PRICELESS
Can You Actually Die from a ‘Broken Heart’? INSIDE: Love your heart: Top 10 things to improve heart health
NEW CHAIRMAN ECMC CEO Tom Quatroche appointed to lead Healthcare Association of New York State board of trustees. Group represents 325 organizations — hospitals, nursing homes, continuing care associations — from Long Island to Buffalo
RIGHT AT HOME Cardiac surgeon Awad El-Ashry feeling right at home after moving to Buffalo from Mississippi
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FEBRUARY 2020 • ISSUE 64 M E N TA L
H E A LT H
Foods to Boost Your Mood
What you eat matters for every aspect of your health —including your mental health. Find out what types of food can help you fight the winter blues. P.12
New Drugs Getting FDA’s Blessing Faster, But Is That a Good Thing? P.7
Among children aged 6 to 19, 14.9% have some level of hearing loss. Local experts discuss the issue
Oh, tofu. Poor, misunderstood tofu. It gets such a bad rap. But what exactly is tofu?
Yes, We Do Sleep More in Winter Study shows many Americans spend more time sleeping during this cold, dark season
So Long, 98.6: Average Human Body Temperature Is Dropping T hink the average human body temperature is 98.6 degrees Fahrenheit? Not anymore, new research suggests. “Our temperature’s not what people think it is,” said senior study author, physician Julie Parsonnet, a professor of medicine, health research and policy at Stanford University. “What everybody grew up learning, which is that our normal temperature is 98.6, is wrong.” That standard was established
in 1851, but a number of modern studies have suggested that it’s now too high. For example, a recent study found that the average body temperature of 25,000 British people was 97.9 F. In the latest study, Parsonnet and colleagues analyzed more than 677,000 body temperature measurements collected in the United States between 1862 and 2017. The results showed that the body temperature of men born in the 2000s is, on average, almost 1.1 F lower
than that of men born in the early 1800s. Meanwhile, the body temperature of women born in the 2000s is, on average, nearly 0.6 F lower than that of women born in the 1890s. That translates into a body temperature decrease of 0.05 F every decade, according to the study published Jan. 7 in the journal eLife. One possible reason for the decrease in average body temperature in the United States could be a reduction in metabolic rate — the amount of energy that people burn — that may be due to a population-wide decline in inflammation. “Inflammation produces all sorts of proteins and cytokines that rev up your metabolism and raise your temperature,” Parsonnet said in a Stanford news release. She noted that over the past 200 years there have been dramatic improvements in public health due to advances in medical care, better hygiene, greater access to food and improved standards of living. It’s also possible that more comfortable homes have contributed to the decline in average body temperature. Homes in the 19th century had uneven heating and no cooling, but central heating and air conditioning are now commonplace. That means people don’t have to expend as much energy to maintain a constant body temperature. “Physiologically, we’re just
different from what we were in the past,” Parsonnet explained. “The environment that we’re living in has changed, including the temperature in our homes, our contact with microorganisms and the food that we have access to… We’re actually changing physiologically.”
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
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Senior Wishes is Seeking Wish Applicants
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ounded by the United Church Home Society, Senior Wishes strives to bring special moments to seniors across WNY by granting numerous wishes each year for individuals 65 years old and older with qualifying incomes or who permanently reside in a care facility. Senior Wishes wants to enrich the lives of deserving seniors by providing an experience to be cherished and remembered. Over 260 wishes have been granted since 2014, including traveling to visit long-missed family, attending a sports or cultural event, or even providing supplies or lessons to continue an abandoned hobby. Qualifying seniors may submit an application which is reviewed bi-monthly by a volunteer wish granting committee. After approval, a Senior Wishes representative will work together with the senior to plan the details of their wish experience. Community members are encouraged to reach out to deserving seniors, talk to them about their unfulfilled dreams, and help them fill out the paperwork.
According to Wendy Miller Backman, executive director, “Senior Wishes was created to recognize many of our seniors have activities they want to participate in or people they’d like to see again, and they are unable to make this happen on their own. It is so rewarding to see a senior light up with joy at a wish granting, especially when it’s been something they’ve wanted to do or someone they’ve wanted to see for years. We remind seniors they are not forgotten.” Wish recipients must be 65 years of age or older and a resident of Western New York with an annual income under $38,000 for a household of one or under $44,000 for a household of two. Permanent residents of care facilities are exempt from the income qualification. Vacations, medical items, furniture, household repairs, bill payments and travel outside of the continental U.S. are excluded. Full details can be found at www. SeniorWishes.org or by calling Wendy at 716-508-2121.
Many Americans Sleep More in Winter L ike the mighty grizzly bear that hibernates in winter, many people spend more time sleeping during this cold, dark season, a new survey reveals. According to the American Academy of Sleep Medicine (AASM), 34% of Americans say they sleep more in winter, compared with 10% who claim they sleep less during this time of year. In summer, these numbers are turned around, with 36% saying they sleep less and 9% saying they sleep more than usual. “The shorter days during the winter create a great, natural opportunity to spend more time sleeping,” physician Kelly Carden, president of the AASM, said in an academy news release. “Getting quality sleep of adequate duration can improve physical and mental health, overall performance and mitigate safety risks,” she added. Here are some tips for getting a good night’s sleep regardless of the season:
Better Hearing Starts At
• Set a bedtime that allows you to get enough sleep. • Avoid screens and electronics before bed. Exposure to light at night can disrupt the sleep cycle. • Avoid caffeine after lunch and alcohol near bedtime — both can disrupt sleep. • Relax before bed, by taking a warm bath, drinking tea, journaling or meditating. • Make your bedroom comfortable. It should be cave-like — quiet, dark and a little cool. • If you have sleep problems, see your doctor.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
New Study Reports Alarming Surge in E-Scooter Accidents
126,800,000 Steps in 2019
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lectric scooter accidents are sending droves to emergency rooms — especially young adults, a new study finds. As e-scooters’ popularity has exploded, so have injuries — skyrocketing 222% between 2014 and 2018 to more than 39,000. Hospital admissions also soared — 365% to nearly 3,300. Head injuries made up about a third of the injuries, twice the rate seen in bicycle accidents, researchers said. Men suffered about two-thirds of the injuries. Most riders hurt for the first time were between 18 and 34 years old, researchers found. “E-scooters are a fast and convenient form of transportation and help to lessen traffic congestion, especially in dense, high-traffic areas,” said senior author Benjamin Breyer, a urologist at the University of California, San Francisco. “But we’re very concerned about the significant increase in injuries and hospital admissions that we documented, particularly during the last year, and especially with young people, where the proportion of hospital admissions increased 354%,” he added in a university news release.
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n pursuit of improved health for Erie County and WNY, the Wellness Institute and its many partners have exceeded their community goal of 125 million steps walked in 2019. Currently, 126.8 million steps have been tracked, according to the Wellness Institute. The 2019 goal was achieved with the help of local participants, organizations and a variety of events. Among those who participated in 2019 are the city of Buffalo employees — “Chairs to Stairs” program, Downtown Buffalo Spring Walking on Wednesday series — UB Step Challenge (over 40 million steps), Explore Buffalo (over 19,000 participants and 72.4 million steps), Sunset Striders Walking Club (Grand Island), Rotary Club walks and First Sunday Reflective Walks at Hoyt Lake. Other partners included the Healthiest [School] Districts Initiative, promotional sup-
port from Refresh Magazine, WBFO, and the Apollo Media Center, and advocacy for regular physical activity by The Western NY Healthy Communities Coalition, Catholic Health, and WNY APHERD. For 2020, the Wellness Institute is in the process of planning its annual Walkability Summit and working to promote its walkability initiative: WNY WALKS! which is designed to promote physical activity as essential to improving health for all ages in our community. Phil Haberstro, of the Wellness Institute, has branded “walking as “the grand slam of physical activities” for its positive social, economic, environmental, and health impact. Organizations interested in partnering in the 2019 Campaign should contact the Wellness Institute at 716-851-4052 or through email at BeActive@City-Buffalo.org.
Health officials nationwide are alarmed by the number of fractures, dislocations and head injuries showing up in trauma centers from e-scooter accidents, researchers noted. A likely reason: Few regulations for e-scooter use exist, particularly about the need to wear a helmet. Only 2% to 5% of injured riders wore helmets, the study found. Researchers think mandatory helmet use would dramatically reduce the number of head injuries from e-scooter accidents. For the study, they reviewed data from a nationwide injury reporting system. Between 2014 and 2018, almost 40,000 injuries from powered scooters were reported nationwide, the study found. The accident rate more than tripled over that period — from Gala ofof The CenterofofNiagara Niagara Inaugural Gala TheCommunity Community Health Health Center six per 100,000 people in 2014 to 19 Inaugural PRESENTS PRESENTS in 2018. The Most common injuries were “THE “THELEGACY LEGACY CONTINUES. CONTINUES. . . . fractures (27%); Scrapes and bruises (23%); and cuts (14%). BECAUSE BECAUSE WE WE CARE CARE ... ..”.” In all, 78% of injuries happened in cities. The report was published online Jan. 8 in the journal JAMA Surgery.
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Meet
Your Doctor
By Chris Motola
Awad El-Ashry, M.D. Fewer Americans Have a PCP Now ‘There has been something of a convenience revolution in primary care,’ doc says
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he number of Americans who have a primary care physician is shrinking — with potential consequences for their health, researchers say. Their new study found that in 2015, an estimated 75% of Americans had a primary care provider — down from 77% in 2002. The declines were most pronounced among people under 60: For Americans in their 30s, for example, the figure dropped from 71% to 64%. The study, published Dec. 16 in JAMA Internal Medicine, could not dig into the reasons. But the new “convenience culture” could be one driver of the trend, said lead researcher David Levine, a physician at Brigham and Women’s Hospital in Boston. Especially for people who are younger and in better health, walkin clinics — promising fast service at nontraditional hours — may be more appealing than an old-style primary care appointment. “There has been something of a convenience revolution in primary care,” Levine said. “And that’s likely one of the things going on in younger populations.” If that is the case, is it necessarily a bad thing? “Continuity of care — having a provider who knows you, and knows your history — is very important,” Levine said. In a study published earlier this year, he and his colleagues found that Americans with a primary care doctor were more likely to receive “high-value” types of care. That, Levine said, includes things like flu shots, counseling on weight loss and smoking cessation, blood pressure checks and standard cancer screening. There are, however, other culprits in Americans’ gradual departure from primary care. “Everywhere else in the world,” Levine said, “’primary care first’ is the health care model.” But in the United States, people often see specialists — who, in the medical world, reign in pay and prestige, Levine noted. And that draws many new doctors into specialties, and away from primary care.
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Cardiac surgeon feeling right at home after moving to Buffalo from Mississippi Q: You’ve recently relocated from down south to join Great Lakes Cardiovascular. What brought you to Buffalo? A: Mainly family; my wife wanted to move north, but the opportunities here attracted me as well. I’m Egyptian. I moved to the States 12 years ago. I did my medical schooling back there but did my training over here. I’d been practicing in Mississippi for four years or so. Q: Is it much of a change workwise? A: It’s basically pretty much the same. The population here is very similar in terms of the atmosphere. The medical and surgical side of it are almost exactly the same. The only real adjustment is the change in weather. Q: What kinds of cases do you see as a cardiac surgeon? A: The overwhelming majority of my practice is dedicated to open heart surgery; coronary artery bypass, valve replacement. I have an interest in aortic aneurysm repairs. That’s along with teaming up with other specialties like cardiology to work on complex cases. Q: How well do you get to know your patients? A: I think surgery is one part of what a provider in my field should do. It’s very important to me to meet the patient multiple times before surgery if time
allows. Sometimes it doesn’t because they need to go to surgery in an emergency situation, but otherwise I like to meet with my patients to make sure they are comfortable with the decision-making process, answering their questions and making sure they’re making an informed decision. At the end of the day, it’s their body, their heart. They need to understand what’s going on, what options are available, what the outcomes could be. That’s for the patient and family as well. It’s very important for the treatment process to have this faceto-face discussion so they know who is taking care of their loved ones. Most of the time surgery is the easiest part. We also have a very good, multi-disciplinary team for following up the patient and helping them get past this event as quickly as possible. It’s a whole process. It takes a lot of time. Q: Do you perform interventions? A: It’s a whole different specialty than interventional where they do things like stents. But we do team up, put our heads together. I don’t personally do stents, but my colleague, an interventional cardiologist would be sitting next to me talking about an image we got back for a patient and try to figure out the best approach for that specific patient. So this partnership is very good for the patient, because they get the best of both worlds. Sometimes they need open heart surgery. Sometimes they need stents. Sometimes they need both.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
Q: Walk me through the process. A: We do it on every single patient. The traditional pathway for coronary heart disease would be the cardiologist sees the patient first, does imaging of the disease, and if the disease is extensive, they get me involved along with the interventional cardiologist. Let’s say the patient needs a three; four; or five-vessel intervention. We pick how many would be done by surgery and how many might need to be done in the future with stents. We call this a hybrid approach. That’s the norm nowadays. We find that when you combine multiple approaches you get the best results. We come up with a treatment plan. It’s a multi-stage process. Q: Do you find yourself being called into a lot of different types of cases. Not just heart-related, but let’s say stroke? A: No. It’s highly specialized. I do open heart surgery. Sometimes there’s collaboration between the interventional cardiology with other specialties like interventional urology and neurosurgery, but my role is a lot more specialized. Q: With the move toward minimally invasive surgery most of the news you hear isn’t related to open heart surgery. What role does open heart surgery still play? A: So most of the valve replacements and repairs we do now are minimally invasive. It saves a lot of pain and effort for the patient, and they tend to go home earlier. If a patient has coronary artery disease, they can get stents in there, but the majority of those patients have disease in multiple vessels. In these situations, surgery is better and has better outcomes than stents. The more disease you have, the more likely you’ll need open heart surgery if you want to live longer. For aortic valve disease it’s an upcoming field for endovascular, but for certain patients you still need open heart surgery. Most patients go home in three to four days, which sounds like a lot, but one day after your surgery you’ll be on your feet and a few days later you’ll feel good enough to go home. There are a few other diseases we treat as well.
Lifelines Name: Awad El-Ashry, M.D. Position: Cardiothoracic surgeon with Great Lakes Cardiovascular, a General Physician practice, at Buffalo General Medical Center Hometown: Alexandria, Egypt Education: University of Alexandria Faculty of Medicine; cardiothoracic surgery fellow, cardiac track, MD Anderson/UT Houston Memorial; chief resident, general surgery, University of Alabama, Birmingham. Postgraduate training: Yale University, resident; Weill Medical College of Cornell University, resident Affiliations: Gates Vascular Institute; Buffalo General, ECMC Organizations: Society of Thoracic Surgeons; Southern Thoracic Surgical Association Family: Wife, three children Hobbies: Soccer, reading, travel
New Drugs Getting FDA’s Blessing Faster, But Is That a Good Thing? Eight out of 10 new drugs in 2018 benefited by special programs that streamline FDA’s approval process
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ew drugs have been approved by the U.S. Food and Drug Administration for patients based on less and less solid evidence, thanks to incentive programs that have been created to promote drug development, a new study shows. Researchers report that more than eight out of 10 new drugs in 2018 benefited from at least one special program that streamlines the approval process. The result is that patients are being prescribed pricey new medications that have not been tested as rigorously, said lead researcher Jonathan Darrow, an assistant professor at Harvard Medical School. “The evidence standards have changed, but it’s not clear that physicians, let alone patients, understand either the basic FDA approval standard or that requirements have become increasingly flexible over the past 40 years,” Darrow said. The share of new drugs support-
ed by two strong clinical trials, rather than just one, decreased from 81% to 53% between the 1990s and the 2010s, researchers found. The time that the FDA spent reviewing each new drug dropped during the same period, from 2.8 years in the late 1980s to about 7.6 months in 2018, Darrow added. This might be good news if highly effective new drugs were reaching the market quicker, but other research has found that the large majority of newly approved drugs offer modest benefits over existing therapies, he said. “In many cases, you can get almost all of the benefit of the new drugs by taking older drugs,” such as generics, Darrow said. The programs also haven’t really improved the number of new drugs approved each year, either. “Even with that flexibility, there has been no strong upward trend in the number of drug approvals, which
on average has remained about 30 new drugs approved per year since the 1980s,” Darrow said. The average annual number of new drug approvals was 34 from 1990-1999, decreasing to 25 from 2000-2009 and then increasing to 41 from 2010-2018, researchers found. The FDA did not respond to a request for comment, nor did PhRMA, a trade group representing the pharmaceutical industry. Since the 1980s, various programs have been enacted by U.S. Congress or developed by the FDA to promote the creation of drugs for rare diseases or accelerate approval of promising medications that could benefit multitudes, researchers said in background notes. “In 2018, more than 80% of new drugs benefited from at least one special program,” Darrow said. These programs have weakened the review process by requiring the FDA to accept more flexible evidence, he said. For example, evidence of
a drug’s effect on cholesterol levels or tumor size can be used to get it approved, rather than evidence that the drug helped people live longer or feel better or avoid emergencies such a heart attacks, Darrow said. But there’s been no benefit from these programs in terms of how long it takes a company to create a new drug, he said. “We found there was a relatively stable period between when clinical trials began and when drugs were approved. We did not see a steep decline in the clinical development period,” Darrow said. Disturbingly, the FDA has also become more financially reliant on money from pharmaceutical companies, researchers found. The amount of the FDA budget that comes from the pharmaceutical industry has increased from about $300 million in the 1990s to just over $4 billion in the 2010s, researchers found. These fees are used to accelerate review times, researchers said.
ACA Fate Undetermined
the per capita cost has increased from $9,677 in 2015 to a projected $12,000 this year. NYS is expecting an overall budget shortfall of $4 billion for the fiscal ending March 31,2020.
Healthcare in a Minute
By George W. Chapman
Impact of Hospital Mergers: Higher Prices, No Significant Quality Improvement
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he New England Journal of Medicine recently published a study concluding hospital mergers and acquisitions have had little positive impact on the quality of care and typically drive up prices in the market. The study compared 246 hospitals that were merged or acquired with 1,986 hospitals that weren’t, for: patient experience, mortality, readmissions and clinical process. As expected, the insurance industry was quick to pounce and agree with the study while the hospital industry was quick to rebut. Regardless,
many mergers and acquisitions have virtually salvaged financially challenged hospitals that would otherwise be closed. Many rural hospitals would not be open for business if they weren’t affiliated with a larger hospital or hospital system. Mergers make it easier for hospitals to attract, employ and retain scarce nurses and providers while offering a broader more expansive range of services to the consumers of the smaller, more remote or financially strapped facility. The department of justice monitors mergers and acquisitions for any untoward impact on prices.
Bill to Cut Drug Costs Stalled
Bill to End Surprise Billing Stalled
The bilateral bill passed by the House, which would empower Medicare to negotiate prices on 250 drugs over the next 10 years, is buried in the pile of 275-plus bills sitting on Senate majority leader Mitch McConnell’s desk. McConnell has “ruled out” taking up the bill which would lower Medicare spending by $456 billion over 10 years. With only two Republican congressmen voting for the bill, it will assuredly die anyway in the Republican-controlled Senate. All the talk by elected officials to control and lower drug costs is stifled by the drug lobby.
Both houses of Congress thought ending surprise billing would be a no brainer. But that was before a barrage of last-minute lobbying by non participating providers and healthcare staffing companies that make money via surprise billing. Congress reached a “compromise” by establishing benchmark rates and an arbitration “backstop” for charges above $750. Vested interests in the status quo will continue to thwart efforts to reform healthcare and lower costs.
President Trump continues to vow to terminate the Affordable Care Act (Obamacare) without offering a viable replacement. Twenty million Americans are insured via the ACA. There has never been an outcry over the ACA from any of the major stakeholders, designers, or founders — including insurance companies, hospitals, physicians and consumers — because it is working. The courts have ruled the individual mandate to carry insurance was unconstitutional because the penalty to not carry insurance was considered an illegal tax. States against the ACA argue the whole law should be thrown out since the individual mandate was declared unconstitutional. A three-judge panel agrees the individual mandate is unconstitutional but has asked the lower courts to review whether or not the entire ACA should be declared unconstitutional. If the entire ACA is tossed, so will be coverage of pre-existing conditions.
NYS Medicaid Problems
NYS has the most expensive Medicaid program per capita in the country. Most of that can be attributed to relatively generous benefits and some of that can be attributed to fraud and mismanagement. Roughly: the federal government pays 50%, NYS pays 25% and local municipalities pay the remaining 25%. NYS enrollment has been steady at about 6.2 million people since 2015 thru 2020 (projected). The budget for the same period has increased from $60 billion in 2015 to a projected $74.5 billion this year. That means
February 2020 •
Genetic Testing Scam
Scammers are targeting seniors. They offer genetic testing kits, then ask for what they really want … your Medicare number. The scammers can be online, on the phone or in person at health fairs and senior centers. Never agree to genetic testing unless ordered by your physician.
Gun Violence Funding
Congress has authorized $25 million in funding for the Centers for Disease Control and National Institutes of Health to study gun violence, which has become one of the leading causes of death. Forty thousand Americans a year die via gun violence. Sixty percent — or about 24,000 of the deaths — are suicides. Although a relatively paltry amount (we spend over a trillion a year on healthcare) the bipartisan bill was seen as at least a start at addressing the issue and getting some evidence-based data for solutions. 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
Touch: One of Life’s Essential Ingredients
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kiss. A hug. A gentle touch. No, this is not a column about romance in anticipation of Valentine’s Day. I am writing, instead, about a related matter: the importance of touching and being touched. Both are essential to our sense of well-being. This subject is especially relevant for those who live alone, because — on our own — we can be susceptible to touch deprivation. When that happens, we miss out on all the benefits of healthy human contact. I’m no expert in this area, but others are, and their research has shown that touch is absolutely essential for emotional and physical health and development. Studies conducted by the University of Miami’s Touch Research Institute revealed that touch can do so much good: it can help reduce pain, anxiety and depression, lower heart rate and depression and even promote immune function and healing. But I don’t need a study to convince me of the value of touch and
affection. I have my own proof and it is revealed to me whenever I am touched or touch another. A friend’s warm hug can lift my spirits, a reassuring hand on my shoulder can hold the demons at bay, even a handshake can be affirming. Those who live alone can often unwittingly, almost unconsciously, neglect this vital component of a happy, healthy life. It’s easy to do, especially if you have a tendency toward isolation or are without a significant other in your life. If that’s the case, I encourage you to take notice. Is touch absent in your life? Has it been weeks or months since you enjoyed the warmth of an embrace? When was the last time you felt the comfort of a soothing caress? Or, exchanged backrubs with a friend? Below are a few tips to “keep in touch.” They have worked for me, and it’s my hope that you, too, will benefit from incorporating positive, loving touch into your life. • Become a hugger. It’s not for everyone, but if you’re not a hug-
ger, consider becoming one. A little practice is all it takes. Hugging didn’t come naturally to me. It wasn’t something I grew up with, so it felt awkward at first. I was forever bumbling the embrace: leaning left, when I should have been leaning right; knocking heads; or sending glasses askew. So, years ago, I made a deliberate decision to become a hugger. Intuitively, I knew I was missing out on this natural form of human expression. The good news? I got better at it over time, and life is sweeter as a result. • Volunteer to touch. The benefits of “loving touch” are not just for the ones receiving it. Those who deliver it also reap great personal rewards and satisfaction. If you look around, there are plenty of opportunities to administer positive, healthy touch to someone in need. Many hospitals have volunteer “rockers” for newborns, and nursing homes are often looking for volunteers to make personal connections with residents who may not have family nearby. Just an hour visiting with a resident, while applying hand lotion, could make her day. To volunteer in this way can be a healing act of kindness, one that says we are in this life together. What soothes one soothes us all. • Own a pet. Study after study has shown that petting a dog or gently stroking a cat can have a calming effect on people by lowering blood pressure and reducing anxiety. Again, I don’t need a study to validate my own experience. Petting my beloved springer spaniel Scout or snuggling with her on the couch has an immediate and relaxing effect on me. After a busy
day, almost nothing is as grounding as a few minutes with my affectionate pooch. • Get in touch with yourself. Self-gratification for pleasure or with the goal to sooth, heal or relieve tension is natural and can be a healthy expression of self-care and affirmation. When you “love the one you’re with,” something profound and restorative can result. • Splurge for a massage. I read recently that, “Massage is to the human body what a tune-up is for a car.” Among its many benefits, therapeutic massage can bring relief from anxiety, reduce stress, fight fatigue and increase your capacity for tranquil thinking and creativity. If touch is absent in your life, this form of safe, non-intimate human contact can refocus the body’s natural ability to heal and regenerate itself. Plus, it just feels wonderful! You can make a conscious effort to bring more touch into your daily life and, in doing so, bring more happiness to yourself and those around you. Touch enhances bonding and gives us a sense of belonging — important essentials for everyone, but especially for those who live alone.
In 2014, about 4% of publicly insured kids and 3% of privately insured children received unnecessary or low-value services at least twice. One of the reasons for these unneeded tests is the culture of American medicine where parents and doctors are expected to do something even if it’s not going to help, Chua said. “Parents understandably want to relieve their children’s suffering and to rule out serious problems,” he added. “Both parents and doctors sometimes have a tendency to believe that prescribing a drug or ordering a test is better than doing nothing, even though the right answer is often to do less.” Also, doctors tend to be overly
cautious. “Doctors have a strong fear of missing something,” Chua said. “Some doctors would rather overtreat and risk the side effects of the intervention than undertreat and risk missing a catastrophic problem.” But unnecessary tests and treatments waste money that could be used for other “valuable causes, and also force many families to pay out-of-pocket for unnecessary care,” Chua noted. “Reducing wasteful care will improve child health and decrease the financial burden of health care spending on society and families.” The report was published online Jan. 7 in the journal Pediatrics.
Gwenn Voelckers leads Alone and Content empowerment workshops for women held in Mendon and 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 workshops, 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
U.S. Doctors Often Test, Treat Kids Unnecessarily
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egardless of their family’s insurance status, many children get medical care they don’t need, a new study suggests. One in 11 publicly insured and one in nine privately insured children in the United States were given what the researchers called unnecessary, “low-value” care in 2014, the researchers report. “While we found that publicly insured children were a little more likely to receive low-value services, the difference was not large. The more important finding is that children are highly likely to receive wasteful care, regardless of what type of insurance they have,” said researcher Kao-Ping Chua, a pediatrician at the University of Michigan’s Page 8
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C.S. Mott Children’s Hospital. “This means that efforts to reduce waste should be global in nature and target the care of all children,” Chua noted in a hospital news release. For the study, his team looked at data on 8.6 million U.S. kids to see how often 20 low-value diagnostic tests, imaging tests and prescription drugs were given. These included unnecessary vitamin D screening, imaging for sinus infections and antibiotic prescriptions for colds. The liberal use of antibiotics can add to the spread of antibiotic-resistant germs and unneeded X-rays and CT scans can expose kids to radiation that might raise cancer risk later in life, Chua said.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
Addressing Pediatric Hearing Loss Among children aged 6 to 19, 14.9% have some level of hearing loss By Deborah Jeanne Sergeant
E
very baby born in a US hospital receives a hearing screening. Of those, only a fraction 0.16% — have some level of hearing loss, according to the Centers for Disease Control and Prevention. But among children aged 6 to 19, 14.9% have some level of hearing loss because of later onset hearing issues. Addressing children’s communication needs as young as possible is very important and bears lifelong effects. “Children use incidental learning from the environment to gain language,” said Ashley Eisen Graney, audiologist with Buffalo Hearing & Speech Center in Buffalo. “That language acquisition leads to reading skills and reading skills to academic achievement. Studies are coming out with definitely confirming that children with hearing loss in one ear should be fit. They don’t do as well in school and have behavioral issues. They are 10% more likely to fail a grade.” Missing aspects of language acquisition without any means of intervention to improve communication can delay children’s learning, cognitive abilities, social development and eventual employment opportunities. Fitting with hearing aids represents the most widely selected choice for mild to moderate hearing loss; however, some parents of children with severe to profound hearing loss choose to use sign language to complement their children’s growing communication skills.
However children acquire communication skills, it’s important to start early. If they do so through hearing aids, “we have a small window of time to get them fitted,” Graney said. “Studies show that if they go unaided, the part of the brain allocated to hearing gets rewired to other senses. That’s why we have newborn hearing screening in the hospital so they can get fitted for a hearing aid.” Many objective tests exist for testing a baby for hearing loss. These can include placing electrodes on the head to measure the response of the auditory nerve. They can measure the brain’s response to sound even while the baby sleeps. Working with a professional after they receive their child’s hearing loss diagnosis can help parents navigate. “When parents are faced with having a child with hearing loss, they often feel at a loss for what comes next,” said Jill Bernstein, audiologist and assistant director at Hearing Evaluation Services of Buffalo. “Having a good audiologist with pediatric experience can make the process so much easier and help them understand what to expect over time.” Hearing aids for babies differ quite a bit from those intended for adults. To make them appeal to children, hearing aids come in bright colors and patterns, similar to the effect of fun options for glasses. They also have low battery lights so parents know when to charge or change the battery. Their tamper-resistant battery doors help prevent inges-
tion. Children’s hearing aids are also compatible with hearing assistive technology (HAT) systems that allow parents’ or teachers’ voices to transmit directly from a microphone into the hearing aid, which reduces the effect of ambient noise interfering with the message. Manufacturers make children’s hearing aids more durable than their adult counterparts. Accessories can help keep hearing aids on children. Many parents use a clip similar to that of a pacifier to keep hearing aids together and attached to the infant’s clothing so they don’t get lost. “It’s definitely challenging,” Bernstein said. “The responsibility falls on parents. The hearing aids should be on every waking hours.” Some parents use headbands, hats or aids with attachments that “hug” the child’s ear. Fitting hearing aids is also different for children. Parents are more involved for pediatric fittings and device care, especially for infants who are both incapable of expressing their experience accurately and lack normal hearing experience for comparison. Bernstein added that usually, infants receive a full prescription,
Parent-Set Bedtimes Linked to Better Teen Mental Health
unlike adults, who have to slowly adjust to hearing aids. Infants are seen every three to four months for adjustments as they grow. By about age five for most children, their ear canals are at adult size. Working closely with an audiologist helps parents from learning of their child’s diagnosis through ongoing hearing aid care, device adjustments and obtaining the support the child needs at school and for extracurricular activities. In-school supports are available to make sure children with hearing loss can have every opportunity possible to learn, such as speech therapists and aides to ensure they have their particular needs met. Bernstein wants parents to embrace their role as their children’s best advocates “if there’s any question about meeting milestones,” she said. “We can test newborns and we have different techniques to cover any age. Insurance covers hearing tests. Talk with the pediatrician. A lot don’t do screening. A hearing screening should consist of something that’s frequency consistent, not whispering or rubbing fingers near the ear. That’s old school. A lot might send the child on for an audiologist evaluation.”
Study led by Daemen College professor shows lack of sleep can cause depression in kids
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eens who are not getting sufficient sleep are more likely to suffer from symptoms of depression, a result that can be mitigated when parents enforce bedtimes with adolescent children, according to new research led by a Daemen College professor. The study, funded by the National Sleep Foundation, will be published in the journal Sleep, a publication of the Sleep Research Society and the leading journal in the field of sleep science. “Our study suggests that inadequate adolescent sleep is associated with symptoms of depression and higher levels of daytime sleepiness and fatigue, which in turn may impact the overall health of teens,” said Jack Peltz, assistant professor of psychological sciences at Daemen
and lead author of the study. “These findings underscore the importance of adolescents getting adequate amounts of sleep to support their well-being and emphasizes the positive influence parents can have by establishing a set bedtime and rules that will help ensure their teens will get more sleep.” For the current study, teens self-reported on their daily sleep duration, energy levels and symptoms of depression throughout the day. Parents completed assessments on enforcement of bedtime-related rules and routines, such as establishing a bedtime, regulating screen time, and prohibiting caffeine consumption. Researchers found that although the majority of families in the study reported they have bedtime rules, 47% of parents did not have an enforced bedtime, 30% did not have
pre-bedtime rules for screen usage, and 48% had no enforced rules regarding afternoon or evening caffeine consumption. All are known factors in influencing the quality and length of sleep among teens. In addition to the recent study findings on depression, poor sleep has been previously linked to having a number of other adverse effects on teens, including poor physical health, academic failure, and increased risk for automobile accidents. On average, teens need 8.5 to 9.5 hours of sleep, but more than half of teens aged 15 to 17 get only 7 hours of sleep a night, according to the National Sleep Foundation’s 2014 Sleep in America Poll, the most recent poll available. Also, the poll showed that approximately 25 percent of parents of 15- to 17- year-olds do not have formal sleep-related rules and only
February 2020 •
35 percent of parents enforce bedtime rules. “Sleep is essential to teens’ physical and mental health, but adolescents are likely going to give pushback about setting a bedtime as they are at an age where they are becoming more independent,” said Peltz. “For parents, enforcing a bedtime and a regular routine will be well worth the effort in helping their teens get sufficient sleep and develop healthy sleep habits.” Other co-authors of the study, “Parents Still Matter: The Influence of Parental Enforcement of Bedtime on Adolescents’ Depressive Symptoms,” are Heidi Connolly and Ronald Rogge, both of the University of Rochester.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Urgent Care Vs. Emergency Room
How Urgent Is Your Health Need? By Deborah Jeanne Sergeant
I
f you or your child need healthcare, how do you determine the urgency of the need? Should you wait for a primary care provider appointment, rush to the local urgent care center or call an ambulance for an emergency room visit? Local experts offered a few guidelines: — Physician Michael Merrell, medical director at Independent Health, Buffalo: • “You should go to the emergency room if you have severe bleeding, significant trouble breathing, head injury, loss of consciousness, signs of stroke or heart attack.” • “It’s hard to give a rule since medicine is complicated. Anything you don’t have to go to the ER for, call your primary doctor to see what you should do. The PCP is the coach for your health. They help you navigate the system. • “Also think about convenience. Can you just pop in somewhere? You likely won’t get the care from an urgent care as you would from your primary care physician. If you want a fast answer, going to urgent care is faster. But some PCPs can see you
immediately. • “There’s also the cost. A primary could be $1,000 if out of network and the PCP would be much less. • “Another option is a 24-hour nurse line you can call if you have questions or want advice.” — Physician Kathy Grisanti, president and owner of Pediatric Urgent Care in Rochester and Buffalo: • “We generally encourage the parents to contact the pediatrician to help make that decision. The pediatrician knows the child and family and can help make that decision. It might need additional testing not available at an urgent care center. • “In general, injuries that require stitches or injuries that are possible fractures are usually something pediatricians don’t do in their office. That usually requires an urgent care center. CAT scans or ultrasound are not done at most urgent care centers and require a hospital ER. • “Difficulty breathing can be taken care of at any of the locations, but the pediatrician could refer to the ER or urgent care. Difficulty breathing is always something we worry
about, especially with young babies. • “The extreme things should go to the ER. Anything life threatening parent should call an ambulance. You can get intervention right at the home. Many urgent care centers can intervene and help stabilize the patient. • “Getting their fever under control can slow down respiratory rate and make them more comfortable. • “If a baby or young infant is breathing fast, has blueness of fingers, lips, toes, lethargic, and is dehydrated, those require medical attention. Babies or young infants are the ones that struggle the most with RSV or influenza. Particularly those under 8 weeks who have a fever, it’s important to be evaluated or something that looks like a seizure. • “Some parents get alarmed by the height of a fever, if it’s over 104 or 105. We don’t necessarily worry about the height of the fever if the child is comfortable. Treat with ibuprofen or Tylenol. It’s the length of the fever that concerns us. Generally, the fever itself — unless in a young infant — we don’t worry about it if the child is well appearing and not dehydrated. • “Pain is something that usually requires more immediate attention. If the child has fallen and refuses to bear weight and is crying or wakes up crying with ear pain,those are difficult to wait until the next day if the child is really uncomfortable. If the child can bear weight, it can probably wait. • “Pay attention to noisy breath-
Having a Baby May Cost Some Families $4,500 Out-Of-Pocket Despite an ACA mandate, some are shouldering more of the expenses tied to having a baby
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ne of the most expensive parts of having a baby may involve the birth itself, a new Michigan Medicine study suggests. For some families, average outof-pocket health care spending for maternity care — including the pregnancy, delivery and three months postpartum — jumped from $3,069 in 2008 to $4,569 in 2015, according to findings published in the January issue of Health Affairs. And the Affordable Care Act (ACA), which required large, employer-based health plans (used by about 50% of women in the U.S.) to cover maternity care, hasn’t protected families from shouldering a big brunt of costs. The reason: while the ACA requires full coverage of preventive services, such as pap smears and mammograms, there are few restrictions on how plans impose co-pays, deductibles and cost-sharing for Page 10
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maternity care. “We were surprised to learn that the vast majority of women paid for critical health services tied to having a baby,” says lead author Michelle Moniz, an obstetrician-gynecologist at Michigan Medicine’s Von Voigtlander Women’s Hospital and researcher with the U-M Institute of Healthcare Policy and Innovation. “These are not small co-pays. The costs are staggering.” The study included a national sample of 657,061 women enrolled in 84,178 employer-sponsored plans who had been hospitalized for childbirth from 2008 to 2015. Researchers analyzed costs for all health care services used before and after delivery that might influence pregnancy outcomes. Ninety-eight percent of women were found to be paying some outof-pocket costs.
Costs of childbirth Childbirth is a leading reason for hospitalization among women of reproductive age. Not surprisingly, out-of-pocket costs for Cesarean sections were higher, with mean total out-of-pocket spending rising from $3,364 in 2008 to $5,161 in 2015 for C-sections compared to an increase of $2,910 to $,4314 for vaginal births. Women also seem to be bearing a higher proportion of total costs. Those with vaginal births covered 21% of expenses in 2015 compared to 13% in 2008. Women with C-sections could expect to pay about 15% of costs, up from 10% during the same years. Maternity care services are vital to ensuring the best possible outcomes for moms and newborns, Moniz says. This is an especially important focus as data over recent
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
ing. We see a lot of croup, typified by a barky cough. The pediatrician often is able to decipher what can wait until the morning. We are staffed by pediatricians so we’re very comfortable in seeing children and making those decisions about which children can be managed at home. • “The primary care provider almost always has someone available on call after hours to help direct which patient needs to be seen immediately.” — Jenilee Foster, urgent care regional lead provider, WellNow Urgent Care, with locations in Rochester and throughout Upstate New York: • “For your run-of-the-mill cold, cough, congestion, sprain, sutures, they can come to urgent care. • “For higher acuity symptoms like chest pain, stroke, heart attack, go to the ER. That doesn’t mean we can’t stabilize them, but the ER has the capability to do more in-depth testing. • “If they’re not sure if it’s life-threatening, we’re happy to help them whether to treat or refer them to primary care or the ER. We’d rather see them than have them sit at home and let someone worry. We can try to determine if it’s life threatening versus non-life threatening. Urgent care is quick, convenient care. We want to be able to give back to our communities. • “If someone’s out of town and they’re at their kid’s house for a week and they forgot their blood pressure medication, we can fill that gap. We can accommodate people with whatever they need: IV hydration, sutures, and things to keep people out of the emergency room. I had an ER doctor tell me that we see 70 patients a day that aren’t in their hospital. We can handle the strep, stitches and other patients in a more timely manner so they can see the acute patients. • “We’re open seven days a week. We have a few clinics with extended hours.
years suggests that the U.S. continues to defy global trends as one of the only developed countries with a rising maternal mortality rate. “The increasing maternal health costs burdening families over time is concerning. Research tells us that out-of-pocket costs for healthcare are often associated with skipped care,” Moniz says. “These financial burdens put women at risk of delaying or missing maternity care, which we know can lead to poor outcomes for women and babies. Restricting patient spending for maternity care may be an important opportunity to improve maternal and neonatal health for American families.” Higher deductible plans and copays, along with possible misconceptions about what the ACA requires for maternity health care coverage, may be areas advocates and lawmakers could target for improvement, Moniz says. “There is strong rationale for policymakers to consider policies to protect the average consumer,” Moniz says. “Maternity and childbirth care are essential health services that promote the well-being of families across our country. Reducing patients’ costs for these high-value services makes sense. We all want babies to have the best possible start in life.”
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Things You Need to Know About SAD
Seasonal affective disorder affects people every year during winter By Ernst Lamothe Jr.
S
easonal change can be a nice change of scenery but the longterm effects are not always pleasing to everyone. Seasonal affective disorder (SAD), which typically occurs during the winter, is a mood disorder characterized by depression. Mostly caused when there is less sunlight and the weather is colder, it can have a crippling and overwhelming sensation in the lives of affected people. “This definitely affects a distinct group of people, but the good thing is that it can be treated,” said physician Steven Dubovsky, chairman of the department of psychiatry at the University at Buffalo. He is also an attending psychiatrist at ECMC’s Behavioral Health Center. Dubovsky talks about five important facts to seasonal affective disorder.
1.
Seasonal Change
Effects of SAD is directly related to the weather, specifically wintertime when we experiment frigid temperatures and cloudy, shorter days. The condition affects people living in northern states. For example, 1% of those who live in Florida and 9% of those who live in New England or Alaska suffer from SAD, according to the National Institute of Mental Health. In some people with bipolar disorder, spring and summer can bring on symptoms of mania or a less intense form of mania, while fall and winter can be a time of depression.
“This can be especially tough for people who already suffer from lack of general energy or people who suffer from depression,” said Dubovsky.
2.
People who are affected
About half a million people in the United States suffer from winter SAD, while 10% to 20% may suffer from a milder form of winter blues, according to the Cleveland Clinic. Three-quarters of the sufferers are women, and the condition usually starts in early adulthood. SAD also can occur in children and adolescents. Older adults are less likely to experience SAD Medical experts and psychologists say less exposure to sunlight alters the internal biological clock that regulates mood, sleep and hormones. Exposure to light may reset the biological clock. Some of the symptoms include having low energy, hypersomnia, overeating, weight gain, craving carbohydrates and social withdrawal. Another theory is that brain chemicals such as serotonin, which transmit information between nerves, may be changed in people with SAD. It is believed that exposure to light can correct these imbalances. “People tend to feel like they want to sleep more, and they are not as motivated during the winter when they suffer from SAD,” he added. “This is really difficult because this is not just something in their imagination. Research has shown that the amount of light you get to your brain
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through your eyes can affect you.”
3.
It is not the holiday blues
Another theory is SAD occurs because of sadness around the holidays. That has been found to be untrue. “The peak season for the depression in the northern hemisphere has more to do with the days being shorter but on the other side the southern hemisphere the peak incidents in places like Australia are in the middle of the summer. It has nothing to do with Christmas or the holidays,” added Dubovsky.
4.
Coping strategies
People who seek help for SAD typically receive counseling as they normally would with a depressive disorder. Not only can counseling help, but the patient has to be willing to want the change. In addition, light therapy is a way to treat seasonal affective disorder and certain other conditions by exposure to artificial light. During light therapy, a person sits or works near a device called a light therapy box. The box gives off bright light that mimics natural outdoor light. Light therapy is thought to affect brain chemicals linked to mood and sleep, easing SAD symptoms. Using a light therapy box may also help with other types of depression, sleep disorders and other conditions. “Light therapy can start working within three days. Those bright
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lights do help offset depression,” said Dubovsky. “You can get a machine that cost around $200 which is worth your mental health. But you need to make sure the light is bright and has some intensity because a regular lamp or simply a brightly lit room won’t work.”
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“sunshine” vitamin because our body absorbs vitamin D primarily through sun exposure. It’s also called the sunshine vitamin because some studies suggest vitamin D can ease the symptoms of seasonal adjustment disorder (SAD), a form of depression that occurs at the same time each year, usually in the shorter, darker days of winter. According to researcher Peter Horvath of the University at Buffalo, many people have insufficient or deficient amounts of vitamin D during Upstate’s winter months, which over time, may result in a variety of health issues, including cognitive impairment. Maintaining proper levels is crucial to overall good health and can be accomplished by taking vitamin D supplements, increasing sun exposure, and eating foods that contain vitamin D or are fortified with vitamin D, such as oily fish, eggs, soy milk, and enriched cereals, milk and orange juice.
Eat endorphin-releasing foods
Foods to Boost Your Mood What you eat matters for every aspect of your health —including your mental health. Find out what types of food can help you fight the winter blues By Anne Palumbo
C
ome February, many of us slump into a winter funk. We’re worn down by the weather; we’re overwhelmed with post-holiday bills; and we’re angry with ourselves for already breaking our New Year’s resolutions. Tack on cabin fever and it’s no wonder we find ourselves parked in front of the TV with an open bag of chips. But chips — highly processed, refined-carb chips — are precisely the kinds of foods we should not be eating if we’re feeling blue. Growing evidence shows that getting the right nutrients — as well as implementing some basic nutrition strategies — can improve moods, tame stress, ease anxiety and even help fight depression. What are these nutrients and nutrition strategies? Though research regarding dietary factors and mental health is still inconclusive, there have been strong hints, according to leading experts, that certain foods may play a significant role in our mental well-being. For example, a recent study conducted at Loma Linda University and published in the “International Journal of Food Sciences and Nutrition” revealed that adults who consumed more junk food were more likely to report symptoms of psychological distress than their peers who consumed a healthier diet. Physician Jim E. Banta, lead author of the study, said that the results are similar to studies conductPage 12
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ed in other countries that have found a link between depression and the consumption of foods that have been fried or contain high amounts of sugar and processed grains. Research using data from large observations studies — like the Nurses’ Health Study and the Women’s Health Initiative — has also found links between food and mood. A study published in the American Journal of Clinical Nutrition found that women who ate more vitamin D-rich foods had a lower risk of depression than those who got less vitamin D in their diets. One diet in particular, however, repeatedly garners more than just hints of playing a role in depression: the Mediterranean diet. According to Patricia Chocano-Bedoya, a visiting scientist who participated in nutrition research at the Harvard T.H. Chan School of Public Health, “There is consistent evidence for a Mediterranean-style dietary pattern and lower risk of depression.” What you eat matters for every aspect of your health, including your mental health. On that note, let’s take a look at some well-founded suggestions for ways we might boost our mood with food.
Work more omega-3 fatty acids into your meals Omega-3s, a major building block of the brain, play an important role in sharpening memory
and improving mood. Because depression appears less common in nations where people consume large amounts of fish, scientists have zeroed in on this healthy fatty acid that is able to (1) interact with mood-related molecules inside the brain, (2) help promote the production of serotonin — the “feel-good” brain chemical, and (3) provide anti-inflammatory actions that may help relieve depression. Foods with the highest amount of omega-3s include oily fish (such as mackerel, salmon, sardines, tuna and herring), flax seeds, chia seeds, walnuts and soybeans.
Boost your serotonin levels An important neurotransmitter, serotonin communicates “happy” messages to your brain. Basically, the more serotonin circulating in your bloodstream, the better your mood. But higher blood serotonin levels — which can result from eating foods rich in the amino acid tryptophan — is but a piece of the feel-good puzzle. Tryptophan must cross into the brain to help serotonin work its magic, a crossing that is greatly facilitated by the consumption of carbohydrates. While any carb will do, experts recommend smart carbs, like whole grains, fruits, vegetables and legumes for their additional health benefits. Foods rich in tryptophan include poultry, eggs, oily fish, tofu, cheese, seeds and nuts. Also, too little folic acid in our diets can cause lower levels of serotonin in our brains. Some experts suggest that eating folate-rich foods — like asparagus, spinach, beans and lentils — may help some people who suffer from depression.
Get enough vitamin D Vitamin D is known as the
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
Naturally produced by the nervous system, endorphins are chemicals that act as a pain reliever and happiness booster. The wellknown “runner’s high,” for example, is due to an increase in endorphin levels after vigorous exercise. Certain foods can also boost endorphin levels. Although no food products contain whole endorphins for easy consumption, several foods contain high levels of the nutrients needed for boosting your brain’s endorphin production and encouraging its release. Chocolate-lovers, are you sitting down? Dark chocolate, with at least 70% cocoa solids, tops the list! Experts say it could be because of the antioxidants found in dark chocolate. Me? I’ll go with taste! Other foods that may influence the release of this “happy hormone” include strawberries, oranges, nuts, seeds, and anything spicy.
Move to a Mediterranean diet A lifestyle rather than merely a diet, the Mediterranean diet is associated with getting regular exercise, eating with family and friends, and practicing a balanced, healthy eating pattern that includes most, if not all, of the nutrients linked to easing or preventing depression. It’s also the diet that for the third year in a row has been named the best diet overall in the U.S. News & World Report annual rankings. The foundation of the diet is plant-based, not meat-based, and is built around daily consumption of vegetables, fruits, whole grains, and healthy fats (i.e., olive oil, nuts); weekly intake of fish, poultry, beans and eggs; moderate portions of dairy products; and limited intake of red meat. Red wine, in moderation, is also part of this highly recommended diet. As we all know, improving our mood by eating certain foods won’t happen overnight. But by moving away from junk food and toward foods that research has linked to better mental health, perhaps we stand a better chance of waking up on the right side of the bed! Anne Palumbo is the author of SmartBites column, published in this newspaper every issue.
SmartBites
Helpful tips:
By Anne Palumbo
The skinny on healthy eating
Why You Should Give Tofu a Chance O h, tofu. Poor, misunderstood tofu. It gets such a bad rap. Too mushy, too bland, too unknown. I used to be in that “not-for-me” camp, but all that ended when three important things happened: I cut down on my meat consumption; I discovered how to cook with tofu; and I realized how nutritious it was. What exactly is tofu? Tofu is condensed soymilk that has been curdled and pressed into blocks (much like cheese). And why should we be eating it? Environmental reasons notwithstanding — it only takes about 200 gallons of water to produce one gallon of soymilk versus the 1800 gallons it takes to produce one pound of beef — tofu is a nutritional powerhouse. Tofu is an excellent “complete” plant protein source, with an average serving of firm tofu providing about 10 grams. While most Americans get plenty of protein, certain groups — such as dieters restricting calories, the elderly and people with cancer — may have trouble eating as much
of this vital nutrient as they need. Over time, a lack of protein can cause swelling, fatigue, a loss of muscle mass, dry skin and hair and mood changes. This versatile food also packs a solid amount of calcium, an essential mineral that contributes to healthy bones. Although the amount of calcium varies between tofu types and brands, an average serving can deliver between 10-20% of our daily needs. Unlike protein, most Americans don’t get enough calcium in their diets. When this happens, children may not reach their full height potential and adults may have low bone mass, which is a risk factor for osteoporosis. Tofu is remarkably high in manganese, a vital mineral that plays an important role in many bodily functions, including the metabolism of glucose, carbohydrates and cholesterol, the formation of bones, the clotting of blood and the reduction of inflammation. Some research suggests that manganese, when combined with calcium, may act as a natural remedy for easing PMS
symptoms. And for people with diabetes, manganese may help lower blood sugar levels. Isoflavones — a type of plant estrogen that is similar in function to human estrogen but with much weaker effects — are abundant in tofu. At one point, isoflavones were thought to increase the risk of breast cancer, but recent studies have suggested the opposite. In fact, the Shanghai Women’s Health Study revealed that Asian women who ate the most soy had a 59% lower risk of premenopausal breast cancer compared with those who ate the least amount. But that’s but one study; more research is needed. A few more reasons to give tofu a chance? It’s super low in fat, sodium and cholesterol, and fairly low in calories: only 90 per half cup!
Turkish-Spiced Baked Tofu 1 block extra-firm tofu, pressed and drained 2 tablespoons extra-virgin olive oil 1 teaspoon each: coriander, cumin, paprika, garlic powder, dried thyme 1/2 teaspoon each: turmeric, Kosher salt 1/4 teaspoon coarse black pepper 1/8 teaspoon cinnamon Garnishes: pickled onions, shredded carrots, cilantro
Read tofu nutrition labels carefully as the nutrition differences between silken and firm tofu are pretty big. Once opened, any unused tofu may be stored in plain tap water for up to 10 days. Just make sure the water is clear when ready to use; if cloudy, discard tofu. slabs side by side on top of the paper towels, cover with another layer of paper towels, place a cutting board on top, and stack something heavy on the cutting board. Let tofu drain for at least 20-30 minutes. Cut tofu slabs into cubes about 3/4-inch thick. Add cubes to large mixing bowl, drizzle with olive oil, and toss gently to coat. Combine all seasonings in a small bowl, sprinkle over cubes, and toss gently again until the tofu is evenly coated. Turn seasoned tofu out onto a parchment-covered baking sheet, and arrange tofu in an even layer (not overlapping). Bake for 15 minutes. Then remove from oven, and flip the cubes for even cooking. Return to oven for 15 more minutes, or until the tofu reaches your desired level of crispiness. Garnish with topping of choice.
Anne Palumbo is a lifestyle
columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorieconscious dishes. She is hungry for your questions about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
Preheat oven to 400 degrees. To press and drain tofu: slice block into 4 horizontal slabs, lay some paper towels on a baking sheet, place the
Meet Your Provider
Grasta’s Beauty and Wig Studio Store carries the largest collection of wigs in Western New York. It serves cancer patients and those with hair loss Q: When and why did you open Grastas Beauty and Wig Studio? A: From 1942 to 1984 my mother Lucille K. Russo owned the LuRue’s Beauty Shop in Rochester. At the age of 14 I was helping my mom. I strived and managed to open my own business in 1973 in another Rochester neighborhood. I worked very hard and walked many blocks and handed papers at everyone’s door telling them about Grasta’s Beauty & Wig Studio. I followed up with many phone calls and invites until I was able to generate a new and loyal clientele. There is much pride between my mother and I in our accomplishments in the field of cosmetology. I was mentored by her and the daughter of a wig supplier. After 13 years I opened a second location in 1985 at 409 Parma Center Road and closed the first one in 2017. I’ve also been able to help many people who are shut-ins or cancer patients. When a client walks out of
Grasta’s Beauty and Wig Studio they will be proud to be wearing a Grasta wig, and no one will ever notice they are wearing a wig!
wigs. Everything is done on a oneon-one basis. No walk-ins allowed to ensure privacy and making clients feel beautiful inside and out.
Q: Do you serve a specific clientele? A: We serve any and all clientele. Whether you’re experiencing hair loss or you’re a cancer patient or someone had a tragic accident — everyone deserves the respect and confidential treatment that only a private appointment can accomplish. The wig shop is open by individual appointment only to ensure a personalized experience every time.
Q: Would health insurance cover any of the costs associated with the wigs or hairpieces? A: Yes, we do accept insurance. Contact your insurance company to see if and how much would be covered, and if prior approval is required.
Q: What are your specialties? A: We have the largest collection of wigs in Western New York. From human hair to synthetics and blends — and don’t forget accessories. We specialize in wig and hairpieces. There’s a wide variety of custom wigs to choose from, including my own line, European wigs, and Remy
Q: How long does it take for a custom wig to be made? A: Usually it takes approximately eight to10 weeks. However, we can do a rush order, if needed, and have the wig as soon as six to eight weeks with additional charge. Q: What is your return policy? A: Once the wig is purchased and you walk out the door there are no retuns. Unfortunately, all sales are final.
Sharon Grasta: “I do this with my whole heart and soul. I just love this work and it is my life. It’s my calling.” Q: Is there any financial assistance for veterans? A: Yes! Ask me about this. You pay first and the form I supply to you gets turned in to Champ VA Benefits for a one-time reimbursement for retirees and spouse. For more information Email: Shargrasta@yahoo.com
409 Parma Center Rd, Hilton • 585-392-7823 • www.GrastaBeautyAndWigStudio.com
Monday thru Friday by appointment only. No walk-ins! February 2020 •
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Heart Month
Can You Actually Die from a ‘Broken Heart’? By Katie Coleman
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ebruary is American Heart Month and a good time to consider your heart health, both physical and emotional. Traumatic life events, stress and grief can affect the human body in so many ways — such as sleep problems, fatigue, inflammation and weakened immunity — but in extreme instances of physical or emotional stress, our hearts can temporarily “break.” The condition is called Takotsubo cardiomyopathy, also known as broken heart syndrome or stress cardiomyopathy, and was first described in Japan in 1990. Together, Takotsubo means octopus trap in Japanese and was coined to describe the shape of the heart’s left ventricle when present with the condition. Although not fully understood, some experts think the flood of hormones produced during a stressful situation, is what affects the
heart. It can happen when people or pets die, during medical treatments, after a job loss or other overwhelming stressors. Mohan Madhusudanan is a cardiology specialist at Trinity Medical WNY in Buffalo who has treated a handful of patients with broken heart syndrome. “One of my patients was very close with her sister and the sister passed away. She came in with shortness of breath and chest pain, and I thought she was having a heart attack. We did everything for her and found no blockages. That’s when we realized this could be broken heart syndrome,” Madhusudanan said. When someone’s heart “breaks,” the left ventricle, which is the heart’s main pumping chamber, weakens or balloons and stresses the heart. It’s a condition that is usually temporary and complications mimic those of a heart attack (without any clogging of
the arteries), causing chest pain and shortness of breath. “Patients may have low heart function and it may not be normal. They may be in heart failure, so we tend to provide the treatment based on what’s needed at that time,” Madhusudanan said. “It’s something you can easily miss if you’re not paying attention. In medical literature, we say this is a diagnosis exclusion: You have to exclude other findings before you can say it’s broken heart syndrome,” Madhusudanan said.
More research needed
“A lot more research needs to happen. It’s very hard to diagnose. If you take all the people who present with heart attack symptoms, only 1% to 2% have it and you can easily miss it if you don’t pay attention or follow up,” Madhusudanan said. The New England Journal of Medicine published a study in 2015 in which 1,750 patients with Takotsu-
bo cardiomyopathy were studied. Of those patients, 89.8% were women at an average age of 66. Physical triggers were more common than emotional triggers. “It predominately affects elderly women and is often preceded by an emotional or physical trigger, but the condition has also been reported with no evident trigger,” the study stated. There are certain exams and tests to rule out a heart attack and determine if someone has broken heart syndrome: an electrocardiogram, which measures the heart’s electrical activity; an echocardiogram, which produces an image of the heart; and a coronary angiogram, which gives doctors a detailed look at patients’ blood vessels. Because symptoms do mimic that of a heart attack, if you suspect you have broken heart syndrome, you should call 911.
on-screen time and be aware that spending time doing that is sedentary. Sitting too much is not good for heart health.” Lose excess weight. “A lot of us need to lose weight,” said Curtis. “That’s a longer-term goal. Try to find the right methods. Sometimes the big resolutions, some can do but most can’t. Small changes, like what you eat for breakfast, how you snack during the day and being cognizant of calories. I don’t think too many people will be successful if they don’t incorporate both diet and exercise into their regimen.” Stay social. “People with a significant other, friends and social network all do better than people who don’t,” Curtis said. “If we’re too focused on connecting with people online, it hurts. Make more connections through work, social activities through volunteering. That all helps.” Imbibe only in moderation. “We all like a glass of wine or beer, but be aware you don’t do it to excess,” Curtis said. “Probably one glass of red wine a day doesn’t hurt, but I don’t think it helps. I think those who avoid it all together, it’s beneficial.”
LOVE YOUR HEART 10 Things to Improve 6. Heart Health By Deborah Jeanne Sergeant
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he American Heart Association lists three major risks for heart disease that you can’t alter: increasing age, gender (men have greater risk than women and tend to have attacks earlier in life), and heredity (those with heart disease in their family or who are of black, Mexican, American Indian, native Hawaiian and some Asian descent). While these can’t change, you can mitigate your risk with lifestyle. Here are 10 tips from local health providers: Manage stress “Try to de-stress and take the pressure off of your body with things like yoga and tai chi. That is important for heart health,” said Lucy Connery, health promotion specialist at Wellness Institute of Greater Buffalo, who is completing a Master in Public Health degree at Daemen College. Get fit. “The Surgeon General’s recommendation for adults is five days a week, accumulating 30 minutes a day of moderate physical activity,” said Phil Haberstro, executive director of the Wellness Institute of Greater Buffalo. “Some research says seven to eight-minute sessions can have benefit, but you have to accumulate 30 minutes. If you want to be more physically fit, be active three days a week with higher intensity.”
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3.Avoid tobacco.
“In all my years as a cardiologist, if you see someone who is under 50 and they have coronary artery disease, if they’re not diabetic, they’re a smoker,” said physician Anne B. Curtis, chairwoman of medicine at University at Buffalo and president of UBMD Internal Medicine. “The bad effects start to go away pretty quickly once they quit.” Eat right. “Drink more herbal teas,” said Barb Sylvester, clinical dietitian and certified diabetes educator with Kaleida Health’s Nutrition & Wellness Center. “They’re very underestimated. We should take more advantage of cooking at home and getting better quality food.” “Follow a plant-based diet, but not necessarily vegetarian,” said Mary Jo Parker, registered dietitian with Nutrition and Counseling Services in Buffalo. “A diet that is rich in fruits, vegetables, whole grains with naturally occurring fiber, limited intake of added sugars and low intake of processed foods. Processed foods are much higher in sodium, which can increase risk of hypertension and heart disease. Use the plate idea, where half the plate is produce, primarily vegetables, 1/4 of the plate being a lean protein — preferably a couple times a week have a vegetable source of protein like beans or tofu — and 1/4 of the plate, have a healthful
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starch. That’s heart healthy way to eat. Keep the amount of sodium in check.” “When choosing a healthy oil, choose non-tropical oils like canola or olive oils,” said Danielle Meyer, a registered dietitian who teaches in UB’s School of Public Health and Health Professions. “Canola and olive oils are very popular and generally more affordable than other specialty healthy oils, such as avocado or walnut oils. Tropical oils, like palm or coconut oil, should be avoided; they tend to be very high in saturated fat. Foods high in saturated and trans fats should be very limited or avoided all together. Limiting saturated fat to 13 grams per day is a general recommendation. Look for the term ‘partially hydrogenated oil’ or ‘hydrogenated oil.’” Exercise. “It has pretty immediate benefits,” Curtis, the president of UBMD Internal Medicine, said. “It helps to lower blood pressure, it gives better physical capacity and many studies show the more physically fit you are, the better your health outcomes long term. It can take all shapes and sizes. Almost everyone can find some way to fit exercise in their day. Be mindful of the activity you’re doing in the day. Or use the buddy system to meet up and do something. Overall, watch your
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
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9.Control health conditions.
“How well you control, diabetes, cholesterol and other metabolic conditions affects heart health,” said physician Linda M. Harris, professor of surgery, program director of Vascular Surgery Residency & Fellowship at Jacobs School of Medicine and Biomedical Sciences at UB. “There are some people who are amazing with exercise and eating right but it’s in their genetics to have high cholesterol. For some it is diet, and for others, it’s a genetic issue and they need to take medications.” Monitor your health. “You should have regular checkups with your primary care doctor,” Harris said.
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TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.
Partner with Your Provider To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.
Be Heart Smart A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure
New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com
Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.
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WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015
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Heart Month
‘Heart Healthy’: Is It Hype or Helpful? Many products have big labels proclaiming they are ‘heart healthy’ — but are they? By Deborah Jeanne Sergeant “Heart Healthy” — you’ve seen it on products from breakfast cereal to snack foods. Many products proclaim this status with a bright, red heart on the package to drive the message home. But is that claim accurate or just clever marketing to push consumers to buy certain brands? “Make sure you read the label for what it is,” said physician Anne B. Curtis, chairwoman of medicine at University at Buffalo and president of UBMD Internal Medicine. “They’ll be things like cookies that say ‘fat free’ or ‘low fat’ and you assume it’s better for you. But they put in a lot more sugar. It’s no more healthier for you. ‘Heart healthy’ on labels isn’t regulated.” Instead of relying upon messages on the front of the label, Lucy Connery, health promotion specialist at Wellness Institute of Greater Buffalo who is completing a Master in Public Health degree at Daemen College, wants people to look at the back of the package. “A lot of it comes down to knowing the nutritional facts,” Connery
said. “It’s about balance and moderation.” Food manufacturers and processors can’t legally make wild claims about the benefits of their foods. Mary Jo Parker, registered dietitian with Nutrition and Counseling Services in Buffalo, said that a few approved health claims are allowed on food labels, such as the health claim for saturated fat and cholesterol and the risk of coronary heart disease and the one for soluble fiber from fruits and vegetables and whole grains. “Studies have shown that people who have a diet higher in soluble fiber from those sources have a lower risk of coronary heart disease,” Parker said. She added that any claims made on packages must be backed up the nutrition facts panel, for example, something that’s “low in saturated fat” must contain 1 gram or less. Or if it’s “reduced fat” it must contain at least 25% less fat than the regular version. Anything labeled “saturated fat free” must contain less than half a gram of saturated fat; however, all of these types of claims doesn’t mean
it’s a healthful food. “What you do see is substitutes like palm or coconut or palm kernel oil for hydrogenated fats,” Parker said. “Technically it’s a step above trans fats, but in terms of heart healthier, not necessarily. The tropical oil is highly saturated. Coconut oil is more saturated than lard.” She warns patients to not fall into the trap of thinking “natural” or other vague terms mean that it’s healthful. Although some ingredient upgrades may offer improvements, “it doesn’t necessarily mean it’s a heart healthy product,” Parker said. “Saying something is ‘natural’ or ‘uses pure ingredients’ are murky claims,” Parker added. Danielle Meyer, a registered dietitian and professor at University at Buffalo’s School of Public Health and Health Professions, said that claims such as “100% whole grains,” “high fiber,” “reduced sodium,” “no trans fat,” and “no sugar added” can help people find healthful foods in a grocery store; however, “be wary of ‘fat free’ or ‘sugar free’ claims,” Meyer warned. “Oftentimes when you remove fat or sugar from a product during processing, something needs to be added back in,” Meyer said. “Generally, if you remove fat there may be more added sugar and if you remove sugar from a product, you may find it is higher in fat than the ‘regular’ version.” In general, sticking with whole, plant-based foods like fruits, vegetables, nuts and legumes to support heart health and avoiding processed carbohydrates and items high in saturated fat, sodium and added sugars can help improve the diet to support
New Minimum Purchase Age for Tobacco Expected to Reduce Youth Use By Deborah Jeanne Sergeant
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ccess to tobacco just became more difficult for youth. New York increased its minimum purchase age for buying tobacco from 18 to 21 in November. President Trump signed into law a new nationwide minimum age of 21 as part of an amendment to the Federal Food, Drug, and Cosmetic Act, beginning Jan. 1. The law includes cigars, cigarettes and e-cigarettes. The increased minimum age should offer a number of benefits, according to area experts. “Keeping it out of the hands of younger patients is definitely important for their health,” said physician Kathy Grisanti, president and owner of Pediatric Urgent Care in Buffalo. “There certainly will be children who will get their hands on it no matter what the age, but it will deter some young adults.” Many 18-year-olds still attend high school and therefore have lots of exposure to younger teens. Since many young adults leave home around age 21, those who smoke take their tobacco habit with them — away from younger siblings and their visiting friends. According to Campaign for Page 16
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Tobacco-Free Kids, about 95% of adult smokers begin before they turn 21 and 80% start before age 18. Those statistics mirror electronic cigarettes, commonly called e-cigs, vapes, or JUULs. (JUUL is a popular brand name.) The numbers speak to the ease at which teens can become addicted to nicotine. “Forty to seventy-five percent of underage youth say that got their tobacco from a social source,” said Deborah Ossip, leader of the University of Rochester Medical Center smoking research program. “If you’re underage, you’re likely to know someone who can get it. Raising the age to 21 is an evidence-based approach and making flavors less available are very positive movements,” she said. The Institute of Medicine reported in 2015 that increasing the tobacco sale age to 21 would reduce smoking by 12%; reduce smoking related deaths by 10%; cause 223,000 fewer premature deaths and 50,000 fewer lung cancer deaths; and prevent 4.2 million years of life lost because of tobacco use. “E-cigarette smoking patterns have replaced cigarette smoking and
we have no reason to believe the effects wouldn’t be the same,” Ossip said. Ossip views the raised minimum age as complementary to the FDA crackdown on mint and fruit flavored vaping liquids which research shows particularly attract youth. The 2019 National Youth Tobacco Survey indicates that more than 5 million U.S. middle and high school students are current e-cigarette users. Most of these say they usually use cartridge products. “Making these products less attractive at the same time the law makes it less available is a good combination for reducing the number of teens who will start using,” Ossip
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
heart health. Whole foods high in fiber are good for heart health. “The big problem with a lot of the packaged foods is fiber,” said Barb Sylvester, clinical dietitian and certified diabetes education with Kaleida Health’s Nutrition & Wellness Center. “It’s hard to get a lot of fiber in processed foods. Anything more than 3 grams per serving is good and 25 to 30 grams of fiber per day is ideal. “Many providers say, ‘Eat more whole grains’ and they buy a bran muffin instead of a chocolate chip muffin and they’re both about the same, just 2 or 3 grams more, but with all the sugar, it’s not that much better. Or people buy whole grain pasta and they end up eating more because they’re not as concerned about portion so they eat more carbs which turn to sugar.” Sylvester stresses portion control and shopping the outer perimeter of the store, where typically fewer processed items are stocked. Connery suggested looking for lean sources of meat. “Have fish and chicken rather than so much red meat,” Connery said. “It’s about moderation. Maybe have a turkey burger sometimes. Venison and some local beef aren’t so high in fat. Look for the percent of fat in the ground beef, for example. A moderate amount of naturally occurring fat found in nuts, seeds, olive oil and fatty fishes can promote heart health. Along with diet, other lifestyle factors contribute to heart health. Anyone concerned about heart health should discuss the topic with a healthcare provider.
said. Enforcing a national minimum age prevents youth from traveling to neighboring states with lower minimum ages to acquire tobacco products. The only caveat Ossip sees is the possibility of young people equating tobacco use as an adult activity on the same level as alcohol use, which has the same minimum purchase age. Ossip doesn’t want teens to look at tobacco use as a similar rite of passage. She believes that a carefully phrased message against tobacco use can help teens understand that the habit is harmful for the health on many levels. Enforcement of the law will go a long way towards reducing underage smoking; however, education will take it further. “I’d love to say it will have an effect, but people manage to get around it,” said physician Linda M. Harris, professor of surgery and program director of Vascular Surgery Residency & Fellowship at University at Buffalo. “People still drink even though they’re not 21. We’re working on educational efforts for high school kids to show them that smoking raises risks of things like amputations, plus lung cancer and emphysema. For people who quit, within 20 hours, blood pressure improves. In two weeks, circulation improves, within six weeks, cough improves, within a year, risk of heart disease is half as high. They won’t go back to normal, but they can massively improve.”
Golden Years ‘I have had several parents and in-laws reside in five local nursing homes. While most facilities are to be praised for their care and compassion, others are understaffed and employee disinterest is painfully obvious.’
Home Away From Home How to make a nursing facility a special place for loved ones By Catherine Miller
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’ve hit that stage in my life when I talk to friends about the quality of nursing homes for our parents the way we used to talk about nursery schools for our kids. Getting proper care for loved ones in nursing facilities is not always easy. I know. I have had several parents and in-laws reside in five local nursing homes. While most facilities are to be praised for their care and compassion, others are understaffed and employee disinterest is painfully obvious. My family learned quickly how to get the best care at each facility and make it feel like home for our loved ones.
Be present The more often you are there, the more comfortable your loved one will be. This lets your loved one know you are still involved in their life and gives you a chance to assess their care. Look around the room. Is it clean? Is the nurses’ call button within reach? Are there photos of family to make it feel more familiar? Is there something you would need if you were there? Regular visits help you to keep on top of small issues and help
your loved one feel connected to you in their new surroundings.
Get them Involved Every facility has recreational activities. My mother-in-law would play “tennis” (balloons and badminton rackets were used), work on art projects, and go for a weekly manicure. She interacted with the other residents and staff members on a social basis. This helped to make the facility feel more like a community. My father recently told us he won at the horse races while at his nursing home. We assumed it was his dementia acting up until one of the aides congratulated him on doing so well at the “track” (virtual horse racing played using videos of old races, she explained). Ask the aides to put your family member on the list to be taken to the activities they would enjoy.
Know the numbers Ask the staff how much of their meal your loved one ate that day? Are they properly hydrated? If your family member is diabetic, ask what their last glucose levels were. If there is a heart issue, ask about their blood
pressure. At one facility, I found my stepfather sitting in his room, slumped in his wheelchair. The nurse’s button was not within reach, his glasses were in the bathroom and he had no access to water. Being diabetic, it was imperative for him to have proper fluid intake. When questioned, the nurse told me he was overdue to have a glucose reading. I waited while they checked his levels, which were elevated. After a lengthy discussion with the lead nurse, there were no future issues. Asking questions regarding care informs the staff that you are holding them accountable and tends to keep the staff more attentive.
Appreciate the staff My father tends to be “difficult” at times. It took him a while to adjust to his facility. Dementia had set in but he wanted to be home. He took much of his frustration out on the staff verbally. I thanked each of his aides and nurses each time I saw them. Their job is difficult and with new residents come fresh challenges. The kindness you show to the staff gets reworked
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into their attitudes, and shown back to your family member. You’ll never know how appreciated a tray of cookies will be until you offer one up to the nursing staff. It was a cold January night when we got the call that my mother-inlaw had passed away in her sleep a short time after my father-in-law had left for the night. She was frail and it was certainly her time. As my husband and I got to the facility, an aide who was a regular face in our mom’s room met us at the locked door. She had been waiting for us to arrive. She held the door open for us and we could see she had been crying. As we reached our mom’s room, I noticed that her hair had been recently brushed and her blankets were neatly tucked around her. The staff had taken a moment to make sure mom looked peaceful and presentable. The employees at this facility had watched over her care to the very end. That meant everything to our family, and is the standard that every nursing home facility should strive for.
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Ask The Social Golden Years Security Office
From the Social Security District Office
Beware of Social Security Scams
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cammers go to great lengths to trick you out of your personal information. We want to help you protect your information by helping you recognize a Social Security imposter. There’s a widespread telephone scam involving callers claiming they’re from Social Security. The caller ID may even show a government number. These callers may tell you there’s a problem with your Social Security number. They may also threaten to arrest you unless you pay a fine or fee using gift cards, pre-paid debit cards, a wire transfer or cash. That call is not from us. If you receive a suspicious call from someone alleging to be from Social Security, please: • Hang up right away. • Never give your personal information, money or retail gift cards. • Report the scam at oig.ssa. gov/ to Social Security’s law enforcement team at the Office of the Inspector General.
Social Security will not: • Threaten you. • Tell you that your Social Security Number has been suspended. • Call you to demand an immediate payment. • Ask you for credit or debit card numbers over the phone. • Require a specific means of debt repayment, like a prepaid debit card, a retail gift card, or cash. • Demand that you pay a Social Security debt without the ability to appeal the amount you owe. • Promise a Social Security benefit approval, or increase, in exchange for information or money. • Request personal or financial information through email, text messages, or social media.
Social Security will: • Sometimes call you to confirm you filed for a claim or to discuss other ongoing business you have with them. • Mail you a letter if there is a problem. • Mail you a letter if you need to submit payments that will have detailed information about options to make payments and the ability to appeal the decision. • Use emails, text messages, and social media to provide general information (not personal or financial information) on its programs and services if you have signed up to receive these messages. Please share this information with your family and friends. Page 18
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Sweet Sorrow
Selling family home does not have to be emotional roller-coaster ride
By Nancy Cardillo
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he sale of a childhood home can be an extremely emotional, time consuming and frustrating task. Even if you haven’t lived in the home for many years, chances are your emotions will get the better of you as you “say goodbye” to the many memories made in the house and face the daunting task of cleaning it out. If the sale is the result of a death, that can add to the trauma. If there are multiple decision makers involved, that can slow down the process and negatively affect the sale price, particularly if one or more decision makers live out of town. But selling the family homestead doesn’t have to be a negative experience. A written, step-by-step plan can save many headaches and help you achieve maximum value in the shortest period of time. When Bill Goodrich’s parents relocated from the family home in Tonawanda to an assisted living facility in Syracuse, Bill and his three siblings were tasked with cleaning out and selling the nine-room house their parents had lived in for nearly 60 years. Fortunately, Bill and his siblings share a very close relationship; however, Bill is the only sibling still living in Western New York. “Our parents kept the house updated, but it definitely needed freshening up and, of course, there was 60 years of ‘stuff’ to deal with,” says Goodrich. “We wanted to be sensitive to our parents but, at the same time, get a good price for the house and get through the process as quickly as possible.” Meeting Michael Olear, Associate Broker at MJ Peterson Real Estate/ The Olear Team, through their mutual church made all the difference for the Goodrich family. “Michael took on the task of guiding us through the process of preparing the house, dealing with the contents and selling the house,” says Goodrich. “He took the emotion out of it, brought a calming presence to the situation and handled
everything from start to finish. It was a huge relief to me, my siblings and, most of all, to our parents.” Olear’s Project Management Program is a “one-stop shopping” service whereby a minimal investment results in a sale price that is, on average, 19% higher than the “as is” value. The cost to the client is a onetime flat fee and any compensation to the insured, pre-screened contractors utilized for painting, repairs, estate sales, etc. “The main goal of this program is to get everyone through this process peacefully, efficiently and with the best value they can achieve,” says Olear, who has more than 30 years in the real estate business as well as a Masters degree in Social Work. “We realize this is one of the most difficult things our clients will ever have to do, so we assist them every step of the way, with the idea of taking as much of the burden off their shoulders as we can. It is, essentially, a blend of social work and real estate techniques,” he says. The Olear team develops and coordinates the implementation of a written plan to sell not only the house, but also its contents - at the highest value and in the most effective and efficient manner. Clients retain all decision making control over expenditures and bill paying. The Project Management Program utilizes a four-step approach including assessment of the property and the family’s needs; development of a plan with recommendations, associated costs and expected completion time for the estate sale, any impediments to financing and repairs that will maximize value; an analysis of the home’s value and correct pricing in the current market, and scheduling needed repairs and updates. “There is a process to making the sale go more smoothly and much more quickly,” says Olear. “For example, knowing what repairs and/ or updates must be made for code
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
compliance, should be made to avoid financing holdups or could be made to increase the value of the home – and when and how to do all this. “In terms of the contents, we recommend the family simply ‘thin out’ the house by boxing items and knick knacks and storing them, then sell the house and hold the estate sale while the closing process is taking place.” Says Olear. “The house will generally sell for more if it doesn’t look completely barren and with every imperfection showing.” “This concept is brilliant,” says Goodrich. “We were overwhelmed, and wondering how we would get through this with everyone scattered all over. Michael and his team did most of the legwork and kept us informed so we all stayed connected and involved and could make informed decisions together much more easily.” Attorney Jeffrey Katz’ law firm, Katz and Baehre, specializes in estate planning; elder law; trust planning and estate administration. “It’s very common when parents pass away or go into assisted living that their children have to deal with the house and everything in it,” says Katz. “This is a time when family members – who quite often are out of state – have to make very important decisions. They have to decide how much to invest in the house or to sell it as is. They have to handle disseminating all the possessions that have sentimental value. It can be overwhelming. “A realtor will typically help with the details surrounding the sale of the house, but having a local presence who can coordinate the entire project is a huge relief,” says Katz. “Programs like the Project Management Program help minimize the fuss and stress and maximize the value of the home. My clients are always grateful when I recommend this program.” Goodrich and his siblings were certainly grateful: based on Olear’s recommendations, they invested some money to beautify the house and increase its value, resulting in multiple offers and a shorter time on the market. “The care, compassion and attention to detail Michael and his team showed in selling Mom and Dad’s home of 60 years was amazing,” says Goodrich. “We could not have gone through this without them.”
Golden Years
‘Live the Best Life You Can’ In the twilight of her life, grandmother enjoying every moment By Jenna Schifferle
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itting across from me in a booth, my grandmother sips her coffee and nibbles on a doughnut bite. Her short white hair shoots out over her glasses, and laugh lines run across her cheeks. She dons a cheetah print blouse, several necklaces, and long, dangling earrings and grips a metallic blue cane that has a pink flamingo hanging on it. More often than not, she refuses to use the cane, telling her loved ones that she’s perfectly capable of walking on her own. In her 90 years of life, her stubbornness and sense of humor have never faltered. When I ask about her mother, she recites detailed accounts of inside jokes and describes moments of relentless strength. They had been best friends, and my grandmother helped her mother raise her three other daughters: Barbara, Jackie, and Mary. Grandma goes on to talk about her aunt, the life of the party, and recalls how her aunt used to do the jitter bug like a pro. At this, my grandmother raises her arms and starts bopping along to an imagined song in her mind. She talks about the countless tragedies that marked her childhood — the loss of her stepfather, the passing of her mother, and so it goes. Her eyes get teary. When I ask my grandmother about more recent memories like my childhood, she closes her eyes and rubs her nose. There’s silence for several moments before she starts to speak about my mother and her sisters; the details start to scramble. So, I share my stories, starting with grandfather, her husband, who had died nearly two decades ago. I remind her about our trips to the thrift shop on Sundays, when we picked out new treasures. I talk about the time my grandpa took us to meet our cousin Vinny for the first time, only to find out it was a hot-dog
stand on the river called Cousin Vinny’s Doghouse. She smiles, though it’s not clear whether she remembers or just enjoys the tale. I let her know that I get my backbone from her. She has been through struggles and losses and half the time — despite her best efforts — she can’t remember things. But she laughs more than anyone I’ve ever known, and whenever I see her, she finds joy in the world around her. Each time she talks about her tragedies, she quickly reminds me of her blessings. When she recounts the birth of her first daughter Belinda, she describes the joy that comes with holding a baby in the palm of her hands and the awe of knowing that two people could create such wonder. She pauses. Then, she laughs wholeheartedly, her shoulders flopping wildly.
Founding a Legacy
“If it hadn’t been for me, you wouldn’t be here. And Belinda’s kids wouldn’t be here, and their kids wouldn’t be here. All these little ones are here because of me!” she says, beaming. I join in her laughter, and soon we’re shaking. A minute later, she straightens up and starts again. “I’m 90; I’m getting older. But I’m going to make it to 100, or at very least, I’m going to try,” she says. I nod and ask her what her secret is. “I love life — the blue skies, the sounds, the lights, everything. I look up at the clouds and think: I see you today! I make the best of what I’ve got, day after day,” she added. She nods decisively and fishes around in the doughnut box before pulling out a maple one. As she munches, I ask her if she has any advice for my brother, sister and myself. For a moment, she thinks while
Want a Long, Healthy Old Age? A Healthy Middle Age Helps
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iddle-aged Americans who are exercising and eating right, give yourselves a pat on the back: Your efforts will pay off, new research shows. A study involving more than 110,000 people finds that a healthy lifestyle in middle age appeared to help folks live longer lives free of major diseases. Researchers at the Harvard T.H. Chan School of Public Health said that many prior studies have made the connection between healthy
living and reductions in a person’s odds for cancer, heart disease and other ills. However, “few studies have looked at the effects of lifestyle factors on life expectancy free from such diseases,” lead researcher Yanping Li, a senior research scientist in nutrition, said in a Harvard news release. To see if a healthier middle age could lead to a long, disease-free old age, Li and her team tracked health data on U.S. nurses and other health professionals, more than 73,000 wom-
Shirley Mozer, of Buffalo (formerly of Amherst) with her granddaughter, writer Jenna Schifferle. Photo provided. licking the sugar off her lips. “Live the best life you can, every day. Do your best. There’s no sense in hating or getting mad or throwing people away, because you only have one life. Enjoy every damn minute,” she says. When she says this, a calm rushes over me. She’s right. In the midst of my 9-to-6 job, marathon training, freelance work, and never-ending list of obligations, days feel like fractions of seconds. Often, I hold my head above water while my feet kick furiously beneath me. Perhaps it’s a trap of youth, but I let life rush by and
often miss the details. When we leave the coffee shop, I grab my grandmother’s hand and trace the wrinkles on her fingers, noting the way they weave up and down like a maze. As we step outside, I stare up at the sky through the darkness of night. When my eyes adjust, I see clouds through the glow of the moonlight and watch them drift, feeling a deep sense of appreciation for the woman beside me. In my heart, I know her words will stay with me long after she’s gone.
en and more than 38,000 men. Each participant was given a “healthy lifestyle score,” ranging from 0 to 5, with 5 indicating the healthiest lifestyle. The score was based on the person’s adherence to five low-risk lifestyle factors: never smoking, maintaining a healthy weight, getting at least 30 minutes of daily physical activity, moderate alcohol intake, and a having a good-quality diet. The participants were assessed regularly over a period of more than 20 years. The research team adjusted their results for factors such as the person’s age, ethnicity and family medical history. The study found that a woman aged 50 years of age could expect 24 more years of life that was free from cancer, heart disease and dia-
betes if she had none of the healthy lifestyle factors on that list of five. But that same woman could expect another decade of healthy life — 34 years — if she had four or five of those healthy factors, the researchers said. Among men, life expectancy free of any of the three major diseases was 24 years for those with no low-risk lifestyle factors and 31 years for those with four or five low-risk lifestyle factors. Men who smoked heavily (15 or more cigarettes a day) and obese men and women had the lowest rates (75% or less) of disease-free life expectancy at age 50, the study found. The study was published Jan. 8 in the BMJ.
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Golden Years
IRS Creates New Tax Form for Seniors By Jim Miller
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he Internal Revenue Service (IRS) has created a new federal income-tax form specifically designed for senior taxpayers, age 65 and older, that should make filing a little easier this year, particularly those who don’t file electronically. Here’s what you should know.
Form 1040-SR
America Woefully Unprepared to Deal with Its Aging Population By George Chapman
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he New York Times recently ran an article on the pending healthcare crisis facing the country as we age. There is no easy solution as several factors contribute, but it’s time to acknowledge and discuss the issue. Our birthrate is at a record low, continuing a steady decline since the 2008 recession. At the same time, 10,000 baby boomers are retiring every day and they are living longer. In 10 years — by 2030 — the population of the prime caregivers (in the 45-65 age bracket) will increase by just 1% a year, while the population of over 80 will increase by an astounding 80%. To compound the approaching dilemma, once you reach 85 your chances of developing Alzheimer’s is 14 times higher than when you’re 65 to 70. Most of the help received by the elderly, 83%, is provided by relatives or neighbors — without compensation — and two thirds of the caregivers are women. According to the National Institute on Retirement Security, the median savings of people in middle age is just $15,000. It is estimated that people over 65 withdrew $22 billion from their savings to cover for what Medicare doesn’t. And Medicare does not cover long term care. It is human nature to kick the can down the road, ignore reality and avoid uncomfortable debate. Pending crises aren’t really addressed until they are smack in front of us. 2030 is just around the corner. George Chapman is the author of Healthcare in a Minute column, published every issue in In Good Health.
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Created by the 2018 Bipartisan Budget Act, the new two-page simplified federal income tax form is called the 1040-SR. Similar in style to the old 1040-EZ form that the IRS discontinued last year, the new 1040SR has larger print and better color contrast that makes it easier to read. In addition, it also includes a chart to help older taxpayers calculate their standard deduction, which may help ensure that fewer seniors neglect to take the additional standard deduction that they are entitled to. For 2019, the additional deduction for those 65 or older or the blind is $1,300. The 1040-SR form also has specific lines for retirement income streams such as Social Security benefits, IRA distributions, pensions and annuities, along with earned income from work
wages and tips. And, it allows a child tax credit for seniors who are still taking care of a dependent child or grandchild. You can also report capital gains and losses, as well as interest and dividends on this new form. Any of the tax schedules available to those using the standard form 1040 may also be used with the 1040-SR. You should also know that the 1040-SR doesn’t put a limit on interest, dividends, or capital gains, nor does it cap overall income like the old 1040-EZ form did. But, if you have to itemize because of state and local taxes or charitable giving, then you will not be able to use the new Form 1040-SR.
Paper Filing Advantage
Seniors who use tax-preparation software to file their taxes will be able to generate a 1040-SR, but the new form will provide the most significant benefit to taxpayers who still fill out and file their returns on paper. Last year, about 88% of the 153 million individual federal tax returns filed to the IRS were filed electronically. About 5% were prepared using tax software, then printed out and mailed to the agency, while about 7 percent were prepared on paper.
To use the new 1040-SR tax form for the 2019 filing year, taxpayers, including both spouses if filing jointly, must be at least age 65 before Jan. 1, 2020. You also don’t have to be retired to use the form — older workers can use it too. But early retirees (younger than 65) cannot use 1040-SR. To see the 2019 new 1040-SR form, go to IRS.gov/pub/irs-pdf/ f1040s.pdf.
Tax Preparation Help
If you need help filing your tax returns this year, consider contacting the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit IRS. treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 4,800 sites nationwide. To locate an AARP Tax-Aide site call 888-2277669 or visit AARP.org/findtaxhelp. You don’t have to be an AARP member to use this service.
Food Assistance Programs Can Help Seniors in Need Less than 40% of those eligible take advantage of some benefits to which they are entitled By Jim Miller
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illions of older Americans struggle with food costs — according to a recent study by Feeding America, 5.5 million U.S. seniors age 60 and older are food insecure. Fortunately, there are several programs that may be able to help. Here’s what you should know.
SNAP Benefits
While there are millions of seniors who are eligible for food stamps, less than 40% actually take advantage of this benefit. Food stamps are now referred to as the Supplemental Nutrition Assistance Program, or SNAP. For seniors to get SNAP, their net income must be under the 100% federal poverty guidelines. So, households that have at least one person age 60 and older, or disabled, their net monthly income must be less than $1,041 per month for an individual or $1,410 for a family of two. Households receiving TANF or SSI are also eligible. Net income is figured by taking gross income minus allowable deductions including a standard monthly deduction, medical expenses that exceed $35 per month out-ofpocket, and shelter expenses (rent or mortgage payments, taxes and utility costs) that exceeds half of the house-
hold’s income. In addition to the net income requirement, a few states also require that a senior’s assets be below $3,500, not counting their home, retirement or pension plans, income from SSI or TANF, and vehicle (this varies by state). Most states, however, have much higher asset limits or they don’t count assets at all when determining eligibility. To apply, seniors or an authorized representative will need to fill out a state application form, which can be done at the local SNAP office or, it can be mailed or faxed in. In many states it can be completed online. If eligible, benefits will be provided on a plastic card that’s used like a debit card and accepted at most grocery stores. The average SNAP benefit for 60-and-older households is around $125 per month. To learn more or apply, contact your local SNAP office – call 800-2215689 for contact information or visit fns.usda.gov/snap. Locally, check https://otda.ny.gov/programs/ snap/
Other Programs
In addition to SNAP, there are other federal programs that can help low-income seniors, aged 60 and older, like the Commodity Supplemental Food Program (CSFP) and the Senior
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
Farmers’ Market Nutrition Program (SFMNP). The CSFP (see fns.usda.gov/ csfp) is a program that provides supplemental food packages to seniors with income limits at or below the 130% poverty line. And the SFMNP (fns.usda.gov/ sfmnp) provides seniors coupons that can be exchanged for fresh fruits and vegetables at farmers’ markets, roadside stands and community supported agriculture programs in select locations throughout the U.S. To be eligible, your aunt’s income must be below the 185 percent poverty level. There are also many Feeding America network food banks that host “Senior Grocery Programs” that provide free groceries to older adults, no strings attached. Contact your local food bank (see feedingamerica. org/find-your-local-foodbank) to find out if a program is available nearby. In addition to the food assistance programs, there are also various financial assistance programs that may help pay for medications, health care, utilities and more. To locate these programs, and learn how to apply for them, go to BenefitsCheckUp.org. Jim Miller is the author of Savvy Senior column, published every month in this paper.
THE PRESENCE STUDY
By Jim Miller
How to Choose the Right Hospital for You Dear Savvy Senior, I need to get a hip replacement, and want to find a good, safe hospital to have it done in. What resources can you recommend for evaluating hospitals? I don’t currently have a doctor. Shopping Around
Dear Shopping, Most people spend more time shopping for a kitchen appliance or flat-screen TV than choosing a hospital. But selecting the right one can be as important as the doctor you choose. Here are some tips and resources to help you research the hospitals in your area.
Hospital Shopping While you may not always have the opportunity to choose your hospital, especially in the case of an emergency, having a planned procedure can offer you a variety of choices. When shopping for a hospital, the most important criteria is to choose one that has a strong department in treating your area of need. A facility that excels in coronary bypass surgery, for example, may not be the best choice for a hip replacement. Research shows that patients tend to have better results when they’re treated in hospitals that have extensive experience with their specific condition. In order to choose a hospital that’s best for you, it is important to discuss your concerns and alternatives with the doctor who is treating you. Some doctors may be affiliated with several hospitals from which you can choose. Or, if you’ve yet to select a doctor, finding a top hospital that has expertise with your condition can help you determine which physician to actually choose. Another important reason to do some research is the all too frequent occurrence of hospital infections, which kill around 75,000 people in the U.S. each year. So, checking your hospital’s infection rates and cleanliness procedures is also a smart move.
Free Researching Tools There are a number of free online
resources that can help you evaluate and compare hospitals in your area, including: • Medicare’s Hospital Compare (Medicare.gov/HospitalCompare): Operated by the Centers for Medicare and Medicaid Services, this tool has data on more than 4,000 U.S. hospitals. • Why Not The Best (WhyNotTheBest.org): Created by the Commonwealth Fund, this is a private foundation that provides performance data on all U.S. hospitals. • The Leapfrog Group (LeapfrogGroup.org): This national, nonprofit organization grades more than 2,000 U.S. hospitals on quality and safety. These websites use publicly available data to rate hospitals on various measures of performance like death rates from serious conditions such as heart failure and pneumonia, frequency of hospital-acquired infections, patient satisfaction and more. On these websites, you plug in your location to find hospitals in your area. You can then check to see how well or poorly each hospital manages patients in various conditions. Two other good sites that can help you choose a good facility include U.S. News & World Report (USNews.com/best-hospitals) and Healthgrades (Healthgrades.com). U.S News & World Report is an online publication that publishes a hospital ranking in 17 medical specialties like cancer, orthopedics and urology, and rates common procedures and conditions, such as heart bypass surgery, hip and knee replacement and COPD. They also rank hospitals regionally within states and major metro areas. And Healthgrades, which is a private for-profit organization, provides free hospital ratings on patient safety and medical procedures, and scores hospitals using a 5-star scale. They also provide comprehensive information on most U.S. doctors including their education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records, office locations and insurance plans.
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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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. © 2020 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, Michael J. Billoni, Katie Coleman, Nancy Cardillo, Jenna Schifferle, Catherine Miller • Advertising: Anne Westcott, Amy Gagliano 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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H ealth News Daemen nursing programs among nation’s best Daemen College’s nursing pro grams have been selected among the best in the country in new rankings released by Nursing Schools Almanac, a comprehensive online educational resource for aspiring nurses. Nosek Daemen is ranked in the top 60 in the Mid-Atlantic region, placing it among prestigious institutions such as Johns Hopkins University, Georgetown University, Temple University, and Seton Hall University. In New York state, Daemen is listed No. 18, making it the highest ranked private college in the Buffalo Niagara region. “We are delighted to have Daemen receive this recognition, which speaks to the quality of all our nursing programs,” said Cheryl Nosek, chairwoman of the Daemen nursing department. “As the premier health sciences educator in Western New York, Daemen offers exceptional educational preparation in nursing that adheres to the highest professional standards, outstanding clinical opportunities, and programs in flexible formats to meet the needs of working nurses.” For the newest rankings, more than 3,000 institutions across the U.S. were evaluated based in academic prestige and perceived value, breadth and depth of nursing programs offered, and student success, particularly on the National Council for Licensure Exam (NCLEX). Nursing Schools Almanac cited Daemen for its unique 1+2+1 nursing program, which enables students to earn both an associate’s and bachelor’s degree in only four years, and gives students the advantage of working as an RN after completing
WNY’s Healthcare Newspaper Reaching consumers, providers. For advertising information email
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their third year of study. The college also was noted for offering flexible learning options, including traditional classroom, hybrid, and online programs, including Daemen’s RN to BS degree. At the graduate level, Daemen offers master’s degrees in adult-gerontology primary care nurse practitioner, nursing executive leadership, nursing education, and RN to MS accelerated programs for registered nurses with a non-nursing bachelor’s degree.
Change in ECMCC leadership announced Erie County Medical Center Corporation (ECMCC) recently announced an appointment to the institution’s executive leadership team. Joseph T. Giglia II, ECMCC’s chief human resources officer, will assume the position of general counsel in addition to his existing responsibilities for ECMCC. ECMCC’s current executive vice president and general counsel, Anthony J. Giglia Colucci III, will retain his position as executive vice president, focusing on leading strategic initiatives between ECMCC and its Great Lakes Health System partners, Kaleida Health and the University at Buffalo. Giglia holds a Juris Doctor degree from Widener University School of Law (Harrisburg, Pennsylvania). He holds a Bachelor of Science in criminal justice from SUNY Brockport. Prior to joining ECMCC in October 2018, he served as vice president of human resources and general counsel at the Buffalo News. Prior to that, he served as vice president of legal and operations, corporate human resources for Catholic Health in Buffalo.
Roswell Park hires new chief pharmacy officer Pharmacist Lijian Cai has recently joined the staff at Roswell Park Comprehensive Cancer Center as senior executive director/chief pharmacy officer. Cai previously served as the director of pharmacy with SSM Health St. Mary’s Hospital in Madison, Wisconsin. He brings extensive Cai knowledge and expertise in medication safety and pharmaceutical training to the position at Roswell Park. In this role, Cai is responsible for evaluating the efficiency of pharma-
ceutical operations for Roswell Park’s main campus, outpatient pharmacy, and hospital-based satellite locations. He will also look at new trends and drug approvals and how they can be utilized in pharmacy practice. He also oversees a specially trained team of oncology pharmacists, who utilize a multidisciplinary approach — personalizing patient care to ensure medication prescribed best suits their treatment plans. As chemotherapy drug shortages continue to delay patient treatment plans at hospitals across the United States, Cai stood with physician Kara Kelly and Congressman Brian Higgins this fall to call for better communication and increased transparency from pharmaceutical manufacturers. “It’s evident that Dr. Cai has passion for patient care and service excellence, which aligns with our center’s mission,” said Shirley Johnson, senior vice president and chief clinical operations officer at Roswell Park. “We’ll look to him for his pharmaceutical expertise as we continue to evaluate care plans to ensure best patient outcomes.” Cai earned his Doctor of Pharmacy from the University of Kentucky College of Pharmacy.
BCBS, Roswell Park announce contract agreement BlueCross BlueShield of Western New York and Roswell Park Comprehensive Cancer Center announced a contract agreement that ensures BlueCross BlueShield members will continue to have access to the center’s nationally recognized cancer care. A member of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers, Roswell Park provides quality care to the members that BlueCross BlueShield has served for more than 80 years. Roswell Park is a designated Blue Distinction Center by the Blue Cross Blue Shield Association (BCBSA) for Cancer Care, Blood and Marrow Transplants, and Cellular Immunotherapy – CAR-T. These designations are given to a select number of hospitals and health systems nationally based on quality and cost criteria. To receive a CAR-T designation, hospitals must be certified by the Food and Drug Administration to provide such therapies and commit to system-wide monitoring of patient outcomes. Roswell Park is the only center in the Buffalo area approved to administer the CAR-T-cell therapies Kymriah and Yescarta. Roswell Park’s Blue Distinction Center designation for CAR-T recognizes their commitment to utilizing the latest immunotherapies that are transforming the landscape for many cancer patients. “We are thrilled that we can count on BlueCross BlueShield of Western New York to cover one of our region’s most vulnerable patient populations,” said Candace S. Johnson, PhD, president and CEO of Roswell Park Comprehensive Cancer Center. “Access to high-quality, com-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020
prehensive care is so important for people with cancer. We are happy to work together so that we can continue to offer our patients the latest and most promising therapies.” “BlueCross BlueShield of Western New York values our strong partnerships with organizations that have a proven history of delivering exceptional care and results to our members, including Roswell Park Comprehensive Cancer Center,” said David W. Anderson, president and CEO of BlueCross BlueShield of Western New York. “The ‘long game’ for a provider such as Roswell is to identify the most effective treatments that minimize the impact of a cancer diagnosis. When we work collaboratively, we have a meaningful impact on the health of our community.” The new contract is in effect through 2022. Terms of the contract extension were not disclosed.
ECMC recognized for knee, hip replacement surgeries BlueCross BlueShield of Western New York has selected Erie County Medical Center Corporation as a Blue Distinction Center+ for Knee and Hip Replacement, part of the Blue Distinction Specialty Care program. Blue Distinction Centers are nationally designated healthcare facilities that show a commitment to delivering high-quality patient safety and better health outcomes, based on objective measures that were developed with input from the medical community and leading accreditation and quality organizations. “ECMC is proud to be recognized by BlueCross BlueShield of Western New York for achieving quality outcomes for knee and hip replacements set by the Blue Distinction Specialty Care program. We could not be more proud of our physicians, nurses and orthopedic care team who always strive to provide the very best care to our patients,” said ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. “We are pleased to recognize Erie County Medical Center for providing exceptional knee and hip replacement care,” said Thomas Schenk, a physician serving as senior vice president and chief medical officer at BlueCross BlueShield of Western New York. “Having these nationally recognized centers in our network ensures that our members have access to high quality, effective specialty care that they rely on.” Facilities designated as Blue Distinction Centers for knee and hip replacement demonstrate expertise in total knee and total hip replacement surgeries, resulting in fewer patient complications and hospital readmissions. Designated facilities include hospitals and ambulatory surgery centers. Between 2015 and 2019, total hip and knee replacement surgeries combined performed at ECMC increased by 97%, contributing to ECMC’s strong orthopedic service line.
Tom Quatroche Jr. Elected HANYS’ Chairman of the Board ECMC Corporation president and CEO to lead Healthcare Association of New York State board of trustees. Group represents 325 organizations — hospitals, nursing homes, continuing care associations — from Long Island to Buffalo By Michael J. Billoni
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homas J. Quatroche Jr., Ph.D., president and chief executive officer of the Erie County Medical Center (ECMC) has recently been elected chairman of the Healthcare Association of New York State’s board of trustees for 2020. HANYS advocates in Albany and Washington on behalf of its members. Quatroche recently answered questions from “In Good Health” about the significance of this position for him and ECMC. Q. What is the Healthcare Association of New York State and how long have you served on its board? A. “The Healthcare Association of New York State is the statewide hospital and continuing care association in New York state, representing nonprofit and public hospitals, nursing homes, home care agencies and other healthcare organizations. HANYS currently represents 325 organizations from Long Island to Buffalo. I joined the HANYS board of trustees in 2015.” Q. What is its mission and how has your position on its board benefited ECMC and other health care facilities in WNY? A. “HANYS mission is to advocate for and support its statewide healthcare member organizations. HANYS works to ensure every New Yorker has access to affordable, high-quality care. They advance the health of individuals and communities by providing leadership, representation and service to not-forprofit and public hospitals, nursing homes and other healthcare organizations throughout the state. Most importantly, HANYS advocates for healthcare organizations both in our state and nationally [in Washington, DC] on issues that directly benefit patients and it assists these organizations to obtain the reimbursements they need to care for their respective communities. “As chair of the HANYS board of trustees, I will have direct input into the organization’s public policy advocacy in Albany and Washington on behalf of the HANYS members and the healthcare needs of New Yorkers. This gives ECMC a ‘seat at the table’ as critical issues such as potential federal DSH [Disproportionate Share Hospital] cuts, 340-B drug pricing and the future of Medicaid are debated among policymakers and
decisions are reached that will have a long-term impact on our patients and community.” Q. How will your position as chairman further benefit you and or ECMC? A. “As chair of such an important statewide healthcare organization, I will have the opportunity to collaborate with colleagues from similar institutions from across the state, sharing best practices, reviewing policy decisions that affect the members’ facilities, their patients and their communities. ECMC has some of the best outcomes and it is a great opportunity to share ECMC’s story as well as other success stories in Western New York. This helps our area receive more funding and strengthens ECMC’s effort in the recruitment of physicians and others as we compete on a statewide and national basis for talent.” Q. How prestigious is this new position and what will that mean for you, responsibility wise and time wise? Where are the board meetings held and how often? A. “It is a very prestigious position. HANYS board of trustees meets four times a year times in person and four times by phone. For me personally, the responsibility to help guide the discussion for state healthcare institutions is an honor. There are a few other times a year when I will be asked to represent HANYS on the federal level. HANYS has strong leadership staff, which does all of the
work related to the day-to-day business of the association. My responsibility is to take a leadership position in HANYS’ advocacy and policy analysis, helping the board take positions and direct association initiatives related to navigating healthcare reform and achieve the shared goal of creating better healthcare across the state at the lowest cost possible.” Q. With representatives in the healthcare field from around the state on the board is there a chance you can host a meeting in Buffalo and show off the current renovations at ECMC and the medical campus? A. “Yes, in fact this year, for
New Board of Trustees at HANYS The HANYS board of trustees 2020 officers and executive committee members are: • Chairman: Thomas J. Quatroche Jr., Ph.D, president and chief executive officer, Erie County Medical Center; • Chairman-Elect: Bruce Flanz, president and chief executive officer, MediSys Health Network; • Secretary: Michael Spicer, president and chief executive officer, Saint Joseph’s Medical Center; • Treasurer: Physician Jose Acevedo, president and chief executive officer, Finger Lakes Health; • Immediate past chairman: Richard Murphy, president and chief executive officer, Mount Sinai South Nassau; • Past chairs: physician Steven Corwin, president and chief executive officer, NewYork-Presbyterian; Kimberly Boynton, president and chief executive officer, Crouse Health; Thomas Carman, president and chief executive officer, Samaritan Medical Center; Steven Goldstein, president and chief executive officer, Strong Memorial and Highland Hospital; Caryn Schwab, executive director, Mount Sinai Queens; Robert Spolzino, JD, trustee, board of overseers, Northwell Health. February 2020 •
the first time, HANYS will hold its annual meeting in Buffalo, which is an excellent opportunity to share the story of ECMC and that of our entire Western New York healthcare community. ECMC has also hosted visits of its 65-acre health campus from other local and national healthcare institutions who have had the opportunity to see the great work being done by the ECMC family.” Q. As chairman of its board, what are your goals for the organization in 2020? How big is the board? A. “The board consists of 11 members. We all know the challenges that are currently confronting healthcare providers across New York state and the country, so our goal at HANYS will be to continue to advocate for the policies and programs that will support our patients and our communities. We are all concerned with the budgetary issues in both Albany and Washington, which have such a profound impact on our individual institutions. We are also concerned with the healthcare insurance companies across the state providing healthcare institutions the necessary reimbursement to care for their members. Collectively, we can make a compelling case for the vitally important role healthcare institutions — both as providers and employers — play in our respective communities. Our responsibility is to remind our state and federal policymakers that our long-term viability is essential to the success and stability of our home communities.”
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ECMC-18108-InGoodHealth_January_Ad | TRIM: 9.75” x 13.75” | No Bleed | CMYK
If ECMC wasn’t there, we wouldn’t be here. In the face of the worst accidents and traumas, ECMC has always been on the front line of our community’s most critical injuries. As Western New York’s only Level 1 Adult Trauma and Emergency Department, we know firsthand the level of dedication and excellence ECMC’s caregivers bring to every patient they serve. For too long, these doctors, nurses, and support staff have provided lifesaving care in a cramped, outdated facility designed for far fewer patients than the over 70,000 individuals who are treated there annually. But with a new, state-of-the-art Trauma and Emergency Department opening in spring 2020, more lives can be saved, more families can celebrate their loved ones, and more stories of hope and healing can be shared throughout our region.
©2019 ECMC
Give to the place where there’s no giving up, and donate today for hope and healing in WNY. SUPPORTECMCTRAUMA.ORG
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2020