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JULY 2020 • ISSUE 69

Becoming Parents During the Pandemic

First-time moms (and dads) dealing with pregnancy and birth share their concerns, fears, hopes

ER visits at Kaleida Health facilities drops by 52% in May Director of glaucoma services at the Ross Eye Institute, physician Sandra Sieminski, talks about her drive-thru glaucoma pressure screenings for patients at-risk of vision loss

BEYOND COVID-19

health numbers you need to know about

To maintain good health, it’s all in the numbers that measure key indicators of health. We talk to local experts who discuss what those numbers are and how we can get them to normal levels. P13

Little Raspberries Score Big on Many Fronts P.

More Young Americans Abstaining From Sex P.P.22

More Young Americans Are Going Without Sex

ex, and lots of it, has long been the primary preoccupation of young adults, but more of them are now going months and years without any intimate encounters. New research shows that one of three men between the ages of 18 to 24 have not had any sex during the past year, putting to rest all the talk of the “hookup culture.” Men and women aged 25 to 34 in the United States also reported an increase in sexual inactivity and a decrease in sexual frequency during the past two decades, the researchers found. “In the age of Tinder, young people are actually having less sex, not more,” said Jean Twenge, a professor of psychology at San Diego State

University. Analyzing national survey data, researchers found that sexual inactivity increased from 19% to 31% among men 18 to 24 between 2000 and 2018. They defined sexual inactivity as no sex at all for a year or more. Among those aged 25 to 34, sexual inactivity doubled among men (7% to 14%) and nearly doubled among women (7% to 13%) during the same two decades, the researchers reported. Many who remain sexually active are having sex less often, the findings also showed. Fewer people are having sex at least weekly, particularly those with one sexual partner. The report was published online June 12 in JAMA Network Open.

Time to Make A Move?

“It is important to distinguish between a decrease in sexual frequency among those who are sexually active and an increase in those who do not have sex at all,” said lead researcher Peter Ueda, a physician-researcher at the Karolinska Institute in Sweden. “While the mean sexual frequency among those who were sexually active may reflect their priorities and preferences, sexual inactivity may reflect an absence of sexually intimate relationships, with substantially different implications for public health and society,” Ueda said. Technology and society appear to be colliding in a way that dramatically affects young adults’ interest in sex, said Twenge, who wrote an editorial accompanying the new study.

Even though kids are entering puberty earlier, they are taking longer to grow into adulthood, Twenge said. It’s not just about sex. These young adults also are taking longer to begin working, start dating, move out of their parents’ home, settle into a career, live with a partner, have kids or buy houses, Twenge said. The generation coming up after millennials, which Twenge calls “iGen,” aren’t even that motivated to hang out with friends, she said. “iGen does those things significantly less than previous generations did at the same age,” Twenge said, noting that young adults these days would rather check out social media, play video games or text their pals. “They’re choosing to spend their leisure time communicating using their phones instead of face-to-face,” Twenge continued. “When people aren’t face-to-face, they’re probably going to have less sex.” All told, young adults now might decide that bingeing Netflix or posting on Instagram is more enjoyable than seeking a sexual partner, Twenge said. “There are just more things to do at 10 p.m. than there used to be,” Twenge explained. Even when people are together, they’re allowing their smartphones to interfere with their chemistry, Twenge added. Many people on dates are guilty of “phubbing” pulling out their phone and snubbing the person they’re with, Twenge said. “What happens to face-to-face interactions when the phones come up? Not surprisingly, it just doesn’t go as well. It’s not as emotionally close,” Twenge said.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Sandra Sieminski, M.D. Eye tests on the go during the pandemic. Director of glaucoma services at the Ross Eye Institute talks about her drive-thru glaucoma pressure screenings for patients at risk of vision loss

Coronavirus May Be Seasonal After All

ere’s a glimmer of hope about the new coronavirus: New research finds it appears to follow a seasonal pattern that is similar to the flu. Scientists found that all cities/regions with large COVID-19 outbreaks have similar winter climates, with an average temperature of 41 to 52 degrees Fahrenheit, average humidity levels of 47% to 79%, and are located within a latitude band of 30 to 50 N. This includes Wuhan, China; South Korea; Japan; Iran; Northern Italy; Seattle; and northern California. The findings also suggest that U.S. mid-Atlantic states may be at risk, as well as New England, according to researchers at the Institute of Human Virology (IHV) at the University of Maryland School of Medicine (UMSOM) and the Global Virus Network (GVN). “Based on what we have documented so far, it appears that the virus has a harder time spreading between people in warmer, tropical climates,” said study leader Mohammad Sajadi, an associate professor of medicine at UMSOM, physician-scientist at IHV, and a member of GVN. The researchers used weather data from the previous few months, as well as typical weather patterns from last year, to predict community spread of COVID-19 within the next few weeks. The next step is to determine if weather and climate forecasts could make the predictions more reliable. Study co-author Anthony Amoroso said, “I think what is important is that this is a testable hypothesis.” Amoroso is an associate professor of medicine at UMSOM and chief of clinical care programs for IHV. “If it holds true, it could be very helpful for health system preparation, surveillance and containment efforts,” he added in an institute news release. The study was published online June 11 in JAMA Network Open.

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Q: You’ve been administering glaucoma tests through the lockdown. How have you gone about it? A: As a field, ophthalmologists can see patients through telehealth. With glaucoma, a large part of the examination for the disease is checking eye pressure, and that’s something we can’t do [with telehealth]. So we developed a clinic where patients could drive up to our front door and have their pressure checked with a handheld device. We also take a look at their eyes with a handheld microscope and talk to them and refill their medications, if necessary. If it looks like they’re having a problem, then they are invited to come inside and have a full appointment. So far we’ve only had to do that once. Q: How quickly are you able to see patients this way? A: We were able in our past two clinics to see 12 patients within an hour and 20 minutes. So just about every 10 minutes, without any patients accumulating in a car line. It was enough time to have a patient come, drive up and do all those things in matter of minutes. In terms of exposure, I am wearing a mask and gloves. The gloves I change between every patient. Also the tip of the device used to touch the eye and check pressure is a disposable piston-like tip. That’s the only real contact with have with the patient. We don’t even need to administer eye drops to check the pressure like we would with the other

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

types of checks we do in the office. This device is called iCare; it’s very convenient in situations where we’re trying to minimize contact. Q: With how convenient it is, are there drawbacks compared to the other tests? A: It doesn’t replace coming into the office to do the normal testing to monitor the progression of glaucoma. Checking the pressure is just one piece of the puzzle when we’re looking at whether the disease is stable or progressing. We are able to, in the drive-thru clinic, look at their last note and see what they’re due for and schedule appointments for testing. But actually looking at the optic nerve and checking peripheral vision really require them to come inside. The patients are pretty aware that just checking the pressure and doing an examination in their car isn’t a substitute for coming into the office, but it’s pretty reassuring to be able to make sure patients are taking their medications and patients are getting their refills and making sure they don’t get lost in the shuffle in the enormous mass of patients who had to be scheduled due to the pandemic. Q: With the lockdowns starting to lift, do you see this model having long-term potential? A: Yes, I do, absolutely. When I heard it was being done in another state, I had my skepticism about it, because I didn’t know that it was going to work as smoothly as it has been working. I do think that, even when all the

restrictions have been lifted on offices, there are still going to be a large number of patients who are reluctant to come into the office and wait in a room with other patients. I see this model working through the summer. Of course, we live in Buffalo, so bad weather will prevent us from doing it all year round unless we devise some kind of high-falutin heating tent or something like that. But certainly through the summer, I see myself doing this once or twice a month through at least September, because I don’t see people rushing back to the office right away. Q: How about after things completely normalize, assuming they do? A: Definitely. I mean, it would be nice to have it all year round. In my practice, as a rule, I usually don’t have patients come in just to have their pressure checked, which is what that is, not diagnostic testing. It’s still not going to replace a full examination. But let’s say we started a patient on a new drop and we wanted to follow up a month later and see if it was working. This could potentially work as an option there. In terms of how accurate the handheld, the iCare, is, it’s comparable to in-office methods, but it’s not the gold standard. So it would be for follow-up patients, not new patients. This is not a great platform for seeing new patients. But for follow-up, weather permitting, it’s something I’d like to see carried forward. Q: Why is it important to regularly check pressure with glaucoma? How quickly does the disease progress? A: Everybody’s different. Glaucoma is sometimes called the silently blinding disease because patients who are untreated may start losing peripheral vision slowly and it starts to close in like a telescope, taking the central vision away in the final stages. So very often that early peripheral vision loss goes unnoticed. That’s just a general statement. There are different types of glaucoma that may affect the central vision earlier. But overall it’s a slow-moving disease. If your pressure is very out of control, you can lose vision in a matter of weeks to months, but generally it’s over the course of years.

Lifelines Name: Sandra Sieminski, M.D. Position: A glaucoma and cataract specialist, she is the director of glaucoma services at the Ross Eye Institute at UBMD. She also serves as the clinical vice chairwoman of the department of ophthalmology and the ophthalmology for the Jacobs School of Medicine and Biomedical Sciences. Hometown: Erie, Pennsylvania Education: University of Pittsburgh (MD); Washington Hospital Center, Washington, DC (internship); Georgetown University, Washington, DC (residency); New York Eye and Ear Infirmary, New York City (fellowship) Affiliations: Erie County Medical Center Organizations: American Academy of Ophthalmology, American Glaucoma Society Family: Husband (Mark); two children Hobbies: Running, traveling, skiing, gardening, art

Popular sports masks available at Plain Jayne’s Gift Shop on Potters Road in West Seneca.

Wearing mask at Charlie’s BoatYard Restaurant, 1111 Fuhrmann Blvd, Buffalo.

Let’s Face It: Masks Are Here to Stay As long as we have to wear a mask, let’s wear it well. Local vendors have just what you need By Catherine Miller

hether you are shopping at the grocery store, walking a busy street or waiting in line at your favorite restaurant, you will be wearing a mask for the foreseeable future. Once worn only by the medical community, a face mask is now required or suggested any time there is a gathering of people. When it comes to staying healthy in today’s environment, covering our nose and mouth in public is just as important as hand washing and keeping your immune system strong. As long as we have to wear a mask — let’s wear it well. When masks were first mandated in March 2020 the best I could find were a box of disposable beige ones from a local hardware shop. That changed rather quickly. It seemed as if overnight during the spring of quarantine local mask-making vendors were rising up throughout the land. There is no

“Whether you are wearing your mask to be trendy, colorcoordinated, or advertising your business, your mask is one of the first things being noticed nowadays.”

need to buy masks online and wait for shipping when you can take advantage of the local variety found in Western New York. Everything from sports related fabrics to specialty prints are available. Plain Jayne’s Gift Shop on Potters Road in West Seneca carries several varieties of locally-made face masks. “Our Buffalo Bills masks are our most popular,” says Jayne Cilano, owner of Plain Jaynes, “Aside from the Bills masks we find that women especially like to have options and are buying a few to color-coordinate with outfits.” Plain Jayne’s Gift Shop is not the only local mask vendor. Check out Alterations by Candice on Abbott Road in Buffalo, or reach out to the Facebook sites for “Sew New Memories” or “Slink Creations” for local vendors that can deliver or ship the masks to you without much wait. In addition to various colors and fabric

patterns, you will find various styles. While many masks are pleated across your face you can find some that will “cone” away from your face for added comfort. You will also find various types of way to attach your mask. Elastic straps that form around the ear are prevalent but there are tie strap styles that alleviate ear discomfort and neck-sleeves that can be pulled up as needed and require no ties or straps. The choice is yours for whatever offers you the most comfortable. At a local farmer’s market Kathleen Cunningham, the owner of KupKate’s Bakery, wore a mask patterned in pastel cupcakes. April Spencer, a local florist, donned a mask with — you guessed it — flowers. The owner of What’s Popping Gourmet Popcorn

Kaleida Concerned by Continued Drop in ER Volume ER visits at Kaleida Health facilities plummet by 52% in May

mergency department volumes at Kaleida Health facilities (Buffalo General Medical Center / Gates Vascular Institute, DeGraff Memorial Hospital, Millard Fillmore Suburban Hospital and Oishei Children’s Hospital) dropped by 52% in May, compared to ER visits in May 2019 — only a slight improvement from the 63% drop in April of this year. The continued decline in patients seeking emergency medical care highlights the ripple effects of the COVID-19 pandemic and is likely fueled by a fear of contracting the coronavirus — a fear physicians have been working to dispel. “COVID-19 is a very serious health threat, but perhaps not as serious as the potential risks associated with delaying or forgoing treatment altogether for other serious health conditions,” says physician

Joshua Lynch, medical director of the DeGraff Memorial Hospital emergency department and corporate emergency services liaison at Kaleida Health. “My colleagues and I worry that unaddressed health issues could result in long-term complications and more limited treatment options down the road if a patient’s condition worsens and symptoms become too serious to overlook. For example, ignoring chest pain or signs of stroke for days or even hours could have dire consequences, such as permanent disability or death.”

Lynch says all Kaleida emergency departments have been adhering to strict precautionary measures to protect patients and health care workers from the moment they enter to hospital. “You can expect temperature screening checkpoints at all entry points, universal masking, rigorous sanitizing processes, enhanced protective equipment, and the separation of confirmed or suspected COVID-19 patient cases from the general population of patients seeking care,” said Lynch.

July 2020 •

had a mask with his favorite logo — “What’s Poppin?” Whether you are wearing your mask to be trendy, color-coordinated, or advertising your business, your mask is one of the first things being noticed nowadays. Why not look good showing off that mask? Experts believe we will have another wave of the coronavirus effecting people in the fall. We can expect that even if mask regulations are relaxed this summer, they will be back in effect in the fall, and hopefully masks worn at the onset of the germ season will help Western New York to limit the number of those infected with the virus. Utilize your masks whenever needed to control the spread of viruses and keep our region safe and healthy.

U.S. Stockpiled 63 Million NowUseless Doses of Hydroxychloroquine

.S. officials are trying to determine what to do with 63 million doses of hydroxychloroquine after the Food and Drug Administration revoked authorization of the drug to treat COVID-19 patients. The government started stockpiling donated supplies of the drug in late March after President Trump touted it as “very encouraging” and “very powerful” and a “game-changer,” despite no proof that it benefited COVID-19 patients. In revoking its emergency use authorization of hydroxychloroquine to treat COVID-19, the FDA said in June that there was “no reason to believe” it was effective against the new coronavirus, and that it increased the risk of heart problems and other side effects. Along with 63 million doses of hydroxychloroquine, the Strategic National Stockpile also has 2 million donated doses of the related drug chloroquine, according to Carol Danko, a Department of Health and Human Services spokesperson.

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Big Need for Blood Donations as Postponed Surgeries Resume

s U.S. hospitals resume procedures put on hold by the coronavirus outbreak, there’s an urgent need for blood and platelet donations, the American Red Cross says. Following a sharp decline in demand for blood products that began in early April, hospitals’ needs have recently spiked 30%. “Blood donors are essential to ensuring the continued health of their community by making sure hospitals have a readily available supply of blood products for patients,” said Chris Hrouda, president of the American Red Cross Biomedical Services. “Blood cannot be stockpiled like other medical supplies and must be constantly replenished.” Hrouda said the Red Cross is

grateful to the tens of thousands of donors who rolled up a sleeve to help early on. Though hospitals have resumed surgeries and treatments that were paused in response to COVID-19, many blood drives continue to be canceled as businesses and community groups remain closed, Hrouda said in a Red Cross news release. He said this has hampered the Red Cross’s ability to collect nearly 13,000 blood and more than 2,600 platelet donations needed at U.S. hospitals and transfusion centers. The Red Cross said it’s urgently seeking donors and hosts for blood drives to ensure blood products are readily available for patients. “During this crisis, we’re all in this together,” Hrouda said.

To make an appointment to donate, go to the American Red Cross website, use its donor app, call 800-RED-CROSS, or activate the blood scheduling skill for Alexa. Donors are asked to schedule an appointment before they arrive at a blood drive and must wear a face covering. Red Cross blood drives and donation centers follow strict safety and infection control measures. The news release said those steps

include checking temperatures of staff and donors; providing hand sanitizer and routinely disinfecting surfaces, equipment and areas that donors touch; keeping donors socially distanced; ensuring staff and donors wear face coverings and that staffers wear gloves and change them frequently; and using sterile collection sets and an aseptic scrub for every donation.

However, he believes the vaccine will not be a one and done solution and will most likely require boosters. Once a vaccine is approved for use, the question remains what will be its durability. It could be six months or a year or two. (It should be noted: Moderna is not the only bio tech firm developing a vaccine.) There has been much confusion over wearing masks. Fauci emphasized the three basics of mitigation are still the most effective at slowing the spread of the virus: frequent hand washing, social distancing and masks in public. The latter all the more important when inside. Meanwhile, in anticipation of a vaccine, the federal government has begun stockpiling 400 million syringes by December.

of elective surgeries and routine office visits have put most providers in dire financial straits. Most have resorted to furloughing or laying off staff as bottom lines flounder. In April, CMS issued guidelines for providers to open up again for normal business. Basically, “non-emergent, non-COVID care (NCC) should be offered to patients, as clinically appropriate, in localities or facilities that have the resources to provide such care, as well as the ability to quickly respond to a surge in COVID-19 cases, if necessary. Decisions should be consistent with federal, state and local orders, and CDC guidance and made in collaboration with state and local public health authorities. Careful planning is required to safely deliver in-person care to patients requiring NCC, and all aspects of care must be considered.” If you have been putting off care, you are encouraged to contact your provider and resume your treatment or address your health concerns.

Healthcare in a Minute

By George W. Chapman

Use of Telehealth Surges: From 10% in 2019 to 46% in April

o one could have predicted that a pandemic would be the catalyst or “black swan” event for telehealth. Up until the pandemic, telehealth was infrequently used. It was approximately 10% of a typical provider’s schedule in 2019. In April 2020, it had ballooned to 46%. Industry experts are predicting that telehealth could be $250 billion a year in spending post-pandemic. Both providers and consumers are adapting to the new reality. According to a recent consumer survey by McKinsey & Company, 75% of respondents are highly or moderately likely to use telehealth services. Seventy-five percent of respondents who recently received services via telehealth were satisfied. Up until the pandemic, providers were somewhat reluctant to incorporate telehealth into their business models, primarily due to poor reimbursement from insurers. Telehealth was used mostly to reach isolated, rural or homebound patients. Because of the pandemic, Medicare began to reimburse providers for a telehealth visit the same as an office visit. Most commercial carriers followed suit. The big question is whether or not Medicare will continue improved telehealth reimbursement beyond the pandemic. The longer this pandemic lasts, the further the horse is out of the barn. Medicare would certainly face a backlash from both providers and consumers who have adapted to this delivery of care option. Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma sounds like she is hedging her bets, though, when she said that while telehealth is getting us through this pandemic, it won’t replace the “gold standard” of in-person care.

AHA Addresses Systemic Racism

The pandemic has disproportionally impacted people of color. It has exposed the systemic racism in Page 6

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public health. Rick Pollack, CEO of the American Hospital Association, recently addressed the problem. “As places of healing, hospitals have an important role to play in the wellbeing of their communities. As we’ve seen in the pandemic, communities of color have been disproportionately affected, both in infection rates and economic impact. The AHA’s vision is of a society of healthy communities, where all individuals reach their highest potential for health … to achieve that vision, we must address racial, ethnic and cultural inequities, including those in health care, that are everyday realities for far too many individuals. While progress has been made, we have so much more work to do.”

COVID19 Vaccine

Dr. Tony Fauci is the nation’s leading expert on infectious disease. As director of the National Institute of Allergy and Infectious Diseases, or NIAID, Fauci is cautiously optimistic about the development of a vaccine by bio tech firm Moderna.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

What We Know So Far

A recent article in the New York Times gave a summary. 1) We will be dealing with this pandemic for a long time. 2) Masks mitigate the spread. 3) Our public health infrastructure needs an update if not an overhaul. 4) The pandemic is hugely expensive: testing, treatment, PPE, lost wages, mitigation, etc. 5) We can’t count on herd immunity to protect us. 6) There are far more symptoms than expected or experienced. 7) We can worry less about surface transmission of the virus. It is mostly person to person. 8) We can worry less about a mutating virus. 9) Warm weather will not defeat the virus. Estimates of the cost of the virus to insurance companies, (commercial, Medicare Advantage and Medicaid) are modeled or based on infection rates. A population infection rate of 10% puts cost estimates around $30 billion while an infection rate of 60% could cause costs to skyrocket toward $500 billion.

Reopening Healthcare

The pandemic forced hospitals and physician offices to close to non-emergent care. The cancellation

CVS Testing NURO

If pizza can be delivered via drone or autonomous vehicle, why not drugs? CVS pharmacy is currently testing delivering prescriptions via autonomous vehicle “NURO” in a Houston suburb. NURO is a business that started in 2018 delivering groceries in Texas and Arizona. The company raised over $1 billion from investors. 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.

Becoming Parents During the Pandemic First-time moms dealing with birth and pregnancy share their concerns, fears and hopes By Jana Eisenberg

ust like in “normal times,” people’s experiences of pregnancy and birth during a pandemic depend on their circumstances, disposition and beliefs. At a time that is generally joyful — and often filled with family and celebration — extra challenges, including physical, emotional and mental health, loom large. “While there are currently no data showing that COVID-19 affects pregnant people differently than others, we know that pregnant people are at greater risk of getting sick from other respiratory viruses than people who are not pregnant,” states the CDC on its website. Especially for those having a baby for the first time, there can be a lot of questions and concerns, from what products to use, to fearing their child missing out on socialization.

“COVID changed all of our plans” Take Vanessa Fineberg, 34, who gave birth to Vincent Valentine on March 24 at Sisters Hospital in Buffalo. She is an admissions screener for Elderwood, a company that runs senior facilities with a range of living and therapeutic options; her partner, John Marfoglia, 58, owns an antique store in Buffalo. They had recently moved into a Buffalo apartment, and were living there when the shutdown came. “COVID changed all of our plans,” she said by phone recently. “I’ve always struggled with anxiety, and I knew that I would be a poster child for post-partum depression. We had arranged for a post-partum doula to stay with us. Of course, we were not able to do that. I was also physically sick after the birth; I would have stayed in the hospital longer if it wasn’t for COVID.” Because she wasn’t well, Fineberg couldn’t help her partner care

John Marfoglia holidng baby Vincent.

for their newborn; her mother stayed with them for a while — after first quarantining. Fineberg has been doing Facetime and Skype sessions with both the doula and a doctor-recommended therapist. She and Marfoglia both worried about the virus, and, with the extra challenges of navigating life in a large apartment building, possible transmission to the baby. She is feeling better, and will be working from home, “with a baby in her lap,” she said.

Aunt would have come from Los Angeles Then there’s Emma Montague, 29, who gave birth to Veronica Valentina on May 3. A therapist who works at a community mental health agency, Montague had been working from home since mid-March, meeting with clients via phone and video. Before she gave birth, she quarantined because of COVID, her pregnancy and a compromised auto-immune system. She and her husband, artist Julian Montague, 47, had moved into a house in Buffalo’s Allentown district in December. Emma had heard growing fears about the spread of the disease, and the threats especially in hospitals; she accepted that she might have to give birth at the hospital alone. Luckily for her and her husband, that didn’t happen. “In many ways, we were incredibly lucky,” she said in a recent phone interview. “I’m younger, and I didn’t have a high-risk pregnancy. Our infant sleeps 16–20 hours a day, that’s very lucky. I was worried that we wouldn’t have help if we needed it, like if I’d had any complications. “It was very upsetting from the perspective of family. Julian’s parents are in their 70s; I was sad and Continued on next page

Emma and husband Julian holding their daughter Veronica Valentina, who was born May 3. “I was worried that we wouldn’t have help if we needed it, like if I’d had any complications,” says Emma.

Vanessa Fineberg, an admissions screener for Elderwood, with baby Vincent. “COVID changed all of our plans,” she says.

Jennifer Sansano and her boyfriend Marcellus Eccles. She is due to give birth in August. After discussing the birth environment they wanted, Sansano had switched her care from a traditional OB-GYN to a midwife, coronavirus notwithstanding. July 2020 •

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from previous page felt bad that they couldn’t meet the baby right away,” she added. “And my aunt, who I am very close with, would have come from Los Angeles.”

A change from an OB-GYN to a midwife

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Jennifer Sansano, 27, never stopped working at a holistic health and wellness center, which was deemed essential; she’s a receptionist. Due to give birth in mid-August, she and her boyfriend, Marcellus Eccles, 28, who owns a technology business, live in their own home in Tonawanda. After discussing the birth environment they wanted, Sansano had switched her care from a traditional OB-GYN to a midwife, coronavirus notwithstanding. That was in early April. Sansano is not as concerned about the virus itself, but rather uncertain about and occasionally frustrated by the situation. “It’s strange to think about giving birth during this time; I wonder if I will still get the same prenatal care treatment, how will my appointments be…and what it will it be like bringing a child into this environment,” she said. “I have had one prenatal care appointment by phone,” continued Sansano. “When I went to the hospital for the anatomy scan, my boyfriend was not allowed to come with me. We’d planned to find out the gender together. I feel like we’re missing out on a lot. I’d envisioned this experience in a different way.” Fineberg agrees that managing expectations can be difficult. “My therapist has helped shape my attitude, to stay as positive as possible,” she said. “COVID didn’t ruin this experience for me, it changed it.” Montague and her husband, who already worked from home pre-pandemic, are viewing the shift to her working at home as well as an “opportunity to do childcare for themselves,” said Julian.

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Caring for the newborn Pediatricians are continuing regular infant care with some extra safety precautions, said both couples who’ve had their babies already. This also follows CDC guidelines. “We have to go in for every appointment; Delaware Pediatrics is wonderful. Monitoring his growth

and staying with the vaccination schedule are important,” said Fineberg. “They schedule ‘well visits’ before 1 p.m., and sick kids after 1. Only one of us can go in; we feel safe about it, they are wearing masks, gloves and sanitizing like crazy.” The Montagues selected Allentown Pediatrics, though, said Emma, they weren’t able to conduct a traditional pre-birth interview to see if the practice was a good fit. “It’s two blocks from our house,” she noted. “Only one parent at a time is allowed in. I went the first time, a few days after giving birth, and then Julian went for the two-week visit.” Another area that presented challenges was the “trial-and-error” aspect of having and dealing with a baby and all its needs. “In a COVID world, you can’t just browse at a store and get something else that might work, for example diaper rash cream,” said Fineberg. “Also shopping like that can be an opportunity to shut your mind off, grab that 20-minute break. Living in an apartment building during COVID, especially with a newborn, is nerve-wracking.” The family is moving to a house nearer to Fineberg’s mother in the suburbs. Sansano has a similar reaction. “Since stores have been closed or online only, there have been some products I’ve wanted to physically touch and ask questions about,” she said. “That’s been really hard, just basing decisions on online reviews.” Socialization is another concern for all of the families, whether for themselves or their babies. “So far, Vanessa’s mother has been the only other person to hold him,” said Marfoglia, Fineberg’s partner. “We want to be able to socialize him with adults and other babies, but we haven’t so far.” With an outdoor space at their house, the Montagues are able to enjoy visits from family and friends at a distance. Sansano adds that she doesn’t think things will be too different in a post-COVID-19 world, though she did cancel the non-traditional, all-gender “baby-cue” shower she’d planned, partly due to concerns over people’s comfort level with large gatherings. She ended up holding her shower “by mail.” “I think of everyone traditionally celebrating together during pregnancy in general; my family has been quarantining themselves,” she said. “I haven’t seen my sisters as much as I normally would, they are missing out on the experience with me.”

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

Williamsville 755 Wehrle Drive

Let’s Get Moving WNY By Catherine Miller

ooking for a workout class without being inside a class? Need new scenery for your next open-air excursion? Summertime is here and what better time to get outdoors and enjoy sunshine and fresh air after being cooped up for most of the spring. Many health and fitness organizations have moved their workouts to virtual classes in the open air. Both Independent Health and BlueCross BlueShield of WNY have workouts available on their websites that you can take virtually anywhere. This allows you to bring your laptop or tablet anywhere you have a hotspot or internet access and enjoy fitness classes at the beach, in the park with a few friends or in the comfort of your own backyard. Look forward to joining BCBS of WNY on the Buffalo Waterfront website. Click the link for “Fitness Happens Virtually Anywhere.” The most noted coaches in our area are available free online to lead you on daily virtual classes, including Zumba, Bridge to Fitness, Boxstar Training, and a variety of yoga classes. With a beautiful Buffalo waterfront backdrop, the new episodes are added throughout the week to keep things fresh. Independent Health’s “Fitness in the Parks” workouts offer virtual classes in kickboxing, fusion, yoga, cardio kick and boot camp. YMCA certified instructors will run their workouts on the YMCA Buffalo Niagara Facebook page. No registration is needed. Just check out the schedule on the Independent Health website (www.independenthealth.com)and show up the YMCA Facebook site for a fabulous fitness session. Add your

favorite classes to your phone’s calendar so you don’t miss a beat. Once you’ve participated in a few classes you may just want to develop your own workout with a yoga mat and a few pieces of equipment available online. If you are keeping socially distant and want a complete change of scenery while staying cool this summer, what better way than to kayak down the Buffalo riverbend? If you have your own kayak you will find plenty of kayak launch sites along the Buffalo River. If you are seeking to rent a kayak, Elevator Alley Kayak is open for the season. Kayaks can be rented from 9 a.m. to 4 p.m. every day and all they ask if for a bit of patience as they thoroughly clean the equipment between uses. Schedule your rental session online and your kayak will be waiting for you at the Mutual Riverfront Park at the base of Hamburg Street. You can also stop into their store in the Old Barrel Factory building to rent, pick up your gear and get some basic tips on kayaking. Masks will be required inside their shop. “Most people think that kayaking is a good arm workout but it’s actually a great core workout,” said Cas Regan, manager of Elevator Alley Kayak, “This is a great place for beginners to start out as we have videos in our store that people can watch prior to taking out the kayak. The videos instruct on proper arm technique and safety information.”

Dozens of little-known trails For the walkers and joggers in the group who are seeking a bit more variety in your outdoor workouts,

Summer Fun For Kids Creative ideas to keep the kids busy this summer. By Nancy Cardillo

t’s the time of year many parents dread: summer vacation. Oh, it’s not that they don’t love their kids, it’s just the exhausting annual worry of how to keep the little darlings busy during the 10 weeks they’re off from school. This summer presents even more of a challenge, as most kids have already been home since mid-March due to the pandemic. What’s more, even though summer day camps in New York state have been cleared to open, many parents are keeping their kids away, either due to health concerns or the inability to pay due to job loss. So, what’s a parent to do during those long days of summer, when many normal outlets — such as playgrounds, stores, pools, parks and play dates – aren’t available? The answer is “get creative.” You’ve already been racking your brain for months trying come

up with creative ideas that help avoid the “I’m bored!” whine, you say? Here are some ideas you might not have thought of (most of which can be adjusted for any age): • Trace your family history: this is the perfect excuse to make sure the kids stay connected with grandparents, aunts, uncles and other relatives. It’s also a great way for kids to learn about their heritage. Create a family tree and have them call or Skype or Zoom relatives who can help fill in the “branches.” See how far back you can go. • Learn about flora: start with your property: download one of the plant and flower apps — such as PlantSnap, Like That Garden or FlowerChecker — and have the kids walk around your entire property photographing and identifying each tree, shrub and perennial (heck, even let them ID common weeds)! Take it a step further and have them

People kayak on the Buffalo River. If you have your own kayak you will find plenty of kayak launch sites along the Buffalo River. If not, you can rent one very easily. Western New York is a great place to get out and get moving. With dozens of little-known trails and day trip get-away options, why not change up your next outdoor activity? Seeking to stay close to home but get your steps in? Ellicott Creek Park offers over 150 acres of land to stretch your legs. Winding through Ellicott Creek the paths offer bird watching and peaceful surroundings. Not far off is Glen Falls Park which offers a scenic waterfall setting with waterfowl and floral peppered trails. The Burchfield Nature Center in West Seneca boasts a wide array of trees you can seek to identify while on your walk and its website offers a trail guide as well as a tree identification brochure. If a water view is what you are seeking, head down Fuhrmann Boulevard and stop — well — anywhere. From Gallagher Beach to Wilkenson Pointe you will find pathways with great views to walk, jog or bike. If you are seeking a travel a bit farther from home consider the beautiful trails at Alleghany State Park, Letchworth State Park or Watkins Glen Park. From cascading waterfalls to thunderous rocks, you

can trek along the most beautiful natural settings this state has to offer. Check out www.alltrails.com/trail/ us/new-york and follow links to the trails near you.

research each plant referent to care, pruning, etc. and help with the maintenance. • Enjoy some homegrown goodness: it’s not too late to plant an herb garden. Have your kids pick a few herbs, and then research some recipes to use what you’ve grown. (Hint: herb infused oils and vinegars make great gifts). Or go to a local spot to pick whatever fruit is in season (practicing social distancing, of course) and make jam, muffins, smoothies, etc. • Make holiday cards: this is the perfect year to get a head start on holiday cards. Have each child draw a holiday or family-themed picture (or take a family photo), come up with an inscription for the inside and then upload all the versions to Shutterfly, TinyPrints or FedEx. When your printed cards arrive, start addressing them, taking the time to write a personal note inside each one. Your friends and family members will love the originality. • Get out and move: set up an agility course for your kids in the backyard. There are plenty of ideas online to get you started, and it can be adapted to any age range. • Be charitable: go through all the toys, games, books and sporting equipment and have each child set aside items to be donated to a charitable organization. Or, research online organizations

that accept fleece blankets, chemo hats, socks, etc. and teach the kids to sew, knit or crochet. • Take a virtual field trip: many zoos, museums, aquariums, planetariums and parks offer online tours and activities your kids can experience from the comfort and safety of your own home. • Get in the car: pick several local places of interest, research them and then go visit them. Drive around and write down the names of 10 downtown streets and come home and research how they got their names. Create bingo cards with local landmarks, etc., get in the car and play car bingo as you drive around. • Let them help: remember to assign each child age-appropriate chores. This teaches responsibility, builds confidence and makes the kids feel like they are contributing. Remember, too, that it’s OK to be bored. In fact, it’s essential, as it teaches kids to be creative and learn to entertain themselves. It’s also necessary for kids to not be overscheduled, to have downtime. There’s no pressure to fill up every minute of their schedules every day. So, mom and dad, take a couple of deep yoga breaths and make the most of this unusual summer with your kids. You got this!

July 2020 •

A biker on Fuhrmann Boulevard in Buffalo. The area has great options for outdoor activities.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Dreams Dashed

Finding your ‘happily ever after’ on your own

met Susan several years ago, when she attended one of my Alone and Content workshops. Below, she plaintively recalls the raw feelings she experienced following her divorce:

“I opted to end my unhappy marriage and initiate a divorce about three years ago. Since then, I’ve been on my own. It wasn’t easy back then. I was surprised to discover that many married friends no longer wanted to socialize with me, fearing I might be a threat and attract the interest of their husbands. Plus, I made my daughter the singular focus in my life, and lost contact with people. Over time, I developed the attitude that I had nothing to offer and slid into a minor depression. Finances were another issue. I had stayed home to take care of my daughter but, after my split, found it necessary to get a job to make ends meet.” Susan, like many divorced women and men, found herself bewildered and fearful of the future after her marriage ended. For many, the experience of having a marriage of many years unravel is not unlike becoming the victim of an unwelcome catastrophe.

No matter what, and even though more people are waiting longer to walk down the aisle, most still hold onto the dream of “happily ever after.” That dream is powerful. Letting go of it can seem next to impossible. I know it was for me. While getting and being divorced can feel overwhelming, most everyone presses on and, lo and behold, eventually experiences a change in attitude and perspective that ultimately enriches their lives and opens up possibilities — possibilities they couldn’t have imagined when they were in the throes of loss. Susan continued: “It’s taken me a long time to get it together. I went back to college and graduated with an advanced degree in nursing. It kept me busy, but now my daughter is preparing to leave for college. Life will be very different (and a lot quieter) without her here, so I am being proactive. I’m walking with friends (six feet apart) and I’m an active member of Meetup.com (now virtual), the social networking program that gives members safe ways to find and connect with others who share common interests — things such as hiking, reading, food, pets, pho-

tography, hobbies, etc. I also make a point of staying in touch with my colleagues at work, through email and Zoom meetings. And, I’m no longer waiting for an invitation; I’m initiating the contacts, which people appreciate. It feels good! Attending Gwenn’s workshop was the jump-start I needed to get moving. Listening to others made me realize that we were all struggling with similar issues. I no longer felt so alone and benefited from hearing how others have dealt with their challenges. When the workshop was over, I made several small, but meaningful changes at home. I now create a nice place-setting for dinner and put fresh flowers on my kitchen counter to welcome myself home. I cleaned up the clutter on my desk and am practicing meditation most mornings (it’s a work in progress). I am also planning a solo travel adventure abroad, when it’s safe to lift off. That’s a huge leap for me!” While few women and men consciously decide to live singly, more and more are finding themselves on their own in midlife. The good news? Like Susan, they are making healthy choices and finding joy on their own. While she acknowledges that there are trade-offs to being single, she has created a life that meets her needs and supports her new dreams:

Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women, and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com

“It seems to be part of a child’s disposition.” Nor do the findings mean that parents cannot do anything about picky eating, she stressed. The study merely followed families to see what happened naturally — and did not test any intervention to change kids’ habits. What does seem clear is that mealtime ultimatums do not help. In this study, mothers of picky eaters reported more efforts to control what their child consumed — including limits on sugary, fatty foods. (When kids are high on the finicky scale, Pesch noted, they often stick to those types of foods.) Despite those battles, children’s fussiness held strong. In fact, coercion is probably

destined to fail, according to Nancy Zucker, director of the Duke Center for Eating Disorders at Duke University in Durham, N.C. Zucker, who wrote an editorial published with the study, pointed to one of its key findings. Based on mothers’ responses to a standard questionnaire, the pickiest eaters also tended to be emotionally reactive in general. And those kids will not respond well to dinner-table demands — “It won’t work,” Zucker said. “These children will just shut down.” She agreed that the findings suggest picky eating is a trait. “These kids may be more harm-avoidant,” Zucker said. “And when you think about it, eating is breaking a barrier — allowing something into your body. These children hold back when everyone else is running to the food.” So what can parents do? Zucker said that making meals a pleasant experience may at least brighten children’s moods around food. And that could, at some point, ease their boundaries. Including kids in shopping and meal preparation, Zucker said, is one way to make it more enjoyable for them. Pesch agreed, adding that simple exposure may help, too. That is, keep making varied meals for the family so that the picky eater gets used to the sights and smells. “But keep it low-pressure,” Pesch said. “Don’t try to force them to ‘clean their plates.’ “

For Many Kids, Picky Eating Isn’t Just a Phase, Study Finds

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limited culinary repertoire. Still, researchers saw bright spots in the findings, published May 26 in the journal Pediatrics. For one, there were no signs that picky eaters were underweight. And the fact that the fussiness seems to be a trait — and not a failure on the parents’ part — might bring some solace. “It can be very stressful for parents to deal with a picky eater,” noted senior researcher Megan Pesch, a pediatrician at the University of Michigan’s C.S. Mott Children’s Hospital in Ann Arbor. But if parents think they did something wrong to cause it, she added, these findings suggest otherwise. “It’s not your fault,” Pesch said.

On her own, Susan has fashioned a life that works well for her. You can, too. Being single can give you the time you need (and deserve!) to sustain a diverse and interesting network of friends, to go new places, to pursue your professional or personal aspirations, and to experience adventures yet to be imagined. My advice? Don’t close yourself off from people. It’s easy to stay home (especially these days), to dig a hole and furnish it — but that’s a big mistake. Be curious, Be courageous. Research things to do and show up. Go ... even if it means going alone. Who knows what you might discover on the corner of happy and delight?!

“After my divorce, I had this dreaded thought that I would be alone for the rest of my life. I identified with Whistler’s Mother, in her dowdy dress and dour expression. I now realize that just because I choose to live alone does not mean that I am alone: Fact is, I’m surrounded by family and friends who love me.

s d i K Corner

or parents hoping their “picky” eater will grow out of it, a new study may be unwelcome news. Researchers found that choosy 4-year-olds were still turning their noses up at many foods at age 9 — suggesting their finicky eating is more of a trait than a phase. The study, which followed over 300 children, found three patterns: The majority were consistently middle-of-the-road when it came to food fussiness — sometimes shunning unfamiliar cuisine, but remaining relatively open to trying new foods. A sizable minority (29%) consistently ate everything their parents offered up. Then there was the picky 14%. From age 4 to 9, they routinely refused new foods and maintained a

I am no longer frantically, desperately seeking a new relationship or the next big thing to ignite excitement in my life. I am content to spend time either at home alone or socializing safely with small groups of dear friends. I’ve even gone on a few ‘virtual’ dates. As I’ve come into my own, I now know that I am fully responsible for making positive changes in my life. That realization is empowering. I’m engaged with others and am having fun and feeling like my old self again for the first time in a very long time.”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

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Matthew G. Smith, executive director, Preventionfocus, Inc. ‘Schools and community-based organizations could get overwhelmed with mental health needs in the coming months’ By Michael J. Billoni

atthew G. Smith is executive director of Preventionfocus, Inc., which has been offering programs and strategies to prevent drug abuse and promote health in Erie County since 1979. Its mission is “making safe and healthy happen by empowering individuals to make positive choices.” Presently, Preventfocus has 12 associates and a budget of $800,000 with most of its funding from the New York State Office of Addiction Services and Supports (OASAS). It also receives support from fundraisers and donations through its website, preventionfocus.org.

there already been one? What about the public demonstrations? Some parents are trying to do their jobs remotely while caring for schoolaged children that need to do online work. All of this stress and worry can be traumatizing and for many, will be felt long after this period of crisis has passed. Schools and community-based organizations could get overwhelmed with mental health needs in the coming months. Most organizations charged with dealing with these issues are government funded and if funds are cuts, they may not have resources to meet demands for their services.”

Q. Where does Preventionfocus operate? A. “Each year, the trained prevention specialists of Preventionfocus serve nearly 5,000 elementary, middle, and high school students in Erie County through multi-session curriculum-based programs. In addition, we offer workshops, trainings, special events, and we support grass roots community coalitions.”

Q. If family members are experiencing drug, alcohol or mental health issues during these times what can they do? A. “Call Crisis Services at 716834-3131 or its addiction hotline at 716-831-7007 where experts will assess the situation and make recommendations. They can also contact Mental Health Advocates at 716-8861242, which is knowledgeable about local services, offers virtual support groups and has a great resource guide on its website. If you notice changes in a loved one’s behavior ask them about it. Help is available, even in this time of COVID-19.”

Q. What are your concerns from issues we are facing today and how are they affecting families? A. “Families are under unprecedented levels of stress. We are still in the midst of an opioid epidemic, COVID-19 has been with us for months and will be for quite some time, and now civil unrest is dominating the headlines. Parents and kids are dealing with fear. Will I get sick? Will there be a job loss or has

Q. What about parents’ behaviors as it relates to their children during this time? A. “Parents need to take care of their own well-being so they can take care of others. Make time to walk, meditate, yoga or whatever coping

strategy you’d like to employ. It’s hard to parent when stress is going unchecked. Also, be aware of the example you are setting. There has been a huge boom in alcohol sales and increases in reports of people drinking during the day. Kids are always watching and what they see parents do will have a great impact on their future choices. I encourage parents to visit TalkItOver.org, a website for parents to help them have important conversations with children about alcohol, drugs, gambling, mental health and other topics, including a new COVID-19 section. It’s organized by topic or age of the child so the conversations can be developmentally appropriate. Since parents and kids have some extra together time, why not check it out and ‘have a talk?’” Q. Describe some of the Prevention-

July 2020 •

focus programs? A. “Too Good for Violence,” “Too Good for Drugs,” “SPORT” and “Life Skills Training” cover empathy, communication, conflict resolution, building relationships, self-esteem, and information on alcohol and other drugs and are all listed on the National Registry of Evidence-based Programs and Practices (NREPP). The programs employ engaging hands-on activities to deliver the facts students need and build important skills like decision-making, setting goals, and solving problems, among many others. We also facilitate several suicide prevention programs for school and community groups and we offer workshops and materials on a variety of other topics.” For more information, visit preventionfocus.org or call 716-884-3256.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Dental Care

Early Orthodontics Can Shorten Treatment By Deborah Jeanne Sergeant

rthodontic braces may seem like a treatment for teens, but the American Association of Orthodontists recommends a screening — and possible treatment — to start by age 7. Instead of waiting for the permanent teeth to come in, orthodontists would rather treat children to prevent or minimize future issues. The molars are the first permanent teeth to come in, around age 6. At that point, orthodontists can tell if they’re likely to cause crowing problems, or if it’s a wait-and-see case. “You can start early to correct things that will get worse once they get older,” said Kevin J. Hanley, orthodontist at Hanley Orthodontics in Buffalo. “We can intercept problems that will cause situations down the road.” An expander, for example, can help widen an upper arch that’s too narrow so that kids’ jaws will grow to the right size. Surgery is the only option once they’re done growing. This intervention offers other benefits, too. “By expanding the upper jaw, you’re expanding the floor of the nose and increasing airway space,” Hanley said. “They breathe easier

through the nose and not through the mouth. When they breathe through the mouth, the jaw drops open and backwards. That increases the lower facial height for the long, narrow face.” Hanley added that an orthodontic screening doesn’t necessarily mean braces are needed. Most providers offer free evaluation screenings. Orthodontist Steven Hietanen at Orthodontists Associates of Western New York said that he has treated between 3,400 and 4,000 children with expanders. Many of his referrals come from dentists. Some parents bring in their children because they see crowding. Others are concerned about other functional issues. “Oral expansion can help with improvement with breathing dysfunction the child has,” Hietanen said as an example. Some children with breathing problems may have their adenoids removed as they may cause obstruction. Hietanen said that a 2019 study by the American Association of Orthodontists states that children who have breathing issues treated only with adenoidectomy experienced a 50% success rate compared with 95%

success for those treated with adenoidectomy along with expansion. “The size and shape of the upper jaw can affect how the lower jaw will develop,” Hietanen said. He referenced a University of Michigan study which suggested that of children treated with an expansion at age 8, more than 90% show spontaneous correction of overbite. “In the untreated control group, there’s a 6% spontaneous improvement,” he said. Some children with speech issues also benefit from orthodontic intervention. It’s all about identifying children who could benefit from early intervention and using the treatment to improve their future growth and

development instead of trying to fix a problem once it’s fully manifested. “If a child was born with hip dysplasia, they’d take that baby prior learning to walk and put him in a brace to straighten the hip out,” Hietanen said. “They wouldn’t wait until he was walking. Why would we do any different in dentistry?” Since their bones aren’t as mature at 8 as 14, the force exerted by the appliances isn’t as great. Some orthodontists use removable appliances for early treatment; others, including Hietanen, prefer fixed appliances to better ensure compliance. He said that younger children are often more eager to please their parents and take better care of their appliances.

Should You Worry If Baby Teeth Get Cavities? By Deborah Jeanne Sergeant

t may seem of little consequence if baby teeth get cavities since they’re just going to fall out to make room for permanent teeth. But orthodontists place a good deal of value on keeping a child’s original teeth healthy. “You want to keep as many baby teeth as you can until they fall out naturally,” said Kevin J. Hanley, orthodontist at Hanley Orthodontics in Buffalo. “They’re placeholders for the adult teeth that come in later. If you lose the baby molar teeth — the six-year molar, which is the first permanent tooth — that can come in forward and block the eruption of the tooth in front of it.” Keeping that space is so important that when a baby tooth must be extracted early, it’s advisable to place a space maintainer in the mouth to hold that molar where it belongs. Orthodontist Steven Hietanen with Orthodontists Associates of Western New York said that baby teeth also help in developing the arches to the proper size. Baby teeth lost too early can mean the tongue is in a different, unnatural position. “Space loss can occur and subsequent crowding will raise the risk for extractions for the future in orthoPage 12

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dontics,” he said. As many as 10% of the population is missing permanent teeth, meaning that an expected permanent tooth didn’t form in the jaw so it never comes in. “Sometimes, when permanent teeth are missing, we elect to save baby teeth as their replacement,” Hietanen said. “If no one has taken X-rays to ensure they have all their permanent teeth and makes the assumption the baby tooth will just fall out and you find out there’s no tooth under there, it’s a miscalculation.” Sometimes, Hietanen said he has a new patient as old as 14 who then learns teeth are missing. Proper oral hygiene can help children keep their baby teeth for as long as they’re needed. Leaving it up to the children is likely not the best strategy. New encourages parents to monitor brushing with fluoride toothpaste—at least twice daily—for two minutes each session. Daily flossing is also important, as it removes plaque before it has the chance to harden onto the teeth. The child’s dentist can provide help in teaching proper technique. As recommended, a fluoride dental rinse can help improve oral

health, especially for children who live in cities that don’t add fluoride to the drinking water. Children can be seen by their dentist as early as the first tooth to get acquainted, become accustomed to dental examinations and develop a relationship of trust. Parents should also set a good example of keeping up with their own home care and scheduled dental visits, as well as carefully monitor their children’s hygiene. “If you teach a child to brush

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

well when they’re young, they’ll hopefully keep that habit through life so they don’t get cavities and periodontal disease later in life,” Hanley said. “You don’t see it a lot in young kids, but if you teach the proper technique, they’ll likely continue. It will save them a lot of problems later on from cavities.” Dental cleanings and exams twice a year or more often if recommended can help prevent problems.

Numbers to Follow for Good Health

o maintain good health, it’s all in the numbers that measure key indicators of health. These include blood pressure, cholesterol, minutes of activity per week, sleep, weight, blood glucose (if diabetic) and waist size. “Different people have different numbers as far as their goals are concerned,” said Joshua Usen, doctor of osteopathic medicine at Primary Care of Western New York in Williamsville. “These are things a person needs to talk individually with their physician to see if they’re at their own goal.” These numbers are important to lower risk of disease and mitigate the effects of any existing health conditions. By Deborah Jeanne Sergeant

er,” said physician Michael Dlugosz, with High Gate Medical Group in Williamsville. “It doesn’t have symptoms until it causes a heart attack or stroke. You want to prevent it when you’re not symptomatic.” That’s why periodically checking it is so important.

Weight

Most health care providers use the body mass index (BMI) to determine a patient’s ideal, healthy weight; however, the body composition can make a difference. Some people may carry a little extra weight, but is exercising and eating an overall healthful diet. “BMI is a general marker of a healthy weight,” Usen said. “There’s the ‘healthy heavy,’” he said. People like this don’t readily fit into the BMI numbers. A very muscular body builder may have a higher BMI than a lighter but less fit person. That’s why Usen said it’s a general guideline. In general, a BMI between 20 to 25 is ideal. For most people, less than 20 is underweight. Between 25 and 30 is overweight, over 30 is obese and over 40 is morbidly obese. BMI calculators are available online a sites such as www.nhlbi.nih.gov/health/ educational/lose_wt/BMI/bmicalc. htm.

Cholesterol and triglycerides

The LDL (“bad”) cholesterol should be under 160 and HDL (“good” cholesterol) over 40 and triglycerides under 150 for generally healthy people Dlugosz starts checking cholesterol for men at age 35 and women at 45 because men have more cardiovascular risk. But he cautioned that anyone with risk factors should start at about 20 years old if they’re overweight, smoke or have hypertension. “There’s been a dynamic shift following the numbers,” Dlugosz said. “Those are screening tests, not a perfect look into your body chemistry. It’s as good as we can get but still not great. If there’s a history of stroke or heart attack, we don’t focus on the numbers, but if you’re adequately treated with a cholesterol medication.” Once a diabetic patient turns 40, Dlugosz automatically prescribes a cholesterol medication because their heavier, stickier cholesterol more readily adheres to the walls of blood vessels. Even if their choles-

terol is under control, that risk factor of stickiness is enough to validate mediation. Tahir said that high cholesterol can indicate inflammation in the body, which has been linked to multiple conditions, such as autoimmune disorders, cancers, heart disease and dementias.

Minutes of exercise per week

To maintain weight, a person needs 150 minutes of moderate exercise weekly or 75 minutes of vigorous exercise. “When you’re talking about what’s moderate, I look at heart rates,” Dlugosz said. To find the target heart rate, subtract your age from 220. Moderate intensity exercise should be between 64% and 76% of the target heart rate. Vigorous exercise should be between 77% and 93% of the target heart rate, according to the Centers for Disease Control and Prevention. “That’s when you’re maximally active,” Dlugosz said. “Everyone’s will be a little different based on age and physical fitness.”

July 2020 •

A1C Blood sugar test

Diabetics should have their A1C blood test reading under 7 “to help prevent eye and kidney problems and neuropathy,” Dlugosz said. Pre-diabetes is identified between 5.5 and 6.6. In general, the A1C is administered annually for those who have prediabetes; biennially for those with Type 2 diabetes who don’t use insulin and have their blood sugar level within their target range; and quarterly for Type 1 or Type 2 diabetics. “People can check it at home and not just diabetics,” Tahir said. “People who are not diabetic should check it once in a while.”

Blood Pressure

Blood pressure is one of the vital signs because it’s associated with stroke and heart attack. Blood pressure should be less than 120/80. “Blood pressure is the silent kill-

of nightly sleep are recommended, and more for children. “It helps emotionally and physically,” Dlugosz said. “The more sleep deprived you are, the more in a state of stress you are.”

Hours of sleep Most experts agree that between seven to nine hours

Waist circumference.

More than just for vanity, waist circumference can indicate weight gain that has been linked with cardiovascular disease. “If I see a person that has central obesity in the belly, that’s when I focus more on circumference and changes in inches,” Dlugosz said.

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Women’s Health

Emotional Abuse: Women Are Often the Target By Deborah Jeanne Sergeant

ne in four women and one in seven men will be victims of at least one incident of severe physical violence by an intimate partner — not a stranger — in their lifetime, according to the Centers for Disease Control and Prevention. Many people do not realize that emotional abuse often precedes physical abuse. Emotional abuse is far different than a spat between partners. Emotional abuse is a repeated pattern of coercion and control using manipulation. Every person occasionally acts snappish or hurtful. Emotional abuse is when a partner gains dominance through consistent use of intimidation, bullying, cruelty, name-calling and humiliating. Gaslighting is yet another tactic. With gaslighting, the abuser contradicts the victim’s memory of the past to cause the victim to doubt the memory of past comments or events for the purpose of undermining confidence and others’ trust. (“You’re forgetful — as always.” or “That’s crazy; it’s not what happened at all.” Or “You must have misheard me; that’s not what I said.”) Using gaslighting helps the abuser “rewrite” the past to gain the upper hand by downplaying their offenses, appearing as victims and presenting the true victim as a wrongdoer. “We’re talking about power and balance,” said Ellen Brauza, executive director Western New York Anti-Violence Project in Buffalo. “It’s not about housekeeping, money or sex or anything used as an excuse. It’s about one partner, usually in order to shore up their own ego, taking power over the other.” Brauza said that instead of a relationship of equals, an emotionally abusive relationship is about control. Brauza said that emotional abuse is usually a precursor to physical abuse. “It’s damaging enough as it is, as it makes people less sure of themselves, less autonomous and able to live their own lives,” she said. Of course, few would willingly enter such a relationship. But the power and control comes by small degrees. Brauza said that it’s usually under the guise of love and helpfulness, but these steps are really about disempowering the other and isolating the victim from others that would help. Mary Murphy, CEO at Family Page 14

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Justice Center in Buffalo, said that abusers gain control initially through emotional abuse and as they discover that’s not working as well, they often resort to physical violence. Forty survivors sit on the organization’s board. “They tell us when they were in the midst of classic domestic violence, they never would’ve identified themselves as a victim of domestic violence,” Murphy said. Oftentimes, the abuser is an active substance addict or has a personality disorder such as psychopath, pathological narcissist, or borderline personality disorder. It’s ineffective to compare interactions with an abuser like this with interactions within a normal relationship. Either partner in a romantic relationship can be victimized — even in couples not living together. Size and emotional needs generally make women easier targets for abusive men. Initially, victims are treated very well. In fact, abusers sweep them off their feet in a whirlwind romance. It’s like a storybook. Victims feel so lucky and dazzled by how attentive and thoughtful the abusers are, lavishing with expensive gifts and flattery. It feels like the love of a lifetime. Abusers slowly begins to exert more and more control over victims and usually under the guise of “protecting” or “helping.” Abusers isolates victims from friends and relatives that would spot any problems or support victims’ considerations of leaving. Abusers

do this by eroding the victims’ trust in others and even accusing them of wrongdoing to drive a wedge in any other relationships. If the emotional abuse begins to lose effectiveness in controlling the victim, that’s when physical violence usually begins. “By the time it goes physical, they’re so broken down psychologically, and sexually, and verbally, and via social media,” Murphy said. “They just remember the fear and the overwhelming emotions that can trump fear: shame and embarrassment. ‘What did I do to make this person who called me soulmate to do this? Finally, someone in the world ‘got’ him and that was me?” She added that many victims feel as if it’s their life work to rescue the abuser, as if they are uniquely qualified to be the only one who really understands. At this point, victims are in the most danger. They need to build a network of people to help. That may include repairing relationships that the abuser has damaged and seeking help with a trained counselor. Well-meaning friends who want to “patch things up” between them likely will make things worse. Abusers are very likely to retaliate against victims in this situation in private and since they cannot see anything they’ve done wrong, they will blame victims “causing problems” in the relationship. Hoping the abuser will change, staying for the children’s sake or thinking that couple’s therapy will

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

help are all reasons victims stay. But abuse is not a marriage problem; it’s one-sided. Anger management classes won’t help, either since anger doesn’t cause the problem. Goodtherapy.com states, “Research shows that men who are abusive often lash out at their partners or spouses with the intent of enforcing what they believe to be their rights, but that they are generally able to keep from reacting in an abusive manner when individuals other than their wives or children do not meet their expectations. This behavior is rooted in logic, demonstrating rationalization that makes it less likely that battering behavior stems from a mental illness, although it may in some cases.” Most of the time, leaving the relationship is the only option when abusers have a personality disorder. Among those who are chemical dependent, only those who are willing to complete rehabilitation have hope of stopping battering. Leaving is usually the only safe choice long-term, yet it’s also fraught with peril in the process. “It’s complex, dangerous business trying to get out,” Murphy said. “That’s why you need a domestic violence advocate. You didn’t cause it and it’s not your fault. We never tell our clients what to do and share with them the resources one piece at a time and it’s highly effective.”

Women’s Health

Charcoal Masks Cleanse, Tighten Skin By Deborah Jeanne Sergeant

ctivated charcoal masks have become a popular facial treatment, available at many spas in the area. “Professional end charcoal masks can be very effective in drawing out toxins and purifying,” said Janine Testa, owner of Holistic Skin Care by Janine in Williamsville. “Just as you have charcoal in a water filter, this attracts charcoal and draws out impurities.” Those applying charcoal masks place a warm towel to the face to open pores. Next, they apply the

Janine Testa, owner of Holistic Skin Care by Janine in Williamsville, applying a charcoal mask on a client’s face. “It’s good for people who have clogged pores, blackheads and oily skin. It’s good for acne. But they can be drying.”

charcoal mask to the skin with either clean fingertips or a brush, keeping care to avoid the eyes, eyebrows, mouth, hairline and inside the nose. The masks can pull hair during the process of mask removal. Once they’re done applying the mask, they allow it to dry for 10 to 15 minutes before removing it. Depending upon the type of mask used, they may peel it off and clean off any leftover bits with a wet washcloth or clean it off entirely with a wet washcloth. A charcoal mask may also be used in problem areas that are prone to excess oil. “There’s lots of good charcoal masks on the market,” Testa said. “It’s good for people who have clogged pores, blackheads and oily skin. It’s good for acne. But they can be drying.” For this reason, charcoal masks are not recommended for dry skin. Oddly, many people aren’t accurate in understanding their skin’s issues. This is why seeking help from a skin care professional can help determine what’s going on and what products can help keep the skin clear without blemishes or flaking. Testa said that the charcoal masks available at stores tend to have more of a glue-like consistency, which can make them peel right off. Especially if they are over used, they can cause irritation. Karissa Karwick, esthetician at Excuria Salon and Spa in Williamsville, said that charcoal masks can

also be used before a different mask, such as one that promotes anti-aging, since the charcoal masks open up pores. “The other products are able to penetrate down deeper into the skin,” Karwick said. She recommended using a charcoal mask about once every couple of weeks for a deep cleaning; however, those with skin conditions such as sensitivity, atopic dermatitis, eczema or broken skin should ask a doctor before using a charcoal mask. People with oily areas such as the “T-zone” of the forehead, nose and chin, sometimes use a charcoal mask in only that area and a moisturizing mask on drier areas of the cheeks. In addition to charcoal masks that are smoothed onto the face, there’s also the fold-out style mask. Karwick said that they’re challenging because of the application and also because some of the ingredients in it can be harsher on the skin. She prefers the washable kind. “They’re easy to remove,” Karwick said. “We remove with a warm washcloth and circular motions. You can add more water if you need to. We’re not scrubbing a kitchen floor. “They really are great masks. The charcoal acts like a magnet drawing out impurities in the skin. It can really make a difference.”

Serving Western New York A monthly newspaper published by Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region In Good Health is published 12 times a year by Local News, Inc. © 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, Ernst Lamothe Jr., Jana Eisenberg Advertising: Anne Westcott, Amy Gagliano, Nancy Cardillo, Catherine Miller 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.

July 2020 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 15

SmartBites

The skinny on healthy eating

Little Raspberries Score Big on This!

hen it comes to a food’s nutritive profile, unexpected discoveries (good or bad) intrigue me. Pale cauliflower high in vitamin C? Who knew? Fibrous celery low in fiber? Didn’t see that one. Rich avocados full of healthy fats? More toast, please! So you can only imagine my delight when I discovered that raspberries — sweet, little raspberries — rock with more fiber than any other fruit: 8 big grams per cup. Since we need between 25 to 30 grams of fiber a day, that’s about a third of our daily needs.

A vital nutrient, fiber promotes regularity, lowers cholesterol levels, helps control blood sugar levels, and may even help us live longer by reducing the risk of dying from cardiovascular disease and many cancers. Another discovery? Luscious raspberries are surprisingly low in sugar: only 5 grams per cup (about a teaspoon of sugar). As a comparison, one medium apple has about 20 grams. Equally low in carbs, raspberries are an excellent choice for anyone who wants to minimize their overall sugar and carb intake. Raspberries, like most berries, are

Helpful tips

By Anne Palumbo full of antioxidants — health-protective compounds that have been tied to lower rates of heart disease, cancer, diabetes, obesity and other chronic diseases. These same antioxidants also help toreduce inflammation, a known trigger of premature aging. On top of everything, a particular type of antioxidant found only in red berries is so strongly associated with brain health and delayed cognitive decline that weekly consumption of berries is highly recommended by many leading health organizations. On the vitamin front, raspberries dish up a healthy dose of vitamin C: about 50% of our daily needs in just one serving. Essential for the growth and repair of tissue body-wide, vitamin C helps to increase the production of infection-fighting white blood cells, which is why many of us turn to vitamin C during cold and flu season and are seeking it now. Those looking to lose or maintain weight will appreciate raspberries’ nutrition stats: only 64 calories per cup and no fat, cholesterol or sodium. What’s more, raspberries’ slow-digesting fiber helps us feel fuller longer, making us less inclined to reach for those tempting chips.

Spinach, Goat Cheese and Raspberry Salad Adapted from Cooking Light Serves 2-4

2 tablespoons extra-virgin olive oil 5 teaspoons balsamic vinegar ½ teaspoon honey ¼ teaspoon Kosher salt (or more) ¼ teaspoon coarse black pepper

Fresh raspberries are highly perishable; use as soon as possible after purchasing or picking to ensure the best flavor and appearance. Choose berries that are ripe, plump and firm. Wash gently and pat dry right before eating or cooking. If not using right away, refrigerate unwashed raspberries in a shallow, covered container on a paper towel for up to 3 days. Be sure to toss any spoiled or moldy berries so they will not contaminate the others. 1 clove garlic, minced ¼ cup chopped red onion (optional) 1 (5-ounce) bag baby spinach (or more) 1 cup raspberries ½ cup chopped walnuts, toasted ¼ cup (or more) crumbled goat cheese or feta Combine first 6 ingredients in a small bowl; blend with a whisk. Combine onion, spinach, berries and walnuts in a large bowl. Drizzle dressing over the salad; toss gently. Top with crumbled cheese and serve.

Anne Palumbo is a lifestyle

columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorieconscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

ECMC Opens State-of-theArt Keybank Trauma And Emergency Department $55 million facility replaces existing department opened in 1978

rie County Medical Center (ECMC) Corporation on May 30 celebrated the opening of the institution’s new $55 million KeyBank Trauma and Emergency Department, which will double the size of the existing 40-year old facility and feature state-of-the-art technology and equipment for the region’s only Level I adult trauma center. Originally opened in 1978 to accommodate 35,000-40,000 patients annually, ECMC’s trauma and emergency department now sees nearly 70,000 patients a year, with patient volumes expected to reach over 75,000 annually by 2024. The project has raised nearly $15 million from private philanthropy and received a $10 million award from New York state earlier this year. With several other commitments in progress, the capital campaign is expected to conclude later this year. ECMC Corporation Board Chairman Jonathan A. Dandes said, Page 16

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“Thanks to the vision and dedication of our remarkable emergency department clinicians, the strong leadership of ECMC’s executive leadership and the incredibly generous support of private philanthropic organizations and individuals, we have achieved the completion — on time and on budget — of the most state-of-the-art trauma and emergency department in our region, our state and beyond.” Dandes went on to recognize the project’s donors: “As chair of the project’s capital campaign, I want to express our deep appreciation to all of our generous donors, particularly KeyBank for their $2.5 million donation to our campaign.” Gary Quenneville, KeyBank regional sales executive and Buffalo market president, said, “The KeyBank Trauma and Emergency Department will set a new standard for patient care at Erie County Medical Center and further add to the growth happening in the Delavan-Grider neighborhood. We are excited to

Ribbon cutting event to mark the opening of ECMC’s the new KeyBank Trauma and Emergency Department facility. From left are Karen Konikoff, vice president, critical care and emergency services, ECMCC; Thomas J. Quatroche Jr., president and CEO, ECMCC; Donna Oddo, nursing care coordinator, emergency department, ECMCC; Elizabeth S. Gurney, director, corporate philanthropy, KeyBank; physician Michael A. Manka Jr., chief of emergency medicine, ECMCC; Jonathan A. Dandes, chairman, board of directors, ECMCC; and Tiffany Wilson, emergency department, ECMCC. see this project completed at such a critical time and applaud the team at ECMC for all they are doing to help our region recover from the COVID-19 crisis.” The new facility, designed by CannonDesign and built by The Pike Company, nearly doubles facility square footage to 54,000 sq. ft. and will increase treatment space from 36 to 57 stations including four dedi-

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

cated trauma rooms, two behavioral health safe rooms, two isolation rooms, and four medical resuscitation rooms. It features intradepartmental imaging consisting of two CT rooms and two X-ray rooms, direct access from the hospital’s rooftop helipad, and a care initiation zone to support an enhanced triage model of care.

Community Action Organization of WNY

Has Immediate Openings for the following positions Come grow with us! By Jim Miller

How to Make the Most of Your Telehealth Appointment Dear Savvy Senior, I manage a large doctor’s clinic that treats hundreds of seniors each month. We are moving to more telehealth visits to help keep our patients safe at home during the coronavirus pandemic, but this new way of seeing a doctor is befuddling to many of our elder patients. Can you write a column educating patients on how to prepare for a telehealth appointment? Regular Reader

Dear Reader, I’d be happy to help! To help keep patients safe and at home during the coronavirus crisis more and more doctors and other health care providers are turning to telehealth (a.k.a. telemedicine) appointments, which are remote e-visits using a digital communication device like a smartphone, tablet or computer. Although telehealth has been around for a few years now, recent updates to regulations and a surge in demand has made it the easiest way to get many different types of medical care. Most telehealth appointments today tend to be primary care or follow-up visits that can assess symptoms or check on people who have had a medical procedure. Telehealth also works well for some specialties like dermatology or mental health care (counseling/therapy) services.

What to Expect The first step is to call your doctor’s office to find out whether telemedicine visits are available and whether you will need to set up an account or install special software on your computer, phone or tablet. Until recently, doctors were required to conduct telehealth visits through platforms such as Doxy, Thera-Link or MyChart that were compliant with the Health Insurance Portability and Accountability Act — or HIPAA. But some of those requirements have been relaxed in the current crisis, so many providers are using popular apps such as FaceTime, Skype and Zoom to conduct visits. Once you know what technology

you will be using, get familiar with it. You don’t want to spend the first 10 minutes of your visit trying to figure out how to unmute the audio. For older patients that aren’t familiar or comfortable with technology, ask a relative or friend with a smartphone, tablet or laptop to assist you. Take the time to clarify the purpose of the televisit before it begins. Prioritize a written list of three or four issues you want to discuss with your doctor and make a list of the medicines you’re taking, along with the dosages. Also, have relevant medical devices or logs on hand, such as a penlight or smartphone flashlight for viewing a sore throat, a blood-pressure cuff and thermometer (or recent readings), blood-sugar logs if you’re diabetic or a food log if you have gastrointestinal problems. If you’ve received medical care at different places, such as an urgent care facility or another doctor’s office, have your latest medical records with you during the telemedicine visit. Wear loose clothing that will allow you to show your medical provider what is concerning you. The length of the appointment may depend on the problem. A routine visit could be very quick, while others, such as a physical-therapy appointment, may last as long as a session at a clinic. Waiting rooms are sometimes replaced by virtual waiting rooms. Before the visit ends, make sure you know the follow-up plan. Do you need to schedule an in-office visit, fill a prescription or get a referral to a specialist? Right now, Medicare and Medicaid are covering the cost of telehealth visits (see medicare.gov/coverage/ telehealth for details), and most private insurers are following suit. If, however, you don’t have a primary care physician or need urgent care, you can get help through virtual health care service like Doctor on Demand (doctorondemand.com) or TeleDoc (teladoc.com). These services currently do not accept original Medicare, but they may be covered by private insurers including some Medicare Advantage plans — be sure you check.

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.

• HR Benefits Specialist • Home Visitor • Substance Abuse • Youth Services Program Counselor Coordinator • Peer Recovery Specialist • Youth Services Counselor • Family Case Worker • Teacher (Certified) • License Practical Nurse • Teacher I/II/III • Family and Community • Nutrition Associate Partnership Coordinator • Maintenance Associate • Family Partner • Substitute Teacher Visit us at www.caowny.org to learn more about the requirements and to complete an online application.

NESTLED IN THE HEART OF WILLIAMSVILLE, STILL WNY’S MOST AFFORDABLE ASSISTED LIVING AND MEMORY CARE • Three home-cooked meals daily and snacks • Beautiful, full-sized Chapel with daily services • Personally tailored Care Services • Stimulating social, educational and recreational activities • Housekeeping and laundry • Beauty/barber salon • Transportation services • Soda Shop open 24 hours a day • Generous common areas

Residents & staff would like to thank all of the families & friends of Park Creek for all of their love & support.

410 Mill St. • Williamsville, NY 14221 • 632-3000 PRICELESS

5 THINGS YOU SHOULD KNOW ABOUT IT

MARCH 2020 • ISSUE 65

BFOHEALTH.COM

SHOULD YOU SKIP BREAKFAST?

Physician Nadia Kousar, infectious disease specialist at Rochester Regional Health, explains the basics of the virus that has killed more than 2,000 so far

DIABETES BREAKTHROUGH

Celebrity TV doctor Mehmet Oz recently said people should skip breakfast. Should you heed his advice? Do we really need the ‘most important’ meal? P. 13

Buffalo endocrinologist Kathleen E. Bethin talks about breakthrough drug that improves the lives of kids with diabetes

Subscribe to

BFOHEALTH.COM

APRIL 2020 • ISSUE 66

CORONAVIRUS Getting on with our lives in this new age Special Issue

Beware of Coronavirus Scams P. 13

Autism: Why Are Incidence Rates So High

2 million lost health coverage or access in Trump’s ﬁrst year

PARKINSON’S

RECORD NUMBER OF PEDESTRIAN DEATHS IN U.S.

Yes, there’s something new in the air in WNY — hatchets

How to detect the disease and what to do when you’re diagnosed

‘Spring Forward’ Brings Surge in Fatal Car Crashes

P. 11

Little Lentils Dish Up Big Beneﬁts P.12

Local experts discuss the dramatic increase in cases of autism in the U.S.

Study estimates 6,590 pedestrian deaths in 2019, an increase of 5% over previous years

Visits to Pediatricians on the Decline

The Amazing Beneﬁts of Olive Oil

P.8

P. 8

Pot Use Among Seniors Nearly Doubled in 3 Years

P. 2

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 17

Ask The Social

Security Office

From the Social Security District Office

Qualifying for Supplemental Security Income With Social Security

W Touch Often Absent for Isolated Seniors By Deborah Jeanne Sergeant

ost people appreciate touch — a heartfelt hug, warm handshake, an arm around the shoulders or a friendly pat on the arm. Touch is the earliest way people communicate as infants and can be the only means of connection for people in the last stages of dementia and those with profound brain trauma. For many older adults who live by themselves, touch is not a part of their lives anymore. Especially in light of the COVID-19 quarantine, touch has been even more limited. But touch is important on many levels. “As people age, a lot of their support system may diminish over time,” said Corey Leidenfrost, Ph.D., research assistant professor in the department of psychiatry at Jacobs School of Medicine and Biomedical Sciences. “Partners and friends pass away. Someone’s social circle may decrease over time. Touch and being close to people is important at all ports of your lifetime.” He further stated that since physical touch is tied to a person’s overall wellbeing and satisfaction with life, “it’s a crucial aspect of making life worth living.” Abundant research has connected physical touch to good health. Shira Gabriel, social psychologist with University at Buffalo, specializes in the human need for social connection. Gabriel cited premature babies in the neonatal intensive care unit. “They grow better and are discharged faster if they’re touched,” she said. “Even having a stranger touch you reduces stress hormones and having it from those you care about helps. Touch makes difficult situations better. Now, it’s difficult since we can’t touch people as much.” In lieu of hugs from grandchildren, she encourages older adults to connect through electronics, although it’s not ideal. Once social isolation ends for older adults, she hopes more children and grandchildren take the Page 18

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time to visit the older adults in their lives. Some older adults who lack family in the area could find a physical connection through spa services once they’re available — they can have a facial, manicure, pedicure, hair styling or massage therapy. Gabriel said that for those who don’t feel sure if massage therapy is right for them, “a chair massage is a great idea if they have the resources.” Massage therapists ask about any pre-existing health conditions and allow clients to wear clothing and drapes that help them feel at ease and comfortable with the temperature. Typically, chair massage clients remain fully clothed. Shawn Marie Cichowski, life and energy coach, certified mindfulness and meditation instructor, and owner of the WNY Life Coaching Center in Williamsville, said that touch is “innate and healing. If we’re in pain, we naturally hold the area. It’s about caring and healing when we touch.” While human interaction may seem the only type of touch that helps, animal connections can also help. Petting soft fur and receiving the reciprocating sniffs and licks does make a difference. Though it’s difficult to say how much animals understand and tune into human emotions, Cichowski said that animal interactions “are very therapeutic and healing. It’s reassuring and comforting. Their love is unconditional.” Cheri Roloson, farm manager at Cracker Box Palace in Alton, welcomes guests who want to visit with the animals and, if possible, volunteer at the farm animal shelter. “People who are into chickens and potbellied pigs will tell you that they’re personable animals,” Roloson said. “I swear by having an animal as a companion.” The farmplaces animals for adoption and also offers a sponsor program that allows volunteers to care for their “Pen Pal” at the farm. But just dropping by the farm when it’s open to pet animals is okay, too.

e pay monthly Supplemental Security Income (SSI) to people with disabilities who have low income and few resources, and people who are age 65 or older without disabilities who meet the financial limits. Income is money you receive, such as wages, Social Security benefits and pensions. Income also includes things like food and shelter. The amount of income you can receive each month and still get SSI depends partly on where you live. Resources are things you own, including real estate, bank accounts, cash, stocks and bonds, which we count in deciding if you qualify for SSI. You may be able to get SSI if your resources are worth $2,000 or less. A couple may be able to get SSI if they have resources worth $3,000 or less. If you own property that you are trying to sell, you may be able to get SSI while trying to sell it.

Q&A

Q: How can I get proof of my benefits to apply for a loan? A: If you need proof you get Social Security benefits, Supplemental Security Income (SSI) and/or Medicare, you can request a benefit verification letter online through your personal “my Social Security” account at www.socialsecurity.gov/ myaccount. This letter is sometimes called a “budget letter,” a “benefits letter,” a “proof of income letter,” or a “proof of award letter.” You even can select the information you want included in your online benefit verification letter. Q: I’ve decided I want to retire. Now what do I do? A: The fastest and easiest way to apply for retirement benefits is to go to www.socialsecurity.gov/retireonline. Use our online application to apply for Social Security retirement or spouses benefits. To do so, you must: • Be at least 61 years and 9 months old; • Want to start your benefits in the next four months; and • Live in the United States or one of its commonwealths or territories. Q: Although I stopped working a few years ago, I had additional seasonal earnings after my retirement. Will my monthly Social Security retirement benefit increase?

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020

We will not count economic impact payments, also known as coronavirus stimulus payments or CARES Act payments, as income for SSI. These payments will also not count as resources for 12 months. You can read more about qualifying for SSI at www.ssa.gov/pubs/EN-0511000.pdf. If you’re an adult with a disability intending to file for both SSI and Social Security Disability Insurance, you can apply online for both benefits at the same time if you: • Are between the ages of 18 and 65; • Have never been married; • Aren’t blind, • Are a U.S. citizen residing in one of the 50 states, District of Columbia, or the Northern Mariana Islands; and • Haven’t applied for or received SSI benefits in the past. We’re here for you. You can find more information at www.ssa.gov/ benefits.

A: Each year, we review the records for all working Social Security recipients to see if additional earnings may increase their monthly benefit amounts. If an increase is due, we calculate a new benefit amount and pay the increase retroactive to January following the year of earnings. You can learn more about how work affects your benefits by reading our publication, “How Work Affects Your Benefits”, at www.socialsecurity.gov/pubs. Q: I am receiving Supplemental Security Income (SSI). Can my children receive dependent’s benefits based on my benefits? A: No. SSI benefits are based on the needs of one individual and are paid only to the qualifying person. Disabled children are potentially eligible for SSI, but there are no spouse’s, dependent children’s, or survivors benefits payable as there are with Social Security benefits. For more information, see our publication, Supplemental Security Income (SSI), available online at www. socialsecurity.gov/pubs. Simply type the title of the publication in the publication search box at the top of the page. You also may want to read Understanding Supplemental Security Income (SSI), available at www.socialsecurity.gov/ssi/text-understanding-ssi.htm. For even more information, visit www.socialsecurity.gov.

H ealth News Roswell Park Names medical director of infusion services Physician Eunice Wang has been selected medical director of infusion services at Roswell Park Comprehensive Cancer Center. Wang will oversee infusion services on the main campus and at Roswell Park’s satellite clinics, focused on a patient-centric Wang approach to care and treatment plans. Wang has served in multiple roles since joining Roswell Park in 2003, including co-chairwoman of the leukemia translational research group and physician leader with the chemotherapy and infusion center. She will continue in her role as chief of keukemia. Most recently, Wang has proved pivotal in disseminating vital information about patient care and safety at Roswell Park during the COVID-19 pandemic, having appeared on a live chat for patients, a webinar for physicians and a 30-minute television special. “Dr. Wang is a fierce and attentive patient advocate, which makes her the ideal person to lead Infusion Services,” says Candace S. Johnson, PhD, president & CEO and M&T Bank Presidential Chair in Leadership at Roswell Park. “Her passion for outstanding care will be a guiding force for this important clinical program.” Wang earned her medical degree from the Keck School of Medicine, University of Southern California, and completed residency training in internal medicine at Yale-New Haven Hospital, Yale University. She completed a clinical hematology-oncology and research fellowship at Memorial Sloan Kettering Cancer Center. Her research focuses on the development of early-stage clinical trials for acute leukemias (AML, ALL) and myeloproliferative disorders.

Sisters Hospital welcomes new cardiologist Cardiologist Emily Battaglia has recently joined Sisters Hospital Cardiology Center and will be part of the team of physician Eram Chaudry and nurse practitioner Michael Robertson. Board-certified in internal medicine, cardiovasBattaglia cular disease and nuclear cardiology, Battaglia specializes in a variety of cardiovascular diseases, including coronary

atherosclerosis, heart failure and atrial fibrillation. A Buffalo native, she completed her cardiovascular disease fellowship at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, where she also completed her residency and earned her medical degree. Battaglia’s care philosophy is a simple one that emphasizes comfort and quality. “Seeing a cardiologist doesn’t have to be stressful,” she says. “I’m dedicated to putting patients at ease by providing them with the best care available.”

Trinity Medical WNY welcomes cardiologist Trinity Medical WNY is pleased to welcome physician Mohamed Metawee to its practice. An accomplished cardiologist with nearly 20 years of experience, Metawee specializes in electrophysiology. Board-certified in electrophysiology, Metawee cardiology, echocardiography and internal medicine, Metawee completed an electrophysiology fellowship at Vanderbilt University in Nashville, Tennessee, where he also served as chief fellow. He also completed a cardiology fellowship at the University of Kentucky and a cardiology residency at the University of Toronto after earning his medical degree at Ain Shams University in Cairo, Egypt. Metawee treats all types of arrhythmia, specializing in atrial fibrillation and ventricular tachycardia ablation with minimal to zero flouro techniques. Additionally, he provides device-based therapy for brady and tachyarrhythmias, and performs procedures for left atrial appendage occlusion devices for stroke prevention of atrial fibrillation. Operating in conjunction with Catholic Health, Trinity Medical provides community-based specialty and primary care practices, serving the needs of families throughout Western New York.

Roswell Park deputy director picked as SITC board member Elected by a body of fellow immunotherapy researchers from across the globe, physician Kunle Odunsi, Ph.D., deputy director at Roswell Park Comprehensive Cancer Center, has been named an at-large drector Odunsi for the Society

for Immunotherapy of Cancer (SITC) board of directors. The nonprofit organization’s members voted for Odunsi during their election in May. He will begin his three-year term in January 2021. Founded in 1984, SITC looks to make cancer immunotherapy a standard of care, striving to improve patient care outcomes by advancing the science and application behind this treatment. Immunotherapy harnesses the body’s own immune system to strengthen it or alter cells to target and attack cancer. Odunsi highlighted his deep passion for advancing immunotherapy research in his platform statement. “My vision is that the SITC becomes a major voice for communicating and advocating for cancer immunology research and treatment, and for the resources that would further propel the immunology revolution to its ultimate destination of changing cancer from a terrifying disease to that of a curable disease,” he wrote. On staff at Roswell Park since 2001, Odunsi has authored and co-authored more than 350 journal publications and book chapters. A fellow of both the Royal College of Obstetricians and Gynaecologists in the United Kingdom and the American College of Obstetricians and Gynecologists, he holds lifetime membership in the National Academy of Medicine, one of the highest honors in medicine.

BCBS contributes $1M to WNY COVID-19 fund To address the growing needs in WNY as a result of the COVID-19 pandemic, BlueCross BlueShield of Western New York’s Blue Fund recently announced a corporate donation of $900,000 in additional funding to the WNY COVID-19 Community Response Fund, bringing the Blue Fund’s total investment to $1 million. As a founding corporate funder of the WNY COVID-19 Community Response Fund, BlueCross BlueShield’s initial $100,000 contribution helped launched the fund in March 2020 — in collaboration with other philanthropic organizations — to address the most immediate community needs. Now, as the crisis continues to unfold, the region’s leading health plan is pivoting its traditional 2020 Blue Fund grant cycle to support recovery and rebuilding efforts in Buffalo-Niagara through an additional $900,000 donation to the WNY COVID-19 Community Response Fund. “BlueCross BlueShield has a longstanding legacy of giving back to the communities we serve, and we are proud to support efforts that can effectively address the evolving needs of Western New York families, individuals and organizations during this difficult time,” said David W. Anderson, president and CEO, BlueCross BlueShield of Western New York. “Together we will rebuild our community and come back stronger than ever.” The giving is coordinated by the Community Foundation for Greater

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Buffalo, the Health Foundation for Western & Central New York, The John R. Oishei Foundation, and the United Way of Buffalo & Erie County. To date, the funds supported initiatives that address social determinants of health and other challenges raised by COVID-19 in the areas of food security, housing, health care, childcare, mental health, transportation and other emergency services. Going forward, the effort is evolving into a “Build Back Better” initiative to support developing strategies focused on recovery efforts through collaborative systems work. “The sudden arrival of the COVID-19 crisis necessitated an immediate response to meet the significant need in the community with everyone working together on solutions. We are grateful that BlueCross BlueShield has continued to generously contribute more resources in this collaborative effort that has already granted out $6.6 million to support more than 156 organizations in Western New York working on the frontlines at this time of great need,” said Clotilde Perez-Bode Dedecker, president and CEO of Community Foundation for Greater Buffalo.

ECMC intensive care unit recognized Erie County Medical Center (ECMC) Corporation recently announced that the hospital’s medical intensive care unit (MICU) has again been awarded a silver-level American Association of Critical Care Nurses (AACN) Beacon Award for Excellence, which is a three-year designation highlighting the unit’s achievement of exceptional care through improved outcomes and greater overall patient satisfaction. ECMC’s MICU had previously received the silver-level Beacon Award for Excellence in June 2017 and is one of 16 silver-level Beacon awards in New York state for 2020. “ECMC receives ICU transfers from hospitals all across Western New York because of the high-level skill of our MICU caregivers,” said ECMC Corporation President and CEO Thomas J. Quatroche Jr., Ph.D. “These skilled clinicians consistently provide excellent, quality care to some of the sickest patients in our community, especially during the last several months of the COVID-19 pandemic. To be only one of 16 silver-level MICU’s in the state is a testament to the remarkable team of caregivers who make ECMC’s MICU such an extraordinarily special Unit. Receiving this high-level national recognition is yet just another example of the high quality of care and dedication of the entire ECMC family.”

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Our dedicated frontline heroes are here for you.

Our ECMC family is incredibly grateful for the doctors, nurses, specialists, and staff who are working tirelessly to care for our community with undeterred dedication. Amid the challenges of the pandemic, you are fighting COVID-19 head-on. Even when we’re through this chapter, your courage and sacrifices will always inspire our community.

The difference between healthcare and true care ECMC.edu

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2020