zsiros, M.D. New gynecologic oncologist at Roswell talks about cancer immunotherapy and other experimental treatment for gynecologic cancers Q: Tell me about your specialty and the patients you see. A: I’m a gynecologic oncologist and we are specialized to treat cancer in the female reproductive system, including ovarian, uterine, cervical, vaginal and vulvar cancers. We also see a large variety of patients who have gynecologic disorders as well, besides cancer patients. Q: Are you mainly involved with the diagnostic end of things, or do you also do treatments? A: We do both. We frequently get patients referred by OB-GYNs or primary care physicians who have a suspected diagnosis of cancer. We perform the surgeries and chemotherapy if those are necessary and manage all their care related to GYN cancer. ly?
Q: You are from Hungary original-
A: I was born and raised in Hungary and grew up there. I completed my medical schooling in one of the most prestigious Eastern European medical schools and then I moved to the United States to become a GYN oncologist. lo?
Q: How did you wind up in Buffa-
A: I originally came to the United States to complete an OB-GYN residency at Northwestern University in Chicago. Then I moved to Philadelphia to do sub-specialty training at the University of Pennsylvania. That was a three-year fellowship. After that I was recruited by Roswell Park Cancer Institute to become a clinician and a physician scientist. [Zsiros started at Roswell Park Cancer Institute in September.]
Q: What do you think women need to know about gynecologic cancers? A: We recommend women have a primary care physician and an OBGYN and have their routine annual exams. If they have changes in their health, they should report it to their physician. Most of these diseases are rare and rarely have warning signs, so it’s sometimes hard to diagnosis them up front. Q: What are some of the differences you’ve encountered between medicine in Europe and the United States? A: In the United States there’s very rigorous training to become a GYN oncologist. We perform a wide variety of chemotherapy administration and clinical trials that are not available in Europe. However, in Europe most cancer care is covered by government, so sometimes patients in the United States have trouble getting access to proper care. Q: What do you think of Buffalo so far? A: So far I love Buffalo. People have been kind. It’s been a very easy transition for me and my family. Q: Have you gotten over to Canada yet? A: I have not yet. Haven’t had time to visit.
Q: A lot of effort has been made in recent years to get women in for yearly exams. How effective have those been? A: We have seen a large decrease in cervical cancer in the last several decades due to the annual tests. People seeing their OB-GYNs on a regular basis has helped to decrease the burden of gynecologic cancers.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • November 2014
Q: Roswell Park is ranked very highly in terms of cancer treatment. Is that intimidating at all? A: No, I was very excited to come here. One of the reasons I joined was Roswell Park’s strength in cancer immunotherapy. It’s a very rapidly growing field even though it’s still experimental for patients with gynecologic malignancies, but we have many new novel clinical trials that we are planning to open in the next couple years. I specifically came to be part of this great team and be a part of these clinical trials. Q: What should we expect from cancer treatments within the next decade? A: We believe that the role of surgery will diminish and that we’ll treat patients with more chemotherapy and immunotherapy. So far surgery alone has not been able to achieve our goals in many of our malignancies. So we’re trying to strengthen the patient’s immune system and develop better chemotherapies to achieve cancer cure. Q: Chemotherapy has a bad reputation. What’s being done to lessen the side effects of the cure? A: Not every chemotherapy drug will make patients lose their hair or make them nauseated. Before starting the treatment, it’s important to have proper patient counseling and to let them know what to expect of their treatment. We have a very compassionate patient clinical environment, including emotional support and different medications to help with the side effects. Immunotherapy generally has very minimal side effects. Q: What is immunotherapy? A: Our goal is to harness the patient’s immune system to treat the disease. In general it’s been very safe and highly personalized care. It often uses different cancer antigens, or the patient’s own cells, to teach the immune system to recognize cancer cells and eradicate them. So this isn’t usually a medication given through an IV or orally. It involves isolating cells, train them outside of the body to recognize tumor cells, and then reintroduce them to the patient’s body. It usually has minimal side effects. Q: Has it been approved for any cancers yet? A: It’s very experimental for treating patients with gynecologic cancers. We have trials looking at different cancer vaccines and their efficacy for different cancers, particularly ovarian cancers. However, there have been some durable clinical benefits using immunotherapies for challenging cancers like melanomas.
Lifelines Name: Emese Zsiros, M.D. Hometown: Budapest, Hungary Education: University of Debrecen Medical and Health Science Center, University of Alcala, Northwestern University, University of Pennsylvania Affiliations: Roswell Park Cancer Institute, Kaleida Health Organizations: American Board of Obstetrics and Gynecology, Fellow of the American Congress of Obstetricians and Gynecologists, Society of Gynecologic Oncology, American Association for Cancer Research Family: Husband (a dermatologist), daughter, 3 Hobbies: Skiing, scuba diving, cooking, dancing, piano
Who is Minding the Store? By Anthony Billoni
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ho is minding the store? When you walk into a convenience store or a gas station, you are bombarded with tobacco promotions. These promotions are impossible to miss — next to the snacks and soft drinks; hanging from the ceiling; and located directly behind the checkout counter. When is tobacco too available and too visible in Western New York? Judge for yourself. There are about 1,000 outlets in WNY. There is one licensed tobacco retailer for every 194 children under age 18 in New York state. A recent Tobacco-Free WNY and the American Cancer Society survey found that tobacco ads were displayed inside 93 percent of stores and that 82 percent of the stores featured tobacco product displays behind the cash register. How does tobacco advertising appeal to young people? The $213.5 million is spent each year by the tobacco companies in New York state to guarantee that everyone, including
Bariatric surgery: Sleeve gastrectomy surpassed Roux-en-Y gastric bypass
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n an analysis of the type of bariatric surgery procedures used in Michigan in recent years, sleeve gastrectomy (SG) surpassed Roux-en-Y gastric bypass (RYGB) in 2012 as the most common procedure performed for patients seeking this type of surgery, and SG became the predominant bariatric surgery procedure for patients with type 2 diabetes, according to a study in the Sept. 3 issue of JAMA. Bariatric surgery is the most effective therapy available for significant and sustainable weight loss in patients with morbid obesity, and its use has increased during the last decade. Changes in procedure use over time reflect emerging evidence regarding the comparative safety and effectiveness of available procedures. An understanding of current trends
Testosterone Promotes Prostate Cancer in Rats
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researcher who found that testosterone raised the risk of prostate tumors and exacerbated the effects of carcinogenic chemical exposure in rats is urging caution in prescribing testosterone therapy to men who have not been diagnosed with hypogonadism, according to a new study published in the Endocrine Society’s journal Endocrinology. Testosterone use has soared in the last decade among older men seeking to boost energy and feel younger. One study published in The Journal of Clinical Endocrinology & Metabolism found that the number of Amer-
kids, will see their products behind the front counter right next to the candy and other youth oriented items. Exposure to tobacco marketing is a primary cause of youth smoking. Convenience store experts report that currently cigarette sales are either flat or declining while the sale of other tobacco products are on the rise. Today’s displays give youth the impression that tobacco products are easy to buy and that it is okay to smoke. Tobacco promotions shout at our young people — smoking is cool, sexy and fun. Reducing the number of tobacco retailers or covering up the ubiquitous tobacco advertising will go a long way toward reducing the rate of youth smoking and sales to minors. In a recent report, the Surgeon General went on to say, “Despite the well-known health risks, youth and adult smoking rates that had been dropping for many years have stalled. We have the responsibility to act and do something to prevent our youth from smoking. The prosperity and health of our nation depend on it.” Wednesday, Nov. 20 is the 39th anniversary of the Great American Smokeout. It is a great day to think about quitting or to support friends and family who would like to stop smoking. For more information visit www.tobaccofree.wny or call 716-8453407. Anthony Billoni is the director of Tobacco-Free WNY.
in bariatric procedure use can inform primary care physicians counseling patients with morbid obesity who are considering surgical intervention, according to background information in the article. Physician Bradley N. Reames of the University of Michigan, Ann Arbor, and colleagues analyzed data on 43,732 adults who underwent primary inpatient and outpatient bariatric surgery within the 39-hospital Michigan Bariatric Surgery Collaborative between June 2006 and December 2013. The researchers found that relative use of SG increased from 6 percent of all procedures in 2008 to 67.3 percent of all procedures in 2013, an increase of 61 percent. During the same period, use of RYGB decreased from 58 percent to 27.4 percent, and use of laparoscopic adjustable gastric banding decreased from 34.5 percent to 4.6 percent. Even though SG was the most common procedure across all subgroups in 2012 and 2013, SG rates were relatively lower in patients 65 years or older, in patients with gastroesophageal reflux disease, and in patients with Type 2 diabetes.
ican men who started testosterone therapy has nearly quadrupled since 2000, despite concerns about potential cardiovascular risks. The Endocrine Society’s Clinical Practice Guidelines on testosterone therapy in adult men recommend prescribing testosterone only to men who have unequivocally low levels of the hormone and decreased libido, erectile dysfunction or other symptoms of hypogonadism, a condition that results from low testosterone. When it is combined with cancer-causing chemicals, testosterone creates a hospitable environment for tumors to develop, said the study’s author, Maarten C. Bosland, PhD, of the University of Illinois at Chicago.
Complementary Medicine
R-O-L-F-I-N-G Can Spell Relief Hands-on treatment helps relieve pain and stress through natural means By Daniel Meyer
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o be rolfed or not to be rolfed, that is the question. An alternative medical treatment that features deep-tissue bodywork that can be so intense that some describe their sessions as excruciatingly painful, rolfing is a holistic system of soft tissue manipulation and movement education that properly organizes the body in gravity. For Nancy Leone, an advanced certified rolfer from the village of Hamburg, her approach to her work remains focused on reducing the body’s aches and pains by balancing the body’s posture and alignment. “Rolfing is all about the relationship of structure to function,” said Leone, a graduate of the Rolf Institute of Structural Integration, based in Colorado. “Your health is an area of your life where you can find some sense of control. Besides gaining more flexibility, you get in touch with your body.” Rolfing was named after Ida Rolf, a biochemist from New York City who analyzed alternative methods of bodywork and healing. Rolf developed a theory that pain experienced by the body arose from basic imbalances in posture and alignment, created over time by gravity and learned responses among muscles and fascia. Rolfing developed as an attempt to “restructure” muscles and fascia. The detailed focus on manipulating fascia is part of what distinguishes it from chiropractic work, which deals with bones, and from therapeutic massages, which works on muscles. “The bottom line of rolfing is organizing the major segments of the body,” said Leone. “When complete organization is achieved, that means we have successfully educated the body to have better alignment within gravity.” While there is no evidence rolfing
is effective for the treatment of any health condition, it does have the reputation of maintaining a healthy lifestyle. Many clients claim to have found new comfort and energy within their bodies after a rolfer gouges and contorts various points of their body with his or her fists. The practice often uses knuckles in an aggressive manner to work on fascia, which can be extremely stubborn material, particularly if it is marked by knots and scar tissue. The ultimate goal, according to Leone, is to loosen tendons and ligaments of the client, no matter if they live a sedentary, moderately active or highly athletic lifestyle. Rolfing cannot only be used to treat injuries and reduce muscle tension, but it can also be used to combat stress, as clients are encouraged to completely relax during the hour-long sessions. “What I have found is some people come in knowing that they could be in a better place physically, whether it has to do with dealing with chronic pain, having better posture or sleeping better,” said Leone. “I like to think of rolfing as lubing the joints of the body.” Leone and other certified rolfers receive referrals for people who are in high stress or physically demanding jobs, people who suffer tension or injury-related aches and pains and athletes involved in intense physical activities such as martial arts and competitive dancing. Rolfing may help relieve your pain and stress through natural means, with Leone saying her rolfing technique has helped many people live more meaningful and fulfilling lives. “I love what I do,” said Leone. “I’ve been doing it for about 35 years. I like people and I really get great pleasure helping people to alleviate and reduce their pain.”
Nancy Leone, an advanced certified rolfer from the village of the Hamburg: “The bottom line of rolfing is organizing the major segments of the body.When complete organization is achieved, that means we have successfully educated the body to have better alignment within gravity.”
November 2014 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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CALENDAR of
From the Publisher Hello Buffalo-Niagara
HEALTH EVENTS
By Wagner Dotto editor@buffalohealthnews.com
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hank you for picking up a copy of In Good Health — WNY’S Healthcare Newspaper and for reading it. I hope you’ll enjoy it and I welcome your comments. This first issue of In Good Health has been mailed to about 3,000 healthcare professionals in the area, including physicians, administrators, chiropractors, massage therapists and nurses, and distributed through more than 1,200 high-traffic locations mostly in Erie and Niagara counties. With the help of nine drivers, we’re distributing a total of 32,000 copies of the paper — it’s in just about every corner of the region, including all 42 locations of Tops Friendly Markets. In the coming months, we plan to increase the number of copies we print, add more drop-off locations (including some Wegmans’ stores when they become available) and add names to our mailing list. To that end, I encourage those who are reading this to take up our offer and get a free six-month subscription to the paper. The free subscription coupon appears on page 12. At the end of the free period, readers will be invited to become regular subscribers and pay the nominal fee of $15 a year (or $25 for two years). In Good Health, unlike other newspapers in the area, will focus exclusively on health and health-related issues. It won’t be a paper about complementary medicine although we will address the topic periodically; it won’t be a trade publication in the sense that we won’t publish technical or scientific articles; it won’t be a lifestyle or fitness paper; and it won’t be paper about seniors, although we will highlight senior-related stories quite often. Instead, we plan to produce a paper with original, interesting stories focusing on a wide range of health issues that will appeal, we hope, to both healthcare consumers and professionals. We hope to fill a niche in the Buffalo-Niagara market by reaching people with healthcare needs, those who are interested in the field and the professionals working in the field. We subscribe to the notion that the more information about healthcare there is out there the better. We’ll have monthly columns such as Calendar of Events, where health-related events will be publicized; Meet Your Doctor, in which local doctors will be featured; and Health News, which will highlight news coming from the area’s several hospitals. And that’s just the beginning. Page 6
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Nov. 20 This first issue brings a good sample of types of stories we want to pursue: a combination of feature stories and some hard news on topics that may or may not get the attention of other publications. This is the first issue of In Good Health in the Western New York region, but the paper has been in publication in other markets for more than a decade — first in Syracuse, then in Rochester and Utica. In these markets, the paper has established itself as a serious healthcare newspaper, which is read by many every month. In this period, it has earned the trust and the confidence of nearly everyone in the medical field and the general public interested in healthcare. We hope to replicate here the good work people in other areas say we’re doing. It only makes sense to publish In Good Health in the Buffalo-Niagara region: the local industry is by far the most important and largest in all Upstate New York. We’re impressed with the area each time we see the growth and the projects and the research taking place here. In our modest way, we’d like to be part of the industry, to contribute to the strengthening of the sector. This is a free-distribution paper. The way we plan to remain that way is by inviting businesses and organizations to advertise with us. Please go over this issue, see what you think and please give us some feedback. If you like it, please consider placing an advertisement in the paper — you can advertise for as little as $80 per month — or subscribe to it if you don’t already get a copy in the mail. If you don’t like it, let us know right away as well. Finally, we’re happy that the paper is printed locally at Buffalo NewsPress. The fact, in a small way helps to keep jobs in the Buffalo area. Again, thank you for reading. Please drop me an email at editor@buffalohealthnews.com.
Cheektowaga event will address health topics The community outreach department at Catholic Health System is sponsoring “Ask Us Anything About Your Health,” an expo-style event with 10 classrooms led by area physicians. The event will give quick presentations on most-asked-for health topics: bariatric surgery, back pain, options for managing knee and hip pain, women’s cardiac care, stroke, vascular, OB-GYN surgery, incontinence and more. Free health screenings and information about health services will be available. Participants will also have a chance to ask a doctor questions. It will take place from 5:30 – 8 p.m., Nov. 20 at The Millennium Hotel in Cheektowaga. Complimentary parking, and snacks will be provided. Register by calling 447-6205 or visiting chsbuffalo. org/events.
Dec. 4
Mature women’s health issues highlighted at event “Ask Us Anything About Menopause: An Open and Personal Discussion with Our Experts” is the title of the event Catholic Health System’s outreach department is sponsoring from 5:30 – 7:30 p.m., Dec. 4, at The Millennium Hotel in Cheektowaga. A variety of topics affecting women will be addressed, including changes throughout and after menopause: changes in your
body, intimacy and medical challenges. The event will be led by OB-GYN physicians Jodi Ball and Scott Zuccala who will guide participants through physical changes they might expect, and will share information about how they can adapt. A complimentary dinner will be served, and free parking is available. Register today at chsbuffalo. org/events, or call 447-6205.
Dec. 9
Seminar to address living with cardiac problems “Have Heart: Life After a Cardiac Condition” is a dinner seminar with physician speakers being brought by the community outreach department at Catholic Health System. If you’ve suffered a heart attack, have coronary artery disease, atrial fibrillation (AFIB) or another heart condition, you are at higher risk for sudden cardiac arrest. And living with a heart issue means you have to be extra careful. Join cardiac experts Joseph Gelormini and Zina Hajduczok for a seminar on staying your healthiest after a cardiac episode or diagnosis of heart ailment. The doctors will discuss heart conditions, and emerging data on treatment, prevention and everyday healthy living. If you’ve had a heart attack or heart ailment, high blood pressure or cholesterol, diabetes or if you have a family history of heart disease, this free seminar is for you. Complimentary parking and dinner will be provided. Registration is required, call 716-4476205, or register online chsbuffalo.org/ events. The event takes place from 5:30 – 7:30 p.m. at Bybles, Grand Island.
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Call In Good Health – WNY’s Healthcare Newspaper at 332-0640.
Wagner Dotto, the publisher of In Good Health, was born and raised in Sao Paulo, Brazil. He has worked as a reporter in several newspapers, including The Post Standard in Syracuse. He holds a bachelor’s degree in journalism from Pontificia Universidade Catolica de Sao Paulo (1984) and a master’s degree, also in journalism, from The University of North Carolina at Chapel Hill (1991).
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • November 2014
Serving Erie and Niagara Counties in good A monthly newspaper published by
Health Buffalo–WNY Healthcare Newspaper
Local News, Inc. Distribution: 35,000 copies. To request home delivery ($15 per year), call 716-332-0640
In Good Health is published 12 times a year by Local News, Inc. © 2014 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 – P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@buffalohealthnews.com
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Chris Motola, George W. Chapman, Daniel Meyer, Jenna Schifferie, Jennifer Fecio McDougall, Kary Clark, Catherine Miller • Advertising: Donna Kimbrell, Jasmine Maldonado, Marsha Preston • Layout & Design: Chris Crocker • Officer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
In Good Health is Printed Locally at Buffalo NewsPress
FOR LEASE
Bad News Crunch Time for Physical Therapists Recent changes mean higher co-pays for patients, lower reimbursement for PTs By Deborah Jeanne Sergeant
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eed physical therapy? It’s going to cost you more. A lot more. And in the near future, physical therapy offices may become scarce. Recent changes in insurance copays have increased patient co-pays as much as three times what they were before and decreased the payment received by physical therapists by up to 15 percent. For example, a patient paying a $15 co-pay may now pay $45. Already receiving among the lowest reimbursements in the nation, Upstate New York’s independent physical therapy offices struggle to absorb the difference of lower insurance reimbursement. “It puts a strain on paying salaries to employees, paying our bills and trying to increase benefits for employees,” said Peter Schaus, physical therapist and owner of Amherst Orthopedic Physical Therapy, P.C. in Buffalo. “All of our fixed prices go up like rent, heat gas and electric. Lowering the fee schedule, especially with HMOs like BlueCross BlueShield, doesn’t help the situation and the fact that we haven’t had an increase in workers compensation rates in almost 20 years.” He added that workers compensation case rates are supposed to increase in Jan. 2015, but he’s unsure by how much. Because insurance companies now classify physical therapists as special-
ists instead of treating providers, physical therapy is viewed as a privilege and not a necessity, even for insured people. Schaus said that regardless of how long a therapy session lasts, his office typically receives between $40 and $45 for it from insurance companies. People without insurance typically pay $85 to $100 for evaluations and $50 to $60 for visits. “It’s difficult,” Schaus said. “We have to see a lot of patients to make expenses.’ Competition from hospital-affiliated offices represents another hurdle for independent PT offices. After surgery, patients may receive physical therapy from a PT office affiliated with the hospital or an independent office. Alanna Pokorski, physical therapist and senior vice president at Sports Physical Therapy of New York, said that few patients realize they can choose whatever physical therapist they want. “Private practices in general are negatively affected by physician and hospital-owned PT practices,” Pokorski. “Where there are physical therapists and physicians in the same structure, there’s a close relationship and it’s hard to get referrals from them [doctors].” Although patients can directly access physical therapy without a referral, it creates a huge headache if
Good News Bill to cover equipment and supplies for ostomies signed into law
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ov. Cuomo in September signed into law legislation sponsored by Sen. David J. Valesky (D-Oneida) that requires every insurance policy to include equipment and supplies necessary for the treatment of ostomies. An ostomy is a surgically created opening connecting an internal organ to the abdomen, caused by many different conditions, including cancer, bowel disease, birth defects and injury. Different kinds of ostomies are named for the organ involved, such as a colostomy, ileostomy or urostomy. Ostomies can be a lifelong health condition and require necessary and costly equipment and supplies, including pouches, seals, belts, tubes and wafers. Previously, the law did not require full coverage of ostomy supplies — as it does with other conditions like diabetes — causing those living with ostomies a great cost burden. The new law sponsored by Sen.
Valesky changes that. In addition to greatly improving the quality of life for those dealing with an ostomy, full coverage of equipment can ultimately result in savings to the healthcare system caused by repeat and extended hospital visits due to lack of or insufficient equipment. “This law makes sense, and makes the coverage of necessary ostomy supplies consistent with coverage for other conditions like diabetes,” Sen. Valesky said. “I thank Gov. Cuomo for recognizing the importance of this issue.” “Not having proper ostomy supplies can be devastating to patients, and this bill will make a huge difference in the lives of ostomy patients throughout New York state. We are very grateful to Sen. Valesky for helping us with this issue,” Heidi H. Cross, ostomy nurse practitioner and a member of the United Ostomy Associations of America, said. Legislation will take effect Jan. 1.
they should need more than 10 visits or 30 days of treatments. At that point, insurance companies require a doctor’s prescription, so the patient must pay the doctor’s co-pay and get a referral anyway, which can create a few weeks’ gap in the treatment. And if the patient can’t get that prescription, private providers don’t receive reimbursement. Hospitals also aren’t under the same daily caps for coverage, meaning that for the same amount of treatment, a hospital-affiliated PT could be paid for an entire 90-minute session instead of just 45 minutes. Although an independent practice may receive $45 for a treatment session, a hospital-affiliated PT may receive two or three times that amount. Schaus’ office, Amherst Orthopedic Physical Therapy, P.C., and other independent physical therapy offices are coming up with creative ways to generate additional revenue streams. One of these is a fitness program for discharged patients. For a rate less costly than a gym membership, they can come to the office and use the equipment a certain number of days a week but without a physical therapist’s direct guidance. Amherst Orthopedic Physical Therapy also offers functional capacity assessment for injured workers and also, once those are complete, runs a conditioning program for employees of companies that may request the evaluation. The office performs ergonomic assessments for some businesses to evaluate the workspace and see how to improve work stations and employees’ posture to prevent injuries. At Sports Physical Therapy of New York, Pokorski said that one of the practice’s PTs who knows about yoga leads a class in it after hours as another revenue stream for the office. The New York Physical Therapy Association, which represents member physical therapists and physical therapist assistants throughout the state, “is aware of the difference of payments by region and the tiered co-pay system between a private outpatient and hospital-based PT clinics,” said Michael Mattia, who has a doctorate in physical therapy and is president of the NYPTA. He added that the Albany-based organization “is actively monitoring the differences in payments and co-payments which affects patients’ overall access to our services, and especially in private physical therapy offices. We are looking into actions that can be taken to correct the situation through legislation and in discussions with payers throughout the state. “Decreasing reimbursement by insurers, unfair co-pays and cost-shifting of the cost of care to the patient continues to decrease our ability to care for our patients. Unfortunately, this can negatively impact the recovery of patients and may in fact lead to increased health care costs in the long term.”
November 2014 •
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Page 7
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Make the Most of Living Alone by ‘Letting Go’
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re you convinced you’ll never be good at relationships? Or, do you regret the way you behaved in your marriage? Still angry at your ex? Or yourself? Holding on to past hurts, slights, negative thinking or lost opportunities can compromise your sense of well-being and ability to live alone with contentment. Whether it’s emotional baggage or tangible reminders that keep you anchored in the past, I encourage you to give them up and start fresh. “Letting go” is a beautiful thing. And not just for those who live alone. Letting go of old ways of thinking, of a negative self-image, of anger, of regret or destructive thoughts or behaviors can free you up to embrace life’s blessings and the possibility of feeling whole and complete on your own. When I purchased my home in the country 15 years ago, one of the first things I did was to carve out a fire pit in my backyard. I love everything about a bonfire: the warm glow it casts on the faces of those gathered around it, the earthy scent of burning branches, the flames that invite inspection . . . and introspection. Little did I know that when I built my fire pit that it would also become the ceremonial dumping ground for my “old baggage” — those
useless beliefs and feelings that were holding me back and keeping my life small. I remember one evening in particular. I’d been holding on to old Day-Timers — large, leather-bound calendar/ planners that I used in the ‘90s before everything went pocket-size. In these Day-Timers, I made calendar entries that captured “the good, the bad, and the ugly” over the course of what turned out to be a bumpy, transforming decade. Why I hung onto these Day-Timers I’ll never know. Maybe out of misplaced sentimentality. But this I do know: Whenever I looked at the neat stack of volumes stashed away in my closet, I would wince inside. And so one night, I decided to hold a private Letting Go ceremony. I started the bonfire, grabbed my Day-Timers, and made my way to the fire pit. And there I sat with my memories (and my wine!), and slowly, deliberately leafed through each bound year of my life, before tossing it on the hot embers. It was a moving experience. Sad at times.
KIDS Corner Teen Driving Vehicle crashes still the leading cause of death among teenagers
M I
otor vehicle crashes are the leading cause of death among teenagers. n 2011, about 2,650 teens in the United States aged 16 to 19 were killed and almost 292,000 were treated in emergency departments for injuries suffered in motor-vehicle crashes. This means that seven teens aged 16 to 19 died every day from motor vehicle injuries that year. Per mile driven, teen drivers aged 16 to 19 are three times more likely than drivers aged 20 and older to be in a fatal crash.
Who’s at Risk?
Among teen drivers, those at especially high risk for motor vehicle crashes are: • Males: In 2011, the motor vehicle death rate for male drivers and pasPage 8
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sengers aged 16 to 19 was almost two times that of their female counterparts. • Teens driving with teen passengers: The presence of teen passengers increases the crash risk of unsupervised teen drivers. This risk increases with the number of teen passengers. • Newly licensed teens: Crash risk is particularly high during the first months of licensure.
But, mostly, I began to feel lighter, freer. And I felt something I didn’t expect: a sense of peace and self-satisfaction for having taken control and done something good for myself. That evening set the stage for many Letting Go ceremonies to come. I look forward to them and the release of the pent-up, negative energy they promise. Interested in giving it a try? Here are some tips: Step One: Identity what is holding you back or keeping you stuck. Be honest. Ask yourself what negative beliefs or thoughts are getting in the way of your ability to feel hopeful and enthusiastic about yourself and your life. What do you need to let go of to feel freer and to move forward? Anger toward something or someone? Regret over a past mistake? Guilt? A negative self-image? A bad habit? A feeling of inferiority? A deep sadness? Step Two: Write down this negative belief or thought in a “Letter to Self.” Put it down on paper and get it out of your system. Or, identify
the risk of involvement in a motor vehicle crash is greater for teens than for older drivers. • In 2012, 23 percent of drivers aged 15 to 20 involved in fatal motor vehicle crashes were drinking. • In a national survey conducted in 2011, 24 percent of teens reported that, within the previous month, they had ridden with a driver who had been drinking alcohol and 8 percent reported having driven after drinking alcohol within the same one-month period. • In 2012, 71 percent of drivers aged 15 to 20 who were killed in motor vehicle crashes after drinking were not wearing a seat belt.
How crashes involving teen drivers can be prevented
There are proven methods to helping teens become safer drivers. • Seat Belts —Research
Other factors that put teens at increased risk
• Low seat belt use: Compared with other age groups, teens have the lowest rate of seat belt use. In 2013, only 54 percent of high school students reported they always wear seat belts when riding with someone else. • Drinking and driving: At all levels of blood alcohol concentration,
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • November 2014
something tangible (as I did with my Day-Timers) that conjures up painful or disappointing memories. This negative “something” — a photograph, gift, letter or other reminder — can be powerful. Even if it’s out of sight, perhaps tucked into a closet, you know it’s there and just having it in your possession may keep you tethered to a past disappointment or regret. Step Three: Hold your own Letting Go ceremony in whatever style or fashion suits you. I like the bonfire approach, but you may prefer another method. Tying your Letter to Self to a stone and throwing it into a lake may be more fitting and symbolic. Or burying your anger in your backyard. You decide. But, on your own or in the company of friends and family, let go of what’s holding you back and keeping you stuck. Doing so may help liberate the hope, passion and power residing deep inside you. It can be a very meaningful step toward independence. Needless to say, Letting Go ceremonies aren’t the cure-all. Believe me, my long-held feelings about my difficult decade didn’t magically dissipate with the burning of my Day-Timers. But letting go can help open the path to personal growth and fulfillment. It’s part of a healthy process, and I encourage you to give it a try. For now, however, I hope you’ll excuse me. I have a bonfire to build and some baggage to burn. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her fall workshop or to invite Gwenn to speak, call 585-624-7887, or email her at gvoelckers@rochester.rr.com
shows that seat belts reduce serious crash-related injuries and deaths by about half. • Not Drinking & Driving — Enforcing minimum legal drinking age laws and zero blood-alcohol tolerance laws for drivers under age 21 are recommended. • Graduated Licensing Systems (GDL) — Driving is a complex skill, one that must be practiced to be learned well. Teenagers’ lack of driving experience, together with risk-taking behavior, puts them at heightened risk for crashes. The need for skill-building and driving supervision for new drivers is the basis for graduated driver licensing systems, which exist in all US states and Washington, DC. Graduated driver licensing puts restrictions on new drivers; these are systematically lifted as the driver gains experience. Research suggests that the most comprehensive graduated drivers licensing (GDL) programs are associated with reductions of 38 percent and 40 percent in fatal and injury crashes, respectively, among 16-year-old drivers. When parents know their state’s GDL laws, they can help enforce the laws and, in effect, help keep their teen drivers safe. Source: Centers for Disease Control and Prevention (CDC).
November is American Diabetes Awareness Month give her shots. When she got older, she started administering her own shots, and, at age 16, she went on an insulin pump. Her levels were equalized, and she was managing her diabetes well, two criteria necessary to go on a pump. The pump attaches to body, so the insulin goes directly to her body when she needs it. After she eats, she simply has to adjust the levels. Even with the pump, though, there are complications. At times, the tube of her insulin pump catches on door handles or snags on a corner, ripping the pump out of her body. Other times, she accidently hits a vein while attaching the pump after a shower. The gushing
Retired FBI Investigative Analyst Don Becker was diagnosed about 10 years ago with Type 2 diabetes, while he was still working at the FBI. His condition was caught during a routine checkup, and despite being a bit more thirsty than normal, he said he had no idea he had it until the doctor told him. “He said my blood sugar was off the charts. It was up really high,” Becker says. He is shown at his current job as a security guard at Bryant & Stratton College.
How Three Area Residents Cope with Diabetes I
Retired FBI Investigative Analyst Don Becker of Grand Island spoke of his diabetes with more formality, his explanations very concise and to the point. Diabetes is part of his life, and he has gotten used to living with it. Before every meal, Becker injects a straight shot of NovoLog into his stomach to give himself the insulin he needs to break down food. Twice a day, he swallows Metformin, and once a day, he gives himself an additional shot of Lantis to stabilize his sugar levels. It has become part of his daily routine, but on occasion, he manages the shot and pill combination better than other days. Balancing everything becomes “almost like a second job,” he said. Unlike Weinstein, the Becker was diagnosed about 10 years ago with type 2 diabetes, while he was still working at the FBI. His condition was caught during a routine checkup, and despite being a bit more thirsty than normal, he said he had no idea he had it until the doctor told him. “He said my blood sugar was off the charts. It was up really high,” Becker said, emphasizing his words. “It was 400, 500….They had a chart in the doctor’s office, and my A1C was so Continues on page 19
How as a Kid I Found Out My Mom Had Diabetes
By Jenna Schifferle n 2012, 1.7 million people were diagnosed with diabetes for the first time, according to the American Diabetes Association. Overall, an estimated 29.1 million Americans lived with diabetes that year, and of that figure, 208,000 were estimated to be under the age of 20. In 2010, diabetes was the seventh leading cause of death in the United States. Type 1 diabetes results when the pancreas fails to produce insulin and cannot break down sugar and starches into energy. Type 2 diabetes, on the other hand, develops when the pancreas cannot use insulin properly and either produces too much or too little to keep the blood-glucose levels normal. The cause of Type 1 diabetes is unknown, but genetic factors and viral infections may play a role, according to researchers at the Mayo Clinic. Type 2 diabetes is found to be both genetic and influenced by lifestyle, including diet and activity levels. While watching what you eat and working out can help manage type 2 diabetes, the condition is often progressive, meaning that over time, the pancreas naturally starts to produce less and less insulin. This makes it more difficult to manage without pills or injections. Complications from diabetes can also arise, leading to nerve damage, kidney failure, poor circulation, stroke and more. These risk factors make it especially important to monitor blood-sugar levels and food intake.
Retired FBI Officer Always Watching Sugar Intake
Weinstein
Diagnosed with Diabetes at Age 8 Lauren Weinstein, a 25-year-old Buffalo native and resident, remembers, with vibrant clarity, the day she was diagnosed with type 1 diabetes. It was Sept. 6, 1996, and Weinstein had a physical at school. When the physician took a urine sample, Weinstein’s glucose levels were too high, and the next thing she knew, she was being driven to the hospital by her parents. She spent the next week under doctor supervision as they monitored her carefully. “They found out I had a lot of sugar in my urine and that was that. I survived eight years being normal,” she said, laughing. “Only eight years.” At the time, Weinstein was devastated when she found out she couldn’t have ketchup. As a kid, ketchup was her favorite food, but the sugar content was too high. “My parents picked me up at school and told me that I had to go to the hospital for a couple days and that I couldn’t have ketchup. And I used ketchup for everything….I was so mad.” In the first few years of her diagnosis, Weinstein participated in a clinical study of inhalable insulin and was one of 20 people in the area to test it. When that didn’t work, her mother had to
By Jenna Schifferle
blood doesn’t bother her as much as it does the people around her. Weinstein said that on one specific occasion, her pump stopped working completely. She was at work, and for three and a half hours, no insulin was getting to her body. She started to get ill to the point of throwing up bile and blood and was quickly rushed to the hospital. “And the doctor told me — I’ll never forget this — he said, ‘If you would have been 10 minutes later, you would have been in diabetic ketoacidosis and not be able to wake up.’” This hit home for Weinstein, because one of her friends had not been so lucky. He lost his life to diabetes. Despite the complications from her condition, Weinstein manages her diabetes successfully with the help of her pump. She eats small meals throughout the day and monitors her levels closely. Through it all, diabetes has shaped her life. During diabetes camp at Rochester Rotary Sunshine Campus, Weinstein made other friends with diabetes. As she got older, she became a counselor at the camp to teach kids about living with diabetes. “I am happy with who I am, and I wouldn’t be who I am if I didn’t have [diabetes],” she said. “So, I wear my pancreas on the outside of my pants. You just have to have a kind of humor about it and not be so serious.”
November 2014 •
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s a kid, you can’t help but notice when your mom suddenly stops buying sweets. One random day, you open the cupboard to discover that the stock is completely depleted and replacements are nowhere in sight. Then you walk into your mom’s bedroom to ask about the missing soda and the missing cookies, only to discover that she is poking herself with a needle to test her blood sugar. You almost pass out at the sight of the blood. That was how I learned that my mother had diabetes. Up until that point, diabetes had been an abstract term for me. After that, I learned that the condition entailed so much more than just checking your blood sugar and monitoring what you eat. I watched my mother lose 40 pounds through diet and exercise and still have to go on more medication to control her blood sugar. I sat with her as she sipped orange juice, trying to desperately shake the dizzy haze that descended when her blood sugar dropped too low. I stared at her with curiosity when her behavior appeared erratic because her sugar was too high.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 9
The Buffalo Niagara Medical Campus: The Momentum Continues By Jennifer Fecio McDougall
T
he Buffalo Niagara Medical Campus (BNMC) is a thriving center of medicine, academics, research and innovation. This 120acre site is a dynamic hub of patient care, education and cutting-edge research. It’s also home to businesses that support, complement and foster these functions. Kari Bonaro, director of communications for the Buffalo Niagara Medical Campus, Inc., the umbrella organization for the anchor institutions that make up the medical campus, says that the BNMC was formed with exactly that idea in mind. She explains that the five founding institutions — the University at Buffalo, Kaleida Health, Roswell Park Cancer Institute, Buffalo Medical Group, and Hauptman-Woodward Medical Research Institute — were located near each other for many years, and over time the leadership of these institutions recognized the benefits of planning together for their shared space. The organizations, working with former Buffalo Mayor Anthony Masiello and other community leaders, examined the model of medical campuses in other Aerial view of the Buffalo Niagara Medical Campus, Inc. Courtesy of BNMC. cities, Bonaro explains. They realized there were many opportunities vation Center seemed like the perfect campus to benefit the greater commuto both grow together and align shared fit. Medical Acoustics is a start-up nity, including connecting those in the services. From the beginning, there was company that produces the Lung Flute, surrounding neighborhoods to career an awareness that this was an urban an innovative device that uses low-freopportunities on the campus. In fact, campus, landlocked. As a result, they quency sound waves to help people the Heron Foundation considers the focused on growing within the commuwith chronic obstructive pulmonary BNMC to be a model across the counnity of four neighborhoods (Allentown, disease (COPD). try in this regard, Bonaro says. Fruit Belt, downtown, and the medical “The patient blows into the device, Such recognition from the Heron campus), according to Bonaro. Foundation is big news for the campus, and a reed flaps inside it to produce The medical campus’ early “siglow-frequency sound waves. With muland for Western New York, because it nature development included research tiple blows, the sound waves thin the will help strengthen the reputation of buildings for the University at Buffalo, the medical campus on a national scale. secretions to the point that the patient Hauptman-Woodward Institute, and This will help the region continue to at- can cough and clear them out,” Codella Roswell Park, with beautiful, modern tract medical professionals, researchers, explains. He says that the device has buildings that energized the campus also proven to be useful for episodic and staff members for all levels of the momentum, and we haven’t stopped conditions, including pneumonia and organizations and businesses located since then,” Bonaro says. bronchitis. on the BNMC. Bonaro says that the Buffalo NiagCodella says that the Lung Flute Bonaro says that the BNMC’s comara Medical Campus just completed earned FDA clearance and has been asmitment to the surrounding neighborapproximately 1.5 million square feet signed a CMS (Center for Medicare and hoods goes well beyond its efforts to of development, and there is an equal help residents find jobs on the medical Medicaid Services) code, which means amount of development in the works. the cost can be reimbursed by Medicampus. “The neighborhoods around care, Medicaid, and most insurance carthe campus are really important to us: riers. In addition, doctors have found a representative from the Fruit Belt Demand for housing around the that the Lung Flute is a helpful tool for neighborhood and a representative campus obtaining a sputum sample for lung from the Allentown neighborhood sit cancer screening. As Codella explains, on the board of directors,” she says. With the Buffalo Niagara Medical this makes early detection easier, which She explains that this provides each Campus at the center, literally and figcan lead to better outcomes. neighborhood with a seat at the table uratively, of the region’s healthcare and There are many advantages to and a voice in the decision-making medical research community, there is being located on the medical campus, process. an increased demand for housing in the according to Codella. In addition to onarea surrounding the medical campus. Businesses on the Buffalo Niagara site IT support and administrative supOn the BNMC’s website, there is a secport, he also cites close collaboration tion devoted to housing in the commuMedical Campus with the University at Buffalo and New nity: www.bnmc.org/live/housing. York State’s Center of Excellence in The housing component is one of As the BNMC continues to grow Bioinformatics & Life Sciences (CBLS) the factors garnering positive nationin size and scope, it attracts greater as major advantages. al attention for the medical campus, local, regional and national attention. according to Bonaro. She says the As a result, businesses eye the campus Signature construction projects in F. B. Heron Foundation, located in as a potential new home. When Frank New York City, is impressed with the the works Codella was searching for a location for BNMC’s commitment to leveraging his company, Medical Acoustics, the the economic development on the BNMC’s Thomas R. Beecher, Jr. InnoNot surprisingly, given all of this Page 10
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • November 2014
Kari Bonaro is director of communications for the Buffalo Niagara Medical Campus, Inc., the umbrella organization for the anchor institutions that make up the medical campus. positive activity, the BNMC is also home to tremendous growth. For example, Women and Children’s Hospital of Buffalo’s move to the medical campus took a giant step forward Oct. 8, when ground was broken for construction of Buffalo’s John R. Oishei Children’s Hospital. The hospital is expected to open in 2017. In addition, Bonaro says that there are three other transformative construction projects in the works. UB’s School of Medicine is building its new medical school on the campus and Roswell Park Cancer Institute is building a new clinical sciences center. The remaining project, Conventus, is a project of the Ciminelli Real Estate Corporation. Conventus will be a center for collaborative medicine, and it is slated to be completed in 2015.
BNMC:
Much More Than Medicine By Kary Clark
O
ne of Western New York’s biggest and most talked-about projects of late involves the creation and innovation of the new Buffalo Niagara Medical Campus, built downtown within the same area as Roswell Park Cancer Institute, Hauptman-Woodward Medical Research Institute, NYS Center of Excellence in Bioinformatics and Life Sciences and Buffalo General Hospital. But if you think this new campus only benefits those with a medical background or need for excellent care, think again. Born of an idea started in 2001, the goal of the BNMC was to connect all of those medical centers more centrally and create a true medical community. The 20-year plan, achieved in just eight years, focuses not only on research, education and clinical practice but also on bringing in and fostering businesses around the area. The nine primary member institutions form a board that focuses on collaboration with the surrounding area — the board includes representatives from the Fruit Belt, Allentown, the City of Buffalo and Erie County, according to Communications Associate Sarah McQuade. She stresses that the point of the board is to allow them to give their input on projects and receive updates on their progress. This includes creating a space that’s environmentally friendly as well. To that end, BNMC has certain specific initiatives that make that a reality: • An energy initiative (energizeBNMC) involves public and private partnerships working closely with National Grid that use alternative power sources around the campus: The parking lot is lit through lights via wind and solar turbine. There are 21 electric vehicle-charging stations on the campus, and solar panels installed in 2010 have reduced energy consumption by the thousands of gallons of gas and pounds of carbon dioxide. • The GO BNMC program promotes alternative transportation opportunities: bikes, transit, car share, walking, carpooling for those who work there and those who visit. “We’re looking to create a healthier campus and not increase parking lots,” says McQuade. • BNMC board partners with nearby neighborhoods (Four Neighborhoods, One Community) to see what they need, offer them jobs and build a sense of community. As McQuade puts it, “We try to practice what we preach; it’s not just lip service.” One of the main members of the BNMC team, Ekua Mends-Aidoo, works specifically to connect the campus to the surrounding neighborhoods, including the promotion of wellness events, workforce initiatives and other events.
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• A housing initiative with the BNMC encourages more of their workers to live in the city of Buffalo, especially near the campus. This ties in with the GO BNMC program in regard to getting to work. Most importantly, the initiative has McQuade and others working with a consultant to figure out housing for everyone that’s affordable and close, from janitorial staff to doctors. • With regard to healthy communities, the campus is looking to create policies and environmental changes that can increase access to healthy food and active living opportunities around the campus. • In keeping with the encouragement of the entrepreneurial spirit, BNMC has created DIG (Design Innovate Garage), a 6000-sq.ft. co-working space for small and new businesses to have a place to meet, rent office space, and collaborate with more established business people in the community. DIG offers mentors to support and teach the business owners who come there, and it’s gotten a number of younger people interested. “We’re creating an ‘entrepreneurial ecosystem’ via DIG to help more private sector companies come and thrive,” says McQuade. • In that same vein, a jobs and workforce initiative offers sharing opportunities with the community such as resume training and a goal of lowering the unemployment rate through various opportunities and mentoring. This initiative has brought a career forum for locals to seek out potential job opportunities on the campus. Currently the BNMC has 12,000 positions; by 2017 they expect additional 5,000 positions. Says McQuade, “When the community succeeds, we all succeed.”
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Page 11
SmartBites
By Anne Palumbo
The skinny on healthy eating
Humble Rutabaga Rocks with Nutrition
G
rown beneath the earth, stored in dark basements for weeks on end, a tad gnarly on the outside: root vegetables can be a scary bunch! It’s no wonder we give some of these veggies the bum’s rush at the market. Many look like they’re from another planet. But hold the phone. Roots are loaded with nutrients, versatile in the kitchen, and last longer than most vegetables when properly stored. Rutabaga, the star of today’s column, shines in the vitamin C department — yes, vitamin C! — with one cup serving up about 50 percent of our daily needs. A powerful antioxidant with immune-boosting capabilities, vitamin C helps the body maintain healthy tissues and is essential for healing wounds. Although no studies confirm that vitamin C prevents colds, it may shorten the length of a cold. This tasty root also packs a decent fiber punch, with one cup providing about 3 grams of primarily insoluble fiber, a type of fiber that does not break down within the digestive tract. Consuming insoluble fiber promotes regularity and, according to the American Heart Association, can lessen your chance of cardiovascular disease. Concerned about blood pressure?
sible for the bitter taste and pungent aroma of these kinds of vegetables. According to research conducted at the Linus Pauling Institute, glucosinolates may help eliminate carcinogens before they damage DNA, thus thwarting the transformation of normal cells into cancerous ones. Lastly, this sweet yet savory vegetable has no fat or cholesterol, scant sodium, a bit of calcium, and is only 60 calories per cup. Helpful Tips Choose firm, medium-sized rutabagas (about two inches across) that feel heavy: extra large ones tend to be tough and not as sweet; lighter ones may be woody. Because they are often waxed, they should be peeled. To peel: trim ends, cut in half, place flat side down on cutting board, and then remove peel with a paring knife. Rutabagas are good keepers and will last up to two weeks (or more) in the refrigerator. To store in fridge: first rinse rutabagas under cool water, cut off tops and small roots, dry well, and then place in a plastic bag.
Reach for a rutabaga: one cup has as much potassium as your average banana. While research has shown for some time that potassium can lower blood pressure, a new study shows that aging women whose diets are rich in potassium are less likely to suffer strokes and die than women who have less of this mineral in their diet. Eating more potassium is essential not only for heart health, but for the skeletal and muscle systems as well. Rutabagas, like all cruciferous vegetables, are top sources of cancer-fighting glucosinolates, which are sulfur-containing compounds respon-
Mashed Rutabaga with Fresh Chives Serves 4
2 medium rutabagas, peeled and cut into 1-inch chunks 2 teaspoons butter (optional) 1/3 cup milk (regular or reduced-fat) 2 tablespoons sour cream (regular or light) salt and black pepper (to taste) 2 to 3 tablespoons chopped fresh chives
Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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Cover the chopped rutabaga with about two inches of cold water and bring to a boil. Add a generous pinch of salt, cover pan, and boil until tender, about 40 minutes. A fork should easily penetrate the chunks. Drain and return to the pot. Mash with a potato masher for a few minutes. Then, add butter (if using), milk, sour cream and salt and pepper; mash until fairly smooth. They will be chunkier than your traditional mashed potatoes. Add more milk or sour cream if you desire a creamier consistency. Mix in the chives, and enjoy! (Not a chives fan? Try dill.)
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Buffalo Transportation
Medical transportation company provides quick, reliable and safe transportation for clients Beginning in 2007 with a fleet of only three vehicles, Buffalo Transportation has grown to become a major medical transportation company that moves thousands of patients across the region with its fleet of more than 130 vehicles, including taxis, medical sedans and wheelchair vans. Its state-of-the-art computerized dispatch system, well trained staff and professional drivers combine to make Buffalo Transportation the transportation company of choice for thousands of Western New Yorkers each and every day. Here are some frequently asked questions about our company:
Q. Can I pay with a credit card? A. Yes, just tell the driver you want to pay with a credit card. We also accept UB “Campus Cash”, Buffalo State College “Bengal Bucks” and Canisus College “Golden Choice” cards. Q. Can I call Buffalo Transportation for my dialysis appointments? A. Yes, and usually all you have to do is contact your insurance provider, and request Buffalo Transportation as your transportation company of
choice. For MEDICAID, call 1-800651-7040; for Fidelis, call 716-564-3630; and for Independent Health, call 716668-7051. Q. Do you have ambulances? A. No. Buffalo Transportation is a non-emergent transportation company. In any emergency, it is always best to call 911.
ground checks, sensitivity training, random testing and safety training, HIPAA training. Our medical drivers are 19A certified. These rigid requirements help to insure professional service at all times, especially when we are providing medical transportation. Q. Can I request using Buffalo Transportation for all of my transportation needs? A. Yes. As long as you are preauthorized to receive transportation services, you can usually request using our company exclusively as your transportation company of choice.
Q. Why should I use Buffalo Transportation over any other company? A. Our drivers go through back-
Q. How much advance notice do I need to give? A. We would always appreciate as much of an advance notice as possible, but we can provide all of our services on an “on demand” basis.
Q. Is there a special number to call for medical transportation? A. No, in all cases you simply have to call: 716-877-5600. Q. Can I book a transportation service online? A. Absolutely. For your convenience, just go to buffalotransportation.com and make a reservation. It’s very easy.
Q. Can you help me if I require a wheelchair? A. Yes, we specialize in transporting those with special needs, such as wheelchair or stretcher transportation.
Buffalo Transportation • 289 Ramsdell Ave., Buffalo, 14216 • 716-877-5600 • buffalotransportation.com
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Buffalo Wellness
Philip Haberstro and his Buffalo Wellness Institute march on as year marks 25th anniversary By Charley Arrigo
H
oused on the sixth floor in Buffalo City Hall, this year marks the 25th anniversary for the Wellness Institute of Greater Buffalo. Founder and executive director Philip Haberstro has been at the helm for the duration of the organization’s service. Through persistence and a tireless passion, the wellness institute has made its mark as one of Buffalo’s true gems in the health sector. It all started in the 1980s when Haberstro began his pioneering of the Buffalo health and wellness scene. After serving as program director for the newly opened Buffalo Athletic Club from 1980-83, he became enthralled by the notion of workplace wellness. Inspired by the opportunity it presented, Haberstro decided to directly pursue fitness at the employer, school and community level. “I thought it would make more sense to go out and talk to an employer, for me, for my professional interests” Haberstro said. “And try to help a company of 5,500, 5,000, whatever it may be or five even for their employees to be healthier.” From there Haberstro created Buffalo Fitness Consulting. His early work consisted of knocking on doors, handing out business cards, which at that time he said served as his brochure. Despite challenges that would come as a door-to-door advocate, Haberstro used the opportunity to network. He met with nonprofits like the American Heart Association the American Cancer
Philip Haberstro is the founder and executive director of Wellness Institute of Greater Buffalo. “I know for sure that our success is really due to a whole lot of people that have helped us along the way,” says Haberstro, referring to the 25th anniversary of the organization. Photo credit to Diane Sabba Page 14
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Philip Haberstro (standing, third from the left) poses with participants from Oct. 18’s Active Walk Series at Como Lake Park. Photo courtesy of Diane Sabba. Society, to which he still keeps great contact. In the late 1980s Haberstro met with an old Buffalo Athletic Club friend and attorney, John Giardino. Together they shared the desire to create a “better place to work, live and play” as Haberstro put it. The goal then became to start an advocacy agency for a healthy Buffalo community. Their big break would come soon after. “The National Civic League in 1989 got a contract from the U.S. government to launch the United States healthy communities’ movement” according to Haberstro. “And the healthy communities’ movement is a little broader than just personal health. That really was intriguing to me, and it was something new and interesting. The movement embraces the idea that the environmental health, the economic health, the civic health, all contribute to human health.” So that year when the Wellness Institute opened up its doors, the first objective was clear. Haberstro understood that the need for harmony between personal and social responsibility was crucial in fulfilling the most optimum wellness standards. That philosophy was brought to the forefront most recently when Western New Yorkers near the Tonawanda Coke plant experienced health problems. “A woman by the name of Jackie James Creedon stepped up to the plate,
she was sort of the whistle blower. There’s the civic part” said Haberstro. “She was having some health issues. Her doctor suggested, well, maybe it’s got something to do with the air quality and so on and so forth. Well, low and behold we got the New York State Department of Environmental Conservation, the Environmental Protection Agency all involved.” The finding was that the Tonawanda Coke plant was illegally emitting excessive of amounts of benzene into the air. However the driving force behind the call to action is what is called civic responsibility. The institute’s paradigm for which all goals can be reached. Evident in its wide-ranging resume of accomplishments, Haberstro and company have helped orchestrate some of the area’s most recognizable wellness movements. They co-founded the Tobacco Free Erie County Coalition, and brought Be Active New York State and the National Association for Health and Fitness presence to Western New York. In 2010 they facilitated a city wide falls prevention initiative, which included the training of Buffalo Fire Department members. In October the wellness institute expanded their presence, opening new office suites in the Elmwood Medical Center. Still some of the wellness institutes’ best work will go unnoticed. Whether it’s working behind the scenes on public policies or encouraging community activism by bringing people together,
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • November 2014
the goal is not credit but results. The approach in many ways reflects Haberstro’s humble attitude. “I know for sure that our success is really due to a whole lot of people that have helped us along the way,” says Haberstro. “But my point is that you also have to recognize the role of public relations in media. You do have to have public relations and media skills in order to get your message out. To influence people maybe, their thinking at least, planting the seeds and those kind of things.” With accounts on both Facebook and Twitter (@PhilHaberstro), the wellness institute is making its mark on our newsfeeds, even hiring young college interns to help raise awareness to that demographic. Haberstro can be found right in the thick of things, leading the charge on events like the active walk series to instructing workplace wellness to employers at the Buffalo Niagara Medical Center. Leaning on one of his favorite men and scholars, he insists that the message on all fronts remains the same. “’The future is ours to make’ as Mr. [Peter] Drucker said. Create our future, it’s that kind of challenge. What we can do as a nation, as a community and as individuals to improve our health” said Haberstro, “becomes part of what we work towards as an organization.”
options.
options:
By Jim Miller
Vaccination Options Available to Seniors this Flu Season Dear Savvy Senior, I understand that there are several types of flu vaccines being offered to seniors this flu season. What can you tell me about them? Cautious Senior Dear Cautious, Depending on your health, age and personal preference, there’s a buffet of flu shots avail-
able to seniors this flu season, along with two vaccinations for pneumonia that you should consider getting too.
Flu Shots Options
Just as they do every year, the Centers for Disease Control and Prevention (CDC) recommends a seasonal flu shot to almost everyone, but it’s especially important for seniors who are at higher risk of developing serious flu-related complications. The flu puts more than 200,000 people in the hospital each year and kills around 24,000 — 90 percent of whom are seniors. Here’s the rundown of the different
Standard (trivalent) flu shot: This tried-and-true shot that’s been around for more than 30 years protects against three strains of influenza. This year’s version protects against the two common A strains (H1N1 and H3N2), and one influenza B virus. Quadrivalent flu shot: This vaccine, which was introduced last year, protects against four types of influenza — the same three strains as the standard flu shot, plus an additional B-strain virus. High-dose flu shot: Designed specifically for seniors, age 65 and older, this vaccine, called the Fluzone HighDose, has four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. But be aware that the high-dose option may also be more likely to cause side effects, including headache, muscle aches and fever. Intradermal flu shot: If you don’t like needles, the intradermal shot is a nice option because it uses a tiny 1/16inch long micro-needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shots. This trivalent vaccine is recommended only to those aged 18 to 64. To locate a vaccination site that offers these flu shots, visit vaccines. gov and type in your ZIP code. You’ll also be happy to know that if you’re a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot, as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays. Private health insurers are also required to cover standard flu shots, however, you’ll need to check with your provider to see if they cover the other vaccination
Pneumonia Vaccines The other important vaccinations the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. An estimated 900,000 people in the U.S. get pneumococcal pneumonia each year, and it kills around 5,000. This year, the CDC is recommending that all seniors 65 or older get two separate vaccines, which is a change of decades-old advice. The vaccines are Prevnar 13 and Pneumovax 23. Previously, only Pneumovax 23 was recommended for seniors. Both vaccines, which are administered just once, work in different ways to provide maximum protection. If you haven’t yet received any pneumococcal vaccine you should get the Prevnar 13 first, followed by Pneumovax 23 six to 12 months later. But, if you’ve already been vaccinated with Pneumovax 23 you should get Prevnar 13 at least one year later. Medicare currently covers only one pneumococcal vaccine per older adult. If you’re paying out of pocket, you can expect to pay around $50 to $85 for Pneumovax 23, and around $120 to $150 for the Prevnar 13. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
Generic Drugs Offer Seniors Big Savings Several well-known drugs will become available in generic form By Jim Miller
T
o start, brand-name medications are not better, safer or more effective than their generic alternative because they’re virtually the same. To gain approval from the U.S. Food and Drug Administration (FDA), generic drugs are required to the same active ingredients, strength, dosage form and route of administration as their brand-name counterparts. The generic manufacturer must also demonstrate that people absorb the drug at the same rate. The only difference between a brand-name drug and its generic is the name (generics are usually called by their chemical name), shape and color of the drug (U.S. trademark laws don’t allow generics to look exactly like the their brand-name counterparts) and price. Generic drugs are often 10 to 30 percent cheaper when they first become available, but by the end of the first year the price can drop in half. And by the second and third year it can drop 70 to 90 percent.
Cost Difference
The reason generic drugs are so much cheaper is because their manufacturers don’t have the hefty startup costs that the original creators of
the drug do. When a pharmaceutical company creates a new drug, it spends millions of dollars on the research, development and clinical testing phase. Then, if it gets FDA approval, it has to turn around and spend even more money to market the drug to the health care industry and the public. The total cost can rise into the hundreds of millions by the time the drug is in the hands of consumers. In an effort to recoup their investment, the brand-name drug makers charge a premium price, and are given a 20-year patent protection, which means that no other company can make or sell the drug during that period of time. After those 20 years are up, however, other companies can apply to the FDA to sell generic versions. But because generic manufacturers don’t have the same research, development and marketing costs, they can sell their product much cheaper. Also, once generic drugs are approved, there’s greater competition, which drives the price down. Today, nearly eight in 10 prescriptions filled in the U.S are for generic, which saves consumers around $3 billion a week.
New Generics Hitting the Market You should also know that in 2014 and 2015, patents on a wide variety of popular brand-name drugs will expire and become available in generic. Some of them include:
• Celebrex • Nexium • Copaxone • Exforge • Cymbalta • Actonel
• Lunesta • Avodart • Abilify
• Evista • Maxalt, • Micardis
For a more information, Community Catalyst, a national, nonprofit consumer advocacy organization provides a list on their website of the top 50 brand-name drugs and the dates they should become available as generics. Go to communitycatalyst.org, and type “Drugs Going Generic 2014 – 2015” in their search bar to find it. You can also find out if a brand-name drug has a generic alternative by simply asking your doctor or pharmacist. Or, visit GoodRX.com, a Web tool that provides prices on brand-name drugs and their generic alternatives (if available) at virtually every pharmacy in the U.S. so you can find the best deals in the Buffalo area.
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The Social Ask Security Office Column provided by the local Social Security Office
Holiday Season: Being Aware of Fraud Is Your First Step to Avoiding It Ophthalmologist David Montesanti of Eye Care & Vision Associates in Buffalo examining a patient. “Many possible problems can be prevented if issues are caught early,” he says.
The eyes have it: Keeping your vision healthy First sign you may need to see an eye doctor is difficulty in reading By Catherine Miller
T
here comes a time as we get older that work and family responsibilities lessen and we finally have time to stop and smell the roses. But what happens when as we begin to have time to smell the roses we begin to have trouble seeing them? While some vision problems are a natural progression of aging, other issues are a true cause for concern — and the only way to diagnosis a serious eye disorder is to see your eye care professional. “The most important thing is to get yourself to an eye doctor,” said David Montesanti, ophthalmologist at Eye Care & Vision Associates, “We need to get in there and get a good look at the various parts of the eye to determine the health of the eye. Many possible problems can be prevented if issues are caught early.” Montesanti says that a small retinal tear can progress to a retinal detachment creating loss of vision and need for surgical intervention if left untreated.
Eye Problems
While difficulty reading is often the first indication that you need to see an eye doctor, other symptoms include pain in and around the eye, flashes of light and trouble with peripheral vision, as well as center vision loss. Visual problems such as floaters can be a warning sign of a serious condition, or simply a nuisance. While sudden onset floaters could mean a retinal problem, floaters could also be simply bothersome, and could be improved by using sunglasses or a tint on your regular glasses. Other common problems: n Glaucoma, a term that describes a group of ocular disorders relating to a loss of optic nerve tissue, normally has no warning signs. Associated with increased pressure built up within the eye, the key is to catch the issue early. The condition is normally easily treated with pressure-lowering medications. n Cataracts, a common problem among our aging population, are clouding of the eye’s natural lens that left untreated can cause blindness. Page 16
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While the first indication may be a loss of “good vision” this is another condition that is better treated sooner rather than later, and may be caught early during an annual visit to your eye doctor. “There are several surgical options available for cataracts,” said Montesanti, “and the good news is that often times once we remove the cataract, it’s often a perfect fix and your vision is restored.” n Diabetic retinopathy is another condition that does not always give the individual the courtesy of a warning sign, and can easily go undetected. A common diabetic eye disease caused by changes in the retinal blood vessels, left untreated, it can cause blindness. A visit to your eye doctor can determine if you are at risk for the disease which can be treated by controlling blood sugar, through the use of injections or with surgery. n Age-related macular degeneration [AMD] is a leading cause of vision loss for people over the age of 50. AMD causes a loss of central vision and progresses at varying rates. As it progresses a blurred area in the center of your vision is common and grows larger with time, causing substantial vision impairment and quality of life issues. Early treatment can include antioxidant therapy, injection therapy or in more advanced cases, surgery. There is a myriad of other eye issues that range from presbyopia to eyelid disorders and dry eyes and they can be best addressed with your favorite ophthalmologist. The need for surgical repair of the eye can make many patients worried, causing them to delay a trip to their eye professional, but often a delay will only worsen a latent or minor condition. “I often tell worried patients that if they weren’t a little worried about surgery I would think they were a little crazy,” says George W. Pfohl, another ophthalmologist with Eye Care & Vision Associates, “The good news is that the anesthesia used for pain also alleviates anxiety and almost all surgical patients experience visual improvement as a result of surgical intervention.”
W
ith all of the holiday shopping going on this time of year, both in stores and online, there is no better time to remind you to beware of fraud — you never know where it is lurking. When it comes to doing business with Social Security online, there is little to worry about — all of our online services are protected by strong Internet security protocols and you should have confidence that they are safe and secure. But there are other ways identity thieves and criminals can obtain your personal information and cause you significant harm. Here are some tips to help keep that from happening. If someone contacts you claiming to be from Social Security and asks for your Social Security number, date of birth or other identifying information, beware. Don’t provide your personal information without first contacting Social Security to verify if Social Security is really trying to contact you. It could be an identity thief phishing for your personal information. Call Social Security’s toll-free number at 1-800-772-1213 (TTY 1-800-325-0778). If you receive a suspicious call, report it by going to http://oig.ssa.gov/ report. Or call 1-800-269-0271 from 10 a.m. – 4 p.m. You should provide as much of the following information as you know: • The alleged suspect(s) and victim(s) names, address(es), phone number(s), date(s) of birth, and Social Security number(s); • Description of the fraud and the location where the fraud took place; • When and how the fraud was committed; • Why the person committed the fraud (if known); and • Who else has knowledge of the potential violation.
Q&A
Q: What is Supplemental Security Income (SSI)? A: SSI provides monthly income to people with limited income and financial resources. People who never worked at a job that withdrew Social Security tax won’t qualify for Social Security, but may still be eligible for SSI. To be eligible, an individual must be a citizen and resident of the United States or be a noncitizen lawfully admitted for permanent residence. There are, however, some noncitizens granted a special immigration status that are also eligible. To get SSI, an individual’s financial resources (savings and assets)
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • November 2014
Identity theft is one of the fastest-growing crimes in the United States. If you or anyone you know has been the victim of an identity thief, contact the Federal Trade Commission at www.idtheft.gov, or 1-877-IDTHEFT (1-877-438-4338); TTY 1-866-653-4261. Another form of fraud that people fall victim to: businesses using misleading advertisements that make it look as though they are from Social Security. These businesses often offer Social Security services for a fee, even though the same services are available directly from Social Security free of charge. By law, such an advertisement must indicate that the company is not affiliated with Social Security. If you receive what you believe is misleading advertising for Social Security services, send the complete mailing, including the envelope, to: Office of the Inspector General, Fraud Hotline, Social Security Administration, P.O. Box 17768, Baltimore, MD 21235. Also, advise your state’s attorney general or consumer affairs office and the Better Business Bureau. If you see or hear what you believe is misleading advertising related to Social Security, you can report it at the address above, by calling 1-800-269-0271 from 10:00 a.m. to 4:00 p.m. Eastern Time, or by visiting http://oig.ssa.gov/report. Protect your investment in Social Security and do your part to report potential fraud. We rely on you to let us know when you suspect someone is committing fraud against Social Security. Reporting fraud is a smart thing to do—and the right thing to do. Visit Social Security’s Office of the Inspector General at http://oig.ssa.gov. Learn more about identity theft and misleading advertising by reading our publications on the subjects at www.socialsecurity.gov/pubs.
cannot be more than $2,000 ($3,000, if married). Recipients must be age 65 or older, or blind or disabled. For more information, please read SSI or What You Need To Know When You Receive Supplemental Security Income (SSI). Both are available at www.socialsecurity.gov/pubs. Q: Are Supplemental Security Income (SSI) benefits subject to federal income tax? A: No. SSI payments are not subject to federal taxes. If you get SSI, you will not receive an annual form SSA1099. However, your Social Security benefits may be subject to income tax. Learn more at www.socialsecurity.gov.
H ealth News New director of supportive care at Women & Children’s Physician Michelle M. Walter has been appointed director of supportive care for Women & Children’s Hospital of Buffalo. In this role, she will be responsible for inpatient supportive care consults for children and adults, as well as educating rotating palliative medicine fellows and pediatrics residents. Supportive care is an additive service to a patient’s primary physician and established specialists. It involves comprehensive patient and family centered care of infants, children and adults with advanced or life threatening illness. “The ultimate goal of supportive Walter care is to maximize quality of life,” said Walter. “Ideally, supportive care is initiated early on in the course of illness, but really can become involved during any point that there is a need identified.” Supportive care provides families with physical, spiritual and emotional support throughout the continuum of care. “Supportive care does not stop at the time of death,” continued Walter. “It includes bereavement care for the family as well. In addition to her director role at Women & Children’s Hospital, Walter is medical director of essential care for Children in Cheektowaga, a pediatric program of Supportive Medical Partners, an affiliate of The Center for Hospice & Palliative Care. Walter received her doctor of osteopathic medicine degree from Lake Erie College of Osteopathic Medicine in Erie, Pa., and went on to receive medical training in internal medicine and pediatrics and palliative care at the University at Buffalo. She is board certified in both pediatrics and internal medicine.
OGH chest pain center earns accreditation The Olean General Hospital chest pain center has recently earned accreditation from the Society for Cardiovascular Patient Care (SCPC) for its quality performance in percutaneous cardiac intervention (PCI). The accreditation recognizes the hospital’s adherence to the society’s stringent standard in interventional cardiac catheterization procedures such as angiography, stent placement and balloon angioplasty. The accreditation was achieved in less than one year of operation of the Olean General Hospital/Gates Vascular Institute Interventional Cardiac Catheterization Laboratory. It is the first and only program in the region to earn full chest pain center accreditation with PCI. The Olean General cardiac catheterization laboratory opened Oct.1 last
year and performed 600 catheterizations in its first year of operation, exceeding all initial volume expectations. “This accomplishment demonstrates that our chest pain center, working in collaboration with our new interventional cardiac catheterization laboratory, is performing at a level equal to or better than heart programs in larger cities,” said Timothy J. Finan, CEO, Upper Allegheny Health System and Olean General Hospital. In September, the hospital’s chest pain center received accreditation from the SCPC for performance in assessing, diagnosing and treating patients with chest pain, only the ninth hospital in New York state to do so.
President Snyder, Dr. Ko to be honored The president of the Seneca Nation of Indians and the medical director for adult behavioral health services at Niagara Falls Memorial Medical Center will be honored at The 2015 Premier, Memorial’s annual dinner gala. The event will be held Jan. 17 at the Seneca Niagara Casino and Hotel, 310 Fourth St., Niagara Falls. Barry SnySnyder der, Sr. has been actively involved in the governing of the Seneca Nation of Indians for five decades. His passion for his people and the collective improvement of the Nation and its members has been central to the many Ko offices he has held in the nation’s government including tribal councilor, treasurer, tribal council chairperson, economic development committee chairperson and president. In 2003, Snyder sponsored legislation that called for the nation’s increased sponsorship of children and elder opportunities. He established the Seneca Diabetes Foundation, which works in collaboration with the American Diabetes Association to enhance the efforts of the Seneca Nation Health Department. Snyder will receive the Nancy Gara Spirit Award. The award is presented in memory of a Western New York banking executive and former medical center board member who was renowned for her positive attitude and personal commitment to serving the community. A respected psychiatrist, Hak J. Ko has practiced medicine in Niagara since 1980. A graduate of the Seoul National University School of Medicine and a former medical officer in the South Korean Army, he plays a key role in Memorial’s new Niagara Wellness Connection Center as well as the medical center’s inpatient behavioral health units. In addition, he has been a long-serving member of the behavior-
Program Offers Help to Women Coping with Recent Breast Cancer Diagnosis The moment a woman hears “you have breast cancer” is a moment she never forgets. Nearly 300,000 women in the U.S. will hear these words in 2014. Some may experience shock, fear and numbness. They may struggle with a lack of information and feelings of vulnerability, confusion and distress. Family and friends may be at a loss as to what to do. Women need their questions answered and they need to learn how to cope, but may not know where to turn for help in those first days after their diagnosis. A new program under study at the University at Buffalo School of Nursing may be the answer. The program, called CaringGuidance After Breast Cancer Diagnosis, was launched in October 2013 by Robin Lally, associate professor of nursing, and her team of collaborators. It is now in its second year of a two-and-a-halfLally year study. CaringGuidance was created, says Lally, with women who have been recently diagnosed with breast cancer in mind. “The program is part of a research project to test the patient satisfaction and effectiveness of the CaringGuidance program in reducing the distress, anxiety and depression women may feel after their diagnosis,” says Lally. “The hope is that use of CaringGuidance will support women’s psychological adjustment and emotional well-being in the first days to months after receiving a breast cancer diagnosis.” CaringGuidance is provided over the Internet so that women can access the program immediately after hearing “you have breast canal health staff at the Buffalo General Hospital, where he served as medical director of the Adult outpatient clinic.
New coordinator at cancer services program Niagara Falls resident and former Niagara County Legislator Renae Kimble has been named coordinator of the Cancer Services Program of Niagara. Her appointment was announced by Anne Passalugo, director of community programs at Niagara Falls Memorial Medical Center. Kimble is a graduate of Niagara County Community College, SUNY Buffalo and SUNY Buffalo Law School. A legislator from 1994 to 2011, she served as vice chairwoman, majority leader and deputy minority leader. She formerly held posts as director of the Niagara Falls Civil Rights Commission and City of Niagara Falls risk manager.
November 2014 •
cer” when they feel most vulnerable and alone. “Women don’t need to wait for their first doctor appointments, which may be weeks away, to get answers,” says Lally. “Another advantage of providing CaringGuidance on the Internet,” Lally adds, “is that it allows women to use the program in the privacy of their homes, day or night. They can explore questions and feelings they might be embarrassed to ask others and in the middle of the night when cancer worries are often the worst.” CaringGuidance is self-guided, allowing women to explore the learning modules, video advice from breast cancer survivors, journaling exercises, resources and a discussion board at their own pace. “Not every woman has the same questions or concerns,” notes Lally. “Some women want to focus on certain topic areas, others on the videos, while others like to read the text. Women in focus groups who tested the program really liked the flexibility offered by this self-guided format.” As women take part in testing the program, says Lally, they also are contributing to its improvement. “Breast cancer survivors have contributed greatly over the last year by reviewing the program and providing feedback from their own experiences,” she says. To this expertise, Lally added scientific evidence from her own and others’ research, as well as input from physicians, nurses, psychologists and researchers so that women can feel confident in the program’s contents. Joining Kimble will be Outreach Coordinator Cassandra Jackson and Data/Intake Manager Darlene Muehlbauer. Jackson has worked as a community health worker for Memorial Medical Center and Roswell Park Cancer Institute since June 2011. During that time she taught several smoking cessation courses and established the 2U ABC breast cancer support group at Memorial. She is a graduate of St. Phillips College in San Antonio, Texas, and holds a certificate in medical administrative assistance. Muehlbauer, who attended Niagara University, is a former retail manager and literacy education teaching assistant. She has been the Cancer Services Program’s data manager since 2006. Niagara Falls Memorial Medical Center was selected earlier this year by the New York State Department of Health to administer the Cancer Services Program of Niagara. The
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Roswell Park Now Offering Screening Mammograms for General Public Roswell Park Cancer Institute (RPCI) recently announced the expansion of its breast imaging services to the general public, offering routine screening mammography to non-patients in an effort to improve breast cancer screening rates and increase detection of breast cancer at the earliest, most curable stages. Current statistics show that as many as half the women who should be receiving an annual mammogram are not getting this important cancer screening. “We are pleased to be able to offer our technology and expertise for breast cancer detection to all women,” says physician Ermelinda Bonaccio, director of breast imaging at RPCI. “Cancer detection, diagnosis and treatment are our specialty. Applying our capabilities to breast cancer screening is an important part of our mission.” Mammography is the only screening test that’s proven to reduce a woman’s risk of dying from the disease. But in the city of Buffalo, a lack of facilities that offer mammography screening makes it more difficult for women to get the screening. “Currently, there are only five U.S. Food and Drug Administration-certified mammography centers in operation in the city of Buffalo, including Roswell Park; in 2012, there were 11 facilities,” says Christy Widman, a community outreach manager with the Western
program, which previously operated under the auspices of the Niagara County Department of Public Health, oversees the delivery of breast, cervical and colorectal cancer screening and diagnostic services to eligible uninsured and underinsured residents.
Reliant Medical Equipment & Pharmacy moves
Physician Ermelinda Bonaccio, director of breast imaging at RPCI. “Cancer detection, diagnosis and treatment are our specialty. Applying our capabilities to breast cancer screening is an important part of our mission.” New York Cancer Coalition (WNYC2) Center to Reduce Disparities at RPCI. In addition, Erie County has the highest breast cancer mortality rate com-
HEALTHCARE CAREERS
pared to the rest of New York state and has the highest breast cancer mortality rate among African-Americans in the state, too.
Reliant Medical Equipment and Pharmacy is relocating to 4114 Union Road near the corner of Union and Genesee in Cheektowaga. The company, a provider of durable medical supplies, which was previously located on 2355 Union Road, is also adding a new retail pharmacy at the new location. The store now serves as a one-stop destination offering a wide array of medical services for its customers. A grand opening celebration was scheduled for Nov. 7. The celebration was to include free screenings for glucose, cholesterol and blood pressure from 10 am – 2:30 pm, a chance to win a rollator or pair of diabetic shoes and numerous other give-aways. The 5,000-sq.-ft. facility features a comprehensive pharmacy suite, consultation room and showroom stocked with thousands of items for bath safety, maternity, fall prevention, orthotic issues, incontinence care, mobility, skin care, over-the-counter treatments and more. In addition, the store features an orthotic/diabetic shoe fitter and lactation specialist. The new pharmacy offers free local prescription delivery, seasonal flu shots and worry-free prescription transfers. “The new store has so many great features including a home-like design and outstanding accessibility,” said Meghan Schobert, vice president. “We’re excited to be able to offer such a wide array of products to keep people of all ages safe and healthy.”
By Deborah Jeanne Sergeant
Phlebotomy: A Vital Career An average phlebotomist earns $25,177 to $30,470
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f you’re interested in working in a medical environment, consider a career in phlebotomy. After only a few weeks of classes, the average phlebotomist earns $25,177 to $30,470 annually, according to Explore Health Careers. Phlebotomists work in a variety of medical settings, for home health companies and at blood banks performing blood draws and to different degrees, handling and processing samples, depending upon the situation. New York does not require certification for phlebotomists to work; however, it does give applicants a distinct advantage over those without certification. Historically, phlebotomists learned only through on-thejob training; however, applicants can obtain a phlebotomy certificate through a vocational program. Catholic Health, for example, prefers applicants with certification. Several area institutions provide phlebotomy certification, including Trocaire College, Niagara County Community College, Bryant & Stratton, and Erie 1 BOCES. “It’s also good to note that alPage 18
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though not required, many phlebotomists go on to get national certification,” said Michelle Mathis-Kay, outreach services manager for Catholic Health Laboratory Services. Most vocational programs cost around $900 and take six to 12 weeks to complete, including clinical work. The job also offers the prestige of a professional career without the burden of an expensive and lengthy education. “Everything we do is to make sure the patient has the appropriate service,” Mathis-Kay said. “Being a phlebotomist is so much more than drawing blood. When many start a phlebotomy class, they may not realize it, but once they get into it, they realize what an important role they’ll play in the healthcare process and the laboratory team.” In addition to drawing blood, phlebotomists may also perform other job functions, including proper identification of patients, venipuncture procedures with the occasional finger or heel stick, patient education regarding tests ordered, specimen collection in the correct tubes, labeling of tubes and delivery of the specimens to the lab in a
timely manner. Within some facilities, phlebotomists can advance from the entry-level position to more advanced levels. Learning these tasks may help them transfer into another, more advanced health-related position. “It can be an excellent stepping stone to clinical laboratory scientists,” Mathis-Kay said. Many of the skills and protocols learned as a phlebotomist transfer to many other medical careers. Pursuing phlebotomy can also offer an inexpensive means of knowing if a medical career is right for a person. Some phlebotomists stick with it because they enjoy the work and helping their patients. “We have some with over 40 years’ experience,” Mathis-Kay said. “For a number of people, this is their passion and it’s their education and career goal. Phlebotomists also enjoy excellent job security once employed, since drawing and testing blood will continue as a vital part of medical care.” In addition to certification, good “soft skills” help people succeed in phlebotomy. Mathis-Kay listed compassion, attention to details, consumer
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • November 2014
skills and the ability to “roll with the punches. Healthcare is a constantly changing environment. We’re always looking to further what we offer. They need to stay open to re-education.”
Rewarding Career
Deborah Summers, health programs coordinator for Erie 1 BOCES, says that friendliness, positive attitude, good work ethic, punctuality and honesty help make a good phlebotomist. “Phlebotomy is a rewarding career option for those who like to work with people, want to be part of a team, and assist clients to maintain or improve health through diagnostic testing,” Summers said. “Phlebotomists are often people who enjoy the healthcare setting, but do not wish to provide direct hands-on care. “It is rewarding to a phlebotomist when they can greet people and make their day more positive by listening to their clients concerns, providing education regarding diagnostic tests, and most of all assisting them to gain the information they need to maintain or improve health.”
My Journey to Lose Weight A newspaper reporter shares his experience trying to lose weight By Gary Band
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leven years ago at the age of 33 it hit me: I was overweight. And it didn’t take long to figure out how it happened. Over the previous four years, my physical activity decreased while my intake of calories increased. Until I was 29, with the exception of the occasional run or walk, I’d always been in decent shape and looked good enough without trying too hard. I played sports as a kid and a teenager, served in the Navy, walked up and down the stairs of my aircraft carrier and all over the countries I visited. In college, other than walking all over campus in Boston and up and down the hills of Brookline to and from the train, I wasn’t doing much of anything else but still I was in great shape. But when I started a full-time job as a newspaper reporter in 1999, it never occurred to me that I needed to engage in any kind of regular activity to keep looking the same as I always had. Day after day I sat at my desk, at my meals, and celebrated the completion of the paper every two weeks with a couple of beers and some bad bar food, blissfully
unaware of what was happening to my body. It wasn’t until I went to a pool party in Swampscott, Mass., one summer day in 2003 that I saw myself for the first time in an unflattering light. Resolving then and there to remedy my condition, I left the party and drove to the nearby Gold’s Gym. I met with a trainer and prepared myself to step on the scale for the first time I could remember in recent years. Incredibly, it read 217, compelling me to sign up for a membership and start working out on a regular basis. But the weight wasn’t coming off. Six years later in 2009, after a variety of regimens, including walking, running and hiking, and trying to eat better, I left Massachusetts for a job in Vermont weighing around 210. Over the next three years working as a newspaper editor in Woodstock and then Chester, Vt., eating at every community supper and area restaurant, I gained back the small amount of weight I had lost and then some. When at last I stepped into the studio of a
Before
Coping With Diabetes Continued from page 8 high, it wasn’t even on the chart!” An A1C test is a common blood test used to measure the percentage of a person’s hemoglobin that is coated with glucose. It is a two to three month average. The higher the percentage, the higher one’s risk of complications becomes. When Becker was first explained his condition, he was in complete shock. Now, he regularly sees an endocrinologist for advice on how to manage his diabetes, and diet plays a huge role in that. He walks more than he ever has before, and eats less ice cream than he used to — on his good days, anyway. Most days, he drinks his coffee without sugar and drinks water every chance he gets. “Well, I’m not supposed to eat a lot of sweets, that’s for sure. But I still do,”
he said. “I’d say the best thing to do, for most people, is to take really good care of yourself and watch the amount of sugar you eat.”
It’s All About How Much You Eat Lynn Gross of Tonawanda pointed out that watching what you eat isn’t always the easiest thing to do. She is a vivacious, 47-year-old woman with a voice that brims with enthusiasm. When we sat down together, she pushed her glasses up her nose and clutched her coffee between her hands. Then, she smiled brightly with her best teacher smile and talked me through her condition.
personal trainer in Chester in November 2012, I weighed 243 pounds. Over the next six months I worked out with this trainer three times a week for over an hour each session and lost over 20 pounds. It was a start, but I had many miles and pounds to go. I moved to Brighton in November 2013 to be with my wife, and worried about how to continue dropping weight in the absence of a strict training regimen and the steep hills of Vermont on which I supplemented my workouts with long walks. On Dec. 1, at a starting weight of 222, I joined After the nearby Jewish Community Center, worked out three to five times a week, and walked a few miles along the Canal Trail whenever the weather allowed. After a long winter, complete with two bad colds in February and March that set me back a bit, by the time our wedding day came around on April 1, I weighed 217. Following the food-filled honeymoon, and a larger wedding party over Memorial Day Weekend, I was at 213. By June, with all the relative gluttony of those days behind me, I really began to focus. I cut back on going to the JCC in favor of being out in nicer weather, doing regular seven- to ninemile walks and five- to seven-mile jogs on the Canal Trail, along with a few 30plus mile cycling trips to Spencerport. Instead of brewing coffee or black tea like I’ve done for years, I started making green tea in the coffee pot every morning. I stopped getting food from
When she was diagnosed with Type 2 diabetes 12 years ago, Gross said that she was filled with “stark terror” because of the horror stories she’d heard about diabetes and because of her own lack of knowledge. She took a nutrition class at Mount Saint Mary’s in Lewiston and worked closely with her doctor to learn how to navigate her new condition. The key to mastering diabetes, she said, is to watch portion sizes and relearn the food pyramid. It’s not so much what you eat, as it is how much you eat, she said. “I love pasta. I love spaghetti. I love to eat. But—especially now that I’m getting older and that the meal is delicious—you look at what you’ve learned and realize: hey, that’s enough for two meals.” Gross takes Metformin and Onglyza orally to help regulate her condition, and she also take a Levemir shot once a day. During the first years of her struggle with diabetes, she only had to take the oral medication. Despite her healthy lifestyle changes, she had
November 2014 •
the hot bar at Wegmans and snacking after 9 p.m. And due to my wife’s dietary restrictions, which requires her and our house to be vegetarian and gluten free, I’ve been eating accordingly at home over these past 10 months. Lo and behold, one day in mid-August the scale showed 203, down 40 pounds from my heaviest weight in November 2012. I still want to lose another 10-20, and believe it can be done by walking, jogging, working out and eating right all year long. Like my former trainer said, it’s not a sprint, but a marathon. Making small changes to your life style makes a big difference. The sooner you start, the healthier you’ll be and the better you’ll look. Gary Band has worked as a reporter and editor at newspapers and magazines in Massachusetts, Vermont and New York. He lives with his wife near Rochester.
to add the shot when her condition got progressively worse. This was a depressing discovery for her; she felt like her best efforts were all in vain. Eventually, she learned to remind herself that part of her condition is genetic, which plays a bigger role than anyone realizes, she said. On occasion, though, Gross admits that she has to let herself eat sweets, because deprivation leads to bigger binges. She doesn’t negotiate with her coffee, for instance, because coffee tastes better with sugar. On occasion, she goes for the cookie with Nutella. Lucky for Gross, she has a support system to get her through her rough days. Her husband was diagnosed with diabetes at the age of 32 and understands her struggle. Together, they encourage each other and influence each other’s decisions. Gross said that living with diabetes isn’t easy. Health choices are like so many other facets of life. “Everything in life is a choice. So if you choose to live, do it.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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