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BFOHEALTH.COM
MAY 2019 • ISSUE 55
Easing Access to the Latest Treatments
ELDER ABUSE New report from the CDC shows a sharp rise in elder abuse in the U.S. — family members commit most of the violence, the report states
New leader at Roswell Park Comprehensive Cancer Center, physician Raghu Ram, to work with physicians, health plans to improve patients’ access to the latest in cancer treatment, technology
R-E-S-P-I-T-E
Caregivers urged to hit the pause button to avoid burnout
Cool Relief at BuffaloCryo Cryotherapy can help relieve pain, say owners of BuffaloCryo
Dental Care
Inside Find out how many cases of abuse have been registered in the Rochester P. 14
SIX
Tips to Get Through Your Midday Slump P.9
UB Dental clinics treat thousands of people every year — it helps patients, gives dental school students experience
Why You Should Eat More Broccoli P. 13
High Rate of Sex Before Age 13 Among Boys P. 10
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CALENDAR of
HEALTH EVENTS
Free rabies vaccination clinics for dogs, cats, ferrets
Erie County Executive Mark C. Poloncarz and Commissioner of Health Gale Burstein have announced six upcoming rabies vaccination clinics offered by the Erie County Department of Health. These free clinics in May and September give family pets protection from rabies, which is a fatal disease for humans and animals. Erie County’s Division of Environmental Health manages the county’s rabies control program, responses to rabid or potentially rabid animals, and these free clinics for county residents. Bats, raccoons, fox and skunks can enter homes, barns and sheds undetected. Pets, including “indoor” and “outdoor” cats, are at risk for rabies exposure inside and outside the home. In 2018, the division of environmental health identified 21 animals in Erie County that tested positive for rabies. Full 2019 schedule is as follows: West Seneca Highway Garage Wednesday, May 15, 4-7 p.m.
39 South Ave., West Seneca (off Union near NYS 400) Town of Tonawanda Highway Garage Wednesday, May 22, 4-7 p.m. 450 Woodward Ave. (Off Military Rd. near Sheridan, Tonawanda Broadway Market Wednesday May 29, 4-7 p.m. 999 Broadway (parking ramp), Buffalo Erie Community College–South Campus Wednesday, Sept. 11, 4-7 p.m. Bldg. #7, Maintenance Garage, 4041 Southwestern Blvd., Orchard Park Erie Community College-North Campus Wednesday, Sept. 18, 4-7 p.m. Noonan Center — Maintenance Garage 6205 Main St. (off Youngs Road/ Tech Drive), Amherst Cheektowaga Highway Garage Wednesday, Sept. 25, 4-7 p.m. 3145 Union Road, Cheektowaga Call the Erie County Department of Health at 716-961-6800 if you or your pet have been exposed to any wild animal, or have been bitten by a dog, cat or wild animal.
Catholic Health Seeking Requests for Community Benefit Grants
June 24-August 30 children grades K-10 To learn more, call Director Michael Garcia: 204-2078. campcenterland.org
Amherst
2640 North Forest Road behind the JCC Benderson Family Building
As part of its commitment to improve the health of the community and increase access to care for the underserved, Catholic Health is seeking requests for its 2019 community benefit grants. Nonprofit, community-based organizations that serve the poor and disadvantaged by addressing unmet health needs are invited to submit a grant application. Each project or initiative can be awarded for up to $10,000 for the grant period, which runs from July 2019 — June 2020. To be considered for grant funding, applications must be received by Friday, May 17. Local churches/ faith communities, non-profit community-based organizations, Catholic Health departments or primary care sites, are invited to apply. Completed applications can be mailed to Catholic Health, Attn: Sharyl Hendel, 144 Genesee St., Buffalo, NY 14203 or emailed to shendel@chsbuffalo.org.
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In Good Health WNY’s Healthcare Newspaper editor@bfohealth.com
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
Grant Request Proposal Criteria • Supports Catholic Health’s community needs implementation plan or unmet health needs in Western New York community as outlined in the New York State Prevention Agenda. • Demonstrates capacity building or sustainability beyond the grant period to have a positive impact on lives and communities it intends to serve. • Shows ability to implement project successfully or demonstrate past success. • Provides services to “safety net” populations such as Medicaid, uninsured. In 2018, Catholic Health awarded $132,000 in grant funding to organizations whose work has a direct impact on the region’s most vulnerable populations. For more information or a grant application, visit www.chsbuffalo. org/community-benefit/grant-request-2019 or call 716-923-4828.
Got an event to share with our readers? Send us an email by the 10th of each month.
editor@bfohealth.com
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
May 2019 •
©WellCare 2015 NA_03_15_WC IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 3
Get Ready For Diseases Spread By Ticks The Community Health Center of Niagara “Where Family Planning is Family Friendly”
Some say women’s health is a complex thing. We believe it doesn’t have to be. Annual paps, cervical exams and breast health are just as important as birth control. Safe sex and confidential access to STD treatment and HIV testing are just a few things available under our Family Planning Program. We’re located at 2715 Highland Avenue, Niagara Falls, New York serving all of Niagara County including Lockport!
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NatureMedicine.ca • (905) 684-4934 St. Catharines, Ontario CANADA Page 4
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
Erie County Health Department: Insects transmit bacteria, viruses and parasites that can cause serious illnesses like Lyme disease
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he Erie County Department of Health is preparing for warmer weather and the surge in the tick population. “Ticks can expose people to tickborne diseases,” said Health Commissioner Gale R. Burstein. “Lyme disease is caused by bacteria and transmitted through bites from infected blacklegged ticks.” She continued, “Lyme disease can affect people of any age, causing fever, headache, a bull’s-eye skin rash and other more serious complications.” “Ticks are active in our region from April through November, depending on the weather,” said Senior Public Health Sanitarian Peter Tripi. “By the middle of the summer, young ticks [larvae] and adult ticks are seeking a blood meal from humans or animals like family pets.” He continued, “Take steps to prevent tick bites by covering your skin and tucking long-sleeve shirts into pants and pants into socks. Tick larvae, active from mid-May through July, are the size of a poppy seed and difficult to see.” Ticks can be extremely small, so a thorough inspection on yourself and your children of skin and clothing is necessary after gardening, camping, hiking, playing outdoors and other traditional summer activities. “If you find a tick on your skin, carefully remove the entire tick and observe for signs and symptoms of disease,” said Burstein. “Transfer of tick-borne illness like Lyme Disease depends on when the tick is feeding, how long it is attached and if it is removed properly. If you suspect a tick bite, consult your health care provider to review any symptoms.” According to the Centers for Disease Control (CDC), Lyme Disease has accounted for up to 82 percent of tick-borne diseases in past seasons. Most cases of Lyme Disease can be treated in its early stages with antibiotics.
What Can I Do To Reduce Ticks In My Yard?
• Keep lawns mowed and edges trimmed • Clear brush, leaf litter and tall grass around the house and at the edges of gardens and stone walls • Stack woodpiles neatly away from the house and preferably off the ground • In the fall, clear your yard of all leaf and garden litter, where ticks can live in the winter • Keep the ground under bird feeders clean so as not to attract small animals that can carry ticks into your yard • Locate children’s swing sets and other play equipment in sunny,
dry areas of the yard, away from the woods where ticks can be abundant • Using an approved insecticide once a year (in June) can significantly reduce tick numbers on a residential property
How Do I Protect Myself and Family?
• Avoid direct contact with ticks • Avoid wooded and brushy areas with high grass and leaf litter. • Walk in the center of trails: stay on cleared trails when walking or hiking, and avoid the edge habitat where ticks are likely to be. • Repel ticks on exposed skin with repellent that contains 20 % or more DEET, picaridin or IR3535. Do not use on children younger than two months. Use according to instructions on the label. • Treat clothing, socks, shoes, boots, and camping gear with products that contain permethrin; do not use this on skin. It can remain protective through several washings. Pre-treated clothing is available and may be protective longer. • Wear a long-sleeved shirt and long, light-colored pants tucked into socks or closed-toed shoes. • Talk to your veterinarian about effective tick control options.
Find and Remove Ticks from Your Body
• Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you. • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair. • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs. • Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks effectively. If the clothes cannot be washed in hot water, tumble dry on low heat for 90 minutes or high heat for 60 minutes. The clothes should be warm and completely dry. Submitted by the Erie County Department of Health.
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May 2019 •
In Good Health Buffalo Region - April 2019 - 9.75”x13.75”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Meet
Your Doctor
By Chris Motola
Raghu Ram, M.D. Study Shows Dogs Can Accurately Sniff Out Cancer in Blood
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ogs have smell receptors 10,000 times more accurate than humans’, making them highly sensitive to odors we can’t perceive. A new study has shown that dogs can use their highly evolved sense of smell to pick out blood samples from people with cancer with almost 97 percent accuracy. The results could lead to new cancer-screening approaches that are inexpensive and accurate without being invasive. “Although there is currently no cure for cancer, early detection offers the best hope of survival,” said Heather Junqueira, who is lead researcher at BioScentDx and performed the study. “A highly sensitive test for detecting cancer could potentially save thousands of lives and change the way the disease is treated.” Junqueira presented this research in April at the American Society for Biochemistry and Molecular Biology annual meeting in Orlando. For the new study, Junqueira and her colleagues used a form of clicker training to teach four beagles to distinguish between normal blood serum and samples from patients with malignant lung cancer. Although one beagle — aptly named Snuggles — was unmotivated to perform, the other three dogs correctly identified lung cancer samples 96.7 percent of the time and normal samples 97.5 percent of the time. “This work is very exciting because it paves the way for further research along two paths, both of which could lead to new cancer-detection tools,” said Junqueira. “One is using canine scent detection as a screening method for cancers, and the other would be to determine the biologic compounds the dogs detect and then design cancer-screening tests based on those compounds.” BioScentDx plans to use canine scent detection to develop a non-invasive way of screening for cancer and other life-threatening diseases. As a next step, the company launched a breast cancer study in November in which participants donate samples of their breath for screening by trained cancer-sniffing dogs. The researchers also plan to separate the samples into their chemical components and present these to the dogs to isolate the substances causing the odor that the dogs detect.
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New leader at Roswell Park Comprehensive Cancer Center to work with physicians, health plans to improve patients’ access to the latest in cancer treatment, technology Q: We had been under the impression that you’d left Buffalo and returned, but you’ve actually been here the whole time. A: I had previously been chief medical officer of HealthNow and left that to join a house-calls medical group called Landmark Health. I was the medical director of their Buffalo operations. Their headquarters is out in Huntington Beach, Calif., so I traveled quite a bit, but I was based here in Buffalo. Q: You’re currently leading a value-based care initiative. What does “value-based” mean in this context? And why is it being adopted? A: Roswell Park Comprehensive Cancer Center has such an amazing set of new advances for the treatment of cancer. Many of those are significantly more expensive than a lot of older treatments that aren’t as good for the patient. So along with that comes the responsibility to make sure that we’re making these treatments affordable and making sure they’re covered by the patients’ insurance plans. So, the initiatives that Roswell Park is undertaking will make sure the treatment is affordable and high quality and that patients can get the best treatment that they can for any cancer they might develop. Q: What kinds of arrangements help you do that? A: One of the things we do is partner with health plans to help identify opportunities where we can identify cancers in earlier stages. One of the initiatives we have is looking at the use of low-dose CT scanning for patients who are at a high risk of developing lung cancer. Lung cancer is one of those cancers that notoriously get diagnosed late, often in stage IV. With the use of low-dose CT scanning, we can identify those cancers much earlier and identify them in stage I. And when we identify them in stage I, we can treat the patients much more effectively, and we can do it at a much lower cost than if they’re diagnosed at stage
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
IV. That’s just an example of the value-based initiatives we’re pursuing in light of the escalating cost of care. Q: It seems like we’ve known the value of preventive care forever, but there’s still a lot of resistance to widening access to health care. What are some of the other barriers? A: I think a lot of times it’s awareness and identify the patients who are at risk. But it’s not just about the testing. It’s also an opportunity to talk to those patients about risk behaviors like smoking in the case of lung cancer, as well as other types of lifestyle changes like diet and exercise. Cancer research has evolved so much. I went to medical school about 35 years ago; over those years, the tools we have to diagnose and treat cancer have evolved a great deal. I know it’s very challenging in a busy practice to stay up to date with everything. So, one of the things we try to do is make sure that the community of physicians know about the new technology and treatment options available to patients with cancer. Q: You also do outreach to community clinics. A: Roswell Park does not have an emergency room, so sometimes when patients who are treated at Roswell Park need an emergent treatment, they do seek care at a hospital near to where they live. Hospitals will sometimes be unaware of the potential risks. So, one of our roles will be to make sure we identify those patients when they’re admitted to other hospitals and make sure we’re able to communicate to that hospital the other treatments that the patient is getting. We want to make sure the treatment they’re getting is in line with the therapies we’re giving them. So that’s one example. Another is that much of cancer therapy is outpatient and it’s chronic therapy. Patients are living many years with a diagnosis of cancer. So other physicians in the community have to coordinate with the care patients are getting for cancer to get optimal outcomes for patients. Q: What kinds of measurable impact have value-based initiatives had
on patient outcomes? A: I’ll answer that by giving you another example of an approach that Roswell Park is very much on the cutting edge of. And that’s identifying cancers that may grow much more slowly or not be as aggressive. Roswell Park clinicians would take an active surveillance approach rather than jumping right to surgery or chemotherapy. An example of that would be renal cell cancer. Oftentimes the outcomes are equally good if we do active surveillance of that than immediate surgery or other forms of treatment. So that’s an example of how our approach may differ than much of the community’s. Q: Is that because not all cancers develop to a point where they’re dangerous or resolve on their own? A: Yeah, so different cancers have different rates and degrees of growth. If a patient may not feel any real impact from that cancer within their lifetime, surveillance may be a better approach than active treatment. Prostate cancer is another example. With proper evaluation, we can do active surveillance of that cancer without treatment and avoid surgery and radiation treatments that might have cause more harm than benefit for the patient. Many of the men who have prostate cancer don’t die of it, because prostate cancer grows slowly over a long period of time. Q: How difficult is coordinating between providers these days given technological improvements? A: People in the community now often have several physicians where in the past they had a family physician who would do most of the taking care of them. Now many of them have specialists. In those cases, collaboration between those physicians is critical in order to get good outcomes. Q: You have a background in electrical engineering. Have you found it helpful in informing your medical career or is it just something you were once interested in? A: As an undergrad, I studied electrical engineering. My background was actually very helpful. When I started my medical training, most practices were using paper charts, so transfer of information was much more complicated than it is today. So my background allowed me to recognize the benefits of electronic medical records early and adapt quickly.
Lifelines
Name: Raghu Ram, M.D. Position: Vice president of value-based care optimization and community clinical collaboration, Roswell Park Comprehensive Cancer Center. Previously served as medical director at Landmark Health, Buffalo operations; 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 Hometown: Syracuse Education: University of Buffalo Affiliations: Roswell Park Comprehensive Cancer Center Organizations: Erie County Medical Society; American Assocation of Family Physicians; American Board of Family Medicine Family: Married, three children Hobbies: Golf, tennis, chess, outdoor activities
Many Misdiagnosed With MS
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lmost one in five multiple sclerosis patients may be misdiagnosed with the autoimmune disease, according to a new study. Of 241 previously diagnosed multiple sclerosis (MS) patients referred to two major Los Angeles medical centers for treatment, nearly 18% did not actually have the autoimmune disease, the researchers found. Those patients spent an average of nearly four years being treated for MS before receiving a correct diagnosis, the study authors said. “I’ve seen patients suffering side effects from the medication they were taking for a disease they didn’t have,” said study leader, physician Marwa Kaisey, from Cedars-Sinai Medical Center in Los Angeles. “Meanwhile, they weren’t getting treatment for what they did have. The cost to the patient is huge — medically, psychologically, financially,” Kaisey said in a Cedars-Sinai news release. The most common correct diagnosis among the patients misdiagnosed with MS was migraine (16%), followed by radiologically isolated syndrome, a condition in which patients do not experience symptoms of MS even though their imag-
ing tests look similar to those of MS patients. Other diagnoses included nerve damage and a disorder of the vertebrae called spondylopathy, the findings showed. Among the patients misdiagnosed with MS, 72% had been prescribed MS treatments. Of those, 48% received therapies that can carry the risk of a viral infection-caused disease in the white matter of the brain (progressive multifocal leukoencephalopathy). The researchers estimated that the unnecessary treatments given to the misdiagnosed patients in this study alone cost nearly $10 million. “The diagnosis of MS is tricky. Both the symptoms and MRI testing results can look like other conditions, such as stroke, migraines and vitamin B12 deficiency,” Kaisey explained. “You have to rule out any other diagnoses, and it’s not a perfect science,” she added. The study was published in the May issue of the journal Multiple Sclerosis and Related Disorders. “The first step, which is what we’ve done here, is to identify the problem, so now we’re working on potential solutions,” Kaisey said.
Healthcare in a Minute By George W. Chapman
Large Employers Limiting Choices to Providers
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aced with continually rising healthcare premiums and costs, many large employers like Walmart are receiving a lot of press for selecting, approving and limiting the physicians and hospitals their employees can use. This “narrowing” of the panel of providers to control costs and raise quality is not new. The concept has been around since the 1970s when staff model HMOs and preferred provider organizations (PPOs) were established and members were limited to a select panel/network of providers. What is new is that the impetus to limit the panel/network is coming from the employer versus the HMO or insurer. In the past, some HMOs and PPOs actually failed because consumers were overly wary of limited networks and demanded almost unlimited choices. To attract business, commercial insurance
Hospital Ratings Challenged
The American Hospital Association is lobbying CMS to either improve its five-star hospital rating system (Hospital Compare) or take it off line. The AHA believes the 14-year-old rating system does not accurately portray hospital performance. Critics claim the star ratings, from one to five, are misleading and harmful oversimplifications of how a particular hospital performs. They suggest working with CMS on developing hospital peer groups (teaching, urban, rural, large, small, regional, etc.) for better and fairer comparisons. Currently, larger teaching hospitals that admit the sickest patients, often transferred from other hospitals, tend to fare worse in the current rating system.
Amazon Accepting HSA Cards
As part of its aggressive foray into healthcare, Amazon announced it will be accepting health saving
companies would tout their huge networks of physicians and hospitals, basically guaranteeing the consumer that their physician and their hospital were in the network. The problem is, it is difficult, if not impossible, to effectively contain costs and maximize quality with so many disparate providers. Taking matters into their own hands, employers are aggressively seeking out the most cost-effective physicians and hospitals with the best results. Walmart reports employees spend less time in the hospital, need less expensive follow-up care and avoid unnecessary procedures including surgeries. Walmart’s plan is administered by the Pacific Business Group on Health. In order to lower costs and improve outcomes, consumers must be willing to forego unlimited choices for smaller panels or networks. accounts cards for the purchase of medical supplies online. More than half of US employees are enrolled in high deductible, HSA-eligible, plans which means high out-of-pocket expenses. Out of pocket spending for healthcare was about $370 billion last year. By offering consumers an affordable and convenient option for medical supplies, Amazon hopes consumers will fund their HSAs and take advantage of the savings. A lot of the confusion with HSAs is over what products are eligible for purchase. Amazon will end the confusion by listing eligible products or items on your screen. HSAs are the best tool for saving money because of the multiple tax advantages. You contribute per-tax dollars to a taxfree account, paying for eligible items tax free. There is no “use or lose it “requirement. Unspent dollars earn interest.
Hackers and Ransom
No industry is completely immune to cyberattacks. Hackers can breach or attack even the best defenses. If you refuse to pay up, they will destroy your files. For healthcare providers, years of records can be wiped out. There is breach insurance and these companies employ negotiators when a client is breached. Typically, negotiations are done through a third party and your ransom money is converted to bitcoin so it can’t be traced to the clandestine hacker. An ENT practice in Michigan was breached and the ransom was $6,500. In this case, the physicians refused to pay and decided to retire early. The hackers deleted all files, including patient records, appointment schedules, payment info. (The physicians are still faced with penalties for the breach.) Fortunately, their patient records were encrypted. IT experts feel HHS privacy and security standards are way too focused on compliance and penalties for breached providers versus focusing more on the criminal hackers.
A Nation in Pain
An analysis funded by the National Institutes of Health estimated nearly 40 million of us experience severe levels of pain. An estimated 126 million reported some type of pain in the 90 days prior to being surveyed. It is hoped the study will help shape future research and development, target more effective pain relievers and complementary health approaches. The latter refers to non-prescription drug relief from yoga, massage and meditation. The study has attracted more attention as the opioid epidemic has worsened.
Battling Drug Prices
Scott Gottleib recently resigned his position as FDA commissioner. Frustrated by the dirty tactics of drug manufacturers to delay or prevent the entry of biosimilar drugs into the market produced by competitors, he is taking his fight to lower drug prices to The American Enterprise Institute think tank. He said his primary focus with AEI will be discovering affordable solutions to innovative
May 2019 •
treatments, including gene therapies. Bringing in substitutable generic drugs to the market under the “conventional drug pathway” (controlled by the pharmaceutical industry) is fraught with roadblocks and politics. The biosimilar pathway should bring about much-needed competition and lower prices.
Primary Care 2.0
It’s been proven that outcomes are better when your care is managed by a personal primary care physician who provides cost effective treatment and preventive services and acts as your quarterback for access to specialists and the healthcare system in general. Unfortunately, with the shortage of primary care physicians, people are seeking more short-term, episodic and expensive alternatives like urgent care and emergency departments. Continuity of care is critical to better outcomes and lower costs. Those without a primary care provider or manager are finding that navigating our confusing healthcare system alone is a nightmare. Primary Care “1.0” must be updated to PC “2.0” to accommodate today’s reality. There must be increased incentives like free medical school tuition, higher residency pay and tax breaks for medical students selecting a primary care career. Empowered nurse practitioners and physician assistants, working in tandem with physicians, can help alleviate the shortage and provide increased access to quality care. But the real panacea will be the evolution of telemedicine as an accepted method of delivering coordinated, low-cost, high-outcome primary care. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
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Providing Great Dental Care Clinics at UB Dental School treat thousands of people every year — it helps patients, gives dental school students experience By Jana Eisenberg
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s part of its teaching and curriculum, the University at Buffalo’s School of Dental Medicine provides low-cost, highquality dental care to the general public — that’s thousands of children and adults every year. This real-world experience, performed by dental school faculty, staff and students in the dental school’s well-appointed dental clinics on the south campus, as well as in state-ofthe-art mobile dental units, help the school to better prepare its dental students for their professional practice. It’s a win-win-win for the community, the school and its students. Many of the clinic’s patients may not have access to quality dental care for a variety of reasons. At the clinic and through its programs, people can access this care easily and affordably
— regardless of whether they have insurance or money to pay for their visits and treatments. For the dental students, the experience — that of working with real people, many from underserved populations — can open their eyes to some of the challenges facing those populations. In some cases, students even change their minds about their professional goals, inspired to do good. And patients receive affordable, respectfully delivered, professional care. The appointments may take a little longer than the standard private service some might be used to — this is because of the layers of faculty oversight and instruction. Rather than feel put out by that, many patients say that they are hap-
py to be part of contributing to future dentists’ training — without patients, the dental students could not complete their studies. “Something we hear all the time is patients saying how much they love the UB Dental Clinic,” said Julie Rockmaker, a social worker on the staff. “Patients have trust in us, and they take pride in the fact that we’re a teaching and research institution.” The services go beyond standard dental care, added Rockmaker. As a social worker, she’s there to help patients overcome any challenges to accessing regular dental care, and also identify other areas where patients might need assistance. “We want to help relieve barriers to dental care for people in the community,” she said. “It might be making sure they have transportation to get to their appointments, or helping them deal with other health issues. If they need help applying for insurance, we can do that. Maybe they are the caretaker for a parent or children, and they need respite coverage so they can come to their appointment. We help get the kids on Medicaid or Child Health Plus. We also have grant funds available for patients to cover the cost of treatment.” With this attitude, the school tries to impart a holistic approach to dentistry — that oral health is not just about the teeth and mouth, but being aware of the person and their needs. “Dental students learn to listen to their patients. From conversations when the patient is in the chair, they can identify an issue, either from what they’re told or what they observe,” said Rockmaker. “They will give me the patient’s number, or have me come talk to the patient while they’re here. Whatever issues they patients have, it’s easy to connect them with a service provider in the community.” In addition to public outreach and screening events, UB Dental Clinic connects with school children through its school-based health center (SBHC) and the Gateway program. For children, the SBHC process
includes sending out thousands of parental consent forms every year through Buffalo Public School nurses. Once parents fill out the forms, indicating that they do want their child to receive care, visits are coordinated, with transportation provided to and from schools. This removes barriers for parents who may not be able to take their kids to regular appointments. “We see some kids who have never been to the dentist,” said Julie Caizza, a dental hygienist and UB Gateway coordinator. “Once we have the kids scheduled, we aim for a 90-minute turnaround from the time they are pulled out of school: they get on a bus [paid for by UB], they’re accompanied by a chaperone from their school, and the parents don’t have to worry about things like missing work.” The dental student population is diverse, and so is the greater Buffalo population. “Sometimes in the clinic, you can hear them paging for anyone fluent in Arabic, for example,” said Caizza. “Because we have so many international students, we can easily overcome any language barriers— and if we don’t have someone on-site who can interpret, we can call a language line, which has interpreters and translators in many languages.” Another way that the dental school connects with community is with its mobile dental van, which has been dubbed “S-miles To Go.” A 42foot long, three-chair, fully equipped dental clinic within a truck, the van heads out annually to over 30 schools in Western New York’s Southern Tier. The van also makes trips to community centers, where the dentists on board can treat seniors and veterans who may not be able to make it to a dentist’s office. It’s so busy that the school is looking into getting a second van. In order to better serve both its students and the people of Western New York, the clinic will soon be getting a $30 million renovation. That’s something to smile about.
Writer on the Run By Jenna Schifferle
The Magic of Running
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or years, the merits of longdistance running have been debated by researchers. On one end of the spectrum, some argue that distance running is hard on the joints and can lead to injuries. These people often claim that it’s not natural to run that far and that it can have a negative impact on the body. On the other hand, some argue that distance running keeps your heart healthy and your legs strong. Apart from applauding the physical benefits, they also extol the mental benefits and praise how running makes your mind tougher. Cultures around the world even go so far as to elevate running to that of the divine. The Tarahumara, for example, are a tribe of people who live in the mountains of Copper Canyon near Chihuahua, Mexico. For members of the Tarahumara, running is a focal point and an impulse as innate as
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
breathing. Families spend days running the valleys, often in sweltering conditions. These journeys are a time to bond and play as they move together toward a common goal. Running unites them and elicits a sense of purpose for their community. Likewise, in Japan, there is a subset of monks who use running as a path to enlightenment. Dubbed the “Marathon Monks,” this group of holy men resides in the Enryaku Temple at the top of Mount Hiei. As part of their monastic preparations, they practice running meditation and run 50 kilometers around the mountain. The next day, they repeat this practice. And the next day? They do it again. This journey is taken every day for 100, 700, or 1,000 days. It brings the monk to the brink of exhaustion as a way to force their mind into the present and help them connect to their surroundings.
“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.
While the 1,000-day journey may seem extreme, there is some truth to the practice. Running calms racing thoughts and provides a clarity that borders on being spiritual. Even when you’re tired and want to stop, your mind is there with you. This is major in a world where we’re always somewhere else, thinking about a never-ending to-do list. Running brings you into the moment and connects you to a community of other runners. And yes, it is true that when your legs turn to lead at mile 12, running certainly doesn’t feel natural. In that moment, the thought of stopping is the only thing that actually does. Yet, that’s exactly the moment when the real magic of running happens. So, while I may not be able to settle the debate on whether or not distance running is “natural” (heaven knows I’ve experienced my share of injuries), I do know that I get stronger with every mile. I’ve trained up to 16 miles, but every day that I get out there is still a blessing.
Meet Your Provider
Community Health Center of Niagara Meet Emily LaDuca, women’s health and family planning nurse practitioner Meet Emily LaDuca, women’s health and family planning nurse practitioner at the Community Health Center of Niagara, located at 2715 Highland Ave., Niagara Falls. LaDuca is a Buffalo native who graduated from the University at Buffalo in 2008 with her Bachelor of Science in Nursing. She graduated from UB in 2010 with a master’s in nursing and women’s health nurse practitioner degree. For the past eight and a half years she has worked tirelessly in the field of family planning. LaDuca, along with four other qualified health professionals, oversees the family planning benefit program at Community Health Center of Niagara, designed to increase access to the full range of FDA-approved contraceptive methods, including long-acting reversible contraception (LARC) and methods. CHCN accepts Medicaid, Medicare and most insurances. If you meet the eligibility criteria and are approved (based on income and family size), the family planning benefit program provides free
family planning services without copay or deductible. A sliding fee scale is also provided for discounted prices for contraception and insertions. What does family planning mean and what family planning services does CHCN offer? Family planning means more than just birth control at Community Health Center of Niagara. It gives men, women and teens access to quality sexual and reproductive health care, as well as control over the decision of when to start or expand your family. Services include confidential access to sexually transmitted disease (STD) screening and treatment, HIV testing, counseling and education. We have on-site treatment medications available for clients and their partners who screen positive for STDs (chlamydia, gonorrhea, syphilis, etc). In addition, our women’s health services include the annual preventive exams (breast exams and pap smear tests) and imaging referrals. We also host mobile
mammogram events each year during National Breast Cancer Month in the Highland Avenue parking lot as well as other sites in Buffalo, Lockport and Cheektowaga. Confidential services are available if you don’t want mail or phone calls going directly to your home. This is notated in your chart to ensure your request for privacy is respected. There is also access to translation services for clients who do not speak English or have limited English ability. If you would like to schedule an appointment with Emily LaDuca or check out any other services (adult and pediatric medicine, dental, and behavior health), contact CHCN. Remember, the Community Health Center of Niagara is building healthy communities one patient at a time!
“I love what I do here at Community Health Center of Niagara! This work is my life’s passion.” - Emily LaDuca
Community Health Center of Niagara n
2715 Highland Ave., Niagara Falls n 716-986-9199 n www.chcb.net n nature scenes on the walls, look out a window or a nature scene on your video device. It seems that even the picture of nature had the potential to reduce feelings of stress.
Break Out That Adult Coloring Book
Can’t absorb any new information? Take a break and take out the adult coloring book you have not taken the time to use. This distraction gives the brain the space it needs to tackle the problem while you focus on the joys of choosing the colors that make you feel better. Pro tip: Choose yellow and other bright colors if you need a pick-me-up.
Incorporate Natural Mid-Afternoon Boosts
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Tips to Get Through Your Midday Slump
By Eudene Harry, MD
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e have all felt it. After lunchtime, you’re lethargic, tired and constantly checking the clock waiting for the day to be over. But fear not! Your day will no longer be ruined by the afternoon lull. Here are some quick tips to avoid the midday slump and allow you to end your day rejuvenated!
Spend Five Minutes in Nature
According to a study published in the Journal of Positive Psychology in 2019, just five minutes sitting in
nature improves moods, decreases negative feelings and increases your sense of being awe and wonder at being a part of something bigger than yourself. If you have more time, combine being in nature with exercise. This can include hiking of simply taking a walk through the park lined with trees. This can reduce your heart rate and improve your ability to recover from stressful events.
Bring the Outdoors In
Feeling overwhelmed and can’t leave the building? Hang paintings of
Grab some green tea, it is high in antioxidants, contains a small amount of caffeine and also has an ingredient that can help create a sense of calmness. If you combine this with a little aromatherapy, either peppermint or lemon to quick lift or lavender to keep the calm going, you might find yourself feeling better after a quick 10-minute break.
Quick Exercises to Do at Your Desk
Here are two quick exercises that help to release stress, and restore a sense of calm while improving moods. Do any exercise that helps bring the heart rate up a little bit to get blood pumping while also releasing the energy of frustration. First, do some quick tricep extensions using a chair. Then follow with a stretch that helps to relieve the tension. Shrug shoulders up to the ear and
May 2019 •
gently rotate forward then backward. Follow this with an open stance arms open wide and slightly raised as if to open yourself up to receive warmth, love and support, then simply cross your arms around your shoulders and give yourself a hug. Cross your arms until you feel the muscles in the upper back gentle stretch and start relieving some of that built up tension. After all, we do tend to carry a lot of stress in the upper back and neck. Bonus, hugs help to relieve stress and improve moods.
Laugh & Breathe
It is as simple as laughing. It decreases cortisol levels and improves moods. A simple way to watch a funny clip or even more simple, record a baby’s laughter and listen to it. That sound of pure joy and wonder can bring a smile back to your face and do wonders for your mood. Lastly, practice stopping and breathing. Four counts in, hold for four and release for four. Do this about four times and feel the stress slowly ebb away. Eudene Harry is the medical director for Oasis Wellness and Rejuvenation Center in Orlando, a wellness practice devoted to integrative holistic care. She is a veteran physician with more than 20 years of experience. She earned her medical degree and performed her residency at Thomas Jefferson University in Philadelphia. Her most recent book, “Be Iconic: How to be Healthy and Sexy at Any Age” is now available on Amazon. She regularly contributes to television and radio shows nationwide.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Alone & Content Workshop: A One-Day Boot Camp Forging a New Life on Your Own
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or some women, living alone in mid-to-later life is a welcome change, especially if they have chosen to step away from an unhappy marriage. But for others, the change is often sudden and not welcome. The prospect of living alone can appear on the horizon as a daunting challenge. The ending of my own marriage years ago fell into the latter category; it was not a welcome change. But it was a change nonetheless and I chose to accept it and ultimately to embrace what would become a defining chapter in my life. It took some time and some hard-knock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to offer support to other women in similar circumstances. “Alone & Content: Forging a New Life on Your Own” is a one-day boot camp I developed to help women discover the know how to create a more satisfying and enriching life on their own terms and timetable. I’ve been leading the workshop for over 14 years now, and often get questions from In Good Health read-
ers about what the boot camp covers and how it is organized: Q. What is the purpose of the boot camp and what do you cover?
A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude and perspective. At the end of our day together, it’s my hope you will feel a few steps closer to finding your way forward, whether it be to get unstuck, to cope better or to thrive. We’ll talk about how to overcome loneliness and other emotional pitfalls, rediscover your true self, socialize in a couples’ world, and let go of self-limiting beliefs or obstacles that get in the way of personal growth. The goal is to embrace what may be a once-in-a-lifetime opportunity to get to know yourself all over again and to create a rewarding life on your own, whether it be for a year or two or for the rest of your life. Feeling comfortable with your independence will improve your chances of finding happiness, and it will improve your chances of finding a new healthy relationship, if that’s
s d i K Corner
High Rate of Sex Before Age 13 Among Boys
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sing information from two national surveys, researchers from Johns Hopkins Medicine and the Guttmacher Institute have found that in some metropolitan areas, more than a quarter of young, African American men reported having sexual intercourse before age 13, and for about 45 percent of them, the sex was either unwanted or experienced with “mixed feelings.” The researchers caution that while self-reporting surveys have limitations, they say similar results drawn from multiple data sources suggest that rates of underage male Page 10
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sex in metropolitan areas are substantially higher than previously estimated using only national data. They also find that race, ethnicity and location play a larger-than-appreciated role. The researchers say their study, described in the April 8 issue of JAMA Pediatrics, points to the need for better and much earlier access not only to sex education, but also sexual health clinics, family planning and parenting services, and mental health counseling services for inner city male youth, particularly if they have experienced unwanted sex.
what you desire. When you feel better about yourself — more self-assured and resourceful — life on your own or with a special someone can be richer and more satisfying. Q. Who attends the boot camp?
A. Most of the women who attend the workshop are in mid-to later life, around my age. I am 64 years young. Almost all have come out of a long marriage or relationship, and some are on their own for the first time in their lives. While their circumstances may differ, they share one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist, and/or their congregation.
Q. I’m still grieving the loss of my marriage/spouse. Is this boot camp right for me?
A. Good question. The Alone & Content boot camp is a “nuts and bolts” practical workshop to help women feel more whole and complete on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend attending a grief support group (check out Lifetime Care) or the help of a professional counselor. Q. What are your credentials?
A. I am not a licensed professional. My expertise is born out of real-life experience. I’ve been there. I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of living alone. After some hits and misses, I found my way and now thoroughly enjoy the freedom, independence and peace that come with living alone. My time-tested experience, resources, tips and techniques have inspired and helped many participants. My boot camp has been the jump-start they needed to rewrite “Young men having sex before age 13 usually haven’t received the appropriate sex education and services, and we need a better system to respond to their needs,” said physician Arik Marcell, senior author of the study and associate professor of pediatrics at the Johns Hopkins University School of Medicine and Johns Hopkins Children’s Center. “The cultural double standard about sexual behavior in the United States, in which it is OK for young boys, but not girls, to be sexually active, has prevented us from effectively addressing male adolescents’ vulnerabilities and their healthy sexual development,” Marcell added. Currently, 24 states and the District of Columbia mandate sex education at some level. Although most adolescents receive some form of sex education between grades six and 12, with some as early as grades four or five, the researchers say what they learn is highly dependent on their region, school and parents’ decisions to allow them in the classes. In 2014, fewer than half of high schools and only 20 percent of middle schools delivered sex education covering all 16 critical sexual education topics identified by the CDC, according to the Guttmacher Institute. “I have heard boys and adolescents talking about their first sex
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
this chapter in their lives.
Q. How large is the boot camp?
A. Ideally, I like to have eight women in each boot camp, although, on occasion, I have led the workshop with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly evolves into a comfortable camaraderie and it’s not uncommon for warm friendships to develop among participants that carry on long after the boot camp has ended. Q. Where is the Alone & Content boot camp held?
A. The boot camp takes place at House Content Bed & Breakfast in Mendon, a few minutes south of Rochester. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the boot camp. What’s my next step?
A. Let’s talk by phone as a next step. That way, I can your answer your questions and you’ll know better whether this boot camp is right for you. Just call me at 585-624-7887 or email me at gvoelckers@rochester. rr.com, and we’ll schedule a time to chat. You’ll also find information about my upcoming boot camp in the Calendar of Health Events included in this issue. Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon, New York. She is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about her boot camp, to purchase her book, or invite her to speak call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com encounters in a way that suggests they didn’t anticipate, understand or know what was happening or what’s appropriate and what’s not,” saidMarcell, “I was concerned that such early sex experiences happening to boys could be unwanted and influence their future health. We used the data available to us in these surveys to attempt a better look at the scale and pattern of this problem across the nation.” Young men who reported in the national family growth survey that they first had sex before age 13 described a range of attitudes about this experience. Only 55 percent said that their first sexual experience was wanted, while 8 percent said it was unwanted and 37 percent said they had mixed feelings about it. The investigators underscored the importance of recognizing young people’s perspectives, and also noted that reports of whether a first sexual experience was wanted may be influenced by gender and race expectations, stereotypes, peer pressure and coercion. “Too often, the sexual health needs of young men are overlooked,” says Guttmacher Institute researcher Laura Lindberg. “Outdated attitudes and harmful gender stereotypes leave many young men without needed information and services.”
Cool Relief at BuffaloCryo Cryotherapy can help relieve muscular aches, chronic pain associated with arthritis, fibromyalgia, multiple sclerosis, among other types of pain, say owners of BuffaloCryo By Catherine Miller
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hile the temperatures are heating up in Western New York, they are continuing to stay chilly at BuffaloCryo — Buffalo’s whole body cryo-therapy establishment. If you haven’t heard of whole body cryo-therapy [WBC], you may not be alone. Cryotherapy, or cold therapy, is the use of sub-zero degree liquid nitrogen gas to relieve muscular aches as well as ease chronic pain associated with diseases such as arthritis, fibromyalgia and multiple sclerosis, among other types of pain, according to BuffaloCryo. Somewhat new to the area, the practice of cryotherapy has been used in Europe and Asia for more than 40 years, and is becoming widely recognized for its many benefits in the U.S., according to BuffaloCryo. Celebrities and sports players might have increased the popularity of the treatment, but it’s the everyday person who battles with the aches and pains of daily life who will truly appreciate the many benefits of cryotherapy. The relief comes as you stand in a full body tubular chamber, cloaked in a robe, mittens and specialized socks, and the cold gas is released in the chamber around you as the attendant carefully watches your temperature and time from outside the chamber on the computerized monitor. And the temperature can get as low as 200 degrees below zero. While the freezing gas encircles your body, it reduces the blood flow to the areas, significantly reduces inflammation and swelling, releases endorphins and temporarily reduces nerve activity, according to BuffaloCryo officials. This, they say, helps to alleviate pain and boosts the natural healing process of your body. After a short three-minute session, you are out of the chamber and peddling
a stationary bike, moving the invigorated oxygen and blood flow back through the body. “I have been coming to BuffaloCryo since they opened,” Karen Makar said after a recent session. Makar competes in weight lifting competitions and co-owns CrossFit Nickel City with her husband. She is no stranger to muscular pain, “I feel great after a session here. I tend to come twice a week for a few weeks before a competition and I definitely feel the difference. I sleep better and I perform better.” Jacob Fay and Pat Connors, owners of BuffaloCryo, have been offering cryotherapy sessions in the Western New York area since 2015. “We get people from all over,” said Connors, “Before we opened, we realized that the closest places that specialized in cryotherapy at the time were Toronto and New York City. Since we opened in 2015 we get people coming in from Rochester, Erie, and a two-hour radius into Canada.” In the Buffalo region, BuffaloCryo has hundreds of clients, including players from the Buffalo Bills, Sabres and Bandits teams. BuffaloCryo caters to young active adults that are proactively treating muscles before a long run, snowboarding, skiing or heading to the gym. It gets middle-agers who are dealing with low back pain, aching knees and the beginning signs of arthritis. Clients include people with fibromyalgia and Crohn’s disease dealing with chronic pain. Anything from the ankle joints and up can be also treated with the localized treatment machine that will aim the cryotherapy to just the area you need to target. The benefit is that you can withstand a longer session, as the cold gas is not effecting your core temperature at the same rate, and you can focus on that aching knee, sore hip or low back area to get
Cryotherapy, or cold therapy, is the use of sub-zero degree liquid nitrogen gas to relieve muscular aches. The patient stands in a full body tubular chamber, cloaked in a robe, mittens and specialized socks, and the cold gas is released as the attendant watches the temperature and time from outside the chamber on the computerized monitor. The temperature can get as low as 200 degrees below zero. the specialized relief you are looking for. If you are a migraine sufferer you may want to consider a cryo-facial. The added benefit — it’s also great for your skin and the face, neck and jaw area will look revitalized. Is there anyone that should steer clear of this cold therapy? “It’s not for everyone,” said Connors. “If you have had a heart attack in the last six months or uncontrolled high blood pressure, cryotherapy is not for you. Also, if you have a pace maker, you will not be able to enter our chambers.”
If you are unsure if cryotherapy is safe for you, speak with your doctor prior to visiting them. When you do go, remember your health insurance will not cover the treatment, but they do accept most flex-spending cards and HSA Cards. BuffaloCryo appointments are short and you will normally be in and out of the office within 20 minutes. You’ll feel great as you leave and even better a few hours later. The business is located at 199 Scott St, minutes from Canalside.
Are You Sabotaging Your Sex Life? R esearch confirms that a good sex life is a key to strong feelings of intimacy and satisfaction for both partners in a relationship. Yet for many, sex goes by the wayside, often because of life’s demands, from the boss at the office to the kids at home. Responsibilities can leave you feeling drained and longing for nothing more than a solitary soak in a warm tub at day’s end. But experts warn that physical
intimacy shouldn’t be sacrificed, because it not only helps you stay connected to your significant other, it also leaves you feeling more alive and youthful. Start by taking care of yourself — your health has a direct relationship on your sex life. If you work outside the home, leave work stress at the office. Don’t sabotage sexual desire by worrying about work all night. Resist the old-fashioned thinking that once you’re a parent, you’re no longer a sexual being. Set bedtimes
for your kids and make sure they’re adhered to so that you and your partner can have “alone time.” Disconnect from your computers, cellphones and other gadgets early in the evening so that you can focus on time with your partner, even if it doesn’t always lead to sex. Resist the temptation to check your work email before bed — most problems can wait until morning. If your sex life needs a refresh, consider a romantic getaway. Because people feel more relaxed when re-
May 2019 •
sponsibilities are left behind, they’re freer to enjoy romance. While you can’t be on vacation all the time, keep that feeling of intimacy you shared top of mind when you go home, and use it as a springboard for making lifestyle changes that will keep you closer as a couple. This article was written by By Len Canter and previously published online in HealthDay Living News.
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Nurse Cheryl Gambacorta, director clinical operations at VNA of WNY
Childhood Illness Sparks Passion for Nursing By Deborah Jeanne Sergeant
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heryl Gambacorta keenly remembers the extended time she spent in the hospital as a 5-year-old seriously ill with pneumonia. What stuck with her most of all was the care she received from the nurses. “I always wanted to care for people,” she said. “I never lost that while I was growing up.” She attended nursing school at D’Youville College, graduating in 1984. Gambacorta worked at Buffalo General Hospital from graduation until 1988, eventually on the medical teaching telemetry floor. “I loved to coach and teach the
new doctors and medical students,” she said. “I was learning and becoming more established. I loved teaching them the basics of the compassion to take care of those patients.” She eventually earned her bachelor’s degree in nursing and began working at Visiting Nursing Association (VNA) of Western New York in Williamsville, where she became director of clinical operations in 2011. A lot has changed since she began with VNA. “When I came here, home care was very different,” she said. “The patients were in the hospital and by the time they came home, they were
very stable. It was about teaching them about diseases and doing wound treatment. From a clinical perspective, they were stable and did well.” Nowadays, nurses’ focus is on helping patients prevent re-admission. Gambacorta said that she feels “very proud of what we do to work together from our facilities to our teams and branches and clinicians. “We do a great job at working with hospitals in keeping people in their homes. From a nursing perspective, these clinicians are top-notch.” VNA’s social workers also help ensure patients have the resources they need, such as private aides, Meals on Wheels and other programs that can help people stay at home longer. “The best part of my day is when I’m conferencing and problem solving to keep patients home,” Gambacorta said. “Even our high-risk people.” She added that she also likes to look at clinicians’ potential and see what she can do to help them grow. To stay up-to-date, Gambacorta has taken courses through Kaleida Health, which she calls “phenomenal.” She also reads many articles related to nursing and leadership. “I came in never thinking I’d stay in this field of nursing but I’ve grown to love taking care of patients in their home in the community,” she said. She added that nursing offers many opportunities for advancement and learning. “If someone is interested in nursing, it’s really about giving back,” Gambacorta said. “It’s always been for me about giving it my all, knowing what’s important to the person you’re caring for and knowing how
General Physician, PC – Cancer Care
Your ally in the fight against cancer Breast Surgery • Gynecological & Medical Oncology Genetic Testing/Counseling • Hematology By your side every step of the way. Trudy Baker, MD Farid Berenji, MD Herbert Duvivier, MD, JD Haider Khadim, MD Meeghan Lautner, MD, MSc David Marchetti, MD
For appointments and inquiries Great Lakes Cancer Care Call Center
716.884.3000 Office Locations
BGMC, 100 High Street, Buffalo 3850 Saunders Settlement Road, Sanborn 45 Spindrift Drive, Williamsville 192 Park Club Lane, Suite 120, Williamsville
cancer care gppconline.com
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In 1993, the American Nurses Association declared May 6-12 as the national week to celebrate and elevate the nursing profession. National Nurses Week is a time for everyone — individuals, employers, other health care professionals, community leaders and nurses — to recognize the vast contributions and positive impact of America’s 4 million registered nurses. Each year, the celebration ends on May 12, Florence Nightingale’s birthday. Nightingale, the founder of modern nursing. best you can care for them and guide them and supporting family members that are caring for patients. It’s also where you fit in in health care because there are so many avenues.” These could include education, administration and management and hands-on care at hospitals or independent health care providers, schools, clinics or other organizations. “If you have that heart-felt passion to take care of patients, you will find your way through and find something that really means something to give back and helps you feel good,” Gambacorta said. “You have to feel good at the end of the day. “It’s such a good feeling when you make a difference and you discharge them from at-home care into the hands of their regular doctor.” Gambacorta and her husband, Philip, live in Williamsville and have two daughters. Gambacorta has volunteered with a local food bank and with the Summit Foundation, SABAH Foundation and Kevin Guest House. She enjoys making crafts and spending time with her family.
SmartBites
Helpful tips:
By Anne Palumbo
The skinny on healthy eating
Why We Should Eat More Broccoli
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eat a lot of broccoli, probably more than your average Jane. When I was younger, I ate it for the taste. But now that I’m older, I make a concerted effort to eat broccoli for its comprehensive nutrition benefits — benefits, in particular, that help my aging body. Ever since I was diagnosed with osteopenia (low bone mass) a few years ago, I’ve been on a mission to slow further bone loss by eating foods that support bone health. While broccoli doesn’t provide much calcium or any vitamin D, it does provide a phenomenal amount of bone-strengthening vitamin K: over 100% of our daily needs in an average serving. Vitamin K improves bone health by helping our body absorb calcium and by keeping it in our bones. My concerns about cancer have intensified with age, especially since age alone is the No. 1 risk factor.
Aware also that cancer-causing substances are a top risk, I can’t help but shudder every time I recall running behind the DDT mosquito trucks when I was a kid. So I look to broccoli, a cruciferous vegetable, for its high concentration of sulforaphane — a powerful phytonutrient that has demonstrated an ability to prevent cancer or slow its progression in multiple studies. Thinning skin and the resulting tears also plague me, prompting me to consume foods that are high in vitamin C. Did you know that an average serving of broccoli serves up well over 100% of our daily needs? An essential nutrient, vitamin C plays a vital role in the formation of collagen and has even been linked with wrinkle reduction. Plus, this powerful antioxidant, which protects cells from free-radical damage, may also reduce our risk of certain cancers. Dogged by LDL (bad) cholesterol that has risen with age, I also seek foods that provide the kind of fiber that helps whisk cholesterol out of the body: soluble fiber. One cup of cooked broccoli has about 5 grams of fiber, of which more than half is soluble. I’m equally grateful for broccoli’s insoluble fiber, as it helps with digestion and promotes regularity. You know what else buoys me about broccoli? It’s super low in fat, cholesterol, and calories (only 60 per cooked cup!). Now, ready to eat more broccoli?
Choose broccoli heads with tight, deep green florets and firm stalks. The broccoli should feel heavy for its size, and the cut ends should be fresh looking. Avoid broccoli with browning stem ends or yellowing florets. Refrigerate unwashed broccoli in a loose plastic bag and wash just before using.
Broccoli-Cheddar Quiche with Quinoa Crust Crust:
Serves 6
2/3 cup dry quinoa, cooked and chilled 1 large egg, beaten ¼ cup grated Parmesan cheese ¼ teaspoon coarse black pepper Filling: 2 teaspoons olive oil 1 small onion, chopped 2-1/2 cups chopped broccoli florets 2 cloves garlic, minced ½ cup fat-reduced milk 4 large eggs 2 large egg whites ¾ teaspoon kosher salt ¼ teaspoon coarse black pepper ¼ teaspoon crushed red pepper (optional) 1 cup grated fat-reduced cheddar cheese
Preheat oven to 375 F. Lightly oil a 9-inch pie dish. Rinse quinoa in a fine-mesh sieve and transfer to a medium pot. Add 1-1/3 cups water and bring to a boil. Cover, reduce heat to low and simmer until water is absorbed, 15-20 minutes. Set aside off the heat for 5 minutes; uncover, fluff with fork, then chill in fridge for 10 minutes. Combine chilled quinoa, beaten egg, Parmesan cheese and black pepper in a bowl; stir well. Press mixture into bottom and up sides of pie dish. (Dust your hands with flour if mixture starts to stick.) Bake in preheated oven for 20 minutes; cool. In a large sauté pan, heat oil over medium heat. Add onions and
broccoli and cook slowly, stirring frequently until vegetables are soft (about 8-10 minutes). Add garlic and cook 1 minute more. Remove from heat; cool. Combine milk and next 5 ingredients; stir with a whisk. Arrange broccoli mixture over crust; top with grated cheese. Pour egg mixture into the dish and bake at 375 F for 35-40 minutes, until center is set. Let stand 5 minutes; cut into 6 wedges. Note: Prefer no crust? Skip the crust steps and head straight to spreading the broccoli mixture in the lightly oiled pie dish.
Anne Palumbo is a lifestyle
columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorieconscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
Oat bran is among foods that experts believe can lower cholesterol. Foods to Lower Your Cholesterol Count
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t’s not always possible to lower cholesterol through diet alone — sometimes there’s no way to override your DNA, and medication becomes a must. But certain foods can be part of the plan to improve your numbers, to both lower low-density lipoprotein (LDL) cholesterol, the bad one, and raise your high-density lipoprotein (HDL), the good one. First, choose foods with soluble fiber. Think of this type of fiber as a magnet, drawing cholesterol out of your body. Good sources are oats, oat bran and barley, along with beans, eggplant and okra. When used in recipes, these foods tend to take on the flavors of other ingredients, so be adventurous with recipe planning — and generous with herbs and spices. Apples, grapes, strawberries and citrus fruits are good
choices because of their pectin, a type of soluble fiber. Next, go for foods with polyunsaturated fats. These include vegetable oils like canola, sunflower and safflower, as well as fatty fish
like salmon, rich with omega-3 fatty acids, and most types of seeds and nuts. Plant-based foods also contain substances called plant sterols and stanols, which help keep the body
May 2019 •
from absorbing cholesterol. Particularly good sources are Brussel sprouts, wheat germ and wheat bran, peanuts and almonds, and olive, sesame and canola oils. In terms of foods to limit, talk to your doctor about your unique needs. High-cholesterol foods like shellfish and eggs aren’t as dangerous as once thought. The verdict is still out on the saturated fat found in meat, but some research has found that full-fat yogurt, milk and even cheese may be good for you. The one type of fat to completely avoid is trans fat. The U.S. Food and Drug Administration banned its addition to foods in 2018, but because of extensions granted to some manufacturers, certain items could be on store shelves until January 2021. So keep checking the ingredients on any packaged foods you’re considering.
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Golden Years
Elder Abuse On the Rise in America CDC: Family members commit most of the violence
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s the American population ages, elder abuse rates are increasing, particularly among men, federal health officials reported in April. Between 2002 and 2016, the rate of assaults among men 60 and older jumped 75%, while it rose 35% among women between 2007 and 2016. Among older men, the homicide rate increased 7% between 2010 and 2016, according to the U.S. Centers for Disease Control and Prevention. “We are still examining the circumstances that appear to be associated with the increase in violence against this age demographic,” said lead researcher Joseph Logan, from the CDC’s National Center for Injury Prevention and Control. “We have identified that many of the assailants were known to the victims and in a position of trust,” Logan noted. Physician Ronan Factora, chairman of the Special Interest Group on Elder Abuse and Mistreatment at the American Geriatrics Society, thinks the problem is probably even worse than the report suggests. “These data underestimate the extent of elder abuse in America,” he said. “We probably underestimate the amount of physical violence, because this study only used records from emergency departments.” Many more cases of abuse were probably seen by private doctors or not reported at all, said Factora, who had no part in the study. “This is really a small fraction that represents a larger problem that has been growing,” he added.
The biggest issue is that most elder abuse isn’t recognized, Factora said. That’s because there isn’t a standard way to screen for it or recognize it. Factora believes, however, that elder abuse is gaining more visibility, which may be part of why it’s seen as increasing. “As the years have gone by, elder abuse has become more highlighted and thus better detected,” he said. “But the increase is not just a demographic issue.” Factora said that much of the abuse among people who are physically or mentally impaired is perpetrated by caregivers who are stressed out by the demands of caring for a loved one. Still, “abuse can have lasting effects that aren’t reversible after a certain point,” he said. “People who need help with transportation, finances and medication put a lot of burden on caregivers,” Factora said. According to the CDC report, it’s family members who commit most of the violence. “A lot of this is because of the demands placed on them for care, which really puts a stress on them,” Factora said. Unfortunately, many seniors are in jeopardy because of their physical or mental condition, and can’t defend themselves, he said. Abuse is really related to dependency, Factora explained. Help in finding ways to cope
with the burden of caring for someone is available. Perhaps if more people took advantage of programs for family caregivers, a lot of elder abuse could be stopped before it starts, he suggested. “The resources are there. The problem is connecting the caregivers who are burned out with the resources that can help them,” Factora said. The best way to deal with elder abuse is through awareness of all its forms. This study deals with physical abuse and murder, he pointed out, but abuse also includes neglect and financial exploitation. Often a person is the victim of several kinds of abuse. Someone who is physically
Erie County: More Than 300 Cases of Elder Abuse By Deborah Jeanne Sergeant
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lder abuse Western New York is more prevalent than many people may realize. According to the New York State Committee for the Coordination of Police Services to the Elderly 2014 Annual Report, Erie County registered 311 cases of domestic abuse committed against those 65 and older; Niagara County had 70 in the same period. The report further determined that only one in 24 cases of elder physical abuse in the community is ever reported to authorities, indi-
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cating the problem is far more widespread. The report provides the most recent local information available. “It is incredibly under-reported,” said Sarah Duval, supervising attorney with the Center for Elder Law & Justice in Buffalo, which provides free services to nine counties in Western New York. “The majority of elder abuse that we see is perpetrated by family, friends and caregivers.” She added that many times, the seniors who eventually come forward say that they waited initially because
of their relationship with the abuser. It’s hard to turn in their own child, as it reflects poorly on themselves as parents. They may feel they’re betraying the family. “There’s also an element of isolation,” Duval said. “Many don’t report because they can’t or it’s not safe.” Abusers typically cut off the senior from the use of the phone, transportation and anyone outside. In cases where the abusers provide most or all of the care, they use that responsibility as leverage. “They might say, ‘If I won’t take
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
abused can also be neglected and financially exploited. Factora believes that if you see or suspect someone is a victim of elder abuse, you should report it to adult protective services. “We need to find these cases, and once we find how big this epidemic is, that may be a push to identify the abuse we don’t see,” he said. “What we are seeing is the tip of the iceberg.” For the study, researchers used data from the U.S. National Electronic Injury Surveillance System All Injury Program and National Vital Statistics System to look for trends in assaults and murders among men and women aged 60 and older. The report was published April 5 in the CDC’s Morbidity and Mortality Weekly Report.
care of you, who will? You’ll end up in a nursing home,’” Duval said. “That’s a very strong tactic to remain in power and in control.”
For help, call: • Erie County Adult Protection Services/Elder Abuse, 716-858-6877 • Center for Elder Law & Justice, 844-296-6404 (toll free) or 716-853-3087 • New York State Office for the Aging Information Line, 1-800-342-9871 • New York State Crime Victims Hotline, 1-800-7717755
Golden Years Finding Respite To locate respite services near you, contact New York Connects and at 800-342-9871 or www.nyconnects.ny.gov.
R-E-S-P-I-T-E Group of caregivers at the respite care program at Eden United Methodist Church in Eden. Photo provided
Caregivers urged to get frequent breaks to avoid burnout
By Deborah Jeanne Sergeant
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f you care for an elderly loved one at home, particularly one with memory issues, you should consider respite care. “For a caregiver, it’s something that’s very critical,” said Robert S. Stall, geriatrician and owner of Stall Senior Medical in Amherst. “Caregivers often wait too long to take advantage of it.” He said that many times, caregivers lack the perspective to realize their own stress level. “Respite care is something that is very beneficial to many family members I’ve had throughout my career,” Stall said. “It doesn’t have to be full-time nursing care, but just an in-home caregiver to let you go watch a movie or get a massage.” Many caregivers feel guilty about leaving their loved one in someone else’s care; however, Stall said that respite care often gives them the ability to provide better care, since people who feel burned out end up giving less-than-optimal care. Respite services may be offered at a day program, at home for short-term or long-term periods, or at nursing homes for long-term, such as for a vacation.
The types of care for the elderly can include companion care, where meal preparation may be provided, but no personal care. The next level is a personal aide who might help with chores like bathing or toileting
and reminders to take medication. The highest level of care is medical care, which includes assistance with taking medication. Changing the mindset about respite involves helping caregivers
realize that respite is both good for them and their loved one. Many frail, elderly adults can’t get out much. Seeing a fresh face or visiting a senior center with activities can provide a pleasant diversion from chronic pain and boredom. “One woman comes in and just loves to dance,” said Kevin Kartstedt, who organizes a monthly respite program at Eden United Methodist Church in Eden. “We do the jitterbug and polka. We do what we can with what they’ve got.” Care doesn’t have to be expensive. When trusted neighbors, friends or family members ask what they can do to help, see if they can sit with your loved one for a few hours once or twice a month. Enlisting several helpers can offer you regular time away. Groups like Kartstedt’s provide a day program that receives some grant funding from Erie County Senior Services but is all volunteer staffed. They receive training from the Alzheimer’s Association. Each of the program’s “guests” — the elderly persons spending the day — has an assigned volunteer. Some guests want to read, play games, play piano, clip coupons, or complete puzzles. Others want to chat. Helping with chores like sorting crayons by color for the Sunday school children help some guests feel useful. Crafts are usually a big hit. “One guest paints something with his dog, like with a shamrock or with a Santa outfit, depending upon the season,” Kartstedt said. “They enjoy it.” The volunteers serve a lunch for up to about 40, half of whom are volunteers. A variety of visitors bring entertainment, such as a dog to perform tricks, musical performances, a group of ducklings or a 1930s classic car. “We brought chairs out and they spent about 45 minutes talking about events during the War, rationing, and going on dates with a car like this,” Kartstedt said. “It was so neat.” Paid services can also help provide respite. Professional care giving facilities can include senior centers, which typically don’t provide personal care, senior daycare, which may provide personal care, and medical day care. Respite workers can also come overnight so caregivers can sleep better. Veterans enrolled for benefits can receive in-home care or up to 30 days per year outside their home. The VA provides a caregiver support line and hosts special events in the community to help caregivers. The organization also counsels caregivers about the help available in the community.
Visit Us Online @ www.bfohealth.com May 2019 •
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Golden Years How Rude We Have Become! By Norb Rug
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am astounded by the total lack of manners some people show today. Everywhere I look, I am surrounded by rude people with absolutely no respect for others and it makes me wonder about their upbringing. Sadly, this world has become a very impolite place to live in. I would like to remind people of some fairly basic manners. Here are some of the most forgotten customs that I see that need to be brought back into today’s society. I think the first set of manners that I was taught as a child was to always say “please” and “thank you.” Saying please and thank you shows good upbringing and is respectful. The one you are saying this to is a person and they are worthy of respect just like you are. Combine this with a “You’re welcome”, and you have a trifecta of good etiquette. My parents instructed me that you are supposed to hold the door for anyone. It does not matter who they are, male, female, young, old, someone you love or someone you hate. You show respect to someone anyways and you hold the door open for them. I will do the same for you. Excuse me, but I do not understand why we have forgotten how to say “excuse me” when we are trying to go past another person or when we accidentally bump into them. Since when did it become OK to
bump into someone and act like it did not matter to you? Oh, yeah, it never has. According to gotquestions. org, saying “bless you” to someone could have begun in several different places. The most prevalent line of thought is it originated from illness. In 590 AD, Italy underwent a terrible plague and the Pope decreed that whenever someone sneezed, people were to say “God bless you” and make the sign of the cross over their mouths, to try to keep the individual from becoming infected with the plague. Because a sneeze was a symptom of the plague, people who heard another sneeze and said “God bless you” took interest in the person’s life. So now, when someone sneezes, and someone else says “bless you,” they are displaying manners from a long time ago. This might seem like a trivial act, but it is something that can show someone you care. It might just be me, but something that can tick me off faster than getting cut off in traffic is when someone you are talking to does not make eye contact while having a conversation. Eye contact is one of the keys to having a good conversation. People nowdays stare at their phones while talking to each other. When someone does this to me I just stop talking. Obviously what is happening on
their small screen is more important than having a real conversation with me. When you are talking with someone, look them in the eyes to let them know they are important to you and you are listening to what they have to say. Interrupting and talking over each other seems to be a national pastime. Watch one episode of “Jerry Springer” and you will see what I mean. There are a few acceptable times when it is OK to interrupt, like when the building is on fire or saying “Watch out” to prevent someone from getting hurt. You don’t monopolize a conversation. I know your life is interesting, but so is mine. I have things in my life that I want to share with you. However if you are talking so much and I can’t get a word in edgewise or you don’t listen to me I feel you are disrespecting me. If you are over the age of 5, you should know proper table manners. You don’t chew with your mouth open, you keep your elbows off the table, you don’t reach in front of others’ plates. Ask to have things
passed to you. You don’t talk with your mouth full and you ask to be excused from the table when you are done eating. I learned these things via the “wooden spoon” method. My mother had a wooden spoon at the dinner table and if you transgressed, well, you know what happened. I believe in good old-fashioned manners. I believe that a man should pay for dinner on a date. I believe that a man should come to the door when he picks up a lady, not sit on the street honking his horn. I believe that a man should open a woman’s car door and hold doors open for her. Norb Rug is a writer from Lockport. He blogs at WhyWNY.home.blog.
Cutting-Edge Treatments Improve Stroke Outcomes By Deborah Jeanne Sergeant
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troke is the fifth cause of death and a leading cause of disability in the United States, according to the American Stroke Association. A stroke happens when a blood vessel is blocked by a clot (ischemic stroke) or bursts (hemorrhagic stroke). A transient ischemic attack (TIA), often dubbed a “mini stroke,” involves a temporary clot that clears on its own. After a clot or rupture happens in a blood vessel, the brain cannot get oxygen carried by blood. That causes brain cells to die. Fortunately, 80 percent of strokes are preventable and many strokes are highly treatable. The medication and methods for breaking up clots may offer much better outcomes for many stroke patients. “Stroke is definitely survivable,” said physician Linda Harris, past-president of the Vascular Society of Western New York and professor of surgery, University at Buffalo. She is board certified by the American Board of Surgery in vascular surgery and general surgery. “Treatment has advanced markedly, but it depends upon when a stroke is identified,” she added. “The sooner they get into a stroke center, the better chance they have of reviving the tissue.” One medication used is TPA, a “clot buster that’s like Drain-o for the Page 16
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human system,” Harris said. “There’s much better imaging of the brain, like perfusion scans. Depending on what we see, that means the kind of therapy they’ll have.” Medication may offer benefits up to four and a half hours after a stroke started. Previously, that window of opportunity was smaller. Recovery depends upon the amount of brain tissue lost during the stroke. “The quality can’t likely get worse from intervention but if you don’t get it, it’s likely to get worse,” Harris said. Many factors can affect the efficacy of stroke treatment, right down to factors particular to the individual. “What we’ve begun to realize is everyone’s circulation in their brain is a little different,” said physician Mary L. Dombovy, who serves as vice president of Neurosciences at Unity Rehabilitation & Neurology and as current board president for the American Stroke Association affiliate in Rochester. “The biggest thing still is it’s very time sensitive. There are some people who are a little further, three to four hours or more from the stroke that can still benefit from clot retrieval.” The clot removal gives patients 60 percent chance of a better outcome. Dombovy said she has seen
patients coming in paralyzed and unable to speak and walking out several days later. One example would include patients who wake up with stroke symptoms. Harris said that previously no treatment would be able to help these. What’s most important is quickly seeking treatment. Some people experience stroke symptoms but hope to recover with sleep and time. That response contributes to worse symptoms. Larger strokes may be quickly and fatal; however, usually, secondary complications are drawn out over a longer period of time. Some people think they should avoid treatment for what they think is a stroke because they don’t want to live with disability, which can include varying degrees of paralysis and issues with speech, memory and behavior. Or, they think that if the symptoms disappear, as with a TIA, they’re fine. “They should absolutely go receive medical attention,” Harris said. “Immediately go to the stroke center. If it’s a TIA, they still need to get it investigated because people who have a TIA may have a major stroke.” Milder-seeming symptoms that come and go or cease altogether may signal a larger stroke yet to come and
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
To reduce your risk of stroke, the American Stroke Association recommends:
• Monitor blood pressure. • Control cholesterol. • Keep blood sugar down. • Get active. • Eat better. • Lose weight if you need to. • Don’t smoke. • Talk with your doctor about taking aspirin or other medication. still require prompt medical attention. “If they have a blockage, they could benefit from treatment, even if the symptoms resolve,” Harris said. “Even if they wake up with a stroke, they should get checked out immediately.” Providers can treat blood vessel blockages for many patients that have experienced a stroke longer than 4.5-hours ago. Guided by imaging, physicians can access the clot through the groin and “vacuum” it out. Harris said to go directly to a stroke center, not necessarily the nearest emergency room. “Otherwise, you may not get triaged soon enough and they might not have the right tools,” she said.
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Golden Years
Things You Need to Know About Hearing Loss By Ernst Lamothe Jr.
osing your hearing can be a scary experience. The unknown or panic of a sudden decrease in hearing ability can send many people into depression or nervousness. On the other hand, hearing loss can be so gradual that some people don’t notice the effects until it starts to affect their quality of life. Hearing is a complex process of picking up sound, processing it and attaching meaning to it. The ability to hear is critical to understanding the world around us and connecting us with loved ones and colleagues. “People associate hearing loss with aging and getting older, or they worry about the stigma attached using amplification and worry that others will judge them,” said Ashley Eisen Graney, an audiologist at Buffalo Hearing and Speech Center. Graney highlights five things people should know about hearing and hearing loss.
1.
It doesn’t resolve on its own
Many times people will strain to hear something but are too embarrassed to tell their friends or family. They continue to let the problem fester until they can’t cover it up. Medical experts say because there is an emotional component to losing hearing, some patients are slow to coming to doctor when they began to feel like there is a problem. About one-third of people in the United States between the ages of 65 and 75 have some degree of hearing loss, according to the Hearing Loss Association of America. For those older than 75, the problem is worse: approximately one in two people in this age group suffer from hearing loss. Most people wait on average 15 years before they obtain amplifica-
tion or see a specialist. “People need to go see an audiologist the moment they start having hearing issues,” said Graney. “When you feel like you are to the point where you are struggling to hear conversation or feeling like people around you mumble, you should have a hearing evaluation completed to at least obtain a baseline hearing test.” “Sometimes it is just a middle ear problem, genetics, or a structural abnormality. It doesn’t always have something to do with you getting older,” said Graney. Just because you hear some things doesn’t mean you have normal hearing
2.
There are those who have the most common type of high-frequency hearing loss — they are able to hear deep loud voices, but struggle to hear birds tweeting and consonant sounds like “s” “f” and “th.” These high-frequency losses make it so you can hear the speaker talking but can’t always make out what is being said because of an inability to hear certain speech sounds. This problem is especially noticeable in a crowded noisy environment. The ear process high-frequency sounds through cells in the lower part of the cochlea, which translates noise into electrical impulses sent to your brain. Audiologists say because those cells that hear low frequency sound are around the top of the cochlea they are more protected so high-frequency hearing loss often occurs first because those cells are exposed to the most sounds during the course of a lifetime. “High-frequency hearing loss is easily explained with orchestral instruments. For example, with a high-frequency loss you can hear
a tuba but you wouldn’t be able to hear a flute as you may remember it,” said Graney. Hearing aids are so much better now
3.
In the 21st century, there have been significant advances in hearing aid devices. Manufacturers have made improvements by developing hearing aids that are more effective for various types of hearing loss. That includes those specifically made for high frequency hearing loss, along with better feedback (whistling management) management, noise reduction, rechargeable batteries and connectivity to Bluetooth technology (a.k.a cell phones and computers). “Some hearing aids today are just a tiny device that sits behind the ear with an invisible wire that fits inside the ear. Because there are hearing aids that connect to every brand of cell phone, they essentially function as both a hearing aid and Bluetooth headset. There are even apps you can download to give a degree of control over your hearing aid,” said Graney.
4.
Watch for some key symptoms of hearing loss When someone first begins to experience decreased hearing, certain symptoms come to the forefront. That includes muffling of speech and other sounds, difficulty understanding words especially when in a noisy and crowded background, trouble hearing consonants and frequently asking others to speak slower, clearer or louder.” Another symptom people are frequently unaware of is withdrawing socially. “My patients will frequently report that they simply avoid certain social situations because they know
Ashley Eisen Graney, an audiologist at Buffalo Hearing and Speech Center. they won’t be able to hear and participate, so they stay home or don’t participate,” she said. This is called social isolation and is actually very concerning. It affects both mental and physical health.
5.
Beware of loud sounds It doesn’t have to be incredibly loud for damage to happen to your ears. Listening safety is determined by a ratio of how loud the sound is to how long you listen to it. Many people participate in activities that produce harmful sound levels, such as attending loud sporting events and music concerts, and using power tools, which repeated over time can cause hearing loss depending on your own individual susceptibility. “If you are in a situation where you have to hear gun noise, even one exposure can cause a decline in certain frequencies. That is one of the reasons why you hear about hearing loss in the armed forces,” said Graney. “No matter what age, if you are hunting, you should be wearing some type of ear protection.”
New Formula Better Predicts Speed of Tumor Growth University at Buffalo researchers unveil new method to estimate cancer growth in 12 types of cancer
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niversity at Buffalo researchers have developed a new method to more accurately predict tumor growth rates, a crucial statistic used to schedule screenings and set dosing regimens in cancer treatment. The mathematical method successfully estimated the doubling time — the amount of time for a tumor to double in size — for 12 types of cancer, ranging from breast and prostate cancers to melanoma. The research, published in February in The AAPS Journal, was led by Dhaval Shah, Ph.D., associate professor in the UB School of Pharmacy and Pharmaceutical Sciences. “This novel method allows clinicians and drug development
scientists to use routinely-generated clinical data to infer doubling times of solid tumors. This parameter can be used to design individualized dosing regimens and develop reliable models for anticancer therapeutics,” says Shah. Tumor doubling time can significantly affect the outcome of anticancer therapy, but the rate is challenging to determine. Current methods calculate doubling time by measuring the size of a tumor at two points in time and assuming the cancer will grow at an exponential rate. However, most doubling times calculated using this method are overestimated, and tiny changes in tumor size can make determining
growth rates difficult. The error impacts the ability of clinicians to schedule optimal follow-up screenings, set effective dosing regimens and determine whether surgery, chemotherapy or radiation therapy is the best form of treatment. The UB researchers instead base their method on data extracted from progression-free survival plots — the length of time during and after treatment that a cancer does not grow or spread. Progression-free survival plots, explains Shah, inherently contain information that could help identify tumor growth rates. The investigators examined data from 47 clinical trials that reported
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plots for any of 12 cancer types: melanoma; pancreatic, lung, prostate, gastric, colorectal and three forms of breast cancer; hepatocellular (liver) and renal cell (kidney) carcinoma; and glioblastoma multiforme (brain). The cancer growth rates predicted by the researchers using progression-free survival plots were within close range to the reported actual tumor doubling times. Additional School of Pharmacy and Pharmaceutical Sciences co-authors include Robert Bies, PharmD, Ph.D., associate professor; Katherine Kay, Ph.D., former postdoctoral fellow; and former student Keith Dolcy, PharmD.
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Golden Years
Medical Marijuana: A Boon for Older Adults? By Deborah Jeanne Sergeant
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he pain older adults suffer is widespread: half of this population who live independently and about 80% of those who live in long-term care facilities suffer from chronic pain, according to the National Institutes of Health. As medical marijuana gains traction across the US, should older adults seek its use? That depends upon whom one asks. “Marijuana has shown to be beneficial for pain and anxiety not just in older adults but for many adults, for chronic pain, particularly cancer pain, anxiety and depression and severe nausea,” said Rochester-based physician Joanne Wu, who practices in Buffalo. But she’s hesitant about its effects on older adults, since marijuana also brings psychoactive side effects and “for some it will make them more anxious, depressed, confused, tired,”
Wu said. “This will be associated with higher fall risk and poorer quality of life.” To take medical marijuana, patients must have physician approval to obtain it at a legal dispensary. Canabidoil, also known as CBD, is a supplement from the hemp plant which contains only minute traces of THC, the compound inherent to marijuana that causes hallucinogenic effects. It’s available over the counter since it’s a supplement and therefore not regulated by the Food & Drug Administration. “CBD, ingested or topical, is an option to alleviate symptoms if medically supervised use of marijuana is not tolerated,” Wu said. Conferring with a doctor about taking either is a good idea to avoid any negative prescription interactions. For a generation that took recreational marijuana, taking prescribed marijuana may seem a more natural course than conventional pain med-
ication. Physician Robert S. Stall, owner of Stall Senior Medical in Amherst, feels wary about any substances people might take. “We want to minimize prescriptions,” he said. “If cannabis can supplant other things that are usually given to take care of issues like chronic pain or seizure disorders, I could see some potential.” He views the possibilities of medical marijuana, however, he expressed caution about the lack of studies on medical marijuana and older adults. If medical marijuana isn’t smoked but taken orally or topically, the experience may be quite different for those who experimented with it recreationally in the past, since its effects take more time to begin and last longer. Part of that may be because medical marijuana is more of a nutrac eutical containing many different compounds than a lab-derived pain
End-of-Life Plans
Baby boomers reflect the ‘I did it my way’ anthem of their generation even in funeral pre-planning
By Deborah Jeanne Sergeant
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ewer people are choosing the traditional embalming and casket burial in a cemetery, according to the area’s funeral industry experts. Though still a popular option, other choices are becoming more common. For some, it’s all about personalizing the experience as a fitting tribute. “The most important thing is people are learning how to personalize the services,” said Anthony Amigone, president and funeral director at Amigone Funeral Home, Inc. in Buffalo and Niagara Falls. Baby boomers reflect the “I did it my way” anthem of their generation even in funeral pre-planning. Amigone said that in recent years, fewer people follow the lead of clergy members for planning memorials or services, and even when they’re involved, they are not as in charge. Whether their ashes become lab-created diamonds, are shot into space in a rocket, or scattered at their favorite fishing spot, it’s all about tying their memorial into something that no one will forget. “We see a lot of Wegmans platters in the funeral home these days,” Amigone said. “It’s more of a celebration of life.” Amigone said that many choose to use video and technology to tell a story about the person’s life by creating a photo slideshow set to music. Some ask for a balloon release after the service. Page 18
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Balloons at a recent funeral ceremony at Amigone Funeral Home, Inc. President Anthony Amigone says many ceremonies are far from traditional. Photo provided They’re not just mourning; “they’re celebrating,” he said. “There are themed funeral services. We had someone who was into comic books and movies, so there was a Star Wars and Batman theme, with Darth Vader and other costumes. The theme of the lighting and flowers were in the theme of Star Wars and Batman.” Expressing the interests of the person can help those attending the funeral recall positive memories. “You can’t take the pain away, but you can make it easier to take,” Amigone said. Brian K. Lewis Funeral Homes sells on its website a variety of urns, from the traditional to the less-than-traditional, including converted motorcycle tanks, biodegradable containers, and sea salt urns, to
reflect the interests and values of the deceased. “I’m seeing a spike in cremation,” said Brian Lewis, the owner. “I think people aren’t into burial as much because this generation may have parents here and they live in California. Years ago, people lived in the same area and had a family plot. That’s probably having some bearing.” As to what to do with the ashes, Lewis said that some choose to have them buried them later with their spouse. Others want spread at the ocean or on the lake or buried under a tree. “A lot of people don’t know what their options are,” Lewis said. “I present them and they say they didn’t know. The funeral industry is evolving and changing.” Fewer want a formal funeral service, according to Jeff Deragon, owner of Cameron Funeral Homes in Leroy. He said that cremation and a memorial service are becoming the more popular options for those who want an event. A few want no obituary or public event. Lewis cautions that may not be the best way to go, as the opportunity to grieve can represent the first step in the healing process, as well as helping the community become aware of the loss so they can extend their support to the bereaved. Lewis recalled a couple that decided against any public notice or
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
medication. Consistency in the product can be hard to achieve. The age of the patients involved also can make a difference. In their 20s, their faster moving metabolism handled marijuana differently than now, when a slower metabolism, other medication and age-related disease processes can impact how marijuana affects the body. “It’s exciting to have something new and potentially effective and with fewer side effects, but there haven’t been studies to any great extent with seniors as to side effects,” Stall said. “The benefits may outweigh the risks.” Further research could help physicians know whether medical marijuana could help older adults; however, like any medication, it’s a tough age group to study because most have several health conditions and other prescriptions. Long-term studies are difficult because their health status can change over the years, which complicates the study. funeral. When the husband died, the news leaked out slowly, so that for many months, every time someone bumped into the wife, she had to hear condolences again. “It was like calling hours at her place of business,” Lewis said. “She said to me several months after, she wished she had some type of calling hours or service so the community could grieve with her and support her.” Keeping a bit of their loved one with them helps some families cope. Crawford said that some families have jewelry made from the cremated remains, such as diamonds (www. lifeGem.com, www.heart-in-diamond.com and www.lonite.com are three such vendors). The process can take months to complete, but processors use only a small amount of hair or ashes for lab-created gems. Some people choose to leave their body as a means of helping others. While indicating organ donation on the driver’s license is a simple way to leave a legacy, donating one’s entire body to scientific study can help medical schools train the next generation of physicians. Anatomical gifts are accepted only from those 18 and older and those of sound mind. The only disqualifying conditions include infectious or contagious disease, obesity and autopsy. The whole body must be surrendered, with the exception of the eyes if they are donated separately. Sixteen medical schools in New York maintain a donor program. In addition to pre-registering, their loved ones need to know about their choice so the medical school is made aware of the donor’s death right away. Bodies must be accepted within 24 hours. Bodies remain with the medical school for about two years, after which time they’re cremated at the school’s expense. The cremated remains may be returned to the family or buried, if they wish.
By Jim Miller
Finding Health Insurance Before Medicare Kicks In Dear Savvy Senior,
If your yearly income falls below the 400 percent poverty level after you retire, the Affordable Care Act (ACA aka Obamacare) marketplace is probably your best option for getting health coverage because of the premium subsidies they offer, which will reduce the amount you’ll have to pay for a policy. ACA health insurance is major medical insurance that covers essential health benefits with no annual or lifetime coverage maximums. And they can’t charge you more or deny you coverage because of a pre-existing health condition. To qualify for the subsidies, your household’s modified adjusted gross income for 2019 must be under $48,560 for an individual, or $65,840 for a couple. If your income is just above these thresholds, you should talk to a tax adviser about perhaps making a larger IRA contribution or strategically timing retirement account withdrawals to help you qualify. To see how various levels of income might affect your premiums and subsidies, see the subsidy calculator on the Kaiser Family Foundation website at KFF.org/ interactive/subsidy-calculator. To shop for marketplace plans in your state, visit HealthCare.gov or call their toll-free helpline at 800-3182596. If you find that you are not eligible for the subsidies and the premiums seem unaffordable, look into ACA-compliant plans that you can purchase off the marketplace directly from the insurance carrier or through a broker. In some states, you might find plans with lower premiums, especially on silver plans. To find off the marketplace policies, see health insurance shopping websites like eHealthInsurance.com, or contact a broker or agent to assist you. See LocalHelp.HealthCare.
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Lease now or plan ahead a year from now Build to Suit available Reasonable Lease gov to locate someone in your area. Short-Term Health Insurance If you can’t find an affordable ACA plan, you may want to consider short-term health insurance, which is much cheaper. These plans, which are not available in every state, are bare-bones health plans that provide coverage for three, six or 12 months – depending on state/federal rules. But be aware that short-term plans don’t comply with the ACA so they can deny sick people coverage, they don’t cover preexisting conditions and they can exclude coverage essentials like prescription drugs. To shop for short-term health insurance, visit eHealthInsurance. com or contact a local broker or agent via LocalHelp.HealthCare.gov. COBRA
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If you need health insurance coverage for less than 18 months, another option you may want to consider is COBRA, which allows you to remain on your former employer’s group health plan, but not every employer plan is COBRAeligible. Contact your employer benefits administrator to find out if yours is. In most cases COBRA is expensive, requiring you to pay the full monthly premium yourself. But, if you’ve already met or nearly met your employer plan’s deductible and/or out-of-pocket maximum for the year, and don’t want to start over with a new plan; or if you find your employer’s health plan to be better or more affordable that the other options, it makes sense to keep your current coverage under COBRA. 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. May 2019 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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From the Social Security District Office
Spruce Up Your Financial Plan With Social Security
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ow that tax season is over, it’s probably a good time to evaluate some financial “best practices” for the rest of the year. A good spring-cleaning can clear out the clutter to let you see a clear path for your future. Social Security is always here to help. Even if you just started working, now is the time to start preparing for retirement. Achieving the dream of a secure, comfortable retirement is much easier with a strong financial plan. Tip 1: Start Early Our online retirement planning resources are helpful to people at any stage of their career. Our many calculators, Benefit Eligibility Screening Tool, and disability resources are all available at www.socialsecurity. gov/planners. From here, you can read and download publications and also email and share with colleagues, friends and family. Remember, the earlier you start, the better chance you have at saving what you need. Tip 2: Be Informed We’re often asked, “What’s the
Don’t Miss the Next Issue of In Good Health Special issue highlighting Men’s Health, Diabetes, Safety/Summer,Health Careers and much more. To advertise and reach nearly 1000,000 readers, please call 716-332-0640 or send an email to editor@bfohealth.com
Serving Western New York A monthly newspaper published by Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Jenna Schifferle, Jana Eisenberg, Catherine Miller, Norb Rug, Nancy Cardillo, Eudene Harry, MD Advertising: Anne Westcott, Amy Gagliano, Karen Weaver • Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Niet No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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Q&A Q: My same-sex partner and I recently married. Will we qualify for Social Security benefits? A: You may be eligible to apply for Social Security benefits. Many factors affect your eligibility for benefits, including how long you worked and your age. Social Security is now processing more claims in which entitlement or eligibility is affected by a same-sex relationship. We encourage you to apply for benefits right away, even if you aren’t sure you’re eligible. Applying now will protect you against the loss of any potential benefits. You can apply safely and securely at www.socialsecurity. gov/applyonline. Learn more about Social Security for same-sex couples by visiting www.socialsecurity.gov/ same-sexcouples. Q: Is it illegal to laminate your Social Security card? A: No, it is not illegal, but we discourage it. It’s best not to laminate your card. Laminated cards make it difficult — sometimes even impossible — to detect important security features and an employer may refuse to accept them. The Social Security Act requires the Commissioner of Social Security to issue cards that cannot be counterfeited. We incorporate many features that protect the card’s integrity. They include highly
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
best age to start receiving retirement benefits?” The answer is that there’s no single “best age” for everyone and, ultimately, it’s your choice. The most important thing is to make an informed decision, based on your individual and family circumstances. To help you make that decision, see our retirement publications at www. socialsecurity.gov/pubs/?topic=Retirement. Tip 3: Estimate the Benefits You Might Get Knowing the amount of money you could get is pivotal in planning your finances. With the Retirement Estimator, you can plug in some basic information to get an instant, personalized estimate of your future benefits. Try out different scenarios, such as higher or lower future earnings amounts and various retirement dates to see the various potential effects on your future benefit amounts. Visit www.socialsecurity.gov/benefits/retirement/estimator.html. Social Security can help you spring into action and take control of your future with the proper planning tools. Share these online resources with friends and family so they, too, will have the tools.
specialized paper and printing techniques, some of which are invisible to the naked eye. Keep your Social Security card in a safe place with your other important papers. Do not carry it with you. Learn more at www.socialsecurity.gov. Q: My daughter receives SSI and child support from her father. Does the child support have to be reported? A: Yes. The child support your daughter receives is countable income for SSI purposes. As with any income received for an individual or a parent, if the child is under 18, it needs to be reported to your local Social Security office. For more information regarding the SSI program, visit www.socialsecurity.gov/disabilityssi/ssi.html. Q: I have medical coverage through my employer. Do I have to take Medicare Part B? A: You are not required to take Medicare Part B if you are covered by a group healthcare plan based on either your employment or the employment of a spouse. When your coverage ends, you may contact Social Security to request a special enrollment for Medicare Part B. We will need to verify your coverage through your employer in order for you to be eligible for a special enrollment. For more information, visit www. medicare.gov.
completely honest with you.” Frank says a good analogy for how body language works is to think of the entire body as an orchestra. “Each body part is a section of the orchestra, with its own cues,” says Frank. “The sections normally tell one story, similar to when the orchestra plays one piece of music. But, at times, one section might play a different tune from the other sections, which alerts us that something might not be right, and what the person says they are feeling might not be what they are actually feeling.” Here are some examples: n Lips and mouth: a world of information can be conveyed by a simple facial expression. A smile can indicate happiness or approval, while a frown signals the opposite. But other emotions — such as anger, disgust, fear, confusion and desire — can also be expressed using the lips and mouth. For example, tightening of the lips can indicate anger.
Former FBI special agent Mike Liwicki, a resident of Orchard Park: “Knowing how to read non-verbal cues can enhance a person’s professional life as well as personal life.”
Body Language What you don’t say can still speak volumes By Nancy Cardillo
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hat look on your mom’s face that indicated you were in big trouble. The gentle touch of a hand on your arm or the small of your back that makes you feel loved. Crossed arms, a raised eyebrow or pursed lips that express someone’s doubt or mistrust. We communicate with each other in many ways, but body language — or nonverbal signals — can account for more than 65 percent of all communication, and can have more than four times the impact than anything we communicate verbally. Understanding how to read and use — or decode — body language is a valuable life skill, as it can help you interpret true emotion, gain insight into someone’s personality and extract information that can help you get a job, close the sale, strengthen a relationship and possibly even save your life. Save your life?
According to behavioral expert, speaker and former FBI special agent Mike Liwicki, yes. “Knowing how to read non-verbal cues can enhance a person’s professional life as well as personal life,” the Orchard Park resident says. “It can also help someone recognize deception, aggression or danger, which can save them from a potentially lifethreatening situation. “In the business world, this skill can make you a better boss or employee, help you motivate or influence others and build trust,” says Liwicki. “It can also help you interpret, strengthen and better understand personal relationships.” Liwicki honed his body language skills during his nearly 30 years of behavioral assessment work for the FBI, where he conducted and supervised national security and criminal investigations and testified in numerous high-profile cases.
These days, the now-retired FBI agent uses his experience with and knowledge about body language to deliver presentations around the world to colleges; universities; government agencies; Fortune 500 companies, and more. “Oftentimes even though a person says one thing, the body language is telling you something else,” he says. “Picking up on those cues can help you get more information, get to the truth and recognize and solve problems.” Mark Frank, PhD, department chairman and professor in the University at Buffalo’s communication department, is also an expert on body language, having spent more than two decades studying people and their expressions. He says the face is the most telling body part to read, as it is tied directly into the emotional system, and controlled by the same part of the brain that causes the heart rate to go up or the hands to become sweaty and so sends signals to the face to respond. He cautions, though, that people have learned to manage facial expressions to some degree [think: boys being taught not to cry]. “But when an emotion is strong enough, despite our efforts to control facial expressions, some can ‘leak out’ and betray what we are saying,” says Frank. “If you know to look for even the most subtle cue, you can tell, for example, if someone isn’t being
May 2019 •
n Eyes: the eyes are very accurate barometers as to how we really feel. Our pupils, which we can’t control, will dilate or constrict when responding to certain stimuli, such as thoughts, arousal or fear. We’ve all seen that “deer in the headlights” look on the face of someone who’s just been surprised or caught off guard. When someone covers, scratches or pokes their eyes, it’s often a sign they don’t like what they are seeing, but when someone looks directly into your eyes during a conversation, it likely means they are interested in what you have to say and are paying attention. When someone is genuinely happy, they smile with both their eyes and lips. With a polite smile, however, one sees only the lips. n Hands and arms: when people are happy, they use their hands to help express that happiness (think: athletes high-fiving or audiences clapping). A clenched fist can indicate anger and gestures such as the thumbs up or a circle formed by the thumb and index finger can indicate approval. Crossed arms can indicate defensiveness, while hands placed on the hips can indicate control or aggressiveness. A firm handshake indicates confidence and tapping fingers can indicate boredom or impatience. n Feet, legs and posture: Liwicki says the feet are the most honest part of the body and the least respected because “people don’t think to control their feet during a conversation.” Someone enjoying a conversation will often rock back and forth or raise their heels. Crossed legs can indicate a person’s desire for privacy. And watch where the toes are pointing: if it’s toward the door, that person is looking to get away, whereas someone standing in a doorway with arms crossed or hands on hips and feet spread wide apart is likely trying to intimidate someone. n Understanding body language can be a critical tool when you communicate with others and are trying to truly interpret and understand what they are saying or what they mean. It’s not foolproof, and won’t take the place of verbal communication but, rather, work in concert to help you gain true insight into the behavior of others.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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H ealth News Elderwood adds six senior living facilities
Elderwood’s senior care continuum has expanded to include six new facilities across New York state. The expansion is the result of a March 28 acquisition by Post Acute Partners — Elderwood parent company — in a deal with Brookdale Senior Living based in Brentwood, Tenn. Terms of the deal were not disclosed. Elderwood’s staff will provide adult home and assisted living services in the facilities located in the Buffalo, Rochester, Binghamton and Albany metro areas. The acquisitions increase the senior care provider’s portfolio to 15 assisted living/adult home, 18 skilled nursing, and two independent living facilities in the northeast, primarily in New York. “With a strong service infrastructure in New York already, we’re excited to offer the same outstanding care and quality that current Elderwood residents enjoy to even more senior care communities in our market,” said Jeff Rubin, co-CEO for Elderwood. The communities joining Elderwood: Brookdale Bassett Road and Brookdale Bassett Park in Williamsville; Brookdale Fairport and Brookdale West Side Rochester in the Rochester area; Brookdale Vestal East in Vestal and Brookdale Colonie in the Albany area. Elderwood assumed operations at each of the sites March 28. Those facilities have been renamed. “We’re looking forward to working with our new staff, providing great service to the residents now in our care, and to welcoming new residents to these great facilities,” said Rubin. Elderwood has extended offers to more than 250 Brookdale staffers at the six sites to continue their employment with Elderwood.
Robert Nesselbush named Kaleida Health’s new CFO
Robert J. Nesselbush has been named executive vice president and chief financial officer (CFO) for Kaleida Health. Nesselbush, a senior-level financial and healthcare leader, comes to Kaleida Health from Rochester Regional Health. Nesselbush At Rochester Regional Health, he spent 24 years rising through the hospital system, beginning as the director of financial reporting and finishing as the executive vice president and chief operating officer. “We are absolutely thrilled to be able to recruit Bob and bring him home to Kaleida Health and Western New York,” said Jody L. Lomeo, president and CEO of Kaleida Health. “He has a tremendous track record in health care and is widely known as a service-oriented leader. Throughout his two decades in Page 22
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Rochester he built employee-friendly operational and financial systems that helped front line staff focus on what’s most important the patients in their care.” Nesselbush was a key part of the executive leadership team that founded Rochester Regional Health in 2014. Combining the Rochester General and the Unity Health systems, the network now includes five hospitals, 87 ambulatory locations,
eight senior living facilities, 16,000 employees and 2,500 physicians. “It’s an exciting honor to be named CFO of one of the nation’s leading health care systems,” said Nesselbush. “Kaleida Health has grown significantly over the past several years, and I look forward to helping continue their impressive success.” Nesselbush and his wife Marlene are Western New York natives, hav-
BCBS Employees Donate $75,000 to Local Charities They have contributed a half-million dollars since 2005
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lueCross BlueShield of Western New York employees recently donated $75,000 to 15 local charities ($5,000 each). The health plan’s 1,500 employees have raised and contributed more than $500,000 to the organization’s “Red Stocking Fund” since 2005. Established more than 60 years ago, the name of the fund was derived from the literal use of red stockings to collect charitable donations around the holiday season. Today, the largest contribution comes from casual Friday donations, in addition to personal contributions and a number of other year-round fundraising efforts anchored by the employee-led “BlueCrew.” “BlueCross BlueShield has a long-standing history of supporting initiatives that enhance the health of Western New York,” said Doug Parks, senior vice president, chief human resources officer, BlueCross BlueShield of Western New York. “Our employees exemplify our company’s values by going above and beyond to make a positive impact in our community.” Employees are given the opportunity to select the Red Stocking Fund’s receiving charities from a long list of worthy 501(c)(3) nonprofit organizations each year. This donation is in addition to the health plans corporate giving
program, which saw community investments of more than $6 million in 2018. The 2019 recipients:
• Autism Services, Inc.: Creates meaningful opportunities that enrich the lives of people with autism, their families and their communities • Black Dog Second Chance: The mission of Black Dog Second Chance is to find the right homes for the dogs in their care and match the best dog with the best family. • Breast Cancer Network of Western New York: Provides education, advocacy, and support for people affected by breast cancer • City of Buffalo Animal Shelter: Promotes the health and welfare of animals in the care of the City of Buffalo Animal Shelter. • Buffalo City Mission: Offers long-term recovery programs, counseling, work and life-skills training, education assistance and health-care services for homeless men, women and families committed to turning their lives around • Camp Good Days and Special Times, Inc.: Provides services for children with cancer, children who have a parent or sibling with cancer or children who have lost a parent or sibling to cancer • Friends of Night People: Pro-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • May 2019
ing grown up in West Seneca. He is a graduate of Bucknell University with a bachelor of arts and completed his master’s in business administration (MBA) with a focus on public accounting. Nesselbush began his career and spent five years as a senior accountant with PriceWaterhouseCoopers in Rochester.
vides food, clothing, medical care, counseling and hope to those in need • Hospice Buffalo: Provides medical care, emotional and spiritual support to people and their families facing life-limiting illnesses • Make-A-Wish Western New York: Grants wishes to children between the ages of 2 1/2 and 18 who are coping with a life-threatening disease • Mercy Flight Western New York: Provides airborne medical transportation and supporting services, ensuring rapid, safe, and cost-effective delivery of expert emergency response personnel, patients, organs, and supplies • Ronald McDonald House Charities of WNY: The mission of RMHC of WNY is to create, find and support programs that directly improve the health and wellbeing of children. • SPCA Serving Erie County: A charitable community resource dedicated to protecting and providing shelter and comfort to all animals in need • The Buffalo Zoo: Promotes wildlife conservation through upclose animal encounters, engaging educational experiences, and participation in regional and international programs for endangered species • Kevin Guest House: The mission of Kevin Guest House is to provide a comfortable and supportive home away from home for patients and their families traveling for medical care. • Wings Flights of Hope: The mission of Wings Flights of Hope Inc. is to provide free air transportation for medical and humanitarian purposes.
H ealth News Colucci appointed ECMCC’s new VP, general counsel
Erie County Medical Center (ECMC) Corporation officials today announced that Anthony J. Colucci III has been appointed executive vice president and general counsel of Erie County Medical Center Corporation Colucci (ECMCC). The appointment was made at the end of 2018. Colucci also serves as general counsel to Great Lakes Health, which includes ECMCC, Kaleida Health and the University at Buffalo. He plays a leading role in the development and execution of strategic initiatives, based on quality and clinical excellence, between ECMCC, Kaleida Health and their Great Lakes Health partners. In 2004, Colucci was part of the team that worked to successfully create ECMCC as a state public benefit corporation and has had a key role in many of the corporation’s achievements since that time. And in 2008, he played a central role in the formation of the Great Lakes Health System of Western New York, clearing the way for unprecedented collaboration among previously competing health systems. At ECMCC alone, that collaboration resulted in the creation of the Regional Center of Excellence for Behavioral Health and the Regional Center of Excellence for Transplantation and Kidney Care. In 2016, Colucci successfully concluded work on another ECMC-related law that further encourages collaboration with Kaleida Health and the State University of New York at Buffalo by exempting certain agreements from potential anti-trust liabilities. He will continue to oversee the legal, compliance and risk management functions at ECMCC and leads business development efforts. In addition to being licensed to practice in New York state, Colucci has been admitted to practice in federal district courts in New York, Illinois, Indiana, Kentucky, Massachusetts, Michigan, Minnesota, Ohio and Pennsylvania, the federal First and Second Circuit Courts of Appeal, and the United States Supreme Court. He received his JD from the Columbus School of Law at Catholic University of America and his AB in government from St Lawrence University.
Roswell Park marketing teams share best practices
Once a year, professionals who work in various communications, marketing and fundraising roles for the nation’s top cancer centers gather for best practice sharing, professional
development and collaboration. Several Roswell Park Comprehensive Cancer Center team members were invited to share their expertise during the just-ended joint gathering of the National Association of Cancer Center Development Officers (NACCDO) and the Public Affairs and Marketing Network (PAMN). Nine different Roswell Park team members were invited to lead sessions at this year’s meeting, hosted by Stephenson Cancer Center, which is among the elite group of National Cancer Institute-designated comprehensive cancer centers to which Roswell Park belongs. They spoke on topics ranging from “Tech Talk: Choosing the Right Digital Tools” and “Visual Story Telling with Purpose” to a plenary session on how to “Collaborate for a Cure.” Those making presentations were: Daniel Cave, online marketing specialist; Karen Cincotti, assistant director of web IT operations, department of development; Laurel DiBrog, chief marketing and communications officer (and PAMN treasurer); Cindy Eller, vice president for development and executive director of the Roswell Park Alliance Foundation (and NACCDO treasurer and chairwoman emeritus); Heidi Findlay, executive director of marketing and communications (and PAMN steering committee member); Jennifer Hickok, director of corporate part-
nerships; Gretchen LaRock, manager of annual giving; Ben Richey, executive director of creative and content technology; and Ashley Snowden, physician relations liaison. “Every year our team is well-represented at this conference, serving as thought leaders among a peer group that is essential to communicating the unique value we bring as cancer centers,” says Roswell Park President and CEO Candace S. Johnson. “Our excellence doesn’t stop at our scientists and faculty. Our entire team is made up of leaders in our field.” The Roswell Park team is active in the NACCDO-PAMN group all year long, lending their expertise to various professional-development activities, such as webinars and blog posts, and plays a vital role in the planning of every annual conference. Roswell Park will host and plan the organizations’ joint 30th anniversary annual meeting, to be held in May 2020.
The BOGO Bunch Foundation donates $75,000 to Roswell
Buffalo Sabre Zach Bogosian and his wife, Bianca, recently presented Candace Johnson, Roswell Park President and CEO, and a patient with a $75,000 donation to support research and care at the comprehensive cancer
Providers at Our Lady of Peace in Lewinston Jeneveive Nablo, director of nursing (left), and Stephanie Meyer, clinical associate, with patient Patrick O’Connell. They are reviewing with how the EarlySense system monitor’s his safety.
Our Lady of Peace Adopts Contact-Free Monitoring
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ewiston-based Our Lady of Peace, a leading provider of nursing and rehabilitation services in Western New York, announced it has implemented EarlySense’s contact-free, continuous monitoring solution. The 250-bed facility installed the patient monitoring platform to advance patient safety and care. “Adoption of our continuous monitoring technology continues to grow rapidly and our customer
partners are seeing incredible results, including dramatic reductions in patient falls, and earlier detection of potential adverse events due to deterioration, all contributing to improved patient care and outcomes,” said Tim O’Malley, president of EarlySense. Jenevieve Nablo, director of nursing at Our Lady of Peace, said that “This technology has resulted in an improvement in the quality of care our residents receive, including improved sleep hygiene, leading to a
May 2019 •
center. The funds were raised at Casino for a Cause II, the BOGO Bunch Foundation’s roaring 1920s-themed event held on in February at Town Ballroom. More than 600 guests attended the event, which featured live and silent auctions, as well as special appearances by Bogosian Buffalo Sabres teammates, who served as the gaming table dealers for the night. To date, the $75,000 gift is the largest donation the foundation has made to any organization. Combined with donations from their first Casino for a Cause event in 2017 and the Bogosian Kancer Jam Kan Jam tournament in 2018, the foundation’s contributions to Roswell Park total $155,000. “Our community is really fortunate to have one of the nation’s leading cancer centers right here in Buffalo, and the BOGO Bunch Foundation is proud to play a part in advancing their mission,” says Bogosian. “Bianca and I are thankful to the Sabres organization, sponsors, volunteers and everyone who attended the event that helped in making this donation possible. We know these dollars are in good hands and will be used to develop new treatments and therapies that can improve the quality of life for patients and potentially save lives from cancer.”
better resident experience.” A study conducted at Our Lady of Peace concluded that the devices have helped prevent adverse events, including code blue (cardiac or respiratory attack) events, preventable hospital transfers, patient falls, and pressure ulcers. “Our clinical team is able to track unstable and new residents non-evasively, in real time,” said nurse Marilyn Gristmacher, subacute unit manager at Our Lady of Peace. “The EarlySense system uniquely monitors resident’s allowing them to sleep through the night, providing restful, healing sleep.” Gristmacher said the new system will notify the nurse immediately, via wireless communication, if the resident’s vital signs fall out of established parameters or if the patient needs to be re-positioned.” “As a locally owned and operated facility, Our Lady of Peace continues to search for opportunities that improve our residents’ care, not just the bottom line,” stated Jonathan Hart, executive director, Our Lady of Peace. “Kudos to our nursing leadership team for seeking technology which protects and promotes positive resident outcomes. Too often facilities miss opportunities to take the next leap forward in resident care, that just seem common sense, because they are either stuck in the routine of “how they do things” or don’t want to invest the capital needed.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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