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BFOHEALTH.COM
April 2019 • ISSUE 54
Understanding the Dramatic Fall in Number of Births
Physician Jon VonVisger, new transplant director at ECMC, wants to expand transplantation program at center
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Things You Need to Know About Autism
Birthrate in the U.S. is at the lowest level in 30 years.
Hot Flashes 101
Russell J. Salvatore’s generosity continues to benefit Buffalo hospitals, community
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With recent acquisition and new sites, Buffalo-based WellNow today has more than 30 facilities in NYS. Physician John Radford, owner and founder of the chain, started the business in 2012. He plans to open 14 new locations this year alone, including some around Chicago. See page 21
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The good, the bad, and the better choices. Story on p. 13
How to Save Money on Your Medication Story on p.18
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New App to Help Patients Prepare for Medical Visits
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atients often only have about 15 minutes with their doctors during an office visit and they often walk in unprepared for what questions they want their doctor to answer about their medical problem or treatment. To help patients prepare for their medical visits, the Agency for Healthcare Research and Quality (AHRQ) developed a new consumer mobile app that builds off the agency’s “Question Builder” online tool. The Question Builder app, which is available at no charge for smartphones, tablets and laptop computers on iTunes and Google Play, aims to help patients organize questions and other information prior to medical visits. “Consumers liked the ability to have questions and other information at their fingertips during medical visits, while doctors, nurses and other clinicians said that better-prepared patients would lead to more effective and efficient visits and potentially more accurate diagnoses and better outcomes,” the agency said in a release. “Patients can get better care by preparing to ask questions about their care and communicating effectively with their doctors, nurses and other providers,” said physician Jeff Brady, who directs AHRQ’s Center for Quality Improvement and Patient Safety. “Asking questions to make sure patients understand instructions
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
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and other aspects of their care can help reduce the chance of missed diagnoses, identify the right tests that are needed, and avoid unnecessary hospital stays.” Through the app, patients can input details of their upcoming appointments, such as date and reason for the visit, and then choose questions they want to ask their doctor, starting with a list to prompt them with commonly asked questions in different situations. To talk to a doctor about medical tests, the app prompts patients to ask questions such as: How accurate is the test and what do I need to do to prepare for the test? Patients can then use the app to email information to themselves or others for reference or can use the app to make notes during the medical visit. The app organizes content and questions by type of medical encounter, such as a medical visit or preparing for surgery, and offers consumer education materials and videos about the importance of asking questions and sharing information. There’s also a camera option that allows patients to document visual information such as a skin rash, upload insurance or prescription medication information, and other photo-enabled features. To download the free app, go the app store and type “AHRQ Question Builder.”
Roswell Park Attracts $28.2M in Grants
$6.6 million award from the National Cancer Institute (NCI) leads the latest slew of grants awarded to Roswell Park Comprehensive Cancer Center researchers. These awards totaling more than $28.2 million in new funding from federal agencies as well as nonprofit foundations and associations will enable critical investigations to help explain why an aggressive form of breast cancer is more common in AfricanAmerican women, learn how cancer metastasizes and develops resistance to treatment, explore opportunities to enhance patients’ recovery following surgery and advance development of a pioneering immunotherapy involving engineered T cells. In 2018, grants and contracts brought in $92 million in newly awarded or continuing funding for research at Roswell Park. “Researchers at Roswell Park continue to lead the way in cutting-edge discoveries.,” said Congressman Brian Higgins. These grants from the National Cancer Institute and other funding sources demonstrate both a confidence in the work being done right here at Roswell and great opportunity to better understand and treat cancer.” “Cancer researchers today have to fight really hard for an increasingly limited pool of available funds, but our team continues to successfully compete and to demonstrate the
impact of their ideas and approaches may have for cancer patients,” says Candace S. Johnson, PhD, Roswell Park President and CEO. The $6.6 million from the NCI, a prestigious five-year Research Project Grant or “R01” award, will fund a project led by Song Yao, PhD, associate professor of oncology in the department of cancer prevention and control. His investigation is a multi-institution, multi-investigator project that seeks to understand how DNA mutations relate to the health disparities we see in breast cancer among African-American women. African-American women face the highest risk for the aggressive triple-negative type of breast cancer and have the highest mortality rate from breast cancer compared to other population groups. This project, B-CAUSE (Breast Cancer in African Americans: Understanding Somatic mutations and Etiology), will pool data and tumor samples from several studies across the nation, creating the largest tumor genomic database from African-Americans with breast cancer. “Our study will provide a more definitive answer to the long-standing question of whether or not breast cancer biology differs by ancestry,” said physician Yao, who will lead this research in collaboration with colleagues from Boston University, Vanderbilt University and the University of Southern California.
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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U.S. Deaths From Suicide, Substance Abuse Reach Record High Hardest hit are 18- to 54-year-olds, men, blacks, whites and city dwellers
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eaths from drugs, alcohol and suicide in the United States hit an all-time high in 2017 — more than 150,000 in all. That number was more than double 1999 levels, according to a chilling new analysis of U.S. Centers for Disease Control and Prevention data by the Trust for America’s Health and Well Being Trust, two health policy organizations. Nationwide, the death rate due to alcohol, drugs and suicide rose 6 percent between 2016 and 2017, from nearly 44 to 46.6 deaths per 100,000, the study found. Though that increase was smaller than in the two preceding years, it was higher than the 4 percent average annual increase since 1999. “It is important to see hope in the slowing of rates — but it’s not nearly enough,” Benjamin Miller, chief strategy officer of Well Being Trust, said in a news release from the two groups. “We should not be satisfied at all. Too many of us are dying from preventable causes.” Synthetic opioids are driving the sharp rise in drug deaths — up 10-fold in the last five years and 45 percent between 2016 and 2017. The number of deaths attributed to synthetic opioids alone now exceeds those from all drugs in 1999. In 1999, fentanyl and synthetic opioids caused fewer than 1,000 deaths a year nationwide. In 2017 alone, more than 1,000 people died every two weeks from a synthetic opioid overdose. Hardest hit were 18- to 54-yearolds, men, blacks, whites and city dwellers. Synthetic opioid deaths were largely concentrated in Northeastern and Midwestern states, the analysis found. The researchers also reported a 4 percent rise in suicide deaths between 2016 and 2017, up from 13.9 per 100,000 to 14.5. That was the largest increase since data collection began in 1999. Between 2008 and 2017, suicide rates rose an average of 2 percent per year, or 22 percent overall, the study
“As a nation, we need to better understand and to systematically address the factors that drive these devastating deaths of despair.” John Auerbach, president and CEO of Trust for America’s Health.
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CALENDAR of
HEALTH EVENTS
April 4
Program on infertility treatments held in Buffalo
Catholic Health is sponsoring an information program titled, “Minimally Invasive Surgical Options to Improve or Restore Fertility” from 5:30 to 7:30 p.m., Thursday, April 4, at the Millennium Hotel, 2040 Walden Ave., Buffalo. Join nationally recognized women’s health expert, physician Ali Ghomi, for dinner and a discussion on how minimally invasive gynecologic surgery can help improve fertility. He’ll discuss how robotic surgery can be used to treat advanced endometriosis or reverse a tubal ligation, increasing a woman’s potential to become pregnant. “Minimally Invasive Surgical Options to Improve or Restore Fertility” 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.
May 22
Internationally-known expert on dementia to speak in Syracuse
whose innovative approach to Alzheimer’s disease and dementia care has been recognized internationally, will be the featured speaker at the Alzheimer’s Association Dementia Care 2019 caregiver conference May 22 at the Holiday Inn-Syracuse/ Liverpool/Exit 37, 441 Electronics Pkwy., Liverpool. The eighth annual conference is intended for family and professional caregivers of individuals living with Alzheimer’s disease or another dementia. Register for the event at alz. org/cny or by calling 315-472-4201. Admission is $65 through April 30 and increases to $80 on May 1. Snow, an occupational therapist and educator with more than four decades in geriatric care, developed The GEMS brain change model focusing on the person living with Alzheimer’s disease or another dementia’s abilities within a moment to create a supportive care environment. According to Snow, “Just as gemstones need different settings and care to show their best characteristics, so do people. Rather than focusing on a person’s loss when there is brain change, seeing individuals as precious, unique, and capable encourages a care partnership and is the core of this model.” The conference registration fee includes access to all sessions and interactive expo, a conference manual, continental breakfast and lunch.
Dementia expert Teepa Snow,
Free Yoga Series at Albright-Knox Art Gallery found. Whites, males and people in rural areas had the highest suicide rates. In 2017, the death rate from alcohol, drugs and suicide was 72.4 per 100,000 for 35- to 54-year-olds. For all men, it was 68.2 per 100,000, and for all women, 25.7 per 100,000. “As a nation, we need to better understand and to systematically address the factors that drive these devastating deaths of despair,” John Auerbach said in the joint news release. He’s president and CEO of Trust for America’s Health. Overall, 43 states and the District of Columbia saw their death rates from alcohol, drugs and suicide rise between 2016 and 2017. Five states -— Massachusetts, Oklahoma, Rhode Island, Utah and Wyoming — saw declines. West Virginia had the highest rate per 100,000 at 91, followed by New Mexico (77); Ohio (69.4); Alaska (67.6), and New Hampshire (66). Miller said tackling such a complex problem is not about adding up small changes but about a bigger transformation. “Each time we make progress — like with prescription opioids — new problems, like synthetic opioids, appear,” he said.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
Art of Yoga offers unique fitness experience for Western New Yorkers
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lueCross BlueShield of Western New York and the Albright-Knox Art Gallery partner to present Art of Yoga, a free and unique yoga series, which continues on Thursday, April 18 at the gallery. Art of Yoga, led by Power Yoga Buffalo, was designed to draw on principles of symmetry and balance to encourage engagement of the mind, body and soul. With a mix of yoga and meditation classes, the free series balances high energy and relaxation for individuals of all ages and fitness levels. “As a community-based health plan, BlueCross BlueShield understands the importance of creating unique fitness opportunities for Western New Yorkers,” said Cait Zulewski, director, corporate rela-
tions for BlueCross BlueShield of Western New York. “Our partnership with the Albright-Knox Art Gallery provides our community with an elevated yoga experience in a vibrant showplace for modern and contemporary art.” “We are very excited to be partnering with BlueCross BlueShield and Buffalo yoga studios to support wellness in Western New York,” said Jennifer Foley, director of education and community engagement for Albright-Knox. Art of Yoga is free and open to the public. No experience or flexibility is required to participate. Participants are required to preregister online at www.albrightknox. org/wellness, call 716-270-8292, or sign up at the Albright-Knox admissions desk.
2019 Art of Yoga Schedule Date
Time
Class
Thursday, April 18
6:30- 7:30 p.m.
Revive: Meditation at the Museum
Thursday, May 16
6:30- 7:30 p.m.
Power Yoga
Thursday, June 20
6:30- 7:30 p.m.
Power Yoga on the Portico
Thursday, July 18
6:30- 7:30 p.m.
Meditation
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April 2019 • In Good Health Buffalo Region - April 2019 - 9.75”x13.75”
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New Nurses Work Overtime, Long Shifts, and Sometimes a Second Job Nearly half of newly licensed nurses work overtime, while more than one in 10 have a side job
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ew nurses are predominantly working 12hour shifts and nearly half work overtime, trends that have remained relatively stable over the past decade, finds a new study by researchers at NYU Rory Meyers College of Nursing. In addition, 13 percent hold a second job, according to the study published in the Journal of Advanced Nursing. Changes in health policy in recent years — from the passage of the Affordable Care Act and increased access to healthcare to the recession, which delayed some nurses’ retirements — have had implications for nurses and the hours they work. “Research shows that nurses’ hours, scheduling patterns, and overtime have been associated with patient safety and nurse well-being,” said Amy Witkoski Stimpfel, Ph.D., assistant professor at NYU Meyers and the study’s lead author. “However, we wanted to understand what these changes in the global economy have meant for the newest generation of nurses. Stimpfel and her colleagues analyzed surveys from more than 4,500 newly licensed nurses in 13 states and Washington, D.C., collecting information on nurse demographics, education, work attributes, and attitudes. Specifically, nurses were asked about their work schedule, daily shift length, weekly work hours, overtime, and whether they worked a second job. Four different cohorts of nurses — those first licensed in 2004-2005, 2007-2008, 2010-2011, and 20142015—completed the survey soon after being licensed; these cohorts were compared to observe changes over time. The researchers found that newly licensed nurses work an average of 39.4 hours a week, predominantly in 12-hour shifts. More than 13 percent report having a second paid job. New nurses prefer working the day shift, and the preferred shift length is 12 hours. Twelve percent of nurses report working mandatory overtime (an average of less than an hour in a typical week), and nearly half (45.6 percent) work voluntary overtime (an average of three hours in a typical week). The researchers observed nuanced changes in overtime hours during the decade studied: there was a decline in both mandatory and voluntary overtime during the economic recession by about an hour per week, but overtime hours rose in the most recent cohort.
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Meet
Your Doctor
By Chris Motola
Jon VonVisger, M.D New transplant director wants to expand transplantation program at ECMC Q: What brought you to Buffalo and Erie County Medical Center? A: I’d been doing nephrology and transplants down at Ohio State for the last 13 years or so, and saw this as an opportunity to grow as a physician. As a director [of Regional Center of Excellence for Transplantation and Kidney], I’m still practicing in the clinical group. There are four of us in terms of transplant nephrologists. Q: Kidney transplants are one of the more common and successful types of transplants. Why is that? A: As a solid organ transplant, it’s by far the most common transplant in the US, somewhere between 10,000 and 12,000 transplants annually. In terms of survival, first year survival rates are above 95 percent, so it’s quite successful. Liver transplant also does pretty well. Other solid organ transplants — heart, lungs — have a much higher mortality rate. Q: Why do kidney transplants have such a high success rate? A: A few things. Back in the ‘70s, Medicare started providing support for dialysis in addition to transplants, so for kidneys, as opposed to heart and lung, there’s this bridging therapy that people use. It doesn’t replace all the organ functions, but it does provide the maintenance of fluids and electrolytes that help you avoid mortality. So even though the mortality rate is higher on dialysis than with a transplant, patients can survive on dialysis for decades. So, it’s a bridging therapy to get them to the transplant. If we can, we like to get referrals for patients even before they’re on dialysis so they’ll be healthier for their transplant. The other side of the coin is the availability of the organs themselves. From a technical perspective, it’s less complicated than a heart, or a lung, or a liver, so we tend to be more successful in retrieving deceased donor organs and also for living donors, which is optimal. Most of us are
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
born with two kidneys, but there’s a lot of evidence that you do just fine with one. So, you get friends, family and even altruistic donors who can offer the organ. Q: Are kidney donors at risk? A.: They go through a pretty stringent process to see if they’re a healthy kidney donor. Post donation kidney health is usually quite good. There’s a rare circumstance where kidney donors do develop kidney disease or failure after donation, but donors who have made the sacrifice and don’t have a living donor of their own get priority for getting a diseased-donor transplant. Q: What are the common causes of kidney failure? A: By far in the United States are diabetes and hypertension. With hypertension we’re less sure if it’s causing patients’ kidney failure or if it presents along with kidney failure and is caused by something else. So, it’s hypertension-associated. It may be hypertension is a primary or secondary cause. FSGS (focal segmental glomerulosclerosis) is becoming more common in the U.S., which is the progressive scarification of the kidney filters. And a significant number of patients with autoimmune diseases, and some with congenital kidney diseases. Q: I saw you also had some background in nerve regeneration research? A: I had been interested in the regeneration of tissues in general and, when I was doing my medical school training, I was heavily clinically involved as a matter of practice. The advances in neurological recovery and treatment has just been much, much slower than other areas, so I changed my pursuits. I do keep abreast of developments in that area, but it was not satisfying for me to pursue, so I switched over to nephrology and the immune system. Q: Do you do a
In the News Physician Jon VonVisger was recently appointed primary nephrologist and medical director at the Regional Center of Excellence for Transplantation and Kidney Care at ECMC. VonVisger completed combined medical and Ph.D. degrees at the University of Maryland, School of Medicine in Baltimore in 1996 with doctoral work on central nervous system regeneration and nerve growth factors. He went on to complete an internal medicine residency in the University of Maryland Medical System. He is specialty trained in nephrology and transplant medicine through Harvard, Massachusetts General and Brigham and Women’s hospitals. VonVisger also practiced transplant nephrology at The Ohio State University (OSU) Comprehensive Transplant Center in Columbus, one of the 10 largest transplant centers in the United States, from 2005 to 2018. lot of direct outreach to donors? A: I do. We do have some of our administrators here who help direct our outpatient clinics as well as going to dialysis centers to speak to potential candidates for transplant and to provide education. We have organizational meetings with the local procurement programs and help make sure they understand our criteria and processes. A fair number of our patients will transition back from our outpatient clinics post-transplant so they’ll have collateral support. Q: What kind of impact do you want to have on the department at ECMC? A: It’s an underserved area here, so outreach is a part of that. We’d really like to grow the program. So this is one of the shortest wait lists in the country. We’re regularly bringing in patients to transplant, and they’re not on the list very long. There are other avenues we’d like to expand; we’d like to do clinical trials and studies that will help improve the outcomes of transplant. Q: How do you keep the wait list so short? A: Well, being not only just more available, some programs turn down offers pretty regularly, whether it’s due to staffing issues or selectivity, what we’d often call “cherry-picking.” The more recently adopted kidney allocation program in the last years really is directed at efforts to expand organ acceptance and organ placement to recipients for whom they’re more appropriate, and discarding fewer organs.
Lifelines
Name: Jon VonVisger, M.D. Position: Primary nephrologist and medical director, Regional Center of Excellence for Transplantation and Kidney Care at ECMC Hometown: Los Angeles Education: Maryland School of Medicine Affiliations: Erie County Medical Center; University at Buffalo Organizations: American Society for Transplantation; American Society for Nephrology; National Kidney Foundation Family: Wife, son Hobbies: Carpentry; outdoor sports
Stroke: Death of TV Actor Confirms Trend More young people are dying as a result of strokes, according to data By Ernst Lamothe Jr.
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he news of TV actor Luke Perry’s death hit people hard for many reasons. Some were his long-time fans. Others were just shocked about the speed in which he went from being hospitalized to being dead. Finally, many people just couldn’t believe that someone could die of stroke, especially someone in their 50s (he was 52 when he died). “A lot of people just think stroke is your grandparents’ disease — that is simply not the case,” said physician Elad Levy, co-director of the stroke center at Kaleida Health. “In reality, stroke is one of the top killers in the United States.” The numbers back that statement. Stroke is the second most common cause of death worldwide, according to the American Stroke Association and there are an estimated 17 million strokes worldwide each year. Stroke is the fifth leading cause of death in the U.S. killing 140,000 people a year. It is also the leading cause of disability among Americans, as it can leave survivors paralyzed or unable to communicate. “People need to know that strokes do not discriminate between gender, culture or age,” said Levy, who is also professor and chairman of neurosurgery at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo. “I have seen strokes in young children to seniors.” A stroke is when a blood vessel that brings oxygen and nutrients to
the brain is either blocked by a clot, which is called an ischemic stroke, or it ruptures, a hemorrhagic stroke. That cuts off the vital blood and oxygen flow to that part of the brain. This kills brain cells, which can kill a person or severely debilitate them. “A stroke can be incredibly fatal and debilitating,” added Levy. “People can die from this because anytime arteries are clogged and you are losing brain cells that can be a dire combination. If you are having a stroke, for every minute that an artery is blocked you lose two million brain cells. Even though we can treat people hours after a stroke, the more you wait the more brain damage you have.” Perry was slightly young for a stroke victim, as 66 percent of those who suffer from such an attack are 65 or older, according to the Center for Disease Control and Prevention. But strokes, which are behind about 5 percent of U.S. deaths annually, are on the rise among those between 25 and 44. Perry’s father died in his mid-30s from a heart attack. “If you have any risk factors like high blood pressure, high cholesterol or smoking, you have to beware. Patients with these issues have a higher likelihood of stroke,” said Fahed Saada, neurologist at St. Joseph’s Health in Syracuse. “That is why you have to watch for as many warning signs as possible.” The American Stroke Association suggests learning the F.A.S.T warning signs that someone is having a stroke, including: • Face drooping: Does one side of the face droop, or does it feel numb? Ask the person to smile; is the smile uneven or lopsided?
“A lot of people just think stroke is your grandparents’ disease — that is simply not the case.”
Levy
Physician Elad Levy, co-director of the stroke center at Kaleida Health.
Actor Luke Perry died recently at age 52.
• Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one drive downward? • Speech: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence. • Time to call 911: If the person shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital ASAP. The faster a person is treated, the more likely they are to recover. Additional symptoms can include sudden numbness or weakness in the face, arm or leg, especially on one side of the body, severe head-
ache, sudden confusion or trouble seeing in one or both eyes. “The medical community needs to do a better job at educating our society on the dangers of stroke,” said Levy. “The brain is such a complex organ. And we need to do a better job at educating people that while you can’t modify your genes or family history, you can exercise more which keeps the blood flow pumping through your body. People who have high blood pressure, cholesterol and other weight issues are more susceptible. Even though we live in western New York where it can be cold, we have to keep moving.”
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Physician Well-being Improving, But Burnout Risk Remains T he good news is that physician burnout appears to be improving, along with indicators for physician well-being. However, physicians remain at high risk for burnout, depression and depersonalization, compared to other professionals. Those are the updated findings from Mayo Clinic researchers and their collaborators that are published in Mayo Clinic Proceedings. “This is good news. It shows that burnout is being addressed nationally and programs are having some impact,” said physician Lotte
Dyrbye, Mayo Clinic researcher and senior author of the paper. “Clearly more organizational change and more research is needed to sustain this trajectory.” Researchers from Mayo Clinic, the American Medical Association and Stanford University collaborated in the national survey of physicians across more than 20 specialties to assess any changes between the previous study in 2014 and the original survey in 2011. While burnout varies by specialist, overall reported levels of burnout and satisfaction with work-life
integration improved between 2014 and 2017 — but only to 2011 levels. The researchers say individual and organizational efforts have improved the situation, but more work needs to be done. Burnout encompasses many aspects but includes the areas of emotional exhaustion, depersonalization, distress and depression. Extreme cases of burnout can lead to medical errors affecting patients, job loss and suicide. Survey responders say the demands of updating electronic health records are a major factor in burnout. These demands
limit the time physicians can spend with patients, and that affects career satisfaction. More than 30,000 physicians were invited to participate in the electronic survey. Roughly 17 percent (5,197) responded, and a second attempt to reach nonrespondents gained 248 more participants. Questions mirrored those on the previous surveys. Researchers say the reason for the change may be due to physicians adapting to the new work environments over the three-year period. Also, much progress may be attributed to interventional programs to stem burnout in hospitals and other facilities. Conversely, they say the indicators may have improved because many distressed physicians have left the profession.
Healthcare in a Minute By George W. Chapman
‘Vaccine Hesitancy’ Among Top 10 Threats to Global Health “Vaccine hesitancy” is the term coined by the World Health Organization to describe the resistance to vaccination due to unfounded safety fears, complacency about infectious diseases or difficulty accessing vaccinations due to supply or price. Vaccine hesitancy is now listed in this year’s top 10 threats to global health. Lately, close to 200 people in New York, mostly children, contracted measles, according to the Centers for Disease Control. An ongoing measles outbreak in Portland, Ore., has sickened 23 people, mostly children. Twenty of them were never vaccinated. Incredibly, despite the overwhelming evidence that vaccines work, the rate of unvaccinated kids has quadrupled in the past 17 years. Thanks to vaccines, smallpox has been completely eradicated and polio soon will be. Some children remain unvaccinated because of choices made by their parents. The American Medical Association is clamping down on providers who flippantly provide feeble excuses for children not to be vaccinated so they can enter school. The CDC is debunking the myths about vaccines. No. 1: Numerous studies have
found no connection between vaccines and autism. People might think the two are linked because the MMR vaccine is administered at the same phase in a child’s development when they may begin to show signs of autism spectrum disorder (not responding to their name, oversensitive to noise). No.2: It is not “safer” to space out the vaccines. The CDC recommended schedule is based on disease risks, vaccine effectiveness at certain ages and vaccine interactions with each other. No. 3. Vaccines do not contain harmful chemicals. Some substances contained in some vaccines do sound harmful, notably formaldehyde and mercury. The former is naturally produced in our bodies and the trace in vaccines is far less. The ethylmercury used in flu vaccines is safe and much different than the toxic methylmercury which most of us should be worried about. No. 4. You cannot rely on everyone else’s immunity/vaccination to protect your unvaccinated children. If an outbreak occurs, unvaccinated children are far more likely to get sick.
Socialized Medicine If your definition of socialized medicine means government controlled or paid for medical care, then we are almost halfway there. Within the next few years, the government’s share of healthcare spending will approach 50 percent, according to The Centers for Medicare and Medicaid. Aging baby boomers entering Medicare will drive this. By 2027, CMS estimates about 74 million people will have Medicare and about 83 million will be covered by Medicaid for a combined total of 157 million which will be about 45 percent of the projected population of 350 million in 2027. When you add in those insured/covered by federal employee insurance, Tri-Care (military), the VA and the Bureau of Indian Affairs, the government pays for over half of us. The “Medicare for All” movement
would slowly transition the other 50 percent, typically by age, into a single payer system, eventually eliminating commercial insurance. Most physicians now very cautiously back a single payer system because most commercial insurers are paying Medicare-based rates, so a single payer would just be easier for them to manage. The American Medical Association’s legitimate concern is once there is a single payer, they are at the mercy of the single payer. Seventy percent of Americans favor universal healthcare, but few are sure how it would work or be paid for. Of course, taxes would go up if the entire cost of universal care is paid for through taxes. But what hasn’t been considered in proposals is, what happens to the amount of care paid for by employers? Will they keep it and then pass the savings along to their
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
employees in higher wages, which would then ameliorate the increased payroll taxes? Or will they continue to pay a percentage of the premium to the single payer? On average, employers cover about 67 percent of the employee’s health insurance. Rural Hospital Jeopardy One in five rural hospitals in the U.S. is at risk of closing unless there is direct fiscal relief or they affiliate with a larger, healthier system. Sixty-five percent of the rural hospitals at risk are considered essential because of their trauma status, services to vulnerable populations, isolation and economic impact on the surrounding communities. The states with the most at-risk rural hospitals are: Mississippi, 31 hospitals; Kansas, 29: Montana, 12; and Texas, 12. Ninety rural hospitals have closed since 2010. Left alone, most rural hospitals will close because of poor finances or their ability to attract and retain physicians. Ironically, telemedicine could hasten closures as rural populations get increased access to physicians in urban areas. More MDs Employed As of a year ago, 44 percent of practicing physicians were employed by hospitals or health systems. Just seven years ago, only 25 percent of physicians were employed. Over the last two years, hospitals acquired 8,000 more practices and another 14,000 physicians left private practice to become employed, according to the Physicians Advocacy Institute. In the last seven years, hospital-owned practices more than doubled from 36,700 to more than 80,000. The vast majority of physicians completing their residencies will bypass private practice and seek employment. The hassle/risk of running a private practice has become overwhelming and unfulfilling for many physicians. Physician employment is actually encouraged/driven by payment policies that favor integrated health systems where physicians and hospitals work in coordinated and managed unison to improve population health. Your medical record Many hospitals and physician offices are still providing only paper copies of records to their patients. Because paper copies are labor inten-
sive, you can be charged per page. It can get expensive, especially if a hospital record. HIPAA regulations state you are entitled to a digital copy of your record if the provider has the capability to do so. In response to complaints from consumers about providers blocking/impeding electronic access to their data, the Department of Health and Human services recently made public several rules that would allow consumers easier access to their record via the app of their choice, like a smartphone, at no additional cost. The healthcare industry has been slow to adapt to available technology. In fairness, providers cannot simply raise prices to pay for their investment in information technology because their reimbursement from their party payers is fixed. Price transparency Unaware of what a procedure costs, consumers inadvertently can drive up their own premiums by unwittingly using more expensive providers. For example, your insurance benefit summary says you have a $50 copay for an outpatient MRI. So, no matter where you go for the MRI, all you know is you owe $50, regardless of the cost. Your insurance company has different payment schedules per MRI provider. It often depends on the negotiating power of the MRI provider. Larger hospital / health systems can demand higher reimbursement than smaller facilities and private physicians. By inadvertently getting your MRI done where the insurer has to pay more, you increase the expense to the insurer which causes your premium to go up. In the cases where you have a 20 percent copay, you still don’t know the overall cost and may be going to the highest price facility. 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.
Meet Your Provider
Nature Medicine Medical tourism in your backyard. Giving you more life to live! You don’t have to go to Switzerland to get the latest in alternative and complementary treatments that are not offered by medical hospitals in North America. Nature Medicine has assembled a variety of devices and medical protocols that are commonly offered in “exclusive” clinics, where the rich and famous go for treatments. We offer the same products at affordable prices in Canadian dollars, which can be a great value for our American friends. As of the summer of 2018, we have added three new revolutionary technologies: Oncotherm, IV Laser and, Hyperbaric or 10-pass ozone therapy. • Oncotherm uses radio waves that generate heat to kill cancer cells. Nature Medicine is one of a dozen clinics in North America to offer this technology. • IV Laser (photodynamic therapy) kills cancer cells and stealth microorganisms and much more! • Hyperbaric 10-pass ozone can kill cancer cells, neutralize fat soluble toxins, increase oxygen in the tissues and kills stealth microorganisms. This
breakthrough technology allows us to administer up to 140,000 ug of ozone per treatment versus the conventional way to administer ozone which is 2,400 ug of ozone. Up to 40 times as much. We are the only clinic in North America to offer all three technologies and more! What is Oncotherm? Oncothermia — or modulatedelectro-hyperthermia for oncological use — is a fast developing supportive, complementary treatment method against different types of tumors. The principles are based on the classical method of hyperthermia. Our aim, besides the absolute increase in temperature, is to direct electric-field absorption to destroy the membrane of the cancer cells. Oncothermia’s effect is synergic to radiotherapy and to numerous chemotherapies. Oncothermia in general is not used as a sole therapy, usually it is combined with chemotherapy, radiotherapy or other
therapies in combination. Oncothermia is approved for cancer treatment by Health Canada but not by the FDA, so at this time it is not available in the United States. www.naturemedicine.ca/oncotherm/ What is IV Laser (photodynamic therapy)? According to the National Cancer Institute, “Photodynamic therapy (PDT) is a treatment that uses a drug, called a photosensitizer or photosensitizing agent, and a particular type of light. When photosensitizers are exposed to a specific wavelength of light, they produce a form of oxygen that kills nearby cells. Each photosensitizer is activated by light of
a specific wavelength. This wavelength determines how far the light can travel into the body. Thus, doctors use specific photosensitizers and wavelengths of light to treat different areas of the body with PDT.” The recent emergence of stealth microorganisms (such as Lyme disease) and the lack of therapies capable of eradicating them has prompted researchers to investigate new modalities. Photodynamic therapy (PDT) is a novel light-based antimicrobial modality capable of efficiently eradicating a wide array of bacteria, viruses, fungal and protozoan parasites. www.naturemedicine.ca/ photodynamic-therapy
Nature Medicine n
296 Welland Ave, St. Catharines, CANADA n 905.684.4934 n www.naturemedicine.ca/ n
Writer on the Run By Jenna Schifferle
The Yin and Yang
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“Writer on the Run” is a monthly column written by Jenna Schifferle of Cheektowaga. She chronicles her experience training for the Chicago Marathon in October.
ome days, you crush every hill that crosses your path. Other days, you trip down them at full speed. And on those exceptionally rough days? Well, a squirrelly spectator might even catch you on camera, mid-fall. If the video doesn’t go viral, the memory of that guy’s face will taunt you at every hill for the rest of your route. During marathon training, you’ll undoubtedly face these extremes, often in the same mile. You’ll be fierce and fearless one minute and completely beside yourself the next — an unstoppable klutz. When I started running, I thought the most important thing I could do was to always push forward. The more I run, though, the more I realize the importance of taking every moment in stride. I’ve run fast miles where nothing could stop me, and I’ve run slow miles when it felt like my feet cemented into the pavement. I’ve run through ice, sleet and snow, and wind storms that suspended me in my tracks. I’ve run through sunshine and sweltering, blistering heat. Some runs have
started beneath blue skies and faded into freezing rain. Other runs have turned into wild adventures after a rough start. I suppose this is part of the process: the good and the bad, the yin and the yang. On one of the long runs I was scheduled for recently, it was hard to see the balance. My running group met at Knox Farm in East Aurora, a picturesque park tucked into a vast and stunning landscape. With the sun ascending over freshly fallen snow, the stage was set for a perfect nine-miler. My pace group took off down a slight incline on a winding path out of the park. By mile three, my shoulders were in my shoes. I started tripping over my own feet and stepping on the heels in front of me. My shoes were shuffling, and I started getting more and more hunched over. At mile five, I slowed down to a meandering crawl. By mile six, I had reached a difficult decision: to run the last three or stop. I chose the latter. When you’re on a training plan, it can be discouraging to “quit” partway through a run. The most important piece of advice I’ve ever heard,
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though, is that doing this is not “quitting.” When your body is aching, and your form is suffering, you need to listen to the warning signs. Sure, there are times when you can and should push through the discomfort, but there are also times when your body just needs a break. Whether you’re a runner or not, you can apply that lesson in so many areas of your life. Self-care matters. When I got back to Knox Farm, I was discouraged and disappointed in myself. But I wasn’t alone. Other runners had also decided not to continue on. They stood around talking and stretching, and taking in the scenery. When I finally caught my breath, I realized that moments like those are also part of the journey. Many people think that it’s the distance that’s difficult. In reality, it’s the process of learning your limits, whether you’re recognizing them or shoving past them. The most important thing is to always fall forward. And if someone does happen to catch you on camera at your worst moment? Well, maybe you should stop and strike your best pose.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
On Her Own: Up Close and Personal with Ginger Howell
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t was love at first sight. At the ripe old age of 14, Ginger Howell met and was smitten by her future husband-to-be Dick Howell in Saginaw, Mich. They happened to be neighbors — and Ginger was robbing the cradle. Dick was 13. “Even at that young age, he was so good-looking, smart, and athletic — especially at swimming!” Ginger beamed. These childhood chums turned into highschool sweethearts, and then years later got engaged when they were students at the University of Michigan. Ginger got “pinned,” an old-time expression, which signaled the beginning of an exclusive courtship akin to engagement. Dick and Ginger tied the knot following graduation. When Dick was drafted, the couple lived and traveled abroad in post-war Germany for a year, then moved to Rochester where Dick was hired by Eastman Kodak and they started a family. Three kids later, they had nestled into a rustic ranch in Pittsford, where Ginger launched Seasonal Kitchen, a cooking school in their home, while Dick made a name for himself at Kodak. When Dick retired, he joined Ginger in the kitchen and together they taught cooking classes that mixed good-hearted ribbing with lots of laughs, helpful cooking tips and demonstrations. The classes, which included dinner, were (and continue to be) a hit! Sadly, Dick lost his battle with cancer five years ago. As a widow,
Ginger was determined to carry on their cooking legacy and love of life, both the sweet and the savory.
Q: After you lost Dick, what were some of the biggest challenges you faced?
classes.
A: Facing life without someone to lean on was a huge change for me. Dick and I did everything together after he retired. We were inseparable. And he did so much around the house. I wasn’t sure how I was going to stay on top of things. I was also very worried about finances and whether I would be able to hold onto the house and continue the cooking
Q: How did you overcome these challenges?
A: Well, I thank my lucky stars for my daughter Holly. She stepped right in to help me lead the cooking school, which was no small feat. Each class requires lots of preparation, shopping and rehearsal ahead of time, followed by hours of clean-up afterwards. While Holly and I couldn’t sustain the 11 classes per week Dick and I led, she and I kept it going. This was important for financial reasons. I needed to pay the bills. But I also needed and wanted to maintain my social network. Many of my class members became friends and, as such, became my support system after Dick died. I’ll be forever grateful for that. My financial consultant was also invaluable. Thanks to his help,
s d i K Corner
How to Keep Your Kids Safe From Cyberbullying
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o type of bullying is acceptable, but cyberbullying can be harder for parents to spot because it takes place via cellphone, computer or tablet, often through social media. Cyberbullying can be a hateful text message or post of embarrassing pictures, videos and even fake profiles of the victim. Victims are often bullied in person, too, and have a harder time escaping it. But unlike facing a bully at Page 10
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school, cyberbullying can happen 24/7, even when your child is home with you. Messages and images can be posted anonymously and spread in no time. And it can be difficult or even impossible to find the culprit. The consequences of being cyberbullied are far-reaching. Young victims are more likely to use alcohol and drugs, skip school, lose self-esteem and develop health problems. What can parents do? The website Stopbullying.gov recommends
Dick and I had a retirement nestegg I could live on as long as I was careful about my spending. That’s not always easy when you love to entertain, cook and enjoy delicious food! But I made it work. Q: There is a commonly held belief that single women in midlife are inevitably unhappy without a partner. How do you respond to that?
A: I’m bemused by that belief. Perhaps these are women — or men, too, I suppose — who haven’t given themselves a chance to see what they can do and experience for themselves. Living alone can be so empowering. I know this may sound cliched, but I find every day to be an adventure.
Q: Has living alone provided you with any unexpected revelations or opportunities?
A: Oh, so many! For one thing, I can still shovel snow at my age — I’m 90! I know this sounds simplistic, but it’s very symbolic. I’ve learned I can do things for myself. My attitude is that shoveling snow is great exercise! Good for the legs. It gives me a great deal of satisfaction knowing that I am capable on my own; that I can depend on myself. I’ve also learned that if things are beyond me, I can ask for help and rely on the kindness of others. Last month, the UPS guy showed up with a delivery on a very snowy day. I asked if he could help shovel the front porch before he left, which he did so gladly. I don’t see asking for help as a weakness; I see it as a sign of strength and self-confidence.
Q: What does an ideal day look like for you now?
A: On an ideal day, I wake up to a clean kitchen, having washed the dishes the night before. I put away the clean dishes, make my list of chores for the day (which typically includes a trip to the grocery store), and then I get busy trying new rec-
ipes or prepping for a cooking class that evening. After the class and everyone has left, Holly and I clean up and collapse exhausted, but happy, in my living room. We are full of gratitude for the beautiful people and purpose in our lives. Q: What advice do you have for women and men who find themselves living alone in midlife?
A: Keep working at something you love to do — something that matters. Working keeps us young and alive! For me, it’s Seasonal Kitchen. For others it could be hiking, writing, playing an instrument, travel, you name it. I encourage people to stay active and engaged in life. And to be with friends and definitely own a pet, if possible. Oh, and take a cooking class!
Q: And one last question: How do you plan to spend this evening?
A: Mercifully alone (smiles). I adore a quiet evening to myself. As you can imagine, I’m very busy food shopping, prepping and leading classes, going out to dinner with friends, participating in wine tasting events, attending fundraisers, etc. I look forward to an evening alone watching “World News Tonight,” followed by “Jeopardy,” and then snuggling up with a good book. I love reading and re-reading anything by Irwin Shaw and Rona Jaffe. Tomorrow I will wake up rested and eager to take on a new day, on my own and looking forward to what’s to come.
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.
being proactive — talk with your kids about cyberbullying, including why they should never bully others, and encourage them to tell you about any incident right away. Friending or following your kids on social media may help you know if they become the victims of unwanted postings.
More tips for parents • Teach kids not to share anything that could hurt or embarrass them or others to avoid retaliation. • Regularly check your kids’ social network pages to look for signs of bullying behavior, such as mean images of another child. • Tell your kids to talk to you if an online message or image makes them feel threatened or hurt. • Encourage your kids to speak up if they see cyberbullying happening to someone else, and not to engage in the bullying by forwarding posts. • If your child is cyberbullied, print and save screenshots, emails and texts for evidence. He/she should not react to the bully, but should block and/or delete him/ her from their friends lists. Block the user name, email address and phone
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
number. If your child finds a profile that was created or altered without his/her permission, contact the site to have it taken down. • Report cyberbullying to your online service provider, and go to its safety center to block users and limit who can contact your child. • Report cyberbullying that involves a crime to police. • Contact law enforcement if cyberbullying involves: Threats of violence, child pornography or sexually explicit messages or photos, any photo or video of someone in a place where he or she would expect privacy, stalking and a hate crime. Also report incidents to your child’s school. The school can use the information to help with prevention and response strategies.
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Things You Need to Know About Autism By Ernst Lamothe Jr.
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here has been a significant increase of autism spectrum disorder diagnoses in the last 40 years, according to the Centers for Disease Control and Prevention. There are three million individuals in the United States and tens of millions worldwide who have autism. While having a child with autism can present some challenges, this diagnosis does not mean that all hope is lost. Half the battle with any diagnosis is understanding what the condition means, how to be proactive in treatment and managing the condition so that the child can still have a high quality of life. “It is essential to let people know that having a child with autism spectrum disorder can be challenging but extremely rewarding,” said physician Michelle Hartley-McAndrew, who runs the autism center at Oishei Children’s Hospital and teaches pediatrics and neurology at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. “People who are diagnosed have many different strengths and challenges.” Here are five key facts you need to know about autism in children, according to Hartley-McAndrew.
1.
Early detection helps When it comes to treatment options, early intervention can improve learning, communication and social skills. In 2018, the CDC determined that approximately one in 59 children are diagnosed with an autism spectrum disorder. The American Academy of Pediatrics recommends that all
children be screened for autism at their 18- and 24-month well-child checkup. Much was not previously known about what causes the disorder, but research is showing that some combination of environmental influences and rare gene changes can contribute to the development of autism, which impacts early brain development. “A child’s brain continues to develop in the early stages so the earlier we are able to diagnose, the quicker we are able to support and teach the child while improving speech, behavior and social skills,” said Hartley-McAndrew. Watch early signs 2. Autism spectrum disorder is a neurodevelopmental con-
dition characterized by differences in social skills and social communication, along with the presence of restricted and repetitive behaviors. Some early signs can often be detected in infants and toddlers, though for some children, their symptoms are more detectable as they age. A child could struggle with understanding spoken language, eye contact, gestures, facial expressions or tone of voice. However, the issue is that because it is a spectrum some children with autism may have limited to no speech, while others may be very talkative. “If the child is not showing any smile or joyful expressions in the first six months, if the child is not mimicking sounds or facial gestures by 10 months if the child is not responding to their name by 12 months, if
Sleep Difficult for Children on Autism Spectrum By Deborah Jeanne Sergeant
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ecent research published in the journal Pediatrics indicates that children with autism spectrum disorders (ASDs) are at double the risk for experiencing difficulties with sleep than children not on the spectrum. Researcher Ann Reynolds, a physician and associate professor, developmental pediatrics, University of Colorado School of Medicine, found that children between the ages of 2 and 5 years are more likely to delay bedtime, struggle getting to sleep, feel anxious about sleep, awaken during the night and have night terrors, all of which can mean fragmented sleep. Children also need sleep for their own mental health benefits. Soda Kuczkowski, owner of Start With Sleep in Buffalo, is certified in maternity, child and adult sleep and is a diagnostic sleep consultant and clinical sleep health educator.
“When children don’t have good sleep habits or aren’t sleeping well, you’ll see a lot more behavioral issues,” Kuczkowski said. “They can’t concentrate and don’t listen well. Behavior in school and in their development is better when you have good sleep.” So why do kids on the spectrum experience sleep disturbances? It’s not entirely clear. Kuczkowski said that it may be because they lack sufficient levels of melatonin, a natural hormone produced by the body that helps set the circadian rhythm of waking and sleeping. It’s usually released close to bedtime. If that doesn’t happen, sleep can prove elusive. Sensitivity issues prevalent with people on the autism spectrum may also affect sleep quality and quantity. Tracy Panzarella, director of clinical services at Autism Services, Inc. in Amherst, said that parents should
the child is not using words by 16 months, these are some signs that they may be autistic,” Hartley-McAndrew said. Autism is a spectrum 3. Besides differences in social skills, social communication and
the presence of restricted and repetitive behaviors, other signs of autism spectrum disorder are the unexpected reactions to sounds, tastes, sights, touch and smells, difficulty understanding other people’s emotions, focusing on or becoming obsessed by a narrow range of interests or objects and engaging in repetitive behavior. However, things should be looked at with a case by case basis. “They say if you have met one child with autism then you have met one child with autism. Every child is different and should be treated as such when being diagnosed and in the selection of an action plan for developing their skills,” she added. “Some children may have a strong aversion to some sensory input.” Boys are diagnosed at a higher 4. rate Boys are four times more likely
to be diagnosed with autism than girls. According to research from the nonprofit agency Autism Speaks, one in 37 boys and one in 151 girls will be diagnosed with autism. This disorder can be reliably diagnosed by 2 years of age, but most children are not actually diagnosed until after the age of 4. “Research says that boys are diagnosed more than girls. There work with their child’s pediatrician to rule out medical issues that can affect any person, such as sleep apnea or acid reflux, when addressing sleep issues. “It’s a partnership with them to help children get better sleep,” she said. Providing those issues are not present or effectively managed, parents can work on making bedtime adjustments to improve sleep. Just before bedtime isn’t a good time for vigorous activity; however, sufficient activity earlier in the day may improve sleep. Quieting the household before bedtime can assist in easing into the transition to sleep. Panzarella recommends a regular nighttime routine, illustrated by a picture board or other display with times listed for older children. “When you’re working with individuals on the spectrum, routine is key,” she said. “It should be consistent and predictable. That way, they know the order they’ll happen in. Do it at the same time every night.” For example, a picture of a toothbrush, toilet, sink, storybook and bed in a row could symbolize the order of use of these objects. “With anything, transition them onto a predictable routine,” Panzarel-
April 2019 •
Physician Michelle Hartley-McAndrew runs the autism center at Oishei Children’s Hospital. could be various reasons for that,” said Hartley-McAndrew. There is still more research that needs to be done to figure out and an exact reason for this cause.” No connection to vaccination and 5. autism Because autism spectrum disor-
der is still something that is not readily talked about in various circles, there are a few myths that continue to stand out. Even in television shows some people with autism are shown in a stereotypical and one-dimensional lens. “It is essential that people know there is no correlation between vaccines and children having autism,” said Hartley-McAndrew. “In fact, there has been various scientific studies published in March 2019 that disproves any theory that vaccines trigger autism. This was a study in Denmark where 600,000 children were examined. Hopefully people understand that this is just a myth.”
la said. For some children, the same pajamas, teddy bear, blanket or other objects associated with sleeping help them settle because they’ve added them to the routine. Panzarella added that environmental factors conducive to good sleep are highly individual. “Our kids on the spectrum have so many sensory sensitivity issues,” Panzarella said. “If your child could be distracted at night, heavy curtains can block the light.” Those who are noise sensitive may find white noise or a fan unbearable, as well as ambient sounds from outside the room. Thick carpeting, soft wall hangings and sound-absorbing ceiling material can help absorb sounds from the rest of the household with a later bedtime. “It may make sense to move their bedroom to a quieter area of the house,” Panzarella suggested. Consider the room’s temperature, as well as the bedclothes and pajamas. It’s difficult to sleep in an overly warm bedroom. Many of the steps towards better sleep are simple and inexpensive; however, maintaining them consistently is key to achieving better sleep.
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Support Group Provides Comfort for ‘Invisible’ Illness Sufferers Young people dealing with serious physical ailments bond over interactive games By Daniel Meyer
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hey are young. They are sick. But they are not invisible, even if they are struggling with challenging health conditions described by some medical experts as “invisible” illnesses. Diagnosed with diseases that include chronic fatigue syndrome, mitochondrial myopathy and fibromyalgia, members of the Invisible Illness Game Night Meetup Group gather on a monthly basis to comfort and support one another as each individual battles with health problems that cause extreme obstacles in their day-to-day lives. “We have people who are dealing with some serious conditions that include different types of cancer, Lyme disease, Chrohn’s disease, lupus and thyroid disorders,” said Ryan Gurnett, who founded and leads the monthly get-togethers at Denny’s on Genesee Street in Cheektowaga. “The levels of pain, the discomfort, and the uncertainty of knowing if you will ever overcome what is ailing you. These are serious issues that need to be addressed and what better way to do that than to spend some time with other people who are going through some of the same things you are experiencing.” Gurnett, who was diagnosed with fibromyalgia and mitochondrial myopathy, has dealt with symptoms of both conditions since elementary school — severe discomfort that only intensified as he went through high school and college. Even now at age 37, the lifelong Hamburg resident faces constant obstacles that impact what he is able to do on a daily basis. “There are certain times that can be a real challenge,” said Gurnett. “I may not look sick to someone — that’s where the ‘invisible’ label comes in — but I have my moments
where things can be a struggle. That’s why I got this group up and running and I’m glad that it’s there for myself and any of our members who need to talk about what they are going through.” The Invisible Illness Game Night Meetup Group is open to men and women between the ages of 18 and 45 with chronic illnesses. The group boasts a membership of close to 100 people, with close to two dozen “active” members who regularly gather in a reserved room at Denny’s to converse, share a meal and play interactive games. It’s all done in an effort to comfort one another and also learn how each person handles their ailments both personally and professionally. “Getting to talk to everybody and having that regular socialization is very important to me,” said Crystal Fudalik, a 37-year-old East Aurora native now in Tonawanda and living with from fibromyalgia and mitochondrial myopathy. “It’s an incredible support group that has helped me in so many different ways. We are friends who are able to trust one another and share specific details about what we are dealing with. It really is incredible.” The games provide the entertainment value of the group’s regular get-togethers, but for some members playing Cards Against Humanity or Sushi Go don’t necessarily drive them to attend the monthly gatherings. “Honestly, my interactive game interest isn’t very high,” said Christy Hummel, a 30-year-old Tonawanda native who resides in Amherst, diagnosed with fibromyalgia and mitochondrial myopathy. “The reason I go every month is for the discussions. Whether they are about
Members of Invisible Illness Game Night Meetup Group at a regular monthly meeting at Denny’s on Genesee Street in Cheektowaga. someone’s latest diagnosis, an upcoming appointment with a specialist or the different symptoms they have, just being able to talk to one another is an amazing opportunity that I look forward to, especially if I’m having a rough time or someone else is dealing with something incredibly difficult.” Always looking to grow the group, Gurnett said scheduling special events outside of the monthly meetings was a natural evolution for the diehard participants. “We’ve kind of all become best friends,” said Gurnett. “What that means is we do other things outside of the meetup group. We hang out together on a pretty regular basis. We go to baseball games in the summer, we check out local escape rooms, and we plan other fun outings throughout the year.” Anyone diagnosed with an invisible illness in the 18 to 45 age bracket looking for like-minded people are encouraged to reach out and learn if the peer-to-peer support group for chronic illnesses would help them.
Members of Invisible Illness Game Night Meetup Group enjoying time together at a Buffalo Bisons game. From left are Joe Kendall, Ryan Gurnett, Kelly Gurnett, Crystal Fudalik and Jenn Offhaus. Page 12
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“We are the most laid-back support group that I’ve ever been a part of,” said Hummel. “If anyone wants to check us out I strongly encourage it because the benefits could be really impactful. We’re here to listen, to provide advice and to be there for anyone who thinks they would get something out of it. We are a fun bunch of people who are always looking to grow the group and make new friends.” More information about joining the Invisible Illness Game Night Meetup Group can be obtained by visiting www.meetup.com/InvisibleIllnessGameNight or by calling (716) 880-0404.
Ryan Gurnett, founder of the Invisible Illness Game Night Meetup Group.
SmartBites
The skinny on healthy eating raise good cholesterol and lower bad cholesterol, and phosphorous, which helps regulate heartbeat and muscle contractions, contribute to heart health. And now for the bad. Ham — versions that are not reduced-sodium, that is — can be loaded with sodium. Loaded! We’re talking around 1,200 milligrams in a 4-ounce serving, which is almost all of the 1,500-milligram recommended daily limit for people with high blood pressure and over half of the 2,300-milligram limit recommended for healthy people. Consuming too much sodium, as many know, increases your risk for high blood pressure and heart disease. Also bad: Processed meats, like ham, can increase your risk for numerous health problems. Studies show that consumption of these cured meats has been linked to a higher risk of heart disease, Type 2 diabetes, and certain cancers. The nitrates used to preserve processed meats and improve the flavor are known carcinogens.
Ham: The Good, the Bad, and the Better Choices
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s eating ham healthy? It’s certainly something to ponder, whether ham only makes a holiday appearance at your table or is a regular indulgence. Truth is, compared to other meats, ham — the cut of meat from a hog’s hind leg that’s preserved by curing — gives many nutritionists pause. But with Easter right around the corner and ham being a crowd favorite, let’s say we start with the good! Ham, like all meat, is an excellent source of complete protein, with a 4-ounce portion serving up around 20 grams. An important component of every cell of the body, protein is needed to build and repair tissues, as well as make enzymes, hormones and other body chemicals. And while we often associate greater protein needs with growing bodies, research is increasingly showing that pumping up your protein — no matter
your age — can boost your health and help prevent a decline in muscle mass with aging. Along with thwarting weakness as we head into our twilight years, maintaining muscle mass has another powerful benefit: it decreases the risk of fracture from falls. Ham, especially lean ham with its fat trimmed away, is relatively low in fat and calories, which is good for those watching their weight and fat intake. An average 4-ounce serving, for example, has only 120 calories and about 4 grams of total fat, of which only 1 gram is saturated fat. Three more good reasons to eat ham, notwithstanding its delicious flavor? Ham delivers healthy doses of selenium, niacin and phosphorous. While selenium plays an important role in the health of our immune system, both niacin, which helps
Honey-Balsamic Glazed Ham with Garlic
Adapted from Eatwell 101 (serves 12-15)
1 (5-6 pound) cooked bone-in ham (uncured, if available) 40 garlic cloves (about 4 heads) 2 tablespoons olive oil 3/4 cup water 1 tablespoon balsamic vinegar 1 tablespoon honey 2 tablespoons Dijon mustard 1 tablespoon chopped fresh rosemary or 1 teaspoon dried rosemary, crushed 1 tablespoon chopped fresh thyme or 1 teaspoon dried thyme Coarse black pepper, to taste Preheat oven to 350°F. Score ham in a diamond pattern by making shallow diagonal cuts at 1-inch intervals. Place ham, cut side down, on a rimmed baking sheet lined with foil. Set aside. Meanwhile, soak garlic cloves in
Healthy tips
Eat ham in moderation. Choose lean, uncured (nitrate-free), low-sodium ham whenever possible. Uncured cooked ham is preserved with a celery juice-sea salt mixture that has naturally occurring nitrites, making it less harmful. Many groceries now carry healthier ham versions. When preparing ham, consider using less salt, less sugar, and ingredients that are lower in both. boiling water and simmer for 3 or 4 minutes. Drain from boiling water and rinse under cold water. Remove skin from cloves; it should come off easily. Pat dry, if moist. Heat olive oil over medium heat in small skillet; brown garlic gently for a couple of minutes until golden, stirring frequently to avoid burning. Remove garlic and set aside. In the same skillet, combine water, balsamic vinegar, honey, mustard, rosemary, thyme, and pepper and bring to a simmer. Cook for 5 minutes until the sauce thickens. Add garlic back to the glaze and cook for 2 minutes more. Remove from heat. Brush ham with about 1/3 of the honey-balsamic glaze, tent with foil, and bake for 50 minutes. Remove foil tent, brush with another 1/3 of the glaze, add garlic to the pan around the ham and bake for an additional 50 minutes. Remove from oven and let rest 10 minutes. Serve sliced ham with remaining glaze and garlic on the side.
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.
Obesity and Diabetes: Your Health Is in Your Hands Expert: Move every day, exercise and eat right By Kelly Cardamone
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besity is one of the most pressing health issues facing the US today. According to the 2015-16 National Health and Nutrition Examination Survey (NHANES), 18.5 percent of children and 39.6 percent of adults are obese, defined by a body mass index (BMI) over 30. Obesity is the leading risk factor for Type 2 diabetes. More than 100 million adults in the US live with prediabetes/diabetes, according to the CDC, increasing the risk of developing conditions such as heart attack or stroke, kidney disease, neuropathy and diabetic retinopathy. The good news is the symptoms and conditions can be managed or,
even, prevented. Your physician and pharmacist control oral or injectable medications and insulin, but diet, exercise and weight loss are under your control and can help manage or prevent the occurrence of diabetes. A registered dietitian or a certified diabetes educator can help you safely set goals for diet, exercise and weight loss. The rewards are measurable. Modest weight loss can reduce blood pressure, improve blood cholesterol and blood glucose levels, and decrease insulin resistance. Finding the right diet and lifestyle is both a science and an art and it is unique to each person. The basic principles are the same — eating fewer calories and moving more
every day. To manage diabetes and see results, you need to make lifestyle changes: • Establish healthy eating habits. Eat low saturated fat and healthy fats — sunflower seeds, olive oil, avocados and almonds. Aim for 5-7 servings of fruits and vegetables a day, fiber-filled whole grains, lean proteins, low-fat dairy products and consume less sugar. • Increase physical activity. There are 1,440 minutes in the day, try to take at least 20 to 30 minutes five days per week to get your heart pumping. Utilizing a registered dietitian or certified diabetes educator can help create the best plan based on your health status, lifestyle, and goals, but it is essential to be under the care of your primary care physician to address any health issues or concerns.”
April 2019 •
Learning to control obesity and diabetes, is essential to living a healthy life. Move every day, exercise and eat right. Kelly Cardamone, a former marathon runner, is a registered dietitian and certified diabetes educator with General Physician, PC, in Williamsville. She has more than 20 years of expertise in health and wellness field and extensive experience providing nutritional counseling. For more information, visit www. gppconline.com
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Personal Assistant Careers Can Start Among Family and Friends By Jennifer Redding
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o you know someone or have a relative whose health care and household needs are not being met? Are you currently caring for a friend or family member in your free time or on a full-time basis, but you are not being paid to provide this work? There is a solution. New York state offers a program for residents who are on Medicaid that empowers individuals to manage their home health care by hiring a family member or friend to work as their personal assistant. This initiative, the Consumer Directed Personal Assistant Services (CDPAS), is growing across Western New York. CDPAS is a unique service that allows members to retain more control of their lives by choosing a person they trust to assist them in addressing their needs, routines and tasks (the hired assistant cannot be a spouse or financially
New York state offers a program for residents who are on Medicaid that empowers individuals to manage their home health care by hiring a family member or friend to work as their personal assistant. responsible for the individual). CDPAS is a benefit that offers long-term value for Medicaid members to rely on someone they know and love at no cost to them. The program is delivered through health care agencies that assist members with enrollment and coordination of their personal assistant plan. The agency oversees the payroll and administrative functions after the member
selects a relative, friend or neighbor as his or her employee to fulfill a variety of responsibilities. The goal of CDPAS is to give people who are chronically ill or disabled additional support with daily activities or skilled nursing services. Individuals with a stable medical condition who are authorized for home care services are eligible to take an active role in hiring and supervising their personal assistants. After members hire their assistants, their lives become easier to manage, and they begin to see the rewards through overall health, comfort and happiness. Under a member’s direction, the assistant commits to a schedule and takes on numerous household and health management duties, including laundry, dressing, bathing, providing medicine, giving insulin shots, transportation, grocery shopping and meal preparation. The situations between member and assistant may vary, but the working relationship is designed to create similar mutually-beneficial satisfaction and productive outcomes. Scenarios could involve an adult caring for their parent full time or a semi-retired neighbor who is willing to help a friend for a specific amount of time each week while earning
Career: Diagnostic Medical Sonography Career requires only an associate’s degree. It pays about $70K By Deborah Jeanne Sergeant
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ould you like a career in a medical field that requires an associate’s degree but starts at around a $70,000 salary in the Rochester area? Consider becoming a diagnostic medical sonographer — or a technician who takes ultrasound images for physicians. In addition to a healthy return on investment, the career offers a job outlook of 17 percent growth from 2016 to 2026, considered “much faster” than other jobs by the Bureau of Labor Statistics. Chelsea Pino, sonographer with University of Rochester Medical Center, works mostly in the children’s Page 14
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hospital. She had always wanted to work in a medical field and after shadowing a sonographer, she realized it was the right fit for her. “I like the availability of options,” she said. Many people stereotypically picture the sonographer as the person who takes ultrasounds of their baby before birth; however, the career has many other options, too. Sonographers work in hospitals, doctor’s offices, and non-medical boutiques that offer sonography sessions for families to “meet” their new baby before birth (although this sub-specialty isn’t diagnostic in nature). The medical specialties include
vascular, ophthalmology, cardiac, pediatric and many more. Pino believes that attention to detail, personal drive and compassion are all “soft skills” that can benefit sonographers. “We have to take it upon ourselves to tell the doctors what we’re finding on the images,” Pino said. “The ‘people’ aspect is a big aspect. Some of that is learned on the job.” She completed Rochester Institute of Technology’s four-year program and completes continuing education credits to keep her credential and stay up-to-date. “I like the interaction with patients,” she said. “If you give them
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
extra income. Personal assistant programs inspire members to actively lead the decision-making in managing their home health care. Instead of living with an “ask for help as things come up” approach, the CDPAS benefit provides the reliability of a schedule and expectations that members prepare for their assistants. Members enjoy increased independence and more consistent care from someone who knows them well, and this valued partnership goes a long way to keeping them happy at home. For more information about CDPAS , call716-274-5000. Jennifer Redding is the vice president of Liberty Home Care, a New York statelicensed home care agency that provides services and durable medical equipment to Western New Yorkers with a variety of health care needs.
a good experience, that’s a lasting memory.” Hamad Ghazle with Rochester Institute of Technology, sees plenty of demand, “locally, regionally and nationwide” for sonography. “Ultrasound is really becoming widespread in many parts of the world,” Ghazle added. “The demand is everywhere. The statistics show the demand will continue to increase into the future.” Ghazle is program director, professor and advanced practice sonographer with the Diagnostic Medical Sonography Program at the College of Health Sciences and Technology at RIT. The school offers an ultrasound program accredited by the Commission on Accreditation of Allied Health Programs. It includes a certificate in general and cardiac sonography and a bachelor’s degree in sonography, though in New York, only an associate’s degree is required before sitting for the required certification exam. At RIT, students receive clinical training and classroom instruction. A strong aptitude in science may be helpful. “They use the latest technology and work in a an outstanding, vibrant environment,” Ghazle said. “As you work in this field, you’re challenged on a daily basis to provide the best care, best examination and provide high quality diagnostic images.” He believes that the work includes elements of other professions, including medical engineering, industrial engineering, mechanical engineering and medical care. Other related opportunities could include managing, education and working for companies that build and sell the equipment. Ghazle said that repetitive motions when performing ultrasounds can result if technicians don’t use proper ergonomics. Because of the high demand, another challenge is the size of the workload for some people. “The field is increasing all the time,” Ghazle said.
Photos courtesy of Donna Stewart Photography.
Russ Salvatore is thanked by Jonathan A. Dandes, right, chairman of the ECMC board of directors after he donated $1 million to the hospital.
Salvatore standing near a plaque at the John R. Oishei Children’s Hospital. All TV sets at the children’s hospital were donated by him.
The Consummate Philanthropist Russell Salvatore’s generosity continues to benefit Buffalo hospitals, community. Total donations amount to $9 million By Michael J. Billoni
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hen Russell J. Salvatore slipped on ice leaving his accountant’s office eight years ago, he knew something wasn’t right with his ankle as he got himself into his car for the short ride back to Russell’s Steaks Chops & More in Williamsville. When he attempted to get out, he fell and could not get up. After what seemed like an eternity to him, his grandson, Robert, discovered the founder and chairman of the famous restaurant and hotel on Transit Road on the cold ground in serious pain. Nearly the entire Bowmansville Volunteer Fire Department arrived after 911 was called. Jody Lomeo, then CEO of the Erie County Medical Center, was alerted that his good friend and hospital supporter was en route to the facility with a broken ankle. “It was embarrassing when they wheeled me into the emergency room. There were so many white coats around me I felt like the president of the United States,” Salvatore recalls. What followed was a perfect operation by Christopher Ritter, but as Salvatore recuperated in his hospital room, little did he realize he suffered the most expensive broken ankle ever. It had nothing to do with the cost of the procedure or the room at ECMC. However, as the cost continues to grow today, Salvatore couldn’t be happier. It all began when he was in his hospital bed recuperating and he wanted to watch TV. First, he did not understand why they had such small box TVs in patients’ rooms and was appalled to learn it costs $8 a day to
watch TV. He asked for a meeting with Lomeo, now the CEO of Kaleida Health, and Sue Gonzalez, executive director of the ECMC Foundation. After a brief conversation, Salvatore proposed a unique donation idea: He would replace each TV with a new flat-screen and eliminate the fee. Once news got out about his generous donation, a restaurant customer said her mother was in Roswell Park suffering from cancer and they were charging her to watch TV. “I just couldn’t believe it,” he said. “Patients suffering from the worst sickness in the world and they have to worry about paying to watch TV. I then made it a point to replace every television located in Western New York hospitals and for fees to end.” Compliments of Salvatore, 2,861 TVs have already been replaced in nearly every WNY hospital room at a cost of more than $3 million. He is in discussions with the final two — Kenmore Mercy and Mount St. Mary’s in Lewiston. Salvatore and Mark Jerge, his vice president-general manager of the restaurant and the Russell J. Salvatore Foundation, has calculated that based on an average of four viewers per day in each hospital room, the gift is providing more than 4.1 million people annually the opportunity to watch TV for free during their hospital stays.
Let there be TV “When you are hospitalized, your connection with the outside world is cut off. Watching television helps to keep you occupied,
entertained and informed,” explains Matthew Clark, who operates a local dance studio and who was in ECMC for a month in 2014 after suffering a massive stroke.
Watching TV on a big flat screen for free at your local hospital? You may owe that to philanthropist Russell J. Salvatore, who has bought 2,861 TV sets that were installed in nearly every WNY hospital room at a cost of more than $3 million. That’s just one of the ways he’s making a difference in the community. He has donated more than $9 million so far.
April 2019 •
He is fully recovered, calling it his “ECMC Miracle.” “Thank you, Mr. Salvatore, for your generous gift that made my stay a little more bearable,” he said. Salvatore’s foundation also funded the Russell J. Salvatore Orthopedic and Rehabilitation Floor at ECMC and last year, he committed $1 million to construct the Russell J. Salvatore Atrium Lobby as part of the hospital’s major renovation. Salvatore’s philanthropy goes beyond local hospitals. He comes to the aid of the American Red Cross, the Veterans Administration Hospital and numerous veterans’ causes; the new University at Buffalo’s downtown medical school; the Kevin Guest House, St. Luke’s Mission of Mercy and the Miracle League, to name a few. “Some of my dad’s blood is in me,” he said. His father owned Salvatore’s Restaurant on East Delavan when he was growing up. “He used to give four-foot chocolate bunnies to my friends every Easter and I would drive with him to Precincts 11 and 16 to deliver Thanksgiving and Christmas gifts. “We ask for my name on the buildings, so 20 years from now when they ask, ‘Who is Russ Salvatore?’ they will say, ‘A club owner who worked hard, made a lot of money but gave every penny away to the community that has supported him very well.’” Jerge, who has been with Salvatore for 21 years, says, “The uniqueness of his desire to help as many people as he can, to the point of spending down his savings, is absolutely amazing. He is doing it now so he can see first-hand the people of Western New York experiencing his generosity. He often refers to it as a debt he owes the community for their 70 years of support.” Salvatore, who greets hotel guests enjoying a complimentary hot breakfast at 9 a.m. and says good night to those who are leaving the restaurant at 10 p.m., is often asked for his secrets to good health. “Work hard. Don’t retire. Drink enough vodka, have a steak every night and two to three cigarettes a day. It won’t hurt you,” he said with a laugh. “Seriously, good health comes from the man above. If you are honest, fair and treat people well, he will reward you with good health.” As Salvatore said: Be his guest and let him do the rest.
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Women’s Health
Dramatic Fall in Number of Births in the U.S. Local experts: Many factors are believed to cause shrinking birthrate, which is at the lowest level in 30 years By Deborah Jeanne Sergeant
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f it seems that people are having smaller families, you’re right. The Centers for Disease Control and Prevention recently reported that the rate of childbirth dropped for nearly every age group of reproductive-age US women in 2017, reaching the lowest levels in 30 years. According to the US Census, the US birthrate in 2017 decreased to 60.2 births per 1,000 between the ages of 15 and 44, which represents a 3 percent drop from the birthrate in 2016. In 2017, the nation experienced 3.853 million births, approximately 92,000 less than the year before. What’s most concerning is that birth declines tend to happen during times of war or economic hardship, not when unemployment is down and the economy is improving such as in recent years. Since 1971, the nation isn’t producing enough children to replace those who have died, a trend also noted by the census. Numerous factors contribute, both physical and societal. “I definitely feel it is cost of living and that there is not as much support to watch the children when both parents are in the workforce,” said Bridget Gilewski, registered
radiologic technologist and diagnostic medical sonography instructor at Trocaire College. “Childcare costs are high — as they should be, they are watching our children — but it can definitely alter the family lifestyle when child care costs are figured in,” she added. Since the women’s rights movement, marrying and having children hasn’t been the expected and main option for women of childbearing years. Pursuing education and career are also options, but they tend to delay childbearing for those who do become mothers. “For birth control, there are great choices and methods are implemented and many women are waiting to have children until they are financially stable,” Gilewski said. Easier access to contraceptives and abortion, plus fewer teen pregnancies, also play a role in reducing births. For those who want to have children, Adam Griffin, board-certified reproductive endocrinologist with Buffalo IVF in Buffalo, said that maintaining overall health is vital to maximizing their chances of fertility, including a healthy weight, healthful diet, regular exercise and eschewing
tobacco use and excessive alcohol. Patient treatment plans all start with a basic fertility analysis and an ovarian reserve test to see the number and quality of eggs. “Women are born with a finite number of eggs and we see a slow, steady decline through menopause,” Griffin said. “Hormonal studies give predictors. While there’s no test that says they can’t be successful, it tells us how aggressive we can be in treatment.” Buffalo IVF also analyzes semen to ensure there’s no male factor involved. There’s also anatomic analysis for both partners. “Typically, in about 60 percent of couples, those basic tests will show why they’re having difficulty in conceiving,” Griffin said. “They may also have unexplained infertility. Based upon their fertility evaluation covers, we use that to look at what treatment they should pursue.” Ashlyn Pardee, acupuncturist with Acupuncture Buffalo, supports fertility through acupuncture. Most
Are Some Birth Control Methods Doomed to Fail?
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omen who get pregnant when using certain contraceptives might have their genes to blame, a new study suggests. A gene variant that breaks down hormones in birth control could be the culprit, researchers reported. “When a woman says she got pregnant while on birth control, the assumption was always that it was somehow her fault,” said lead study author, physician Aaron Lazorwitz. “But these findings show that we should listen to our patients and consider if there is something in their genes that caused this.” According to Lazorwitz, an assistant professor of obstetrics and gynecology at the University of Colorado School of Medicine, “The findings mark the first time a genetic variant has been associated with birth control.” Contraceptives are not 100 percent effective, but the reasons they fail are not fully understood. The new study included 350 healthy women, half older than 22.
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All had a contraceptive implant in place for between 12 and 36 months. Five percent of the women had a gene called CYP3A7 1C, which is usually active in fetuses and then switched off before birth. But some women with this gene continue to make the CYP3A7 enzyme into adulthood, the study authors noted. “That enzyme breaks down the hormones in birth control and may put women at a higher risk of pregnancy while using contraceptives, especially lower-dose methods,” Lazorwitz said in a university news release. The gene variant can be found through genetic screening, he added. Pharmacogenomics is a relatively new field that focuses on how genes affect a person’s response to drugs. The study shows how this field could dramatically change women’s health, “especially in light of the social, financial and emotional consequences of contraceptive failure,” the researchers noted. The report was published March 12 in the journal Obstetrics & Gynecology.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
receive acupuncture to complement standard fertility treatments. “Acupuncture has a great and gentle way of augmenting fertility,” Pardee said. “It’s part of Chinese medicine which is herbs, lifestyle and advice.” She said that acupuncture can aid in balancing hormones and supporting the health of endocrine system, ovaries, uterus and circulatory system. Clients also tend to sleep better, feel less anxious, and experience greater wellbeing. Pardee said acupuncture lowers the level of inflammatory markers. She said her patients tell her they can feel it’s helping them. “Some studies show acupuncture increases the success rate of IVF process,” Pardee said. She encourages couples interested in IVF to begin acupuncture treatments sooner than later to help support good health and improve their chances.
The recently issued report by the Centers for Disease Control and Prevention report also found:
• The rate of births to women ages 15 to 44, known as the general fertility rate, sank to a record low of about 60 per 1,000.
• Women in their early 40s were the only group with higher birth rates in 2017, up 2 percent from the year. The rate has been rising since the early 1980s. • The cesarean section rate rose by a tiny amount after having decreased four years. Studies have shown C-sections are more common in first-time births involving older moms. • Rates of preterm and low birth weight babies rose for the third straight year. • Birth rates for teens continued to nosedive, as they have since the early 1990s. In 2017, they dropped 7 percent from the year before. • Rates for women giving birth in their 20s continued to fall and hit record lows. They fell 4 percent. • Birth rates for women in their 30s fell slightly, dipping 2 percent for women ages 30 to 34 and 1 percent for women 35 to 39. Birth rates for women in their 30s had been rising steadily to the highest levels in at least half a century, and women in their early 30s recently became the age group that has the most babies. The U.S. once was among a handful of developed countries with a fertility rate that ensured each generation had enough children to replace it. The rate in the U.S. now stands less than the standard benchmark for replacement. It’s still above countries such as Spain, Greece, Japan and Italy, but the gap appears to be closing. A decade ago, the estimated rate was 2.1 kids per U.S. woman. In 2017, it fell below 1.8, hitting its lowest level since 1978. Information based on reports published in USA Today.
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Women’s Health
Hot Flashes 101
What are hot flashes?
The most common menopause-related discomfort is the hot flash . Although the exact cause still isn’t fully understood, hot flashes are thought to be the result of changes in the hypothalamus, the part of the brain that regulates the body’s temperature. If the hypothalamus mistakenly senses that a woman is too warm, it starts a chain of events to cool her down. Blood vessels near the surface of the skin begin to enlarge, increasing blood flow to the surface in an attempt to dissipate body heat. This produces a red, flushed look to the face and neck in light-skinned women. It may also make a woman perspire to cool the body down. The heart may beat faster, and women may sense that rapid heartbeat. A cold chill often follows a hot flash. A few women experience only the chill.
How long will I have hot flashes?
Most women experience hot flashes for six months to two years, although some reports suggest that they last considerably longer — as long as 10 years, depending on when they began. For a small proportion of women, they may never go away. It is not uncommon for women to experience a recurrence of hot flashes more than 10 years after menopause, even into their 70s or beyond. There is no reliable way of predicting when they will start — or stop.
I’m having a hot flash. Should I be concerned about what lies ahead?
Menopause is a fact of life for every woman around the world. However, the physical and mental impact of this physiologic inevitability varies both within and across all cultures. While there is no universal menopause experience, it can mark the beginning of an exciting new time of life for all women.
As I mature past menopause, how can I achieve the best possible health?
Get the checkups you need and maintain a healthy lifestyle. The risks of osteoporosis, heart disease, diabetes and cancer all rise after menopause. Most women visit their primary care doctor or gynecologist once a year for a “well-woman visit,” which insurance now covers with no copay. Even height, weight, and blood
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LibertyHomeCare.org / 716-274-5000 2424 Niagara Falls Blvd Niagara Falls, NY 14304
What are the treatments for hot flashes?
Although the available treatments for hot flashes do not cure hot flashes, they do offer relief. Hot flashes usually fade away eventually without treatment, and no treatment is necessary unless hot flashes are bothersome. A few women have an occasional hot flash forever. There are a number of low-risk coping strategies and lifestyle changes that may be helpful for managing hot flashes, but if hot flashes remain very disruptive, prescription therapy may be considered. Prescription hormone therapy approved by the US Food and Drug Administration include systemic estrogen therapy and estrogen-progestogen therapy (EPT; for women with a uterus) — are the standard treatment. Another FDA-approved hormone product, for women with a uterus, combines estrogen with bazedoxifene instead of a progestogen. Bazedoxifene is an estrogen agonist/ antagonist, which means that it works like estrogen in some tissues while inhibiting estrogen activity in others. In this case, it helps to protect the uterus from cancer. For women who prefer not to take hormones or cannot hormones, nonhormone drugs approved to treat depression, called selective serotonin-reuptake inhibitors (SSRIs), have been found to be effective in treating hot flashes in women who don’t have depression. The only SSRI FDA has approved thus far for treating hot flashes is paroxetine 7.5 mg.
Source: The North American Menopause Society.
Your best defense against Breast Cancer
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How to Save Money on Your Medication By Jim Miller
T You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org
he rising cost of prescription drugs is a problem that stings millions of Americans. While there’s no one solution, there are some different strategies and resources that can help reduce your drug costs, so you can afford what you need. Here are several to consider. • If you have insurance, know your drug formulary: Most drug plans today have formularies (a list of medications they cover) that place drugs into different “tiers.” Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less than a drug in a higher tier, and higher tier drugs may require you to get permission or try another medication first before you can use it. To get a copy of your plan’s formulary, visit your drug plan’s website or call the 800 number on the back of your insurance card. Once you have this information, share it with your doctor so, if possible, he or she can prescribe you medications in the lower-cost tiers. Or, they can help you get coverage approval from your insurer if you need a more expensive
drug. You also need to find out if your drug plan offers preferred pharmacies or offers a mail-order service. Buying your meds from these sources can save you some money too. • Talk to your doctor: Ask your doctor if any of the medications you’re currently taking can be reduced or stopped. And, find out if the ones you are taking are available in generic form. About 80 percent of all premium drugs on the market today have a lower-cost alternative. Switching could save you between 20 and 90 percent. • Ask for a three-month prescription: This can be significantly cheaper for drugs you take long-term. If you use insurance, you’ll pay one co-pay rather than three. • Split your pills: Ask your doctor if the pills you’re taking can be cut in half. Pill splitting allows you to get two months’ worth of medicine for the price of one. If you do this, you’ll need to get a prescription from your doctor for twice the dosage you need. • Find and use online discounts:
Safe Ways to Get Rid SMALL DONATIONS of Expired, Unused MAKE A BIG Medicine
DIFFERENCE
By Jim Miller
C
leaning out the medicine cabinet is a chore that most people don’t think about, but it’s an important task that can help prevent medication problems, and protect children who may have access to these old, unused drugs. Here’s how you can clean out your medicine cabinet so it’s safe and useful.
• Return Them
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Your local pharmacy, as well as hospitals, clinics, long-term-care facilities, and narcotic treatment programs, might accept your mom’s unused medications, often as part of programs that collect and destroy unused drugs. Search for an authorized facility near you at DisposeMyMeds. org. You can also drop off her unused meds at designated police departments, fire stations, and other sites on National Prescription Take Back Day, Saturday, April 27. To find a collection site near you, visit TakeBackDay. dea.gov.
• Use a Disposal Kiosk
Many Walgreens and CVS stores have free, anonymous, and secure kiosks where you can dispose of any medication. Remove your personal Page 18
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information from the packaging and drop unwanted medication, including opioids, in the slot.
• Mail Them
Costco, Rite Aid and CVS pharmacies sell postage-paid envelopes for customers to mail any prescription, including opioids and over-thecounter medications, to a disposal facility.
•Throw Them Out
If mailing them in or getting to one of the drop-off sites is not an option, you can dispose of them yourself, but do so carefully. The Food and Drug Administration recommends taking the medications out of their original bottles and putting them in a sealable plastic bag with an undesirable substance like coffee grounds, dirt or kitty litter. Then seal the plastic bag and throw it in the trash. This will make the medication less appealing to children, pets or other people who may fish through your trash. But don’t do this with dangerous drugs, such as opioids, which can be abused. For these, the FDA says flushing them down the toilet is
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
Start by trying GoodRx.com, BlinkHealth.com or WeRx.org. They will ask for the name of the drug, the dose, the number of pills, and where you live. Then they will show you what you can expect to pay at various pharmacies if you use their discount coupons or vouchers, which you can print out or download to your phone to show a pharmacist. • Pay cash: Most generic medications cost less if you don’t use your insurance. For example, chains like Target and Walmart offer discount drug programs that sell generics for as little as $4 for a 30-day supply and $10 for a 90-day supply if you pay out-of-pocket. While some insurance companies charge a $10 copay for a 30-day supply. Also ask your pharmacy if they offer a drug discount card program and compare costs with your insurance plan. You can also find free drug discount cards online at sites like NeedyMeds.org, which can be used at most U.S. pharmacies. • Shop online: You can also save by using an online pharmacy like HealthWarehouse.com but be sure to use an online retailer that operates within the U.S. and is licensed. The site should display the VIPPS symbol, which shows it’s a Verified Internet Pharmacy Practice Site. • Search for drug assistance programs: If your income is limited, you can probably get help through drug assistance programs offered through pharmaceutical companies, government agencies and charitable organizations. To find these types of programs use sites like BenefitsCheckUp.org, PatientAdvocate.org, RxAssist.org and NeedyMeds.org.
OK. But trace amounts of drugs can end up in the water supply so this should be done only as a last resort. To see the FDA list of medications that should be flushed when they are no longer needed, go to FDA.gov and type “flush list” into the search box. Or, another option is to purchase some medication disposal bags like the Medsaway Medication Disposal System. These are carbon pouches that are designed to neutralize all medication including narcotics, liquid medication, transdermal patches and controlled substances so you can just add water, and toss them in the trash. You can find medication disposal bags at some local pharmacies or online at Amazon.com for around $15. You’ll also want to make sure to scratch out all your mom’s personal information on the empty medicine bottles or other packaging before throwing it away to protect her identity and privacy. If you have other questions about proper drug disposal, talk to your pharmacist.
Senior Living Community Stimulating Social, Educational and recreational activities Medication management Access to 24-hour personal care assistance Affordable memory care
By Jim Miller
Does Medicare Covers Vision Services? Dear Savvy Senior, I will be enrolling in Medicare in a few months, and would like to know how Medicare covers vision services? I currently have vision insurance through my employer but will lose it when I retire.
Looking Ahead Dear Looking, Many people approaching 65 are unclear on what Medicare does and doesn’t cover when it comes to vision services. The good news is that original Medicare covers most medical issues like cataract surgery, treatment of eye diseases and medical emergencies. But unfortunately, routine care like eye exams and eyeglasses are the beneficiary’s responsibility. Here’s a breakdown of what is and isn’t covered. • Eye exams and treatments: Medicare does not cover routine eye exams that test for eyeglasses or contact lenses. But they do cover yearly medical eye exams if you have diabetes or are at high risk for glaucoma. They will also pay for exams to test and treat medical eye diseases if you’re having vision problems that indicate a serious eye problem like macular degeneration, dry eye syndrome, glaucoma, eye infections or if you get something in your eye. • Eye surgeries: Medicare will cover most eye surgeries that help repair the eye function, including cataract surgery to remove cataracts and insert standard intraocular lenses to replace your own. Medicare will not, however, pick up the extra cost if you choose a specialized lens that restores full range of vision, thereby reducing your need for glasses after cataract surgery. The extra cost for a specialized lens can run up to $2,500 per eye. Eye surgeries that are usually not covered by Medicare include refractive (LASIK) surgery and cosmetic eye surgery that are not considered medically necessary. • Eyeglasses and contact lenses: Medicare does not pay for eyeglasses or contact lenses, with one exception: If you have had a conventional intraocular lens inserted during cataract surgery, Medicare will pay for eyeglasses or contact lenses following the operation. Ways to Save Although original Medicare’s vision coverage is limited to medical issues, there are ways you can save on routine care. Here are several to
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check into. • Consider a Medicare Advantage plan: One way you can get extra vision coverage when you join Medicare is to choose a Medicare Advantage plan instead of original Medicare. Many of these plans, which are sold through private insurance companies, will cover routine eye care and eyeglasses along with all of your hospital and medical insurance, and prescription drugs. See Medicare.gov/find-a-plan to shop for plans. • Purchase vision insurance: If you get routine eye exams and purchase new eyeglasses annually, a vision insurance plan may be worth the costs. These policies typically run between $12 and $20 per month. See Ehealthinsurance.com to look for plans. • Check veterans benefits: If you’re a veteran and qualify for VA health care benefits, you may be able to get some or all of your routine vision care through VA. Go to Vets. gov, and search for “vision care” to learn more. • Shop around: Many retailers provide discounts — between 10 and 30 percent — on eye exams and eyeglasses if you belong to a membership group like AARP or AAA. You can also save by shopping at discount retailers like Costco Optical, which is recommended by Consumer Reports as the best discount store for good eyewear and low prices — it requires a $60 membership fee. Walmart Vision Centers also offer low prices with no membership. Or consider buying your glasses online. Online retailers like WarbyParker.com, ZenniOptical. com, and EyeBuyDirect.com all get top marks from the Better Business Bureau and offer huge savings. To purchase glasses online you’ll need a prescription. • Look for assistance: There are also health centers and local clinics that provide free or discounted vision exams and eyeglasses to those in need. To find them put a call into your local Lions Club (see Directory. LionsClubs.org) for referrals. 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.
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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Do you have glaucoma or high eye pressure? If so, you may qualify for a new investigational eye drop research study! If you have previously been diagnosed with glaucoma or increased eye pressure and are at least 18 years of age, we invite you to participate. The study involves 7 office visits over the course of approximately 11 weeks. You may be compensated for your time and travel.
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Don’t Miss the May Issue of In Good Health Special issue highlighting Golden Year’s, Nurse’s Week, Eyecare / Hearing, Skin Issues, Allergies and much more. To advertise and reach nearly 1000,000 readers, please call 716-332-0640 or send an email to editor@bfohealth.com
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From the Social Security District Office
How Social Security Decides If You Still Have a Qualifying Disability
S
ocial Security is required by law to review, from time to time, the current medical condition of all people receiving disability benefits to make sure they continue to have a qualifying disability. Generally, if a person’s health hasn’t improved, or if their disability still keeps them from working, they will continue to receive their benefits. These continuing disability reviews help us ensure that only eligible people receive disability benefits. It supports the integrity of the Social Security system while delivering fair services to wounded warriors, chronically ill children and adults and other people with disabilities. To help us make our decision, Social Security first gathers new information about an individual’s medical condition. We’ll ask their doctors, hospitals and other medical sources for their medical records. We’ll ask them how their medical condition limits their activities, what
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Q: I usually get my benefit payment on the third of the month. But what if the third falls on a Saturday, Sunday, or holiday? Will my payment be late? A: Just the opposite. Your payment should arrive early. For example, if you usually get your payment on the third of a month, but it falls on a Saturday, we will make payments on the Friday prior to the due date. Find more information about the payment schedule for 2019 at www. socialsecurity.gov/pubs/calendar. htm. Any time you don’t receive a payment, be sure to wait three days before calling to report it missing. To ensure that your benefits are going to the right place, create a my Social Security account. There, you can verify and manage your benefits without visiting your local office. Please visit www.socialsecurity.gov/myaccount to create your account. Q: I suspect that someone I know is collecting Social Security disability benefits when they shouldn’t be. What is the best way for me to report fraud? A: You can report fraud online at www.oig.ssa.gov/report or call the Social Security Fraud Hotline at 1-800-269-0271. Social Security has zero tolerance for fraud and uses many proven tactics to prevent fraud, waste and abuse. Our Office of the Inspector General is relentless in its
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
their medical tests show and what medical treatments they’ve been given. If we need more information, we’ll ask them to get a special examination or test, for which we’ll pay. If we decide their disability benefits will stop, and they disagree, they can appeal our decision. That means they can ask us to look at their case again. When they get a letter telling them about our decision, the letter will tell them how to appeal the decision. You can read more about how we decide if you still have a qualifying disability at www.socialsecurity.gov/ pubs/EN-05-10053.pdf. People can check the status of their disability application with a personal my Social Security account at www.socialsecurity.gov/myaccount. This secure account gives people access to many tools that can save them time. Find out how Social Security is securing today and tomorrow at www.socialsecurity.gov.
pursuit of people who conceal work activity while receiving disability benefits. We investigate and seek prosecution for people who receive benefits for a child or children who aren’t under their care, or who fail to notify Social Security of the death of a beneficiary and continue to receive and cash checks of the deceased. We also depend on you to help stop fraud. Q: I own a small business. How can I verify employees’ Social Security numbers? A: Employers can use our Social Security Number Verification Service to verify the names and Social Security numbers of current and former employees for wage reporting purposes. For more information, go to www.socialsecurity.gov/employer/ssnv.htm. Q: What is the earliest age I can begin receiving Social Security retirement benefits? A: The earliest age you can begin receiving Social Security retirement benefits is age 62. If you decide to receive benefits before your full retirement age, which for most people is age 66 or 67, you will receive a reduced benefit. Keep in mind you will not be able to receive Medicare coverage until age 65, even if you decide to retire at an earlier age. For more information, go to www. socialsecurity.gov/retire.
7
Questions to John Radford, MD, owner and founder of Buffalobased WellNow Urgent Care With recent acquisition and new sites, WellNow today has more than 30 facilities in NYS. Owner, who launched the business in 2012, plans to open 14 new locations this year alone, including some around Chicago By Payne Horning Tell us a little about your back1. ground in health care. I am an emergency room doctor
turned healthcare entrepreneur. In my almost 20 years as an entrepreneur, I have been driven to find ways to keep patients healthy and safe in a rapidly changing health care industry. Appropriately, the companies I’ve founded share a common commitment to offering quality care that is accessible, affordable and quick. I’ve always believed that patients come first. How did your experience in 2. the industry contribute to your decision to create a chain of urgent-care
facilities? In my time working in the emergency room, I worked closely with health systems, doctors and patients. This gave me a firsthand appreciation for the challenges faced by healthcare practitioners and patients. It’s an up-close experience, and you truly empathize with the emotional and financial complexities that patients face. I saw an opportunity to provide greater and convenient access to non-emergent care that put patients first. This inspired me to create Five Star Urgent Care, which today is WellNow Urgent Care. Since 2012, your company has 3. quickly expanded its presence in New York state – and continues to grow today. Was that expansion and large footprint always part of the plan? From our earliest beginnings, we have always been committed to serving communities where there is a need for greater access to quality
urgent care. Our growth is a reflection of the rapidly growing urgent care industry across New York state. It connects directly to how we provide our communities’ residents with greater access to quick and convenient medical care for non-life-threatening injuries and illnesses. Today, we have more than 30 locations and are one of New York’s fastest growing urgent care providers. We are very proud of that. WellNow Urgent Care is not currently located outside New York state but we do have plans to expand to the Illinois area with locations in Crestwood and Evergreen — both suburbs of Chicago — in 2019. In October, Five Star rebrand4. ed itself as WellNow. Why the change and what does it represent?
The name “WellNow” ties back to our company’s strong history of putting the needs of our patients first. We believe the new brand best aligns with our mission of providing high quality, quick and convenient urgent care. It also reinforces our focus on empowering every patient when it comes to managing their healthcare decisions about where, when and how they receive treatment. For us, the name is a true representation of our service and our standards of getting patients and their families back to being well. Now. How is WellNow addressing the 5. medical needs of Upstate New York?
The urgent care industry continues to grow, both in Upstate New York and across the country. As a
Physician John Radford during the opening of a WellNow Urgent Care in Vestal. Radford is the founder and owner of WellNow, which has more than 30 locations in New York, mostly Upstate. He’s planning 14 new facilities this year, including in the suburbs of Chicago. He started the business in 2012. Western New York native and longtime healthcare practitioner, I’ve seen it firsthand and saw the need for an urgent care network that can match this region’s growing demands for quality care. This is especially true for smaller communities where it’s common for care to be less accessible. We address this in a few ways. WellNow employs highly talented and experienced urgent care providers. We have more than 600 employees, which include 95 percent full-time staff. This allows us to truly get to know our business, so that we can deliver quality, convenient care with consistency. Our recent growth, which includes Western New York’s MASH Urgent Care joining our network, also means that we are able to serve an even greater number of communities — both in Upstate New York and across the state. What role does urgent care play 6. in the larger health care industry, and has it changed at all in recent years?
As the urgent care industry continues to grow, we are always looking for ways to stay ahead of our field by continually making ourselves available to patients. For example, demand for urgent care clinics is growing rapidly. Patients seeking medical care often don’t want to wait. By offering longer
hours, walk-in service and the opportunity to check in online, urgent care centers can fulfill patients’ needs in a way that traditional doctors’ offices often cannot. Financial burden is another consideration. Urgent care centers can sometimes provide an alternative to emergency departments and facility fees. It’s a way to provide middle ground to care for non-emergent needs. We’re cognizant of all of these things — capacity, hours, convenience and more. We don’t take our status for granted and are always looking for new ways to stay connected with patients. Trust is earned, not to be expected. What is next for WellNow? 7. We are continuing to grow. Looking ahead, we have
plans to open approximately 14 new locations in 2019 which will allow us to further deepen our connections across New York state, while also starting to expand into Illinois. Through it all, our commitment to putting patients first will never change. We deeply value the strong relationships with communities and individuals we serve. This passion is what brings us to work, every day.
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H ealth News PA program at Daemen among nation’s best
Daemen College’s physician assistant studies program has been recognized as one of the best in the country in the U.S. News & World Report’s 2020 Best Graduate Schools rankings. Daemen is tied for No. 74 in the newly released rankings, placing it among the 100 best physician assistant programs in the United States and one of only two in the Buffalo Niagara region named to the list. Daemen joins other distinguished institutions in the latest annual rankings, including Duke, Cornell, Gannon, and Yale universities, and Albany Medical College. “This prestigious ranking is a reflection of the exceptional academic quality of our physician assistant studies program, high caliber faculty and students, and our college’s growing national reputation as a premier health care educator,” said Daemen President Gary Olson. “We are proud to have Daemen recognized with other elite institutions from throughout the United States.” The health schools ranking is based on peer assessment surveys completed by deans, administrators, and/or faculty at accredited programs or schools in the discipline. Participants rated the academic quality of physician assistant programs on a scale of 1 (marginal) to 5 (outstanding). “As we celebrate the 20th anniversary of our first graduating physician assistant class, it is wonderful to be recognized nationally by our peers for the quality education that we are known for regionally and beyond,” said Gregg Shutts, professor and chairman of physician assistant studies. “At Daemen, our combined BS/MS model is a unique opportunity that offers high-performing students an expedited path to earn their physician assistant degree and prepares them for one of the fastest growing and most respected careers in the country.”
Dr. Raghu Ram joins Roswell Park
Physician Raghu Ram has joined Roswell Park Comprehensive Cancer Center as vice president of value-based care optimization and community clinical collaboration. He started in his new role March 4. Bringing significant Ram leadership experience in health systems and health plans, Ram most recently served as regional medical director of Landmark Health, a medical group that provides care for the frail elderly. His duties at Roswell Park include developing strategy and negotiating contracts with health Page 22
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Kaleida Announces New COC, Other Key Promotions
K
aleida Health recently announced several leadership changes designed to improve care delivery, coordinate operations and further integrate Kaleida Health’s hospitals and affiliations. Donald Boyd was named executive vice president and chief operating officer (COO). In this role, he will be responsible for overseeing the day-today operations of the health system’s hospitals, longterm care Boyd facilities, home care division, laboratories, surgery centers, clinics and ambulatory sites. “As we continue to evolve and change to better meet our patients’ needs, Don’s leadership and unique skill set will help us better coordinate operations across the organization,” said Jody Lomeo, president and chief executive officer (CEO) of Kaleida Health. “In this role, we will work together to make Kaleida Health the very best place for patients to receive care, our caregivers to work and our physician partners to practice medicine.” Boyd, who has been with Kaleida Health since its inception in 1998, most recently served as the executive vice president for business development and affiliations. He oversaw Kaleida Health’s affiliations with partners like Upper Allegheny Health System, Brooks Memorial Hospital, TLC Healthcare Network and Eastern Niagara Hospital. He also led numerous successful transactions and business development initiatives over the years, including MASH, Western New York Urology Associates, Cancer Care of Western New York and the Great Lakes Health Cancer Care operation.
insurance companies. He will also support the cancer center’s business development efforts and engagement with primary-care physicians across Western New York. No stranger to the region, Ram was previously the senior medical director and chief medical officer of HealthNow New York Inc., associate medical director of Univera Healthcare and chief of family medicine at Kenmore Mercy Hospital. Ram believes it’s critical to ensure that all patients have access to quality healthcare. With clinical experience as a family physician as well, he hopes to collaborate more with partners across the community. “With all the advancements in cancer care, it’s our role to get information out to both our colleagues and the public about the best op-
Boyd was appointed senior vice president of business development for Kaleida Health in 2009 after serving as the president at the former Millard Fillmore Gates Circle Hospital. He also held various other roles as vice president for ambulatory services and business development, director of ambulatory services, manager of quality improvement and director of Kaleida Health’s ambulatory surgery center in Williamsville. He has a Master of Business Administration degree with a concentration in corporate finance and healthcare systems management, from the University at Buffalo (UB). He also holds a Bachelor of Arts degree in community mental health and psychology from UB.
Other appointment Jonathan T. Swiatkowski, CPA, has been named vice president of finance and strategic integration for the Great Lakes Health System of Western New York. In this new role, Swiatkowski will be responsible for coordination and oversight Swiatkowski of Great Lakes Health financial planning and reporting, supporting Kaleida Health, ECMC, affiliations and business development efforts. He will also provide financial oversight and support to the organization’s various non-hospital entities like Optimum Physician Alliance, Great Lakes Cancer Care and the EMR optimization project. Lomeo said, “As Great Lakes Health continues to evolve and we further integrate with our partners, it is vital that we are even more coordinated on a clinical, operational and financial level. I am confident that Jon’s skill set and experience will only help us achieve that. He has tions available to them,” Ram said. “Many of my patients over the years received great care at Roswell Park, so I’m especially pleased to have the opportunity to expand access to that world-class care and ensure good collaboration among providers in different clinical settings.” Ram holds a medical degree and a bachelor’s degree in electrical engineering from the University at Buffalo.
Roswell Park workforce swells to record level
Employment numbers at Roswell Park Comprehensive Cancer Center have reached record levels, growing to a workforce of more than 3,500. The latest appointments announced by Roswell Park President and CEO
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2019
been an important part of our past collaborations and integration. We are looking forward to him focusing on these specific initiatives and helping Great Lakes Health grow in the future.” Great Lakes Health System is the planning entity comprised of Kaleida Health, the University at Buffalo, ECMC and The Center for Hospice & Palliative Care. Swiatkowski, who has been with Kaleida Health since 2001, was named chief financial officer (CFO) for the organization in 2014. He has also served as the vice president for finance and business operations. Swiatkowski has guided Kaleida Health through major financial milestones, including an improvement in system operating results; the expansion of Millard Fillmore Suburban Hospital; the closure and sale of the former Millard Fillmore Gates Circle Hospital; the financing, construction and opening of the Gates Vascular Institute and HighPointe on Michigan; the financial integration of several affiliates; and the planning, financing and fundraising for the new John R. Oishei Children’s Hospital. Michael P. Hughes, senior vice president and chief of staff, will now oversee business development for the organization. Hughes has been with Kaleida Health for 15 years and Hughes currently oversees external affairs including marketing, communications, government affairs, corporate relations, campus development, construction, real estate and planning. As chief of staff, he also coordinates executive team planning, strategy and communications
Candace S. Johnson, Ph.D., and her senior leadership team mark a milestone for the 121-year-old cancer center, reflecting expansion across all areas of operations, from clinical care and education to new frontiers in cancer research. “I couldn’t be prouder of the team we have in place today,” notes Johnson, who just entered a fifth year as the cancer center’s chief executive. “We are able to attract and retain the very best candidates to an extent I have never seen in my 17 years at Roswell Park. These are people who could work anywhere, but they choose to work here because they are motivated by our mission and energized by the things they see our team accomplishing together.”
H ealth News K
New Electronic Medical Record System Debuts at Kaleida
aleida Health’s multi-year, $125 million project to upgrade and expand its electronic medical record (EMR) achieved a major milestone recently with the successful launch of the first two new components of the system, nursing and provider documentation. “We will accurately collect data once, store it with minimal redundancy and ensure widespread access to caregivers in full compliance with privacy and security regulations,” said physician David Hughes, chief medical officer for Kaleida Health. When complete, the modernization project will result in a single patient record throughout the region’s leading healthcare system. For the first time, a patient’s entire health history — from doctors’ visits to hospital stays to laboratory
Visco to serve as Roswell first chief technology officer
Paul Visco has been promoted to the role of chief technology officer at Roswell Park Comprehensive Cancer Center. A new position at Roswell Park, Visco’s role as CTO involves developing and implementing new technologies that benefit the experiences Visco of both patients and clinical teams. He will be the technical lead on several important campus-wide projects aimed at maximizing the effective use of technology for improved and streamlined internal and patient processes. As CTO, Visco hopes to capitalize on creative energy he’s gained throughout his time at Roswell Park. He’s been instrumental in the development of the center’s Intranet and MyRoswell Patient Portal, and several other critical technology platforms. Visco and his team have also built hundreds of systems through open source technologies. These platforms and systems greatly enhance care and quality of life for our patients. “Given the rapid pace of technological changes in IT and its application in healthcare, Paul’s position as CTO is critically important for strengthening Roswell Park’s mission,” said Thomas Furlani, PhD, Roswell Park’s chief information officer. “We look forward to seeing how he will leverage many of these new technologies for the betterment of our patients and clinicians.” Visco previously served as assistant vice president of technology development and acquisitions, and in several other roles within the
results to medical imaging — will be recorded in a single, consistent digital format that treatment providers at any location can easily access and update. “Our goal is to enhance the patient experience and quality of care we deliver,” said Hughes. “Providers will be spending much less time in front of a screen so they can spend more time face-to-face with their patients.” Providers will have an instant, detailed, up-to-date record of a patient’s clinical history, while patients are spared from repeating the same information at each new provider visit. The patient’s complete medical record will, in effect, travel with that patient wherever he or she goes for treatment. Thanks to Kaleida Health’s participation in statewide and nationwide consortiums, that information will even be available
to providers in other states, with the patient’s prior consent. The clinician’s ability to diagnose problems and determine treatment strategies will also be greatly enhanced by the quality and quantity of data that will be at their disposal. Kaleida Health is partnering with Cerner Corporation to engineer the enhancement and expansion of its existing EMR. Cerner is a global leader in healthcare technology, with 40 years of experience and contracts at nearly 27,500 facilities worldwide. The first two elements of the system to “go live” at the end of February were upgrades to the way physicians, physician assistants, nurse practitioners and nurses enter and store patient data in the EMR. More than 400 providers attended mandatory training sessions to learn how to take full advantage of all the new features. Future improve-
ments will touch almost every aspect of the patient experience, from blood transfusions to rapid response management to transportation within and between facilities, and even staff scheduling will be optimized. Kaleida Health is in the second year of the implementation process. “This is a patient-centered, clinically-driven project to improve health outcomes for the communities we serve,” Dr. Hughes said. “Representatives of all medical specialties and nursing worked with experts from Cerner to set priorities and design the improvements our clinicians wanted before any changes were made to the system.” That phase of the project is now complete and the changes providers requested are going live.
information technology and marketing departments at Roswell Park. He holds an MFA in media studies and communications from the University at Buffalo, and a bachelor’s degree from Northern Arizona University.
program through Gannon University. • Justine Kaurich has joined ECMC as vice president of operations. She will provide oversight support for ECMC departments, including dialysis, dietary, environmental services, laboratory, palliative care, pharmacy, patient transport and wound care. Kaurich Kaurich has significant experience throughout the
healthcare industry and brings great leadership skills to this important position. She served over 20 years in several leadership roles at The Cleveland Clinic and has relocated to Western New York to bring her skills and acumen to ECMC. Most recently, Kaurich served as senior vice president of patient care services at St. Luke’s Miners Hospital, Coaldale, Pa. Kaurich earned a bachelor’s degree in nursing and a Master of Business Administration degree from the University of Phoenix. She is a member of the American College of Healthcare Executives (ACHE) and holds nurse executive advanced certification and registered nurse board certification.
ECMC appoints two new VPs to its team
Erie County Medical Center (ECMC) Corporation officials recently announced the appointment of two new vice presidents to its leadership team. • Marie Johnson has been promoted to the position of vice president of rehabilitation services. In this role, she provides leadership to the acute care therapy staff, the medical rehab unit, the outpatient rehabilitation department, therapy staff at School 84 and P.E.D.S (PediatJohnson ric Educational and Diagnostic Services) located in Amherst. She will also consult collaboratively with all areas of the hospital. Johnson most recently served as assistant vice president of rehabilitation (since 2015). She has held many titles within rehabilitation services at ECMC (since 1996). Under her leadership, rehabilitation services has accomplished a successful CARF re-accreditation which represents the department’s commitment to the delivery of excellent quality care and patient outcomes consistent with the ECMC mission. Johnson holds a Bachelor of Science degree in occupational therapy from the University at Buffalo. She is currently enrolled in a post profession occupational therapy doctorate
R
Roswell Park Accredited to Provide Tobacco Treatment Specialist Training
egistration is open for tobacco treatment specialist training workshops presented by the department of health behavior at Roswell Park Comprehensive Cancer Center. Roswell Park was recently awarded full accreditation by the Council for Tobacco Treatment Training Programs, Inc., making it the first accredited provider in New York state that prepares health professionals for the National Certificate for Tobacco Treatment Practice. The 4.5-day in-person workshops prepare health care professionals from all backgrounds and disciplines to provide effective, evidenced-based treatment to a range of individuals in many settings and modalities. Attendees will learn from nationally and internationally renowned experts through lectures and a variety of hands-on learning activities. Highlights include updates on new and emerging tobacco products, tobacco product marketing, basic and advanced phar-
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macotherapy, and evidence-based behavioral treatment approaches. Completion of the program satisfies the training requirement for the National Certificate in Tobacco Treatment Practice (NCTTP). “We encourage all health care providers who interact with tobacco users to register for one of these workshops,” says Laurie Krupski, PhD, training and development coordinator for health behavior at Roswell Park. “Tobacco causes over 30 percent of all cancers in the US. It remains the most deadly health behavior today and we have effective, evidence-based treatments. These trainings will give participants proven strategies and tools to treat tobacco use in your setting. ” Upcoming workshops are being held April 22-26, July 22-26, and Oct. 21-25. To register, visit the Roswell Park Tobacco treatment specialist training program at www.roswellpark.org.
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