PRICELESS
Looking for Better Treatments for COPD Sanjay Sethi, a Buffalo physician, is one of the nation’s foremost experts in studying and treating COPD — he is working to find better drugs, treatments for the disease
5
Things You Need to Know About Skin Cancer Prevention
Only half of U.S. kids, teens have ideal cholesterol levels. See ‘Kids Corner’ inside
Is Herbicide, like Roundup, Safe?
BFOHEALTH.COM
JULY 2019 • ISSUE 57
Summer Fitness for Women
Do’s & Don’ts
The Top 5 Fruits to Add to Your Diet Researchers have looked at the most nutrient-dense fruits and vegetables to see which provided meaningful amounts of B vitamins including thiamin, riboflavin, niacin, folate, B6 and B12, vitamins C and K, iron, fiber and protein. Most of the top spots on their ranked list of powerhouse fruits — those most strongly associated with reducing the risk of chronic diseases — were various citrus fruits with one popular berry mixed in.
The top 5 nutrient-dense fruits
Women’s Health by Decade Main issues women should pay attention to as they age
p. 12
• Lemons • Strawberries • Oranges • Limes • Pink and red grapefruit As terrific as blueberries are considered, blackberries were actually the next fruit on the list,
followed by white grapefruit. Now this isn’t to say that blueberries, which many studies rank very high for antioxidants and other healthful compounds, shouldn’t be on your shopping list along with raspberries. Eating fruits in a rainbow of colors gets you the widest variety of nutrients and phyto-nutrients — those hard-to-duplicate compounds that go beyond vitamins and minerals. It’s also important to pay attention to a fruit’s ripeness. Studies show that ripe fruits, including all berries, offer more antioxidants than fruits that are not quite ready. Based on that criteria, strawberries topped the list, followed by black raspberries, blackberries and red raspberries in that order. Remember that fruits have more calories than vegetables, so watch your portion sizes. P. 23
Can Italian sausage be part of a healthy diet? Story on p. 11
1,000,000
Number of new sexually transmitted infections cases every day among people aged 15-49 years, according to the World Health Organization.
Story on p. 7
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Jennifer Lynn Hoffman recently received a third cancer diagnosis. The director of WNY Dyslexia Specialists in Buffalo is planning a July 21 benefit to raise funds to help with medical expenses.
Help Jennifer Lynn Hoffman Heal Her Cancer
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ennifer Lynn Hoffman is the owner and director of WNY Dyslexia Specialists in Buffalo. She and her husband Ken opened this literacy center after realizing the need in the community for specialized reading and spelling instruction for dyslexics. Since its opening in 2016, the center has treated many children and adults who have shown vast improvement. In August 2018, Hoffman was diagnosed with Stage 3 oral squamous cell carcinoma (the same cancer Buffalo Bills Hall of Fame quarterback Jim Kelly was diagnosed with) and she had surgery and received radiation therapy. In March 2019, the cancer returned. Hoffman underwent a second surgery. A third diagnosis of cancer in her neck was detected in May 2019, this time more aggressive than the first two diagnoses. She is currently in chemotherapy at ECMC with surgery to follow.
A benefit will be held for her from 3 to 8 p.m. Sunday, July 21, at Iron Workers Hall, 196 Orchard Park Road, West Seneca. Three local bands will provide musical entertainment: Shadows Dawn, (nominated Best New Band, Buffalo Music Awards 2018), Walter Oblivion (nominated Best Alternative Band, Buffalo Music Awards 2019) and The Knight Crew (Winner Best Rock Band, Best Female Vocalist in Debbie Juliano Knight, and Best Rock Guitarist in Scott Gay, Buffalo Music Awards, 2019) Tickets to attend are $30 per person pre-sale and $35 at the door. It will cover general admission, entertainment, food and refreshments. Basket raffle, 50/50 and other raffles will take place. For further information on Hoffman’s journey, visit http://www. facebook.com/livingwithoraltonguecancer/
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
In Good Health
WNY’s Healthcare Newspaper Reaching consumers, providers. For advertising information email
editor@bfohealth.com
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Meet
Your Doctor
By Chris Motola
Sanjay Sethi, M.D.
Buffalo physician, one of the nation’s foremost experts in studying and treating COPD, working to find better drugs, treatments for chronic pulmonary obstructive disease Q: We hear a lot about COPD (chronic pulmonary obstructive disease) nowadays, but I’m not sure most people really understand what it is. What is it exactly? A: We used to use the terms “chronic bronchitis” and “emphysema” to describe types of it. Essentially, it’s the persistent obstruction of airflow structures. A substantial majority of it is caused by tobacco smoking, about 85% of it, at least in this country. It can be caused by other things like pollution and biomass smoke exposure, but those things are more common in other parts of the world. Q: You’ve recently done some research that looked at the role of bacteria in the lungs and the relationship it is has to COPD symptoms. A: We’ve been working on this for quite some time. Our contribution has been to understand how much of a role infection, especially bacterial infection, plays in COPD development. Patients with COPD have periodic episodes where it seems to get worse. So we have found that infections do contribute to these exac-
erbation episodes. They also contribute to the progression of the disease. The lungs are normally capable of keeping themselves, not quite sterile, but with fairly low concentrations of bacteria. But in patients who develop COPD, their local immune functions are compromised and they end up with chronic infections in their lungs. So that’s what our work has been, and there have been many offshoots of that research with clinical studies. Q: What can be done once that chronic infection develops? A: Right now, the one resource we really have is antibiotics, which is normally what we use on bacteria. We advocate appropriate use of antibiotics on these patients, because of course resistance becomes an issue. What we’re looking for more ideally is vaccine development. We are trying to develop vaccines for some of those bacteria. The other thing we’re trying to figure out is what are the mechanisms of the immune dysfunction. Why do these people become more susceptible to infections in the first place? If we figure that out,
we may be able to correct it. In my opinion, this is the right approach. In the meantime, we have antibiotics, mostly to treat exacerbation. There has been some research indicating a potential use for chronic usage of antibiotics. That would be in people who have frequent exacerbations. It’s kind of a last resort. We do already have a pneumococcal vaccine, as well as the influenza vaccine, but we’d like to have other vaccines available as well. Q: And just to be clear, the pneumococcal vaccine is for pneumonia, correct? A: Yes, it’s the pneumonia vaccine. It’s very helpful, but it only deals with one of the bacteria that we’re concerned with. There are others that contribute to the disease, and we’d like to see vaccines for those as well. Q: You’ve done some work with veterans. Are they generally more at risk for COPD? A: Yes, but there’s also a higher rate of smoking among veterans, especially if you’re going back to the Vietnam and Korean War vets, so that’s from before we knew how bad smoking was. A lot of them got addicted to tobacco back during their time in the service. Q: So it’s mostly just a smoking issue? A: Well, mainly smoking. There is some interesting stuff from the Gulf, Iraq and Afghanistan wars. A lot of those veterans were exposed to burn pits that these used to dispose of things at their posts. So it’s actually not so much COPD with those vets, but it presents with airflow obstruction, but it is related. Some of them present with closer to asthma symptoms. That’s something I haven’t really done research in, but I’ve dealt with it clinically. It’s not COPD, but it’s related to it.
Q: What other research are you currently involved in? A: I do a lot of clinical studies in terms of new drug development. It’s not just lab-based research, it’s clinical as well. I used to only see patients at the VA, but I started seeing patients at outpatient clinics for UBMD, Buffalo General and Roswell. We do a lot of clinical research now with non-veterans at those locations. Most of the clinical research likes to focus on COPD, but we just launched an asthma study looking at another version of a drug that’s currently available. We also got funded to do something very interesting called “network biology.” So essentially in the past, when we were looking at the lung, we could only look at a handful of molecules at a time. Now with all these new techniques we can example multiple molecules or genes as the same time. So the question now is how do you analyze them? So this work it going to be done at the VA, UB and Rochester Regional. The person from Rochester does network biology research, so we’re going to share data from COPD patients, try to understand how all these molecules talk to each other and how it differs when they’re stable versus when they’re having an exacerbation. Q: What’s been responsible for the increase in asthma rates? A: If you look at COPD and asthma, the prevalence of COPD had been going up, but now it’s going down, and that’s because finally there is less smoking; the smokers there are do still often develop it, but there are fewer of them. Asthma is a whole different story. Asthma is generally not smoking related. There’s a lot of diagnostic confusion between the two; there’s a lot of overlap. But asthma may be allergic or non-allergic. Essentially, with asthma the prevalence went up and it’s not really clear why. One of the interesting hypotheses is that having too sterile environment during the first couple years of life may not actually be good for you and may actually encourage asthma development. It’s called the “hygiene hypothesis.” There are a lot of studies trying to understand why this happens, but we may have created too sterile an environment for infants. It’s almost as if the immune cells that should be dealing with pathogens end up with nothing to do and orient themselves toward normal environmental exposure. And there’s some good evidence that this may be what’s happening.
Lifelines
Name: Sanjay Sethi, M.D. Position: Professor and chief, division of pulmonary, critical care and sleep medicine in the department of medicine, Jacobs School of Medicine and Biomedical Sciences at UB and a physician with UBMD Internal Medicine. He is a staff physician at VA Western New York Hometown: Delhi, India Education: Maulana Azad Medical College Affiliations: Buffalo General, Roswell Park, VA Western NY Organizations: American Thoracic Society Family: Wife, one daughter, one son Hobbies: Tennis, traveling Page 4
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 5
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Friendships Can Blossom Any Time of Year: It’s Never Too Late Question from a reader:
I’ve been divorced for about a year now, and struggle with loneliness. I miss the friends we shared as a couple, but I’m just not comfortable socializing with couples anymore. I’m 56, and it feels awkward to try to make friends at my age. Any advice for me?
Answer from Gwenn:
I
t’s unfortunate, but what you are experiencing often happens in the aftermath of a separation or divorce, especially if it was acrimonious. Friends’ loyalties can be split and, just as you feel uncomfortable relating to your former “couple” friends, some couples feel uncomfortable relating to a now-single friend. So how do you meet new people and cultivate friendships as an adult? Here are a few tips: First, be your own best friend. Taking care of yourself matters. Loving yourself shows. The better you feel about yourself, the better friends you’ll attract. Positive people appre-
ciate and gravitate to other healthy, positive people. Do what you like doing. You won’t make friends sitting alone at home. Get out of the house and do those things you enjoy, whether it’s going to the gym, walking your dog, taking a cooking class, joining a book club, or any number of activities that are fun and active. You’ll meet people who share your interests and love of life. Friendships will likely follow! Consider a support group. It’s not uncommon for new friendships to be borne out of compassion and empathy. A divorce or grief support group will put you in touch with others facing similar challenges. A friend of mine met her second husband in a divorce support group. She shared, “We got to know each other as friends first, and have remained ‘best friends’ throughout our marriage. It’s the best thing that ever happened to me.” Say “yes” to invitations and opportunities to be with people. Circulating at parties, neighborhood meetings,
work events, etc. is one of the easiest ways to make new friends. You’ll be out and about with people with whom you share something in common. Show up and don’t be shy about extending an invitation to someone you meet. It could be a cup of coffee, drinks after work or walk in the park. Don’t overlook your family. My sister is my best friend, and she helped me re-establish a network of friends after my divorce. I had gone into the proverbial “cave” and lost contact with practically everyone. Her friends became my friends, and now, years later, I enjoy the company of her friends, as well as my own. Rekindle relationships with old friends. Sometimes friends drift away when you get married, and are therefore long gone when you may need them most. That’s not unusual. New priorities take over and establishing a new married life together requires time and focus. But now, when you’re looking to find new friendships, consider reconnecting with old friends. They were an important part of your life at one point, and may still have lots to offer. Pick up the phone. Give a “singles” event a try. Many divorced or widowed men and women find fun and friendship in community activities organized just for singles. It could be a hike, bike ride, dinner club or dance. These opportunities are often included online in community calendars or in your local newspaper. Volunteer or join a cause. Supporting an organization or cause you believe in will put you in contact with people working toward a common
goal. Community gardens, political parties, hospitals, museums, animal shelters and many other organizations often need volunteers. Strong connections can be made when you work alongside others who want to make the world a better place. Join an online community of people who share your interests. Social networking sites can be a safe and satisfying way to meet people. One popular site is www.meetup.com, which facilitates group meetings in cities and towns near and far. Meetup allows members to find and join groups unified by a common interest, such as nature, photography, hiking, books, movies, health, pets, careers, hobbies, you name it! Good friendships can make life better. The company of someone who makes you laugh, who provides a shoulder to lean on when you need one, and who is just plain fun to hang out with can provide a welcome boost to your health and happiness. So, if you feel your social network is too small, remember you can always meet new people, make new friends, and nurture existing ones. It’s never too late. Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon. 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
s d i K Corner
Only Half of U.S. Kids, Teens Have Ideal Cholesterol Levels
C
holesterol levels in U.S. youth have improved from 1999 to 2016, but only half of children and adolescents are in the ideal range and 25% are in the clinically high range, according to a study published in JAMA, led by cardiologist Amanda Marma Perak at Ann & Robert H. Lurie Children’s Hospital of Chicago. The study is the first to report estimated prevalence of high cholesterol in youth in recent years, analyzing nationally representative data from more than 26,000 children and adolescents (aged 6-19 years). “High cholesterol in childhood is one of the key risk factors for developing heart disease later in life,” says Perak, who is also an assistant professor of pediatric cardiology and preventive medicine at Northwestern University Feinberg School
Page 6
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of Medicine. “Although we see favorable trends in all measures of cholesterol in children and adolescents over the years, we still need to work harder to ensure that many more kids have healthy cholesterol levels. We know that high cholesterol is the critical initiator of atherosclerotic plaques in the arteries, and even in childhood it is associated with these changes in the blood vessels that can lead to heart attack in adulthood.” For children and adolescents, ideal measures include total cholesterol (TC) at less than 170 mg/ dL, LDL or “bad” cholesterol at less than 110 mg/dL and HDL or “good” cholesterol at greater than 45 mg/ dL. These levels are associated with better long-term health. All youth should have their cholesterol checked at aged 9 to 11 years and again at 17 to 21 years, according to the latest
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
guidelines from the National Heart, Lung and Blood Institute. “If a child is found to have borderline-high or high levels of cholesterol, we can usually improve those levels through lifestyle changes, such as healthier diet and increased physical activity,” says Perak. “Children are rarely placed on cholesterol-lowering medications like statins.” The improving cholesterol trends observed in the study are surprising given that obesity is one of the factors that drives abnormal cholesterol levels and childhood obesity continues to increase.
“More research is needed to understand the reasons for the favorable cholesterol trends we found,” says Perak. “Some factors that influence cholesterol may be improving, such as decreased trans fats in the food supply. Although more efforts are needed, the fact that cholesterol levels are moving in the right direction warrants some optimism about the future cardiovascular health of our population since cholesterol is such an important driver of cardiovascular disease.”
MORE LIFE TO LIVE!
More Than 1 Million New Sexually Transmitted Infections Every Day
Chlamydia, gonorrhea, trichomoniasis and syphilis lead list of most common STI cases
E
very day, there are more than 1 million new cases of curable sexually transmitted infections (STIs) among people aged 15-49 years, according to data released in June by the World Health Organization. This amounts to more than 376 million new cases annually of four infections: chlamydia, gonorrhea, trichomoniasis and syphilis. “We’re seeing a concerning lack of progress in stopping the spread of sexually transmitted infections worldwide,” said physician Peter Salama, executive director for Universal Health Coverage and the LifeCourse at WHO. “This is a wake-up call for a concerted effort to ensure everyone, everywhere can access the services they need to prevent and treat these debilitating diseases.” Published online by the Bulletin of the World Health Organization, the research shows that among men and women aged 15–49 years, there were 127 million new cases of chlamydia in 2016, 87 million of gonorrhea, 6.3 million of syphilis and 156 million of trichomoniasis. These STIs have a profound impact on the health of adults and children worldwide. If untreated, they can lead to serious and chronic health effects that include neurological and cardiovascular disease, infertility, ectopic pregnancy, stillbirths, and increased risk of HIV. They are also associated with significant levels of stigma and domestic violence. Syphilis alone caused an estimated 200,000 stillbirths and newborn deaths in 2016, making it one of the leading causes of baby loss globally. STIs remain a persistent and en-
demic health threat worldwide. Since the last published data for 2012, there has been no substantive decline in either the rates of new or existing infections. On average, approximately one in 25 people globally has at least one of these STIs, according to the latest figures, with some experiencing multiple infections at the same time. STIs spread predominantly through unprotected sexual contact, including vaginal, anal and oral sex. Some — including chlamydia, gonorrhea, and syphilis — can also be transmitted during pregnancy and childbirth, or, in the case of syphilis, through contact with infected blood or blood products, and injecting drug use. STIs are preventable through safe sexual practices, including correct and consistent condom use and sexual health education. Timely and affordable testing and treatment are crucial for reducing the burden of STIs globally, alongside efforts to encourage people who are sexually active to get screened for STIs. WHO further recommends that pregnant women should be systematically screened for syphilis as well as HIV. All bacterial STIs can be treated and cured with widely available medications. However, recent shortages in the global supply of benzathine penicillin has made it more difficult to treat syphilis. Rapidly increasing antimicrobial resistance to gonorrhea treatments is also a growing health threat, and may lead eventually to the disease being impossible to treat.
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, Jenna Schifferle, Julie Halm, Jana Eisenberg, Kimberly Blaker • 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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Is Herbicide Safe? By Deborah Jeanne Sergeant
I
f you want your property to look like the putting green at Pebble Beach, you might rid your lawn of pesky weeds with a glyphosatebased herbicide such as Roundup. The popular brand introduced by Monsanto in 1973 has become a staple of groundskeepers, farmers and homeowners who want to kill weeds while keeping beneficial plants. The European Food Safety Authority (EFSA) and the U.S. Environmental Protection Agency (EPA) had stated that glyphosate is unlikely to pose a cancer risk to humans. However, in 2015, the World Health Organization’s research entity, International Agency for Research on Cancer, decided that Roundup was “probably carcinogenic” like other items such as red meat on its list of possibly carcinogenic items. After a series of lawsuits were filed against Monsanto regarding Roundup’s use correlating with development of cancer, many consumers wonder about its safety. The first notable case in the US was that of Dewayne Johnson (not the actor Dwayne “The Rock” Johnson), who received an award of $78 million because Monsanto did not offer enough warning of the product’s cancer risks. Page 8
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Johnson worked as a groundskeeper and developed non-Hodgkin’s lymphoma after regularly using Roundup and Ranger Pro, another Monsanto herbicide. The jury’s decision revolved around whether or not the company warned about health dangers, not that any dangers were present. For homeowners who use it sparingly once or twice a season as the package directs and with the proper safety equipment, any risk involved is likely less than for those who use it daily and without taking safety precautions. “Their use is not to be taken lightly,” said Rochester-based physician Joanne Wu, who practicesin Buffalo. “Their use is associated with inhalation, oral, and contact injury of our organs such lungs, brain, kidneys, liver and eyes. They are meant to keep our lawns beautiful but at a price.” Physician Sanford Levy, board certified in internal medicine and clinical associate professor of medicine, University at Buffalo, cautioned about using RoundUp and related products. “There’s emerging scientific data [showing] that it can be harmful to human health in numerous ways,”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
Levy said. “It’s best avoided but if it is used, use it sparingly, as opposed to spreading it in large areas.” Anyone who chooses to use herbicides should use approved, well-fitting personal protective equipment to protect the eyes and cover the skin, and a face mask to avoid inhaling any mist. Following the package directions on the package is also important to minimize the risk. More isn’t better. If the formulation requires diluting, do so with care and per the package directions. Apply only what’s necessary where it’s advised to do so and avoid using it on windy days. Users can also minimize the amount of chemical products sprayed by using organic herbicide (it’s most effective
on small weeds) and strategic planting. Cover crops and mulching discourage weed growth, for example. Some gardeners use boiling water to wither weeds and keep areas prone to weeds mowed before weeds go to seed. Physician Wu also warned that eating produce grown with herbicides and pesticides can negatively affect health. She and Levy both advise eating organic. If that is not affordable, Levy said to at least buy the “dirty dozen” organic. These are the produce categories identified by the Environmental Working Group as most likely to bear pesticide. The group doesn’t offer a list related to herbicides. The dirty dozen is comprised by strawberries, spinach, kale, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery and potatoes. “People should be concerned,” Levy said. “Approval of chemicals in the United States is a matter of philosophy. We don’t follow the precautionary principle that some European countries follow. From a regulatory standpoint, it’s not approving the chemical unless there’s significant evidence of safety. In US, it is a lack of evidence of harm instead of showing they’re safe. It doesn’t mean much that there’s a lack of harm.” The “clean fifteen” are items that pose the lowest risk when conventionally grown: avocadoes, sweet corn, pineapple, sweet peas (frozen), onions, papayas, eggplant, asparagus, kiwi, cabbage, cauliflower, cantaloupe, broccoli, mushrooms, and honeydew. At www.roundup.com/en-us, Roundup offers an array of videos for selecting and using their products more safely. Organizations such as Northeast Organic Farming Association of New York (www. nofany.org) offers tips on how to grow things without chemical inputs.
U.S. Cancer Cases, Deaths Continue to Fall
Good news on a major killer: U.S. cancer deaths continued to fall between 1999 and 2016. So finds the latest Annual Report to the Nation on the Status of Cancer, from a consortium of leading cancer organizations. The report also found that the rate of new cancer cases fell among men from 2008 to 2015, after increasing from 1999 to 2008, and was stable in women from 1999 to 2015. Still, much more progress is needed. “Major declines overall in cancer mortality point in the right direction, yet significant differences remain in cancer cases and deaths based on gender, ethnicity and race,” said physician Robert Redfield, director of the U.S. Centers for Disease Control and Prevention. Overall, cancer death rates decreased 1.8% per year in men and 1.4% per year in women, continuing an ongoing trend. From 2011 to 2015, cancer incidence rates — the rate of new cases
— were stable in women and decreased 2% per year in men. Why men are charting a bit more improvement in avoiding cancer compared to women isn’t clear, Redfield said. “A better understanding of these discrepancies improves cancer diagnosis and recovery for all patients and is vital to our public health mission,” he said in a news release from the U.S. National Cancer Institute (NCI). Among individual tumor types, progress appears to be continuing against lung cancer, largely due to declines in smoking; and against melanoma skin cancer, due to new and better treatments. On the other hand, cancers where obesity is a risk factor — early-onset colon cancer, breast cancer in older women, and uterine cancers — are on the rise. A special section of the report tracked cancer rates for younger Americans — those aged 20 to 49. It found that, in this age group, cancer
incidence and death rates were higher for women than men. From 2011 to 2015, the average annual incidence rate for all invasive cancers in this age group was 203 per 100,000 among women and 115 per 100,000 among men, the report found. Lead author Elizabeth Ward, a consultant at the North American Association of Central Cancer Registries (NAACCR), said, “The greater cancer burden among women than men ages 20 to 49 was a striking finding of this study.” Among this younger cohort, cancer incidence rates fell an average of 0.7% a year among men but rose an average of 1.3% per year among women, the report found. And from 2012 to 2016, the average annual cancer death rate was 27 per 100,000 among women and nearly 23 per 100,000 among men in this age group. Still, some improvements were seen: From 2012 to 2016, cancer death rates fell overall for young Amer-
icans. The death rate fell 2.3% per year among men and 1.7% per year among women, the report found. Among Americans aged 20 to 49, the most common cancers and their incidence rates among women were breast cancer (73 per 100,000), thyroid cancer (28 per 100,000), and melanoma (14 per 100,000). The most common cancers among men in this age group were colon and rectal cancer (13 per 100,000), testis (nearly 11 per 100,000), and melanoma (10 per 100,000). Younger women’s heightened vulnerability to cancer compared to their male peers appears concentrated in one cancer type, Ward noted. “The high burden of breast cancer relative to other cancers in this age group reinforces the importance of research on prevention, early detection, and treatment of breast cancer in younger women,” she said. And physician Douglas Lowy, acting director of the NCI, said that “it is important to recognize that cancer mortality rates are declining in the 20- to 49-year-old age group, and that the rates of decline among women in this age group are faster than those in older women.” The report was published May 30 in the Journal of the National Cancer Institute.
Healthcare in a Minute
By George W. Chapman
‘Surprise’ Bills —Senate Health Committee to Deal with Problem
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hese are bills sent to you by providers who, unbeknownst to you, are non-participating providers in your insurance plan. They can send you a bill for the difference between their charge and what your insurance company paid them. (Participating providers contractually agree to accept your insurance payments.) A typical example would be when you receive services from a participating hospital emergency department only to learn when the bill arrives (surprise!) that the emergency department is staffed by a national MD group that doesn’t accept nor participate in your insur-
Price Transparency
The same bill that addresses “surprise” billing also addresses price transparency. It would require providers and insurers to give patients price quotes on expected out-of-pocket expenses so consumers can shop around. It would require insurers to keep up-to-date directories so patients know what providers are in network in the first place which would virtually eliminate surprise bills. It would also ban anti- competitive language in contracts between an insurer and a healthcare system that prevent patients from seeking lower cost/higher quality providers.
JAMA and Single Payer
For the first time in a long time, JAMA (Journal of American Medical Association) published an opinion piece supporting the concept of a single payer for healthcare. Recent surveys and polls reveal half of
ance. The obvious question is, why would a participating hospital staff its ED with non-participating providers? The answer is they may not have much of a choice, especially if it’s a hard-pressed rural hospital that cannot maintain its own staff. A rare bipartisan bill coming out of the Senate health committee deals with surprise bills. It would require all providers that work for an “in network” hospital to accept a patient’s insurance. In this ED example, the national MD staffing group company must agree to become participating providers or agree to send their bill directly to the hospital vs. the patient. physician respondents now support the concept of a single payer system for healthcare. This was not nearly the case 20 years ago or so, when commercial payers paid physicians considerably more than Medicare for the exact same service. Over time, commercial insurance companies gradually lowered their fees to the equivalent of Medicare fees, or close to them, causing a lot of physicians to wonder what’s the point of the administrative hassle created by multiple payers if all are now paying about the same as Medicare. The Medicare physician fee schedule, once derided as a necessary evil by physicians, has become the “gold standard” of all physician fees. By dropping their fees to Medicare equivalents, commercial carriers have unwittingly created the case/ justification for a single payer system. Despite the rationale, physicians remain justifiably wary of a single
payer that would have a monopoly on their fees. To counter, the idea of a physician’s union has been floated.
sponding “medical loss ratio” was 103%, meaning the insurer spent 3% more on claims than it made in premiums. In 2018, the insurers made an astounding $166.82 per member per Advantage Plans month. The corresponding medical Medicare Advantage (MA) plan loss ratio was an industry enviable applications were up 87% the first 70% meaning the average insurer quarter of 2019 vs. the same period spent 30% less on claims than it made last year. MA plans are administered by commercial carriers like Aetna, Ex- in premiums. The ACA requires a small market insurer to refund moncellus, Cigna, United, etc. They typey to its members when their medical ically charge a small premium more loss ratio is under 80%. Stated anothper month than regular Medicare because they offer more benefits. The er way, insurers can keep up to 20% typical MA “premium” decreased this of their premiums, but must refund year from $12 to $8 a month. Industry anything over that. All told, insurers will refund about $800 million to experts believe the price drop is due members. to competition, increased efficiency and tech savvy baby boomer consumers. Seniors are free to move back CVS Health Hubs and forth between regular Medicare As further evidence of the exand MA plans during annual open pansion and encroachment of retail enrollment periods. People who corporations into the provision of switched from traditional Medicare healthcare, CVS announced it will to an Advantage plan spent/cost an increase its community-based hubs average of $1,253 per year less (2016 by 1,500 locations over the next two versus 2015) than those remaining on years. Twenty percent of a CVS store traditional Medicare. will be dedicated to these “HealthHUBs” that will provide “new product categories, digital tools, ACA Best Year Ever on-demand health kiosks, trusted Despite more than 60 attempts advice and personalized care.” CVS to repeal the Affordable Care Act argues it is fulfilling unmet consumer and continuing efforts to scuttle the preferences and is keeping up with ACA by the current administration, competitors like Walmart. the insurers still offering individual plans on the exchanges are not only surviving but are thriving. They are experiencing their best year ever. As some major carriers either scaled back George W. Chapman or completely exited the exchanges, is a healthcare busiprimarily due to the uncertainty ness consultant who created by Washington, other carriers works exclusively took advantage of the void and either with physicians, hosnewly entered the market or expandpitals and healthcare ed their existing footprint. The Kaiser organizations. He opFamily Foundation looked at insurer erates GW Chapman performances between 2011 and 2018. Consulting based in In 2015, there was an average loss Syracuse. Email him of $9.21 per member per month for at gwc@gwchapmanall participating insurers. The correconsulting.com. July 2019 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Should You Go Organic? By Ernst Lamothe Jr.
T
here was a time when you would have to shop at high end, specialty grocery stores to find the organic products of your dreams. Not anymore. Currently a more than $43 billion business, organic food choices are aplenty at your local grocery aisle. But more goods doesn’t mean that more people understand what they are eating. “The science is still young and there are a lot of things that we are still unclear about,” said Nicole Klem, program director of dietetic internship at the University at Buffalo School of Public Health and Health Professions. “There are a lot of people making money out of providing organic products to customers who may not be as informed on what organic means or if they really need the product at all.” The U.S. Department of Agriculture has established an organic certification program that requires all organic foods to meet strict government standards. These standards regulate how such foods are grown, handled and processed. Any product labeled as organic on the product description or packaging must be USDA certified. If it is certified, the
producer may also use an official USDA Organic seal. The only exception is for producers who sell less than $5,000 a year in organic foods. These producers still must follow the guidelines for organic food production, but they do not need to go through the certification process. “The good thing is there are very clear and tight guidelines on what is considered organic,” said Klem. She discusses key things you need to know about organic foods. Price Finding locally-grown organic foods is possible in more ways than ever before. In many communities, you can skip past the grocery store and go right to the source. “Farmer markets are an excellent way to purchase locally-grown organic food without paying a premium price,” said Klem. “If you have a large family, it might not make sense to buy everything organic, especially when it comes to fruits and vegetables. The cost can quickly become unmanageable. You can purchase those foods in regular grocery stores, and as long as you make sure you are washing them thoroughly, you should be fine.”
Klem said she is encouraged that more farmer markets are opening up in various underserved communities in and around Buffalo and that kids are gravitating toward eating fresh fruits and vegetables. Quality Organic farming practices are designed to meet various goals, including enhance soil and water quality, reduce pollution, provide safe, healthy livestock habitats and promote a self-sustaining cycle of resources on a farm. The term organic refers to the way agricultural products are grown and processed. In the U.S., organic crops must be grown without the use of synthetic pesticides, genetically modified organisms or GMOs, petroleum-based fertilizers, and sewage sludge-based fertilizers. “There is no question that any food that doesn’t have preservatives is going to be better quality. While it is going to spoil quicker, there is incredible advantages of eating fresh fruits and vegetables,” said Klem. Preference We are all looking at what is our golden ticket to longevity. Klem said if eating organic food is something that you want in your life then you should pursue it. “If this is part of your lifestyle and the knowledge and pursuit of making sure you eat organic helps
you feel better, then there is nothing wrong with that,” said Klem. “Eating the right food fuels your body.” She said there is not enough research to show that eating an organic apple is far better than eating an apple grown on a conventional farm. Even in cases like milk, there are various factors that influence the quality, including seasonal changes, the cow’s genetic and the types of foods it was fed even in organic farms. Eating non-organic food is fine While there are various good reasons to start living a more organic life, expert say there are enough safeguards to make sure the food we are ingesting is healthy. Klem believes the most important lesson learned is that people should eat plenty of fruits and vegetables in their daily lives whether it is organic or not. “The U.S. Food and Drug Administration have vigorous testing to test milk, meat, eggs and other produce,” said Klem. “There is a misconception that even the hint of pesticides can give you a risk for cancer and that is why people have flocked to organic food. But if you eat food from a conventional farm, you are going to be fine. You would be better off eating a tomato from a regular farm for your entire life then then not eating them because you are worried about pesticides. You should focus on making sure you are eating healthy regardless.”
“Farmer markets are an excellent way to purchase locally-grown organic food without paying a premium price,” says Nicole Klem, program director of dietetic internship at the University at Buffalo School of Public Health. Page 10
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
SmartBites
By Anne Palumbo
The skinny on healthy eating
sodium and have since switched to poultry Italian sausage, shaving off half the calories, over half the fat and a modest amount of sodium. Served alongside sautéed veggies, it’s a delicious “sometime” meal.
Braised Italian Sausage with Broccoli, Garlic, and Lemon 5-6 Italian sausage links (recommend: Trader Joe’s Italian Style Chicken Sausage) 2 tablespoons olive oil, divided 1 medium yellow onion, cut into ½-inch wedges 2 cloves garlic, minced 1 teaspoon ground coriander ¼ teaspoon red pepper flakes 3 crowns broccoli, cut into 2-inch long florets with florets then halved or quartered 2 cups water 2 tablespoons lemon juice Salt and pepper
Can Italian Sausage Be Part of a Healthy Diet?
O
ur nation’s Italian sausage consumption skyrockets during summer months — who can blame us? The irresistible aroma of sizzling sausage sends our taste buds into overdrive! Fan the flame with some peppers and onions, and it’s no wonder many of us indulge in seconds and thirds. But as tasty as Italian sausage is — and for reasons easily imagined — it’s not the best food to eat on a regular basis. Occasionally? Yes. Daily? No. So what makes Italian sausage a “sometimes” food versus an everyday staple? In a word, most sausage tends to run fairly high in fat, calories, and sodium; most are no slouch in the cholesterol department; and, all are a processed food. Although nutritional stats vary widely for Italian sausage, a typical link of Italian pork sausage has around 200 calories, 16 grams of total fat (of which six are saturated), 50 grams of cholesterol, and 550 mg of sodium. Of course, depending on your eating habits, you may need to double (or triple) those stats. Gulp! Overconsumption of any one of the above — from the calories to the fat, the cholesterol to the sodium — can lead to serious health issues, including obesity, heart disease, diabetes and cancer. Another good reason to rein in consumption: Italian sausage is clas-
sified as a “processed meat,” meaning it’s been preserved by smoking, salting, curing or adding other preservatives. According to the American Institute for Cancer Research, any amount of processed meat eaten regularly increases the risk of both stomach and colorectal cancers. It’s why the AICR and other health organizations recommend limited consumption of processed meats like sausage, hot dogs, bacon and deli meat. On the plus side, Italian sausage is an excellent source of complete protein and some B vitamins (especially B12). An essential nutrient for building and maintaining tissues and cells, protein also makes up the enzymes that power many chemical reactions in our body. The B vitamins play a key role in converting food to energy and in supporting nervous system function and red blood cell formation. Those monitoring carbs will be thrilled to know that Italian sausage has next to none! So, can Italian sausage be part of a healthy diet? On average and with limited consumption: yes. But for those battling health issues that may be exacerbated by eating processed meat, probably not. If you’re unsure, seek a doctor’s advice. Although my husband and I love the succulent flavor of pork sausage, we don’t love the calories, fat, and
Preheat oven to 200 degrees. Place sausages in large skillet: drizzle with 1 tablespoon olive oil; add ½ inch water. Over medium-high heat, boil sausages to cook through. Once water cooks away (about 8-10 minutes), lower heat to medium and brown sausage in remaining oil. Remove from heat; transfer to foil-lined baking sheet; place in oven to keep warm. In same skillet, heat remaining olive oil over medium-high. Add onion and sauté until golden, about 6 minutes, lowering heat if needed. Add garlic, coriander, and red pepper flakes and cook for 30 seconds.
Helpful tips
Read Italian sausage labels carefully. Keep in mind that claims like “natural” or “uncured” or “nitrate- and nitrite-free” do not necessarily mean the food is healthier. Some products cured with sea salt or juices such as celery juice that contain naturally occurring nitrates may end up with just as high nitrite content as meats with sodium nitrite added. Choose lower-temperature methods of cooking—such as roasting or braising—to thwart the “grilled char” that can develop harmful carcinogens. Add prepared broccoli and 2 cups water; stir well. Bring to a boil, then reduce heat and cover. Cook until fork-tender, about 8 minutes, stirring throughout. Mix in lemon juice; season with salt and pepper. Serve sausages atop broccoli mixture.
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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Summer Care
Do’s & Don’ts:
Summer Fitness for Women By Deborah Jeanne Sergeant
W
arm, sun-filled days can jumpstart your fitness routine. Try these tips from area experts to make this your fittest summer yet. • “Stay active and stay hydrated, especially when you’re outdoors and in high humidity situation. Don’t wait until you are thirsty. Use water above all other hydration choices. Water is essential to life. If you’re sweating nicely, add a pinch of sea salt and slices of lemon or lime per liter of water to add in much needed electrolytes, potassium and sodium. • “Avoid excess sugar foods or beverages, for example Gatorade. Sugar is pure white and a dose-dependent toxic substance to the human body. “ Frank Giardina, board-certified registered dietitian nutritionist, owner of SMART Nutrition by Frank, Williamsville.
• “Though we’re an indoor climbing gym, we do have a portable
rock wall to take to events. When you’re exercising outside, you need to stay hydrated and not push your body too far. You don’t want to over exert yourself. • “Climbing is a good sport for women, as many don’t have a lot of upper body strength and this helps you become stronger. You use muscles you typically don’t use. Rhonda McGuire, director of marketing, Niagara Climbing Center, North Tonawanda. • “Some big things are to pay attention to the weather. Humidity can be a factor, as the moisture sticks to our skin and doesn’t evaporate. • “Replenish with plenty of water and electrolytes from fruits and vegetables. Stay on top of fruits and vegetables. They’re loaded with sodium and other things your body needs. • “The time of day is very important, too. Exercise early in the morning before the heat becomes in-
Eat Right This Summer
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icnics, parties, barbecues, ice cream stands — they’re all summer staples and all ways to derail your healthful eating plan. Three area experts offered tips on how you can eat right this summer.
• “If you know you’re going to a party later, eat lighter earlier in the day. • “If you will be drinking, it’s really important to alternate with a glass of water. You want to keep yourself hydrated. • “Stay on top of eating fruits and vegetables. • “You could bring a supplement with you or a nutritious shake you could sip. Or maybe a nutrition bar. Enjoy things at the party, but stay up on your water intake so you’re not overeating. Don’t be rude and not eat at the party. Take a multi-vitamin earlier. • “If it’s a party where you can bring something, bring a healthful dish.
• “If it’s a wedding or something like that, remember that it’s one party. It’s not the end of the world to enjoy yourself. It’s not going to ruin it if you’re otherwise doing well. The problem is, people do it and slowly get on the wrong track.” Warren Paschetto holds a Master of Science degree in health and human performance with a specialization in strength and conditioning. He is also a certified personal trainer and the owner of Warren Paschetto Fitness in Williamsville. • “Stick to lots of non-starchy vegetables — two to three cups per day, choosing all colors — lean protein varieties, like seafood, poultry, eggs, game, limited beef, and healthy fats such as nuts, seeds, olive and/ or avocado-type oils, for the bulk of foods, energy and calories consumed. • “Add an appropriate amount of fresh fruits, whole grains and legumes. These could include grilled corn on cob or chilled hummus with
tense. People become more motivated to get it done when they exercise early. • “Look for heat exhaustion, which can lead to heat stroke. If you feel a little faint, dizzy, have muscle cramps or nausea, don’t try to tough it out. Cool off and rest and rehydrate and refuel yourself. Pace yourself a little slower, especially if you haven’t done much during the winter. More so in this area, as we have such different climates throughout the year. • “If you’re pregnant, definitely be more careful. I wouldn’t push it hard. It would be a thing to talk about with your obstetrician. • “I see a lot of clients who want to start working out now that it’s warm out. They want to start dropping weight and they want to start losing weight in a few weeks so they really overdo it. That can be very dangerous. A lot of women feel pressured to live up to the image portrayed in the media. • “Wear clothing that’s lightwhole grain as tolerated and small amount‚ two to three tablespoons of probiotic-loaded plain yogurt to round out daily dietary intake needs. • “Cook more meals at home with family and friends. • “If you drink alcoholic beverages, set a limit of one, 5-oz. glass of antioxidant-rich wine per day.” Frank Giardina, board-certified registered dietitian nutritionist, owner of SMART Nutrition by Frank,Williamsville. • “In terms of being busy and running places, planning ahead is important. Some find if they grill a bunch of chicken breasts ahead, they have the main focus of the meal done. Then they can do salads or mix it up with Greek, Mexican or Chinese influences. Use shortcuts like prepared, clean produce washed and ready to go. That is helpful. • “Fruit and vegetable trays cost a little more but there’s no waste and you’re inclined to eat it all. • “Keep it simple and do saladbased meals. • “Have raw materials on hand.
BlueCross BlueShield Offers Largest Variety of Free Fitness Yet
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lueCross BlueShield of Western New York is expanding Fitness at Canalside this summer to offer more than 30 free fitness classes, the largest series since the program launched in 2015. Drawing thousands of individuals from across Western New York each year, Fitness at Canalside offers a broad range of classes that appeal to all ages and fitness levels. Led by the areas most recognized coaches, classes are offered from sunrise to sunset every day of the week. In addition to returning fan
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favorites, BlueCross BlueShield is adding a variety of new classes to the roster, including Rise Fitness Pilates, Generation POUND, BikeorBar HIIT, Kids Get Moving- Creative Movements, Studio J’s Kids Dance, Shannon Connors Fitness, Boxstar Training, Get Livin Bootcamp, SilverSneakers Dance and Chair Yoga, Silent Disco with La’ Movement, Himalayan Institute Meditation, Yoga with Steve, Soma Cura Yoga, Core Velocity Yoga and Graceful Warrior Yoga. CoreFit Athletics Bootcamp is
also joining the lineup, and will be offered at 6 a.m. on Tuesdays. This is the earliest class that’s ever been offered as part of the free series. “Getting fit has never been so fun,” said Julie R. Snyder, vice president, corporate relations, BlueCross BlueShield of Western New York. “As the official health plan of Canalside, we’re excited to kick off another season of outdoor fitness with more free classes than ever before.” Fitness classes are free and open to individuals of all ages, regardless
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
weight in light colors to keep you cooler.” Warren Paschetto holds a Master of Science degree in health and human performance with a specialization in strength and conditioning. He is s certified personal trainer and owner of Warren Paschetto Fitness in Williamsville.
You can buy fresh bins of organic greens. Local produce is coming out. You can throw some protein on there. • Keep the meal simple in the summer. Many people don’t like heavy meals anyway. Try a tapis idea for a meal, where you have a Greek yogurt for protein or a hardboiled egg or higher protein grain like quinoa, fruit, raw veggies. It doesn’t have to be a meat, potato and vegetable meal. Serve cold soup, like gazpacho. Make a big batch and rely on that for your produce base and have protein on the side. • “On vacations, people eat out more. I always recommend that you check the menu ahead and have in mind what you’d be more inclined to order. • “Cold beverages go down easily in the summer and they can contain a lot of calories. • “It’s about being discriminating. Of course, it’s okay to indulge occasionally. If people say they’ll never eat something, that will backfire. Mary Jo Parker, registered dietitian, Williamsville. of fitness level or experience. Participants can share their experiences on social media through #BCBSFitness. BlueCross BlueShield Blue Bikes are also back for 2019 and are available for rent daily from 11 a.m. to 8 p.m. Individuals and families can pedal and explore downtown Buffalo and the waterfront – no membership needed. BlueCross BlueShield members will receive their first hour for free by presenting their member ID card. A full calendar of fitness classes and information about all of the activities taking place this summer can be found at bcbswny.com/play. All classes are weather-dependent.
Summer Care
Summer Sun-Safety ‘My worst sunburn ever was…’ By Kimberly Blaker
M I
y worst sunburn ever was from lying out on an overcast day. didn’t expect to get much of a tan, let alone sunburned, given the conditions. I was especially unconcerned since I couldn’t see any color change at the time. But by evening, my skin was pinkish-red, and the pain set in. I couldn’t wear clothes and had to call in sick for two days. Aside from a serious sunburn, there are other equally important reasons to take extra precautions in the sun, especially during the hot summer months. Skin cancer is the most widely recognized health problem resulting
from sun exposure. To reduce your risk: • Avoid afternoon sun. • Apply sunscreen with an SPF of 30 or higher at least 15 minutes before you go out and then reapply every two hours. • Look for products carrying the Skin Cancer Foundation’s blue seal of approval. • Wear clothing that covers your arms and legs as well as a hat to shade your face. The sun’s rays also damage our eyes. Exposure can cause cataracts as well as damage to part of the retina, cornea and lens. Physician Cheryl Khanna of Mayo Clinic recommends wearing sunglasses that block 99 to
100 percent of UVA and UVB rays. Also, some sunglass designs offer better protection. The best designs to block out as much UV rays as possible are wrap around or close fitting glasses. The risks of dehydration and heat exhaustion also increase during warmer months. It’s important to
Picnics, Cookouts: How to Keep Food Safe Picnics and cookouts raise the risk of issues such as cross-contamination and food-borne pathogens — follow a few simple rules to avoid problems By Deborah Jeanne Sergeant
N
ow that it’s picnic season, why not brush up on food handling tips to ensure your food is safe? Picnics and cookouts raise the risk of issues such as cross-contamination and food-borne pathogens because we’re cooking and handling food outside the routine environment of the kitchen. Justine Hays, registered dietitian, senior nutritionist with Eat Smart New York through Cornell Cooperative Extension of Niagara County, reminded those grilling to defrost frozen meat properly. “Defrost them a few days before in the fridge, never on the counter,” she said.
Grilling safely means using a meat thermometer to ensure the meat reaches the proper temperature. Cook beef, pork, veal, fish, shellfish and lamb to 145 degrees F, ground meats to 160 degrees, and all types of poultry to 165. Always insert the thermometer in the thickest portion, away from the bone. “Don’t just say, ‘It’s not pink anymore,’” Hays said. Hays also advised nesting bowls of foods like potato salad into a larger bowl filled with ice. “If it’s on a buffet, make sure it’s back in a fridge or cooler where it will stay below 40 degrees within two hours,” Hays said. “If it’s above 70 or 80 degrees outside, get the food
in the cooler even sooner.” Physician Gale Burstein, commissioner of health with Erie County Department of Health, said that the “danger zone” of perishable foods is between 40 and 140 degrees. That’s when bacteria rapidly multiply. She also said that picnickers should use separate utensils while grilling. For example, if you place cooked meat on the same platter that held it before it was cooked, the prepared food can become contaminated with bacteria. Or if you moved raw meat with the same set of tongs that you use for serving it. Or if you marinade raw meat and later use the marinade to baste the meat as it cooks, you spread bacteria all over it.
July 2019 •
drink several glasses of water every day of the year, but especially during the summer months. If you’ll be in the sun or heat for any length of time, carry plenty of water with you. Better yet, carry sports drinks, since they contain electrolytes. Also, try to restrict outdoor physical activity to cooler parts of the day. Foods that can cause cross contamination include raw steak, chicken, ground meat and seafood. Burstein also said that cutting boards can promote cross contamination. “Just because it’s a picnic doesn’t mean you don’t follow food safety rules,” she said. Never use a cutting board for raw meat followed by food that’s not cooked, like fresh fruits and vegetables. By preparing as much as you can at home, you can help prevent many cross-contamination issues. Begin with cold foods that are already cold. Don’t try to rely on the cooler to chill foods. How you serve cold items can affect their temperature as well. For instance, keeping all the drinks with the cold salads in one cooler isn’t a great idea, since constantly opening the cooler to retrieve drinks reduces the temperature inside. Burstein recommends packing a cooler with a layer of ice at the bottom, followed by raw or marinating meat in sealed containers, followed by other foods on top, which can prevent any meat drippings from leaking into ready-to-eat foods. It can also help to fill coolers up to the brim. Use up any empty space with things like napkins and plates or snacks that don’t need refrigeration. While it’s healthful to fill up your plate at least half full with colorful fruits and vegetables, Sally Gower, registered dietitian with Eat Well Buffalo, said that produce should always be washed before it’s eaten. If you’re bringing along a melon to slice, don’t forget to wash it first; otherwise, every cut of the knife draws bacteria inside, to the flesh. Cut it on a clean surface. “For greens, select heartier choices that won’t wilt as fast as thinner, less stable varieties,” Gower suggested. “Slaws and marinated veggies will last longer.” Gower also said that it’s important to promptly unpack any leftover foods at home. “Toss those items that have been out in the sun for too long, and refrigerate or freeze those with minimal exposure,” she said.
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Summer Care
5
Things You Need to Know About Skin Cancer Prevention
By Ernst Lamothe Jr.
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imply put, skin cancer or melanoma is one of the deadliest of skin cancers. In 2019, it is estimated that there will be 96,480 new cases of melanoma in the United States and 7,230 deaths from the disease, according to the Melanoma Foundation. In the U.S., melanoma continues to be the fifth most common cancer in men of all age groups. Rates of diagnosis for the disease have increased dramatically over the past three decades, outpacing almost all other cancers. Today, it is one of the most common cancers found among young adults in the United States. Ultraviolet rays are an invisible kind of radiation that comes from the sun, tanning beds and sunlamps. UV rays can penetrate and change skin cells. “If diagnosed early, it is a very curable disease. There is a 90% survival rate within the first five years,” said physician Csaba Gajdos, clinical associate professor at University at Buffalo and also chief of general surgery at the Buffalo VAMC. “Too often people ignore symptoms and just don’t know how much damage has been done.” Gajdos, who has more than two decades in the surgical treatment of complex melanomas and other cancers, offers five tips for skin care during the summer.
1.
Watch your exposure to the sun The Centers for Disease
“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.
Control and Prevention says rays from the sun can reach you on cloudy and hazy days, as well as bright and sunny days. UV rays also reflect off of surfaces like water, cement, sand and snow. UV rays are strongest and most harmful during midday. “We all know after a very tough winter all we want to do is be outside in the summer during the summer,” said Gajdos. “But you should still be cautious about being outdoors all day without the proper protection for your skin.”
2.
Watch symptoms A change in your skin is the most common sign of skin cancer. This could be a new growth, a sore that doesn’t heal or a change in a mole. Melanoma lesions are often darkly pigmented and could have some uneven borders. They can be a quarter inch in diameter. “People who had previous sunburns at a young age should have regular appointments with a dermatologist,” said Gajdos. “They can give you recommendations and check to see if any pigment or legions are problematic.”
3.
Cover up during the summer If possible, seek shade under a tree, an umbrella or a pop-up tent. Hats that shade the face, scalp, ears and neck are easy to use and give great protection. Baseball caps are popular among kids, but they don’t protect their ears and neck. If your child chooses a cap, be sure to protect exposed areas with
sunscreen. When possible, longsleeved shirts and long pants and skirts can provide protection from UV rays. Clothes made from tightly woven fabric offer the best protection. A wet T-shirt offers much less UV protection than a dry one, and darker colors may offer more protection than lighter colors. “We cannot overstate that when you can, go with long sleeves, hats and long pants for as long as possible,” he said.” That is especially the case for young children when parents want to do everything they can to protect their children early on from extreme sun exposure.”
4.
Wear adequate sunscreen Use broad spectrum sunscreen protection every time your child goes outside. For the best protection, apply sunscreen generously 30 minutes before going outdoors. Reapplication of sunscreen is just as important as putting it on in the first place, so re-apply the same amount every two hours. Don’t forget to protect ears, noses, lips, and the tops of feet. “People have to remember to keep applying sunscreen,” said Gajdos. “Just putting one application for the whole day before you go out will not suffice and leaves you vulnerable.”
By Jenna Schifferle
n a cool, hazy May morning, I started passing people. Ten miles in to a half marathon, and I felt strong — like the iconic Rocky Balboa himself. My feet were weightless. My airs formed perfect pendulums. My lungs moved rhythmically with my stride. As the crowd looped along the Outer Harbor, I knew I was going to set a personal record. Call me confident, but I felt it three miles before I ever saw finishers’ chute. When I crossed the finish line, I threw my hands in the air as a sign of victory. This was my fourth year running the Buffalo Half Marathon and my ninth half in total. It was also the first time I’ve managed to cross the finish line feeling refreshed and reassured with the knowledge that I’d brought my best. Sure, I’d trained with Fleet Feet before in preparation, but there’s Page 14
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ning beds radiate UVA rays, which penetrate the skin more deeply and damage collagen, the basic building block of our skin and elastin that helps us look younger, according to the Cleveland Clinic. There are studies that say your risk of skin cancer can go up 15% for every four tanning bed visits. There’s no such thing as a safe tanning bed, and there aren’t any tanning beds that don’t damage the skin. “Tanning beds have been associated with melanoma. The damage that it causes to your skin is not worth the short-term glowing look that it gives you for the summer,” said Gajdos.
Writer on the Run jenna.schifferle@gmail.com
Now Onward to Chicago!
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5.
Avoid tanning booths Because tanning beds have been around for so long, many people believe using them to get a tan is a safer than exposure to sunlight. That is not true. Tan-
Physician Csaba Gajdos is clinical associate professor and chief of general surgery at the Buffalo VAMC: “If diagnosed early, [skin cancer] is a very curable disease. There is a 90% survival rate within the first five years,”
something about race day that usually makes me shoot out of the gate too fast or forget to fuel quite right. For this particular race, though, everything fell into place and my training paid off. Couple that with unparalleled crowd support and a well-organized event, and it made for an unforgettable experience. For anyone who’s never been in downtown Buffalo on Memorial Day weekend, race weekend is kind of a big deal. It kicks off on Friday with free yoga and shifts to a convention and 5K before culminating with the half marathon and full marathon on Sunday. To make it even better, there’s something for all ages and stages, including a Kids Mini Marathon, Diaper Dash, and even a Ruffalo Stampede for pups. Part of the proceeds from the events go to benefit various local charities like Girls on
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
the Run and Hospice Buffalo. My friend from Syracuse comes in yearly with his wife to run the race with me, and it has been incredible to see the event grow by leaps and bounds each time. While I’ve run the same race on four separate occasions (more if you count running the course during training), there is always something more to see and do. This year, my friend’s son did the Diaper Dash and came away with a mini medal, a Buffalo onesie, and a new milestone. For me, achieving a personal record is incredible, but being surrounded by such a strong community of friends and fellow runners is what makes the miles worth it. Buffalo’s energy always gives me the fuel I need to channel my inner Rocky. Just picture it: Spectators brandish hilarious signs, as lines of people crowd the sides of the chute and shout names as runners pass by. Not every run comes easily. Oftentimes, I miss my mark or watch my goals disappear around the
corner. But every now and then, an accomplishment is worth celebrating and the Buffalo Half is definitely one of those achievements. Now, I turn my sights to Chicago and envision what it will be like to cross the finish line after going the distance. In the meantime, I will practice my victory pose, and start adding on the miles. Now onward to Chicago!
Women’s Health
Bone structure 3-D illustration, normal and with osteoporosis. Stock illustration.
Osteoporosis Risk Often Overlooked
Half of women 50 and older and 20% of men will break a bone because of osteoporosis at some point in their lives. By Deborah Jeanne Sergeant
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umerous health organizations state that osteoporosis is widely under-diagnosed in older adults. Among them is the National Osteoporosis Foundation, which stated recently that it is “often left undiagnosed and untreated” despite its devastating consequences. The foundation stated that breaking a hip often contributes to overall decline in health and physical condition and increases an elderly person’s risk of greater frailty, losing independence and living in a long-
term care facility. Half of women 50 and older and 20% of men will break a bone because of osteoporosis at some point in their lives. Women are at greater risk for osteoporosis. Because its effects aren’t often recognized until a bone break occurs, few think to screen for it. A woman’s risk of breaking her hip equals her combined risk of breast, uterine and ovarian cancer, according to the National Osteoporosis Foundation.
So why are older women more prone to osteoporosis than men? Frailty is certainly a big part of it for older women. And, in general, women’s bones tend to be smaller and thinner than men’s. For this reason, Asian women have a higher risk of osteoporosis, as do those of any race with smaller-sized frames. Lifestyle factors that disrupt nutrient absorption or weaken bones include lack of exercise, smoking, excessive alcohol and carbonated beverages. Medical issues include bulimia, anorexia, celiac disease, chemotherapy, and use of medication such as steroids and anti-seizure medication. Once women hit menopause, the decline in bone-protecting estrogen declines, making them more prone to a broken bone. Fortunately, women can do quite a bit to prevent and slow bone loss. Melissa Kimbrell, Eat Smart New York resource educator for Cornell Cooperative Extension Erie County, promotes a balanced diet for supporting good health, including bone health. “USDA’s MyPlate give us a nice and easy roadmap to getting necessary vitamins and nutrients,” Kimbrell said. “MyPlate illustrates the five food groups that are the building blocks of a healthy diet: fruits, veggies, grains, proteins and dairy. Dairy provides a source of calcium, vitamin D, potassium, protein, and other nutrients necessary for the health and maintenance of the body. Dairy products should be low-fat or fat-free — to cut calories and saturated fat.” Older children, teens, and adults need three cups daily; children 4 to 8 years old need two and a half cups; and children 2 to 3 years old need two cups. Kimbrell cautions against foods in the dairy groups high in saturated fats and cholesterol, as they raise the bad cholesterol levels in blood, a risk factor in coronary heart disease. “Also, some foods are made from milk but have little to no calcium, such as butter, cream cheese, and
cream so they don’t have the same nutritional benefits,” Kimbrell said. Instead, she suggested low-fat or fat-free milk or yogurt, low-fat cheeses, or calcium fortified products like juices and cereals. Other foods that provide calcium include dark leafy green, canned fish with bones, and broccoli. “Helpful tricks to easily work calcium into your daily routine are to dip veggies in low-fat yogurt-based sauces, serve milk with dinner instead of a sugary beverage or use a little milk in smoothies for breakfast,” Kimbrell said. “Calcium and vitamin D fortified soy milk or tofu can be a great substitute for those that can’t digest dairy. “ The body naturally generates vitamin D, a pre-hormone, when skin is exposed to sunlight. Just 10 to 15 minutes’ sun exposure twice a week suffices; however, the Buffalo and the rest of Upstate New York doesn’t receive sufficient sunlight for several months of the year. That means deficiency is inevitable without supplementation. Eggs and oily fish varieties like salmon contain vitamin D. Few other foods naturally contain vitamin D, though commercially sold milk is fortified with it, as are many foods like breakfast cereal. Minerals such as magnesium and potassium are also associated with lowered risk of bones breaking, which is why a well-balanced diet with a wide variety of foods can help keep bones strong. “When you think about bone health, it is important to remember that physical activity is a critical ingredient for maintaining healthy bones and muscles too,” Kimbrell said. “This is true across all age groups, and across the entire wellness spectrum. Strength training is particularly good for bone health, and even weight-bearing aerobic exercise, like walking or running, can help.”
Why So Many Older Women Develop UTIs U
rinary tract infections are one of the indignities many women face as they age. One reason why is because their bladder walls can be invaded by several species of bacteria, a new study finds. Urinary tract infections, or UTIs, are among the most common type of bacterial infections in women, accounting for nearly 25% of all infections. UTI recurrence rates can range from 16%-36% in younger women to 55% in postmenopausal women. In the new study, researchers at University of Texas Southwestern (UTSW) in Dallas analyzed bacteria in bladder biopsies from 14 postmenopausal women with recurrent UTI. The investigators found that, in these patients, several species of bacteria can get inside the bladder’s surface area. Bacterial diversity, antibiotic resistance and immune response all play significant roles in recurrent UTIs, according to the study. “Our findings represent a step in understanding [recurrent] UTIs in postmenopausal women,” senior study author Kim July 2019 •
Orth said in a university news release. Orth is a professor of molecular biology and biochemistry at UTSW. “We will need to use methods other than antibiotics to treat this disease, as now we observe diverse types of bacteria in the bladder wall of these patients,” Orth added. UTI is the most common reason for antibiotic prescriptions in older adults. The high rate of UTIs has a significant social impact, and treatment costs billions of dollars a year, the study authors noted. Recurrent UTI “reduces quality of life, places a significant burden on the health care system, and contributes to antimicrobial resistance,” Orth said. Other factors believed to contribute to higher UTI rates in postmenopausal women include pelvic organ prolapse, diabetes, lack of estrogen, loss of Lactobacilli in the vagina, and higher levels of E. coli in tissues surrounding the urethra, according to the researchers. The report was published online recently in the Journal of Molecular Biology.
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Women’s Health
What Women Need to Watch For By Deborah Jeanne Sergeant
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reventive health measures can help us maintain good health. As Ben Franklin stated, “A stitch in time saves nine.” While we can’t do anything to change the genetics we were born with, we can mitigate health risks by preventing some health issues decade by decade.
and prioritize rest. Lombardo suggested reaching out to a doula long before delivery to have extra help lined up. Discuss your health with your provider before you conceive and contraception if you want to space your children or once your family is complete.
In your 20s The healthful habits established in your teens and 20s offer a lifetime of benefits. You greatly reduce risk of obesity, metabolic disorders, nutrient deficiencies, heart disease, cancer and more by eating right and staying active. It’s also important to drink only in moderation and abstain from tobacco use. Tobacco damages every cell of the body and represents a factor in numerous disease processes. Young women also need to get plenty of calcium to enjoy strong bones later in life. Taking care of your teeth — flossing daily, brushing after meals, avoiding sugary and starchy snacks and visiting your dentist regularly — correlates with heart health, mounting evidence shows. Take care of any dental issues promptly. Prepare for a healthy pregnancy. “In general, it’s about proper nutrition: be sure you’re getting enough nutrients during pregnancy and breastfeeding to keep your own body healthy,” said Jennifer Lombardo, owner of Buffalo Doula Services, LLC, and a certified labor doula, breastfeeding educator, and postpartum doula. “The baby is going to take whatever nutrients it can from your body so it’s easy for the mom to be depleted,” Lombardo added. “Still take the prenatal vitamins after the baby is born for the nutrients you need to bounce back and keep your body healthy.” Along with babies come sleepless nights, so moms should accept help
In your 30s In the 30s, many women become extremely busy with family, household and employment responsibilities, which can make it difficult to keep weight off. Warren Paschetto, certified personal trainer and owner of Warren Paschetto Fitness in Williamsville, encourages women to ramp up their fitness routine and strength training, as well as keeping closer track of calories to manage weight. He likes the app MyFitnessPal. “You don’t need the ‘pro’ version,” he said. “You answer the questions, and it gives you the number of calories you need in a day. Log in everything you eat throughout the day. It’s OK to have an ice cream, but as you use the app, you realize you have to keep it in balance.” Paschetto posts healthful recipes on his website, https://warrenpaschetto.com/recipes. It’s also vital to begin performing self breast exams monthly if you’re not already. Report any suspicious lumps, bumps, discharge or discoloration to your provider. In your 40s The 40s can be a stressful decade with children who are middle schoolaged or teens with crazy schedules. Unwind in healthful ways, such as connecting with friends and family and joining in relaxing hobbies not with substances. Physical activity provides stress relief and help in weight control. “Involve yourself in healthy activities,” said Rhonda McGuire, di-
rector of marketing, Niagara Climbing Center, North Tonawanda. “Find something you like to do.” She added that patrons of the center range from people who want a break from the typical gym environment to families working out together to serious rock climber training. Also in this decade, ask your care provider about when you should begin mammograms. In your 50s In your 50s, caring for elderly parents while still working can make maintaining fitness more challenging, but it’s still vital for good health. Get help with elderly parents as needed. Keep track of your own health by knowing the signs of heart attack, stroke and aneurism. At this point, your risk goes up, particularly if you haven’t managed your weight and watched your diet. Take “minor” illnesses seriously. It will take longer to recover from the flu. Don’t push yourself when you’re sick. Have an annual physical if you aren’t already. Your provider can keep closer tabs on your vital numbers like blood pressure, cholesterol and weight. Discuss any menopausal symptoms; you have more options than hormone replacement therapy. Get a baseline vision and hearing exam so you can benchmark any future vision or hearing loss. In your 60s When you reach your 60s, work on functional fitness — movements that keep you strong for doing daily activities. “Practice body squats,” Paschetto said. “Stand up and sit down. Start with five reps and build up to 10 reps. Then maybe do a few sets. That will build up leg strength.” He said that as people age, increasing time sitting can lead to less strength and balance. The “body squat” is further enhanced by
working balance into it. Paschettto said to put the hips back and not let the knees come over the toes while performing the movement. Obtain a bone density scan. Even if your bones are fine, it’s good to have a benchmark so you can tell if you’re losing bone later. Ask your doctor about colonoscopy and any other exams and screenings based upon your family health history. Speak up if you experience “embarrassing” issues like incontinence, low libido, or vaginal dryness. You won’t embarrass your care provider. You may also consider seeing a geriatrician, as their medical expertise can address the multi-faceted medical issues often accompanying older age. Ask about vaccinations, like pneumonia. In your 70s and beyond In your 70s and beyond, it’s all about staying active. “Yoga moves help you move your core, which is important,” said McGuire at Niagara Climbing Center in North Tonawanda. “It helps you be stable and flexible,” she added. “A strong core and good flexibility helps to prevent injury. The core helps with balance.” It’s also important to stay involved. Becoming isolated can hurt your health, since you move less and aren’t as mentally engaged when alone. Volunteers, join clubs and stay social. If arthritis bothers you, ask your doctor what you can do. Many find that walking and swimming help their symptoms. If some chores become too much, ask for help. Stay positive. By focusing on what you still have and fostering an outlook of gratitude, it’s easier to look forward instead of ruminating over the past.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
How to Reduce Post-Partum Depression Risks By Deborah Jeanne Sergeant
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ocial media portrays bringing home a new baby as a magical time of cuddles, snuggles and adorable baby photo ops. While some of that is true, it’s also messy, exhausting and life-changing. The changes that take place in a woman’s body, schedule and life can contribute to risk of post-partum depression, especially but not limited to women who are already at risk for depression. No woman is to blame for developing post-partum depression. The hormonal changes inherent to pregnancy can trigger it unexpected; however, some controllable factors can help lower the risk for many women. Breastfeeding the baby can help moms reduce risk for post-partum depression. “It promotes a bonding experience when a woman breastfeeds the baby as soon as possible after the baby is born,” said Jennifer Lombardo, owner of Buffalo Doula Services, LLC, certified labor doula, breastfeeding educator, and postpartum doula. In the initial hours after breastfeeding, the mom’s body releases
oxytocin, a hormone that causes the uterus to begin returning to its normal size. This helps control post-partum bleeding and kicks off the mom’s recovery. Breastfeeding doesn’t always go that way. For some moms, breastfeeding is painful and difficult. They may struggle with milk supply or helping baby latch on. Lombardo said that for many women who struggle, more breastfeeding support and education can help them nurse successfully. Women should reach out to a lactation consultant before delivery so they have an established resource ready. Since babies don’t have a circadian rhythm for at least three months, they often awaken during the night. They also need to eat at night. Though babies sleep a lot, they waken every few hours around the clock. Lombardo advises moms-to-be to create a post-partum plan. “We plan so much for pregnancy, but not that part,” she said. “It is so hard to forget that after baby comes, you’re exhausted and sore and you need to recover from that. It can be a very difficult time. Your hormones are all over the place.”
Well-meaning friends and family come by, but are more interested in the baby than practically helping, unless moms plan ahead. A suggested list of things that could help may let visitors know that folding some wash or holding the baby awhile so mom can sleep can provide a much-needed break. “Don’t be afraid to set up a meal train after you have a baby,” Lombardo said. “When someone asks what they can do, send them to the meal train online, like www.mealtrain. com.” The site organizes food drop-off, tasks to be done, rides and more, all without the expectation of stopping in as a guest–which puts more burden on a new mom. Njeri Motley, certified birth doula with Birthing Center of Buffalo, also encourages moms-to-be to plan for not only their delivery, but also the first few months post-partum. “They should think about this prior to birth, especially if they have no family,” Motley said. “People rely on that. That’s why the Medicaid reimbursement program can help, as families have the ability to have a doula.” She said that in addition to pro-
viding assistance like light housekeeping and childcare, doulas can also “help you realize the different emotions your body and life experiences.” “The doula can give the mom resources. There’s a relationship of trust and they tend to follow through with what the doula tells them to do.” She said that that kind of emotional support can help new moms who are struggling with the “new normal” of mothering a newborn. Lombardo said that family and friends are usually the first to notice signs of post-partum depression. They go beyond the two weeks post-partum of “baby blues,” a normal phase when hormones and schedules are adjusting, and reflect a longer period of persistent feelings of sadness, anxiety, hopelessness and crying. “They need to seek help at that point,” Lombardo said. Anyone who experiences symptoms of depression should seek medical attention and anyone with thoughts of harming herself or anyone else should seek emergency medical help.
University at Buffalo Study Questions Breast Milk Merit By Deborah Jeanne Sergeant
“Breast is best” has long served as the mantra regarding infant nutrition; however, research from the University at Buffalo seems to indicate that the correlation between nursing and positive health outcomes isn’t as clear cut as once thought. Researchers believe that mothers who intend to breastfeed but then formula-feed once the baby is born have more information on healthy lifestyle and nutrition and those factors influence baby’s health. Julie Szumigala, board certified OB-GYN and medical director for the Women’s Ambulatory Center at Kaleida Health, said that nursing babies obtain antibodies through breast milk. “When the baby is born, it’s like a blank slate without an immune system,” Szumigala said. “The breast milk transmits some of the immune system to the baby. The mom produces antibodies which helps the baby stay healthy.” Nursing also helps moms and babies feel closer. “Initially, the baby and mom’s relationship benefits,” Szumigala said, “with the baby attachment and calming the baby.” She added that moms who nurse have a lifelong lower risk of breast cancer as well. Many neo-natal intensive care units (NICUs) encourage “kangaroo care,” which involves parents holding their babies skin-to-skin because of its positive effects on respiration, heart rate and wellbeing. At first, premature babies usually cannot take nutrition by mouth, so they would otherwise miss the close contact typically provided during feeding times. Nursing also stimulates the release of hormones that help mom
and baby bond and relax. Newborns’ nervous systems aren’t capable of self regulating and breastfeeding helps. Premature babies especially benefit from breast milk, as they are particularly vulnerable to gut conditions such as necrotizing enterocolitis (NEC), which kills many premature infants. Those who survive NEC may require surgery to remove part of their bowel and use a colostomy for life. That’s one of many reasons neonatologists strongly urge mothers to provide breast milk for their premature babies. Moms benefit from nursing as well, including reduced risk of breast cancer, ovarian cancer, and lasting weight gain. Nursing burns about 500 calories a day. Unless moms compensate for that by increasing caloric intake, breastfeeding can help them lose “baby weight” and prevent lasting weight gain. Jennifer Lombardo, owner of Buffalo Doula Services, LLC, is a certified labor doula, breastfeeding educator and postpartum doula. In her role as a breastfeeding educator, Lombardo works with mothers who want to breastfeed but encounter difficulties such as low milk supply or little knowledge of breastfeeding. She believes that providing better and earlier education and support for new moms may help more to successfully breastfeed their babies. “There’s no question that breast milk is the optimal food, which is why our bodies create it for them,” Lombardo said. “Formula has come a long way and has an important place, but we’re faltering as a society with new moms not providing the support they need to successfully breastfeed.” The American Academy of Pediatrics and World Health Organi-
zation recommend babies breastfeed up to a year, and longer if desired. Lombardo said that physical inability to nurse is rarely the reason behind why 80 percent of women who want to breastfeed don’t meet their goal of how long they nurse. She said it’s because they lack knowledge on breastfeeding. “Pediatricians often don’t have enough education and formula is slapped on like a bandage,” Lombardo said. “A woman struggling to breastfeed needs help to get to the root of what’s happening. Well-meaning family and friends just say, ‘Switch to formula.’” Lombardo added that skimpy maternity leave policies, lack of support at home, and public shaming of nursing also inhibit moms. “I think every breastfeeding woman I know has gotten a dirty look or comment because of breastfeeding in public or they stop when the baby reaches a certain age because breastfeeding a toddler is considered disgusting,” Lombardo said. Njeri Motley, Buffalo-based certified birth doula through Life Cycles Collective Doulas, is a mother of six. She said that she has met only one mother who didn’t produce enough milk and needed to supplement with formula. Like Lombardo, she believes more social support for moms would encourage more breastfeeding, including education on nursing. “With Gov. Cuomo implementing the pilot program for doula reimbursement, that’s a good gateway for doulas to educate moms,” Motley said. “We’re there for moms to help them find the resources they need.” Motley also lauded area hospitals
July 2019 •
for encouraging breastfeeding and offering the services of doulas and lactation consultants in-house. Community-based resources include a breastfeeding “cafe” or La Leche League meeting for tips and support. In addition to learning about latch, holding positions and more, women learn about the value of breastfeeding UB Study Based on 1,000 Participants The University at Buffalo study on breastfeeding was led by Kerri Raissian, an assistant professor in the University of Connecticut’s Department of Public Policy and co-authored by Jessica Su, assistant professor of sociology at University at Buffalo. Researchers based their findings on information from more than 1,000 participants in the Infant Feeding Practices Study II, which was designed by the Centers for Disease Control and Prevention and the Food and Drug Administration. Raissian and Su sought to look at what factors determine positive health outcomes for infants to help “contextualize the tradeoffs that a lot of mothers have to make when deciding how to feed their children,” Raissian said in a statement released by UB. In the same release, Su stated, “It’s important to more carefully quantify the trade-offs between breast milk and formula given the strong breastfeeding recommendations and the realistic challenges that many mothers face, particularly among working mothers.”
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Women’s Health
Fika Midwifery: Offering Options for Out-of-Hospital Birth Team of midwives helps moms at home, at the Coit House, Buffalo’s oldest residence By Jana Eisenberg
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p until around the 1920s, it was normal for American women to give birth at home. So, concludes Maura Winkler, it makes sense that she opened her midwifery in Buffalo’s oldest known residence, the Coit House. The original lady of the house, Hannah Townsend Coit, would have given birth to most of her eight children there after her marriage in 1815. The house, built around 1818, is also older than any Buffalo hospital. “For most of human history, birth largely happened at home,” said Winkler of her commitment to providing midwifery services for women who make the choice to emulate their foremothers. “About 100 years ago, doctors — who were mostly men, since women didn’t become doctors then — started doing births in hospitals; that’s about the same time that the obstetrics field was invented. “Giving birth in hospitals has be-
come normalized, but the fact is that 90-95% of women are low-risk and healthy and could give birth outside of the hospital; that’s ‘normal,’” said Winkler. “Medical school does not offer any training for ‘normal’ birth; it’s all taught in terms of ‘pathologies.’” “Pathology,” according to Merriam Webster is defined as “the study of the essential nature of diseases and especially of the structural and functional changes produced by them.” Winkler, a Buffalo native, is a certified nurse midwife (CNM). She had originally enrolled in medical school, planning to become a doctor. But she quickly realized that it did not jibe with her personal beliefs, and switched tracks to become a midwife, so that she could provide care to women across the spectrum of their health and wellness needs. “Access to midwifery is an opportunity for women to take birth back, both as midwives and the women choosing to give birth out of
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hospitals,” she said. Winkler, and the other practitioners at Fika Midwifery specialize in low-intervention birth whether in a client’s home, at Coit House or in the hospital. (“Fika,” pronounced “fee-kah,” is borrowed from the Swedish concept that encompasses socializing and welcoming — it describes both a traditional coffee and cake break, and an attitude.) “When I walked in this building, it felt right; it has an amazing energy for birth,” recalled Winkler. “It’s not logical, just a feeling, but clients say that too.” The space at Coit House, which was most recently formerly occupied by an interior designer, is soothing and serene. It’s been configured with several exam and waiting rooms as well as comfortable birthing suites over its three floors. The suites have room for mothers in labor and their partners or families, where they can labor and rest before, during and after the birth. “There are basically two groups of women who come to us,” Winkler said. “The first is someone who leads a holistic lifestyle, they may be having their first baby, and the option to not give birth in a hospital fits with their beliefs. The women in the second group, in general, want a different model of care; they feel that they’ve had unwanted or unnecessary interventions during a previous birth experience — maybe they had an unnecessary C-section, or they didn’t want an epidural, or medically induced labor.” She adds that the desire for home birth and midwifery care spans diverse races, ethnicities, religions, ages, and socioeconomic status. “Nearly every woman of color we’ve worked with has chosen to give birth outside of the hospital,” said Winkler. “Maternal and infant mortality is three times higher for women of color than for white women; our clients seem to understand they’ll get particularly poor care in the hospital.” Since starting the midwifery in 2017, Winkler has expanded her staff to include another midwife, and anticipates growing to a total of four or five; this year, she anticipates that she and her colleagues will attend from 150 to 200 births, mostly at clients’ homes and at the Coit House. Potential clients are naturally curious about what could go wrong, and how the midwives and staff handle it. “It’s not like the Wild West,” said Winkler. “For example, it’s fairly common for babies to not breathe right when they are born. We can deal with that; we have all the same equipment that they have in hospitals, plus ours is portable, and can be
Maura Winkler, a Buffalo native, is a certified nurse midwife. moved easily, unlike in the hospital. And, we don’t have to cut the umbilical cord, which continues to provide blood and oxygen to the baby.” “In addition, the things that many consider problems — like long labors, big babies, or going past your due date — aren’t problems to us; those have all been normalized to be pathologies,” she said. “And if there is an emergency — like a post-partum hemorrhage — we also have the same medications hospitals have to handle them.” Of course, there are times when women need to be in a hospital, said Winkler, and she’s supportive of it in those cases. “Hospitals are necessary; some women need access to epidurals or the infants to a NICU. I think they are used too excessively though,” she attested. “Ninety percent of clients who plan to give birth in the community, [either at home or in our birthing center], do so successfully. The percentage who do transfer to the hospital during labor are mostly firsttime moms — maybe they are experiencing a long labor and choose to go, or they need pain management. If they do transfer to the hospital, they generally go in their own car; it’s rare that we call an ambulance — maybe one or two times a year.” “Hospitals are not built for normal birth. They are businesses — they want to make money, and they don’t make money when moms give birth at home without the interventions they’d get if they were in the hospital,” said Winkler. “We feel confident about what we offer; we give amazing care, and women want it.”
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
Williamsville 755 Wehrle Drive
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By Jim Miller
How a Government Pension Might Reduce Your Social Security Benefits
Come for the Art Dear Savvy Senior,
As a teacher for 20 years, I receive a pension from a school system that did not withhold Social Security taxes from my pay. After teaching, I’ve been working for a small company where I do pay Social Security taxes. Now, approaching age 65, I would like to retire and apply for my Social Security benefits. But I’ve been told that my teacher’s pension may cause me to lose some of my Social Security. Is that true?
Ready to Retire
Dear Ready, Yes, it’s true. It’s very likely that your Social Security retirement benefits will be reduced under the terms of a government rule called the Windfall Elimination Provision (or WEP). The WEP affects people who receive pensions from jobs in which they were not required to pay Social Security taxes — for example, police officers, firefighters, teachers and state and local government workers whose employers were not part of the national Social Security system. People who worked for nonprofit or religious organizations before 1984 may also be outside the system. Many of these people, like you, are also eligible for Social Security retirement or disability benefits based on other work they did over the course of their career for which Social Security taxes were paid. Because of your teacher’s pension, Social Security will use a special formula to calculate your retirement benefits, reducing them compared to what you’d otherwise get. How much they’ll be reduced depends on your work history. But one rule that generally applies is that your Social Security retirement benefits cannot be cut by more than half the size of your pension. And the WEP does not apply to survivor
benefits. If you’re married and die, your dependents can get a full Social Security payment, unless your spouse has earned his or her own government pension for which they didn’t pay Social Security taxes. If that’s the case, Social Security has another rule known as the Government Pension Offset (or GPO) that affects spouses or widows/ widowers benefits. Under the GPO, spousal and survivor benefits will be cut by twothirds of the amount of their pension. And if their pension is large enough, their Social Security spousal or survivor benefits will be zero. There are a few exceptions to these rules most of which are based on when you entered the Social Security workforce. Why Do These Rules Exist? According to the Social Security Administration, the reason Congress created the WEP (in 1983) and GPO (in 1977) was to create a more equitable system. People who get both a pension from non-Social Security work and benefits from Social Security-covered work get an unfair windfall due to the formula of how benefit amounts are calculated. These rules ensure that government employees who don’t pay Social Security taxes would end up with roughly the same income as people who work in the private sector and do pay them. For more information on the WEP visit SSA.gov/planners/retire/ wep.html, where you’ll also find a link to their WEP online calculator to help you figure out how much your Social Security benefits may be reduced. And for more information on GPO, including a GPO calculator, see SSA.gov/planners/retire/gpo. html.
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Ask The Social
Security Office
From the Social Security District Office
Social Security Can Help If You’re Young and Lose a Parent
F
or young people whose parent dies, Social Security is here. Losing a parent is both emotionally painful and oftentimes devastating to a family’s finances. In the same way that Social Security helps to lift up the disabled and seniors when they need it, we support families when an incomeearning parent dies. You should let Social Security know as soon as possible when a person in your family dies. Usually, the funeral director will report the person’s death to Social Security. You’ll need to give the deceased’s Social Security number to the funeral director so they can make the report. Some of the deceased’s family members may be able to receive Social Security benefits if the deceased person worked long enough in jobs covered by Social Security to qualify for benefits. Contact Social Security as soon as possible to make sure the family gets all the benefits they’re entitled to. P lease read the following information carefully to learn what benefits may be available. Your unmarried child can get benefits if they’re: • Younger than age 18; • 18-19 years old and a full-time student (no higher than grade 12); or • 18 or older with a disability
Q&A
Q: I can’t seem to find my Social Security card. Do I need to get a replacement? A: In most cases, knowing your Social Security number is enough. But if you do apply for and receive a replacement card, don’t carry that card with you. Keep it with your important papers. For more information about your Social Security card and number, and for information about how to apply for a replacement, visit www. socialsecurity.gov/ssnumber. If you believe you’re the victim of identity theft, read our publication Identity Theft and Your Social Security Number, at www.socialsecurity.gov/ pubs. Q: What should I do if an employee gives me a Social Security number but cannot produce the card? A: Seeing the card is not as important as putting the correct information on the worker’s Form W-2. You can verify employee Social Security numbers by using the Social Security Number Verification Service. Just go to www.socialsecurity.gov/ bso. This online service allows registered employers to verify Page 20
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
that began before age 22. To get benefits, a child must have: • A parent who’s disabled or retired and entitled to Social Security benefits; or • A parent who died after having worked long enough in a job where they paid Social Security taxes. Benefits stop when your child reaches age 18 unless your child is a student in secondary school or disabled. Within a family, a child can receive up to half of the parent’s full retirement or disability benefit. If a child receives survivors benefits, he or she can get up to 75 percent of the deceased parent’s basic Social Security benefit. There is a limit to the amount of money that we can pay to a family. This family maximum is determined as part of every Social Security benefit computation. It can be from 150 to 180 percent of the parent’s full benefit amount. If the total amount payable to all family members exceeds this limit, we reduce each person’s benefit proportionately (except the parent’s) until the total equals the maximum allowable amount. Children with disabilities may also be eligible for benefits. You can read more about benefits for children with disabilities at www. socialsecurity.gov/pubs/EN-0510026.pdf. employee Social Security numbers against Social Security records for wage reporting purposes. Q: I am nearing my full retirement age, but I plan to keep working after I apply for Social Security benefits. Will my benefits be reduced because of my income? A: No. If you start receiving benefits after you’ve reached your full retirement age, you can work while you receive Social Security and your current benefit will not be reduced because of the earned income. If you keep working, it could mean a higher benefit for you in the future. Higher benefits can be important to you later in life and increase the future benefit amounts your survivors could receive. If you begin receiving benefits before your full retirement age, your earnings could reduce your monthly benefit amount. After you reach full retirement age, we recalculate your benefit amount to leave out the months when we reduced or withheld benefits due to your excess earnings. Learn more about Social Security reading our publication, How Work Affects Your Benefits, at www.socialsecurity.gov/pubs/10069. html.
H ealth News Roswell’s doctor named to national panel
Physician Michael Kuettel, the longtime leader of Roswell Park Comprehensive Cancer Center’s radiation medicine program, has become the latest official from the Buffalo cancer center to be named to a national healthcare Kuettel advisory board.
He has been appointed to the Advisory Panel on Hospital Outpatient Payment, which provides expert guidance to the secretary of the U.S. Department of Health and Human Services (HHS) and the administrator of the Centers for Medicare & Medicaid Services (CMS) on issues affecting outpatient medical care. “Dr. Kuettel is an outstanding choice for this role,” said Roswell Park President and CEO Candace S. Johnson, PhD. “He has provided exceptional leadership to our radiation medicine program for two decades, bringing both his nationally recognized clinical expertise and his keen insights on the delivery of health care to his work on behalf of
The Martin Group wins 29 awards in the Healthcare Advertising Awards
T
he Martin Group, a “bestin-class” integrated communications agency with offices in Buffalo, Rochester and Albany, has received 29 awards in the 36th Annual Healthcare Advertising Awards. This is the oldest, largest and most widely respected healthcare advertising awards competition, sponsored by Healthcare Marketing Report, based in Marietta, Georgia. “The Martin Group is proud to work with a number of incredible organizations across our footprint and beyond, each of which is making a significant difference to the communities and customers they serve,” said Tod Martin, president and chief creative officer, The Martin Group. “To be involved with these companies, and to be recognized for that work by the Healthcare Advertising Awards, is truly an honor.” The Martin Group and its clients were recognized in the following categories: • Best in Show (one award): Great Lakes Cancer Care (newspaper ad); • Gold (six awards): Buffalo Medical Group (email blast); Erie County Medical Center (100th anniversary long video); Great Lakes Cancer Care (print ad); Great Lakes Cancer Care (website); Samaritan Medical Center (billboard); Trillium Health (magazine ad); • Silver (seven awards): Buffalo Filter (awareness campaign); Buffalo Medical Group (launch campaign); Erie County Medical Center (service lines campaign); Great Lakes Cancer
Care (billboard); Great Lakes Cancer Care (service line brochure); Samaritan Medical Center (branding campaign); Trillium Health (magazine ad series); • Bronze (eight awards): Erie County Medical Center (trauma campaign); Great Lakes Cancer Care (poster); Great Lakes Cancer Care (TV spot); Great Lakes Cancer Care (campaign); Great Lakes Cancer Care (magazine ad); Samaritan Medical Center (Walker Cancer Center logo); Samaritan Medical Center (branding TV); Trillium; • Merit (seven): Erie County Medical Center (100th anniversary TV spot); Erie County Medical Center (TV spot series); Great Lakes Cancer Care (airport poster); Samaritan Medical Center (branding ad series); Samaritan Medical Center (annual report); Samaritan Medical Center (branding campaign); The MOCHA Center (transit signs). All entries were reviewed by a national panel of judges and evaluated for creativity, quality, message effectiveness, consumer appeal, graphic design and overall impact. This year, more than 4,000 entries were received, making the awards the largest healthcare advertising awards competition and one of the 10 largest of all advertising industry awards.
our patients.” Kuettel, who is professor and Barbara C. & George H. Hyde Chairman in radiation medicine at Roswell Park, joined the cancer center from Georgetown University Medical Center in 1999. He is also professor and chairman of radiation oncology at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences. The advisory panel on hospital outpatient payment consists of 15 employees of hospitals, hospital systems and other Medicare providers who advise CMS and HHS on the clinical integrity of payment classifications and regarding supervision of outpatient services. Panelists are not compensated for their service, and serve four-year terms. Kuettel is a member of the American Society for Radiation Oncology (ASTRO) board of directors, chairman of ASTRO’s Health Policy Council and serves as ASTRO’s representative to the American Medical Association/Specialty Society Relative Value Scale Update Committee. He also helps craft national guidelines for the treatment of prostate cancer in his role on the National Comprehensive Cancer Network’s Prostate Cancer Panel.
Immunologist honored for contributions to medical science
Roswell Park Comprehensive Cancer Center immunologist Elizabeth Repasky, Ph.D., was awarded the 2019 Distinguished Biomedical Alumna Award from the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. Presented on May 3, the annual award recognizes Jacobs School graduates, residents and volunteers who have been recognized nationally or internationally for outstanding contributions to medicine and biomedical Repasky
sciences, the arts or humanities. Repasky earned her doctorate in anatomical sciences from the Jacobs School in 1981 and completed a postdoctoral fellowship at the California Institute of Technology. Repasky is a distinguished professor of oncology, the Dr. William Huebsch Professor of Immunology and program leader for the cell stress and biophysical therapies program at Roswell Park. In recent years, her groundbreaking research into the impact of body temperature and thermal stress on immunotherapy has led to clinical trials at the cancer center. “Betsy is not only a leading expert in thermal medicine and the impact of cellular stress, but someone whose work is helping us to make cancer therapies more effective,” said physician Kelvin Lee, chairman of the department of immunology at Roswell Park. “We are so very proud to see her selected for this well-deserved honor.” “Dr. Repasky’s ongoing contributions to the field of immunology, as well as her generous mentoring of graduate and postgraduate trainees at Roswell Park Comprehensive Cancer Center, has been a source of pride for the Jacobs School of Medicine and Biomedical Sciences,” said physician Michael E. Cain, vice president for health sciences and dean of UB’s Jacobs School. “It is a privilege to recognize her exceptional achievements.” A native of western Pennsylvania, Repasky also earned a bachelor of arts in biology from Seton Hill University. Her previous awards include the 2018 J. Eugene Robinson Award and the William C. Dewey Award for mentorship, both from the Society for Thermal Medicine, Seton Hill University’s Distinguished Alumna Leadership Award, Roswell Park’s Thomas B. Tomasi Hope Award and several mentorship and teaching awards, including UB’s 2018 Graduate Student Association Award for Faculty Excellence in Mentoring and Teaching.
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solution to this crisis. But he says at least it’s offering a resolution to some of the current hardship until lawmakers find a way to address the larger issues. “We need to do much more to help people not be in hardship or go insolvent,” Antico said. “For now, it’s a matter of getting more donors to
Charity Tackles Country’s Massive Medical Debt by Buying It RIP Medical Debt buys medical debts, then eliminates them By Payne Horning
W
hile most people spend years trying to escape the weight of their medical debt, Craig Antico has made it a career of acquiring it. He spent 30 years working in the financial industry in collections, debt buying and outsourcing. But several years ago he made a change one that would end up making a change the lives of hundreds of thousands of people. In 2011, Antico received a phone call while running a collections agency in New Jersey. His former partner Jerry Ashton was in Zuccotti Park in New York City talking with the protesters of the Occupy Wall Street movement. They needed help with their plan to buy and eliminate $1 million worth of medical debt. Because many hospitals sell medical debt to collections agencies for pennies on the dollar, the group only needed to raise about $50,000. Antico agreed to help and soon began reverse-engineering his company to become a debt-forgiveness outfit. The results of the experiment exceeded expectations. The group ended up raising $700,000, which abolished just under $40 million in debt. It relieved financial burdens for 20,000 people in all. And Antico says they did much more than forgive medical debt. The money also erased millions in student loans, credit card debt, and payday loans. When the movement started to fizzle out in 2013, Antico who had been reluctant to join the operation in the beginning now found himself partially responsible for keeping it alive. He and his former partner Ashton did just that, helping launch RIP Medical Debt in 2014. The company has spent the past five Page 22
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years buying large portfolios of debt from medical providers and debt sellers on the cheap and wiping it out. “Those people will get a letter from us that says your debt is abolished,” Antico said. “It’s a nostrings attached gift from the donors to RIP Medical Debt.” The team at RIP Medical Debt begins their work by approaching hospitals, doctor’s groups, and debt buyers to tell them about their cause. Once they get access to the databases of patients with outstanding debt, a data formula Antico created helps identify those who are in the most need of assistance. “We can pretty much figure out which people are in between a rock and a hard place and are not going to be able to pay,” Antico said. “We say let us identify the accounts that we know will not pay you and can never pay you and you are just hurting them by continuing to collect on them and sell them to us for the same amount that you would sell to companies to make money.” Most hospitals attempt to retrieve outstanding patient debt through the use of collections agencies that receive a share of what’s collected. But many medical providers decide to instead cut their losses, and sell the right to collect on that debt to outside companies for very low percentages of the total amount. In either system, patients who are incapable of paying what they owe are barraged by phone calls and letters a process Antico says is unconscionable. Enter RIP Medical Debt. To date, the charity has abolished $550 million in debt for more than 200,000 people. Most of the donations come
from individuals, but there are a variety of donors. According to Antico, the charity was recently able to forgive $20 million in debt for New York residents because of the contributions raised by two women from Ithaca and from NBC Universal in New York City, and RXR Realty and its philanthropic owner Scott Rechler. “I can’t believe the generosity of people to help other people,” He said. “They’ve just never had an opportunity to make such a multiple of their dollar. Like, $100 will abolish $10,000 in debt. Where can you get that kind of an amplification of your money?” RIP Medical Debt just celebrated a milestone. It recorded the biggest medical debt abolishment in U.S. history at the end of 2018 by wiping out $250 million thanks to one couple’s generous donation. But Antico says it’s just the tip of the iceberg. The charity’s records show 1.5 million New Yorkers currently have more than $1.2 billion in medical debt on their credit reports. Nationwide, it’s $75 billion. And since only 10 percent of medical debt is listed on credit reports, the problem is much costlier than this charity can currently afford. They don’t turn any kind of profit from it. One hundred percent of the money comes from donors and is applied to eliminate debt. Antico, Ashton, and Robert Goff another founding member of RIP Medical Deb wrote a book with ideas on how to improve America’s healthcare system called “End Medical Debt.” Proceeds from the book are donated to the charity. Despite its success, Antico doesn’t believe RIP Medical Debt is the
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2019
12 Medical Debt Facts The United States spends 1. more per capita (per person) on health care than any other
nation on earth. The United States is the only industrialized country reliant on commercial insurance instead of universal healthcare. At least 20 percent of all working-age Americans with health insurance have trouble paying medical bills. An unexpected $500 outof-pocket medical bill is too much for many people to pay or pay in a timely way. More than 60 percent of all insured Americans will deplete most or all of their savings to pay medical bills. About 10 percent of adults delay or skip medical care due to costs; worsening health costs more to treat. At least 43 million Americans have about $75 billion in pastdue medical bills on their credit reports. Medical debt on a credit report generally prevents people from buying or renting homes and cars. Medical debt on a credit report can keep people from getting a job to pay off their medical bills. Only 10 percent of all unpaid medical bills appear on credit reports; at least $1 trillion exists.
2.
3. 4. 5. 6.
7. 8. 9
10.
Medical debt drives 11. middle class and lowerincome families into poverty or homelessness.
Medical debt is the number 12. one cause of personal bankruptcy in the United States.
Power & Grace:
the Practice of Tai Chi
Master: Each motion in tai chi must be done with purpose and intent By Julie Halm
T
ai chi is a practice that looks very graceful when done correctly, but according to a local expert cannot be thought of as a dance of any kind. “There is a rule not to be violated that every move in tai chi should be good for both health and martial art applications,” said Sifu James Roach (“sifu” is a Chinese word that means teacher). “After all, the real benefit of tai chi is the development of ‘neigong’ or, in English, ‘internal discipline’ in the body and not a fancy dance routine.” Roach is a master certified teacher in classical tai chi instruction and has been a practitioner of the martial art for more than four decades. He teaches at Buffalo State. He initially became interested in tai chi after experiencing some karate instruction in the U.S. Marine Corps. He was drawn to the internal aspect of the practice and eventually began to study under Stephen Hwa Ph.D., prominent tai chi master. In attending one of Roach’s classes, held at Buffalo State College, a first-timer might think that the moves do not look overlycomplicated. As a teacher, Roach is quick to show his pupils how subtle differences in how those moves are executed make all the difference in their benefit to the body and the fulfillment of their intent. Each motion in tai chi must be done with purpose and intent, or else the value of the move is lost. There are many forms of tai chi, which share some roots, but they have variations in their modern practices. Noreen Starr practices at the Taoist Tai Chi Society of Buffalo. The form taught at the society is based in the traditional yang form of tai chi, but was adapted by Master Moy Lin Shin when he emigrated from Hong Kong to
Canada. The Buffalo-based nonprofit organization does not focus its practice as strongly on the martial arts aspect of tai chi, according to Starr. “Ours is not taught for martial arts purposes,” she said. “The main focus is health purposes in the way we teach it.” Starr, who is now almost 70, first heard of tai chi in her final year of college. By the time she decided to drop in on a class, however, many years had gone by and she was experiencing some health issues. “I had fibromyalgia. I was getting to the point where walking was becoming almost impossible,” she said. But practicing tai chi has changed that entirely for Starr.
“One of the big events post-tai chi was the first time I was able to go upstairs or downstairs one foot at a time,” she said. Starr noted that individuals with a range of ailments have found relief through practicing tai chi. She mentioned people suffering from Parkinson’s disease, scoliosis and some back issues have benefited from practice tai chi. For Starr, she has also experienced increased peace of mind, calmness and a reduction in anxiety levels. Roach agrees that the benefits can be numerous, but that tai chi is not a magic bullet of any kind. “There are mental and physical benefits with the caveat that ‘tai chi gives back what you put into it,’” said Roach. “I have been doing it for 40-plus years and I have experienced
James Roach teaching a tai chi class at Buffalo State. Roach is a master certified teacher in classical tai chi instruction and has been a practitioner of the martial art for more than four decades. July 2019 •
improved joint health, internal organ health, more energy and much more but with another caveat ‘it is not a panacea.’” Roach describes tai chi as a treasure chest of sorts, the benefits of which must be uncovered. In that treasure chest lies the understanding of the concept of “Yi,” the martial art intent of the practice, according to Roach. “It is single-minded and somewhat intuitive with the desire to deliver the internal power externally through hands, arm and foot, whatever the movement is. If the hand is moving forward, then the yi goes to the palm and fingers,” says Roach. “If the hand is moving laterally in a blocking movement, then the yi goes to the leading edge on the side of the hand, etc. Once the practitioner masters the yi, it is no long a conscious effort anymore. It becomes subconscious and comes naturally whenever the practitioner makes a move.” For Starr, part of the riches she has found in practicing Taoist tai chi is simply the community, which it has brought her. “It’s possibly the most laid back and accepting community I’ve met in my life,” she said. That tai chi community is made up of volunteer instructors, which, according to Starr, want to bring the benefits of tai chi to as many as possible. As a result, the Buffalo chapter offers classes focused on pain reduction twice a week, which are free to the public. Instructors help people of all different physical capabilities modify the movements to their own needs. “Tai chi does not cure anything,” she said. “But it makes a lot of things better.” For more information on Taoist Tai Chi of Buffalo, visit www. taoisttaichi.org/locations/buffalocenter. For more information on Classical Tai Chi of Buffalo, visit www.classicaltaichiofbuffalo.com.
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