IGH - WNY 58 - AUGUST 19 by In Good Health: WNY's Healthcare Newspaper

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Expanding Roswell Park’s Footprint Physician Thomas Schwaab, Roswell Park chief of strategy, business development and outreach, is working to expand Roswell’s services to the entire state and beyond

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AUGUST 2019 • ISSUE 58

GENERICS Recent news stories raise questions about effectiveness and safety of generic drugs sold in the U.S. One problem: Most of these drugs are manufactured in China and India, where oversight is not as stringent as in the U.S. or other countries. See story on page 9

Fried dough, funnel cakes, corn dogs, deep fried cookies — should you resist all these temptations? We’ve asked the experts about eating those delicious treats

Aging Eyes Droopy eyelids, dry eyes, floaters, cataracts, ocular migraines are just some of the eye problems we may have to deal with as we age

It’s Time to Play

It’s a new day for play in Buffalo at Explore & More — The Ralph C. Wilson, Jr. Children’s Museum. P. 13

Baby Red Potatoes What’s the go-to type of potato the author of column SmartBites reaches for? Yes, baby red potatoes. Find out why. Page 11

Vaccination 5 things you need to know about it, according to pediatrician Larry Denk. Page 12

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In a U.S. First, Baby Is Delivered From Womb Transplanted From Deceased Donor

octors at the Cleveland Clinic announced that they’ve achieved a first in North America: delivering a baby from a uterus that had been transplanted from a deceased donor. The healthy baby girl was delivered by C-section in June. This is only the second time such a delivery has happened worldwide, the first having occurred in Brazil in December. “We couldn’t have asked for a better outcome. Everything went wonderfully with the delivery, the mother and baby girl are doing great,” physician Uma Perni, a Cleveland Clinic maternal-fetal medicine specialist, said in a hospital news release. Perni stressed that “it’s important to remember this is still research. The field of uterus transplantation is rapidly evolving, and it’s exciting to see what the options may be for women in the future.” According to the Cleveland Clinic, the baby’s mother required a uterus transplant due to a condition called uterine factor infertility, which affects about one in every 500 women of childbearing age. The unnamed woman was in her mid-30s when she joined an ongoing clinical trial at Cleveland Clinic, exploring the possibility of uterus transplant to help her bear a child. In late 2017, the patient underwent transplant surgery and received a uterus from a deceased donor. In

late 2018, she conceived through in vitro fertilization, her medical team said. “It was amazing how perfectly normal this delivery was, considering how extraordinary the occasion,” said Cleveland Clinic transplant surgeon Andreas Tzakis. “Through this research, we aim to make these extraordinary events ordinary for the women who choose this option. We are grateful to the donor and her family,” Tzakis added. “Their generosity allowed our patient’s dream to come true and a new baby to be born.” Specialists from many departments collaborated on the effort: transplant surgery, obstetrics and gynecology, fertility, neonatology, bioethics, psychiatry, nursing, anesthesiology, infectious disease, interventional radiology, patient advocacy and social work. The baby’s delivery is expected to be just the first of many, the Cleveland Clinic team said. So far, five uterus transplants have already been completed. “Three transplants were successful and two resulted in hysterectomies,” the clinic said. “Currently, two women are awaiting embryo transfers, while several more candidates are listed for transplant.” The clinic said their program seeks to eliminate risks to living donors by only sourcing the transplanted uterus from a deceased donor.

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,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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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

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Guidance for Fish Consumption In Erie County Pregnant, breastfeeding mothers and young children urged to avoid eating fish from local waterways

omen under 50 years old and children under 15 years old are urged not to eat any fish caught from the Buffalo River, Buffalo Harbor, Cayuga Creek, Delaware Park Lake/Hoyt Lake, the Erie Canal or Eighteenmile Creek. The recommendation comes from the Erie County Department of Health. Additional restrictions are placed on fish coming from Lake Erie and the Niagara River. These advisories are based on the potential that fish from these sources are contaminated with PCBs (polychlorinated biphenyls), dioxins and other pollutants that can cause disease, hormonal imbalances and immune system impairment. “Fish and seafood can be part of everyone’s balanced diet, but we are urging caution when it comes to fish from local waterways,” said Erie County Commissioner of Health Gale R. Burstein. “Know what type of fish you’re eating and where it came from, especially if caught by a friend or family member, and check it against the latest advisories from

the New York State Department of Environmental Conservation and NYS Department of Health.” In early July, the U.S. Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) issued a joint press release with advice for women of child-bearing age and children on eating fish. Their recommendations described the health benefits of eating certain types of fish when pregnant or breastfeeding, and how fish and other protein-rich foods can support growth and development in children. The FDA and EPA advise pregnant women, women who may become pregnant, breastfeeding mothers and young children to avoid eating certain fish based on high levels of mercury and other contaminants. These types include shark, swordfish, king mackerel, tuna (bigeye), marlin, orange roughy and tilefish from any source. Submitted by the Erie County Department of Health.

San Francisco Is First U.S. City to Ban E-Cigarette Sales

an Francisco is the first major U.S. city to ban the sale of electronic cigarettes. City supervisors passed the measure in a second and final vote in June, the Associated Press reported. Supporters believe the ban will reduce underage use of e-cigarettes, while critics say it will make it more difficult for adults to buy an alternative to regular cigarettes. San-Francisco is also home to leading e-cigarette manufacturer Juul Labs. The company says it’s opposed to youth use of e-cigarettes and is working on a ballot initiative that would regulate but not ban e-cigarette sales, the AP reported. The new law would forbid the sale of e-cigarettes that have not undergone a premarket review by the Page 4

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U.S. Food and Drug Administration, something no e-cigarette maker has done, CNN reported. The ban also applies to flavored tobacco products and covers sales in brick-and-mortar stores and online sales shipped to a San Francisco address. “E-cigarettes are a product that, by law, are not allowed on the market without FDA review. For some reason, the FDA has so far refused to follow the law,” city attorney Dennis Herrera said in statement after the measure passed an initial vote, CNN reported. “Now, youth vaping is an epidemic,” he said. “If the federal government is not going to act to protect our kids, San Francisco will.”

CALENDAR of

HEALTH EVENTS

Aug. 3

Strike Out Breast Cancer befits local survivors, research The Breast Cancer Network of WNY (BCN), in collaboration with the Buffalo Bisons and Amherst Federal Credit Union, will present its Third Annual “Strike Out Breast Cancer” event on Saturday, Aug. 3. This family-friendly event includes a two hour pre-game party downtown at Cathedral Park, a short breast cancer awareness walk to Sahlen Field, and admission to that evening’s Buffalo Bisons baseball game. Activities begin at 3 p.m. with the pre-game which will feature food, entertainment, games, photos, and contests for best T-shirts and best dancers. Tickets are $30 for adults and $12 for kids 12 and under. Breast cancer patients and survivors are free as are children under 3. Proceeds from Strike Out Breast Cancer 2019 will benefit local breast cancer survivors through the programming of BCN, and will also be used to help fund metastatic breast cancer research. “As an independent nonprofit organization, we depend on fundraising and the generosity of our community to fund the important work we do,” said Breast Cancer Network Executive Director Rob Jones. “Strike Out Breast Cancer is not just a fundraising activity, but also gives us the opportunity to let people know who we are and how we help all people in Western New York who have been impacted by breast cancer. Plus we are raising funds for metastatic research, which is a very important focus of this organization.” Metastatic breast cancer is the Stage IV disease that causes more than 40,000 deaths in the United States each year. BCN has created a restricted fund that donates specifically to metastatic breast cancer research and that fund will benefit from this event. The Breast Cancer Network of WNY, founded in 1988, is dedicated to the education, support, and advocacy for breast cancer patients and survivors of WNY. This volunteer driven organization presents a full schedule of support groups, restorative health classes, education programs, and outreach for survivors and newly diagnosed patients. BCN is a local organization and keeps 100% of all donations it receives in Western New York. Strike Out Breast Cancer 2019 tickets are available online at www. bcnwny.org or at the BCN offices at 3297 Walden Ave. in Depew.

Aug. 14, Sept. 11

Catholic Health hosts free summer yoga series in Lockport Catholic Health is hosting “Get Centered Wednesdays: Yoga and Wellness” throughout the summer at

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

Mount St. Mary’s Health Center Lockport, 6000 Brockton Drive, suite 106. Niagara County residents are invited to join the group from 5 to 7 p.m. Aug 14 and Sept. 11 for a free yoga class and open house. The first of the three meetings occurred July 10. The sessions are presented by East End Yoga at Ultimate Physique. All participants will receive a Catholic Health water bottle and yoga mat (while supplies last). No prior experience necessary. All are welcome, including expectant moms. Friends and neighbors are encouraged to attend as well. Before the yoga class, there will be an open house and Q&A session with Catholic Health OBGYNs. Light refreshments will be provided and participants will have the opportunity to win one of three family photo sessions with Zula Sonner Photography. The events is free and open to all ages. Space is limited. For more information or to make reservations, call 716-447-6205. Information can also be found by visiting chsbuffalo. org/events.

Sept. 7

Walk to End Hydrocephalus scheduled for Grand Island The Western New York chapter of the Hydrocephalus Association is organizing the Walk to End Hydrocephalus, which will take place 9 a.m., Saturday, Sept. 7, at Beaver Island State Park in Grand Island. The event raises fund for research and cure of hydrocephalus and raises awareness for the condition. Hydrocephalus is the abnormal accumulation of cerebrospinal fluid in the brain. Over one million Americans are born with or develop this condition. The only treatment to date is brain surgery. Hydrocephalus is more common than Down syndrome, according to the organizers. The WNY Walk was started seven years ago by Stacey Monaco Fonagy, a woman in her 30s who had been having symptoms of hydrocephalus for years before she was diagnosed correctly in her mid-20s. By that time, she had to undergo emergency brain surgery to relieve the abnormal buildup of cerebrospinal fluid. Since then, she has married, has a young boy, and has been working full time for National Fuel Gas. During her recovery from brain surgery, she decided to initiate a Western New York walk in conjunction with the national Hydrocephalus Association. Over the last six years the local walk has grown to more than 300 participants. There is no registration fee for the event. There will be face painting, magicians, dancers, appearances by Sabertooth and Wonderwoman and a basket raffle. Lunch is provided by a series of generous donors. The festivities last until about 1:30 p.m. For more information, email samonaco25@gmail.com or FonagyS@ natfuel.com or call 716-510-5075.

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U.S. Suicide Rate Rose 33% Between 1999 and 2017

he United States’ suicide rate in 2017 was 33% higher than in 1999 and is at its highest since World War II, according to a new study. It found that suicide rates among Americans aged 15-64 rose from 10.5 per 100,000 in 1999 to 14 per 100,000 in 2017, CNN reported. American Indian or Alaska Natives had the highest increase among all racial/ethnic groups, according to the findings released in June by the Centers for Disease Control and Prevention’s National Center for Statistics. There were significant increases in suicide deaths among girls and women in all racial/ethnic groups except Asian or Pacific Islander. The largest increase (139%) was among American Indian or Alaska Native girls and women, CNN reported.

Significant increases were also seen in suicide rates among boys and men in all racial/ethnic groups except for Asian or Pacific Islander. The largest increase (71%) occurred among American Indian or Alaska Native boys and men. American Indian or Alaska Native, aged 15 to 44, had the highest suicide rates for both males and females in 2017, CNN reported. A separate study published in June in the Journal of the American Medical Association found that suicide rate among U.S. teens aged 15 to 19 rose from 8 per 100,000 in 2000 to 11.8 per 100,000 in 2017. Among young adults aged 20 to 24, the suicide rate rose from 12.5 per 100,000 in 2000 to 17 per 100,000 in 2017. A CDC report released last year said U.S. suicide rates rose 25% between 1999 and 2016, CNN reported.

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partner.” The exact way in which Vyleesi helps stimulate sexual desire remains unclear, but it works on melanocortin receptors on cells, the FDA said. The drug is injected under the skin of the abdomen or thigh at least 45 minutes prior to a sexual encounter, although the best timeframe for dosing could vary from user to user. Side effects can occur, the FDA added, and include nausea and vomiting, flushing, injection site reactions and headache. Nausea was especially common, affecting 40% of users in the clinical study that led to approval. The new drug will not be available until September, and pricing and reimbursement have yet to be determined.

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FDA Approves Second Drug to Help Women With Low Libido

he U.S. Food and Drug Administration in June gave its approval to Vyleesi, the second medication so far approved to help women with low sexual desire. In a news release, the FDA said that Vyleesi (bremelanotide) is a drug that would be administered by injection prior to having sex. It’s been specifically approved for premenopausal women with a condition known as acquired, generalized hypoactive sexual desire disorder (HSDD). “There are women who, for no known reason, have reduced sexual desire that causes marked distress, and who can benefit from safe and effective pharmacologic treatment,” said physician Hylton Joffe, who directs the FDA’s Center for Drug Evaluation and Research’s Division of Bone, Reproductive and Urologic Products. “Today’s approval provides women with another treatment option for this condition,” Hylton said in the news release. According to the agency, HSDD is not caused by any medical or psychiatric condition, relationship issues or drug side effects. Instead, women with HSDD have “previously experienced no problems with sexual desire,” the FDA said. “Generalized HSDD refers to HSDD that occurs regardless of the type of sexual activity, situation or

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Meet

Your Doctor

By Chris Motola

Thomas Schwaab M.D.

Roswell Park chief of strategy, business development and outreach is working to expand Roswell’s cancer-related services to the entire state of New York and beyond

Meals on Wheels Delivers an Extra Health Bonus for Seniors

eals on Wheels might do more than deliver hot food to isolated seniors: New research suggests it can serve as an early warning system for declining health. The study included Meals on Wheels drivers in Guernsey County in Ohio and San Diego County, who were trained to use a mobile app to alert care coordinators if the drivers had a concern or noticed a change in a senior’s condition. The care coordinators then followed up with seniors to provide support and connect them with health and community services. Over the 12-month study period, the drivers submitted 429 alerts for 189 clients. The most frequent alerts were for changes in health (56%), self-care or personal safety (12%) and mobility (11%). Follow-ups on the alerts led to 132 referrals, with most for selfcare (33%), health (17%) and care management services (17%), according to the researchers at West Health Institute at Brown University in Rhode Island and Meals on Wheels America. The study was published recently in the Journal of the American Geriatrics Society. West Health and Meals on Wheels America plan to expand the research program to as many as 30 Meals on Wheels sites across the United States, that include about 40,000 seniors. “By collaborating with Meals on Wheels America, we’ve developed a safe, cost-effective and scalable program to preemptively identify and address concerns that too often result in deterioration of a senior’s medical condition or pose a major safety risk,” said physician Zia Agha, chief medical officer at West Health Institute. “We’re excited learnings from this research program are now being implemented across the country within Meals on Wheels America’s expanded program that will positively impact as many seniors as possible,” Agha added in an institute news release.

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Q: You’re responsible for developing strategy for Roswell Park Cancer Network? A: Yes, I’m the chief of strategy, business development and outreach at Roswell. Q: Can you give us an overview of what the network is and what it’s trying to accomplish? A: The Roswell Park Care Network spans the entire state of New York, from Western New York and Buffalo to the Catholic Health Services of Long Island. Our goal is to provide as much quality comprehensive services as you’d get if you walked into our downtown Buffalo campus, and have all of those services available throughout the state. And obviously patients benefit from that tremendously. Q: What are the challenges of coordinating a network with such a wide geographical distribution? A: The distance is the greatest challenge, but it’s also the greatest opportunity for our patients. Take our affiliate in Oneida, just outside of Syracuse. Modern oncology care really consists of multiple services that have to be carefully orchestrated. The three mainstays are: surgical services, ideally a subspecialized surgeon that focuses on certain cancers, you need a medical oncologist and you need a treatment center with a radiation oncologist. But you also need the ancillary services that make Roswell Park an NCI [National Cancer Institute] designated cancer center. That includes access to clinical trials, access to pathologists, interventional radiologists and care coordination of different services. So, to pull this all together, you need to be able to control the quality of services that are provided, and we do that in a number of ways. For exam-

ple, on the medical oncology side, we have input into the physicians who provide care. The long-term goal is that all of our affiliates will follow our oncology pathways, which is essentially embedded into the electronic medical records and helps us ensure that they’re following our quality standards. And it allows us to audit our quality standards and make sure they’re actually helping patients. It allows us to enroll patients in clinical trials if they’d benefit from it. Our radiation oncology team in Buffalo supervises all of the radiation treatment plans in the network even if they don’t walk into our downtown campus. We have access to telemedicine, so if any physician in our remote network needs advice, they can talk to us and even provide telemedicine consults. Technology has really made a big difference. Q: With reimbursement moving toward outcome-based models, does this help smaller providers in the network meet the standards better? A: Ultimately I think that’s the goal, to elevate the quality of care in the areas that we can impact. Patients benefit, health systems benefit, patients are taken care of better, and more cost efficiently. Q: Do you have input into who becomes a member, or reaching out to potential new members? A: In general, Roswell is interested and willing to partner with anyone interested in providing the highest quality care of cancer services to their patients. There are certain quality metrics that we look to but also, like any other business, certain interpersonal relationships. If you have a good interpersonal relationship between the teams, it’s easier to cooperate and set up the network. The physicians who provide care in the network need to be willing to be audited and educated, and that’s not always an easy conversation to have with the physicians. So, it’s all about the quality and the cooperation.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

Q: A big cliché in New York is the Upstate/Downstate divide, viewed

almost as two separate states. Do you see that an obstacle to operating in both regions given the differences in population density, demographics, resources, etc.? A: That’s a good question. I think the challenges are different. Downstate you have a huge population with lots of competing healthcare services. Upstate you only have one NCI-designated cancer center, and that’s us. So we have a very good relationship with the governor, and the governor expects us to follow our vision, and that’s to reach as many patients with our services as possible. We do have to cover a lot more ground than a center based in New York City, for instance, but I think everyone is striving to do the best for their patients. Q: Do you see the network expanding over state lines to Pennsylvania or Ohio, or do differences in regulations make that impractical? A: So, in theory and concept, absolutely. We could include not only interstate partners, but international partners. Having said that, there are regulatory pieces to that — for example, making sure physicians working with patients in that state are licensed in that state and that kind of thing. It’s not like we’d be the first to do this. Q: What’s the next step for the network? A: Our next step is to solidify services we provide. If you drill down, you’ll find that, in Niagara Falls for example, we’re only providing thoracic surgery services. But the goals is that these multidisciplinary services are delivered at all over our affiliates. So, we want to solidify those relationships and open those services at as many sites as possible that way. Q: How does your own practice factor in? A: I’m a urologist who specializes in kidney cancer. I was in private practice, so a lot of our conversations with our affiliate partners are natural to me because I know what our partners are looking for, particularly physicians who are in private practice in a rural area. I think that makes it a bit easier for me to communicate with them. But I still see patients, which is important to maintain credibility.

Lifelines

Name: Thomas Schwaab M.D., Ph.D. Position: Chief of strategy, business development and outreach at Roswell Park Comprehensive Cancer Center; professor of oncology and immunology Hometown: Hamm, Germany Education: MD and Ph.D. from Hannover Medical School Residency: Klinikum Lippe-Detmold, Detmold, Germany; DartmouthHitchcock Medical Center, Lebanon, New Hampshire. Fellowship: Tumor immunotherapy program, Dartmouth College, Hanover, New Hampshire Affiliations: Roswell Park Comprehensive Cancer Center; Catholic Healthcare System Organizations: American Urological Association; Society of Urologic Oncology; Association of Healthcare Executive Family: Wife, four children Hobbies: Soccer

Med Students’ Smartphones Loaded With Staph, Other Germs

martphones have become an essential part of modern medicine, but they might be exposing patients to potentially deadly staph infections, a new study suggests. Tests of cellphones at a Brazilian medical school revealed that 40% carried Staphylococcus aureus, a common cause of hospital infections. Worse, 85% of the bacteria isolated were resistant to antibiotics, and half had the ability to adhere to surfaces. The majority of the contaminated phones — seven out of 10 — belonged to nursing students, researchers said. “The possibility of disseminating pathogenic bacteria through cellphones is frightening,” said lead researcher Lizziane Kretli Winkelstroter, a professor at the Western University of Sao Paulo, Brazil. “If we are talking about a super bacteria, it would be difficult to cure the infection, and unfortunately, it could lead to the death of patient.” The senior director of infection prevention for the Johns Hopkins

Health System, physician Lisa Maragakis, said she has “no doubt” that cellphones in the United States are also contaminated. “Staphylococcus aureus is a bacteria that lives on all of our skins, so just by the sheer amount we handle our cellphones, we know through routine use they’re going to become contaminated with a variety of bacteria from the environment and from our hands,” she said. Doctors these days rely heavily on cellphones for communication, collaboration and information-sharing, the researchers said. But since these phones are handled frequently, it’s difficult to say how contaminated they might be from a variety of infectious bacteria and viruses. “Germs can be present in the equipment and utensils we use on a daily basis. The fact that they are not perceptible to the naked eye do not mean that we should not give its due importance,” Winkelstroter said. To gain a sense of the problem, Winkelstroter’s team took cultures from 100 cellphones of health-care

students at Western University. Health students regularly attend practical classes and clinical stages where they have direct contact with samples, objects and surfaces that contain infectious germs, researchers said. Physician Waleed Javaid, director of infection prevention and control at Mount Sinai Downtown in New York City, noted that “hand hygiene and cleaning of devices are one of the major factors that decrease chances of spread of these organisms.” But it’s not clear whether doctors, nurses and other medical staff are being as scrupulous in keeping smartphones clean. “I can say that personal devices like cellphones are probably less frequently cleaned and disinfected,” Maragakis said. “I imagine if we went around and cultured a bunch of different cellphones we would find a variety of different bacteria and viruses on them.” Antibiotic-resistant staph can cause serious or fatal illnesses in health-care settings, where patients often have compromised immune

systems, according to the U.S. Centers for Disease Control and Prevention. These include sepsis, pneumonia, infection of the heart valves and bone infections. “I do think we can do a better job of wiping off our devices, both in the health-care setting and in general,” Maragakis said. “Even an alcohol wipe goes a long way to reducing the bacterial load on something like a cellphone.” However, smartphones probably couldn’t — and shouldn’t — be banned from hospital premises, Winkelstroter said. “Banning cellphones does not seem to be the most appropriate measure since they are currently very useful in obtaining information in a quick way and are very helpful to health professionals,” she said. “However, more attention should be given the sanitation and disinfection of these phones. My suggestion is to develop a protocol for disinfecting the cellphones of these professionals at least once a day.” The findings were presented in July at the annual meeting of the American Society for Microbiology in San Francisco. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

Healthcare in a Minute

By George W. Chapman

Coming to a Hospital Near You: Artificial Intelligence in the OR

t’s coming to your local hospital sooner than you think. According to industry experts, up to 45% of operating rooms will have AI in just three years. Robotic assisted surgery devices (RASDs) are already used by surgeons to provide faster and more precise treatments which reduce recovery times and improve outcomes. Experts predict the RASDs market will increase to $7 billion by 2022. Currently, operating rooms account

Wearable devices

Wearable devices are a form of AI. According to several surveys, about two thirds of consumers responded they would be willing to use a wearable device, like an Apple Watch or a Fitbit, if it means fewer trips to their provider’s office. Fifty-five percent of respondents said they would wear a device at home if it meant their health could be monitored by someone remotely. Many insurers are offering discounts to members with wearable devices. According to a study by Evidation Health, diabetic and hypertensive patients with wearable devices are far more compliant with adhering to their meds. The biggest challenge is engaging patients to adopt and integrate virtual care into their daily lives. Despite all the advances in medicine, it still takes two to tangle. Poor patient compliance still frustrates physicians.

Retiree Concerns

Insurance companies fare better

for 60% of hospital revenues. By integrating with advanced home care devices, sophisticated urban hospitals can expand the range of their surgical expertise into rural areas. The goal of AI is to interpret, synchronize and coordinate data to achieve optimal OR results and patient outcomes. The proliferation of artificial intelligence in healthcare will help mitigate the projected shortage of physicians by increasing the efficiency.

when claims decrease. No longer remaining passive, insurers are more actively involved with their members to improve their health (and of course lower claims). To learn more about their membership and to develop strategies that help members stay healthy, insurance giant United Healthcare surveyed their Advantage members. Not surprisingly, 70% of respondents said health was their No. 1 concern. Eighty-six percent said they were worried about falling ill or becoming hospitalized in the near future. When asked what would you do to live healthier, 70% said they would start a new routine like a better diet, more exercise or volunteering. Forty percent of United’s Medicare Advantage members have multiple chronic conditions and 40% of their members live alone. Ten thousand people a day turn 65.

FDA Revolving Door

Dwight Eisenhower warned us against the “acquisition of unwarranted influence, whether sought or

unsought, by the military-industrial complex.” Arms manufacturers were hiring retired generals to act as lobbyists to their former employer. Now the same can be said of the FDA-pharmaceutical complex. Former FDA commissioner Scott Gottleib resigned in early April “to spend more time with his family.” Less than three months later, he is working for drug giant Pfizer. This has become standard fare in Washington and is just another example of why President Trump wants to require or mandate a two-year waiting period between working in government and becoming a lobbyist for the very industry you were regulating. The US has the highest cost of healthcare per capita in the industrialized world and the pharmaceutical industry plays a huge part in our costs. Drugs invented, tested and manufactured in the US are sold abroad far cheaper. President Trump wants to establish what’s called a “favored nation” policy whereby the US takes advantage of the lowest world-wide price charged for a drug sold outside the US by a US manufacturer. So far, there has been a lot of talk but no action.

ED claims

It’s a tough place to work and it’s where the worst cases present themselves. Emergency departments are a classic metaphor for high reward coupled with high risk. Boston-based Coverys, a professional liability insurance company, analyzed over 1,300 claims against EDs from 2014 thru 2018. Cardiac and cardiovascular conditions, (like heart attacks, aortic aneurisms and ruptures), triggered the most liability claims. More than half the cases filed against EDs were due to: the failure or delay to make a diagnosis; lack of

August 2019 •

an appropriate family history and physical; and inappropriate ordering of diagnostic tests. (Similarly, diagnostic errors are the leading cause for claims against primary care providers.) A boon to emergency departments is the increased availability of and access to crucial patient information via the electronic medical record, especially when the patient presents to the ED unconscious and/or alone.

Cost of Cancer

According to a study published in JAMA Oncology, in addition to the cost of treatment, premature deaths caused by cancer account for over $94 billion in lost earnings annually. Lung cancer caused the most lost wages at $21 billion. It caused 23% of all premature cancer-related deaths. Utah had the lowest amount of lost wages at approximately $20 million, while Kentucky had the most lost wages of any state at $35 million. Researchers suggest states use the data to guide future policy decisions that address risk factors like smoking, obesity and lack of exercise. For example, did states that adopted Medicaid expansion fare better than states that did not when it comes to cancer prevention and premature deaths?

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone at Home: Spending Quality Time with Yourself

t’s a warm August Friday night, and the weekend is stretching out in front of you — a big, empty void to fill. But with what? You can feel your anxiety rising. You can feel yourself spiraling down, questioning the past. And that’s when you grab for the TV remote, a pint of Ben & Jerry’s, and head for the couch, or maybe, for bed. Sound familiar? It’s not uncommon for those who live alone to find time alone at home a real challenge. It’s especially true for those coming out of long marriages or relationships where familiar routines, chore schedules and social obligations filled evenings and weekends. I can remember many nights after my divorce, coming home after work to an empty house with hours on my hands and a hole in my heart. The prospect of a long, lonely evening ahead was almost unbearable. I was fine during the day, but when the sun started to set or the weekend rolled around, I would start to panic. After way too many bowls of ice cream and episodes of Dateline, I had finally had enough and started making better use of my “me time.”

I am now thoroughly comfortable spending time by myself and have come to enjoy my own company. In fact, it’s not unusual for me to pass on an invitation out, in favor of spending a nice quiet evening at home relaxing or fully engaged in something I love to do. If you are challenged by time alone, as I was, consider the suggestions below. You might even clip this column and put it on your fridge as a handy reminder. n Read. In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely evening. Don’t know where to start? Ask a friend for a suggestion or select a book from The New York Times’ best-seller list. Snuggle up in a comfy, well-lit place, and let a good book introduce you to new people, new places and new ideas. We are never alone when reading. n Write. Marcel Proust wrote, “We are healed of a suffering only by

expressing it to the full.” Even if you never look back at what you write, the act of committing your thoughts and feelings to paper can be therapeutic. Consider starting a journal if you haven’t already done so. A few minutes in the evening before bed can be a perfect time to capture what’s on your mind and in your heart. As you work through and write about some of the challenges you face living alone, you will find that reading and rereading your journal entries will be a great way to reflect on and track the progress you are making. n Clear Out the Clutter. I know this might sound mundane, but clearing out the clutter can be very satisfying and a great way to spend a few hours alone. I spent one recent Tuesday night sorting out my closet and filling two Hefty bags for Volunteers of America. It felt good. I not only lightened my load; I did something for a good cause. As a result, I felt part of something bigger than myself and less alone. n Pursue a passion. This can sound daunting, especially if you’ve yet to identify your passion, but hang in there. Many men and women in long-term relationships often sacrifice their own interests in favor of attending to the needs of others. The pursuit of what delights you can be lost in the process. Now’s a good time to rediscover your “loves” and to dedicate your time alone to these pursuits. Do some “internal” digging and identify the things you loved as a child or young adult and make a conscious decision to revisit them now. Evenings or weekends spent doing what you love can shift your perspective and change your world. Whether it’s cooking, exercising, gar-

dening, writing, or practicing music, when you’re absorbed doing the things you love, loneliness dissipates and you feel alive. n Reach Out. With time on your hands, you are in a great position to reach out and make connections with others, especially with long, lost friends. This can be a very meaningful way to spend your time. Just yesterday, I received a hand-written note from a friend I hadn’t seen in a while. I was very touched and inspired to do likewise with my own old friends. Pick up the phone, send an email, or send a “snail mail” note to someone with whom you’ve lost touch. n “Veg out.” That’s right, “veg out.” Grab the TV remote, a pint of ice cream, and head for the couch — or better — for bed. But this time, do it without guilt; do it without beating yourself up. Everyone is entitled to an occasional night when they just hang out, do nothing and eat yummy comfort food. Indulge yourself and tell yourself you deserve it. Wake up the next morning — free of remorse — and ready to take on the day: alone at home and “at home” with yourself!

dies with more than 38,000 participants, also revealed that the image of the overweight gamer lolling on the couch with a controller, potato chips and a bottle of soda may be more applicable to adults. Appel and his colleagues noticed a small correlation for video game playing and excess weight among adults. A possible explanation for the correlation is indirect: Those who spend more time playing video games are likely to spend less time exercising, thus weighing more. The prevalence of adult obesity in the United States is a staggering 39.8%.

In the past, the relationship between video games and obesity has been studied. Other forms of sedentary media consumption, such as watching TV, have shown a strong link to weight gain. “TV use is more reliably related to body mass in kids and adolescents,” Appel said. He offered a reason for this link. “There are more ads for high-calorie food and drinks in TV than in games,” Appel said. The study was published online recently in the journal Social Science and Medicine.

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

Will Video Games Make Your Kid Obese? Maybe Not

o the millions of parents who worry about the extra pounds their child might pile on while playing Xbox all day, rest easy. A new study suggests that video game-loving kids aren’t any heavier than those who aren’t into the gaming scene. Childhood obesity affects an estimated 13.7 million children and adolescents in the United States, according to the U.S. Centers for Disease Control and Prevention. But researchers from Germany challenge the notion that gaming is fueling the epidemic. Excess weight gain in kids has a slew of causes: high-calorie, low-nutrient snacks and beverages, lack of physical activity, medication use, sleep routines and sedentary activities. However, the study found that video games can’t be counted as one of those activities. “Given our results, it is likely Page 8

•

that the energy intake [food and drinks] and their energy expenditure [including non-sedentary activities] are not closely related to playing games,” said researcher Markus Appel, from the University of Wurzburg. Childhood obesity can lead to significant health problems like Type 2 diabetes, asthma, sleep apnea and psychological stress. Obesity-related conditions are some of the leading causes of preventable, premature death. Changing eating habits and activity levels are some of the best ways to prevent obesity. Jason Bruck, a nurse anesthetist at Mount Sinai West in New York City, shared some advice for parents. “Make sure your children stay active,” Bruck said. “Prepare meals ahead of time, provide healthy snacks. A lot of small details can influence your child’s health.” The research, involving 20 stu-

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

GENERICS

Are they really safe and effective? Recent news stories raise questions about these drugs By Deborah Jeanne Sergeant

re generic prescription medications as safe and effective as their name brand counterparts? News reports such as NBC’s “Tainted Drugs” story by Didi Martinez, Brenda Breslauer and Stephanie Gosk in May indicate that imported generics may be subpar compared with name brands. One example was a nationwide recall of generic drug valsartan, a popular blood pressure medication which was found to contain carcinogens. The NBC story stated that about 85% of facilities manufacturing the ingredients used in American drugs come from factories in countries like China and India, where cost is lower, but oversight is not as stringent as in the U.S. or other countries. Since summer 2018, manufacturers have sent out about 45 recalls of generic blood pressure drugs, including losartan, irbesartan. Their ingredients have been sourced from imported ingredients, according to the NBC story. In India and China, local laws make it more difficult to inspect. In some cases, manufacturers demand advanced warning before inspec“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.

tions, which in effect negates the point of “surprise” inspections. In addition, area physicians raise more concerns. Physician Raul Vazquez , founder of Greater Buffalo United Accountable Healthcare Network (GBUAHN), said that as a rule, generics are supposed to contain the same active ingredients as the name brand medication. “If you use certain generics, like for a thyroid condition, you should stick with the same medication,” Vazquez said. “If you use different product, the bioavailability may be different.” These could affect how the medication is absorbed or cause other side effects. James Della Rocco, director of pharmacy systems for Unity Health in Rochester, isn’t worried about U.S.-sourced medications’ safety. Like Vazquez, he said that the binders and other inactive ingredients may affect how the drug acts for certain patients, such as not dissolving in the same way. But the low cost of generic drugs makes medication obtainable for many people who would not otherwise be capable of affording

their prescriptions, he said. “If you have concerns about where a drug comes from, ask a pharmacist,” he said. “They can say if it comes from the U.S.” The Food and Drug Administration inspects medication production plants every two years, but with foreign plants, “they’re not monitored the same as the plants in the U.S.,” Della Rocco said. “Maybe 50 to 100 are inspected and they need to inspect maybe 700. Oftentimes, you have to notify plants in places like China if you’re going to inspect them. These are points of trade agreements we have to look at.” In the case of carcinogens in the generic drug, valsartan, Della Rocco said that patients would have to consume vast quantities of the medication to “get to the point where you’d get cancer.” Yet he is concerned about medicinal safety because imported medication isn’t as highly regulated as domestically produced medication. “We have got to make sure everything that comes into this country is inspected and is safe,” he said. “If you hear about less oversight and that it’s going to be deregulated, I’d

be concerned. You’ve got to be vigilant about what you take and where it comes from.” Physician Vazquez is also concerned about when drug manufacturers merge, which he said can cause a monopoly or near monopoly for a particular generic, which can cause its price to skyrocket. He has observed commonplace medication such as heartburn medication cost $200 to $300 in co-pays for those with insurance but cost only $79 if they paid cash for it without using their insurance cards. Their insurance actually makes prescriptions cost more. “Pricing is crazy; it costs the state a lot of money,” Vazquez said, referencing state-funded health coverage benefits. He has seen medication available for $20 over the counter cost patients $430 as a prescription, “and the insurance company gets a rebate for it.” The FDA doesn’t control drug prices. It’s up to consumers to discuss available medication with their physicians and ask their pharmacists about costs.

Writer on the Run By Jenna Schifferle

jenna.schifferle@gmail.com

When Injury Strikes: 8 Tips to Keep in Mind

hen you´re accustomed to running 30 to 40 miles a week, suddenly being sidelined feels grueling. There is nothing worse during a training program than being injured. It can be detrimental to your training schedule and set you behind by weeks or months. I´ve been down this road before, and I´ve recently taken another detour straight back to square one. During a long run, I felt it: a familiar pull in my left calf. I stopped and stretched, and then I proceeded. After all, I was only 4 miles in to my 10-miler. By mile 8, I knew I had made a mistake, so I headed back, stopping a humble one mile short of my goal. My calf was sore, and I assumed I could foam roll to get ahead of it. The next day, however, I could hardly walk. Since that time, it has been painful and swollen, taking me out of the running game for a week to date. It’s starting to feel better, but not running can be discouraging for any aspiring marathoner. Like I said, I’ve dealt with injuries before. Tight hip flexors? Check. Random knee pain? Check. A nasty bout of debilitating plantar fasciitis? Check. (That one took me three Cortisone shots and a year off to heal).

Running can be tough on the body, and sometimes taking the steps necessary to ease the wear and tear isn’t always possible. Stretching, foam rolling and cross-training take time. But it is critical to incorporate these into your training — days like these really remind me of that. I’m not out of the game yet. In a couple weeks, I will be back to hitting the pavement and preparing for Chicago. Life throws setbacks at us sometimes, but it’s how we handle them that makes this crazy journey worthwhile. When they’re overcome, challenges serve to make the end result even sweeter. Yes, it’s discouraging, but as someone who’s been there and is still there right now, I’ve learned a few things that I want to share. Please note that I am not a doctor. If you are injured, I strongly encourage you to consult your physician to determine what’s best for you. Don’t run through it! Or skip 1. through it. Or do backflips through it. Stop when you feel the

pain. Any additional activity after the initial injury can cause more damage. When I had plantar fasciitis, I ran through it for months before the pain became debilitating and forced me to

take way more time off than I would have needed if I’d just stopped. Consult your doctor, and actu2. ally take his or her advice to heart. If the recommendation is to

take a week off, take a week off. It’s also important not to jump back into the game before you’re fully healed (see previous comment about taking a year off from running).

Cross-train. When you’re used to waking up and having a regimented training schedule, it can feel strange not to do something. Instead of seeing it as time off, look at it as a time to try something new with your fitness. I’ve been biking my tailfeather off to keep up my cardio and going to yoga classes … which brings me to my next point.

Don’t overstretch it. If the doctor says it’s OK, you can gently stretch, but refrain from doing anything that might make the injury worse. If you go to a yoga class, ask your instructor for modifications. Rest, ice, compress and elevate 5. (RICE). Also, anti-inflammatories are your friend.

August 2019 •

Ditch the running sneakers and 6. get new ones. Anytime I’ve noticed my feet or legs suffering, it’s usually because my sneakers are at the end of their lifespan. Toss them and invest in a new pair. You can never be too safe.

Likewise, try to work with your 7. physician or a certified physical therapist to uncover the root

cause of your injury. Is it poor running mechanics? Is it not warming up before a run? Is it not recovering after a run? For me, it’s the trifecta. Lastly, keep your eyes on the 8. finish line. Remember that a setback doesn’t necessarily mean you can’t reach your goal; it means you have to be more flexible with your strategy. Onward — to the next bike ride!

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 9

Navigating Fair and Festival Food

Fried dough, funnel cakes, corn dogs, deep fried cookies — should you resist all these temptations? We’ve asked the experts about those delicious treats By Deborah Jeanne Sergeant

rom sugary drinks to deep fried everything, fairs and festivals offer a bevy of nutritionally poor food choices. To stick with your healthful eating plan, try these tips from area health experts: • “One of the easiest ways to eat healthy at fairs and festivals is to bring your own water bottle. Avoid sugary sodas and lemonades — it can help you avoid tons of unnecessary calories. • “Niagara County and Erie

County fairs both have public water fountains and most vendors will give you a cup of water for free too. Bringing your own bottle or getting free water cups saves money for more rides. • “Drink unsweetened ice tea to save calories. • “ If you’re getting a sweet treat like a fried dough, try sharing it with a friend and going light on the toppings.” Justine Hays, registered dietitian, senior nutritionist with Eat Smart New York

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through Cornell Cooperative Extension of Niagara County, Lockport. • “I usually suggest that people prepare themselves for this. If you know you’re going to a fair or festival, don’t set yourself up for overeating. Eat healthy that week you’re going and then make sure you have a good meal before you get there. When you’re not super hungry, you can exert your control a little bit better. You can think about it and peruse the food available. You can see who’s got what. • “Share a portion. • “You can also take your own stuff, like fruit or nuts. • “Look for better options. You might be able to catch them before they butter the roasted corn and get one plain. Turkey legs are usually done on a spit or open grill. That’s a reasonable option. Many fairs and festivals have barbecued chicken, which will be a lighter item. Most events have peppers and onions to serve with sausages. You might get a turkey burger or grilled chicken sandwich instead of fried stuff. A lot of places have a salad option. They might add chicken. A lot of times, they might have food with an ethnic fair. Greek or Mexican food may have healthier options like tzatziki on meat. Have them go easy on the cheese. You can do fajitas, which are

going to be typically grilled chicken or steak with vegetables. • “If you want ice creams, many places have frozen yogurt, which don’t have as much fat though they’re sugary. You can get a simple cone versus a gloppy sundae. You can do a fruit-based treat like a smoothie, which may be better than a milkshake. • “Look for water rather than liquid calories. People eat the same amount when they drink their calories and they don’t realize it. People think I’m walking a lot so I can eat more but it takes a lot of walking. You burn only 100 calories a mile. Don’t rely on that. It’s not going to undo a lot of caloric damage. • “These days, there are a lot of double burgers, triple burgers, and fried things. But I’m noticing more healthy options. That’s refreshing. You can find a lot more grilled and broiled things. •”If there’s a real favorite of yours that’s fried, give yourself a chance to have it. Be present and really enjoy it, but be picky about it. Have the thing you really want, but not the things that make you go ‘hohum.’ You don’t have to finish the whole thing.” Mary Jo Parker, registered dietitian who offers nutrition and counseling services in Williamsville.

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IGH_StPaulMall_4-79x6-69_7-2019_V2.indd 7/22/19 1:03 PM 2019 Page 10 • IN GOOD HEALTH1 – Buffalo & WNY’s Healthcare Newspaper • August

SmartBites

By Anne Palumbo

The skinny on healthy eating

Compelling Reasons to Dig into Red Potatoes

aby red potatoes are my go-to variety of potato and here’s why: They offer a smidge more nutritional benefit than white; their nutritious skin is easily edible; they affect our blood sugar levels slightly less than white; and they hold their shape when roasted or boiled. First, let’s unearth a potato’s nutrition. From red to white to purple, this popular vegetable delivers the same nutritional goods across the board. All potatoes are an excellent source of vitamin C (nearly half of our daily needs in one serving) and a good source of potassium (more than a banana). Antioxidant-rich vitamin C is vital to our overall health, helping to repair tissues and boost immunity. Potassium, on the other hand, helps to maintain normal blood pressure and keeps the hardest working muscle in our body beating strong. Naturally low in fat, sodium and cholesterol, potatoes also serve up healthy amounts of disease-preventing fiber, mood-boosting vitamin B 6, and bone-strengthening manganese. Un-doctored and simply boiled or roasted, potatoes are not that caloric: around 110 per average serving. Deep-fry them in oil or smother them with the works, however, and this healthy spud quickly becomes a nutritional dud. Red potatoes are moderately more nutritious than white because

Helpful tips:

Go easy on the add-ins and caloric toppings (one meager pat of butter adds 100 calories); avoid processed potatoes, like chips and fries. Select firm potatoes, minus sprouts and green coloration. Store potatoes in a cool, dark place — away from onions, as they cause potatoes to spoil faster of their thin, rosy-hued skin, which comes packed with nutrients, fiber and health-promoting phytochemicals. Their red color also means they contain anthocyanins, a specific antioxidant that may fend off major health problems, including heart disease, cancer and obesity. Studies have found that red- and purple-skinned potatoes have nearly two to three times more antioxidant powder than white. Potatoes have gotten a bad reputation for causing weight gain and having a high glycemic index (GI), a measurement of how quickly a food raises blood sugar. But, according to experts at Tufts University, the type of potato, the preparation method, and the foods eaten in tandem can lower the GI. Recent studies suggest the following to lower this tasty tuber’s GI: choose fingerling or red potatoes, elect to boil or roast, and pair potatoes with protein-rich foods to slow digestion and slow the release of glucose into the blood.

Cream Potato Salad with Lemon and Fresh Herbs Adapted from Bon Appetit; serves 8 3 pounds baby red potatoes, washed and dried 2 tablespoons olive oil, divided 1 teaspoon kosher salt ½ teaspoon coarse black pepper ¾ cup plain Greek yogurt 2 ½ tablespoons lemon juice 1 teaspoon grated lemon zest 1 garlic clove, minced ½ cup chopped fresh dill ½ cup chopped fresh basil 2 celery stalks, diced 3 green onions, thinly sliced salt and pepper to taste

Preheat oven to 375 degrees F. Cut the potatoes in half (or quarters, if large) and place in a bowl with 1 tablespoon olive oil, salt and pepper; toss until the potatoes are well coated. Dump the potatoes on two baking sheets, spread out into 1 layer, and roast for 35-40 minutes, flipping once with a spatula during cooking to ensure even browning. While the potatoes are cooking, combine the yogurt, remaining olive oil, lemon juice, zest, and garlic in a large bowl. Add the herbs, celery and green onions on top (don’t stir yet). When the potatoes are cool, add them to the large bowl, stirring gently to combine (hands work great!). Taste and adjust seasonings.

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.

Often Feel Bloated? One Ingredient May Be to Blame

f you often feel bloated after a meal, don’t be too quick to blame high-fiber foods. The real culprit might surprise you. Your gut may be rebelling because you’re eating too much salt, a new study suggests. “Sodium reduction is an important dietary intervention to reduce bloating symptoms and could be used to enhance compliance with healthful high-fiber diets,” said study researcher Noel Mueller, an assistant professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore. He and his research colleagues looked at data from a large clinical trial conducted in the late 1990s known as Dietary Approaches to Stop Hypertension-Sodium, or DASH-Sodium for short. Their conclusion: Consuming a lot of salt increases bloating, as does a healthy, high-fiber diet. Although it’s not clear exactly how salt contributes, Mueller suspects fluid retention may be the key. Eating more salt can promote water retention and make digestion less efficient, which can lead to gas and

bloating, he said. Studies in mice have shown that dietary salt can alter the makeup of gut bacteria. And that, in turn, can affect gas production in the colon, Mueller said. “Our study suggests that selecting foods with lower sodium content, such as those that are not ultra-processed, may help relieve bloating in some people,” he said. Bloating affects as many as a third of Americans, including more than 90% of those with irritable bowel syndrome. It’s a painful buildup of excess gas created as gut bacteria break down fiber during digestion. For the current study, the researchers used findings from a 19981999 trial. In that trial, the DASH diet — one low in fat and high in fiber, fruits, nuts and veggies — was compared with a low-fiber eating regimen. The trial’s goal was to learn how salt and other factors affected high blood pressure. The new review found that about 41% on the high-fiber diet reported bloating, and men had a bigger problem with it than women. And diets high in salt increased the odds

of bloating by 27%. “We found that in both diets, reducing sodium intake reduced bloating symptoms,” Mueller said. The upshot is that reducing sodium can be an effective way to prevent gas — and may help people maintain a healthy, high-fiber eating regimen. Many things can cause bloating — lactose intolerance, celiac disease, small intestinal bacterial overgrowth, infection or other conditions, said Samantha Heller, a senior clinical nutritionist at New York University Langone Health. “If someone is experiencing gastrointestinal symptoms such as bloating on an ongoing basis, they should see their health care practitioner to see if the cause can be pinned down,” said Heller, who wasn’t involved with the study. “This way they will

August 2019 •

know how to manage the issue.” Occasional bloating is not uncommon, she added. To help you avoid excess gas and bloating, Heller offered these tips: • Increase physical activity. • Limit highly processed foods, such as fast food, frozen meals, junk food and fried food. • Increase your fluid intake, and make peppermint tea part of it. Avoid carbonated beverages. • Eat more foods that are rich in fiber, such as vegetables, legumes and whole grains. Increase these slowly and in small portions, and be sure to increase your fluid intake at the same time. • Have smaller meals. The report was published recently in the American Journal of Gastroenterology.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 11

Things You Need to Know About Vaccination

By Ernst Lamothe Jr

his was a banner year for measles and mumps. Not good news for health officials and various communities that were rocked by these two viruses. The number of patients diagnosed with measles in the United States grew substantially with more than 900 confirmed cases in 23 states. Measles is an infectious viral disease-causing fever and a red rash on the skin, typically occurring in childhood. The United States is presently seeing the highest number of measles cases since the disease was considered eliminated in this country in the year 2000. Measles were reported several states, including New York. “We have seen the substantial positive results in society when vaccinations occurs,” said UBMD physician Diana Wilkins. “They can help prevent deadly diseases and help protect the community at large by reducing the spread of that disease.” Wilkins, assistant dean for graduate medical education and clinical assistant professor of family medicine at the University at Buffalo Jacobs School of Medicine, discusses five essential vaccinations.

DTaP

DTaP vaccine can help protect children from diphtheria, tetanus and pertussis. The vaccine is given at 2 months, 4 months, 6 months and 15 to 18 months, and again at 4 to 6 years of age. Diphtheria can cause breathing problems, paralysis and heart failure. Before vaccines, diphtheria killed tens of thousands of children

every year in the United States. Tetanus causes painful tightening of the muscles. It can cause locking of the jaw so you cannot open your mouth or swallow. About one person out of five who gets tetanus dies, according to the CDC. Pertussis, also known as whooping cough, causes coughing spells so bad that it is hard for infants and children to eat, drink, or breathe. It can cause pneumonia, seizures, brain damage, or death. “Now even mothers in their third trimester are being encouraged to get the DTaP shot so the immunity can be transferred to their babies,” said Wilkins. “Also, when kids that follow the vaccine schedule early on it sets them up for a strong immunity throughout childhood.”

Measles Mumps and Rubella

During the first six months of this year, 44 states and the District of Columbia reported mumps infections in 1,471 people, according to the CDC. Before the U.S. mumps vaccination program started in 1967, about 186,000 cases were reported each year, but the actual number of cases was likely much higher due to underreporting. Since the two-MMR dose vaccination program was introduced in 1989, U.S. mumps cases decreased more than 99 percent, with only a few hundred cases reported most years. However, since 2006, there have been several increases in cases and outbreaks about every five years, according to the CDC.

“This vaccine is required before kids enter school-age environments,” said Wilkins. “In New York, the governor signed legislation taking away non-medical exemption from schools when it comes to vaccines. We recommend all children get two doses of measles-mumps-rubella vaccine starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age.”

HPV

Human papillomavirus is a group of more than 150 viruses. Many people who get HPV have no symptoms. Some people who get HPV develop warts in their genital area. Some HPV infections do not go away and can cause cancer, such as cervical cancer, cancer in or outside of the vagina, cancer of the penis, cancer of the anus or rectum and cancer of the throat. HPV spreads by intimate skin-to-skin contact. “Because this vaccine has been known to help with several kinds of cancer, there are various reasons why this should be a vaccine that people take seriously,” said Wilkins. “We also tell women that is one of the reasons why they should continue to receive regular pap smears.”

Flu Shot

Since 2010, CDC estimates that flu has resulted in between 140,000 and 960,000 hospitalizations each year. About 20,000 children under age 5 are hospitalized due to

UBMD physician Diana Wilkins. flu each year. On average, nearly 100 children die in the US from the flu and its complications each year. “We cannot underestimate how essential the flu vaccine is for society,” said Wilkins. “Many times the reason why we push for our adult community to get vaccinated is because they can pass dangerous diseases to newborns and infants whose immune system is not strong enough to combat it at this time. It leaves some of the most vulnerable members of our society unprotected when we don’t get vaccinated.”

Shingles

Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on the body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso. “Shingles is incredibly painful and can leave permanent rashes all through your body,” said Wilkins. “They have even changed the shingles vaccine so that it can accommodate people’s immune system.

So You’ve Had Weight-Loss Surgery. Now What?

ating habits and physical activity have a greater impact on weight-loss surgery’s longterm success than measures like counting calories, a new study finds. Researchers also found that evaluation of patients’ mental health and eating habits before weight-loss (bariatric) surgery did not help predict who would be successful in keeping weight off years afterward. “Bariatric surgery is the most effective treatment for severe obesity. It results in sustained weight reduction and remission of diabetes and other health problems in the majority of patients,” said study author Wendy King. She’s an associate professor of epidemiology at the University of Pittsburgh’s School of Public Health. “However, as with all types of weight-loss interventions, patients usually regain at least some of the weight they initially lose,” she added in a university news release. The study included nearly 1,300 adults who had a type of weight-loss surgery called Roux-en-Y gastric bypass. The patients were followed for an average of six and half years. Limiting sedentary behaviors (such as watching TV), self-weighing at least once a week, avoiding fast Page 12

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food, and correcting “problematic” eating behaviors were all factors associated with a greater chance of limiting weight gain after weightloss surgery. Problematic behaviors included eating continuously, eating when full, loss of control and binge eating.

Younger patients were likely to gain more weight than older ones. Other characteristics linked with higher weight regain included having venous edema with ulcerations — a disease of the veins accompanied by sores on the skin; difficulty with daily physical tasks such as bathing,

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

dressing and walking; and symptoms of depression after surgery. “This may sound like common sense,” King said. “But several behaviors and characteristics that clinicians hypothesized to matter were not related to weight regain. For example, while frequency of fast food consumption was associated with greater weight regain, frequency of meals and eating at restaurants were not,” she explained. According to study senior author m physician Anita Courcoulas, “As clinicians, we know that weight maintenance is the most important, yet challenging, aspect of longterm post-bariatric surgery care.” Courcoulas is chief of minimally invasive bariatric surgery at the University of Pittsburgh Medical Center. “Because we found that most individual patient characteristics at the time of surgery do not clearly identify those most at risk for poor weightloss maintenance after surgery, it is especially important that clinicians and programs engage with patients early and often after surgery about behaviors that can aid in limiting weight regain,” Courcoulas said. The study was published April 4 in the journal Annals of Surgery.

It’s Time to Play It’s a new day for play in Buffalo at Explore & More — The Ralph C. Wilson, Jr. Children’s Museum By Nancy Cardillo

hen you think of your favorite way to play as a child, what comes to mind? Board games? Kickball in the street? Playing dress-up in the basement? Playing is an important part of childhood and, believe it or not, our ability to play begins at a very early age. Babies who are just a few months old who smile back at dad’s goofy faces and mom’s silly noises are demonstrating one of the first forms of play. But playing isn’t just a form of entertainment — it is a critical part of development. Ninety percent of our brain development happens before the age of 5, and one of the most important ways children learn is through play. Playing not only encourages children to use their imaginations and express their creativity, it also helps develop the whole child: socially, emotionally, cognitively, physically and academically.

Special programs play into curiosity.

Bringing accessible play experiences to improve school readiness. A 2014 study by the Institute of Museum and Library Services concluded that kindergartners who visited museums showed higher achievement scores by third grade, regardless of socioeconomic status, than those who do not. Explore & More — The Ralph C. Wilson, Jr. Children’s Museum, recently opened its brand-new facility at the base of Main Street in downtown Buffalo, on the historic footprint of the terminus of the Erie Canal in the heart of Canalside’s bustling boardwalk. But the museum has been bringing the power of play to children and their families for 25 years, since its humble beginnings in a 500-square-foot school basement in East Aurora. The museum eventually grew to 6,000 square feet and served more than 60,000 children and their families each year for two decades. “Explore & More was started by a visionary group of educators, designers, parents and fabricators in East Aurora who recognized the importance of play for healthy development,” says Jeannine Weber Kahabka, director of marketing and public relations for the museum. “Their desire was to provide high-quality, play-based learning for children and their goal was to eventually be more centrally located in downtown Buffalo.” In 2017, construction began on the museum’s new, 43,000-squarefoot Canalside facility; it would be the first place-based children’s museum of its kind, with educational play zones that tell many of Buffalo’s unique stories and highlight the region’s history, geography, culture,

what it feels like to be a part of the sports teams that make Buffalo great. • Lighting Buffalo’s Imagination: Museum guests can explore the ideas and innovations that fueled Buffalo’s prosperity and continue to power new ideas through wonder, discovery and imagination. • Building Buffalo: Visitors will be inspired by Buffalo’s storied architectural history while working together to construct their own great structures out of different building materials. • Farm to Fork: Drawing on Buffalo’s rich agricultural history, on this farm you can plant, grow, and harvest crops, as well as care for a milking cow and chickens. • Rooftop Terrace: This outdoor play zone has a barn feature, a windmill, wind and music instruments, along with various plantings to soak up the sunshine. Additional hands-on learning spaces include the Tinkering Tank, Cooking Galley and Art Studio. Centrally located, the museum is now accessible to more than 225,000 children under the age of 15 in a 50-mile radius of the museum. It is fully wheelchair accessible and features visual, social, communicative, sensory and behavioral supports including quiet kits, sensory-friendly rooms and a universal changing table to serve those with special needs.

Photos by Joe Cascio, courtesy of Explore & More — The Ralph C. Wilson, Jr. Children’s Museum. agriculture, architecture, athletics, industry and innovation — all through hands-on exhibits that celebrate the power and benefits of play. “Children learn through play and by doing,” says Amanda Blake, manager of learning and education.

“Children learn through play and by doing. They are naturally curious explorers. So, by offering accessible, child-led play experiences, our museum is working to help improve school readiness for all children.” Amanda Blake, manager of learning and education.

“They are naturally curious explorers. So, by offering accessible, childled play experiences, our museum is working to help improve school readiness for all children.” The museum offers four stories of fun to explore, including seven play zones and three educational play studios filled with thoughtfully-crafted exhibits to help children and adults develop a deeper sense of the world, the community and our place in it. The seven play zones are: • Being Good Neighbors: Visitors can learn about the diverse mix of cultures and families that make up Buffalo–Niagara’s neighborhoods. • Moving Water: Visitors can follow the waterways (including a two-story waterfall and replica Erie Canal) through time as they carry boats, move people and power Buffalo. • Playing Together: Families can run, move, play and dress up to see

August 2019 •

Explore & More also offers a wide range of fun, engaging and educational programming daily, weekly, monthly, quarterly and seasonally, as well as on school holidays and breaks. “We have something new and exciting happening every day in the museum,” says Kahabka. “Program topics can include subjects ranging from STEM activities, art, music, culture and cooking to learning more about ourselves, our health, and our region.” There’s “Au-some Evenings,” a program designed to meet the specific needs of children on the autism spectrum; “Super Sundays,” featuring monthly themed programming and activities; “HomeSchool,” weekly homeschool-specific programming tied in to monthly themes and that meet NYS state academic standards; “School Break Weeks and Fearless Family Play Day,” a full day of fun and engaging healthy activities throughout the museum’s play zones and educational studios the first Saturday of each month and presented by BlueCross BlueShield of Western New York (BlueCross BlueShield of Western New York members receive $1 off admission.) “Play is good for the entire body, including brain development and physical health,” says Cait Zulewski, director of corporate relations for BlueCross BlueShield of Western New York. “The Fearless Family Play Day program is focused on physical health for the whole family, and designed so they can have fun together by engaging in physical activity that is approachable and enjoyable.” n For more information about Explore & More — The Ralph C. Wilson, Jr. Children’s Museum, including hours, directions, admission fees, membership and birthday and rental options, visit exploreandmore. org, email info@exploreandmore.org or call 716-655-5131.

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Working Too Many Hours? You May Need to Reconsider Study: Long work hours tied to higher odds for stroke

eing first at the office and the last to leave may help get you that promotion, but new research warns that working long hours may not be so good for your heart. And the longer you do it, the higher your risk for a stroke, French researchers said. The findings come from a review of self-reported work habits and heart health among roughly 144,000 French men and women between the ages of 18 and 69. Those who worked long hours had a 29% greater risk of stroke, and those who worked long hours for at least 10 years had a 45% greater risk

of stroke, the analysis found. For the purpose of the study, “long work hours” meant working more than 10 hours a day for at least 50 days out of the year. “Previous studies in South Korea, the U.S. and Europe have raised this issue,” said study author, physician Alexis Descatha. “But for the first time we had data to show an association with duration, [meaning] 10 years or more.” Descatha is a specialist in emergency medicine at Paris Hospital in Versailles, as well as a professor in occupational health with the French National Institute of Health and Medical Research (Inserm).

He and his colleagues outline their findings in the July issue of the journal Stroke. Investigators focused on those who had been in the workforce for at least six months. Most were full-time employees. In addition to completing questionnaires, all participants also underwent medical interviews, during which investigators collected information on past stroke histories; body mass index (a standard measure of overweight/obesity); diabetes and high blood pressure status, and any family history of heart disease. The team found that about 30%

of the French participants said they had worked long hours, while about 10% reported having worked long hours for 10 years or more. After setting aside those who had experienced a stroke prior to embarking on a long work hour routine, roughly 1% of the respondents were characterized as stroke survivors. In the end, the team found a strong association between working long hours and stroke risk, for men and women alike. The link seemed stronger for people under the age of 50. Descatha characterized the latter finding as “unexpected,” and said more research is needed to understand why younger workers are more affected. But he suggested it could be that at a younger age the working conditions, irregular schedules and stress that can accompany working long hours might have more of a negative impact on the heart than other factors such as being overweight and having high blood pressure — that typically affect older men and women. Physician Gregg Fonarow is director of the Ahmanson-UCLA Cardiomyopathy Center and co-director of the UCLA’s preventative cardiology program. He noted that “a variety of potential mechanisms have been considered as helping to explain this excess risk. “These include long hours spent working leading to less daily physical activity, prolonged sitting, greater exposure to stress, and disruptions in sleep,” Fonarow said. “It has also been suggested that those with long work hours may pay less attention to their cardiovascular health or seek attention for concerning symptoms.” He added that the findings suggest greater attention is needed for modifying cardiovascular risk factors for those who work long hours. “It is possible to work long hours but still maintain a healthy blood pressure, healthy body weight, healthy cholesterol levels, and get sufficient levels of physical activity to substantially decrease the risk of stroke or heart attack,” Fonarow believes.

CDC Warns of Start to ‘Season’ for Mysterious Paralyzing Illness in Kids

he “season” for a polio-like illness that mainly strikes children is about to begin, so public health officials sent out an early warning to doctors in early July. The largest recorded outbreak of acute flaccid myelitis (AFM) occurred last year, with the illness debilitating 233 people in 41 states across the nation, according to the U.S. Centers for Disease Control and Prevention. AFM cases typically spike between August and October, so the CDC is alerting medical professionals around the United States. “Doctors and other clinicians across the United States play a critical role,” CDC Principal Deputy Director Anne Schuchat said during a media briefing in July. “We ask for your help with early recognition of patients with AFM symptoms, prompt specimen collection for testing, and immediate reporting of suspected AFM cases to health departments,” she added. Page 14

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“When specimens are collected as soon as possible after symptom onset, we have a better chance of understanding the causes of AFM, these recurrent outbreaks, and developing a diagnostic test,” Schuchat explained. AFM is a rare but serious disease that attacks the spinal cord, causing the muscles and reflexes in the body to become weak. The disease mainly affects the arms and legs, causing serious limb weakness, but it can endanger a person’s ability to breathe by weakening the muscles of the respiratory system. One out of four confirmed AFM patients in 2018 required respiratory support, and most often they were put on a ventilator, the CDC said. The average age of a confirmed AFM patient in 2018 was 5, the CDC reported. Currently, there are no proven ways to either treat or prevent AFM.

And at least half of patients do not recover from the illness, CDC officials have said. Officials continue to track the long-term progress of patients. The CDC began tracking AFM in 2014, following an initial outbreak of 120 cases. The disease has since settled into an every-other-year pattern, with major outbreaks recurring in 2016

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

and 2018. In 2016, 149 cases were reported. All told, there have been 570 AFM cases in 48 states since 2014, the CDC said. Doctors are being urged to look for early signs of limb weakness, and to gather a wide array of samples from patients as soon as possible, the CDC said.

Join WNY’s ‘Year of Cessation’ Movement

WNY residents encouraged to quit smoking this year

hile adult smoking rates are at all-time lows, the fight isn’t over to promote tobacco-free living in New York state. This is one of several reasons the Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health designated 2019 as the “Year of Cessation.” With support from the CDC’s “Tips” Campaign, the NYS Smokers’ Quitline, area healthcare professionals and Health Systems for a Tobacco-Free Western New York, local residents have more resources than ever before to reduce or eliminate tobacco-use. During the “Year of Cessation’s” summer months, the CDC highlights the integral role quitlines play in cessation and the 15th anniversary of the national network of state quitlines.

Six new online videos demonstrate what callers can expect when calling a quitline and emphasize free, confidential and nonjudgmental coaching. These resources complement the ongoing “Tips From Former Smokers” campaign, now in its eighth year. “The ‘Tips’ campaign creates a noticeable boost in call volume to the NYS Smokers’ Quitline,” said Andrew Hyland, Ph.D., director of the Quitline and professor of oncology at Roswell Park Comprehensive Cancer Center. — the Quitline’s physical location. “The year of cessation is yet another valuable

My Drug Addiction, and How to Kick the Tobacco Habit By Kimberly Blaker

woke up this morning and felt the agonizing withdrawal symptoms washing over me. It’s a persistent anxiousness that doesn’t cease until I get my fix. I slipped on my robe and slippers, poured a cup of coffee, and frantically headed to the garage, where I try to keep the substance from my family. As always, my habit is waiting to greet me. As I take a hit, a peaceful feeling washes over my body and mind. I can now begin my day feeling alive once again. Yet as the day wears on, I feel the chemicals drain. Every hour or so, this drug starts calling me, unrelentingly, and I continue to replenish my body with the chemicals I so desperately need. Every worrisome or sad thought or happy reminiscence drives me to another fix. Even tiredness, hunger and boredom can be eased through this addiction of mine. Now, as I lie in bed, I reflect on it. It’s my best friend and my worst enemy. I deliberate on how much it’s costing me, not just financially, but the toll it’s taking on my body. It’s stealing the rug from under my feet. It’s draining my energy and making my heart race through life. I can’t catch my breath. My skin is aging, and the substance leaves my body with a repulsive odor. I think about the diseases it puts me at risk for, such as cancer, heart disease, and emphysema. I don’t want to die that way. I want to live a full life. I tell myself to go to sleep, and tomorrow I’ll start anew. I’ll dry up and go straight. But as I drift closer to sleep, I know tomorrow will go unchanged, for the craving is already creeping in again. I’m dependent in

this love-hate relationship. I look forward to my next drag off a cigarette. Nicotine is my life—and will probably be my death.

Three years later

Fortunately, this relationship finally soured and came to a screeching halt. I kicked the habit and slammed the door behind. Through the years, I tried relentlessly to cut my ties with this shadow that seemingly couldn’t be shed; quitting cold turkey, cutting back, New Year resolutions, patches, gum, Zyban. All were temporary at best. But I never gave up. Today I wake up to the smell of the fresh summer breeze rather than the stench of stale cigarettes that once drenched my body. My skin glows, and my heart is calm. My midnight cough is long gone. Walking up the stairs doesn’t leave me breathless. My energy soars, and I look forward to the once dreaded pleasures of life. Now I can enjoy a vigorous peddle through the park or a spirited hike in the woods. Best of all, the diseases I could almost feel setting in have mostly erased from my body and mind. I now feel an inner peace I could never leave behind.

Getting Health

Try one of the follow-

CDC initiative to help educate about the dangers of smoking and benefits of becoming tobacco-free. On a local level, NYS residents should know that besides the CDC and the Quitline, their healthcare professionals and regional tobacco-free organizations play a major role in these efforts.” Most people who call the Quitline at 1-866-NYQUITS or visit www.nysmokefree.com are eligible for a complimentary starter kit of nicotine replacement therapy, including patches and gum or lozenges. The Quitline’s quit coaches will work with tobacco users to ing nicotine replacement methods or medications, most approved by the FDA for quitting smoking. n Nicotine Patches: These come in a 16-hour and 24-hour patch and don’t require a prescription. Manufacturers typically suggest eight weeks, though the FDA recommends three to five months. n Nicotine nasal spray: By prescription only, nasal spray delivers a quick dose of nicotine to the bloodstream. Recommended use is three to six months. n Nicotine gum: No prescription is required for nicotine gum, which comes in two strengths. It can be used for up to six months, though one to three months is the usual recommendation. n Nicotine lozenges: These should not be confused with tobacco lozenges. Tobacco lozenges are a form of smokeless tobacco and have not been proven a successful cessation aid. Nicotine lozenges, on the other hand, have been approved by the FDA for quitting smoking. n Nicotine inhalers: These can be used for up to six months and are by prescription only. n eCigarettes: Electronic cigarettes and vaporizers have become the latest success story in helping millions of people to quit smoking. While useful for quitting smoking, there is much debate on their safety as they have not been around long enough for any conclusive studies. n Bupropion: An anti-depressant, also known as Zyban, requires a prescription. It doesn’t contain nicotine, yet affects brain chemicals that lead to nicotine cravings. n Varenicline: Chantix is a drug developed for smoking cessation. Studies have shown a high success rate with Varenicline. Some studies have found it to have higher success rates than Bupropion. n Hypnosis: This method is useful for some smokers. Ask your doctor to recommend a hypnotist.

August 2019 •

develop a customized quit-plan and steps to overcome triggers. The Quitline also encourages tobacco users to talk with their healthcare professionals and access their health plan benefits for additional cessation support and stop-smoking medications. Locally, as part of Health Systems for a Tobacco-Free New York, Health Systems for a Tobacco-Free Western New York works directly with area healthcare professionals and organizations to develop appropriate screening for tobacco-use and to improve the reach and delivery of evidence-based tobacco dependence treatment. More information about the regional contractors with Health Systems for a Tobacco-Free New York is available online by visiting www. tobaccofreeny.org. “We’re proud to support the CDC’s ‘Year of Cessation’ and the Quitline, and remind all Western New York tobacco users that quitting is the very best thing they can do to improve their health and quality of life,” said Kimberly Bank, program coordinator for Health Systems for a Tobacco-Free Western New York. “Tobacco users should always talk with their doctor or healthcare provider and call the Quitline for extra support.”

Smoking Ban Extended to All Library Grounds in NYS

s of June 19 all New York state public or association libraries have been protected from smoke under the NYS Public Health Law 1399. This law, which currently includes no smoking at hospitals, daycare centers, residential treatment facilities etc., has been expanded to prohibit smoking within 100 feet of library entryways. “Every year nearly 28,000 deaths in New York state are attributed to smoking related illnesses including but not limited to heart disease, stroke and lung cancer,” said Annalisa Rogers, director of the Smoking & Health Action Coalition. “Of that number, a little more than 3,000 adult non-smokers die from second-hand smoke exposure. When a cigarette is lit, it impacts everyone around it.” “Libraries are a public resource often used by senior citizens, school children and populations that may be more vulnerable to the types of respiratory illnesses that can be triggered by second hand smoke,” said Elizabeth Hamlin, directory of Advocacy for the American Lung Association in New York state. “Library visitors deserve to breath healthy air on public grounds.” Some libraries had imposed tobacco free policies voluntarily, before the law was passed. All New York state local libraries will now begin posting signs around library access points to ensure compliance with state law.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Oh, the Aging Eyes Droopy eyelids, dry eyes, floaters, cataracts, ocular migraines are just some of the eye problems we may have to deal with as we age By Deborah Jeanne Sergeant

s you begin to “play trombone” with your reading materials to get them in focus, it becomes apparent you may need reading glasses. Most people require correction for presbyopia — short distance vision — around their mid-40s to early 50s. While an unwelcomed sign of aging, it’s easily corrected with drugstore “cheater” glasses. Less common are other changes in vision related to aging. Some are more serious than others. To tell the difference between what’s normal and what’s not, physician Raul Vazquez, founder of Greater Buffalo United Accountable Healthcare Network (GBUAHN), recommends annual eye exams. “You may have a change in pressure and glaucoma becomes an issue,” he said. “If it’s not treated, you can go blind.” Family history plays a role in glaucoma, which is damage to the optic nerve. Usually, loss of the Page 16

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peripheral vision indicates onset. The lost vision cannot be restored. The risk of vision loss is higher for people with certain health issues. Vazquez noted diabetics and those with hypertension should be especially vigilant about their vision. Slowly, over time, cataracts can develop in older age, although for diabetics and those with hypertension, they can develop the condition at younger age. The vision becomes dim and more yellow in tone and night driving becomes very difficult. The lens, which sits behind the iris, becomes cloudy. Exposure to UV light, diabetes and certain medication can hasten the otherwise age-related condition. With a 10-minute, outpatient surgery, doctors can replace the lens with an artificial lens. “If you’re looking at graph paper and you see distortions in those lines, that’s telling you have problems in the back of your eye,” Vazquez said. “You may have macular degeneration and if you have a bleed in your

eye, you can go blind.” People with family history of macular degeneration or smoking are more likely to develop the condition. Droopy eyelids may affect vision as one ages. “The eyelids may feel heavier and crepey,” said Rajeev Ramchandran, associate professor of ophthalmology, public health sciences, at the Center for Community Health and Prevention at Flaum Eye Institute in Rochester. “In the front of the eye as you get older, you get more wrinkles. You start getting brow aches from having to lift your brow up.” As the lid droops, it can block vision. An evaluation can help determine if a surgical approach could remedy the problem. Dry eyes can also cause vision issues for older adults. It may feel like a foreign body is in the eye or that the eye tears a lot. Ramchandran said that the lipid layers may not be as present. “You may not be taking in as

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

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much water as you used to,” he said. “The intake of liquid may also be affecting your tears.” The eyelid also may not close as well as it used to, which can cause tears to leak and the eye to water more. Or a duct in the lower lid may be locked. Ramchandran recommends using non-tearing baby shampoo on a warm washcloth to clean away any build-up. Behind the lens, there’s the vitreous jelly. “It’s mostly made of collagen and water,” Ramchandran said. “Just as you have breakdown in the skin, you have breakdown in the collagen of the eye. That can result in some more mobility of the jelly and also the condensation you see as ‘floaters’ which are common. For someone who’s nearsighted, they get floaters sooner.” He said that having a few floaters shouldn’t concern anyone, but a sudden increase or very large numbers of floaters or seeing “flashing lights” can indicate that the jelly is pulling hard enough to cause retinal tear. Retinal detachment can cause permanent blindness, so anyone experiencing these symptoms should seek immediate medical care. Some people who have ocular migraines suffer temporary vision loss that returns right away; however, losing vision without history of migraines should definitely seek prompt care. Stroke can also affect the retina and optic nerve. “If you have any pieces of your vision that you’re losing, those are signs you really need to get checked out,” Ramchandran said. Kerstin Abreau, doctor of ophthalmology at The Eye Care Center in the Finger Lakes area, also said to seek immediate medical attention for symptoms such as “flashes of light, an increase in floaters, a black curtain coming across your vision, loss of vision in one or both eyes, or double vision.” If your regular provider cannot see you, you may need to go to the emergency room. “Please, do not wait to see if your symptoms go away on their own as this may result in permanent damage,” Abreau said. She recommends that people 60 and older visit their vision care provider annually to ensure that changes in vision are normal. Diseases like glaucoma and macular degeneration are more common with older age. People with eye conditions may need more frequent eye exams.

Golden Years

Foods for Healthy Aging By Deborah Jeanne Sergeant

hile the phrase “super foods” may create buzz around fad foods, it’s true that eating a healthful diet can help support healthy aging. Area experts share their advice for eating right. Here’s what they say: • “What you’re looking for is a plant-based diet, not necessarily vegetarian, but lots of fruits and vegetable, whole grains, and that should make up the bulk of your diet. • “If you’re looking at the plate, it should be half vegetables or more, and with lean protein. The exception to that rule is fatty fish. Eat lean poul-

try and lean red meat once in a while, lean pork, fish, and a vegetarian meal or two in there with beans, nuts and seeds. • “Fatty fish is important for ometa-3 fatty acids. They’re anti-inflammatory and offer a lot of benefits. A diet that’s heavy on anti-inflammatory food will keep you healthy. • “The MIND diet may help. A study was done that looked at dementia, Alzheimer’s and brain function as you age. The MIND diet is a combination of the DASH diet and Mediterranean diet. The Mediterranean and DASH diets are very

Seniors Less Likely to Use Health Tech Tools By Deborah Jeanne Sergeant

espite their status as heavier uses of healthcare, older adults are the least likely to use technology to augment their healthcare, according to a recent study led by physician David Levine, a researcher in the division of general internal medicine and primary care at Brigham and Women’s Hospital in Boston. His researchers looked at how Medicare recipients used technology that relates to healthcare between 2011 and 2014. Many don’t use smartphones or the internet for health, only as tools for communication. Only 16% looked up health information online. Just 8% ordered prescriptions online and a mere 7% contacted a doctor and 5% handled insurance matters through the internet. Despite more than 80% of seniors owning smartphones, they’re not using the devices’ “smart” functions — but why? Physician Raul Vazquez, founder of Greater Buffalo United Accountable Healthcare Network (GBUAHN), said that for some older

adults, the complexity of the technology creates a barrier. That’s why his organization is putting together an Alexa Dot offer at a price of about $30. The smart speakers perform tasks based upon voice commands. “You can teach it skill sets,” he said. “One model we use it in is medical reconciliation. It can tell you you’re due to take your medicine. Building this into Alexa can really engage those patients. If you can talk, you can use it.” Instead of complicated directions and confusing icons, patients simply say what they need. “You can say, ‘I need my medication refilled’ and it will trigger a connection to the pharmacy,” Vazquez offered as an example. “The patients with the greatest needs are the ones within that age group.” Other barriers make accessing technology difficult for older adults. “Fear is a big factor,” said Daniel Jones, owner of Daniel Teaches, a Rochester-based business that offers

similar and the primary fat that is in that diet is monounsaturated, like olive oil. Some is from nuts and avocados and fatty fish. Having a diet that’s 25% to 30% from healthy fat rather than low fat may be a better way to eat to sustain youth and promote longevity. Eat lots of fiber from fruits and vegetables and whole grains. These diets are all plant-based. Some produce we focus on more than others, like greens, berries and some of the herbs and spices like rosemary and pepper, and Indian spices like cumin, turmeric, oregano and basil. It would be those and legumes like dried beans and peas as protein sources and healthy carbohydrates. They’re good sources of fiber and phytonutrients. These diets basically emphasize more of the produce and the plant-based stuff. You’re eating meat more like a condiment as one-quarter of the plate. One-quarter of the plate should have a whole grain. That in a nutshell is the healthiest way to eat as you age. • “ The MIND diet recommends a glass of red wine, but it comes with a caveat. If someone’s predisposed to some kinds of breast cancer, that’s a no. Or predisposed to alcoholism or if they have predisposition to addictive behaviors, that may not be a great idea. Some research states that stout beer has some benefits, but all of that is in moderation: one for women and no more than two for men daily. Plus, you can get all of these benefits elsewhere in the diet. If someone’s overweight, that’s pro-inflammatory and alcohol is contraindicated. People like to pick and choose from diets for things they like, like they say the French are healthy and they drink wine, but they don’t

eat the portions the French do, or get the exercise they get. • “Get enough sources of vitamin D. • “A lot of people don’t eat as much as they get older, so they need to make sure they get calories that count and don’t rely on packaged foods. • “Packaged and processed foods will age you quickly. Saturated fat, tropical oils and animal fats will do so, too. • “As we age, blood pressure goes up, so does weight. Look at not having a lot of empty calories and excessive sodium. • “Work on bone health. Yogurt is one of my favorites for calcium and its probiotics. A lot of them are like candy now. Go with single digits on the label per serving and keep in mind that some sugars are naturally occurring in milk.” Mary Jo Parker, registered dietitian offering nutrition and counseling services in Williamsville.

small group and one-on-one technology education for older adults. “Or, they’re afraid they’ll break something or mess it up. The No. 1 factor is the lack of instruction and assistance.” Many students’ adult children buy them a tablet or smartphone, but never show them how to use it, Jones said. Or they offer a brief tutorial but never let them practice and perfect their skills. While operating their microwave oven, dishwasher and washing machine is second nature, their new technology baffles them because they don’t know more than the basics of its operation and don’t use it often enough to recall how to use more of its functions. “They say, ‘My son shows me once

or twice and the third time, they do it for me,’” Jones said. “The mom feels inadequate and isn’t empowered. They need to see the benefit of how it will help them and really instruct them on it.” Jones said that the usability of some devices makes their use difficult for older adults. For example, the screen size of smart watches and some phones challenges those with vision and dexterity issues. For those who want to learn and have adequate help, Jones says anyone can learn technology. He has students as old as 103. “Whenever I hear, ‘I’m too old to learn it,’ I say, ‘You’re not as old as she is,’” Jones said.

August 2019 •

• “Everyone talks about organic, but it’s not the only thing you need to do. Look at meals low in cholesterol. If you’re eating chicken, remove the skin. Eat less red meat. Your sugar content should be within range. • “The Mediterranean diet has a lot of benefits. It’s higher in olive oil and things like that that help your whole system. • “Don’t go into stores and buy supplement pills to take. They can create a lot of problems. I like to keep it simple with patients. “ Raul Vazquez, MD, founder Greater Buffalo United Accountable Healthcare Network (GBUAHN).

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 17

Golden Years

For Seniors, Walking the Dog Can Sometimes Be a Dangerous Thing Fall-related bone breaks involving senior dog walkers has risen substantially. But there are ways for seniors mitigate the problem By Deborah Jeanne Sergeant

wning a dog can provide lots of motivation to get out and walk. While that’s great for your health, dog walking can raise the risk of falling, especially if you’re an older adult. A study recently published in JAMA Surgery looked at 100 hospital emergency rooms nationwide. The number of fall-related bone breaks involving senior dog walkers has risen substantially for more than a decade, from 1,671 in 2004 to 4,396 in 2017. Of those involved with the study, 79% were women, who because of their smaller bone structure are more at risk for bone breaks. The most commonly broken bone was the hip (17%) but more than 50% broke an upper body bone, including the shoulders, arms, hands, wrists and fingers. Nearly one-third required hospital admission. The researchers blame both dog manners and owner conditioning. Many elderly people who experience a hip fracture never quite regain the level of health they experienced previously. Some also become so deconditioned that they can no longer live independently. Physician Raul Vazquez, with

Greater Buffalo United Accountable Healthcare Network (GBUAHN), recommends that older adults receive a full screening for fall prevention. “Based on the screening, you could have macular degeneration and you don’t realize you have a blind spot,” Vazquez said. “You may not know you have hearing issues, which can effect balance, or foot problems, like bunions.” Deterioration in physical fitness may also contribute to dog-walking related falls, since muscle mass and balance tend to decline with age. For that reason, Warren Paschetto, certified personal trainer and certified strength and conditioning specialist, recommends increasing strength to improve stability, which can help prevent a fall. “Balance is huge and something I work with a lot no matter what the age,” Paschetto said. He owns Warren Paschetto Fitness in Williamsville. “I’m in my mid-40s,” he added, “and I’ve lost some balance. In the studio, we try TRX bands and balancing on one foot.” Walking lunges also help improve strength and balance. For an older individual at home, he advises

practicing lunges or standing on one foot with stable furniture nearby. “Practicing these will definitely help with walking the dog,” Paschetto said. Using the right equipment will make a big difference while walking the dog. Wearing stable footwear as well as selecting the right leash can greatly improve safety. Kim Sauer, certified professional dog trainer, dog walking academy graduate, and owner of Sit ‘N Stay Pet Services in Orchard Park, suggests harnesses that fit at the front of the chest instead of the back, or a head harness. “They are very effective at controlling dogs,” Sauer said. Owners should also hold their leashes properly. Wrapping it around the hand means that if the dog pulls, they’re likely going down. “It’s much better to let go, even though people don’t want to, than to be dragged down by the dog,” Sauer said. “Equally as important is basic training of the dog to make sure the dog has good impulse control. They have good leash walking skills and

How Pets Can Benefit Senior Health Matching the person and the pet is crucial for pet owners By Deborah Jeanne Sergeant

erhaps you always had pets as a kid but haven’t for years. Or maybe your cat or dog died a while ago and you haven’t sought out another pet. If you don’t have a pet as an older adult, you have many good reasons to consider one. Julie Covert, president of Awesome Paws Rescue in Buffalo, has been in rescue for 14 years and cites many benefits of pet ownership for older adults, such as the quiet evoked by spending time with a pet. “Bonding for just 15 minutes can lower levels of cortisol and raise serotonin levels,” she said. “It can lower cholesterol and fight depression.” Animals need a gentle touch and a patient approach, so a petting session requires owners to slow down and remain calm. Pets also encourage more movement, something that some older adults don’t get enough. “Walking a dog is good exercise,” Covert said. She added that lower-energy dogs and cats can also increase activity and maintain range of movement. Page 18

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Think of the work of feeding, watering, grooming and cleaning up after a pet. Some of these activities can also encourage social interaction, Covert noted, like taking a dog to the groomer or dog park. Simply having something to talk about — “Do you know what Muffin did yesterday?”— can make conversation more interesting. For those living alone, a pet can offer someone to talk to and something to look forward to. Of course, not everyone loves animals. Covert warns to not spring a pet gift on anyone, even those who enjoy the company of pets. A homemade gift card for a pet adoption, where you can select a pet together, may be a better way to give a pet. Older adults may have additional considerations, including the physical and financial ability to care for a pet. For the former, some assistance and accommodation can enable keeping a pet. A helper can aid in dog walking or changing cat litter, for instance. Installing a dog run can

reduce the need for dog walking. Placing a covered litter box on a flat-topped kitty condo could make scooping litter easier. Of course, allergies are a big consideration. People with pet allergies tend to better tolerate poodle and labradoodle dogs and sphynx, bambino and Ukrainian Levkoy, Siberian, Cornish rex, Devon rex, javinese, oriental shorthair, Balinese cats. Check with shelters for breeds of interest — not all animals in shelters are mixed breeds. Keeping the pet out of the bedroom can also help reduce allergy issues. Pets with dark colored fur may present a greater tripping hazard, as it’s harder to see them when they’re curled up on the floor. Covert recommended using a reflective collar or a bell. Large, strong dogs can be more difficult to walk, but tiny dogs can easily get underfoot. Covert recommends an in-between-sized breed, such as a beagle or Springer spaniel as a happy medium. The animal’s age can also influ-

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

learn to walk on one side, instead of going back and forth.” If you’re in the market for a new dog, consider your choice carefully. Large, powerful dogs may be much harder to control than a smaller dog. But the dog’s personality and age also make a difference. “With a puppy, it’s a guesstimate of what you’re going to get,” Sauer said. “If you’re looking at an older dog, you know the energy level so that can be a great benefit.” The dog’s breed can influence these tendencies and the need for exercise. Working dogs, like German shepherds for example, need much more exercise than dogs bred as companion dogs, like King Charles spaniel. The dog’s exercise needs should match your lifestyle, fitness level and desire to walk.

ence the amount of care it will need. Kittens and puppies need much more attention and tend to play more vigorously. Lifespan also matters. For these reasons, many shelters pair “seniors with seniors” when recommending pets. “Puppies are a lot of work,” Covert said. “To match a puppy with a senior can be silly. I ask people, ‘What will your plans be if your dog outlives you?’ Oftentimes, they think a family member will take a dog, but we have had a dog returned because an owner ended up in a nursing home unexpectedly.” Older dogs, like older people, tend to feel more content to relax. While they enjoy walks, they don’t walk as far nor as briskly. Rock Ballone, president of Lakeshore Humane Society in Dunkirk, also recommends no untrained dogs for older adults. “Cats can make perfect pets for older people, especially when it’s cold out and they don’t want to have to take a dog out continuously,” Ballone said. “Or for people who travel, it’s a lot easier to have someone stop by to take care of a cat than to kennel a dog or have someone take care of a dog. They need more day-to-day care. “Matching the person and dog is really important. For someone who’s home and retired, a lap dog or cat is ideal.”

By Jim Miller

Looking for Care: How to Hire an In-Home Caregiver

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Finding a good in-home caregiver for an elderly parent can be challenging. How can you find one that’s reliable and trustworthy, as well as someone your parent likes and is comfortable with? Here are some tips that can help. Know Your Needs Before you start the task of looking for an in-home caregiver, your first step is to determine the level of care your mom needs. This can pinpoint the type of help she’ll need. For example, if she only needs help with daily living tasks like shopping, cooking, doing laundry, bathing or dressing, a “homemaker” or “personal care aide” will do. But if she needs health care services, there are “home health aides” that may do all the things a homemaker does, plus they also have training in administering medications, changing wound dressings and other medically related duties. Home health aides often work under a nurse’s supervision. Once you settle on a level of care, you then need to decide how many hours of assistance she’ll need. For example, does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or perhaps bathe? Or does she need more continuous care that requires daily visits or a full-time aide? After you determine her needs, there are two ways in which you can go about hiring someone. Either through an agency, or you can hire someone directly on your own. Hiring Through an Agency Hiring a personal care or home health aide through an agency is the safest and easiest option, but it’s more expensive. Costs typically run anywhere between $14 and $25 an hour depending on where you live and the qualification of the aide. How it works is you pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriately trained and prescreened staff to care for her, and finding a fill-in on days her aide cannot come. Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may

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change or alternate, which can cause a disruption. To find a home-care agency in your mom’s area ask for referrals through friends, family or doctor’s offices, or use the home-care locator service tool at PayingForSeniorCare. com — click on “Find Quality, Affordable Care.” In addition, Medicare offers a home health compare tool at Medicare.gov/ HomeHealthCompare to help you find and compare home health care agencies. You also need to be aware that original Medicare does not cover inhome caregiving services unless your mom is receiving doctor’s ordered skilled nursing or therapy services at home too. But if your mom is in a certain Medicare Advantage plan, or is low-income and qualifies for Medicaid, she may be eligible for some coverage. Hiring Directly Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $12 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom. But be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any workerrelated injuries that may happen. If you choose this option make sure you check the aide’s references thoroughly, and do a criminal background check, which you can do through sites like eNannySource. com. To find someone, ask for referrals or try eldercare-matching services like Care.com or CareLinx.com. Or, for a fee, an aging life care expert (see AgingLifeCare.org) can help you find someone.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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Page 19

MS Patients Now Pay 20 Times More for Drugs Than a Decade Ago

ultiple sclerosis, epilepsy and Parkinson›s can be physically taxing conditions, but new research shows they exact a huge financial toll as well. Over a 12-year period, out-ofpocket costs for Americans with these illnesses jumped, with the biggest increase seen among people with multiple sclerosis (MS). Those patients paid 20 times more for their drugs in 2016 than they did in 2004. That means someone paying just $15 a month for medications in 2004 had to pay an average of $309 a month in 2016, the study findings showed. Study author Brian Callaghan said that increase wasn’t just for newer medications. He noted that both newer and older medications for MS all cost about the same. “Out-of-pocket costs are mostly proportional to how expensive the drugs are,” he said. Callaghan is an associate professor of neurology at the University of Michigan in Ann Arbor. Still, MS wasn’t the only neurological condition to see a steep outof-pocket increase. The study also looked at dementia, epilepsy, Parkinson’s disease and peripheral neu-

ropathy (a disorder affecting nerve sensation). For example, the monthly outof-pocket cost for epilepsy more than doubled, from $18 in 2004 to $40 in 2016, the researchers reported. The study relied on information from a large, privately insured health care claims database. The researchers included data on more than 100,000 people with MS, more than 300,000 with peripheral neuropathy, over 280,000 with epilepsy, nearly 121,000 with dementia and almost 91,000 with Parkinson’s disease. Monthly out-of-pocket costs for those in high-deductible plans were twice as high compared to those with different insurance plans. In 2016, someone with MS and a high-deductible health insurance plan paid an average of $661 per month, compared to $246 a month for those who didn’t have a high-deductible plan. The total costs someone paid varied widely. The study found that 5% of people with MS paid just $90 for their medications in two years. But another 5% had to pay nearly $10,000 for their medications. The findings were published online May 1 in the journal Neurology.

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Communities Fighting Fraud

lder people are at a greater risk of fraud and other forms of financial exploitation. The United States Postal Service has seen an increase in mail fraud and is promoting community strength and fraud awareness as a way to prevent abuse. Social Security agrees. You can help your more vulnerable loved ones fight fraud. You or a loved one might receive an advertisement in the mail, but it could be from a private company or even a scammer. United States law prohibits people or non-government businesses from using words or emblems that mislead others. Their advertising can’t lead people to believe that they represent, are somehow affiliated with, or endorsed or approved by Social Security. Scammers commonly target people who are looking for Social Security program and benefit information. If you receive misleading information about Social Security, send the complete advertisement, including the envelope it came in, to: Office of the Inspector General Fraud Hotline Social Security Administration P.O. Box 17768 Baltimore, MD 21235

Q&A

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Q: I will rely on Medicare when I retire. Can you explain the different parts of Medicare? A: The different parts of Medicare cover your specific needs. There are four parts, all of which work in tandem to deliver healthcare services: • Part A (hospital insurance): Helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care, and hospice care. • Part B (medical insurance): Helps pay for doctors services and many other medical services and supplies that hospital insurance doesn’t cover. • Part C (Medicare Advantage plans): If you have Medicare Parts A and B, you can join a Medicare Advantage plan. Private companies offer Medicare Advantage plans, which are approved by Medicare. These plans generally help you pay the medical costs not covered by Medicare Part A and B. • Part D (prescription drug coverage): Helps pay for medications doctors prescribe for treatment. Q: What is the difference between Social Security disability and Supplemental Security Income (SSI) disability?

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

Community can simply mean your family unit. The more you know about what your loved ones are exposed to, the better you can protect them. We also receive reports where someone pretending to be a Social Security employee has contacted members of the public. The intent of this type of call may be to steal your identity and money from your bank accounts. They may state that your Social Security number will be suspended or they may demand immediate payment. The caller generally asks you for personal information such as your Social Security number, date of birth, your mother’s maiden name, or your bank or financial account information. You should not provide any of this information to these individuals. It’s possible that a Social Security employee may contact you to followup on a previous application for Social Security benefits or to followup on other business you initiated with Social Security. Remember, Social Security employees will never threaten you or demand any kind of payment in exchange for services. It’s important that you report any and all fraud. This can only strengthen our communities and your family. You can report Social Security fraud at oig.ssa.gov/report.

A: Social Security Disability Insurance (SSDI) is based on prior earnings. SSDI is financed through the taxes you pay into the Social Security program. To be eligible for a SSDI benefit, the worker must earn sufficient credits based on taxable work to be “insured” for Social Security purposes. SSDI benefits are payable to eligible blind or disabled workers, the widow(er)s of a disabled worker, or adults disabled since childhood. SSI disability payments are made based on financial need to adults or children who are disabled or blind, have limited income and resources, meet the living arrangement requirements, and are otherwise eligible. SSI is a program financed through general revenues. For more information, visit www. socialsecurity.gov. Q: Can a noncitizen get Supplemental Security Income (SSI)? A: The laws and regulations concerning noncitizens differ for Social Security and SSI programs. Social Security administers both, even though they have different eligibility requirements. Some noncitizens do qualify for SSI. See Supplemental Security Income (SSI) For Noncitizens at www. socialsecurity.gov/pubs for more information.

Norb’s Take By Norb Rug

Norb Rug is a writer from Lockport. He blogs at WhyWNY. home.blog.

Losing Our Privacy

e are losing our privacy bit by byte. I recently noticed that when I looked on the internet for something, ads for this product would appear on the side bar of my browser. A simple search for my name on the internet resulted in over 5,000 results. Every move we make on our PCs, smartphones and tablets turns into data that trackers can easily collect and share. The ads appear because you have left behind your digital footprint. When you log onto a site, that information is stored for a vendor’s future use. A large variety of online sites insert “cookies” (small bits of data) on your computer. Take a look at the “Cookies” on your computer bowser some time. It will list almost every website you have ever signed in on. Some of these cookies let companies track you as you surf the web, seeing which websites you visit, which advertising you click on and what you buy online. When you click on the “keep me connected” option on websites like Facebook, you are likewise permitting those sites to follow you as you surf the Web. Every time you purchase something with a credit card, pay your property taxes or even subscribe to a magazine — that information is entered into a database somewhere. Not only is your financial and medical history shared but also where you travel and what you buy. It is virtually impossible to find out the amount of information that different organizations have on you, to ensure its accuracy or to be able to control who has access to it.

Social security numbers are highly valued by identity thieves. They are used both as identifiers and to authenticate banking, credit card and other transactions. Hackers have accessed these data bases and stolen credit card numbers or applied for new credit cards in the victim’s name and gone on buying sprees. Even innocent looking apps like Facebook “quizzes” may be collecting a great deal of information about you. They might collect data about your name, your age, your gender, your physical address, email address or your phone number. Some of them even collect info on which device you use to surf the Internet and quite possibly your religious and political affiliation or relationship status. The increasing volume of data that numerous organizations gather about a person can then be linked because they all use the same identifier. In the U.S. it is your social security number. This identifier based approach trades security against your

personal privacy. The more information that organizations have on you, the less privacy and control you maintain. This information could be used to shield them against fraud or merely to simplify targeted marketing. Much of the data amassed doesn’t involve a person’s financial information. In today’s identifier based world, all of a person’s credentials are easily linked. If an insurance agent is deciding whether to insure a customer they can use thier name and date of birth to access thier credit score, medical records, driving information and even criminal record. It is estimated that there are over 30 million surveillance camer-

as in the United States. An average American citizen might be caught on camera many times a day. Every time you walk past a security camera, it captures a picture of you. Cameras can be hidden in smoke detectors, light fixtures and even children’s toys (nanny cams). Almost every store, pharmacy and fast food drive-thru you visit, has cameras. They’re also at parking garages, banks and the post office. If you are waiting in line at a store, you are having your picture taken for security reasons. If you want to see a lot of cameras just go into Home Depot. They must have one every 20 to 25 feet. I gave up trying to count them. I see cameras hanging off my neighbor’s garage, telephone poles and buildings in high security or high crime areas. There are weather cams and cameras installed on public transportation. The police also have dash cams and license plate cams mounted on the police cars that read your license plate number as you drive by. According to the ACLU, “The information captured by the readers — including the license plate number, and the date, time, and location of every scan — is being collected and sometimes pooled into regional sharing systems.” There are 35 traffic cameras on the New York State Thruway in the Buffalo region alone, and 35 on the I-190. There are multiple traffic cams on the international bridges to Canada and 18 cameras on Route 33. You cannot travel on any of the major roads in Western New York without being photographed Many cell phones have a Global positioning system (GPS) feature on them. You frequently will have to turn this feature off as it is on by default. This is how law enforcement and others can locate you. If you have Sirius radio on your car, where you can call for help, Sirius can locate you using GPS. They can even detect when you have an accident and send emergency help automatically when you need it. People concerned about losing their personal privacy are just a little too late. They lost it years ago. We have locked the front door and left the back door wide open.

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Page 21

H ealth News Quatroche reappointed national healthcare advocacy

Erie County Medical Center (ECMC) Corporation President & CEO Thomas J. Quatroche Jr., PhD, was recently elected to the board of directors of America’s Essential Hospitals (AEH) through a nationwide election process. Quatroche The national organization represents 325 safety net and public hospitals. First formed in 1981 as America’s Public Hospitals, America’s Essential Hospitals is a leading advocate on federal public policy issues that affect public safety net hospitals across the United States. In 2018, Quatroche was first appointed to the board to fill a vacancy. According to its website, America’s Essential Hospitals has a rich history and long record of accomplishments on behalf of its members. Since its inception, America’s Essential Hospitals has been universally recognized for its expertise on issues affecting care for the nation’s most vulnerable patients. This deep knowledge revolves around not only the organization’s advocacy, but also its contributions toward research on issues essential hospitals face and the practical application of that research in areas such as quality improvement. AEH’s mission statement is: “America’s Essential Hospitals champions excellence in health care for all, regardless of social or economic circumstance, and advances the work of hospitals and health systems committed to ensuring access to care and optimal health for America’s most vulnerable people.”

Julie R. Snyder promoted at HealthNow New York

Julie R. Snyder has been promoted to senior vice president, chief mar keting and communications officer at HealthNow New York, Inc. Snyder, a seasoned marketing and communications executive with nearly two decades of experience in Snyder the healthcare industry, will lead the integrated marketing and communications function for the company. Functional responsibilities include advertising, brand positioning, media and public relations, corporate social responsibility, corporate communications and partnerships that enhance the organization, executive leadership, and the company’s brand in meaningful and measurable ways. Page 22

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Snyder joined HealthNow in 2011 as director of corporate relations and has served as vice president of corporate relations and special assistant to the CEO since 2015. Snyder’s leadership has been pivotal in the development and launch of the company’s health-focused grants program, Blue Fund, the creation of the signature Point of Health podcast, and the coordination of award-winning partnerships with Buffalo’s Canalside, Buffalo Sabres and the National Safety Council, which recently brought the impactful “Prescribed to Death” exhibit to both Buffalo and Albany. Snyder is also a co-founder of the company’s Women’s Leadership Circle. Previously, Snyder served as executive director for the Sisters Hospital Foundation and as director of communications for the Buffalo Niagara Partnership. Snyder earned a bachelor’s degree in public communication from American University in Washington, D.C. She serves on the board of trustees for Buffalo Olmsted Parks Conservancy, Medaille College and the Buffalo Therapeutic Riding Center, and is a sustaining member of the Junior League of Buffalo. She is also a member of several marketing committees for various nonprofits including the United Way of Buffalo & Erie County. Snyder serves on the BlueCross BlueShield Association Strategic Communications Advisory Network, the BCBSA Ad Collaborative, and has served on the BCBSA Community Investments and Partnerships Workgroup. Snyder received a “Woman of Influence” award from Buffalo Business First in 2017 and the Junior League of Buffalo’s Susan Reid Greene Russell Award in 2016.

Inspire Dental Group appoints new doctor

Inspire Dental Group, a multi-specialty dental practice with offices in Amherst, West Seneca and downtown Buffalo, recently announced the addition of Justin Au to the practice. He specializes in oral and maxillofacial surgery. Au Au received his Bachelor of Science degree in life science (with distinction) from Queens University; his Doctor of Dental Medicine degree from Tufts University; his Doctor of Medicine degree from the University at Buffalo School of Medicine and his oral and maxillofacial certification from the University at Buffalo department of oral and maxillofacial surgery, where he is currently residency program director and attending oral and maxillofacial surgeon. “We are very excited to welcome Dr. Justin Au to our clinical staff,” said Inspire Dental CEO Ron Sadler.

“Dr. Au exemplifies our core values of treating patients in a humble, respectful and compassionate manner. He brings with him vast knowledge, experience and training for even the most complex cases, and his expertise will enhance the quality and extent of care we provide our patients.” Au is a member of the American Association of Oral and Maxillofacial Surgeons; American College of Oral and Maxillofacial Surgeons; American Cleft Palate-Craniofacial Association; American College of Surgeons; American Dental Association; 8th District Dental Association; NYS Society of Oral and Maxillofacial Surgeons and the Western New York Oral Surgery Society. A native of Dallas, Texas, Au grew up in Toronto, Canada. He now resides in Clarence.

Roswell researcher earns Presidential Award for Scientists

Roswell Park Comprehensive Cancer Center’s Binnian Wei, PhD, has received a presidential award recognizing his scientific achievements and future promise. President Donald J. Trump and the White House office of science and technology Wei policy recently recognized the cancer researcher with a prestigious Presidential Early Career Award for Scientists and Engineers (PECASE). The PECASE is the highest scientific honor bestowed by the United States federal government, and recognizes scientists and engineers who, while early in their careers, show leadership potential and are at the forefront of scientific knowledge in the 21st century. The award was established in 1996 by the National Science and Technology Council. With Roswell Park since 2017 as an assistant professor of oncology in the department of health behavior, Wei explores emerging health issues such as exposure to chemicals in consumables like e-cigarettes, secondhand marijuana smoke and tobacco smoke. Wei was nominated for the PECASE by former coworkers at the Centers for Disease Control and Prevention. While there, he was a research scientist for the Division of Laboratory Sciences in the Tobacco and Volatiles Branch. “Dr. Wei is an important part of our team here at Roswell Park, where he is doing incredible work to advance our understanding of how chemicals and other environmental factors may be affecting us,” said Andrew Hyland, PhD, chairman of the department of health behavior. “We congratulate him on this well-deserved accomplishment, and look to him for strong future research efforts.” Wei earned his Ph.D. from Rutgers University, a master’s degree

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • August 2019

from Peking University and a bachelor’s degree from Nankai University.

Kalos Health celebrates fifth anniversary

Kalos Health has recently commemorated its fifth anniversary of managing health care for Western New Yorkers with a reception and ribbon cutting with the Niagara USA Chamber. Kalos Health is a regional nonprofit health insurance organization specializing in Medicaid Managed Long-Term Care (MLTC) and Medicare Dual Advantage Plans that collaborates with health care providers to improve the quality of life for Western New Yorkers. During the event, Kalos Health Vice President Kathleen Velasquez and Niagara USA Chamber Executive Director Kory Schuler introduced elected officials and health care industry partners who discussed the recent achievements of the organization. Founded in 2014, Kalos (Greek for “noble” or “good”) Health coordinates health care services through a vast network of medical providers designed to meet the medical needs of the diverse populations it serves. The organization began operating with an MLTC plan for Medicaid recipients who have chronic health conditions and then expanded its scope in 2018 to include an HMO-Special Needs Plan (SNP), called Kalos Health Gold Plus (HMO-SNP), designed specifically for members with Medicare Part A & B who also have full New York State Medicaid benefits. “Our focus is always on improving the quality of life for our members as they are challenged by a variety of health conditions and symptoms that need managing and extra support,” said Velasquez. “The ultimate goal is to preserve the independence of our members and support them as they live in nursing homes or remain in their homes for as long as possible. We are dedicated to delivering thorough, personalized care and counsel for each member’s unique circumstances, and we are proud of our trusted network of medical providers that collaborate with us to elevate the wellness and peace of mind for Western New Yorkers of all ages.”

Primary care practice to launch in the fall

Latus Medical Care, a new inno vative primary care practice that will exclusively serve BlueCross BlueShield members, will begin accepting patients this fall. Latus Medical Care is named to Schenk evoke the idea of interlacing the components that

H ealth News make up the health care experience. The practice will provide an integrated primary care experience for BlueCross BlueShield members. It is designed specifically to address several of the key challenges affecting the current health care landscape, including access to care, patient experience and quality of care. “Primary care is vital to a healthy, thriving population, yet our entire country continues to face an unprecedented demand for accessible primary care,” said physician Thomas Schenk, a founding partner of Latus Medical Care. “Latus Medical Care will not only increase access to care locally, but will provide a seamless and transformative health care experience for BlueCross BlueShield members.” The practice will offer an array of primary care and other integrated services, including preventive care, complex care for members with chronic diseases, and behavioral health counseling. “Latus Medical Care will provide everything a member needs to manage their care, health, and benefits right at the tip of their fingers,” added Schenk. “Whether it’s finding a doctor or pharmacy, or viewing test results or health history, this model is designed to simplify health care.” This concept is part of a growing national trend for health care insurers to identify dedicated practices to care for their members. “BlueCross BlueShield has been a leader in supporting initiatives that are transforming primary care in our region. This new partnership is another step we are taking to increase access to quality primary care for our members,” said David W. Anderson, president and CEO, BlueCross BlueShield of Western New York. “Latus Medical Care will connect our members to the care they need.” The new 8,000-square-foot office will be located in at 2350 Maple Road in Amherst.

New leadership positions announced at Roswell Park

Two physicians at Roswell Park Comprehensive Cancer Center have been promoted to new leadership positions that the Roswell says will focus on complete, patient-centric clinical care. They are: • Laura Mango has been named medical director of the Assessment and Treatment (ATC) Center. With Roswell Park since 2017, Mango has served as a consulting physician for the ATC, a service that supports current patients when they are sick with urgent, but not life-threatening symptoms 24 hours a day, 365 days a year. In her newly created role, Mango’s responsibilities include teaching and mentoring advanced practice providers in the department, enhancing patient care and experience, and focusing on maintaining strong relationships and communication with clinicians inside and outside of Roswell Park. Prior to Roswell Park, Mango

was a physician and supervisor in the immediate care unit at Buffalo General Hospital. She earned her medical degree from Ross University School of Medicine and completed residencies at the University at Buffalo Jacobs School of Medicine. • Paul DeJac has been promoted to chief of hospitalist medicine. In this new position, he will assist in the growth and professional development of his team, implement

initiatives to boost patient care, and lead the hospitalist medicine consult service. Additionally, he will partner with other faculty in research on quality initiatives to improve inpatient care. DeJac joined Roswell Park in 2016 and was named lead hospitalist in 2017. He played an integral role in developing the ATC and his efforts helped it expand to 24/7 coverage over the last year. DeJac continues to

serve on the patient safety committee. He previously worked in the University at Buffalo department of medicine, gaining valuable skills in level I trauma care, stroke treatment, and care of underserved populations. DeJac holds his medical and bachelor’s degrees from the University at Buffalo.

Orientation day for 125 high school students who are participating in a four-week comprehensive healthcare self-development program administered by the ECMC Foundation. “Thanks to the strong support of Mayor Brown, ECMC Foundation and the First Niagara Foundation, this competitive program helps educate our youth and provide them with opportunities to serve the patients of our community,” said Thomas J. Quatroche Jr., Ph.D., president and CEO of the Erie County Medical Center.

ECMC Holds 12thn Annual Summer Youth Intern Program

he Erie County Medical Center (ECMC) Corporation recently launched the 12th annual summer youth intern program with an orientation event held for 125 high school students who are participating in a four-week comprehensive healthcare selfdevelopment program administered by the ECMC Foundation. Sixty-five city youth, who are participants of Mayor Byron W. Brown’s annual Summer Youth Employment and Internship program, have been assigned to take part in the ECMC internship initiative, providing them with firsthand experience in the healthcare industry. The program, sponsored by ECMC Foundation, the city of Buffalo and Mayor Brown, First Niagara Foundation, Millennium Collaborative Care, and Big Lots, offers summer interns a hospital-based career exploration to stimulate interest in employment in healthcare services and to help meet the future need for qualified personnel in this field. The

interns are required to work two (2) six-hour days for a total of 12 hours per week, which includes a hospital-based career exploration program, a heart health education program, an accident prevention course, and/or a CPR certification course. The criteria in which interns are selected to be in the ECMC Summer Youth Intern Program include: an 80% overall GPA, two letters of recommendation from their school, 14-17 years of age; attendance of 9th, 10th, 11th or 12th grade in the fall 2018, medical assessments, working papers, parent permission and successful completion of a personal interview. Participating high schools include: Akron High School; Alden High School; Amherst High School; Bishop Timon-St. Jude; Buffalo Academy for Visual and Performing Arts; Buffalo Academy of Sacred Heart; Buffalo Academy of Science; Burgard High School; Canisius High School;

August 2019 •

Charter School for Applied Technologies; Christian Central Academy; City Honors High School; Clarence High School; Fredrick Law Olmstead; Frontier High School; Global Concepts High School; Grand Island High School; Hamburg High School; Health Science Charter School; Hutchinson Technical; Kenmore East High School; Kenmore West High School; Leonardo DaVinci High School; Lewis J Bennett Innovative Technology High School; Math Science Technology Prep; McKinley High School; Mount Mercy Academy; Mount Saint Mary Academy; Nardin Academy; Niagara Wheatfield High School; Nichols School; North Tonawanda High School; Orchard Park High School; St. Joseph’s Collegiate Institute; West Seneca East Senior High School; West Seneca West Senior High School; Williamsville East; Williamsville East High School; Williamsville North High School; Williamsville South High School; and Wilson High School.

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The future of healthcare calls. ECMC Answers. With unmatched services, resources, and facilities, ECMC is proud to be a destination of choice for Western New York today and to be building to meet the needs of all of our community’s tomorrows. From a nationally-accredited bariatric program to our community’s most accomplished head and neck cancer specialists, our state-of-the-art Russell J. Salvatore Orthopaedic Unit, to the shortest wait times in the country for kidney transplants, to comprehensive behavioral healthcare, we’ve answered the call to care for over 100 years—and always will.

ECMC.edu/Bariatrics ECMC.edu/Cancer ECMC.edu/Ortho ECMC.edu/Transplant

ECMC.edu/Behavioral

The difference between healthcare and true care

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