PRICELESS
Meet Your Doctor UBMD pediatric orthopedist Allison Binkley discusses common problems affecting young kids and lists the most accident-prone sports (yes, football tops the list)
HOW CONTENT ARE YOU? Quiz from author of “Live Alone & Thrive” assesses degree of contentment
BFOHEALTH.COM
MARCH 2019 • ISSUE 53
Taking Antibiotics? You may not need to. Study shows a quarter of antibiotics prescriptions unnecessary. See what local doctors say about it. Story on. Page 9
ALSO INSIDE: The measles outbreak and the ‘anti-vax’ movement. Page 8
What health questions people ask Google the most
5
Hot Health Apps
Colon Cancer
Five things you need to do to prevent one of the deadliest cancers
LOOKING FOR A CHIROPRACTOR? Quick questions that will help you select the best chiropractor SAVVY SENIOR: Do I Need to File a Tax Return This Year?
Gray and Addicted: How Substance Abuse Affects Older Adults Page 21
Millet
Fluffy like couscous or creamy like polenta, millet has many things going for it. Page 13
High Price Price of insulin, MS drugs skyrocket. Find out why. Page 11
Worldwide, More Die After Surgery Than From HIV, Malaria: Study A
bout 4.2 million people worldwide die every year within 30 days of surgery — more than from HIV, tuberculosis and malaria combined, a new study reports. The findings show that 7.7 percent of all deaths worldwide occur within a month of surgery, a rate higher than that from any other cause except ischemic heart disease and stroke. About 313 million surgical procedures a year are performed worldwide, according to The Lancet Commission on Global Surgery, but little is known about the quality of surgery around the world. That’s what this study set out to explore, using available data on volume and type of procedures and death rates. “Surgery has been the ‘neglected stepchild’ of global health and has received a fraction of the investment put in to treating infectious diseases such as malaria,” said lead author, physician Dmitri Nepogodiev. He’s a research fellow at the University of Birmingham in England. Along with finding that 4.2 million people a year die within a month KH-CCRET-18294_GLCC_PrintAds / half page horizontal / live: 10.25”w / no bleed / pub: In Good Health discovofx 6.75”h having surgery, his team
ered that half of those deaths occur in low- and middle-income countries. Researchers from Birmingham’s NIHR Global Health Research Unit on Global Surgery said 4.8 billion people worldwide lack timely access to safe and affordable surgery. They estimated that there is an unmet need for 143 million surgical procedures a year in low- and middle-income countries. But answering unmet needs those countries would increase the worldwide number of postoperative deaths to 6.1 million a year, the investigators said. “Although not all postoperative deaths are avoidable, many can be prevented by increasing investment in research, staff training, equipment and better hospital facilities,” Nepogodiev said in a university news release. “To avoid millions more people dying after surgery, planned expansion of access to surgery must be complemented by investment in to improving the quality of surgery around the world,” he noted. The findings were published Feb. 2 in a research letter to The Lancet medical journal.
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TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.
Partner with Your Provider To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.
Be Heart Smart A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure
New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com
Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.
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WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015
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5
CALENDAR of
of the Hottest Health Apps
By Angela Underwood
I
n a day and age when “there’s an app for that,” there is no excuse not to be fit and healthy. That is why it is important to point out the five of the hottest health apps to start using. So if you used the excuse that there were too many apps, we’ll try to narrow it down for you.
MyFitnessPal
It’s as simple as it sounds. It’s a fitness friend in the form of an app. Ranked as the No. 1 health and fitness app on iTunes, reports Men’s Health of the Under Armour-sponsored service. “This app pushes users to keep tabs on their diet programs through an easy-to-use database that offers nutrition information for over 5 million different foods,” according to Men’s Health magazine. Available on Android and Apple, MyFitnessPal is like having your best friend nudge you to go to the gym or put down that candy bar when bikini season is right around the corner. “There are about 5 million foods in their database to choose from so you’re not just typing in ‘chicken’ — which means you can determine how many calories you’re actually taking in and burning off,” reports Marie Claire magazine. The app costs $9.99 monthly or $49.99 for the year.
Fooducate
the ad-free version or allergy-related health advice. In that case, it will respectively cost $3.99 or 4.99 monthly.
Couch to 5K
Don’t let the app’s title intimidate you. No one says you have to run a 5K, but this app will set you up for success if you so choose. “It only requires sweating for 30 minutes per day, three days a week for nine weeks,” according to Marie Claire. Breaking down each day with a personal avatar trainer, users can track their time and distance during their warm up, jog and walk or cool down. The app is free at first, but after a couple of runs, it costs $4.99 to continue the service.
Charity Miles
The app works like it reads. Sponsors like Johnson & Johnson, Chobani, and Humanity donate a few cents for every mile you move biking, running or even walking to charities, according to Marie Claire. Needless to say, when you are not in the mood to work out, this app helps the hungry, homeless, veterans or other nonprofits. So, if you don’t want to work out for yourself, do it for someone else at no cost a month. Now that’s charity.
Headspace
Calories, fat grams, carbohyCan’t sleep, stressed out or just drates and protein are key items to out of the groove? Then Headspace track when maintaining a healthy will put you right back where you lifestyle but standing in the grocery need to be. The initial free 10-day store aisle adding and subtracting program promotes mindfulness, said numbers on the side of packages - HEALING CAREGIVERS PRESENTS - work productivproven to ramp up just doesn’t cut it anymore. That is ity. And be warned, it really works. where Fooducate comes in. Simply “Look out for improved mental type in the product of your picking acuity, patience, productivity and and moments later an you eventwill for know inspiration, sleep education support with&daily use,” according to what the best brand is to buy. “As - HEALING CAREGIVERS PRESENTS New- Jersey-based physician Chirag the app’s name suggests, its goal Shah as quoted in Men’s Health. is to teach you about the products Family Caregiving Essentials & Wellness SATURDAY, MARCH 30, 2019 After the free 10-day trial, Headspace you buy atan the grocery store,” reevent for inspiration, education &costs support 9:00AM - 2:00PM anywhere from $7.99 to $19.99 ports Men’s Health magazine. And monthly depending on the level of the advice is free, unless you wantTICKETS - $10.00 / LUNCH INCLUDED meditation you choose to access.
Family Caregiving Essentials & Wellness
WICK CENTER @ DAEMEN COLLEGE SATURDAY, MARCH 30, 2019 9:00AM - DOOR 2:00PM PRIZESPRESENTS • FREE PARKING - HEALING CAREGIVERS - • OFF BUS LINE TICKETS - $10.00 / LUNCH INCLUDED WICK CENTER @ DAEMEN COLLEGE
Family Caregiving Essentials & Wellness an event for inspiration, education &BUS support ADDRESSING FAMILY CAREGIVING ISSUES DOOR PRIZES • FREE PARKING • OFF LINE
Real world advice on dealing with aging parents & difficult conversations MARCH 30,&2019 Experts on Dementia,SATURDAY, Parkinson’s, Diabetes, heart disease other long-term illnesses SATURDAY, MARCH 30, 2019 9:00AM - 2:00PM ADDRESSING FAMILY CAREGIVING ISSUES The best way to take care of loved ones - at home or local facilities TICKETS $10.00 / LUNCH INCLUDED WICK CENTER @ DAEMEN COLLEGE Real world -advice on dealing with aging parents & difficult conversations 9:00AM - 2:00PM Handling difficult conversations Experts on Dementia, Parkinson’s, heart diseasePARKING & other long-term DOORDiabetes, PRIZES • FREE • OFFillnesses BUS TICKETS $10.00 / LINE LUNCH INCLUDED Financial & legal issues The best way to take care of loved ones - at home or local facilities
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Thank You to Our Sponsors: Get the resources you need from over 50 local associations & agencies world on dealing with aging parents & difficult conversations New Real research onadvice mindfulness used by health care professionals, patients & caregivers Experts onErie Dementia, Diabetes,|heart disease & otherServices long-term illnesses County Caregiver Coalition ErieSponsors: County Senior ThankParkinson’s, You to Our Sponsors: Thank You to Our The best wayCoalition toCaregiver take care lovedSenior ones -Services atCounty home orSenior local facilities Erie County Coalition | Erie Services Erie County Caregiver | Erieof County Handling difficult conversations Financial & legal issues
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HEALTH EVENTS
March 6
Osteoarthritis, rheumatoid arthritis, bone loss and injury are all common causes of hip pain. If hip pain is preventing you from doing everyday activities or the things you enjoy, there are options to consider. Catholic Health is sponsoring a community lunch program, “Treatment Options for Hip Pain” from noon to 1:30 p.m., March 6, at Four Points by Sheraton, 7001 Buffalo Ave. Niagara Falls. Join orthopedic surgeon Matthew Mann for lunch and a discussion on surgical and non-surgical options for relieving hip pain. From the latest in injection-based therapies to joint replacement surgery, Mann will review a full range of treatments and procedures to help you enjoy life free from hip pain. “Treatment Options for Hip Pain” is open to the public. Guests are invited to attend one free community program per calendar year. After that, the cost is $20 and includes a meal. Space is limited and reservations are required. For more information, call 716-447-6205 or visit chsbuffalo.org/events.
givers of local resources available throughout Erie and surrounding counties. The event offers real world advice and information on aging parents and loved ones with long-term chronic illnesses. Caregivers will be able to learn from experts on dementia, Parkinson’s, diabetes and heart disease; financial and legal issues. Caregivers will also come away with suggestions on how to handle those difficult conversations with loved ones about medical matters and longterm wishes. An emphasis will focus on taking care of loved ones at home and when to consider local assisted living or acute care facilities. The popular topic of mindfulness will also be included. Participants will learn how mindfulness is taught and practiced by professionals in the medical profession, with patients and caregivers. The majority of the caregiver resources are volunteer members of the Erie County Caregiver Coalition, coordinated by Erie County Senior Services. Other local nonprofits, health and wellness agencies are participating to expand the educational resources that caregivers need. For additional information, call 716-206-8479, send an email to hello@ healingcaregivers.com or visit healingcaregivers.com
March 13
April 1
pate in the Mental Health Advocates of WNY’s 57th annual dinner March 13 at The Atrium @ Rich’s, located on Niagara Street in Buffalo. This is MHA’s signature event and the biggest fundraiser of the year, with proceeds directly benefiting the programs and services it offers. This year, the event will a professional auctioneer for a live auction, a new and improved sound system and video screen, and online bidding for all auction items. Registration will end March 8 and can be made online. For more information, visit https://mhawny. org.
The University at Buffalo’s School of Public Health and Health Professions will host its fourth annual Step Challenge April 1-30. Registration opens March 1. The 2019 Step Challenge is free and open to the public. Participants will be asked to log their individual step counts, with each participant’s submissions contributing toward the collective goal of reaching 375 million steps during the month of April. All participants actively stepping, regardless of distance, will qualify to win various prizes each week throughout the contest, ranging from water bottles to iPads. Registration opens for all on March 1 at http://sphhp. buffalo.edu/home/news-events/national-public-health-week/step-challenge.html. To learn more about the 2019 Step Challenge, visit sphhp.buffalo. edu/UBsteps19. The challenge is the main event for the school’s celebration of National Public Health Week, a campaign organized by the American Public Health Association to recognize and celebrate public health and highlight issues that are important to improving our nation’s health.
Catholic Health offers free lunch program on treating hip pain
Mental health group holds Public invited to participate in Step its biggest event Challenge The public is invited to partici-
March 30
Event to gather agencies, nonprofit organizations More than 40 local agencies, nonprofits and associations are part of the Family Caregiving Essentials & Wellness Event, which will take place from 9 a.m. to 2 p.m. March 30, at the Wick Center at Daemen College. Registration is required and can be made at healingcaregivers.com or by calling 716-775-5748. Tickets are $10. The purpose of the annual event is to serve and inform family care-
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Two teams, one goal: Get stronger Buffalo.
“If you’re rehabbing from surgery, a stroke, a sports injury or any other kind of injury, choose Buffalo Center or Ellicott Center.” –MARTY BIRON, former goaltender for the Buffalo Sabres
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Page 5
Meet
Your Doctor
By Chris Motola
Allison S. Binkley, M.D. Emergency Rooms the Destination for Many Electric Scooter Users
R
ented electric scooters have become all the rage in getting around larger cities, but they are also accidents waiting to happen, a new study reveals. In two Southern California emergency departments, nearly 250 people were seen for injuries linked to electric scooters in a single year, researchers found. “Riders of electric scooters share roads with fast-moving vehicular traffic and share sidewalks with lots of pedestrian traffic and uneven curbs, and riders seem to underestimate hazards,” said senior study author Joann Elmore, a physician and professor of medicine at UCLA’s David Geffen School of Medicine. Injuries associated with these electric scooters are a new phenomenon, she noted. “While the injuries vary in severity, some are serious, including fractures and head injuries,” Elmore said. These data are likely a conservative estimate because the researchers only included patients seen in emergency rooms. “Our findings do not cover the many patients seen in our outpatient clinics,” Elmore added. “Electric scooters are an innovative and inexpensive method of transportation for short distances,” she pointed out. The companies offering these electric scooters are rapidly expanding in the United States and internationally. “This is now a billion dollar market, with ride-sharing companies like Uber and Lyft recently entering the market,” Elmore explained. For the study, Elmore and her colleagues used medical records from University of California, Los Angeles-affiliated hospital emergency departments to look at accidents associated with standup electric scooters over one year. In all, 228 patients were injured as riders and 21 as non-riders.
UBMD pediatric orthopedist discusses common problems affecting young kids and lists the most accident-prone sports (yes, football tops the list) Q: Pediatric orthopedics isn’t necessarily a specialty a lot of people come into contact with. What kinds of issues do you treat? A: Pediatric orthopedics is a very broad spectrum specialty even as it’s a fairly unique one. I see patients from day zero of life up through 21 years old. We treat everything from congenital hip dysplasia or hip dislocation to sports injuries in a 17-yearold athlete. So it’s a wide range of things. And we treat traumas in all these individuals. A broken arm in a baby is different than in a skeletally mature teenager. Q: And that’s because the bones aren’t fully formed? A: Correct. A child has growth plates in multiple areas of their bones. The growth can be altered by the injury. But the other side of that is their remodeling potential in children. If their growth plates aren’t damaged, they can remodel a lot of different fractures and injuries that adults can’t. But if their growth plate is damaged in the initial trauma, there may be a growth disturbance as they develop. And sometimes that needs to be addressed. With a skeletally mature teenager, we’re going to treat that fracture more or less the same way we would an adult’s. It’s all related to growth. Q: At that age are we mostly talking traumas? A: The biggest thing that I see, especially in the summer, is fractures. Children tend to be rambunctious and, in the summer, you have all the sports and trampolines and monkey bars. So the most common thing is
upper extremity fractures. Some of the other common things we see are hip dysplasia and clubbed feet. Q: How do you treat deformities? A: For hip dysplasia, the treatment varies depending on the severity and the age of the patient. For instance, if the child is born breech, they’ll get an ultrasound screening from their primary care physician. A lot of times it’ll show mild dysplasia. If that’s the case, we treat them with a harness that they’ll wear full time for about three months, which usually takes care of it. Now if a child is born with a dislocated hip, that can be more problematic. The child may have to go the operating room for a closed or open reduction and then put in a full-body cast. Once in a while, we get a child whose parents never sought care and is now 5 or 6. For those children their pelvic bones need to be cut and reshaped. So the treatment does vary quite a bit depending on the age and the severity. Q: Do you perform those types of surgeries? A: Yes, I do. I do everything from non-operative treatment to treatments of every part of the muscular skeletal system, including surgeries. Q: I remember as a child having to go down to the gym for scoliosis screenings every year. What’s the deal with scoliosis? A: I just did a scoliosis surgery yesterday! Scoliosis is another thing we do see a lot of. The treatment of that does vary a lot depending on the severity. The vast majority of kids with scoliosis just need to be watched. If the curve reaches 25 degrees and they’re still skeletally immature, then we’ll brace them. If it goes beyond 50 degrees then we’ll do surgery. Otherwise we just observe. Q: Is it not worth intervening at less than 25? A: Scoliosis is mostly a cosmetic thing. Studies show that it won’t continue into adulthood if it’s less than 50 degrees. If it’s above that, it’ll progress about 1 to 2 degrees per year, which can lead to deformity and even pulmonary issues. Less than that we haven’t found it to cause any functional difficulties whatsoever.
The report was published online Jan. 25 in JAMA Network Open. Page 6
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2019
Q: Do parents have a good sense of what their kids can and can’t take? Are they overcautious? Reckless? A: There’s a wide variety of parents. We’ll see anxious parents bring in their perfectly normal child for a gait disturbance. Or they’ll
bring in their toddlers for in-toeing, which is a normal growth pattern for their gait. And then you have parents who will only bring their kids in when they can barely walk. So the spectrum is very wide, and a big part of my practice is managing families. I’m a mom myself, so that helps me relate to them, even the over-anxious parents. I try to put myself in their shoes and try to reach them that way. But, yeah, there’s a huge spectrum of personalities and parenting styles. I think the important thing for parents to understand is that children’s bones are not the same as adults, and there are some unique problems that can occur. I think parents should trust their guts. If they think something is wrong, they shouldn’t ignore it. Q: Have cultural and technological changes affected the types of injuries and issues you see? I have a standing desk now to help deal with some posture-related issues. I’m wondering if those issues are showing up in younger people now. A: Yeah, in young patients, the biggest newer development is stress-related injuries related to overuse. One of the causes is that a lot of children are doing a single sport year-round now. There are a lot of repetitive injuries that can occur to their growth plates. For example, throwing athletes can damage the growth plate in their humerus [a long bone in the arm or forelimb that runs from the shoulder to the elbow]. Back in the day, kids didn’t play yearround or quite so competitively. In gymnasts we see back issues, wrist issues. And many of these are unique to children because they involve injury to growth plates. Q: I take it the sports medicine side of your practice usually involves teens? A: For the most part. Once in a while we’ll get a 10-year-old boy with a growth plate injury because his parents make him pitch 200 throws a day. But for the most part it is teenagers. Q: Which sports are the biggest culprits? A: Football is huge is the fall. Lots of football injuries. Soccer is also pretty big. For girls cheerleading is pretty big, believe it or not. Gymnastics is a pretty big one. Football is probably the biggest, though. From football, we get a lot of forearm fractures, even femur fractures, hip dislocations. So they can be pretty bad, but usually it’s an arm fracture.
Lifelines
Name: Allison S. Binkley, M.D. Position: Pediatric orthopedist with UBMD Orthopaedics & Sports Medicine; clinical assistant professor at University at Buffalo; specialist in pediatric orthopedics, scoliosis and sports medicine Hometown: Buffalo Education: University at Buffalo Affiliations: Oishei Children’s Hospital Organizations: American Academy of Orthopedic Surgeons; American Medical Association Family: Husband Matthew, also an orthopedic surgeon with UBMD Orthopaedics & Sports Medicine; a daughter, Ava; and another child on the way Hobbies: Working out, running, baking
Hospital-Acquired Conditions Declined By Nearly 1 Million
N
ew data released in January by the Agency for Healthcare Research and Quality (AHRQ) and Centers for Medicare & Medicaid Services (CMS) show reductions in hospital-acquired conditions such as adverse drug events and healthcare-associated infections helped prevent 20,500 hospital deaths and save $7.7 billion in health care costs from 2014 to 2017. AHRQ’s preliminary analysis estimates that hospital-acquired conditions were reduced by 910,000 from 2014 to 2017. The estimated rate of hospital-acquired conditions dropped 13 percent; from 99 per 1,000 acute care discharges to 86 per 1,000 during the same timeframe. AHRQ’s new report quantifies trends for several hospital-acquired conditions, including adverse drug events, catheter-associated urinary
tract infections, central-line associated bloodstream infections, Clostridioides difficile infections, pressure injuries (pressure ulcers), and surgical site infections. The report showed that harms decreased in several categories, such as adverse drug events, which dropped 28 percent from 2014 to 2017. However, opportunities for improvement exist in other harm categories, such as pressure ulcers. “CMS is delivering on improving quality and safety at America’s hospitals,” said CMS Administrator Seema Verma. “Our work isn’t done and we will continue our efforts to hold providers accountable for delivering results.” AHRQ Director Gopal Khanna, MBA, added, “The updated estimates are a testament to the successes we’ve seen in continuing to reduce
hospital-acquired conditions. There’s no question that challenges still remain in addressing the problem of hospital-acquired conditions, such as pressure ulcers. But the gains highlighted today were made thanks to the persistent work of many stakeholders’ ongoing efforts to improve care for all patients.” The continued decline in hospital-acquired conditions is a signal that patient safety initiatives led by CMS are helping to make the nation’s health care safer, federal officials said. AHRQ, CMS, the Centers for Disease Control and Prevention, and
other federal and private partners throughout the field support ongoing improvements in health care and are establishing a growing foundation of knowledge about how to keep patients safe. CMS has set a goal of reducing hospital-acquired conditions by 20 percent between 2014 and 2019. If achieved, AHRQ projects the 20 percent reduction would result in 1.8 million fewer hospital-acquired conditions over this period, potentially resulting in 53,000 fewer deaths and saving $19.1 billion in hospital costs.
Healthcare in a Minute By George W. Chapman
State of the Union — Five Major Healthcare Initiatives
P
resident Trump delivered his SOTU address on Feb. 5. Here are some of his plans. 1) Obliterate the “HIV epidemic” within 10 years by focusing on geographic hotspots; funding an HIV health force; improving access to testing and proper medication. 2) Cure childhood cancer by providing $500 million of research over the next 10 years. 3) Produce a plan for a national paid family leave act, which has been the pet project of Ivanka Trump. 4) Pass legislation to prohibit
late term abortions. 5) Continue to focus on lowering drug prices and mandating pricing transparency among drug manufacturers, hospitals and physicians. Surprisingly, there was little mention of how he would lower overall healthcare costs, making premiums more affordable. Trump also promised to protect pre-existing conditions. Ironically, he has systematically dismantled the Affordable Care Act, which protected pre-existing conditions.
Opioid epidemic
Anthem insurance. Anthem includes rides as a benefit to Advantage members. Ninety percent of Anthem’s non-emergent patient transportation is booked with Lyft. As a result, Anthem’s ride costs have decreased 39 percent and wait times for a ride have decreased 40 percent. This clever benefit could benefit physicians by reducing patient no-show rates.
Thirty-five states are suing opioid manufactures. Recently, the state of Massachusetts attorney general filed a lawsuit against Purdue Pharmaceutical and its owner family, the Sacklers, for knowing their pain killer OxyContin was highly addictive and for deceiving physicians and consumers alike. Several incriminating internal emails and documents from Purdue have been subpoenaed. Roughly 130 people per day, or about 47,000 people per year, die from opioid addiction. The worse states for opioid-related deaths per 1,000 are: West Virginia 50; Ohio 39; District of Columbia 35; New Hampshire 34; Maryland and Oregon 32. New York ranks 24th with 16/1,000. The state with the least opioid deaths per 1,000 is Nebraska at 3.
Need a Lyft?
The ride provider Lyft (vs. Uber) sees Medicare Advantage plans as a good market for their business. Lyft’s first Advantage plan partner was
Fewer People Have EmployerSponsored Insurance
Twenty years ago, 67 percent of us received health insurance through our employer —Today, the percentage has dropped to 58 percent, according to research conducted by the Kaiser Family Foundation. Some experts surmise the gradual decline over 20 years could be due to retiring baby boomers and employees of small businesses purchasing their insurance on the exchange. Recently, the Trump administration struck down the individual mandate to have insurance which may fuel the downward trend going forward.
About 156 million people, or slightly less than half of the US population, were covered by employers in 2017. The other half of us were covered by Medicare, Medicaid, the VA, federal employment, co-ops, the Bureau of Indian Affairs and the exchanges.
Smaller Hospitals Seek Affiliations
In order to enhance their reputations, remain independent and provide their communities access to the best care, let alone survive, smaller community hospitals are affiliating (versus merger or acquisition) with larger, more prestigious hospitals. In return, the larger hospital increases its market for the specialized services that most smaller hospitals can’t provide. Most of these affiliations have eventually resulted in a complete merger or acquisition of the smaller by the larger. Because today’s consumers are far more savvy and demanding, smaller hospitals need to shed their local or “community” reputation and rebrand as part of a larger more comprehensive health system.
Drug Costs
Uncontrolled, skyrocketing and mysterious drug costs are a bipartisan issue. Trump mentioned this in his State of the Union. But few of the invited drug CEOs bothered to show up, voluntarily, at a Senate Finance Committee meeting to discuss drug costs. The CEOs who failed to show told committee chairman Chuck Grassley they would prefer to meet in private versus in public. (Talk about transparency.) The committee is threatening to force the CEOs to testify if they continue to balk. There have been several suggestions on controlling drug costs. But most are convoluted and difficult to monitor and enforce. The best solution for
March 2019 •
controlling drug costs would be to allow CMS (Medicare/Medicaid) to use its massive purchasing power to negotiate drug costs. This solution is not favored by the powerful drug lobby. Bowing to pressure from the lobby, Congress is still dancing around the real solution.
Artificial Intelligence in Healthcare
The healthcare industry is slowly incorporating artificial intelligence — AI — when it comes to assisting physicians in determining a diagnosis or treatment plan. AI is already being used in radiology, pathology and dermatology. It assists physicians with faster and highly accurate diagnoses. Combining AI with physician experience and judgment results in higher diagnostic confidence. Telehealth continues to be perfected and more widely accepted. Robots and 3-D printers are being used in operating rooms. AI in psychotherapy is becoming more prevalent due to the limited availability of psychiatrists, the cost of treatment and the greater willingness of patients to be honest about themselves, especially when it comes to socially deviant behavior, with a computer versus a human. The integration of AI in healthcare will lessen, if not negate, the impact of the projected physician shortage. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
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Writer on the Run By Jenna Schifferle
Running on Delaware Ave
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f you ever happen to be driving by Delaware Avenue in Buffalo on a Monday or Wednesday, you might see people shuffling down the sidewalk as a fleet of reflective gear shines off the headlights before them. Some nights, they take to Delaware Park, running circles around the tennis courts and the zoo; some nights, they trace circles around the surrounding neighborhoods. With temperatures in low digits and snow coating every inch of the town, you might think them a bit nuts — that is, until you join them. If you would have asked me seven years ago if I wanted to go for a run with you, I probably would have laughed and treated myself to a large mocha latte, because why run when you can caffeinate, right? And then slowly, I started to go for a run here
As U.S. Measles Outbreaks Spread, Why Does ‘Anti-Vax’ Movement Persist?
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easles outbreaks across the United States — including one in Washington state where 50 cases have now been identified — have again shone the spotlight on parents who resist getting kids vaccinated. These outbreaks are a clear sign of the fraying of “herd immunity,” the overall protection found when a large majority of a population has become immune to a disease, said physician Paul Offit. He is director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “Measles is the most contaPage 8
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gious of the vaccine-preventable diseases, so it’s always the first to come back when you see a drop in herd immunity,” Offit said. The World Health Organization has taken notice, and recently declared the anti-vaxxer movement a major threat to public health. Given this, why does anti-vaccine sentiment continue to thrive in certain locales throughout America? Offit suspects it’s because people have forgotten just how bad diseases like measles, chickenpox and whooping cough can be.
and there, crawled a few races, fell on the wagon and off again. So the cycle goes. Then, I discovered Fleet Feet Sports. For anyone who isn’t familiar with Fleet Feet, it’s a running store that’s nestled into a plaza near Hertel on Delaware Avenue. Someone casually mentioned to me that they do free group runs on Monday and Wednesday nights, and since I’d tinkered with running, I figured I would give it a try. The rest, as they say, is history (in the making, of course). It wasn’t long before I formed bonds with the people there, and the closer I got to them, the more I started believing that I could do the impossible. A few more miles? Sure! Tackle a few hills? Why not!
“It’s happening because people aren’t scared of the diseases,” Offit said. “I think vaccines in some ways are victims of their own success.” But other factors come into play, including a reluctance to give a slew of vaccines to a young child so early in life, now-debunked fears of a link to autism, a feeling that diseases are a natural part of childhood, and a deep-seated distrust of the medical community. Measles outbreaks were “inevitable,” said physician Dawn Nolt, an associate professor of pediatric infectious disease at OHSU Doernbecher Children’s Hospital in Portland, Ore. She lives close to the Washington border, where the biggest current measles outbreak rages. “Pockets of communities where there are low vaccine rates are ripe to be ground zero for an outbreak,” Nolt said. “All you need is one person in that community. We knew this was going to happen.” That’s particularly true of measles, which is incredibly virulent. Offit explained that “you don’t have to have face-to-face contact with someone who has measles. You just have to be within their air space within two hours of their being there.” According to Nolt, despite its power to spread, there are three questions that typically come up with parents who are hesitant about having their children vaccinated against measles: Is the vaccine safe? Is the vaccine needed? Why shouldn’t I have freedom of choice regarding my child’s vaccinations? “I think what’s important is to really understand that families have certain concerns and we need to understand those concerns,” Nolt said. “We can’t lump them all together and think that that one conversation serves all of their concerns.” Parents’ concerns regarding vaccination are often first sparked by the recommended vaccine schedule, Offit said. “What’s happened is we ask parents of young children in this country to get vaccines to prevent 14 different diseases,” Offit said. “That can mean as many as 26 inoculations during
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2019
Run a half marathon? I’m in! Even in other areas of my life, I started to have more confidence and energy. When times get stressful, running helps me stay centered and focused. Not to mention, runners are there for each other. Even on my worst runs, the people at Fleet Feet have helped me laugh through the tears. Because of them, I’m able to keep going, even when it’s uncomfortable. So, it’s no surprise that in October, I will be attempting my first marathon in the same city that sparked my fascination with running — Chicago. After seeing crowds of people crossing the finish line with looks of triumph and exhaustion, I felt inspired. When I joined Fleet Feet, I learned to take that inspiration and run with it. From one “non-runner” to the next, I hope my journey will inspire you to take the first step in any area of your life. After all, sometimes it just takes a good group of people to get you moving. Feel free to join us on Mondays and Wednesdays at 2290 Delaware Ave., starting at 6 p.m.
those first few years of life, as many as five shots at one time, to prevent diseases most people don’t see, using biological fluids most people don’t understand.” So, it’s important that doctors explain to parents that these vaccines are “literally a drop in the ocean” compared to the myriad immune system triggers a child encounters each day, Offit said. “Very quickly after birth, you have living on the surface of your body trillions of bacteria, to which you make an immune response,” Offit explained. “The food you eat isn’t sterile. The dust you inhale isn’t sterile. The water you drink isn’t sterile. You’re constantly being exposed to bacteria to which you make an immune response.” Vaccine and autism Doctors also still have to deal with an erroneous 1998 study that linked vaccinations and autism, said physician Talia Swartz, an assistant professor of infectious diseases with the Icahn School of Medicine at Mount Sinai, in New York City. The study was later found to be fraudulent and withdrawn, but “significant press has continued to raise concern about this, even though these concerns have been refuted based on large-scale population studies,” Swartz said. It’s important to emphasize that these vaccines are heavily tested for safety, said Lori Freeman, CEO of the National Association of County and City Health Officials. As to whether vaccines are needed, outbreaks provide a powerful argument in favor of that premise, experts said. However, some parents still greet outbreaks with a shrug. Nolt said that “some people think vaccines aren’t needed because the disease is more ‘natural’ than the vaccine.” And arguments based on altruism — vaccinating your child to protect the rest of the community, especially kids who can’t be vaccinated — only go so far, she added.
A Quarter of Antibiotics Prescribed Unnecessary By Deborah Jeanne Sergeant
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he Centers for Disease Control and Prevention recently stated that 25 percent of antibiotic prescriptions aren’t necessary. But it’s more than simply wasting medication for a case where it cannot help. Over-prescribing antibiotics contributes to a major health issue: antibiotic resistance. “Bacteria are everywhere, good and bad,” said Emil Lesho, an infectious disease physician at Rochester General Hospital. “When exposed to antibiotics, they want to survive. They tend to mutate and survive. It triggers them to be resistant.” This can cause both individual resistance, when a particular person discovers antibiotics don’t work as well as they used to, and universal resistance, when bacteria mutate to the point where no antibiotics can treat them, regardless of a person’s history of taking antibiotics. Dubbed “super bugs,” these more aggressive bacteria “have become a public health crisis,” Lesho said, and can even cause fatal complications “We are running out of antibiotics,” he said. “If nothing is done to slow down the spread of resistance, and no new antibiotics are developed, we can come to the point where we have infections we can’t treat. People could die of minor infections. That’s the opinion of the World Health Organization, Infectious Diseases Society of America, and the Centers for Disease Control.” Because antibiotics kill both good bacteria and bad, patients are more susceptible to yeast infections, diarrhea and stomach upset. The natural flora of the gut and, in women, vagina, are negatively affected. Some say it takes weeks to restore that balance. So why are doctors prescribing antibiotics to patients who don’t need them? Undue patient pressure on physicians represents one reason, according to Lesho. He said that electronic medical records tend to focus
on patient satisfaction, as does media feedback. “Doctors know that they’ll be evaluated based on patient experience and if they don’t provide a good patient experience, that could be another driver of over-prescribing,” Lesho said. Sometimes, it’s for dental procedures, where some providers routinely recommend antibiotics. Lesho said that as many as 80 percent of antibiotic prescriptions are unnecessary in this setting. Pediatricians often face upset parents who want something they think will help their sick, crying children. Edward Lewis, pediatrician at Lewis Pediatrics in Rochester, has also observed a rise in antibiotic resistance. He said that for the past decade, his office has been practicing “antibiotic stewardship” to reduce antibiotic use only to cases where it’s necessary, and then for a shorter duration if possible. “We realized we have to use antibiotics more carefully,” he said. “If you as a pediatrician spent time with parents to explain why they don’t need it — and it does take a little more time — it works.” Parents are beginning to understand why it’s not routine for children. Lewis said it helps to give out a handout on what to expect with their child’s viral illness and planning to follow-up call or, as needed, visit. Antibiotics cannot help viral infections. Anti-viral drugs can help for rare, serious viral illnesses for people prone to complications, but are not prescribed for routine cases. For those, Mary L. Beer, RN and public health director for Ontario Co Public Health, recommends treating symptoms. “If you have a fever, take Tylenol,” she said. “Get plenty of fluids and rest. Over-the-counter medication can help with decongestion.”
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1/22/19 2:32 PM9 • Page
Live Alone & Thrive
YOUR SCORECARD
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Quiz Time: How Content Are You? M erriam-Webster defines contentment as “the state of being happy and satisfied.” This dictionary definition sounds like a nice way to feel, doesn’t it? Oh, if we could just snap our fingers and be happy with who we are and what we have. Wouldn’t life be grand? I’ve had the privilege of meeting and talking with a lot of women and men who live alone, and our conversations often turn to the subject of contentment: how to find it, how to keep it and how to find it again once it has been lost. Those on their own often feel a lack of something in their lives, and many have trouble letting go of a craving for things to be different. I know. I’ve been there. For years after my divorce, I had trouble seeing the good in myself and in my life. But with time, intention and practice, I was able to stop yearning for what I didn’t have and start appreciating what existed right in front of me. It all began with an important first step — taking a hard look at myself. While I’m no expert in survey design, I created the simple quiz be-
Calculate your total points using this scale:
low to help you assess where you are on the road to contentment. Your results may light a new and hopeful way forward.
How Content Are You?
Circle the choice that best answers the questions below:
If asked, how many positive personal qualities come immediately to mind? A. 5 or more B. 1 to 4 C. Nothing really comes to mind
1.
How would you describe your home? 2.own! A. Very “me” — I’ve made it my
B. It’s fine. I keep meaning to redecorate, but just haven’t gotten around to it C. It’s a place to sleep
How would you describe your suc3. cess in letting go of old ways of thinking and of negative thoughts or behaviors
that keep you anchored in the past? A. I live in the present; it’s full steam ahead! B. I still go “back there” from time to time C. I can’t let go, I obsess about the past
4.
Could you imagine planning a trip by yourself and traveling alone to a favorite destination? A. In a heartbeat! B. Maybe someday C. I can’t imagine that
Does the thought of going alone to a 5. cafe for a cup of coffee, or grabbing a bite to eat in a local restaurant, feel perfectly comfortable — even enjoyable?
A. I do it all the time B. Occasionally, but I’m not at ease C. I’m just not ready you exercise, get enough sleep, 6.A. Doand stay on top of health screenings? Of course B. I know I should, but I don’t always take care of myself C. I’m too preoccupied to think about my health
How often do you pamper or reward 7. yourself by taking some time just for you or by purchasing that little something
special you’ve had your eye on? A. As often as I can! B. More often than not, I put others’ needs first C. I can’t remember the last time I pampered myself
you imagine your life without a 8.A. Can special someone on your arm? I would enjoy sharing my life with someone special, but could also find contentment with my “family of friends” B. Maybe, but not for long; I feel incomplete without a “one and only” C. Life doesn’t feel worth living when I’m not in love
3 points for each A answer 2 points for each B answer 1 point for each C answer 8 points: Contentment may feel elusive at the moment — beyond your grasp. But it can be found. You may benefit from talking with a professional or your pastor. Help and encouragement might also be found in grief support groups and other gatherings that offer emotional support. 9-15 points: You experience feelings of contentment, but you know there’s more to be found. Continue to stretch yourself. Reach out to others. And “try on” healthy pursuits outside your comfort zone. Success and achievement breed contentment. You might also find inspiration and a needed jump-start in workshops, classes, and lectures devoted to personal growth and development. 16 points: Good for you — what you have is precious. Being content with yourself opens up all kinds of possibilities. It enables you to feel peace and joy, whether you are alone or with others. It is an invaluable inner springboard on which you can launch all things imaginable! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon. She is also the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” To purchase her book, learn about workshops, or invite her to speak call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.
s d i K Corner
Almost All U.S. Teens Falling Short on Sleep, Exercise
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oo little sleep. Not enough exercise. Far too much “screen time.” That is the unhealthy lifestyle of nearly all U.S. high school students, new research finds. The study, of almost 60,000 teenagers nationwide, found that only 5 percent were meeting experts’ recommendations on three critical health habits: sleep; exercise; and time spent gazing at digital media and television. It’s no secret that many teenagers are attached to their cellphones, or stay up late, or spend a lot of time being sedentary. But even researchers were struck by how extensive those issues are among high school students. “Five percent is a really low proportion,” said study leader Gregory Page 10
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Knell, a research fellow at University of Texas School of Public Health, in Dallas. “We were a bit surprised by that.” In general, medical experts say teenagers should get eight to 10 hours of sleep at night, and at least one hour of moderate to vigorous exercise every day. They should also limit their screen time — TV and digital media — to less than two hours per day. The new findings show how few kids manage to meet all three recommendations, Knell said. It’s easy to see how sleep, exercise and screen time are intertwined, he pointed out. “Here’s one example: If kids are viewing a screen at night — staring at that blue light — that may affect
their ability to sleep,” Knell said. “And if you’re not getting enough sleep at night, you’re going to be more tired during the day,” he added, “and you’re not going to be as physically active.” The report was published online Feb.4 in the journal JAMA Pediatrics. Ariella Silver is an assistant professor of pediatrics and adolescent medicine at Icahn School of Medicine at Mount Sinai in New York City. She offered some advice for parents: • Instead of telling kids to “get off the phone,” steer them toward alternatives, like extracurricular activities, community programs or family time. “Their screen time will go down by default,” she noted. • Be a good role model. Get off
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2019
your phone and demonstrate healthy habits, including spending time being physically active with your kids. • Talk to teenagers about the importance of healthy habits. “Ask them, ‘How do you feel when you don’t get enough sleep?’” Silver suggested. “Ask, ‘How do you feel when you don’t get outside in the sun and get some exercise?’” It’s important, she said, that kids notice how their bodies feel when they do or don’t engage in healthy habits. • Set some clear rules around screen time, such as no devices in the two hours before bedtime. “Make sure your kids realize these devices are a privilege, and not a necessity to living,” Silver said.
Things to Ask When Checking Out Chiropractors By Deborah Jeanne Sergeant
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f you need a chiropractor, keep in mind these questions to ask as you look for a provider.
Janelle Munroe, office manager, Munroe Chiropractic, Williamsville • “You want a doctor that delivers results. • “Word-of-mouth references are huge. Some people also look online and seek references, too. • “There are chiropractic wellness programs as well as spinal adjustment. Ask about what you want as a patient. • “We don’t want them to have to come in weekly for months. Patients should have a clear representation of their case and we try to educate patients on the course of treatment. We take an x-ray on them
so we know what we need to do. • “Look for quality and experience. On your first visit, we take steps to provide patient feedback. • “Chiropractors have to be licensed. Look for chiropractors that provide all sorts of techniques.”
-------v------Brenda Covell, chiropractor, Covell Chiropractic, Buffalo • “Ask about the type of practice they operate. There are different types of chiropractors you can seek out, depending upon your need. If you’re looking for sports injury care, there are doctors with advanced training in that field. My expertise is in prenatal pregnancy care, involving
What Are the Healthcare Questions People Ask the Most? By Angela Underwood
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oogle it —and Google we did. On the eve of 2019, CNN reported that the “Dr. Google” spat out more information on healthrelated questions regarding a fad diet and ALS more than any other ailment in 2018. Along with other health concerns — including endometriosis, the flu, how long marijuana stays in system, implantation bleeding, heartburn and high blood pressure — the Ketogenic Diet and ALS were the top two health-related searches. Keto, the high-fat low-carb diet, may be proven to shed weight, but it is not a way of life, according to nutritionist Lisa Drayer. “It doesn’t teach you how to acquire healthy eating habits,” Drayer said. “It’s good for a quick fix, but most people I know can hardly give up pasta and
bread, let alone beans and fruit,” she said. Whether or not the death of world-renowned physicist Stephen Hawking in March 2018 death contributed to the spike in searches about ALS — also called Lou Gehrig’s disease — is unknown, just like ALS itself, of which “little is known about the causes of the disease, and there is no cure,” reported CNN. Lupus topped the list in 2017 as the top searched disease, along with mental illness, both of which have a direct link to singer Selena Gomez. As the producer of “13 Reasons Why,” a Netflix series dealing with mental health and suicide and as a Lupus sufferer herself, Gomez brought her creative direction and health concerns to masses, especially since the Netflix series reportedly
mothers who are expecting. There are different techniques for this type of care. Also, there are pediatric chiropractors and many other types of specialties to meet the various needs people have for seeking chiropractic care. • “One of the best ways to find a chiropractor is word-of-mouth. Ask people you know about the places they have sought care. If your friends and family are recommending a chiropractor and they go back to that one, that speaks highly of that chiropractor. • “Check with the New York State Chiropractic Association. They are evidenced-based. Doctors that are associated with them are interested in using best practices and the most up-to-date techniques and methods to support their treatment protocols with their patients. • “I’d be wary of any practitioner that tries to sell you a long, extended treatment plant. Everyone is an individual and each body responds differently to treatment. We’re not fortune tellers. We can’t tell you what will happen six months in the future with a treatment plan or how the body will respond to a particular treatment. • “Keep in mind that the patient is always in control of their own health. There should be a dialogue between the chiropractor and patient regarding the patient’s goals and the treatment the chiropractor offers. If those two things are not in tandem, it probably will not be a good, working relationship between the patient and the chiropractor.”
sparked an interest in suicide ideology. Unlike the last year, opioid addiction did not dominate the search engine questions as it did in 2017 after it was declared a national public health emergency by President Donald Trump. However, three health related questions that did remain the same in 2017 and 2018 concerned the flu, blood pressure and lethargy. Speaking of the flu, Marie Claire magazine points out that Googling the illness can literally leave you feeling worse than when you clicked search. “We’ve all typed in flu symptoms only to have the internet suggest that it’s anything from pregnancy to ebola,” reports Marie Claire. “Which, unsurprisingly, leaves you feeling anxious, upset and confused.” The reason why “a whopping one in four people,” Google their illnesses, according to Marie Claire, is because of doctor availability and work schedule conflicts; however, that is still no excuse for not “being seen by a trained professional, rather than, well y’know, your own imagination and a bunch of random web searches.” Only time will tell what Dr. Google who tracks health-related questions annually from January to mid-December will report the top 2019 health concerns are, so until then, maybe go to the doctor rather than the search engine for the answer to what ails you.
March 2019 •
Insulin Price More Than Doubles in U.S.
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ome Americans with Type 1 diabetes have cut back on their insulin usage as the cost of the lifesaving drug nearly doubled over a five-year period. The annual amount that people with Type 1 diabetes spent on the drug rose from about $2,900 in 2012 to about $5,700 in 2016, according to a new analysis from the nonprofit Health Care Cost Institute (HCCI), CBS News reported. Those are gross amounts and don’t factor in the use of rebates or coupons, which can reduce costs for some people. The cost of living rose 6.5 percent between 2012 and 2016. A study published last year found that more than one-quarter of people with diabetes said they reduced their use of insulin due to the rising cost. Doctors warn against cutting back on insulin usage, CBS News reported. “There has been a flurry of news reports sharing stories of individuals with diabetes rationing their insulin because they cannot afford higher and higher prices,” according to HCCI.
MS Drug Costs Skyrocket After Medicare Rule
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edicare rule changes could trigger a spike in out-of-pocket drug costs for patients with multiple sclerosis (MS). Due to rules that restrict access and require patients to cover more of the cost, those without low-income subsidies can expect to spend almost $6,900 a year out of pocket for MS medicines, researchers reported. “It’s a dysfunctional market that lacks the typical incentives for most other consumer products,” said lead author Daniel Hartung. “Aside from the public optics, there are few incentives for companies not to raise prices. Most intermediaries in the drug distribution channel, including drug companies, benefit from higher prices.” MS is an unpredictable disease of the central nervous system, resulting in symptoms that include vision problems, muscle weakness, tremors and difficulty with balance and coordination. Out-of-pocket drug costs are often tied to undiscounted list prices, and there appears to be a link between rising prices for MS drugs and more use of restrictive policies by Medicare drug plans, according to the researchers. For example, they found that patients who are prescribed the only generic drug in one class — glatiramer acetate — will pay more out of pocket than patients using any brand-name drugs in the same class. Medicare rule changes last year were meant to reduce patients’ out-of-pocket costs through increased discounts from brandname drug manufacturers. But the change resulted in higher out-ofpocket costs for users of certain generic products.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Make America Mooo Again Milk is cool with farm-to-table freshness By Cherie Messore
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ilk has been called “nature’s perfect food” for generations. Packed with nutrients and protein, cow’s milk is budget friendly and easily available. By the 1980s, soy milk bubbled up in popularity, followed by almond and other nut ‘milk’ beverages in the early 2000s, touting reduced fat and cholesterol benefits. Other factions jumped off the milk wagon, too, claiming that dairy products (from cows fed low-quality feed and antibiotics) were putting Americans at risk. Despite this, milk is still out front with refreshed scientific studies proving that modern animal care practices and healthier cows produce dairy products full of flavor and nutrition with healthful benefits for everyone. In fact, the 2017 State of the Industry report from Dairy Foods magazine said that milk is “on trend” because of its nutritional value, wholesomeness, and farm-to-table delivery. “It is a challenge to get the nutrition we need in our daily intake without dairy products,’ says Michelle Barber, nutrition specialist for the American Dairy Association. “Studies with adults and kids have shown how missing those nutrients can have a negative health impact. The truth is, not all non-dairy milks have the same nutrients as real milk. For instance, dairy milk has eight times the protein of almond and rice milks which also contain a long list of added ingredients, like sugar, syrups, salt, thickeners and stabilizers. Real milk’s ingredient list is short and simple, with only ingredients you know.” Nutrition experts agree that dairy products are important ingredients in a healthy diet. “A glass of milk has nine essential nutrients plus protein and gives us a fuller feeling, especially whole
milk. Those are important benefits,” said Bridget O’Brien Wood, food service director for Buffalo Public Schools. Wood feeds thousands of students every day, and dairy products are prominent on the menu. “What’s really popular right now are smoothies and yogurt parfaits,” she said. “Milk is still our beverage of choice,” she says. “Water lacks calories and nutrients. Children need calories to grow, and while there is naturally occurring sugar, it’s not added sugar. Dairy milk is more wholesome,” she says. Dairy product consumption isn’t limited to school lunches. “Milk isn’t just for kids, although it is especially important for growing kids who need the nourishment that milk provides,” Barber, the American Dairy Association representative, said. She says that milk also helps to build and maintain bone strength which is even more important for maturing baby boomers and older Americans. Athletes have even rediscovered milk as a more healthful recovery drink. Physician Greg Miller, chief science officer for the Chicago-based National Dairy Council, says, “Research shows that milk — both white and chocolate — can be just as beneficial for the body as some sport drinks because milk contains four things your body needs after a workout.” These four nutrients in milk, according to Miller, are: carbohydrates, the primary source of energy for athletes; high quality protein to help rebuild and repair your muscles. Protein contains the essential amino acids your body needs to build and maintain your muscles and help your body work properly; and fluids and electrolyte to replace lost minerals like sodium, chloride and potassium.
Miller says, “Rehydrating with milk can help replenish your body’s fluids and electrolytes lost in your sweat.” Milk is also less expensive that processed energy drinks and much more wholesome. Consumers may be confused about dairy’s benefits, according to Kendra Lamb, a fifth generation dairy farmer who also serves on the board of directors for Milk for Health on the Niagara Frontier. Even though there are nearly 800 dairy farms in the eight counties of Western New York, “People are removed from the farm,” she says, “They don’t understand the process of producing milk.” At Lamb’s farm in Genesee County, 2,400 cows are milked three times a day. Milk is immediately tested for purity and is stored in refrigerated vats until the milk truck takes it to a nearby milk plant for pasteurizing, a simple heat process which doesn’t diminish its nutrient values. Then it’s ready to be bottled or made into yogurt, ice cream, and other dairy products. Lamb says, “While there are lots of different labels on milk in the grocery aisle, please don’t miss this: ALL milk is free from antibiotics. If a cow is ill and our veterinarian recommends that we administer medication, she will be milked in another location and her milk is kept separate so it can’t enter the food supply. There are lots of safety checks along the way to make sure our food supply remains pure and safe.”
U.S. Healthcare Spending Highest Among Richer Nations
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igher costs, not better patient care, explain why the United States spends much more on healthcare than other developed countries, a new study indicates. U.S. healthcare spending was $9,892 per person in 2016. That was about 25 percent more than second-place Switzerland’s $7,919 and more than twice as high as Canada’s $4,753, researchers found. It was also twice what Americans spent in 2000, and 145 percent higher than the Organization for Economic Cooperation and Development (OECD) median of $4,033. The OECD includes 34 countries. “In spite of all the efforts in the U.S. to control health spending over Page 12
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the past 25 years, the story remains the same — the U.S. remains the most expensive because of the prices the U.S. pays for health services,” said study author Gerard Anderson. He’s a professor at Johns Hopkins Bloomberg School of Public Health in Baltimore. “It’s not that we’re getting more; it’s that we’re paying much more,” Anderson said in a school news release. Evaluating the drivers behind soaring U.S. spending, his team cited higher drug prices, higher salaries for doctors and nurses, higher hospital administration costs and higher prices for many medical services. Despite those higher costs,
Americans have less access to many healthcare services than residents of other OECD countries, according to the study. In 2015, for example, there were 7.9 practicing nurses and 2.6 practicing physicians for every 1,000 Americans, compared to the OECD medians of 9.9 nurses and 3.2 physicians. That year, the United States had only 7.5 new medical school graduates per 100,000 people compared to the OECD median of 12.1. And the nation had just 2.5 acute care hospital beds per 1,000 people compared to the OECD median of 3.4. Yet the United States ranked second in the number of MRI machines
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2019
Whole milk fat products get a bad rap sometime, but more recent research tells a different story. Miller says, “While the advice from dietary guidance is to choose low-fat or fat-free dairy foods, the science is evolving. As noted in the 2010 Dietary Guidelines for Americans and as research continues to show – regardless of fat content – dairy foods, such as milk, cheese and yogurt, are associated with improved bone health, especially in children and teens, and reduced risk of CVD, Type 2 diabetes and lower blood pressure in adults. Whole milk dairy foods can be a part of a healthy eating styles, you will just want to be mindful of other food choices to balance saturated fat and calorie intake.”
per person and third in the number of CT scanners per person, suggesting relatively high use of these expensive resources. (Japan ranked first in both categories, but was one of the lowest overall healthcare spenders in the OECD in 2016). Among the other findings: • U.S. health spending outpaced that of the other OECD countries between 2000 and 2016 — growing an average of 2.8 percent a year compared with the OECD median annual increase of 2.6 percent. • Inflation-adjusted spending on pharmaceuticals rose 3.8 percent annually in the United States versus an OECD median of 1.1 percent. • In 2016, U.S. health care spending accounted for more than 17 percent of gross domestic product, compared with an OECD median of less than 9 percent. The findings appear in the January issue of the journal Health Affairs.
SmartBites
The skinny on healthy eating
Whole-grain Millet: Good for Hearts (and More!)
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luffy like couscous or creamy like polenta, millet has many things going for it: it’s gluten-free (appealing for those trying to avoid gluten), a good source of protein, and loaded with health benefits. So why aren’t we consuming more millet on a regular basis? Especially when it’s so versatile, inexpensive, and easy to prepare? One word: birdseed. Most people equate this delicious whole grain with birdseed, even though the millet for human consumption differs from what our feathered friends eat. Like other whole grains that retain all parts of the seed (bran, germ and endosperm), millet helps protect the heart and it does so in more ways than one. Millet’s fiber helps prevent heart disease by lowering both blood pressure and bad cholesterol. Hearts also benefit from millet’s rich supply of magnesium, an essential mineral for maintaining a steady heartbeat and normal blood pressure. And because millet is relatively low in calories (only 200 per cooked cup), this satisfying grain helps hearts by assisting us with weight loss and
maintenance. Extra pounds, as many know, put significant strain on your heart and worsen several heart-disease risk factors. Millet may reduce your risk of developing Type 2 diabetes, thanks to its healthy concentration of two minerals that regulate blood sugar: magnesium and manganese. According to the Centers for Disease Control, nearly 10 percent of the U.S. population has diabetes, and the majority have Type 2. Studies have shown that low blood levels of both minerals can increase insulin resistance, which leads to diabetes. Of course, millet’s overall nutritional profile — high in filling fiber; low in fat, sugar and salt — is just as important in keeping diabetes at bay. One cup of cooked millet serves up six grams of protein, an important building block of bones, muscles, cartilage, skin and blood. You also use protein to make enzymes, hormones and other body chemicals. Millet, however, is not a complete protein because it lacks the amino acid lysine. The addition of lysine-rich beans to any millet dish easily creates a complete protein.
Lemony Millet Salad with Fresh Asparagus, Mini Peppers and Black Beans 3/4 cup millet 1 1/2 cups water 1/2 bunch asparagus 8 mini peppers 1 can black beans, rinsed and drained 3 tablespoons olive oil juice and zest from 1 lemon 1 large garlic clove, minced salt and pepper to taste 1 cup flat-leaf parsley, rinsed, dried and roughly chopped 1/2 cup slivered almonds, toasted Combine millet with water in a medium saucepan. Bring to a boil, reduce to a simmer, cover, and cook until water is absorbed (about 20 minutes). Remove from heat and let it sit, covered, for 10 minutes, before fluffing it with a fork. While millet is cooking, cut the asparagus, including the tips, into
thin slices, crosswise, and place in a medium bowl. To prep the mini peppers, cut off the end, cut out the seeds, and then slice the peppers into rings, about 1/8-inch thick. Add black beans, millet and chopped parsley to vegetables; lightly toss. Make the dressing by whisking together olive oil, lemon juice and zest, minced garlic, and salt and pepper. Drizzle over millet mixture, mix well, adjust seasonings, and top with toasted almonds.
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
Moringa: An Ancient, New Super Food By Deborah Jeanne Sergeant
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lso known as horseradish tree or Indian horseradish among its many monikers, moringa is emerging as a super food in the Western hemisphere and as a supplement that appears to offer a bevy of benefits to support good health. Interestingly, all parts of the plant are edible. In its native sub-Himalayan areas of India, Pakistan, Bangladesh and Afghanistan, where the leaves, bark, flowers, fruit and seeds are used medicinally and the pods are eaten as a vegetable. Moringa grows easily in poor soil, making it an ideal source of nutrients in under-developed countries. In the U.S., numerous other foods are already cultivated that provide the same nutrients, so moringa hasn’t caught on as a crop. More commonly, the leaves, dried and ground into powder supplement, are the most commonly consumed part of moringa. “It does have a pretty robust nutrition profile: amino acids, anti-oxidants, anti-bacterial effects, and studies say it can balance insulin lev-
els and increasing insulin sensitivity versus resistance,” said Kristen Gill, registered dietitian with Sisters Metabolic Center for Health & Wellness in Buffalo. “A lot of people are using this as a ‘super food.’” WebMD.com, a website specializing in medical news, states that moringa may be used for anemia, arthritis, asthma; cancer; constipation; diabetes; diarrhea; epilepsy; stomach pain; stomach and intestinal ulcers; intestinal spasms; headache; heart problems; high blood pressure; kidney stones; fluid retention; thyroid disorders; and bacterial, fungal, viral, and parasitic infections. It’s also used to reduce swelling, increase sex drive, prevent pregnancy, boost the immune system, and increase breast milk production. The site further stated that some use it topically as a germ-killer or drying agent, and treatment for abscesses, athlete’s foot, dandruff, gum disease, snakebites, warts, and wounds. “I’ve tried it and it has got a very light taste to it,” Gill said. “You can’t really detect it in things. It’s palatable
and has a stevia taste to it, slightly sweet.” Moringa tastes a bit like green beans or spinach, only slightly sweeter, making it ideal for green smoothies. Dana Ingebretson, a local registered dietitian, said that anyone interested in supplementing with moringa should check with their doctor to make sure it won’t negatively interact with their current medication. “Get a variety of more fruits and vegetables,” she said. “Buy in-season, mix up fruits and vegetables and shoot for five servings a day and strive for more if you’re already eating that many. Frozen is just as good as fresh. Or eat canned if that’s most accessible.” Pregnant and breastfeeding women should avoid moringa, as no
March 2019 •
studies have shown it’s safe for them. The roots should be avoided as they’re toxic. Mary Jo Parker, registered dietitian in private practice in Williamsville, cautioned that “quality assessments of safety haven’t been conducted. There isn’t a whole lot of research for all of the claims they’re making. “It’s very promising because it’s loaded with nutrients, a good source of vitamin A, vitamin c, beta-carotene, calcium, iron, essential amino acids and natural phenols. It’s good for diminishing the effects high cholesterol. But a lot of times what ends up happening is people run with it because it looks like a wonder food without doing research. If you eat a food or part of a food, it’s different than an extract.”
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What’s Behind the Drop in Cancer Rates? Despite dramatically drop, cancer rates are on the rise for certain groups of people. One of the culprits? Obesity By Deborah Jeanne Sergeant
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he rate of cancer mortality has decreased by about 25 percent for many types of cancer over the past two decades, according to the American Cancer Society. Today, fewer die from lung, breast, prostate and colorectal cancer. The organization states that the decrease in cancer deaths relates to advances in several areas. Some of the decrease in cancer incidence has to do with guidelines for cancer screening. If more or fewer receive screening, that affects the statistics. For many years, smoking rates have decreased, which has reduced rates for many types of cancers. Occupational exposure harmful to lungs, such as applying pesticides on farms, handling asbestos in construction and welding has also decreased, thanks to more safety standards and material regulations. Improved screening rates and availability for screening represents a big factor for detecting cancer earlier and more curable, such as mammograms, in some cases, pre-cancerous lesions, such as colon cancer and cervical cancer screenings. From 1989 to 2015, breast cancer deaths decreased 39 percent; from 1989 to 2015 and colorectal cancer went down 52 percent between 1970 and 2015.
HPV vaccine should eventually eliminate cervical cancer for most women, providing they receive vaccination. Though care providers have made great progress in preventing and treating cancer, some areas still need improvement. Ovarian cancer is one of the types that “hasn’t seen statistic change at all,” said Kathleen Maxian, president of Ovarian Cancer Project in Buffalo and survivor of ovarian cancer. Physicians gave Maxian, now 56, a 20 percent chance of living for five years when she was diagnosed at 47. Most women with ovarian cancer die within five years of diagnosis since most ovarian cancers are detected Maxin only in the latter stages, like Maxian’s. Women diagnosed at stage 1 have a 95 percent chance of living five years. “It’s the deadliest of the gynecologic cancers,” Maxian said. “Fourteen thousand will die from it this year.” Cancer recurred in her lymph
nodes, but it’s been five years since her last treatment. No routine exam or test such as the PAP smear can screen for ovarian cancer. Called the “silent cancer,” its symptoms could easily signal something else: bloating, pelvic and abdominal pain, urinary frequency, feeling full quickly and fatigue. A blood test for ovarian cancer can offer false positives, so it’s not routinely offered. Only a biopsy can confirm it. Except for obesity and use of hormone replacement therapy, the risk factors are outside patients’ control, including age, history of endometriosis and family history of cancer of the reproductive organs, colon cancer, or the BRCA-1 or -2 mutation. Other cancers with obesity as a factor have seen an increase in the past 25 years. An estimated 15 percent of cancers are related to obesity. The American Cancer Society suggests that obesity-related cancers such as colorectal, pancreas, uterine, kidney, and gallbladder cancers are increasing in people aged 25 to 49, and that the youngest adults, age 25 to 29, are seeing the biggest rise in obesity-related cancers. It’s uncertain whether it’s obesity itself or causes of obesity — such as poor diet, stress and sedentary lifestyle — contribute to cancer.
Physician Leslie Kohman, board chairwoman of the American Cancer Society for Upstate New York and professor of surgery and director of outreach at Upstate Cancer Center in Syracuse, said that the cancer death rate is increasing for liver cancer, endometrial cancer, brain cancer and head/neck cancers. “The death rate in the poorest New York county is far greater than in the wealthiest,” she said. “Every one should have health insurance but they don’t. Not everyone has equal access to transportation. Poverty is a barrier to medical treatment and screening.” To address Kohman these issues, her organization takes an approach of bringing greater availability to health care, including mobile mammography vans, community outreach, and community education. “Almost half the cancers can be prevented by what we know now,” Kohman said. To sum it up, she said that avoiding tobacco, sun exposure, and obesity, and minimizing alcohol and red meat, especially cured and processed meat, can greatly reduce cancer incidences. Mothers should breastfeed as long as possible to protect both mom and baby. Discuss screenings with a healthcare provider. Each New York county is part of the Cancer Services Partnership, which covers screening for colorectal, cervical, and breast cancer for those who are uninsured. “Everyone can reduce their own risk of developing cancer,” Kohman said. “The good news is if you develop cancer now, your chance is much better than 25 years ago.”
The Problem with Pancreatic Cancer Compared to other cancers, the survival rate is quite poor for those suffering from pancreatic cancer By Deborah Jeanne Sergeant
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espite the steady progress in reducing cancer deaths in recent decades, a few types seem stagnant in their rates. One of these is pancreatic cancer, the nation’s third deadliest cancer, according to the Pancreatic Cancer Association of Western New York. Only 8 percent of patients survive for five years after diagnosis. In the past decades, all other cancers’ survival rates have risen at a rate ranging from 49 to 67 percent and, for a few, even 90-plus percent. More than 40,560 died of pancreatic cancer in 2015. As with most types of cancer, earlier detection can improve outcome; however, “in contrast to colon cancer, screening for pancreatic cancer has no established benefits for the average-risk person,” said Christos Fountzilas, gastrointestinal medical oncologist with Roswell Park Comprehensive Cancer Center. Page 14
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Instead, providers try to identify high-risk patients. This can include people with two or more first-degree relatives with pancreatic cancer or families with history of breast, ovarian, prostate cancer and melanoma. “Another high-risk group are people with cysts and other non-cancerous lesions in their pancreas,” Fountzilas said. “Though the majority of the cysts are not cancer and they don’t transform into cancer, there is a type of pancreas precancerous conditions known as intraductal papillary mucinous neoplasms, or IPMNs for short.” He said that Roswell has established a high-risk pancreas cancer-screening program that includes periodic screening with MRI and endoscopic ultrasound as well as screening for other cancers. For those with cyst and non-cancerous lesions in the pancreas, providers may remain watchful and
use endoscopic ultrasound and MRI as needed. “Certain conditions such as the development of diabetes can be an early sign of pancreatic cancer, especially if accompanied by weight loss rather than gain,” Fountzilas said. “These patients should be screened by their primary care provider for pancreatic cancer.” Health care providers offer the only screenings for pancreatic cancer. It’s much different from when breast cancer patients sometimes detect a lump during a home breast exam or during a routine mammogram. Without this kind of early detection, cancer has an opportunity to metastasize to other areas, which is why pancreatic cancer is so often deadly. “Most who have prostate cancer and breast cancer survive,” said physician Leslie Kohman, board chairwoman of the American Cancer Society for Upstate New York and
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2019
professor of surgery and director of outreach at Upstate Cancer Center in Syracuse. “Pancreas cancer patients die from it. The differences are great. Early detection improves your chances of surviving cancer.” That’s why people such as physician Aimee Lucas, an American Cancer Society-funded researcher, studies the effectiveness of pancreatic cancer screening for people who rated as high risk. This includes people with a first-degree relative with pancreatic cancer and cancers associated with germline mutations, such as BRCA1 and BRCA2 genes which predispose to breast and ovarian cancer. “Compared to other cancers, the survival rate is quite poor,” said Lucas, who is an associate professor of gastroenterology at Icahn School of Medicine at Mount Sinai in New Continued on next page
Pancreatic Cancer: Difficult to Pinpoint Symptoms
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Things You Should Know to Prevent Colon Cancer
By Ernst Lamothe Jr.
From previous page York City. “There’s a lot of work being done on all fronts.” This includes focusing on highrisk individuals so care providers can know who needs screening, when and how and if earlier screening can improve survival and even, eventually, prevent pancreatic cancer. Cancer in the pancreas, an organ in the mid-upper posterior, doesn’t offer obvious symptoms. Weight loss, abdominal pain and changes in urine and feces color could be attributed to any number of causes. Some patients experience jaundice. “It’s often very difficult to pinpoint,” Lucas said. “There are a lot of groups working on discovering blood markers. CA19-9 is one, but it can be a positive in pancreatic cancer and also positive in several other conditions, including gallstone disease that are not cancer. The other problem is that not all pancreatic cancer express CA19-9. Sometimes the blood level is normal.” Clinical screening is important since most patients remain asymptomatic until the cancer has become advanced. Lucas said that 80 percent of patients are diagnosed when the tumor cannot be surgically removed. Pancreatic cancer doesn’t respond to chemotherapy and radiation like other cancerous tumors. “My goal and the focus of my group is to improve earlier detection so we can detect more patients earlier so treatments are more effective,” Lucas said. “Or we could pick up a lesion in the pancreas before the development of pancreatic cancer.” To lower the risk of pancreatic cancer — and especially for those with family history — Lucas advises avoiding tobacco use, obesity, and heavy alcohol use. Diabetics need to manage their condition according to their care provider’s orders. People with family history and who smoke may hasten development of pancreatic cancer by 10 years. “Nutrition can certainly impact the disease,” Lucas said. “A few studies have shown that certain dietary factors such as diets high in red meat and low in fruits and vegetables can be associated with an increased risk of developing pancreatic cancer.”
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he numbers are scary. For those who are diagnosed with latestage colon cancer, the fiveyear survival rate is an abysmal 12 percent, according to the American Cancer Society. Colorectal cancer can start in the colon or in the rectum and begins as growths in the inner lining. The growths — called polyps — can change into cancer over time, although not all polyps become cancer. This year alone, more than 145,000 new colon and rectal cancer cases are expected to be detected and more than 51,020 people will die from the disease. That figure takes on even more weight considering what medical experts have been telling patients for decades — colorectal cancer is highly preventable. “Colonoscopies are the gold standard when it comes to colorectal screening,” said Steven Nurkin, a surgical oncologist and associate professor of oncology at Roswell Park Comprehensive Cancer Center in Buffalo. Nurkin offers five important elements people need to know about colon cancer.
1.Screening
Screening tests can detect colon and rectal cancer at its earliest, most treatable stage. It is important to consult your doctor if you experience a change in bowel habits — such as diarrhea or constipation — or have a feeling that your bowel is not emptying completely or there is a narrowing of the stool. Other feelings include an enlarged abdomen, weight loss for no known reason, nausea or feeling of bloating. The five-year survival rate for colon cancer found at the early age is 90 percent, according to the Colon Cancer Alliance. Once a person reaches 50 years of age, most routine, preventable screening colonoscopies are covered with no co-pay under the Patient Protection and Affordable Care. “Colonoscopies allow the doctor to examine the colon lining for polyps, which can be removed on the spot,” said Nurkin. “Removing polyps before they become malignant effectively prevents cancer, so it’s
really important to get screened as recommended.” He added that other treatments, such as send-away stool-based screening tests, can be offered to some people. “You should speak to your doctor to see if you qualify for them, or which test is best for you,” he said.
2.Listen to your body
Symptoms to colon cancer include rectal bleeding, stomach pain, weakness, weight loss and low red blood cells. Colorectal cancer is a disease in which abnormal cells in the colon or rectum divide uncontrollably, ultimately forming malignant tumors. “Know some of the symptoms, and be sure to consult with a doctor to get them checked out,” said Nurkin. “Even if you have one of the known symptoms, you should pay attention.”
3.Know your family history
There is no way to know for certain if you will develop colon or rectal cancer, but there is a variety of factors that may increase your risk for these cancers. The risk increases with age —if you are over the age of 50 you are at a higher risk, for example. It also increases if the person has a close family member —parents, brother or sister — with history of the disease. “Ten percent of the population has a first-degree relative with colon cancer, which significantly increases your risk for colon cancer,” said Nurkin. “Men and women are at equal risk of developing the disease. Other risks include personal history of polyps, inflammatory bowel disease, and African-American or Native American ethnicity.”
increasing among 4.Incidence young adults It’s the second leading cause of cancer deaths in the U.S., and incidence rates are on the rise for people under the age of 50. A 2017 study shows that people younger than 55 are more likely to be diagnosed with late-stage disease. The American
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5.Adopt a healthy lifestyle
Smoking causes many types of illnesses — including some that people may not immediately associate with cigarettes, such as colon cancer. Smokers not only have a higher risk of developing colon cancer, they also have a higher risk of dying from the disease. Staying both in shape and watching for potential risk factors are essential to stay ahead of the trend. “It’s one of the best ways to reduce your risk. Exercising regularly, eating a high-fiber, low-fat diet, limiting your alcohol intake, and quitting smoking are all really effective changes on the prevention front,” added Nurkin.
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All her life, Judy Culbertson, 73, of Dansville, has battled with her weight. Though she’s currently reached her weight loss goal, she still works to maintain it. She is shown with her husband Harold in 1997 and in 2018.
Dansville Woman: ‘How I Lost 50 Lbs. and Kept Them Off’ WNY Coordinator of TOPS (Taking Off Pounds Sensibly) shares her experience losing weight By Deborah Jeanne Sergeant
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ll her life, Judy Culbertson, 73, of Dansville, has battled with her weight. Though she’s currently reached her weight loss goal, she still works to maintain it. That’s part of the reason she’s the Western New York area coordinator for Taking Off Pounds Sensibly (TOPS) — she wants to keep the pounds off and wants to help others lose weight. With 1,000 group members located from Rochester to Buffalo, Culbertson’s region has many reasons to emulate her, but perhaps her persistence should be the biggest reason. Culbertson said that since she was about 10, she has had a weight problem. “I come from a family of addictive personalities,” Culbertson said. “Dad was an alcoholic. My mother was always overweight — nearly 300 pounds at one point. I grew up with people who were battling something. My sister was on anti-depressants and drank.” A self-described emotional eater, she turned to food to dull pain, celebrate, cure boredom. “A lot of people eat for emotional
reasons,” she said. “It seems to me that we treat it like a friend, like it’s always there for us. It’s not.” Eventually, her weight had crept up to 200 pounds. At 5 feet, four inches, she was obese according to the Centers for Disease Control and Prevention (CDC) guidelines. At 200 pounds, she had hit the number she promised herself she would never let herself surpass. She joined groups including Weight Watchers and Jenny Craig. While she lost weight, she felt she could justify paying the dues to continue with these groups, unlike when her weight loss hit occasional plateaus. For 30 years of her adult life, her weight fluctuated. Culbertson joined TOPS in 2002, just after she had retired from her role as food service director at Nicholas H. Noyes Memorial Hospital. With more time available, she could really focus on her weight loss goals. TOPS’ rates — averaging well under $5 a month — helped Culbertson stick with it. For once, she kept weight off once she lost it, except for only minor setbacks. For Culbertson, TOPS helped her build a support system and surround herself with peo-
ple who would keep her accountable, yet not judge her harshly. Eventually, she rose in the ranks of leadership within the organization, along with her husband, Harold, who’s a group leader under her. “We have really good educational programs and talk about exercise, nutrition and anything to improve health,” Culbertson said. “There are people there who are at all points of their journey.” She believes that the supportive atmosphere helps people open up about why they have gained weight so others can share tips and offer emotional support. “It gives you what you need to keep going,” Culbertson added. She also likes that TOPS stays realistic about weight loss goals. She felt that the goal she had at other groups was too low. She had not weighed that little since she was 13 years old. Before TOPS, she had managed to reduce to 150 pounds by walking three miles and eating 1,200 calories daily; however, she could not lose more to arrive at her desired goal. “I felt like a failure,” she said.
“Eventually, I quit. In TOPS, the goal you have is a number that you and your doctor agree on.” Though she’s not obese anymore, she is still considered 15 pounds overweight according to CDC standards. But she is 50 pounds lighter than her heaviest weight and has kept that weight off for many years. Culbertson thinks that losing 50 pounds has helped her avoid many of the health issues that befell her mother: glaucoma, arthritis, diabetes and more. “If I hadn’t lost that weight, I’d probably have to have knee replacements by now,” Culbertson said. Instead, she can lead an active life, attending Silver Sneakers events, exercise classes and joining friends and family for outings. Culbertson said that she’s happy she and her husband, Harold, could watch her grandchildren grow up and enjoy knowing her great-grandchildren. She encourages anyone interested in losing weight to sit in on a complementary TOPS meeting. “You will find people who are likeminded and in the same boat you’re in, who’ve felt the same way you do,” Culbertson said. “They might have felt hopeless. AT TOPS, you get hope back again. TOPS helps us believe in ourselves and believe we can accomplish the weight loss we need with the support of our friends. You still have to do the work and have a plan but we help people form their plan.” She added that TOPS encourages participants to start slowly, making gradual changes in their lifestyle until it becomes a healthy one.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2019
Fresh produce grown at The Massachusetts Avenue Project’s Growing Green Urban Farm. Photo provided.
UB to Host Nation’s First Veggie Van Summit By Katie Coleman
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niversity at Buffalo is hosting the nation’s first mobile produce market summit March 5-6 with mobile produce market representatives across the U.S attending to collaborate, share research and attend trainings. The summit is an opportunity for mobile market managers, who run mostly isolated operations, to share their struggles and successes and discuss best evidence-based practices to running a successful market. Veggie vans are mobile produce markets that sell locally grown produce at a reduced cost in communities facing healthy food barriers due to transportation, availability, knowledge or cost. The summit will share research
from UB’s veggie van project, a $3.1 million project federally funded by the National Cancer Institute. Lucia Leone, Ph.D., is the lead researcher for the veggie van project and an assistant professor of community health and health behavior at UB School of Public Health & Health Professions. She first worked on the veggie van project at the University of North Carolina at Chapel Hill, and her team found that, on average, people with access to the veggie van reported eating one additional cup of fruits and vegetables per day than those who don’t. “In 2010 when we started, there weren’t many veggie van models to look toward or good research out there. We want to make sure peo-
ple operating veggie vans are using effective, evidence-based practices,” Leone said. “Mobile market managers have been interacting informally, but to get together and share best practices, this is the first time we’re doing it,” Leone said. As part of the veggie van project they created a tool kit to offer evidence-based research and best practices on running a mobile market. They will be selecting eight partners to provide funding and technical assistance to help grow their mobile markets. Allison DeHonney is one of eight finalists for partnership, chairwoman for the Food Policy Council of Buffalo & Erie County, and president of Urban Fruits & Veggies, which has run a mobile produce
market in Buffalo since 2015. She started the business to bring access to Buffalo neighborhoods in food desert areas and sells produce at three farmers markets on Buffalo’s East side as well as other locations. DeHonney plans to expand from one to three mobile markets serving Buffalo to increase partnerships and serve more customers. She would like to see a community for veggie van operators to collaborate or help each other. “Our community needs so much. No one organization can tackle it all. I was not welcomed when I started my mobile market. I’ve found organization, scheduled times and marketing are key to running a successful mobile market.” The Massachusetts Avenue Project, an urban farm on Buffalo’s west side that runs a going green mobile market, is also a finalist to partner with the veggie van project. MAP has been running a mobile market since 2009 and operates a food box truck that they set up as a farm stand. They plan to use the assistance and funding to pilot a food box program. “Receiving the grant would change how much time is spent at our different locations. Right now we’re spending a few hours at each location and haven’t been able to start a food box program as of yet,” said MAP’s markets director Danielle Rovillo. When it comes to collaboration, Rovillo said by and large there are not a lot of resources specific for mobile produce markets. “Most of the resources are not attuned to a mobile market operation. And models for veggie vans are all so different. Collaboration has to happen at the national level,” Rovillo said. “I’m excited to get to the summit and hear how other managers have overcome certain challenges, and what their best practices are.”
The Summit The summit will take place at UB at Jacobs School of Medicine and Biomedical Sciences at 995 Main St. in Buffalo. It runs from 9 a.m. to 5 p.m. on March 5 and 8:30 a.m. to 2:30 p.m. on March 6. There will a bicycle tour from 3-5 p.m. on March 6 limited to 30 people.
Why Do More and More Americans Use Medical Marijuana?
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asing chronic pain is the main reason Americans use medical marijuana, a new study finds. “We wanted to understand the reasons why people are using cannabis medically, and whether those reasons for use are evidence-based,” said lead author Kevin Boehnke. He’s an investigator at University of Michigan’s Chronic Pain and Fatigue Research Center. Boehnke and his colleagues examined data from a 2017 report by the National Academies of Sciences, Engineering and Medicine on medical use of marijuana (cannabis).
That report found conclusive or substantial evidence that marijuana eased chronic pain, nausea and vomiting due to chemotherapy, and muscle spasms of multiple sclerosis. Though the number of registered U.S. medical marijuana patients rose from more than 641,000 in 2016 to nearly 814,000 in 2017, researchers said that’s likely far lower than the actual number of users. Of the license holders, 85.5 percent said they were seeking treatment for an evidence-based condition, with chronic pain accounting for 62 percent of qualifying conditions,
according to the study. Researchers said the finding is consistent with the prevalence of chronic pain, which affects an estimated 100 million Americans. As of 2018, medical marijuana use is legal in 33 states and the District of Columbia, while recreational use is legal in 10 states. The federal government still classifies pot as a drug, however, with no currently accepted medical use and a high potential for abuse. The study was published in the February issue of the journal Health Affairs.
March 2019 •
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Careers in Healthcare
Lactation Consultants Profession expected to experience a 15 percent job growth rate from 2016 to 2026 By Deborah Jeanne Sergeant
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he Bureau of Labor Statistics projects that registered nurses with credentials as lactation consultants will experience a 15 percent job growth rate from 2016 to 2026. The BLS doesn’t account for independent lactation consultants, but with that rate of growth and the resurging interest in lactation, working as a lactation consultant sounds like a solid career option. That’s not why most lactation consultants pursue this type of work, however. It’s a work of love. Physician Jessica A. Donhauser, clinical assistant professor of pediatrics and pediatric hospitalist at John R. Oishei Children’s Hospital, wanted to pass on more information to her patients about breast feeding. Last February, she completed training and passed the International Board Certified Lactation Consultant (IBCLC) exam, even though the certification doesn’t mean a pay bump for most health care providers. “The thing I realized and a lot of pediatricians realize is we don’t get a lot of training on breastfeeding in medical school or in residency,” Donhauser said. “Taking this course gave me this background.” Lactation consultants help mothers who want to learn more about breastfeeding or experience problems with milk supply, the baby latching on properly, or other issues. Women who have undergone breast reduction or augmentation may face issues with breastfeeding. Adoptive moth-
ers of newborns may want to induce lactation and could use the help of a consultant. Having her own baby has also made a big difference for Donhauser. “You feel vulnerable when you’ve just had a baby,” Donhauser said. “The support in the first two weeks is so critical. Even in subsequent children, the support is necessary. For moms eager to breastfeed, it may not come easily.” While breastfeeding is perfectly natural, many young mothers weren’t breastfed themselves or don’t know other moms whom they can ask about nursing. They need someone who can mentor them in breastfeeding. For Donhauser, earning her certification in lactation consulting has improved her confidence in offering more information to new moms. Libby DiPiano, a registered nurse with Millard Fillmore Suburban Hospital, is an international board certified lactation consultant. She achieved the certification in 2000 to better serve her new mom patients. “Anyone who goes into this has to be so supportive of our moms,” DiPiano said. “It’s so hard for moms in our culture. So many didn’t see their mothers breastfeed as they were growing up. And women go back to work sooner.” DiPiano added that the job outlook for lactation consultants is good because many lactation professionals are retiring and will need replacements. She thinks that those
interested in lactation consulting should seek a mentor in addition to the coursework. A healthy dose of passion helps, too. “You have to really, really believe in it,” she said. Before sitting for the IBCLC exam, a lactation consultant candidate must complete sufficient required health science classes (or have completed training such as an RN or obstetrician), complete a minimum of 90 hours lactation-specific education and complete a required number hours of supervised breastfeeding clinical support. The requirements vary depending upon the individual’s educational background and if they take the mentorship route. According to www.salary.com, a median annual income for lactation consultants is $79,007, but that was based upon registered nurses who have completed lactation consultant training. Since many work independently or else completed training to augment other related work, it’s
difficult to estimate how much a lactation consultant earns. Lactation consultants work in obstetric and pediatric offices; as a midwife, doula or labor and delivery nurse; or as part of a women’s wellness/health practice. Independent lactation consultants charge around $125 to $150 to meet with a client and engage in follow-up calls and emails. The rates depend upon several factors, including if it’s an in-home session. Many hospitals offer ongoing consulting as part of the birthing experience. “It’s hard work and dedication for sure,” DiPiano said. “Sometimes the day shift doesn’t get home until 10 or 11 p.m. But I feel you have to believe in this. It’s not unusual we can be sitting down charting and the dad will say, ‘Would you see my wife one more time before you go home?’ How do you say no to this? This is reality, something I want the ones I mentor to really, really think about.”
Inflammation: Mother of all Diseases By Deborah Jeanne Sergeant
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nflammation represents the body’s natural response to injury. If you sprain an ankle, it swells up. However, chronic, systemic inflammation — where the body remains in a prolonged and ongoing state of inflammation —signals something more serious. Reducing the causes of systemic inflammation largely has to do with identifying and minimizing dietary sources of inflammation. “It really is a priority, because inflammation is the root of all diseases,” said JoAnn Colosimo, nurse practitioner in functional medicine at Invision Health in Buffalo. “We address it immediately at our initial consult. It’s one of the first things we do right away.” She said that if this problem lasts for too long, the individual can become more susceptible to disease and struggle with nerve-related issues. Colosimo added that food sensitivities such as gluten and dairy, can trigger inflammation in the gut that Page 18
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can go systemic. Colosimo said that lab results before and after changing the diet have shown her difference food can make, as inflammatory markers go down over time once inflammatory foods are eliminated. Sally Gower owns Eat Well Buffalo and is a certified life coach from the Institute for Integrated Nutrition, plant-based diet certified through Cornell University, and certified food for life educator for Western New York. She said that nutrition and lifestyle can reverse inflammation. “Sugar is extremely inflammatory, along with red meat, saturate fat, white flour, pop, diet soda, sweetened tea, alcohol and processed foods,” she said. “If you’re going to eat grains, which are healthy, eat whole grains.” She also listed smoking, obesity, sedentary lifestyle and poor sleep as contributory to inflammation. “Find something you like to do and do it,” she said. “Get a standing
desk. People with the highest activity level have the lowest level of inflammation.” Stress also contributes to inflammation. Taking time to relax and partake in pleasurable activities can help reduce and manage stress, such as walking in nature, massage therapy, mindfulness and tai chi. As for food that reduces inflammation, Gower recommends green tea, coffee, water and kombucha, a fermented tea beverage. “Add spices with healthful foods, like turmeric and ginger,” she said. Foods rich in omega-3 fatty acids, olive oil, leafy green vegetables, cherries, nuts and seeds are also anti-inflammatory. It may seem confusing knowing what’s anti-inflammatory and what’s not, but it all comes down to focusing on a plant-based diet, according to Mary Jo Parker, registered and certified dietitian nutritionist, nutrition therapist and consultant in private
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2019
practice in Williamsville. “You could look at the traditional Mediterranean diet, even diets like the Okinawan or DASH diet,” she said. “They all have in common that they’re rich in fruits and vegetables and have nuts, seeds, fish and things like flax, walnuts and other things rich in omega 3 fatty acids.” Unfortunately, the typical American diet revolves around convenience and fast foods with too many sources of simple carbohydrates and too much red meat. Parker said people should limit these to help reduce inflammation. Remaining stressed out, overfed and under-exercised “all contributes to greater states of inflammation and more likely to develop chronic disease states over time,” Parker said. “Everything points back to an inflammatory state in just about any chronic disease. Inflammation is a hallmark.”
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Do I Need to File a Tax Return This Year?
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What are the IRS income tax filing requirements for retirees this tax season? My income dropped way down when I had to retire last year, so I’m wondering if I need to file a tax return this year.
Retired Ron Dear Ron, Whether or not you are required to file a federal income tax return this year actually depends on several factors: how much you earned last year (in 2018); the source of that income; your age; and your filing status. Here’s a rundown of this tax season’s IRS tax filing requirement thresholds. For most people, this is pretty straightforward. If your 2018 gross income — which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately — was below the threshold for your filing status and age, you may not have to file. But if it’s over, you will. • Single: $12,000 ($13,600 if you’re 65 or older by Jan. 1, 2019). • Married filing jointly: $24,000 ($25,300 if you or your spouse is 65 or older; or $26,600 if you’re both over 65). • Married filing separately: $5 at any age. • Head of household: $18,000 ($19,600 if age 65 or older). • Qualifying widow(er) with dependent child: $24,000 ($25,300 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554) or see IRS. gov/pub/irs-pdf/p554.pdf. Check Here Too There are, however, some other financial situations that can require you to file a tax return, even if your gross income falls below the IRS filing requirements. For example, if you earned more than $400 from self-employment in 2018, owe any special taxes like an alternative minimum tax, or get premium tax credits because you, your spouse or a dependent is enrolled in a health insurance marketplace (Obamacare) plan, you’ll need to file. You’ll also need to file if you’re receiving Social Security benefits, and one-half of your benefits plus your other gross income and any taxexempt interest exceeds $25,000, or $32,000 if you’re married and filing jointly.
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MEAT RAFFLE – March 30 To figure all this out, the IRS offers an interactive tax assistant tool on their website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. It takes less than 15 minutes to complete. You can access this tool at IRS. gov/filing — click on “Do I Need to File?” Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get faceto-face help at a Taxpayer Assistance Center. See IRS.gov/localcontacts or call 800-829-1040 to locate a center near you. Check Your State
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Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency before concluding that you’re entirely in the clear. For links to state tax agencies see Taxadmin.org/statetax-agencies.
SE N
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Tax Preparation Help If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TCE provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit IRS.treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at around 5,000 sites nationwide, including several in Upstate New York. To locate an AARP Tax-Aide site call 888-227-7669 or visit AARP. org/findtaxhelp. You don’t have to be an AARP member to use this service.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Medicare: Rules for Those With Higher Income
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f you have higher income, the law requires an upward adjustment to your monthly Medicare Part B (medical insurance) and Medicare prescription drug coverage premiums. But if your income has gone down, you may use form SSA44 to request a reduction in your Medicare income-related monthly adjustment amount. Medicare Part B helps pay for your doctors’ services and outpatient care. It also covers other medical services, such as physical and occupational therapy, and some home health care. For most beneficiaries, the government pays a substantial portion — about 75 percent — of the Part B premium, and the beneficiary pays the remaining 25 percent. If you’re a higher-income beneficiary, you’ll pay a larger percentage of the total cost of Medicare Part B, based on the income you report to the Internal Revenue Service (IRS). You’ll pay monthly Part B premiums equal to 35, 50, 65, 80, or 85 percent of the total cost, depending on the income you report to the IRS. Medicare Part D prescription drug coverage helps pay for your prescription drugs. For most beneficiaries, the government pays a major portion of the total costs for this coverage, and the beneficiary
Q&A Q: I’m gathering everything I’ll need to file my taxes this month. Do I have to pay taxes on Social Security benefits? Also, where can I get a replacement 1099? A: Some people who get Social Security must pay federal income taxes on their benefits. Still, no one pays taxes on more than 85 percent of their Social Security benefits. You must pay taxes on some portion of your benefits if you file an individual federal tax return and your income exceeds $25,000. If you file a joint return, you must pay taxes if you and your spouse have combined income of more than $32,000. If you are married and file a separate return, you probably will have to pay taxes on your benefits. You can read more about tax preparation in relation to Social Security at www. socialsecurity.gov/planners/taxes. htm. Social Security benefits include monthly retirement, survivors, and disability benefits. They don’t include Supplemental Security Income (SSI) payments, which are not taxable. You can also get a replacement 1099 or 1042S when you open your own personal my Social Security account at www.socialsecurity.gov/ myaccount. Page 20
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2019
pays the rest. Prescription drug plan costs vary depending on the plan, and whether you get Extra Help with your portion of the Medicare prescription drug coverage costs. If you’re a higher-income beneficiary with Medicare prescription drug coverage, you’ll pay monthly premiums plus an additional amount, which is also based on the income you report to the IRS. Because individual plan premiums vary, the law specifies that the amount is determined using a base premium. Social Security ties the additional amount you pay to the base beneficiary premium, not your own premium amount. If you’re a higher-income beneficiary, we deduct this amount from your monthly Social Security payments regardless of how you usually pay your monthly prescription plan premiums. If the amount is greater than your monthly payment from Social Security, or you don’t get monthly payments, you’ll get a separate bill from another federal agency, such as the Centers for Medicare & Medicaid Services or the Railroad Retirement Board. You can find Form SSA-44 online at www.socialsecurity.gov/forms/ ssa-44.pdf. You can also read more in the publication “Medicare Premiums: Rules For Higher-Income Beneficiaries” at: www.socialsecurity.gov/ pubs/EN-05-10536.pdf.
Q: I got an email that says it’s from Social Security, but I’m not so sure. They want me to reply with my Social Security number, date of birth, and mother’s maiden name for “verification.” Did it really come from Social Security? A: No. Social Security will not send you an email asking you to share your personal information, such as your Social Security number, date of birth, or other private information. Beware of such scams — they’re after your information so they can use it for their own benefit. When in doubt, or if you have any questions about correspondence you receive from Social Security, contact your local Social Security office or call us at 1-800-772-1213 (TTY 1-800325-0778) to see whether we really need any information from you. Q: I know that Social Security’s full retirement age is gradually rising to 67. But does this mean the “early” retirement age will also go up by two years, from age 62 to 64? A: No. While it is true that under current law the full retirement age is gradually rising from 65 to 67, the “early” retirement age remains at 62. Keep in mind, however, that taking early retirement reduces your benefit amount. For more information about Social Security benefits, visit www. socialsecurity.gov/planners/retire.
in smaller amounts and for shorter duration. This also helps reduce the number of hoarded pills. Since many families spread out and neighbors aren’t always as close as they used to be decades ago, many older adults continue to abuse substances unnoticed. More vulnerable as we age
Gray and Addicted: How Substance Abuse Affects Older Adults Substance abuse is highly under-diagnosed among older adults, says UB School of Nursing associate dean for research By Deborah Jeanne Sergeant
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ngst-ridden teens and anxietyridden young adults seem easy examples of typical substance abusers; however, a growing number of older adults turn to alcohol and prescription and illicit drugs. They’re seldom identified as having a substance abuse problem. According to the National Institutes of Health (NIH), the rate of people over 50 who abuse substances is expected to top 5.7 million by 2020. The baby boomer generation grew up in the era of widespread drug experimentation. To those who used drugs recreationally in the ‘60s and ‘70s, the current growing expansion of acceptance of medical and recreational marijuana tacitly condones using substances to self-treat physical and mental health issues. The NIH also states that alcohol predominates as this age group’s substance of choice, although abuse of illicit and prescription drug has risen in recent years, too.
Yu-Ping Chang, associate dean for research and scholarship at UB School of Nursing, studies addiction in seniors. She said substance abuse is highly under-diagnosed among older adults. She added that respect for elders and the generational mindset of minding one’s business may keep substance abuse problems taboo to discuss for either the elder or their children and the peers around them. “We feel they’re wiser and should know better because they’ve been through so much,” she said. “It’s a stereotype.” Ironically, many older people often visit a physician for chronic health issues, yet a substance abuse issue often goes unnoticed by their physicians. Even family and friends may not notice, suspect something else or choose not to say anything if they do suspect. “Mental health issues are co-existing issues oftentimes,” Chang said. “[Seniors] want to feel better
and may use a substance as a coping mechanism. The providers aren’t well prepared to detect the problem, especially in the emergency room setting.” Chang wants more providers to screen for substance abuse and to look deeper at psychological issues. For some older adults, chronic pain from an illness or injury initiated a prescription for pain medication. Once the refills end, alcohol, other prescriptions or illicit drugs may stand in for pain control or to ease loneliness, depression or anxiety. According to experts, it’s not uncommon for seniors abusing prescriptions to “borrow” extras from a neighbor or family member who has hoarded medication from their own prescriptions. Feeling sympathetic, they unknowingly enable further substance abuse. The opioid crisis has influenced more physicians to minimize opioid use and help patients develop a plan to use habit-forming pain medication
Drugs and alcohol may affect older adults differently than when they were younger. For instance, muscle mass declines decade by decade as the body ages. Frail older adults have less muscle mass and cannot process alcohol and drugs as efficiently as they used to. “Their health has changed over the years so the amount that would become problematic is much less than a younger adult,” said Kelly Whitman, licensed clinical social worker and vice president of Substance Use Disorder Services & Housing at Best Self Behavioral Health in Buffalo. “They also have medication they’re taking oftentimes. That can change how alcohol affects the body and mind.” Substance abuse can contribute to a greater risk for falling and breaking bones, which can trigger loss of independence and many negative health outcomes. Whitman said that older people who abuse substances are usually either early onset users, who have been using a substance throughout their lives as a coping mechanism, and late onset users, who perhaps were social drinkers and later in life turn to a substance to cope with a tragic event. Unfortunately, few substance abuse programs exist to help older adults who abuse substances. Whitman said that many older adults feel uncomfortable in a typical group setting with mostly younger people. “They need to be able to relate to people in the group,” Whitman said. “Most are middle aged and younger in group therapy. We need treatment modalities that relate to older adults.” One-on-one help may be too costly for some seniors. For some of these, accessing care is complicated by affording co-pays and transportation three times a week well. “We have to be good with checking on our older adults and asking uncomfortable questions and seeing possible signs,” Whitman said. “Don’t avoid it. Ask how things are going. Maybe you see that prescription bottle and ask how much they’re taking.”
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Parent Network of Western New York is one of the local agencies that help people with disabilities get a job. “Individuals with learning differences do make good employees,” says Tonia Weichmann, transition coordinator at the organization.
Disabilities: Agencies Aid in Making Employment Accessible to All By Deborah Jeanne Sergeant
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he route to employment for individuals with developmental disabilities is often not as linear or rapid as for those who are developmentally typical. Various organizations in the area can help families with resources helpful for their young adults who want to find employment. “Everyone deserves to work,” said Kayt Davidson, director of transition services at job path employment services, a division of The Arc of Monroe in Rochester. “It gives you that satisfaction. When you meet someone new, you ask what they do. Everyone deserves to answer that question.” The Arc also provides programming in Erie County in a similar fashion to Monroe County. Davidson said that schools are improving their ability to help families learn about employment readiness programs that pick up when the
Graser, director of marketing and communications at The Arc of Monroe. “Employers get good quality people, the same if not better than someone coming off the street.” The Arc also helps with employment search, filling out applications and connecting with businesses in the area to help them fill openings with appropriate candidates. Davidson said the community is very accepting of on-the-job mentors who enhance the employer’s training and help identify small areas where accommodation would enhance the employee’s success. For many individuals The Arc serves, streamlined, written procedures or lists help, but employers find that these can help the entire staff and they’re universally adopted, according to Davidson. “The people we work with maintain employment longer in entry level positions which generally have higher turnover,” Davidson said. In addition to feeling proud of their accomplishment of obtaining employment, individuals learn life skills they may not have otherwise. Davidson said that a parent of one worker recently told her that his daughter decided to take the bus to Target by herself and later call for a ride home. Her phone died while she was gone. She realized she could ask to use the phone at the customer service desk. “He was flabbergasted she would know to do that,” Davidson said. “They had never talked about it. She had gained that skill. She learned all these other things that were so helpful for her in life.” Parent Network of WNY
school district’s services end at age 21. Arc is also working on getting involved sooner so parents realize what is available to help their young people. “The biggest misconception is, ‘How will my son or daughter get there? They can’t use public transportation,’” Davidson said. The Arc starts with assessing skills, interests and abilities and then provides whatever coaching, pre-employment readiness, supported employment through The Arc and on-the-job mentors the individual needs to learn skills for successful employment. Most of the time, it’s for entry-level, low-skill employment. “They learn about etiquette, showing up on time every day, how to navigate transportation on their own, social interactions, and they write a professional resume, they learn interview skills,” said Lindsey
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Working with parents and youth also represents the mission of Parent Network of Western New York. Though not a provider of services, Parent Network helps families navigate how to meet their young person’s needs and assists in reaching goals. Among its programs, the organization helps young people with all sorts of disabilities who are finishing high school and looking forward to using what they’ve learned to begin working or perhaps explore further education. “We can help them understand the type of accommodation they may need to ask for and the law about reasonable accommodation,” said Tonia Weichmann, transition coordinator at Parent Network. “It’s guiding the family so their child is successful.” She said that many individuals
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and their parents don’t realize what supports would help nor how to advocate to receive the supports needed for success in further education or employment. While these are usually readily available in school, the supports are less apparent or non-existent in the working world. Weichmann said that one example could be asking for a written routine and explaining that will help get the job done. The organization also helps connect families with non-college training programs and on-the-job training opportunities. Parent Network belongs to different committees and organizations that are made up of employers, which can help identify ways individuals can become part of the working world. Parent Network also strives to help employers “to understand that individuals with learning differences do make good employees,” Weichmann said. “They just need a chance.” She said that some employers think that if an individual has developmental disabilities, he won’t may be able to do the job. “It’s been found most individuals want to work, do a good job and make people happy,” Weichmann said. She said that for the individuals finishing high school, many of their social connections disappear once they turn the tassel. Becoming part of the working world requires rebuilding a sense of community, which presents different challenges to people with special needs. Even getting to work represents a challenge to many individuals if they don’t drive and there’s no school bus to pick them up at 7:30 a.m. and drop them off later. “We talk with them about what it takes to go to work,” she said. “A lot of parents say, ‘I’ll drive them’ which works until someone’s schedule changes. That conversation about that reality helps them understand what’s going to happen.” Weichmann said that in addition to earning money to buy what they want, individuals achieve a great sense of satisfaction and independence working a job. “The most common question asked when you meet someone new is ‘What do you do?’ Most can respond and say, ‘I do this’ and it’s that piece of community and involvement. They’re out meeting new people and developing their own community. “It’s a sense of worth and accomplishment.”
Serving Western New York A monthly newspaper published by Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr.,Jenna Schifferle, Angela Underwood, Cherie Messore, Katie Coleman Advertising: Anne Westcott, Amy Gagliano Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler
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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.
H ealth News Eye Care & Vision Associates has new CEO
Bradley E. Hall has been ap pointed chief executive officer at Eye Care & Vision Associates (ECVA). In this role, Hall will lead the core administrative and strategic planning components of the practice, Hall including finance, human resources, business development, clinical operations, facilities management and health information technology. He is based out of ECVA’s Maple Road office in Williamsville. A native of Hamburg, Hall received his bachelor’s degree in business administration with a concentration in finance from SUNY Fredonia, and his Master of Business Administration (MBA) degree, with a concentration in health care administration from Canisius College. Hall is a certified medical practice executive through the American College of Medical Practice Executives, and has more than 25 years of progressive health system, medical practice and business leadership experience as a healthcare and human services executive. Currently, Hall is vice president of the Medical Group Management Association (MGMA), Buffalo Chapter. He resides in Orchard Park.
vice president, chief medical officer, BlueCross BlueShield of Western New York. “We’re proud to partner with WebMD to bring national wellness capabilities to our employers and members locally.” John Harrison, general manager, WebMD Health Services, said, “WebMD Health Services has been a leader in the well-being industry, and we are proud to partner with BlueCross BlueShield of Western New York to deliver a holistic well-being program to their members. BlueCross BlueShield members will now have access to our health assessment, digital health assistant and other digital well-being tools which align with NCQA standards.”
Roswell, NFMMC launch cancer care collaboration Roswell Park Comprehensive Cancer Center and Niagara Falls Memorial Medical Center recently announced a collaborative effort to greatly improve the availability of cancer care in Niagara County. The first step of the new collaborative partnership is a comprehensive thoracic clinical program. With
the establishment of a jointly operated thoracic center at Memorial, Niagara County residents now have convenient access to a wide range of specialized services, from lung cancer screening and early detection through to state-of-the-art cancer treatment and survivorship support — the first time such specialized and comprehensive cancer services have been available in the Niagara region. The new program focuses on the prevention, detection and outpatient treatment of lung cancer and other malignant conditions of the chest and chest wall and is directed by Sai Yendamuri, chairwoman and attending surgeon for Roswell Park’s department of thoracic surgery. “This new program will be an important addition to cancer care services in Niagara County,” said Niagara Falls Memorial President & CEO Joseph A. Ruffolo. “The per capita incidence of lung and bronchial cancer in Niagara County is much higher than in the state or the nation as a whole, making it even more important to make this specialized care readily available to those who live and work here.”
“This partnership is another way that Roswell Park is expanding its footprint right here in Western New York to be sure that no matter where you live, you are afforded easy access to truly comprehensive cancer care, including treatments that are not offered elsewhere in our region,” added Roswell Park President and CEO Candace S. Johnson. “This natural partnership between two cutting-edge institutions continues to demonstrate NFMMC and Roswell Park’s dedication to people of Niagara County and the need for state-of-the-care,” says Niagara Falls Mayor Paul Dyster. “Today’s life-altering announcement will undoubtedly impact the lives of so many as NFMMC and Roswell Park continue their mission to eradicate one of the leading causes of death in our community once and for all.” Cases of lung cancer in Niagara County have risen about 36 percent over the last 40 years, and today the county’s rate of incidence is one of the highest across the state. And the New York State Health Department lists lung cancer as the leading cause of death for women in Niagara County and the second leading cause of death for men.
BCBS partners with WebMD Health Services
BlueCross BlueShield of Western New York announced a new partnership with WebMD Health Services, a subsidiary of the leading online health information company, WebMD Health Corp, to support the launch of a newly designed wellness website, MyBlueHealth. MyBlueHealth offers enhanced digital wellness capabilities for the 169 employers in Western New York that utilize the health plan’s suite of wellness programs to engage their 85,000 employees. Employers will now have the ability to offer incentives to their employees through BlueCross BlueShield’s wellness website for their participation and progress to positively drive their overall health. The new user-friendly platform also seamlessly integrates with a span of wearable fitness devices, while delivering national expertise to BlueCross BlueShield members. These include interactive resources like health guides, quizzes, recipes and videos designed to support effective and informed health-care decision making. “BlueCross BlueShield of Western New York provides innovative tools and resources that empower our members to make informed decisions about their health,” said physician Thomas Schenk, senior
Plans for the new ECMC emergency department call for a 54,000-sq.-ft. facility with 54 treatment stations, including four trauma rooms and two medical resuscitation rooms. File photo.
ECMC Project Capital Campaign Exceeds $10 Million Over $10.2 million in private funding reached midway through campaign for ECMC’s new, state-of-the-art trauma center and emergency department
E
rie County Medical Center (ECMC) Corporation has received more than $10.2 million in private funding for the hospital’s future trauma center and emergency department. The fundraising milestone was achieved midway through the institution’s campaign of raising $15 million for the project that will double the size of the existing facility. “The community’s response to supporting this vitally important, lifesaving project has been nothing short of amazing,” said ECMC Corporation Board Chair-
man Jonathan A. Dandes. “We are deeply appreciative of these important contributions that will support ECMC’s future trauma center and emergency department, providing our dedicated clinicians with stateof-the-art equipment and technology that matches their remarkable skills and expertise.” ECMC Corporation President and CEO Thomas J. Quatroche Jr., said, “This is the first time we have ever sought support from the community in a significant way to support our caregivers. The community has been and continues to be amazingly supportive. We are very
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thankful for the strong response from hundreds of organizations and individuals who have given so generously to our future trauma center and emergency department.” In 2018, ECMC’s trauma center and emergency department caregivers provided critically important lifesaving services to more than 70,000 patients, the highest oneyear volume in ECMC’s history in a facility designed in the 1970’s to accommodate 45,000 patients annually.
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How will weight loss improve my health? cancer Can I beat this cancer? fracture Where do I go for a fracture? How do I get a transplant in time?
For many questions, one easy answer: ECMC. The answers to health questions are right at home in Western New York. Because ECMC’s medical campus is home to the services, resources, and facilities that make it a simple choice for patients— including a nationally-accredited bariatric program. Our community’s most accomplished head and neck cancer specialists. The state-of-the-art Russell J. Salvatore Orthopedic Unit. And the shortest wait times in the country for kidney transplant. No matter your health questions or concerns, learn how ECMC can be the answer:
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