In Good Health: WNY #111 - January 2024 by In Good Health: WNY's Healthcare Newspaper

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JANUARY 2024 • ISSUE 111

WHY YOU SHOULD CONSIDER Doing Pilates

Growing in popularity, the practice can help keep you limber and strong

Meet Your Doctor

ANNE B. CURTIS, M.D. Cardiologist says WNY winters can cause increase in number of people having heart attacks, especially in the over-65 population. She explains why P.4 ALSO INSIDE

COLD WEATHER RUNNING MAY BE EVEN HEALTHIER

THYROID DISORDERS CAN AFFECT WOMEN’S HEALTH IN A BIG WAY

BENEFITS OF CHAIR YOGA

Although mostly a seated activity, chair yoga promotes good health

Cold Weather Running May Be Even Healthier

reary, chilly winter days might cause some year-round runners to think twice about their jog, but recent research suggests the benefits of cold weather running outweigh those of running in warmer conditions. Specifically, cold weather can help runners burn more bad fat, lose more weight and feel healthier overall. “Cold weather doesn't have to force runners indoors and I encourage my patients to continue safely running outdoors,” said physician Joshua Blomgren, an assistant professor at Rush University Medical Center in Chicago. “Exercise is medicine, even in the winter.” Running in cold weather produces less heat stress on the body, which can make a winter jog easier than one in the summer, Blomgren said. Higher body temperatures are associated with increased exertion and strain on the heart, lungs and metabolism. On the other hand, winter running can boost your metabolism at a time when cold temperatures are causing your average metabolism to slow down in an attempt to preserve fat, Blomgren explained.

Cold weather jogging tricks the body into stopping that slowdown, helping you maintain a healthy weight. Scientific evidence also suggests that exercising in cold temperatures can help convert “bad” white fat to “good” brown fat, Blomgren said. White fat can cause inflammation and insulin resistance, while brown fat is metabolic tissue that helps burn calories. Blomgren does issue some cautions to folks who choose to run in the cold, however: • Dress in appropriate layers • Wear sweat-wicking fabrics rather than cotton or wool • Wear a head covering • Drink lots of water before and after a run • Keep an eye out for hidden ice on running paths • Don a nose and mouth covering to warm the crisp air, making it easier to breathe But even the hardiest cold weather runners should consider staying indoors during sub-zero cold waves, and always remain alert for any signs of frostbite while outside, Blomgren added.

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A new sur vey shows a new job that 25% once the of all wo rkers are COVID-19 For those pla pan aged 2540, the num demic is no lon nning to find positions ger an issu is ber of peo want to get a whopping 34% e. ple planni .Th ng a better work-life e main reason? The to switch balance. y said the Page 7 y

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If you get the impression that there are more children with disabilities, the numbers agree 82 • ISSUE you. AUGUST 2021with But there’s more to the story. P. 11

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Meet

Your Doctor

By Chris Motola

Anne B. Curtis, M.D. Vaping Now Outstrips Smoking Among U.S. Young Adults Young adults are now more likely to vape than to smoke cigarettes, with more becoming addicted to nicotine through vaping than traditional smoking, researchers say. Nearly three in five young adults who vape (56%) have never regularly smoked cigarettes, according to data from an ongoing federal study of tobacco use. This is the first time that there are more young people who began to use nicotine through vaping rather than smoking, researchers said in a research letter published Nov. 13 in the journal JAMA Internal Medicine. “We now have a shift such that there are more 'never smokers' who vape than established smokers,” said researcher Benjamin Toll, director of the Medical University of South Carolina (MUSC) Health Tobacco Treatment Program. “That is a massive shift in the landscape of tobacco.” “These 'never smokers' are unlikely to start smoking combustible cigarettes — they're likely to vape and keep vaping,” Toll added in a university news release. “And it's this group, ages 18 to 24, who are going to forecast future e-cigarette users.” E-cigarettes could be a less harmful option than smoking, but it's not harm-free, researchers said. Because of that, it's disheartening to see young non smokers begin to vape. “If you currently smoke and you've smoked combustible tobacco cigarettes for a few decades — those people are at very high risk of cancer, and so we want to help them to get off combustible cigarettes. Ultimately, we'd like to help them to quit tobacco altogether, but if they're not ready for that, switching to e-cigarettes is at least a partial win,” said co-lead researcher Naomi Brownstein, an associate professor in the MUSC Department of Public Health Sciences. "Now, if you are an 18-yearold and your friends are like, 'Hey, let's vape some banana bread nicotine,' and you've never smoked, those are the people for whom we think starting vaping is a problem,” Brownstein added.

Cardiologist says WNY winters can cause increase in number of people having heart attacks, especially in the over-65 population. She explains why Q: You’re the former chief of medicine at UB. What were some of your accomplishments? A: I’m a cardiologist by training. I’ve been here at UB since 2010. As chair of the department of medicine, it put me in charge of about 500 people. We do run an internal medicine practice that involves seeing inpatients and outpatients. We expanded the faculty and increased research as well as stabilized and grew the practice. So I think we left everything better off. Q: So this tends to be a rough time of year for heart attacks. Why is that the case? Is it due to exertion? A: I don’t know if I could quote you statistics on it, but there are definitely situations where people can have a cardiac arrest, and you hit the nail on the head with exertion. What happens is you have people, especially men who are older, who are pretty sedentary most of the time. A big snowstorm hits and they shovel the driveway and the walkway and they’re doing more exertion than they’re used to. That really does put a strain on the heart. If they have known or undiagnosed heart disease and those blockages are in the coronary arteries, it may not be a huge problem when they’re at rest. But that sudden burst of exertion on top of cold weather, which takes its toll anyway, and you can have a myocardial infarction, a heart attack. Sometimes what happens in that setting is you’ll get a sudden, lethal arrhythmia. So the heart goes out of rhythm all of a sudden and, if the person doesn’t get help almost instantaneously, it can lead to death.

Q: So the exertion is a bigger factor than the cold? A: That is correct. Q: Why do you think people have this hole in their knowledge about what they’re able to do physically? You don’t see people deciding to run a 5K on a moment’s notice. A: You’re making a good point. Why, all of a sudden? It might be the perceived necessity of doing it or they just don’t think it’s as much exertion as it actually is. Living in Buffalo, snow can be extremely wet and heavy. I happen to be in very good physical condition and it can still be exhausting. It might be the perception that “I won’t be out here that long. It won’t be that bad” and “I need to take care of this.” In it leads to adverse outcomes. Q: How might someone more accurately assess their readiness to do tackle large amounts of snow removal? A: It depends on risk factors. If you’re a male over 65, you’re in a demographic that often gets into trouble. If you’re obese. If you have Type 2 diabetes. If you have hypertension. If you have high cholesterol. If you have a family history of heart disease. All those risk

Page 4 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2023

factors, the more you have, the more likely you are to get into trouble. And it’s not just diagnoses but how well treated you are. If you’re prescribed medications for cholesterol, for example, and you’re compliant, you’re at less risk than someone who isn’t. Q: If you do think you’re at risk and still need to deal with the snow yourself, what kinds of precautions should you take? A: I’d say take frequent breaks. Even a snowblower can be exhausting if the snow is pretty deep. But doing a little bit at a time, not trying to get it all done at once. And realize that there’s always tomorrow. It’s rare that someone has that urgent a need to get out in that kind of weather. If you have a medical emergency, call to have someone come and help you. People sometimes think things are urgent when they really aren’t. Especially when it puts them at risk of fatal cardiac event. The other thing to think about is keeping provisions in your house if you know that a storm is coming so you don’t have to worry about going out right away. Q: You mentioned snowblowers even present some risks. Are there types of equipment that are better than others? A: Hiring a teenager to do it is best for you. There are services that can do this, especially in a city that gets as much snow as Buffalo does. If you live in an area that doesn’t get as much snow, it may be harder to find services. People who do it more often, too, usually have a better idea of how much exertion it requires. It also helps to be well-dressed. You don’t want to put extra exertion on yourself by not being dressed for the weather. Q: How does that contribute? A: It’s an added stress. You can get short of breath. Hypothermia is a risk if you’re out there long enough. That’s not likely to happen if you’re dealing with temperatures in the 30s, but it can be a risk if it’s colder and you’re not dressed for it. Q: How can older man and women too, keep themselves conditioned for labor? A: There are very clear recommendations with regards to getting exercise every week. And at absolute minimum, you should be trying to walk 30 minutes at a time at least five days a week. Even that kind of minimal exercise will get you into better condition regardless of your age. If you have knee and hip problems, you can do exercise that’s gentler on the joints like using a pool, bicycle or elliptical machines.

Lifelines

Name: Anne B. Curtis, M.D. Position: Cardiac electrophysiologist and former president and chairwoman of UBMD Internal Medicine. Chairwoman of the Department of Medicine at UB. Hometown: Brooklyn Education: Columbia University College of Physicians and Surgeons, M.D.; Columbia Presbyterian Medical Center, residency; Duke University Medical Center, fellowships; Affiliations: Buffalo General Medical Center Organizations: Heart Rhythm Society, American College of Cardiology Family: Three adult children Hobbies: Tennis, pickleball, running

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Doctors Are Excited, Concerned About AI

merican physicians have mixed feelings on the advent of artificial intelligence (AI) into mainstream medical practice, a new survey shows. The survey of nearly 1,100 doctors, conducted by the American Medical Association (AMA) in August, found 41% of physicians saying they were "equally excited and concerned" about AI in the workplace. “Physicians are optimistic about the advantages that properly designed AI-enabled tools can have for patient care, and nearly two-thirds of physicians see an advantage to AI if key requirements are met,” AMA President Jesse Ehrenfeld said in an AMA news release. “The AMA survey illustrates that physicians' greatest hope for AI rests in reducing the crushing administrative burdens that plague modern medicine, which drain health care resources and pull physicians away from patient care.” That's the "up" side, according to the poll: Sixty-nine percent of doctors thought AI would help with work-

flow efficiency during their busy days; another 54% said they were enthusiastic about AI that might ease the burden around "documentation;" and another 48% hoped it might cut down on the red tape of prior authorization for insurance coverage. As for actual patient care, 72% thought AI could be helpful in better diagnosing patients, and 61% hoped it might help improve clinical outcomes for patients. Worries around AI centered on its impact on patient-doctor interactions, with 39% of doctors concerned the technology might harm that relationship. Another 41% had concerns about AI's impact on patient privacy. AI is already making inroads in hospitals and doctors' office, the AMA survey found: More than a third (38%) of physicians said they were already using it. While only 11% said they'd used it to so far to help with diagnosis, larger percentages said they'd used AI to help with office paperwork or translation services.

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SERVING WESTERN NEW YORK A monthly newspaper published by Local News, Inc. Distribution: 25,500 copies throughout more than 1,500 high-traffic locations. In Good Health is published 12 times a year by Local News, Inc. © 2023 by Local News, Inc. All rights reserved. P.O. Box 550, Amherst, NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto

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January 2023 IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 5

Healthcare in a Minute By George W. Chapman

Repeal the Affordable Care Act? Please Leave it Alone

wo Republican presidential candidates — so far Trump and DeSantis — are, for some inexplicable reason, pledging to get rid of the ACA, often referred to as “Obamacare.” Trump calls Obamacare a “disaster” and “terrible healthcare.” There have already been more than 40 exhausting, politically motivated attempts to repeal the widely popular ACA. So this begs the question, who is lobbying and pressuring the presidential candidates to get rid of this “disastrous” program? Interestingly, neither candidate refers to the historical health insurance act as the “Affordable Care Act” because they are deliberately politicizing and confusing the issue by referring to it as “Obamacare.” They won’t call it the “ACA” because it is widely popular, in both red and blue states, especially for those who are covered by it. By calling it “Obamacare” they are hoping to dredge up some lingering antipathy toward the former president and grab some misinformed votes. Past surveys have confirmed the confusion. When asked should “Obamacare” be repealed, many people’s knee jerk response was “yes.” But when asked if the “Affordable Care Act” should be repealed, the same people thoughtfully answered “no.” The ACA has been law for 13 years and has grown in popularity every year. As of the end of 2023, 40 million people are covered by the ACA either by qualifying for expanded Medicaid or qualifying for discounted premiums based on household income.

The ACA has decreased the percentage of us without health insurance from around 15% to around 8%. I can’t imagine it’s the very people that rely on the ACA for coverage that are trying to get rid of it. Maybe it’s the insurers? The ACA is administered by some of the same commercial carriers that cover those fortunate enough to be covered by employer-sponsored health insurance, mostly paid for by employers. Granted, commercial carriers have opted in and out of the ACA market every year, but insurance companies do that in all their markets. It’s not just the ACA. Carriers are prone to exit a particular market

for care; they don’t provide care.) Fact is, I have not heard or read that any of the various medical associations (AMA, AHA, ANA, etc.) expressing their displeasure on behalf of their members with the ACA, per se. If there is any displeasure among providers, it is with all payers. So, you can’t single out the ACA. Thanks to the ACA, hospitals and physicians worry far less about uninsured patients (less than 8%) unable to pay for their care. (Early critics and naysayers of the ACA, back when it was first being proposed, predicted it would create pure hell — vandals at the gates — for providers because their offices, ERs and operating rooms would be flooded with people with years of pentup medical problems, Never happened.) Without the ACA, more hospitals, especially rural ones, would have eventually closed under the weight of unreimbursed care. The ACA is popular in both red and blues states with the former probably having more rural hospitals. The ACA also made deciphering dozens of insurance plans and making valid comparisons, far easier. (Just ask anyone in human resources.) The ACA created three levels of insurance with increasing amounts of mandated coverage: bronze, silver and platinum. Most employees are covered by a medium priced “silver” level. An individual who purchases health insurance on the exchange would have the same three coverage options. When considering either BlueCross silver or Aetna silver for

‘The Affordable Care Act has been law for 13 years and has grown in popularity every year. As of the end of 2023, 40 million people are covered by the ACA. It has decreased the percentage of us without health insurance from around 15% to around 8%.’

because of low enrollment or low profitability. Most states have around five carriers involved in the ACA. I don’t think insurers are too upset with the ACA. Maybe it’s the providers. Hospitals, physicians and nurses must be behind the idea of nixing the ACA. And to show their utter dissatisfaction, they single out their patients covered by the ACA and provide them with “terrible” sub par healthcare. When someone claims the ACA provides “terrible healthcare” they are insulting every hard-working physician, nurse and hospital in the country. (Insurers, like the ACA, pay

Page 6 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2023

‘Most importantly and now taken for granted, the ACA finally ended the infamous preexisting condition clause in insurance contracts that basically prevented anyone with a “preexisting condition” from switching plans because any new plan would refuse to cover the condition.’

example, it is apples to apples. Of course, insurers can “spice up” their plans to attract more members, but they must include the minimum mandated benefits for the level. Most importantly and now taken for granted, the ACA finally ended the infamous pre-existing condition clause in insurance contracts that basically prevented anyone with a “pre-existing condition” from switching plans because any new plan would refuse to cover the condition. Pre-existing conditions could include cancer, AIDS, pregnancy, cardiac disease or even hypertension. Pre-existing conditions virtually locked employees into their place of employment. Some people would have to refuse a better job offer at another employer for fear of losing coverage if the new employer offered different insurance. So, I cannot fathom which of the four major stakeholders in the ACA (insurers, hospitals, physicians, patients) are pressuring the two presidential candidates to get rid of the “terrible healthcare” paid for by “Obamacare.” Surveys show there are far bigger challenges on voters’ minds like immigration, climate change, inflation, national security, voter rights and reproductive rights to name a few. Surveys do indicate however that voters are dissatisfied with the expense of healthcare in our country and rightly so. If you want to campaign on healthcare, our entire system needs a fix. Just don’t single out the ACA as the problem.

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.

Annual Checkup: Should You Stick With That?

Univera physician: ‘Going to your doctor visit is such a big part of your health maintenance and prevention’

Insurance requirements for medical screenings

By Jane Schmitt

f you are in good health and thinking about skipping your annual doctor’s visit, think again. A yearly physical exam is important for so many reasons, according to physician Lorna Fitzpatrick, vice president of medical affairs and senior medical director at Univera Healthcare. “The heart and soul of medicine is prevention, and we all want to be as active as we can about that,” she said. “Going to your doctor visit is such a big part of your health maintenance and prevention.” Here, Fitzpatrick talks about why she rarely misses a routine checkup and how that makes sense for so many others, as well.

Establish a baseline with your healthcare provider A well visit can help build a trusted relationship with your doctor and enables him or her to understand

your unique needs. It also provides a record of baseline functions including heart rate, cholesterol level and blood pressure. Maintaining a dialogue with someone who knows your medical history is a smart move for people of all ages. Your doctor will encourage lifestyle changes to improve your health and prevent illness. “I go every year,” Fitzpatrick said. “I am fortunate not to have any issues, but it’s a good time to check in and make sure everything is still working. I want to hear it from my doctor.”

Spot potential problems These visits are valuable not only to assess your overall health but to update vaccinations and review medication. But another big part is a medical screening to check for disease. Indeed, a test or scan might detect an issue even if the person

AI Might Accurately Spot Autism in Early Childhood

niversity of Louisville researchers say they’ve developed an artificial intelligence (AI) system with a near-perfect record of diagnosing autism in toddlers. Using specialized MRI scans of the brain, the tool diagnosed toddlers with 98.5% accuracy, according to findings presented at a December meeting of the Radiological Society of North America (RSNA). Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal. “Our algorithm is trained to identify areas of deviation to diagnose whether someone is autistic or neurotypical,” Mohamed Khudri, a visiting research scholar who was part of the team that developed

isn’t experiencing any symptoms. “We are very in tune with our own bodies and think we know everything. But so many things in the body are silent. You just never know,” Fitzpatrick said. A prime example is high blood pressure. “We call it the silent killer,” she said. “Some people don’t have any signs or symptoms. They might be walking around with high blood pressure right now and not even know it. But if you don’t go to your doctor and get it checked, we won’t be able to start treating it and prevent longer-term outcomes like kidney damage or stroke.” Other common tests recommended by doctors include colonoscopy, mammogram, cholesterol check and urinalysis. “The reason for an annual physical is to prevent problems or catch problems early in the disease process. So screening is huge. If you can’t prevent illness, you want to catch it as soon as possible so that you can mitigate the outcome,” Fitzpatrick said.

the system. said in an RSNA news release. The AI system relies on DT-MRI, a special technique that detects how water travels through the brain along what are known as “white matter tracks.” The AI system isolates images from DT-MRI scans and looks at markers revealing the level of connectivity between brain areas. A machine learning algorithm compares patterns in the brains of children with autism to those of normally developed brains. “Autism is primarily a disease of improper connections within the brain,” co-author, physician Gregory Barnes, a professor of neurology and director of the Norton Children’s Autism Center in Louisville, said in the news release. “DT-MRI captures

Insurers may require patients to have an annual exam before covering certain procedures and potentially lifesaving screenings such as mammogram or colonoscopy. “Those screenings stem from getting in for that doctor visit,” Fitzpatrick said. “Once you have those done, it may remind you to get other things taken care of,” such as bloodwork, a specialist visit or prescriptions to be filled.

The holistic approach Modern health care is multi-dimensional and holistically emphasizes a patient’s physical and mental health. “Preventative visits don’t just address physical health. It’s so much more now,” Fitzpatrick said. “How are you (handling) stress? How are things overall in your life right now? We want you to talk to your doctor. That’s why we run late on appointments sometimes; it’s because we

these abnormal connections that lead to the symptoms that children with autism often have, such as impaired social communication and repetitive behaviors.” Researchers tested their method with 226 children between 24 and 48 months of age from the Autism Brain Imaging Data Exchange-II. Of those, 100 were developing normally; 126 were affected by autism. The AI approach was 97% accurate in spotting real cases of autism (avoiding false-positive reports) and it was 98% accurate in identifying children who did not have autism. It’s overall accuracy was 98.5%, the team concluded. “Our approach is a novel advancement that enables early detection of autism in infants under 2 years of age,” Khudri said. “We believe that therapeutic intervention before the age of 3 can lead to better outcomes, including the potential for individuals with autism to achieve greater independence and higher IQs.”

Physician Lorna Fitzpatrick is the vice president of medical affairs and senior medical director at Univera Healthcare. had a long conversation with someone about what’s going on in their life.”

Your health can change in a year Don’t underestimate how much your life and health could change in a single year. “Annual visits to the doctor do matter,” she said. “A year can make a big difference. You can go from having low blood pressure to high in a short amount of time. Other things can come up, like a breast lump you didn’t feel but that your doctor feels.” Another condition that could be detected is prediabetes. Indeed, the Centers for Disease Control and Prevention reports that approximately 96 million U.S. adults (more than one in three) have prediabetes and don’t know it. The condition puts them at increased risk to develop Type 2 diabetes, heart disease and stroke. Lifestyle changes made now may prevent or delay more serious health problems. “Maybe your weight creeped up one year from the next,” Fitzpatrick said. “There are changes you can make in your diet to prevent that. ‘Hey, maybe I should be walking a bit every day.’ Losing just 5% of your body weight can have a significant impact on blood pressure, diabetes and other outcomes. We encourage patients to come in and have a conversation with their doctor.”

Fewer than half of children with autism received a developmental evaluation by 3 years of age, according to new report from the U.S. Centers for Disease Control and Prevention, and 30% of those who meet criteria for autism were not diagnosed by age 8. Researchers cited several reasons for delayed diagnosis, including lack of resources at testing centers. Khudri said the AI system could help speed the process. It produces a report detailing which brain pathways are affected, the likely impact on function and a severity score that can be used to guide intervention. “The idea behind early intervention is to take advantage of brain plasticity, or the ability of the brain to normalize function with therapy,” Barnes said. Researchers are seeking clearance for the AI software from the U.S. Food and Drug Administration.

January 2023 IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

In This New Year, Resolve to ‘Let it Go’

re you convinced you’ll never find love again? Or regret the way you behaved in your marriage? Still angry at your ex? Or yourself? Holding on to past hurts, slights, negative thinking or lost opportunities can compromise your sense of well-being and ability to be alone and content. Whereas “letting go” can be the catalyst for a fulfilling and enriching solo journey. As someone who’s walked this path, I’ve discovered that letting go isn’t just a phrase; it’s a powerful resolution, especially for those navigating life alone after a divorce or the loss of a spouse or partner. And it isn’t about erasing the past; letting go is about releasing the grip of memories, fears and limiting beliefs that keep us from leading our best lives. In contemplation of this column, I reached out to several divorced and widowed friends and asked what keeps them stuck in unwelcome thought patterns and behaviors. Below, I’ve shared their very personal and, in some cases, heart-tugging issues, many of which I’ve struggled with myself. As uncomfortable as it can be, I’ve found that sitting with and reflecting on my issues has been liberating and life-giving. Under each issue, you’ll find some probing questions that may help you move through the letting go process. It might be euphoric recall, but I can’t let go of memories of my past family life when we were all together. I worry I’ll never feel that joy again. • Are you idealizing those past times or not allowing room for new, different kinds of joy in your current life?

• What specific qualities or experiences in that former family life do you miss the most? • What new activities, connections and traditions could you create in your present situation that would bring you similar joy? I can’t let go of feelings of insecurity about making big life decisions on my own, decisions such as whether to move or buy a new car or renovate my kitchen. • What positive experiences have you had in making decisions on your own? Your past experiences can point to successful outcomes! • Are there resources and experts you can consult when making significant life decisions? • Can you embrace the freedom and empowerment that come with making decisions independently? I’m having a hard time letting go of the anger I feel toward my spouse for his betrayal and the upending of our life together. • How does holding onto this anger impact your mood, your relationships and your quality of life? • Have you been able to express your anger in healthy ways, either through therapy, writing or other outlets? • Can forgiveness, for your own peace, be part of your healing journey? Where did my courage go? I love to travel, but the idea of traveling alone scares me to pieces. I can’t let go of that fear. • What exactly are you afraid of — is it the logistics of travel? Safety? Social concerns? • Would talking with or reading articles or blogs from solo travelers help you reframe solo travel as an

Spotting Epilepsy in Kids Isn't Always Easy: Know the Signs

eurologist Deborah Holder says she often has parents come to her with kids who've experienced what they call "funny spells." “Sometimes I start talking to a parent and find out the parent has [also] had 'funny spells' for years, but had no idea they were epileptic seizures," said Holder, who practices at Cedars-Sinai Guerin Children's Hospital in Los Angeles.

She believes that epilepsy in kids is too often missed as a diagnosis, interfering with a child's learning and development. Why? Parents believe seizures have to be far more dramatic than they typically are to be deemed to be epilepsy. Often, according to Holder, a seizure can simply be a child seeming to be unable to talk for a few seconds. Childhood epilepsy seizures can also

opportunity for personal growth and discovery? • Can you start small, maybe with a day trip or weekend trip alone to test the waters and build your confidence? Do it; pack your bags! I live in constant fear of the future, especially when it comes to money matters. My husband (rest his soul) took care of everything. • What is the source of your financial insecurity? Is it lack of experience or knowledge or is it more about your own self-doubt? • Could you ask advice from a friend in a similar situation who has successfully managed her finances alone? • How about seeking the advice of a financial adviser? Your friend may be able to recommend someone. I fear I will be forgotten. I live alone now. Who will be here to care for me if I get sick or feel lonely? • What can you do to build a support network or community that you can rely on in times of need? • How can you cultivate meaningful connections and relationships that transcend your fear of being forgotten? • What steps can you take to maintain your health and well-being, such as exercise and a healthy diet, to reduce the likelihood of needing extra care? I’m consumed with regrets. Should I have worked harder to save my marriage? Why didn’t I see trouble brewing? Why did I let myself go? Help! • How does dwelling on your regrets hinder your ability to move forward? • Are there any steps you can take to forgive yourself for past mistakes or regrets, such as acknowledging that you were doing the best you could at the time? • Can you reframe past experiences as life lessons that have shaped who you are today and offer the promise of a fulfilling future? I worry I’ll never find love again, especially at my age. Negative beliefs about myself and my aging body have taken up permanent residence in my head.

be confused with other conditions. “Sometimes children experiencing seizures will see flashing lights or have temporary blurred vision, which leads them being misdiagnosed with migraine,” Holder explained in a Cedars-Sinai news release. About one in every 26 Americans ends up being diagnosed with epilepsy, which is characterized by seizures and abnormal electrical activity in the brain. Holder offered up some key facts on epilepsy. First off, a seizure can take many forms, including: • A few seconds of quiet staring (this is the most common form of epilepsy seizure) • Moments where speech/language is tough to process or sounds garbled • Uncontrolled motor activity, such as a twitching arm, leg or one side of the face. This might last for 30 seconds or so • Numbness or tingling in a part of the body, or sensations such as weird smells or tastes in the mouth that come and go.

Page 8 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2023

• Do you have any examples of older people in your circle of friends who have found love later in life? It could be helpful to chat with them about their experiences. • What qualities and strengths do you possess that you believe are attractive to others, regardless of age? • Would you consider affirmations or a meditation practice to help you cultivate self-love and acceptance? You’re worth it! Letting go isn’t a one-time event; it’s a continuous process of self-reflection, growth, and liberation. By probing these personal issues and asking ourselves these tough but empowering questions, we can pave the way for a life and a future filled with purpose, joy, and connections. I wish you and all my readers a Happy New Year. Let it go . . . and let the party begin! Gwenn Voelckers is the founder and facilitator of Alone and Content empowerment workshops for women (now on hiatus) and the author of "Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own" To contact Voelckers or purchase her book, visit www.aloneandcontent.com • Convulsive seizure, where the person falls to the ground and their whole body convulses. That's the rarest form of seizure, Holder noted. According to Holder, once a child suspected of epilepsy is brought to a doctor, diagnosis is often relatively easy, based on symptoms. Sometimes an EEG (electroencephalogram) is performed to confirm the diagnosis. Family smartphones can help, as well. Often, parents will use the phone to record an episode a child might have at home, and play it later for the physician, Holder said. "I advise families, if you see a child having a funny spell, get it on a video camera. We are very good at being able to tell by looking at the recording if the event is a seizure or not," she said. If epilepsy is diagnosed, the condition can often be managed with medications. Tests are pinpointing the genes that drive epilepsy, and in some cases genetic testing can help doctors decide which medications can work best to curb a child's seizures. In many cases, kids will outgrow epilepsy, Holder noted.

ecutive leadership and change from Daemen University.

which has a selection of books for ages ranging from 3 years old to teenagers. We found that a lot of people living in high poverty areas have fewer books in the home. With our programs, book banks are available so clients can take a book, keep a book, or return it.

Q: You’ve been in your position for nearly a decade. How long has the agency been in service and where are you headquartered? A: We’ve been in business for 58 years. Our original name was Literacy Volunteers, which was changed 10 years ago to Literacy Buffalo Niagara. Our offices are located inside the Central Library, 1 Lafayette Square in Buffalo. In Niagara County, we have a mobile office. Q: What type of grant was your organization awarded by Highmark Blue Cross Blue Shield’s Blue Fund? A: We are deeply grateful to Highmark Blue Cross Blue Shield for their generous $100,000 grant. It will be instrumental in launching our health literacy initiative and our goal to improve communication systems and personal literacy skills for 150,000 area residents in need. As seen from the COVID-19 pandemic, promoting health literacy is a key component to public health, healthcare delivery systems, and efforts to empower individuals and society to take an active role in managing their overall health and well-being. What we’ve been through as a community and as a direct result of the pandemic, we know that navigating the complexities of healthcare systems by understanding the language of health ensures informed choices, fosters self-advocacy and illuminates the path to a healthier, more resilient future.

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Executive director of Literacy Buffalo Niagara explains how agency helps improve literacy and quality of life in WNY

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Erie and Niagara counties, 17.5% of adults struggle due to lack of functional literacy, reading at or below level 1. In Good Health recently spoke with Tara Schafer, executive director of Literacy Buffalo Niagara — the sole provider of free, individual literacy services — about the objectives of her organization and a major health literacy grant the nonprofit received from the Highmark Blue Cross Blue Shield’s Blue Fund. An Alden resident, Schafer earned a bachelor’s degree from SUNY Brockport and master’s in ex-

Q: How do you match a tutor to a student and what is the time commitment? A: We match the client to the tutor to make the best possible fit. Our clients are generally split among people who struggled in school and refugees new to our country. Each meeting takes place in a public setting. It could be at a library, a coffee shop, a park, etc. I tutor as well; the session becomes the highlight of my week. Q: How is your organization funded? A: Funding comes from a variety of sources: local foundations, grants, corporate sponsorships, the state Department of Education, and private donations.

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Q: Literacy Buffalo Niagara employs six people on a full-time basis. Can you use the help of volunteers? A: We are a volunteer-driven organization and always need more. We accept anyone over age 21 with at least a high school education or equivalent. The volunteer must undergo a mandatory 14-hour training, half in-person and the other half done virtually. We ask for a minimum one-year commitment to the program.

Q: How will volunteers from Literacy Buffalo Niagara reach people who would like to improve their health literacy? A: We are partnering with Oishei Children’s Hospital to open “Literacy Corners,” which will launch in April. We will also open some centers in the city on Broadway and the West Side in outpatient pediatric clinics. In partnership with the hospital, we’ll distribute books to 5,000 low-income youth. These funds will allow us to create and distribute those new health literacy materials using the CDC’s health equity guiding principles and best practices, ensuring they’re available in multiple languages.

By Brenda Alesii

Change starts with a word.” That’s the philosophy espoused by Literacy Buffalo Niagara, an organization that provides free one-on-one tutoring and small group instruction. The basic literacy and English language learning programs are for adults seeking to improve their reading skills and who are new to speaking English. Typically, students receive a customized learning plan to work toward their reading goals and meet with a volunteer tutor in a public setting for two hours per week. In the combined population of

Q: What about popular titles, best sellers? A: We have our own internal library, covering every genre. It’s imperative that digital literacy is learned, too. So we are organizing a series of workshops and training sessions to help parents and children acquire those skills. These workshops will cover internet safety, using tools for healthcare information and online communication skills. In trying to embrace technology, we introduced Digi-Skills for people struggling with technology.

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Wellness & Fitness

Doing Pilates with Sarah Griffin-Divincenzo, certified Pilates instructor and owner of Pilates Art Studio in Buffalo.

Why You Should Consider Doing Pilates Growing in popularity, the practice can help keep you limber and strong By Deborah Jeanne Sergeant

opular through studios, videos and online, Pilates provides a system of strength training that helps participants gain muscle and recover from injuries or surgery. In fact, Joseph Pilates developed the practice in the early 1900s to help bedridden patients develop better strength through breathing exercises and by using springs affixed to their hospital beds. That rudimentary apparatus became the Pilates Reformer, equipment that current practitioners use. Numerous styles of Pilates have developed since its founder introduced it. “Pilates has a lot of physical and mental health benefits: strength, flexibility, control and overall gracefulness of movement,” said Sarah Griffin-Divincenzo, certified Pilates instructor and owner of Pilates Art Studio in Buffalo. “It’s adaptable to

any body, so I can have a range of clientele from an 85-year-old to a 20-year-old athlete. A lot of people like that there is a graceful flow to the workout. It’s kind of in between yoga and strength training. It can be whatever the client needs it to be, especially if they’re doing private lessons. In a class setting, I give a general, whole-body workout that covers all the bases.” Working with a certified instructor one-on-one can also help modify Pilates movements to accommodate injuries. But it takes time to see progress. Unlike many types of workouts, its long-term effects are subtle. “We move through repetitions,” Griffin-Divincenzo said. “It has a strength training type of workout. If you take a class on the reformer or the apparatuses, there’s spring resistance. Every exercise is also a core exercise because you hold yourself in

a certain position. It’s different from yoga where you’re holding a pose. But there are pose type of positions that we do. We really move the body through every direction it moves. That’s what makes a complete workout.” Pilates includes working the small, connective tissues are often overlooked with other activities. Much of the equipment used in Pilates is proprietary, such as the Reformer. There’s also the Cadillac (also known as the trapeze table), named jokingly because of the simultaneous introduction of the upscale automobile. The raised mat — complete with a framework, springs and other apparatuses — allows instructors to not have to get down on the floor with each student to adjust and correct them. The apparatuses aid students who need to improve their physical

Page 10 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2023

condition and resistance to challenge them. Students perform movements on an exercise mat also. “You can do a lot of these functional movements on a mat or on the floor,” said Robyn Stein owner, certified massage therapist and Pilates instructor at REAL Therapeutic Massage + Pilates and Acupuncture in Amherst. She said that much of the benefit of Pilates has to do with aligning the muscular and skeletal systems, as doing so supports the health of all the body’s systems. “They work more efficiently when you have more agility and strength with a realigned body,” Stein added. “You create muscle memories with your movements.” Because Joseph Pilates’ studio was located near a dance school, many dancers came to him to help them recover from injuries. This early

By Jim Miller

Tips on Caring for an Aging Parent Dear Savvy Senior, Where can I turn for caregiving help? I help take care of my 80-yearold father and work too, and it’s wearing me out. Worn Out Wendy

Dear Wendy, Taking care of an aging parent over a period of time — especially when juggling work and other family obligations — can be exhausting. But help and resources are available. Here’s what you should know.

Identify Your Needs To help you determine and prioritize the kinds of help you need, a good first step is to make a detailed list of everything you do as your dad’s caregiver and the amount of time each task takes. Identify the times when you need help the most and which tasks others might be able to do for you. Then list the types of care needed, such as simple companionship or doing active chores, like shopping or running errands. Once you determine this, here are some tips and places you can reach out to for help.

Care Helpers

association has caused many people to erroneously think that Pilates is a “woman’s activity” or that only ballerinas would benefit from it. Nancy Shea, certified Pilates instructor and certified yoga teacher and co-owner of Balance Pilates in Williamsville, likes the mind-body connection fostered by Pilates. “Mind-body movement is my jam,” Shea said. “I also do tae kwon do. They’re both like moving meditation. I say to my clients, ‘Let your body lead the dance.’ We do certain things to help you understand your body better, but I want your body to tell you what you’re doing on a daily basis. We start to correct it so they can be their own advocate. I never want clients to feel like they’re being told what to do.” By strengthening the core, Pilates helps people improve in many types of athletic pursuits. This may include

athletes who want to improve to people recovering from surgery, sedentary lifestyle or an injury. During their session, “people don’t think they’re doing a lot,” Shea said. “They’ll text me and say they’re feeling so many muscles the next morning. I’m not doing it in an aggressive way.” She recommends taking a Pilates class once or twice weekly and weight training once or twice weekly. In addition to improving athletic performance, Pilates improves mobility for supporting day-to-day activities, especially for those coming from physical therapy, according to Shea. “It takes the isolated movement in physical therapy into functional movement to mimic what they’ll do in life,” she said. “That’s the biggest thing we’ll do.”

If you have siblings or other loved ones close by, start by asking them if they could come and help with specific tasks. And see if friends, neighbors or faith group members could help too. You also need to check into local resources that may be available. Many communities offer a range of free or subsidized services that help seniors and caregivers with basic needs such as home delivered meals, transportation, senior companion services and respite services, which offers short-term care so you can take an occasional break. Call the office of the aging in your county for referrals to services. There are also a bevy of online services you can use to help you save time on certain chores. For example, online grocery shopping and home deliveries, and online pharmacy medication refills and deliveries. You can also order meal-kits or pre-made meals online through numerous meal service delivery companies and arrange needed transportation with ride sharing services like Lyft or Uber. Or, if you can afford it, you may want to consider hiring someone a few hours a week to help with things like cooking, housekeeping or even personal care. Costs can run anywhere from $12 up to $25 per hour. Care.com or CareLinx.com are two

good websites to help you find someone, or you can work with a local home care agency.

Financial Aids If you’re handling your dad’s financial chores, make things easier by arranging for direct deposit for his income sources, and set up automatic payments for his utilities and other routine bills. You may also want to set up your dad’s online banking service, so you can pay bills and monitor his account anytime. Or, if you need help, consider hiring a bill paying service like Silver Bills (SilverBills.com), which charges a flat fee of $150 per month. BenefitsCheckup.org is another excellent tool to look for financial assistance programs that may help your dad, particularly if he’s lower income.

Technology Solutions To help you keep tabs on your dad when you are away at work or if he lives alone, there are affordable technology devices that can help. For example, there are medical alert systems and smart speakers that help with communication and allow him to call for help if needed. Home video cameras with two-way speakers that allow you to monitor and talk to him when you’re away. Electronic pill boxes that can notify you if he has taken his medications. And to help you coordinate his care with other members of his care team there are websites like LotsAHelpingHands.com.

Other Resources There are also a number of other organizations you can draw on for additional information like the Family Care Alliance (Caregiver. org), which provides a state-by-state listing of caregiving programs and services; the Alzheimer’s Association (ALZ.org/help-support/caregiving) that provides information unique to the challenges of dementia caregivers; and the U.S. Department of Veterans Affairs (Caregiver.va.gov), which offers caregiver support services to veterans and spouses.

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.

January 2023 IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 11

Wellness & Fitness

Benefits of Chair Yoga

Although mostly a seated activity, chair yoga promotes good health By Deborah Jeanne Sergeant

or people with limited mobility, practicing yoga seems unattainable. But chair yoga may offer an entry point. Chair yoga is an informal term that may refer to practicing yoga, including some modified poses, entirely while seated or it can also refer to using a chair more like a yoga prop for people capable of standing but who need support to augment their balance. “Chair yoga is an inclusive practice, unlike the traditional yoga you have to do poses standing or on the floor,” said Brian De Luca, physical therapist and strength coach with UBMD Orthopedics and Sports Medicine in Buffalo. “The chair is a way to have a stable base where you can go through modified poses without the risk of falling. At a certain age, you’re not going to be able to get on and off the ground as easily. Chair yoga is a ramp up for traditional yoga.” He also views chair yoga a helpful starting point for people who are recovering from injuries to safely practice yoga and later transition into

more traditional yoga movements as they’re able. The point is that patients are moving and De Luca views “movement is medicine.” Rolling out a yoga mat in one’s cubicle isn’t practical, but De Luca said that learning a few chair yoga moves can help desk-based workers breathe deeper, relax, stretch and strengthen. Chair yoga can also help people improve focus. Nancy Shea, certified Pilates instructor, certified yoga instructor and co-owner of Balance Pilates in Williamsville, said that with chair yoga, participants are in a static position, yet moving their arms. “A lot of people when I studied it notice it’s difficult to keep yourself still,” Shea said. “For me, it’s much more mental. When you’re thinking about the body, chair yoga puts you in a place where you are sitting still and everything on the body has to disassociate from your center, so your arms come outside of your body but you don’t want to move. You’re in a static place, but if you’re moving your arms up and down, how can

Exercise Bands Useful for Resistance Movements By Deborah Jeanne Sergeant

hey’re stretchy and springy and a staple among personal trainers and physical therapists. But what are exercise bands and what can you do with them? “They’re a great tool, but there are different tools for every job,” said Anthony Serrano, personal trainer and nutrition coach certified by the International Sports Sciences Association. “I wouldn’t say one tool is better than the other. Like a hammer, mallet or sledgehammer, they all do different things. You can load more weight on a barbell. But bands have their place in everyone’s fitness routine. We use them here every day with our clients.” He directs personal training at Jada Blitz Fitness in Buffalo and holds a second-degree black belt in

taekwondo. When lifting free weights, it’s easy to jerk and drop the weight. Exercise bands naturally create a more fluid, controlled movement. If you drop an exercise band on your foot, it won’t hurt, unlike dumbbells or kettlebells. “It’s a very versatile piece of equipment,” Serrano said. “You can pack in a suitcase and go. Or if you live in a studio apartment or have only a small area where you can exercise, you can use exercise bands.” Although he likes their affordability and portability, Kevin Phengthavone, certified strength and conditioning coach, cautioned that exercise bands can snap eventually. “Replace them every year if you use them consistently,” he said.

Sandra Kurzdorfer is a certified yoga instructor and owner of Sunflower Vibrations in Rochester. She is a proponent of chair yoga. “It’s great for people who can’t do weight bearing exercise such as those who’ve had foot or knee surgery,” she says. you move them without moving your central body?” Chair yoga can make the practice accessible to older adults. Elizabeth Hornak, certified yoga instructor at JCC Rochester, leads gentle yoga classes, mostly attracting older participants. “As we age, our muscles will contract,” Hornak said. “We’re looking to lengthen and strengthen. Breath is a huge part of yoga. It’s incredibly nourishing and healing for tissues.” Hunching over decreases lung activity, but Hornak said that yoga

poses can help people learn to breathe more deeply. She views chair yoga as a way to help keep participants safer, more active and able to explore their potential. Even if a pose isn’t perfect or traditional, it keeps participants moving, which provides much benefit. “One of the ‘foundational’ moves is cat cow,” Hornak said. “You’re on all fours and as you breathe, you bring your spine into flexion and extension. You can do cat cow seating, standing or on all fours. It’s an incredibly versatile pose.”

“Monitor the time you have them for how long they sit. They have a tendency to dry rot over time. A year to a year and a half is how long they work. Examine them for little cracks. The seams where they’re fused is where they tend to pop.” Phengthavone directs Sport Performance and Impact Sports Performance at UBMD Orthopaedics & Sports Medicine. Jean Sica uses bands a lot with her clients. A certified tai chi instructor and certified personal trainer, owns Kokoro Fitness in Rochester, she finds them handy for taking to sessions in clients’ homes. “I think that they’re really good for people who don’t care to know whether they’re lifting 10 or 30 pounds,” Sica said. “They are marked, but it’s just a guideline. Depending on how far you pull the band, that will make a difference as to how heavy the resistance is. They’re handy for a home gym or for travel. Bring a few bands and you can do all kinds of things with them. You can use them for triceps work and pectoral work and long thin ones you can use in different ways.” Bands come in different lengths for different uses. Flat bands are made from vinyl or cloth and cord varieties may offer handles. Some brands of bands come in different colors to signify the level of resistance they offer. Sica recommended working the upper legs by slipping a short band around the thighs above the knees, squatting, and walking sideways like a crab. “It’s great for the glutes and quads,” she added. To work the chest and arms, Sica said to hold the ends of a short band

and pull the hands apart, hold, then release. Another move for short bands to work the triceps is to hold one end close to the body with the left hand near the right side of the waist. Take the other end with the right hand and pull towards the floor, creating resistance between the arms. Switch sides after a set of 10 repetitions. “People always want to work their biceps for some reason,” Sica said. To do so, step on a long band and pull the handles upward. Serrano recommends using exercise bands for a palace press, which works both upper and lower body muscles. Tie to band to a stable pole. Stand squarely next to the pole, with feet placed shoulder’s distance apart holding the band with both hands. Draw hands to the center of the body with the band lax. Slowly pull the band away from the chest and then to the chest. Phengthavone said that bands can be useful for resistance lunges. “Hold each band in your hand and step into a lunge with the band under your back foot,” he said. “You can lower yourself to the ground on your knee and step back up.” Using bands while performing calisthenics can challenge the muscles more. “Hold the band in one hand and across your back to the other hand for resistance while doing pushups,” Phengthavone said. The extra tension creates greater difficulty without adding a physical weight to the movement. Anyone new to resistance training should consult their healthcare provider before beginning a regimen.

Page 12 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2023

Wellness & Fitness

Feldenkrais Method and the Alexander Technique How these modalities can help improve how you feel through how you move By Deborah Jeanne Sergeant

osture habits affect how your body moves and can cause stiffness, tension and stress. Both the Feldenkrais Method and the Alexander Technique have to do with body alignment and movement. Physician Moshe Feldenkrais, an Israeli, developed his program during more than 40 years of research. As a scientist and an athlete (he earned a black belt in judo), Feldenkrais applied a scientific approach to movement for the purpose of improving and supporting good health. Mara Neimanis, owner of Buffalo Feldenkrais in Williamsville, said that F.M. Alexander and Moshe Feldenkrais, the founders of their eponymous programs, were contemporaries. “The Feldenkrais Method uses movement as a way to communicate to the brain and change patterns of behavior,” Neimanis said. “A lot of the movement sequences are based on early childhood development and are ‘primordial movement’ that we’re born with. It’s a way to reteach the body to move more effortlessly and to look at patterns that are with effort so you can address them and change

them. It’s neurological.” Moving in ways that avoid pain and reduce risk of injury eventually becomes a way of living — an awareness that eventually becomes force of habit. Neimanis said in that way, FM is similar to AT. But AT lends more of a corrective aspect, a certain way to hold the head, whereas FM is based upon what the individual is going through on a particular day. “It’s about how to stay aware of what you need,” she added. “Feldenkrais is more of a challenge because it’s always asking, ‘How can you organize this? How can this be easy?’ Even if you’re at the computer and it’s now working. ‘How can you do this? Should you leave it?’ It’s based in reality. It gives you more than taking a deep breath. You’re looking for the path of least resistance and how you do it.” The various lessons and strategies integrated into FM provide tools to meet any circumstance as well as any type of client. Neimanis has helped people of any ages and across a wide array of medical conditions. Participants in an FM class begin by lying down to gain a sense of

proprioception and by the instructor’s verbal cues, begin moving into various positions so the instructor can see how their bones are moving and how they correlate with eye movement. Classes typically last about an hour and they meet weekly. Many students who engage in FM are musicians, actors and singers, as proper alignment help them perform better and avoid injury. “The classes are conducted very slowly,” Neimanis said. “It’s repetitive. When I first started, it drove me crazy. You’re working on the quality of the movement, not the volume or how far you can go. The quality is ultimately the home base of how something is. Can you find the ease in it or not? If you can’t find that, how can you find the quality to a capacity? We build strategies and aren’t afraid to change directions.” The Alexander Technique developed a century ago by F.M. Alexander. The program teaches students about how to improve and self-correct their posture to foster proper movement, improve performance and alertness and relief chronic issues caused by poor posture. Many of the people seeking to learn through the Alexander Technique are involved in music performance, acting, dance or other performing arts because of the toll these careers take on the body. Katie Fittipaldi is certified to teach Alexander Technique and instructs at the Eastman School of Music and the Eastman Community Music School, as well as offering performance programs in the surrounding area. She is also a cello teacher. “In AT, we acknowledge that our system works as a whole: the mind and body works together and works best when it’s free to move,” Fittipaldi said. “We’re interested in creating gentle conditions for movement to move freely. We don’t stiffen ourselves in a position. We let those relationships among body parts be in a relationship that’s unstuck and dynamic and ever changing. The system knows how to calibrate. We don’t have to manage all of this directly.” Fittipaldi likens it to young children who move freely and without effort or thought about posture. She discovered AT because as a cellist, she wanted to play with less tension and anxiety. Self-awareness is the first step in

How to Select a Personal Trainer By Deborah Jeanne Sergeant

hoosing a personal trainer can represent an important step in achieving your fitness goals. After all, the trainer is your coach, mentor and guide. Knowing your goals can help you know what type of trainer or coach you need — and if the potential trainers you consider can help you meet those goals. The trainer should have an education and experience in the type of training you need. “You want to work with someone with the right knowledge,” said Anthony Serrano, a certified personal trainer and nutrition coach and director of personal training at Jada Blitz Fitness in Buffalo. “Find someone with the proper qualifications to meet your needs, like you have had a torn anterior cruciate ligament in the

past. The person should be able to work with that.” Serrano’s personal training certification is from the International Sports Sciences Association, among his other certifications in exercise and athletic performance. He also holds a second-degree black belt in taekwondo. A personal trainer should have nationally recognized credentials, not just a weekend course. You should set some goals as to what you want and Serrano advised diving deeper into “I want to lose weight.” Why is that your goal? Will that help you become more active, feel more vibrant or increase longevity? “There’s more to why you want to get in shape,” he said. He also advised looking at online

references and listening to wordof-mouth referrals from people you know, as “that goes a long way,” Serrano said. In addition to professional credentials, Conner Lorenzo, director of operations of Fitness Science and CHAMPP at URMC Department of Orthopaedics and Physical Performance, also looks for personability, since it’s tough doing something challenging alongside someone you can’t stand. He calls the trainer client relationship a personal one because of the deeply emotional reasons many people have for wanting to get healthier, such as sensitivity about their weight, a dire health warning from their doctor or an urge to improve their physical appearance. “No matter what the goals or reason for getting into it, it’s pretty

AT as students focus on how they’re breathing and how they’re positioned while typing, playing an instrument or doing anything at all. A student may notice he’s holding his breath, tapping a foot or suspending his shoulders. Making the posture more comfortable and easier is the next part of the lesson, along with developing a helpful and healthful habit that holds the body comfortably and without causing problems. Fittipaldi helps students find the helpful positions and develop the healthful habits. “It’s about being curious about how we’re responding to live and then letting go of things that aren’t helping us,” she said. As students continue to learn, they apply AT to other things they do all day, such as sitting in an armchair, walking across the room, standing at the kitchen sink to wash dishes. “We’re more aware when we’re moving in ways that are hurting us and we can choose ways that are not hurting us,” Fittipaldi said. “If we’re cultivating that kind of relationship with the body, it opens the door to the possibility of pain reduction. They often come with neck, arm or back pain. It’s helpful for injury reduction and prevention.” In addition, musicians and athletes often come in to improve their performance. And like their professional pursuit, it takes practice to improve in AT. But Fittipaldi sees AT as a way of approaching everyday movement, whether sitting, standing, walking, riding a horse, washing dishes or anything else. “AT is a gentle way to bring more presence, calm and choice to what we are doing,” she added. “And if we find that we are responding to life in a way that is not particularly helpful, AT offers a way to let go of ways of thinking and moving that are no longer serving us.” This may include tightening, bracing, straining, generally making things harder than they need to be. Fittipaldi said these responses are often evident during stressful times but can surface at any time. “Let’s say I’m at Wegmans waiting in line and I give myself some space to stop and tune in,” Fittipaldi said. “I can ask: Am I moveable? Free to breathe? Gripping the cart? I wonder if this could be easier somehow?”

personal,” Lorenzo said. The location and availability of the trainer can make a difference as to how faithfully you adhere to the program. Driving too long or meeting a trainer at oddball times can make it easier to slough off and skip sessions. Lorenzo said that asking about the location and availability early on is important. In addition to asking about certification credentials, Jean Sica, certified tai chi instructor, ACE certified personal trainer and owner of Kokoro Fitness in Rochester, recommended asking friends about their personal trainer as well as meeting with trainers to discuss your fitness. “Ask to sit down with them to get a sense of who they are and if you connect with them,” she said. “I’d never sign up with someone for more than one class with them in the beginning. You may not like what they do. See how it feels.”

January 2023 IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 13

OMEN'S HEALTH

10 Women’s Health Myths Do you believe any of these? Really? By Deborah Jeanne Sergeant

aybe it was information passed down to you. Or perhaps you always assumed something to be true. But it’s time to clear up a few myths about women’s health. Myth: Women don’t need to lift weights to be healthy. Truth: “Strength training and good nutrition is how women can stay healthy,” said Brian De Luca, physical therapist and strength coach with UB MD Orthopedics and Sports Medicine in Buffalo. Myth: Strength training only builds muscles. Truth: “Strength training can help women prevent a lot of the age-based degenerative osteoporotic conditions,” De Luca said. Building muscle strengthens bones, as the tension placed on bones helps them become stronger. Any weight-bearing exercise also helps strengthen bones. Myth: Lifting heavy weights makes women look bulky and less feminine. Truth: “Women will sometimes undertrain with strength, whether that’s a body image thing or cultural expectation,” De Luca said. “That’s starting to change and move in a good direction, especially with younger women who want to get

more involved with lifting and want a more athletic body than a skinny body.” Myth: Being athletic is for only young women. Truth: “There’s a conversion of some of the women in their middle age getting involved in strength training and wellness that they didn’t have the opportunity doing growing up,” De Luca said. “They might start in their 30s with running or yoga or cross fit or strength training at the gym.” Myth: If I’m having trouble losing weight, it’s probably a thyroid disorder. Truth: Although it’s important to rule out a thyroid disorder if a few of the symptoms are evident, the reason could be something else. “We get a lot of referrals for people who are having trouble losing weight or have difficulty with sleep,” said physician Ajay Chaudhuri, division chief of endocrinology, diabetes and metabolism at UBMD Internal Medicine and Jacobs School of Medicine and Biomedical Sciences, University at Buffalo. “Once the blood test shows there’s not a problem, we look at improving general health. Drink enough water, eat a proper diet, get enough exercise, like walking and try to improve sleep hygiene. All of us are rushing and we ignore

those little things that generally affect wellbeing.”

number of visits without a primary care provider’s referral.

Myth: Pelvic floor problems like sexual issues and leaking urine affect only older women. Truth: “It’s not an age or a gender-related issue,” said Liz Loycano, doctor of physical therapy at Finger Lakes Health.

Myth: I’ve had ongoing issues with painful bowel movements or pain with sex since I broke my tailbone and there’s nothing I can do about it. Truth: “It could be an injury that happened 20 years ago, but physical therapy can help,” Loycano said. “It’s another venue to go down. Medications help with pain but if you want to get to the root of the problem, there’s another option: physical therapy.”

Myth: I have had children, so leaking urine when I sneeze or laugh is just part of my life now. Truth: “Physical therapy can definitely help that,” Loycano said. “People think about PT for their knee, shoulder or neck but the pelvis gets forgotten. They don’t realize that your pelvic floor muscles are part of your core; it’s not just the belly. You need it for breathing, posture and movement in general.” Some physical therapists even specialize in pelvic floor issues. In New York, patients can self-refer to a physical therapy practice and most health insurance will cover a certain

Myth: There’s so much caffeine in green tea that you should avoid it. Truth: “Drink caffeinated or decaffeinated green tea three times a day because the polyphenols and antioxidants are so good for you,” said Trudy Arsentault, Rochester Regional Health nurse navigator, lifestyle medicine nurse and host of Wellness Wednesdays at the JCC.

More Evidence That Regular Mammograms Save Lives

woman who gets her regular mammograms as scheduled is much less likely to die from breast cancer than if she skips screenings, a new study shows. Women with breast cancer who underwent all her scheduled mammograms had a survival rate of 80%, compared with survival rates as low as 59% for women who didn’t participate in any screenings, researchers found. “The purpose of mammography is to detect breast cancer during the few years it can be seen on a mammogram, but before symptoms are apparent,” explained researcher Robert Smith, senior vice president and director of the American Cancer Society Center (ACS) for cancer screening, in Atlanta. “If a woman unknowingly has breast cancer and misses or postpones her mammogram during this time when she has no symptoms, but her breast cancer is growing and perhaps spreading, then the window for early detection will be lost,” Smith added. Women between the ages of 45 and 54 are recommended to get mammograms annually, according

to the ACS. Women 55 or older can switch to every other year if they like. To see how important it is for women to stick to that schedule, Smith and his colleagues analyzed data on more than 36,000 breast cancer patients in Sweden from 1992 to 2016. Among those women, there were more than 4,500 breast cancer deaths. The researchers then tracked the women’s participation in as many as five of their most recent invitations for breast cancer screening prior to cancer diagnosis. Women who attended all five screening mammograms saw a 72% reduction in their risk of dying from breast cancer, compared to those who didn’t participate in any screenings. Even after adjusting for other factors, the women who got their scheduled mammograms still had a 66% reduction in their risk of breast cancer death, researchers said. “Women who attended all five previous mammography examinations prior to a diagnosis of breast cancer were nearly three times less likely to die from breast cancer compared with women who had not

attended any examinations, and each additional examination attended among the five previous examinations conferred an additive protective effect against dying from breast cancer,” Smith said. The findings were to be present-

Page 14 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2023

ed in November at the Radiological Society of North America (RSNA) annual meeting in Chicago. Such research should be considered preliminary until published in a peer-reviewed journal.

OMEN'S HEALTH

Thyroid Disorders Can Affect Women’s Health in a Big Way Women are nine times more likely to have a thyroid disorder

Physician Ajay Chaudhuri is a division chief endocrinology, diabetes and metabolism at UBMD Internal Medicine.

By Deborah Jeanne Sergeant

hyroid disorders are important to treat as this small gland at the base of the neck below the Adam’s apple controls numerous bodily functions. Without its proper function, people can become more likely to experience potentially deadly blood clots, stroke, heart failure and other heart issues. In addition to regulating aspects of the autonomic nervous system for either gender, the thyroid also affects women regarding menstruation, ovulation, cyst development, pregnancy and postpartum complications and early onset menopause. In hyperthyroidism, the thyroid makes too much thyroid hormone; in hypothyroidism, the thyroid makes too little. Since it increases the body’s metabolism, hyperthyroidism typically causes weight loss, hand tremors and rapid or irregular heartbeat. Those with hypothyroidism may notice fatigue, feeling cold, constipation, dry skin, weight gain, puffiness in the face, hoarseness, coarse and thinning hair, muscle weakness, muscle aches, muscle stiffness, irregular or heavier menstrual cycles, slower heart rate, depression and memory problems. “A lot of symptoms, especially with hypothyroidism, could have other causes,” said physician Ajay Chaudhuri. “Get a blood test done and confirm the diagnosis. Once it’s confirmed and they start the medication, they obviously want the test in

the normal range.” Chaudhuri serves as division chief endocrinology, diabetes and metabolism at UBMD Internal Medicine and Jacobs School of Medicine and Biomedical Sciences, University at Buffalo. He added that even if the findings are within normal, but two or more symptoms are still present, a specialist may be able to help the patient through medication. About 12% of US adults will develop a thyroid disorder during their lifetime and about 20 million currently have a thyroid disorder, according to www.thyroid.org. Women are nine times more likely to have a thyroid disorder, likely because Hashimoto’s syndrome, a precursor of hypothyroidism, is more common in women. It’s an autoimmune disorder, a category of diseases to which women are more prone than men. In addition, “women are more prone to ask for help,” Chaudhuri said. “Sometimes it can dysregulate menstrual periods. That kind of gets women in to see their provider and get a blood test.” Chaudhuri warns women planning to get pregnant to have their thyroid level checked first and also early in the pregnancy because babies rely upon the mother’s level of thyroid early in the pregnancy. “It may not be causing any symptoms, but you don’t want an underactive thyroid while pregnant,”

he said. He also tells patients about to test for thyroid and those who have been diagnosed that they should tell their provider about any other medication and supplements they take, as these can affect the efficacy of their thyroid medicine. Az Tahir, physician, practicing in functional medicine near Rochester, advises people experiencing these symptoms to seek a blood test. “Most doctors are not attentive to these issues,” Tahir said. “The main problem in modern medicine is because a doctor isn’t thinking about the thyroid, when a patient says, ‘I’m tired, I have constipation, my periods are irregular and my skin is dry,’ they will give other tests and not test the thyroid.” Tahir said that even among physicians who test the thyroid for their patients, they tend to overlook the need for treating them for thyroid issues if their test results are borderline, even if they experience classic hypo- or hyperthyroid symptoms. The test measures thyroid stimulating hormone (TSH) in the blood stream. “They’ll say your TSH is normal, but it’s not actually normal,” Tahir said. “They won’t listen to the patient and that’s the basic principle of medicine. Hippocrates said to listen to the patient and the patient will tell you the diagnosis.” He uses a compounding pharma-

cy as needed to ensure he can make available to patients the formula that best meets their needs. Tahir also thinks that although medication is necessary, physicians tend to fixate on medication only without giving enough merit to overall lifestyle. In addition to medication to help control the problem, Tahir recommends improving diet. “A number of studies link Hashimoto’s with leaky gut,” Tahir said. “I make sure the gut is strong.” He recommends bone broth for chicken soup to improve gut health, along with foods such as yogurt, kefir and kimchi. Enough water and fiber are also necessary. Tahir said that clear urine that’s not odorous indicates sufficient hydration. Foods that can support thyroid health includes Brazil nuts; turmeric; garlic, ginger; mushrooms; berries; fish such as yellowfin tuna, halibut, sardines and salmon; meat like ham, pork, beef and turkey; poultry; eggs and breads and grains, especially those enriched with selenium. “I advise patients to try to not eat out; cook at home, especially when they’re sick,” Tahir added. “They know the ingredients and eat the least ingredients.” He also promotes tea made with turmeric, ginger, milk thistle, dandelion root, echinacea or rosemary.

January 2023 IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 15

OMEN'S HEALTH

Hormonal Contraception Linked to Increased Risk of Violent Death

Studies find shocking increase in risk of violent death in ever-users of hormonal birth control By Amanda Jowsey

n 2021, a review published in Behavioral Endocrinology, a section of Frontiers in Behavioral Neuroscience, brought light to concerning risks for ever-users of hormonal contraceptives. The article, written by Angela Lanfranchi, breast cancer surgeon and co-founder of The Breast Cancer Prevention Institute, explores two cohort studies of British and American women. The studies found a statistically significant increase in the “risk of violent death in ever-users of hormonal contraceptives.” An overall increased long-term rate of death wasn’t noted, only the substantially increased risk of violent and accidental deaths specifically — the potential causes of which the study’s authors could not explain. The increased risk of violent death among ever-users of hormonal contraceptives (HC) was 92% — 116% if the HC was used longer than eight years. Even more alarming, one-third of the deaths were the result of suicide. This information prompted a

review from the National Institutes of Health in 2021 to examine possible causes of this link between HC and violent death. The NIH review cites evidence that HC alters a woman’s biological preference for men, leading to low sexual responsivity toward their long-term partner, more relationship problems, even issues conceiving or the increased risk of having unhealthy children. “This can have a real impact on the quality of spousal relationships… Therefore, it is not unreasonable to suspect that such effects could also influence rates of intimate partner violence,” NIH said. The long-term use of HC is related to several factors “that have the potential to influence relationships,” which can negatively impact partners, increase the risk of suicide, and increase accidental deaths through substance abuse (NIH). Comprehensive research on the physiological and psychological dangers of taking synthetic birth control spans decades. However, and

is by no means limited to just these studies. HC has been shown to create or worsen symptoms of mental illness such as PTSD, borderline personality disorder and depression through its potential to modify brain structure and function. The Association for Child and Adolescent Mental Health published a study showing that oral contraceptive use in adolescence “predicts lasting vulnerability to depression in adulthood… and the age when hormonal contraception is first started impacts the likelihood of major depressive disorder.” “Women who started hormonal contraception while still adolescents had long-term increase in MDD regardless of current use. It is postulated that there are changes that occur which are more lasting if the hormonal contraception is used during the final brain maturation before

adulthood,” according to ACAMH. “There is a great need for further research concerning brain function and structure relating to exposure to hormonal contraceptives, especially since these drugs are often given to young women whose brains are not fully matured. Using physician screening and patient education, the incidence of violent death can potentially be mitigated,” according to NIH. In the United States today, roughly 12 million women currently use hormonal contraceptives, including the 6.4 million women who take oral contraceptives (estrogen-progestin combination drugs). NIH advises: “All women taking hormonal contraceptives should be apprised of all the critical risks, including the potential for effects shown to be associated with an increased risk of violent death, to make an informed choice.”

Cannabis Use During Pregnancy Ups Risk of Premature Birth

sing cannabis during pregnancy may not be as benign as some think, with a new review showing it raises the risk for both premature and low-birth-weight newborns. In turn, that raised the chances of these infants winding up in a neonatal intensive care unit (NICU) for special care. There was reassuring news in the analysis, published Nov. 16 in the journal Addiction: Exposure to cannabis while in the womb did not translate into a higher risk for birth defects, death within one year or death from SIDS (sudden infant death syndrome). Some moms-to-be turn to weed

for help with morning sickness or general malaise, but the researchers noted that may be a dangerous decision. “The global increase in cannabis use among women of reproductive age also extends to pregnant women,” said study first author Maryam Sorkhu, at the University of Toronto’s Centre for Addiction and Mental Health. “We know that THC, the main psychoactive constituent in cannabis, can cross the placenta from mother to fetus and bind to receptors in the fetal brain,” Sorkhu said in a news release from the Society for the Study of Addiction. “Our study adds to that knowledge by showing that prenatal

exposure to cannabis heightens the risk of several adverse birth outcomes.” In their review, the investigators pooled the results of 57 published studies that involved a total of nearly 13 million infants, almost 103,000 of them exposed to cannabis. Three different outcomes were measured: premature birth, low birth weight and admission to a NICU. Twenty of the studies measured the association between cannabis exposure and the risk of preterm delivery. In these, the combined results showed that pregnant women using cannabis were over 1.5 times more likely to have a preterm delivery, compared with women not using

Page 16 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2023

cannabis during pregnancy. Meanwhile, 18 of the studies measured the risk of low birth weight. There, investigators found that women using cannabis during pregnancy were more than twice as likely to have a low-birth-weight baby compared with women who didn’t. Last but not least, 10 of the studies measured the risk of needing NICU admission. In these, exposed newborns were more than twice as likely to require NICU admission as non exposed newborns. The studies in the meta-analysis were published between 1984 and 2023 in a wide range of countries.

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January 2023 IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 17

The serene view around Quaker Lake, inside Allegany State Park in Cattaraugus County.

My cabin at Allegany State Park: Quaint rustic green unit with its furnace already turned on for me when I first arrived.

A little bonfire outside my cabin at Allegany State Park.

It’s Winter in WNY. Time to Go Camping!

Writer discusses her winter camping trip to Allegany State Park. ‘I highly recommend it,’ she says By Amanda Jowsey

inter in Buffalo has this way of overstaying its welcome. My cabin fever, ironically, led me to book a cabin at Allegany State Park last winter. I highly recommend it to anyone who needs a change of scenery and a new perspective to get through their countdown to spring. The main roads at Allegany are plowed and maintained, there is a 24-hour rental desk and maintenance on duty and any unsafe roads are closed off so you can’t get yourself into trouble. New York State Parks, Recreation and Historic Preservation and the Department of Environmental Conservation make finding a site for winter camping in Western New York easy. Just go to their website to navigate, search for campgrounds with winter camping through the “find your site” and “camping this weekend,” links at the top of the page.

Accommodations Winter camping was new for me, but Allegany State Park made it seem perfectly normal. I felt comfortable. I was a little hesitant at first, not knowing what to expect, but when I arrived at Quaker Lake, a few minutes down the road from my site,

the first thing I saw was a bald eagle flying overhead — my first. OK, I got this, I thought. The universe is on my side. I rented a basic cabin on Weller trail with propane heat, a fridge and gas stove and four beds for $94.50 a night. There was no sink or running water, but a bathroom at the end of the loop. It’s pet friendly, so I brought my dog along for the adventure. I checked in at the rental office down the road and got my key. When I arrived at the quaint rustic green cabin, the furnace had already been turned on for me and was nice and warm. I found firewood at a stop on the reservation in Salamanca on the way in and had a fire later that night in the outside pit. Cabins can be upgraded to cottages, which include a bathroom with shower, electric refrigerator, gas stove, microwave, furniture, pillows, bedding, cooking utensils and dishes. Cottages have two bedrooms, a main room and kitchen, and five beds for $172.50 a night.

Health benefits of unplugging in the winter The world was quiet. I could hear myself think again, but I didn’t need to. I slowed down. I resourcefully made myself meals and ground-

ed myself, resetting that constant fight or flight state of a nervous system in this over-stimulating world. Except for a few friendly neighbors (who helped me start my fire after an hour of unsuccessfully and stubbornly trying to do it without cheating), the only sounds around were birds chirping and the faint squawk of a crow off in the distance — signs of the slow arrival of spring all around that seemed to daunt me underneath the freshly fallen snow. It was beautiful. It helped me appreciate winter in a whole new way. New studies find that the strongest motivator for going camping is seeking feelings of happiness. Campers, on average, are shown to be happier and less anxious than non-campers, rating significantly higher across six areas of psychological well-being than non-campers. Camping, especially in winter, has numerous physical benefits. It also burns more calories when hiking and doing activities outdoors because your body works harder to stay warm. Camping is shown to improve cognition, as it challenges the mind to learn and develop new skills or hone old ones. It improves mental well-being by reducing screen time and promotes physical activity. I can attest to that.

Page 18 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2023

If You Go For more information on how to book your getaway: • NYS Parks, Recreation & Historic Preservation, Department of Environmental Conservation: newyorkstateparks. reserveamerica.com/camping/allegany-state-park Reservations can be made online or through the Reserve America Call Center: 1-800-456-2267 • New York State Park Campgrounds: Same-day reservations will be allowed until 3 p.m. on day of arrival. This applies to campsites only. Walk-ins will not be permitted. • DEC Campgrounds: Same-day reservations will be allowed until 2 p.m. on day of arrival at all DEC campgrounds. Walk-ins will not be permitted.