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March 2018 • Issue 41
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MEN’S HEALTH
Physician Brian Clemency: CPR, not ‘scoop and run,’ should be priority with cardiac arrest patients
SPECIAL ISSUE
• “I Survived Prostate Cancer” • Reasons to See a Urologist • Men Less Likely to Seek Treatment for Depression • Pain Meds May Affect Sperm Count • Risks and Signs of Testicular Cancer
ALSO INSIDE:
Sleepy Drivers May Be Causing More Crashes ThanThought
Number of Men in Nursing Schools Steadily Growing p.15
Accidents involving sleepy drivers about eight times higher than current federal estimates
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How Old Should Kids Be to Get Their First Cell Phone?
Things You Need to Know About Robotic Surgeries
Twenty years ago, cell phones were rarely sighted and could be found nearly exclusively in the hands of high-powered business people. Fast-forward to 2018 and it’s not uncommon to see an elementary school student happily tapping away at a game on the screen of a smart phone. But how old should kids be to get a cell phone?
ACUPUNCTURE Find out why some cancer patients are seeking treatment through this ancient Chinese medical practice
p.9
Yogurt: Greek vs. Regular Which one is better for you? The answer may surprise you. SmartBites.
p.12
Dog Bites
Men are nearly twice as likely to have been bitten as women, according to the study.
p.2
Dog Bites More Common for Anxious People Also: Men are nearly twice as likely to have been bitten as women, according to the study
M
aybe there’s some truth in the long-standing belief that dogs can sense fear in a
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human. According to a new British study, anxious people may be at increased risk for dog bites. The finding came from a survey of nearly 700 people in northern England, done by researchers from the University of Liverpool. As part of the study, participants were asked if they were ever bitten by a dog, whether they knew the dog that bit them, and the severity of the bites. They also took a 10-item personality test. The more emotionally stable and less neurotic the participants were, the less likely they were to have been bitten by a dog, the study found. As a person’s emotional stability score increased by a single point, between one and seven, their likelihood of having been bitten fell by 23 percent. “Dog bite prevention schemes may also need to target particular behaviors around dogs by different
victim personality types,” wrote the authors led by Carri Westgarth, from university’s Institute of Infection and Global Health. Overall, one in four participants had been bitten by a dog. Men were nearly twice as likely to have been bitten as women. More than half of the participants — 55 percent — had been bitten by a
dog they didn’t know. Also, people who owned several dogs were three times more likely to have been bitten than those who didn’t own dogs. Dogs’ characteristics — sex, age and breed — were not taken into account. The study only found an association between human personality traits and frequency of dog bites.
The study results were published online in the Journal of Epidemiology and Community Health. “It is essential that previously assumed risk factors are reassessed as this study has revealed that prior beliefs — such as bites typically being from familiar dogs — are contested,” the study authors said in a journal news release.
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GET FIT Get Informed Exercise in older adults is very important for balance, heart health, muscle strength, blood circulation and more. You can benefit from physical activity even if you already have a condition such as osteoarthritis or heart disease. Being more active may improve your quality of life and can prevent or delay disability.
Partner with Your Provider It’s never too late to start getting active. Your first step toward healthy living is to get a handle on your health status right now. Make an appointment with your primary care physician. Talk to your primary care physician about the exercise plan that is right for you.
Start Now Healthy living isn’t just about your personal habits for diet and activity. It’s also about your connections with other people – your social network. Take a class, volunteer, play games, see old friends or make new ones. Stay social!
New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 | www.WellCareNow.com
Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Sources: WedMed.com, fnic.nal.usda.gov, and helpguide.org.
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WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-MY-WELLCARE (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-877-374-4056（TTY：711）。 Y0070_NA029064_WCM_ADF_ENG CMS Accepted 05242015 ©WellCare 2015 NA_03_15 March 2018 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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CALENDAR of
HEALTH EVENTS
March 3
Mount St. Mary’s Hospital and Niagara Yogo Co-op have signed on as sponsors of the event. For registration or more information, call 716-297-2022.
For the second year, Macerich’s Fashion Outlets of Niagara Falls, USA will host the One Heart, One Mile Winter Wellness Walk and Health Fair to benefit the Buffalo Niagara American Heart Association (WNY AHA). The free event will take place on Saturday, March 3. Registration will begin at 9:30 a.m. and festivities kick off at 10 a.m. At 10 a.m., walkers will follow a onemile path around the mall. Immediately following the walk, a variety of health-related vendors will be available to educate guests on a wide selection of health-related topics. “This time of year can be difficult for many to get motivated to move, especially with the frigid outside temperatures,” said John Doran, senior manager of Macerich’s Fashion Outlets of Niagara Falls. “By hosting the one-mile walk in the Fashion Outlets, we’re giving people a fun, indoor option to get moving and do something good for their heart health. “We brought the Niagara County Heart Walk back last year after a 12year hiatus. It was a great success for our first year and we look forward to continuing the tradition with the WNY AHA and educating our community in an enjoyable way.” Local Niagara Falls businesses, including United Health Care, Niagara Falls Memorial Medical Center,
May 12
Niagara Falls event to benefit Heart Association
You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org
ECMC announces annual gala event, honorees The ECMC Foundation recently announced that a doctor and a nurse will be recognized during the 29th Annual Springfest Gala to be held at the Buffalo Niagara Convention Center May 12. • Physician Mark J. Anders will receive ECMC 2018 Distinguished Anders Physician Honoree award. He is director of orthopedic trauma, Center for Orthopaedic Care at ECMC; and clinical associate professor, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences. An orthopedic surgeon with more than 20 years of experience with UBMD Orthopaedics and Sports Medicine, Anders specializes in reconstruction and surgery related to trauma. Anders’ practice also encompasses general orthopedics, including hip and knee replacement. Board-certified by the American Board of Orthopedic
Surgery, Anders’ experience spans more than two decades treating adolescent, adult and elderly patients. He is one of only two trauma fellowship-trained orthopedists in the Buffalo area. • Registered nurse Sandra Lauer will receive the ECMC 2018 Distinguished Nurse Honoree award. She is director of, continuum of care, supportive care and palliative medicine at ECMC. According to a news release, Lauer is a vitally important member of ECMC’s palliative care outreach team, specially trained in the discipline of advance care education and planning. Having developed a highly regarded and community-based initiative, “The Conversation Project,” Lauer helps guide and assist in bridging the continuum of care to end-of-life care to ensure, in a respectful, culturally sensitive manner, that the community is engaged in this topic. Springfest Gala will take place at the Buffalo Niagara Convention Center beginning at 6 p.m. Those individuals interested in attending or sponsoring Springfest Gala 2018 should contact Susan Gonzalez or Lauer Stacy Roeder in the ECMC Foundation offices at 716-898-5800,or email Stacy Roeder at sroeder@ecmc.edu. Pegula Sports and Entertainment along with the Buffalo Bills and the Buffalo Sabres are Springfest Gala 2018 Presenting Sponsors. All donations to the ECMC Foundation directly benefit the life-saving medical mission of ECMC and plans to build the region’s new level 1 trauma center and emergency department. Windsong Radiology Group is the largest free standing imaging provider in Western New York and one of the busiest in the nation, performing more than 400,000 imaging exams per year.
Erie, Niagara Counties
Windsong Radiology Begins Mobile Mammography
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Online
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indsong Radiology Group’s mobile mammography is now driving early detection throughout Western New York. As a provider of mobile breast cancer screening, Windsong now has the ability to eliminate barriers to breast cancer screening in communities with limited or no access to breast cancer screening. A recipient of funding from the NYS Department of Health and Health Research, Inc.’s (HRI) Mobile Mammography Van grant, Windsong is working collaboratively with churches, payors, community and healthcare partners to improve breast cancer screening rates in Western New York. Underserved and never before served women in all eight counties (Allegany, Erie, Cattaraugus, Chautauqua, Wyo-
ming, Niagara, Orleans and Genesee) who have had limited or no access to breast cancer screening, will now have access to the high quality services that Windsong provides. The mobile mammo coach will provide 3D mammography or digital breast tomosynthesis, a state of the art technology that has proven to detect smaller cancers earlier, when they are easier to treat. Windsong has hired six new staff members for this important initiative. “This aggressive breast cancer screening initiative is designed to eliminate barriers to screening and will enable Windsong Radiology to work closely with community partners throughout Western New York in an effort to improve access to this vital service,” said physician Thomas Summers, president of Windsong Radiology.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
• 8 a.m. to 4 p.m., March 7, at Balaban-Stahl medical office, 21 N. Main St Middleport; • 8 a.m. to noon., March 10, at St. Marks Open Door-TNWP, 2901 Highland Ave., Niagara Falls; • 9 a.m. to 5 p.m., March 12, at Niagara University, 5795 Lewiston Road, Niagara University; • 9 a.m. to 2 p.m., March 13, at NCCC, 3111 Saunders Settlement Road, Sanborn; • 7 a.m. to 3 p.m., March 16, at Canisius College, 1829 Main St., Buffalo; • 8 a.m. to noon., March 17, at Canisius College, 1830 Main St., Buffalo; • 11 a.m. to -4 p.m., March 19, at Faith United-Barker, 1449 Quaker Road, Barker; and • 3 p.m. to 7 p.m., March 28, at IHA-Westminster Community Charter School, 24 Westminster Ave., Buffalo To check dates in surrounding counties, call 716-929-9494 or visit windsongradiology.com/mobile.
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still surprised by just how many crashes we found to involve driver drowsiness in our study.” The study found that “approximately 10 percent of all motor vehicle crashes involve driver drowsiness,” Tefft said. The U.S. Centers for Disease Control and Prevention estimates that about one-third of American drivers aren’t getting the minimum seven hours of daily sleep that experts recommend. A recent AAA survey found that nearly three in 10 drivers said that in the past month they’d been so exhausted while driving that they weren’t able to keep their eyes open at some point. To identify driver fatigue during car crashes, the researchers examined video taken during the one-tothree minute period preceding each accident. They then tallied the amount of time each driver’s eyes were closed in that timeframe. Drivers were deemed to have been “drowsy” if their eyes stayed closed for more than 12 percent of the time. The study team concluded that current federal estimates — which link 1 to 2 percent of all car crashes to driver fatigue woefully underestimate the dimension of the driving-while-tired problem. “Our previous research has shown that a driver’s risk of crashing increases significantly when they don’t get at least seven hours of sleep, and climbs to levels similar to the crash risk of a drunk driver after missing more than two to three hours of sleep over a 24-hour period,” Tefft said.
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Accidents involving sleepy drivers about eight times higher than current federal estimates river fatigue causes many more car accidents in the United States than previously estimated, a new report suggests. The finding comes from an analysis of several months’ worth of video recordings taken of nearly 3,600 Americans while they were driving. During that time, participating drivers were involved in 700 accidents. All participants’ vehicles had been outfitted with a dash-cam video recorder. That allowed researchers to analyze each driver’s face in the minutes right before crashing. The researchers also had video of the road scene in front of the drivers. Together, the footage suggested that the percentage of accidents involving sleepy drivers was about eight times higher than current federal estimates. The finding was highlighted in a report released recently by the AAA Foundation for Traffic Safety. The foundation describes the investigation into drowsy driving as the most in-depth of its kind to date. “Driver drowsiness is a notoriously difficult problem to quantify because it typically doesn’t leave behind evidence that a police officer can observe after the fact when investigating a crash — in contrast to alcohol, for example,” said Brian Tefft, a senior research associate with the foundation in Washington, D.C. “Thus, we expected that our study would find that the problem was substantially bigger than the official statistics from the U.S. DOT [Department of Transportation] suggest,” he said. “But we were
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(Just 1.5 miles from previous location) Welcoming new patients. All female providers and staff. Expanded hours including Saturday 2 On-Site Mental Health Counselors and Health & Nutrition Coach Specializing in Women’s Health Issues. New location conveniently located on a bus route.
Now accepting Fidelis
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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Julie Halm, Danel Meyer, Katie Coleman, Nancy Cardillo, Catherine Miller Advertising: Anne Westcott (716-332-0640.) Tina LaMancusa (716-946-2970) Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 5
Meet
Your Doctor
By Chris Motola
Brian Clemency, D.O. CPR, not ‘scoop and run,’ should be priority
Don’t Count on with cardiac arrest patients, says physician at an American UBMD Emergency Medicine to Do CPR Q: You’ve been championing some Just over half of Americans know how to perform the emergency procedure.
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f someone collapsed in front of you, could you perform CPR? If you answered no, you’re hardly alone. Just over half of Americans know how to perform the emergency procedure. And even fewer know the recommended hands-only technique for bystanders, a new Cleveland Clinic survey reveals. The survey also found that many Americans can’t tell the difference between heart attack and stroke symptoms. This could lead to delays in patients receiving proper treatment. “When someone is suffering from cardiac arrest, time is not on their side,” physician Steve Nissen, chairman of cardiovascular medicine, said in a clinic news release. “Immediate CPR can be the difference between life and death, doubling or even tripling a person’s chance of survival. It’s a skill that can be easily learned, and we encourage everyone to equip themselves with this knowledge and not be afraid to use it during an emergency,” Nissen said. The online poll queried more than 1,000 U.S. adults. Fifty-four percent of respondents said they know how to perform cardiopulmonary resuscitation. However, only one in six knew that hands-only (just chest compressions, no breaths) is the recommended CPR method for bystanders. And only 11 percent knew the correct rate (100 to 120 a minute) for chest compressions. An automated external defibrillator (AED) can also be a lifesaver when someone suffers cardiac arrest, but only 27 percent of respondents said there is an AED where they work, the survey found. The survey also found that heart attack and stroke symptoms were frequently confused. Fifty-nine percent falsely believed that sudden numbness or weakness of the face, arm or leg is a symptom of a heart attack. And 39 percent incorrectly thought that slurred speech is a heart attack symptom. These actually are common stroke symptoms.
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pretty major changes to the way that we respond to cardiac arrest. A: What we’ve done is not so much changed the protocols so much as change the way we think of cardiac arrest management. All the same skills that were always being performed are still being performed, but we’re doing them in a different way. We’re reprioritizing the things that matter and deprioritizing the things that aren’t as important to our patients.
Q: What’s being prioritized? A: The single most important thing in cardiac arrest is focusing on high-quality chest compressions and defibrillation. The other things, which are sometimes glamorized on TV, or that the public expects — things like rapid transportation to the hospital, putting a breathing tube into the person, or giving cardiac medication. We know those things are not as helpful, so we focused our efforts on CPR. For instance, the expectation is that, when someone’s heart stops, we show up on scene, scoop them up, put them in an ambulance and rush them to the hospital. By doing that, we rob them of time where they could be getting chest compressions. So we’re getting the message out to our providers, fire department partners and now the community.
The expectation is that, if you’re in cardiac arrest, we are going to have a prolonged effort of trying to bring you back to life on scene, which is where we have the best chance of saving your life and give you a meaningful recovery. We’re not just going take you to the hospital automatically. Q: Have we underestimated CPR as an intervention? A: CPR is always seen as a basic thing, but I think it’s fair to say that it’s very powerful in comparison to other interventions. Anyone can do basic chest compressions. That’s what’s circulating blood to the body and the brain. Anything that interferes with that is really detrimental to that person’s survival. Q: Are we talking about CPR as a stop-gap treatment or a remedy for the heart attack. A: Just to be clear, a heart attack is different than cardiac arrest. A lot of people use the terms interchangeably, but they are actually different. In cardiac arrest, where the heart is stopping, chest compressions are circulating blood through the body, giving us time to hopefully shock the heart back into a rhythm that can sustain life. There are cases where CPR alone can bring a person back, but in most cases it’s kind of a stop-gap to lengthen the time to treat the patient and get them better. Q: What makes a chest compression high-quality? A: We want to be sure that we have proper depth and a rate of about 100 to 120 beats per minute. We find that’s the appropriate compression rate. We also want to be doing them as much as possible. Every time we take a break to move them or do another procedure, we’re robbing them of oxygen to their brain. So the most important thing is doing chest compression continuously. Sometimes the public is concerned when called on to do chest compression. The message for the public is that CPR is unbelievably safe. A study came out on patients who mistakenly received CPR despite not being in cardiac arrest. And that study showed that no real harm was done to the patients who got them inappropriately. Q: What about the mouth-to-mouth component?
Brian Clemency, associate professor of emergency medicine in the Jacobs School, medical director at AMR and a physician with UBMD Emergency Medicine
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
A: We find that’s less important and don’t recommend it for the lay public. We teach them to focus only on chest compressions. It simplifies the process. It’s also not as important in those first few minutes. We also think it makes people more willing to do chest compressions since some people feel uncomfortable putting their mouth on someone and might decide to do neither. Q: How much training does a layperson need to reach competency? A: That’s a great question. There’s a course called Anytime CPR, which can be done in about 20 minutes, where people can be exposed to performing chest compressions. Even if you don’t know how to do chest compressions already, 911 will usually walk you through the process. So we encourage you to take a class, but it’s easy enough that you can be talked through it. Q: Should we be concerned about breaking ribs? A: That’s always a concern and can be happen, but that study we talked about earlier showed that the chance of harm is very low. And if you are in cardiac arrest, the risk of broken ribs is small compared to the risk of dying from not receiving chest compressions. The risk/ benefit balance is totally in favor of performing chest compressions. We don’t want those small risks to deter anyone. Q: How do the metrics look on these new guidelines? A: We have now more than doubled our cardiac arrest survival. We had 1.3 survivors per month with favorable neurologic outcomes. After we implemented the initiative, we saw 3.0 favorable neurologic outcomes survivors. These are people who are able to not just survive, but make strong recoveries. What we’re doing is a paradigm shift. We’ve seen tremendous results as a result of it. Q: What are the indications here, do you think, for “deputizing” laypeople as immediate responders for medical emergencies? A: There’s lots of different layers to that. I think hands-only CPR is the single most meaningful thing we can teach the average person to do. We know from previous work that you’re more likely to get CPR from a stranger in a public place than your family members at home. There are other issues we’re looking at like hemorrhage control, properly applying tourniquets, for example.
Lifelines Name: Brian Clemency, D.O. Position: Medical director of American Medical Response (AMR); emergency medicine physician at Erie County Medical Center Hometown: Manhasset, NY Education: New York College of Osteopathic Medicine Affiliations: Erie County Medical Center Organizations: National Association of EMS Physicians, AMR Foundation for Research and Education; Town of Hamburg Fire Companies Family: Wife, four children Hobbies: Apple-picking, spending time with his family
ACA Enrollment, Marketplaces ‘Remarkably Stable’ About 11.8 million Americans enrolled in 2018 coverage, down 3.7 percent from last year’s total
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fter much drama leading to this year’s open enrollment for Affordable Care Act coverage — a shorter time frame, a sharply reduced federal budget for marketing and assistance, and confusion resulting from months of repeal-and-replace debate — the final tally paints a mixed picture. With all states now reporting, ACA plan enrollment ticked downward this year, a report out
recently shows, but states running their own marketplaces saw slight gains and did better than those relying on the federal exchange. About 11.8 million Americans enrolled in 2018 coverage, down 3.7 percent from last year’s total, according to the National Academy for State Health Policy. Open enrollment began shortly after the Trump administration sharply cut federal enrollment
outreach efforts and ended a type of cost-sharing subsidy paid directly to insurers, which generally responded by raising premiums to make up for the loss. “Despite all that, enrollment in the marketplaces across the nation was remarkably stable,” said Trish Riley, executive director of the academy, a nonprofit, non-partisan group. Enrollment in marketplaces fully or partially run by states, for example, showed a small overall increase of 0.2 percent over the previous year, while the 34 states that rely entirely on the federal hub saw sign-ups drop by 5.3 percent, the report said. Officials from states operating their own exchanges said their ability to make changes led to their gains. “We could extend our openenrollment period, control our marketing budget and nimbly mitigate the impact of the loss of cost-sharing subsidies [to insurers], which led to a very successful open
enrollment,” said Zachary Sherman, director of Rhode Island’s state-run market. Enrollment there is up 12 percent this year, he said, with sharp increases in the number of newly enrolled and policyholders aged 18 to 34. California, which has the nation’s largest state market with about 1.5 million enrollees, saw a 2.3 percent drop in overall sign-ups. Covered California Director Peter Lee attributed some of that to efforts by the state to encourage off-market purchases by consumers who don’t qualify for subsidies. Despite their upbeat tone about this year’s enrollment, directors of several state marketplaces warned that 2019 looks grim. “Just the removal of the [individual mandate penalty in Congress’ recently enacted tax overhaul] will mean premiums go up 15 percent to 30 percent or more depending on the state,” said Lee.
Healthcare in a Minute By George W. Chapman
Buffet, Bezos to Get Into the Health Insurance Business
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arren Buffett, CEO and chairman of Berkshire Hathaway, has long purported that U.S. healthcare costs are the underlying reason why U.S.-based firms find it difficult to compete globally. Businesses in other countries spend less than half on healthcare as their U.S. competitors. Buffett is teaming up with Jeff Bezos, CEO of Amazon, and Jamie Dimon, CEO of JP Morgan Chase, to develop a system of care for their combined 1 million employees that is “free from profit-making incentives.” The headquarters and management team are to be announced. The mere threat of this alliance caused healthcare stocks (United Healthcare, Anthem, Aetna, Humana, etc.) to drop. Industry observers have noted, however, that there already is a nonprofit system in place. It’s called Medicare.
Federal Budget Passed On Feb. 9, Congress finally passed, and the president signed into law, a two-year $400 billion budget. Among the healthcare-related items are: $6 billion to fight the opioid epidemic and treat mental illness; $2 billion for National Institute of Health research; $90 billion for disaster relief; accelerates the closing of the infamous “doughnut dole” in Medicare Part D (drug) coverage; delays funding cuts to disproportionate share (more Medicaid and indigent care than average) hospitals; continues funding of the National Health Service Corps; expands the VA Choice program which allows vets to seek care from the private sector; repeals the Independent Payment Advisory Board which used to make seemingly arbitrary budget cuts to Medicare; continued community health center funding. Uninsured Rate Up It should come as no surprise that the number of uninsured Americans increased, by an estimated 3.2 million people, to 12.2 percent of the US population in 2017. That’s up from the record low of 10.9 percent in 2016. However, 12.1 percent is far better than the 18 percent uninsured rate before the ACA went into effect. The individual mandate repeal takes effect in 2019. The CBO estimates that
repeal will cause 13 million people to drop health insurance over the next decade. Cost of US Healthcare It’s well established that we spend almost twice as much on healthcare, $10,000 per capita, as any other industrialized nation. In 2016, we spent $3.3 trillion, which was 18 percent of our GDP. Interestingly, several studies have shown we actually use about the same amount of healthcare as other countries. The major cost culprit is price. We simply pay a lot more for care than most countries. Neither population growth nor aging can account for the fact that we pay far more. A study by the Institute for Health Metrics and Evaluation in Seattle, published in the Journal of the American Medical Association (JAMA), found that 63 percent of the increase in spending from 1996 to 2013 was due to the combination of more being done for patients during office visits/hospital stays and inflated prices. U.S. hospital prices are 60 percent higher than those in Europe. Another report, from the Healthcare Cost Institute, found that spending per person reached an all-time high in 2016 in employer-sponsored plans despite lower utilization. According to the report, increasing prices were the major factor in rising costs. Between 2012 and 2016 drug prices increased
25 percent and hospital prices increased 24 percent. Opioid Crisis A large bipartisan group from the House of Representatives has made fighting the crisis a top priority. They are focused on getting a package of eight new bills passed and signed by Trump. Among the eight bills are: directing funds for substance abuse centers to rural areas; requiring states with federal health grants to track written scripts and what pharmacists dispense; forcing all Medicare Part D scripts to be electronically transmitted to curb pharmacy shopping; and stopping illegal trafficking of opioids. In his state of the union address, Trump noted that 174 people a day die from an opioid overdose and that he is committed to fighting the epidemic. To date, there has been little funding to fight the battle. Killer Air Pollution was responsible for over six million global deaths in 2016. That is 12 percent of all global deaths that year. While not officially listed as the “cause of death,” pollution is strongly linked to lung cancer and emphysema, according to the Institute for Health Metrics and Evaluation. Two thirds of the six million deaths are due to outdoor or ambient pollution, which is caused by vehicles, coal fired plants and steel mills. Deaths per 100,000 due to ambient pollution are highest in central Africa, India, China and Pakistan. Team-Approach to Care A physician can no longer do it alone. Several factors, including the pending physician shortage, uncertainly in Washington, increased regulations and moving target reimbursement methodologies, have made it all but impossible for physicians to effectively keep up. According to research by the AMA itself, consumers prefer coordinated healthcare that is delivered by a physician-led team. The key is the physician is responsible for providing a safe and effective way
March 2018 •
of delivering and managing your care. Well-trained staff should be able to handle several of the chores traditionally handled by the physician including: data gathering and recording, taking vitals and history information, and patient education. The team approach allows each member to perform at the maximum level of their training, be they medical assistant, LPN, RN, care coordinator, PA or NP. Many visits may not even require a physician. Aetna/CVS The much ballyhooed, potentially game-changing merger of the insurance and pharmacy giants, is facing another hurdle. Aetna shareholders filed a class action complaint alleging that a document filed with the SEC contains incomplete and misleading information to win over Aetna shareholders. The Aetna shareholders believe the price offered by CVS is unfair and inadequate. Medicare Advantage Plans Currently, about 60 million seniors are covered by Medicare. Twenty million of them chose to enroll in a Medicare Advantage plan offered by commercial carriers. Among the larger players: United’s enrollment grew 7.3 percent, Humana’s grew 5.8 percent and Anthem’s grew 3 percent. Ironically, these large for-profit insurers have become increasingly dependent on Medicare and Medicaid for their bottom lines. M&M accounts for almost 60 percent of the revenues of the five largest publically traded insurers in the US.
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.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Making New Friends: It’s Never Too Late
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uestion from a reader: I’ve been divorced for about a year now, and struggle with loneliness. I miss the friends we shared as a couple, but I’m just not comfortable socializing with couples anymore. I’m 56, and it feels awkward to try to make friends at my age. Any advice for me?
Answer from Gwenn: It’s unfortunate, but what you are experiencing often happens in the aftermath of a separation or divorce, especially if it was acrimonious. Friends’ loyalties can be split and, just as you feel uncomfortable relating to your former “couple” friends, some couples feel uncomfortable relating to a now-single friend. So how do you meet new people and cultivate friendships as an adult? Here are a few tips: First, be your own best friend. Taking care of yourself matters. Loving yourself shows. The better you feel about yourself, the better friends you’ll attract. Positive people appreciate and gravitate to other healthy,
positive people. Do what you enjoy doing. You won’t make friends sitting alone at home. Get out of the house and do those things you enjoy, whether it’s going to the gym, walking your dog, taking a cooking class, joining a book club, or any number of activities that are fun and interesting. You’ll meet people who enjoy similar pursuits. Friendships can follow. Consider a support group. It’s not uncommon for new friendships to be born out of compassion and empathy. A divorce or grief support group will put you in touch with others facing similar challenges. A friend of mine met her second husband in a divorce support group. She shared, “We got to know each other as friends first, and have remained ‘best friends’ throughout our marriage. It’s the best thing that ever happened to me.” Say “yes” to invitations and opportunities to be with people. Circulating at parties, neighborhood meetings,
s d i K Corner
Hey Kids, Just Say No to Energy Drinks H ighly caffeinated energy drinks aren›t safe for children and teens, and should not be marketed to them, a leading sports medicine organization warns. The American College of Sports Medicine (ACSM) recently released an official statement about the beverages. “Energy drinks are extremely popular, and concerns about their consumption are coming from every sector of society, which is why we’ve published these recommendations,” said physician John Higgins. He’s an associate professor of medicine at the University of Texas McGovern Medical School in Houston. Children and teens appear to be at particularly high risk of complications from energy drinks because of their smaller body size and potentially heavy and frequent use, according to the statement. Page 8
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work events, etc. is one of the easiest ways to make new friends. You’ll be out and about with people with whom you share something in common. Show up and don’t be shy about extending an invitation to someone you meet. It could be a cup of coffee, quick bite to eat or a short walk. Don’t overlook your family. My sister is my best friend, and she helped me re-establish a network of friends after my divorce. I had gone into the proverbial “cave” and lost contact with practically everyone. Her friends became my friends, and now, years later, I enjoy the company of her friends, as well as my own. Rekindle relationships with old friends. Sometimes the friendships you made when you were single drift away after you get married. That’s not unusual. New priorities take over and focusing on married life requires time and attention. But now, when you’re looking to find new friendships, consider reconnecting with old friends. They were an important part of your life at one point, and may still have lots to offer. Pick up the phone. Give a “singles” event a try. Many divorced or widowed men and women find fun and friendship in community activities organized just for singles. It could be a hike, bike ride, dinner club or dance. These opportunities can be found online in community calendars or in your local newspaper. Volunteer or join a cause. Supporting an organization or cause you believe in will put you in contact with
people working toward a common goal. Community gardens, political parties, hospitals, museums, animal shelters and many other organizations often need volunteers. Strong connections can be made when you work alongside others who want to make the world a better place. Join an online community of people who share your interests. Social networking sites can be a safe and satisfying way to meet people. One popular site is www.meetup.com, which helps people meet others nearby who share their interests. Meetup allows members to find and join groups unified by a common interest, such as nature, photography, hiking, books, movies, health, pets, careers, hobbies, you name it! Good friendships can make life better. The company of someone who makes you laugh, who provides a shoulder to lean on, and who is just plain fun to hang out with can provide a welcome boost to your health and happiness. So, if you feel your social network is too small, remember you can always meet interesting people, make new friends, and nurture existing ones. It’s never too late.
sporting events involving children and teens. • Do not consume energy drinks before, during or after intense exercise. Some deaths linked with energy drinks occurred when a person consumed energy drinks before and/or after vigorous activity. • Educate consumers about the differences between soda, coffee, sports drinks and energy drinks. Energy drink education should be included in school nutrition, health
and wellness classes. The statement, which also called for more research into the safety of energy drinks, was published Feb. 9 in the journal Current Sports Medicine Reports. The American College of Sports Medicine is said to be the largest sports medicine and exercise science organization in the world.
The warning applies to beverages like Red Bull, Monster and Full Throttle. The fact that they are not meant for children needs to be emphasized and widely publicized, the group stated. “Our review of the available science showed that excessive levels of caffeine found in energy drinks can have adverse effects on cardiovascular, neurological, gastrointestinal, renal and endocrine systems, as well as psychiatric symptoms,” Higgins said in an ACSM news release. “More needs to be done to protect children and adolescents, as well as adults with cardiovascular or other medical conditions,” he added. Among the group’s recommendations: • Stop marketing to at-risk groups, especially children. This includes marketing energy drinks at
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women held throughout the year in Mendon, N.Y. For information about her workshops, book, or to invite Gwenn to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.
How Young Is Too Young for Their First Phone? Parents need to determine when their children are ready for cell phones By Julie Halm
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wenty years ago, cell phones were rarely sighted and could be found nearly exclusively in the hands of high-powered business people. Fast-forward to 2018 and it’s not uncommon to see an elementary school student happily tapping away at a game on the screen of a smart phone. Technology has progressed at lightning speed, leaving behind the bricks with buttons that were once such a status symbol and making way for mass consumption of all types of media on a device that fits easily into one’s pocket. While cell phones are incredibly handy, countless parents have been left to tackle the question, “How young is too young for children to get their first phones?” Elizabeth Beaty, a claims adjuster from Youngstown, has had the somewhat unique experience of parenting children throughout the entire dawning of the cellular age. Her oldest son, Brendan Lindahl, is 29 years old. “When Brendan came through, kids didn’t have cell phones, only parents did,” she said. The eldest of her children didn’t get a cell phone from his parents at all; instead, he bought one for himself when he was a young adult. A small age gap made a big difference when her daughter, Kaitlin Jackson, 27, went off to college. She received a cell phone but was not allowed to text for the first year as
the cost was too high. It wasn’t until her sophomore year of college that cost-savings plans became more common and the family joined one of its own. Her middle son, Gavin, 23, was younger when cell phones began to become commonplace. “When Gavin came about, the biggest thing for us was that data cost so much. We gave him a handme-down phone and he was on that a long time. He didn’t get a smart phone until college because it cost so much,” she said. Now, she is debating when the right moment will be to get a phone for her youngest son, Logan. He is 14 and on the autism spectrum, adding another layer to the already complicated decision. Danger ahead? Cell phones can now put children within a click or two of all of the benefits and the multitude of dangers that can come with the Internet and social media. “We worry about him meeting inappropriate people, being able to get onto the amount of sites that he could. However, he already uses a laptop. I think with the phone it just scares you that they might be able to trace it or track it or hack it,” she said. For now, she’s holding off for that reason, as well as to preserve some of the innocence of childhood. “I’m glad we’re not giving it to
him because I think they’re getting way too much too soon. They’re going to be burned out. Everything comes with an age,” she said. Amy Ferrari, a mother of two, said she now regrets her children having gotten smart phones at such a young age. Her children, now 20 and 17, received their first phones at 14. Ferrari said she felt pressured by the notion that they were becoming independent and might need a cell phone in order to call home. In the end, she thinks the devices did far more harm than good. “The kids did not learn any communication skills. That is the optimal age where you’re teaching them to communicate with other human beings and we missed those opportunities,” the Wheatfield resident said. If she could do it all over again, she would have waited until they were 16 and driving and then given her children phones without all of the bells and whistles. That is the route that Teri Cross has opted for with her two children, aged 14 and 16. Each of them has a Tracfone to be used in case of an emergency. “For teens, I like them to have one for emergencies and last-minute school changes I need to know about,” she said. South Buffalo resident Andrea Brown’s only daughter is 6, but she says that she has already given thought to the inevitable decision,
and the deciding factor is simple. “She will have to have her own job and pay for her own phone,” she said. Children and Cellphones
• On average, children are 12.1 when they receive their first mobile device. • 56 percent of children, aged 8 to 12, have a cellphone. • 60 percent of families who have provided a cellphone to their child did so between the ages of 10 and 11. 20 percent provided their 8-to-9 yearolds with a cellphone. • Among children 8 years of age and younger, 21 percent use smartphones. • 69 percent of families with young children under 8 years old have a smartphone. • 38 percent of children under 2 used a mobile device for media. • Dads are more likely to give kids smartphones in elementary school while moms are more likely to give kids smartphones in middle school. Source: www.growingwireless. com/
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Cancer Patients Can Get Help from a Surprising Source: Acupuncture By Deborah Jeanne Sergeant
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ancer and its treatment can cause patients numerous unpleasant side effects, including pain, fatigue and nausea. These can also contribute to insomnia, as can stress and anxiety, right at a time when patients need sufficient rest to battle cancer. Acupuncture may help. “Acupuncture: Patient Version,” published by the National Cancer Institute (www.cancer.gov) states that acupuncture has been shown in clinical trials to “control pain and to relieve nausea and vomiting, fatigue, hot flashes, xerostomia [dry mouth], neuropathy, anxiety, depression and sleeping problems.” Yuehui Li “Lisa” Zhou, licensed acupuncturist at Chinese Medicine & Rehab Center in Amherst, said that for thousands of years, Chinese practitioners have successfully used acupuncture for people experiencing pain and nausea. Some patients struggle to com-
plete all the grueling rounds of chemotherapy or radiation and must take a break. Zhou said that acupuncture may also help improve clients’ energy. “It’s very helpful for the pain,” Zhou said “It’s really helpful for nausea, too. We always give herbal medicine, too, to make that feeling of sickness go away. Some people won’t need medication for the nausea. With the acupuncture and herbal medicine, they don’t feel so weak. It’s a lot of help.” Anyone who has received a cancer diagnosis would likely agree that anxiety and fear caused some sleepless nights. Andrea Schilling, licensed acupuncturist at Acupuncture Works in Williamsville, said that acupuncture “is known for its calming the whole nervous system, which helps with stress and anxiety. Like other modalities of Chinese medicine, acupuncture offers a holis-
Dentist Maureen Sullivan, chief of the department of dentistry/division of oral oncology and maxillofacial prosthetics at ECMC’s Center for Cancer Care: “Our robust and in-depth team takes care of patients with head, neck and other cancers.”
ECMC Cancer Center Care Offers Options for those with Cancer Multidisciplinary team pays close attention to all elements of patient care By Jana Eisenberg
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personal experience with a family member experiencing oral cancer led Maureen Sullivan to want to become a dentist specializing in oncology. Now, as the chief of the department of dentistry/division of oral oncology and maxillofacial prosthetics at ECMC’s Page 10
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Center for Cancer Care, she’s deeply involved in patient care, treatment and outcomes. ECMC’s Center for Cancer Care focuses on head and neck, plastic and reconstructive surgery, dental and medical oncology, maxillofacial prosthetics, and breast oncology — and
tic perspective that supports clients’ wellness rather than the typical Western perspective that focuses more on patient diseases. “Acupuncture is about creating balance in the body. If you have pain, stress, or any health-related symptoms causing these issues, something’s not in balance,” Schilling said. Acupuncture has no medical contraindications for cancer patients and may help lessen their need of pain medication and the medication to mitigate treatment side effects. Medication may bring many benefits to treating the disease, but it’s not always harmless to natural functions of the body. By lowering the medication load, the patient’s body has fewer substances to filter out and contend with. Acupuncturists generally work by using hair-thin, sterile, one-use needles to stimulate the nervous system and circulatory system, and trigger the release of endorphins. By
knowing the correct areas to stimulate, the acupuncturist can achieve the desired results. Schilling said patients usually receive benefits from acupuncture within 24 to 48 hours. “Many are choosing a variety of modalities to support them through that time in life,” said Ronald Pratt, licensed acupuncturist in Buffalo. He added that acupuncture can help cancer patients stay strong, along with promoting well being and stress reduction. He believes that acupuncture is really about reestablishing homeostasis, or, normal function. “Whenever there’s an imbalance in the body, the result is a certain set of symptoms,” Pratt said. “We use the needles to stimulate a variety of responses so the body balances and the body heals itself. With pain, there’s stagnation. Something is stuck. The needles offer free flow.”
uses a multidisciplinary team which pays close attention to all elements of patient care, including diagnosis, treatment and maintenance, all provided with a cooperative approach. The center occupies an entire floor at the medical center, where it is well-positioned to provide this integrated and centralized care in the Buffalo region. “Our robust and in-depth team takes care of patients with head, neck and other cancers,” said Sullivan. “Even if a patient doesn’t have a head or neck cancer, treatments for other cancers can affect the oral cavity. “We see patients before they start breast and other cancer treatments, to help avoid treatment-related dental infections, to manage long-term care and monitor any long-term complications,” said Sullivan. “We also work closely with patients on ‘cancer survivorship,’ performing restorative surgery and/or providing complicated prosthetics.” One of the programs of which she is justifiably proud is the oral cancer screening program. Dentist Jennifer Frustino is the director of oral cancer screenings and diagnostics. She works with the latest technology to screen and diagnose patients at high risk for oral cancer. “Many patients have survived head and neck cancer treatments,” added Sullivan. “But if they continue to smoke, for example, they remain at risk. We monitor their health closely.” Smoking cessation is another obvious focus. The ECMC Center for Cancer Care has a group of faculty who rigorously engage with patients to participate in smoking cessation, which can greatly reduce people’s chances of getting cancer. “It is a heavy lift to get patients to quit smoking,” attested Sullivan.
“We have the highest number of patients who enroll in the state quitline.” The center focuses some of its work on cutting edge treatments, as new and effective drugs and treatments are being developed every year. “I feel fortunate that our head and neck surgeons push the envelope on induction and immunotherapies,” said Sullivan. “We use a team effort to work toward survivorship with minimal side effects. So, if there is a chance to cure a patient with a novel drug and/or minimally invasive surgery, we like to avoid radiation. That can improve survivorship and enhance quality of life.” A confident team which communicates well is one of the keys to the center’s abilities to treat this wide variety of patients. “For every new patient, we meet to discuss the case — the treatment options, or any challenges,” said Sullivan. “Our comfort level as a professional team is great. If I, or any of us, sees something that might be a problem, we don’t hold back. You can find your colleagues, and get that patient admitted that day. I know who to find and how to get a handle on it. And I know that the team expects the same from me.” As an example, Sullivan points to a recent patient who traveled from Watertown in Northern New York, which is about three and a half hours away. “This patient was coming in to be fitted for a complicated prosthetic,” said Sullivan. “I was needed for surgery, then the lab tech needed a long time — there were also two prosthodontists needed. The patient was there the whole day…but they were done in one day! What makes it work is that all the attending physicians, assistants, and lab technicians care so much about the patients. That means everything.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
Meet Your Provider Brilliant Light Therapy
Find out how this innovative, FDA-approved light therapy treatment can help you What is Infrared Light Therapy? FDA-approved, this medical equipment contains light-emitting diodes, also known as LLLT (low level light therapy). The Infrared and visible red LED’s provide gentle but powerful non-coherent light to the body to create an environment in which change can occur. How Does Infrared Light Therapy Work? The therapy works at a cellular level. Mitochondria are very sensitive to light therapy. The light energy stimulates the release of nitric oxide from our red blood stream. When this occurs, the nitric oxide enters the muscle cells in the wall of the blood vessels. Muscle
cells relax and the blood vessel diameter becomes larger allowing greater blood supply, oxygen, glucose and increases cellular energy. This promotes nerve healing to happen in all of the nerve tissues, including nerve fibers. Benefits of Using Infrared Light Therapy • Increased ATP which is energy for the cell • Decrease in inflammation • Decrease in pain • Stimulates healing at the cellular level • Angiogenesis, the formation of new blood vessels • Stimulates production of collagen • Increases lymphatic system activity • Stimulates tissue granulation
Typical Uses for Infrared Therapy • Peripheral Neuropathy • Traumatic Brain Injury • Acute neck and back pain • Inflammation • Carpal Tunnel • Diabetic Ulcers • Wound Healing • Arthritis and restricted movement • Bone fractures, Bone spurs • Burns How can I learn more about Brilliant Light Therapy? If you are interested in learning more about the success so many individuals are having with this FDA-approved therapy, you can attend a free seminar by calling Terri at 716-427-7744. Brilliant Light Therapy is conveniently located at 1515 Kensington Ave. Buffalo, NY. You can also see some of her clients’ success stories on her Facebook page, Brilliant Light Therapy.
Terri Songbird, a registered nurse who worked in critical care units in the U.S. and Canada for more than 15 years, has combined her medical and scientific knowledge with her 30 years of experience in natural health to educate and empower her clients with infrared light therapy.
Brilliant Light Therapy • 1515 Kensington Ave. Buffalo • 716-427-7744 Find us on Facebook: Brilliant Light Therapy.
Getting in Shape? Get a Trainer By Deborah Jeanne Sergeant Walking laps, playing a sport or following an exercise video can help you improve your health. But dropping pounds and gaining muscle is harder now than ever before. Especially if you’re mid-life and looking to get in shape, consulting with a personal trainer may help you improve your chances of achieving your fitness goals. Here’s why, according to a few local experts. • “Working with someone who can guide them is safer and is more enjoyable so they stick with it. • “I’d say to someone middle aged or older looking at starting an exercise program, that’s fantastic but they should make sure they can safely do so. They should be seen by their primary care provider to see if they can safely do this. Their primary may give a thumbs up or thumbs down.” Physician Michael S. Freitas, Primary Care Sports Medicine Physician, UBMD Orthopaedics & Sports Medicine, associate professor, Jacobs School of Medicine and Biomedical Sciences, UB. • “The vast majority of personal trainers don’t understand the science of movement. Finding a good personal trainer is every bit as hard as finding a good mechanic or financial adviser. It would probably be helpful to look for a facility that has func-
tional medicine and physical therapy with sports medicine or someone that is functional movement system certified. • “Be very wary of CrossFit. The injury rates are through the roof. Any physical therapist will tell you that they get a lot of clients through it. I’m sure there are some CrossFit people who understand movement, but we see a lot of clients who are hurt doing it CrossFit. • “Many, many people buy workout CDs and videos, watch stuff on YouTube and use apps. The vast majority is really, really bad stuff that will hurt people over a period of time. It’s terrible. • “The certifications won’t guarantee you’ll stay injury-free, but it increases the likelihood. • “Multiple physical therapists referring the same trainer also helps. Movement is medicine but if you don’t understand movement, don’t prescribe it. A lot of fox trainers don’t understand movement and they hurt a lot of people.” Joe Fox, certified personal trainer,
certified Functional Movement Systems professional, and president and founder at Train Smart, Williamsville • “The motivation that relationship with the trainer will keep the person coming back to the facility or wherever they’re training. The relationship between the trainer and the health seeker is significant. • “The personal trainer can make modifications in relation to injuries they’ve had or osteoarthritis or joint issues. They have professional knowledge the person might not have on their own. • “The personal trainer has knowledge of equipment, proper alignment which is significant as we age and it’s more important to be aware of this to avoid injury to bones, joints. Personal training is an excellent avenue. Mary Shaw, active older adult coordinator for Ken-Ton Family YMCA in Kenmore • “Hiring a personal trainer helps big time. Clients learn the proper way to do things if they haven’t worked out in a while or never. • “Motivation is a big reason to hire a personal trainer. • “For a lot of people, scheduling an appointment ‘forces’ them to come in. • “Paying for something as opposed to going for walks or working out at home motivates people to use
March 2018 •
what they’ve paid for. • “Personal trainers help their clients progress towards goals. For example, I find a lot of people working out every day use the same weight for the same exercises. It’s beneficial for a while, but eventually, they stagnate in their progress. I had a couple people who’d used the same weights for the past six months. It had gotten easier, but they hadn’t increased the weight. • “It can get you revamped to feel good about yourself. If you stay active, you look and feel better as you age. Being able to go up and down stairs is beneficial. By doing strength training, it helps you stay stronger. Personal trainers can help people do that.” Andy Cowan, fitness director, certified personal trainer at LeRoy Physical Therapy and Village Fitness with locations in Macedon, LeRoy and Batavia
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SmartBites
The skinny on healthy eating
The Lowdown on Nutrient-Rich Yogurt
Is Greek yogurt better than the regular one?
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s Greek yogurt better for you than regular yogurt? Based on all the press it’s received lately, along with its takeover of the dairy aisle, you might automatically think “yes.” I know I did. While indeed Greek yogurt has certain benefits that surpass those of regular yogurt, its nutritional profile is not necessarily better. It all depends on your dietary needs. Since one of my dietary needs is protein, Greek yogurt is better for me. On average, Greek yogurt contains nearly twice as much protein as regular yogurt. One cup of FAGE nonfat Greek yogurt, in fact, provides a whopping 22 grams. Why is the 60-plus me (who is no longer in a growth spurt or running three miles a day) concerned about getting enough protein? According to research, boosting your protein intake or at least getting an adequate supply helps combat the natural loss of muscle mass and strength that occurs with aging. Greek yogurt, however, is not necessarily better than regular yogurt for my friend who suffers from osteoporosis and seeks calcium. The
cially helpful for those who have lactose intolerance. And fewer carbs and sugar hold huge appeal for those looking to lose or maintain weight. Both Greek and regular yogurts boast the Holy Grail of stomach health: probiotics, aka the “good” bacteria that promote a healthy gut and boost immune health. Eating yogurt with probiotics helps improve digestion and potentially ease conditions like constipation, inflammatory bowel disease and diarrhea. Doctors often suggest eating yogurt while taking antibiotics (which can
Avocado Hummus with Yogurt Adapted from FAGE recipes
straining process that creates Greek yogurt — and gives it its thicker, richer texture — unfortunately removes some calcium. On average, regular yogurt provides 30 percent to 40 percent of the daily recommendation, compared to Greek’s 20 percent to 25 percent. Concerned about carbs and sugar? Lactose? If so, Greek yogurt might be the better choice for you, since the straining process to remove whey reduces all three. Less lactose, the sugar in dairy products that can sometimes upset stomachs, is espe-
2 garlic cloves ½ jalapeno (optional), seeded 2-3 tablespoons fresh cilantro (or 2 teaspoons dried) 15.5 oz. can chickpeas, drained and rinsed 2 avocados, peeled and cubed ½ cup plain, low-fat yogurt: Greek or regular 2 limes, juiced Salt and coarse ground pepper, to taste ½ teaspoon cumin 3 tablespoons extra virgin olive oil Place garlic, jalapeno and cilantro in food processor; pulse to mince. Add chickpeas and pulse for about 2 minutes. Add remaining ingredients and blend until smooth. Serve with toast, tortilla or pita chips, or cut-up veggies.
Drinking 100% Fruit Juice Leads to Weight Gain: Study Data from more than 49,000 women concludes that drinking 100 percent fruit juice leads to weight gain, while consumption of fresh whole fruit results in weight loss
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he study, led by Brandon Auerbach, an internal medicine and primary care physician at Virginia Mason Medical Center, was posted online Jan. 9 by Preventive Medicine. “American adults gain an average of one pound per year, and it is a public health priority Page 12
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to determine which foods and beverages contribute the most to this gradual weight gain,” the report states. Specifically, this study analyzed data from 49,106 women in the United States enrolled in the Women’s Health Initiative between 1993 and 1998. Food-frequency
questionnaires assessed food and beverage consumption, while their body weight was measured during in-person clinic visits. The study found that an increase of one six-ounce serving of 100 percent fruit juice per day was associated with a modest amount of long-term weight gain. The average
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
cause “bad” bacteria to flourish) to help reduce the side affects of this treatment. Both yogurts are rich in vitamin B-12, an essential nutrient for nerve and brain function and for forming red bloods cells and DNA. This all-important vitamin also helps prevent a type of anemia that makes people tired and weak. One cup of plain, nonfat yogurt provides about half of our daily needs. What’s more, the B-12 in dairy products, such as yogurt, tends to be more readily absorbed by the body.
Helpful Tips Read yogurt nutrition labels carefully (some have more sugar than you may expect) and look for the words “contains active cultures” to assure the brand you choose has probiotics in it. Use caution when cooking with yogurt, since prolonged high temperatures can kill the beneficial bacteria. Fruit-flavored yogurts tend to be higher in sugar, so opt for plain yogurt and add your own fruit
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
weight gain of 0.4 pounds (6.4 ounces) per person over three years was similar to two earlier published studies on this topic. This amount of weight gain was also similar to weight gain associated with increasing regular soda consumption (0.6 pounds or 9.6 ounces). On the other hand, increasing consumption of whole fruit by one serving per day resulted in the loss of 0.9 pounds (14.4 ounces) over three years. “It is biologically plausible that drinking 100 percent fruit juice is associated with long-term weight gain,” the study concludes. “One six-ounce serving of 100 percent fruit juice contains 15-30 grams of sugar, 60-120 calories, little or no dietary fiber, and has a moderately high glycemic load. Even high-pulp, 100 percent orange juice is not a significant source of dietary fiber.” The study’s findings support recommendations of the “2015-2020 Dietary Guidelines for Americans” that individuals should drink 100 percent fruit juice in moderation and choose whole fruits over fruit juice when possible. “Adults should have at least two servings of fruit a day, ideally more,” Auerbach said. “Even though 100 percent fruit juice has lots of vitamins, minerals and nutrients like antioxidants, it’s really better to get your daily fruit in the form of whole fruit. Especially for adults trying to lose weight, 100 percent fruit juice is not your friend.”
Buffalo Golden Gloves: Competition, Camaraderie and Character Development By learning how to box, young men and women develop physical and mental skills By Daniel Meyer
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oxing is arguably the most humbling sport you can participate in because of the physical and mental challenges offered during a traditional bout between two competitors. While the need to be physically fit and possess an aggressive attitude are obvious to casual observers, not everyone grasps how important the mental aspect of boxing is when training a successful fighter. “I think everyone understands how beneficial boxing can be for the body, but what many people fail to realize is what the sport can do for your mind,” said Don Patterson, who serves as the coordinator of Buffalo Golden Gloves. “Boxing can get you into shape physically but it also provides unlimited opportunities to build mental endurance because it requires complete dedication and a total commitment to achieving your goals. Boxing can improve a young person’s overall health, which includes physical, mental and emotional components.” The history of the Golden Gloves organization dates back to 1923. The local entity in Buffalo was established in 1928 and eventually circulated to different locations throughout the state, including several years in Syracuse until Patterson took on a leadership role and brought it back to Buffalo in 2009. There are now close to three dozen Golden Gloves franchises throughout the country, including well established franchises in Washington, D.C., California,
Colorado and Michigan. Mentoring by coaches and trainers plays an important role as each Buffalo Golden Gloves boxer learns about individual responsibility, goal setting and establishing a firm mental fortitude while at the same time improving self-esteem. “We are teaching young people life skills and how to become responsible, confident and contributing members of society so that they are able to make a positive impact in our community,” said Patterson. “Boxing teaches you how to fight and you develop a skill set on how to throw punches while defending yourself. But it also teaches lessons that down the line will make each one of these men and women quality citizens.” The current Buffalo Golden Gloves roster lists boxers from various areas throughout upstate New York, including Niagara Falls, Rochester, Lockport, Jamestown, Syracuse, Albany, Elmira, Ithaca and Cortland. “We bring together young men and women anxious to learn how to box and we use that desire as a tool to build and enhance their character, enrich social development and hopefully achieve outstanding athletic achievement,” said Patterson. In addition to intense physical training inside the ring, Buffalo Golden Gloves also provides guidance for achieving academic goals for boxers enrolled in either high school or college. “We want well-rounded people, men and women who you would
Akhmend Aliyev of Buffalo deliveres a series of body blows to his opponent this recent bout involving Buffalo Golden Gloves. want to hire to work for your company or move next door to you and be your neighbor,” said Patterson. “Helping someone become a quality athlete is an impressive accomplishment, but helping mold them into a top-notch person is what I and the people we have working with these young folks get great satisfaction from.” Patterson said the recent focus on head injuries – specifically concus-
Competitors and coaches from Buffalo Golden Gloves traveled to Louisiana last year to participate in the National Golden Gloves Tournament. March 2018 •
sions – in other sports is something Buffalo Golden Gloves takes seriously. The health and safety of each fighter is closely monitored. “We don’t mess around when it comes to anything involving head injuries,” said Patterson. “Boxing is a physical activity where damage can be inflicted, that’s the nature of the sport. As coaches and trainers, we recognize that. We constantly focus on safety by teaching our boxers to be conscious of their personal well-being.” Buffalo Golden Gloves is currently running a tournament involving approximately 150 different boxers. The tourney began in late January and will continue over the next few months, with semifinal bouts for men and women in various weight categories scheduled for March 18 at Buffalo RiverWorks. The winners of those fights will then advance to the championship matches on April 8 at a celebratory event also set to take place at Buffalo RiverWorks. From there, the winning boxer from each open weight class will have the opportunity to compete at the National Golden Gloves Tournament, which will be held from May 14 through May 19 in Omaha, Nebraska. “What I love about boxing is the competition, the camaraderie and the character development that takes place,” said Patterson. “The outlook for Buffalo Golden Gloves is bright because we stay consistent with our mission in helping our youth and giving them guidance to achieving success both in and out of the ring.” For more information about Buffalo Golden Gloves, including results from recent boxing matches that have taken place in Buffalo, visit www. buffalogoldengloves.com.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Six Things You Should Know About Robotic Surgery By Ernst Lamothe Jr.
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obotic surgery has been around for some time but still can remain a mystery to some patients. They hear the term and think they know exactly what it means. Not only are many incorrect but they are unaware of the vast changes and number of procedures where the new technology has become commonplace. “The advent of robotic surgery has really changed the profession with some surgeries having tremendously better outcomes for the patients,” said physician Steven D. Schwaitzberg, chairman of the department of surgery at the University of Buffalo. “It is still something that you should discuss with your doctor first because not all surgeries need to be done robotically.” Schwaitzberg would like the public to understand more about the technology and had several thoughts and facts to share about robotic surgery.
1.
Latest trends
As technology continues to move forward in health care, it has allowed robotic surgery to enter some previously uncharted territory. The latest trend is using robotics for outpatient hernia and gallbladder surgeries. Schwaitzberg said more than 1 million people have their gallbladders removed every year and about 8 percent are using robotic surgery. “This is something we have definitely seen an increase in over the last few years,” he said. “There are instances where we truly see a difference in recovery time.” In addition, he has seen increases in robotics for hysterectomies as well
as hernias. Thanks to innovations in robotic technology, surgeons can perform hernia repair surgery through tiny incisions rather than the large incisions associated with traditional open surgery. The result is less damage to surrounding tissues, less pain for the patient and a much quicker recovery — often within days.
2.
You are still getting a real doctor People hear robotics and their minds wander to maybe the unimaginable. While robotic technology has taken the health care industry to some of those unimaginable heights, there is not a robot that is doing the procedure. Robotic surgery is a set of instruments for doing laparoscopic surgery done through small incisions and a camera.
3.
The human touch
“The single-most popular myth or stereotype is that people think the robot is going to do something on its own and that is not the case,” said Schwaitzberg, who is also the director of surgical planning for Great Lakes Health. “Each robotic procedure is performed by a surgeon sitting at a console directing the robotic arms for every movement.”
4.
There is training involved
A surgeon can’t simply perform robotic surgery just because he or she wants to. The first step in learning how to make the most out of what these tools have to offer is to start by watching robotic surgery. As part of robotic surgery
Fewer Americans Are Getting Herpes
H
erpes infection rates are dropping among young Americans, and safer sex practices may be one reason why. Roughly 12 percent of adults were infected with genital herpes (HSV-2) in 2015-2016, down from 18 percent in 1999-2000, a new government report found. The same promising trend was seen with HSV-1, a form of herpes that causes sores around the mouth and lips, sometimes called fever blisters or cold sores. Forty-eight per-
cent of Americans had the condition in 2015-2016, a drop from 59 percent in 1999-2000. “The report tells us that two of our most prevalent viruses in the U.S population, HSV-1 and HSV-2, are steadily declining,” said report author Geraldine McQuillan. She is a researcher with the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). McQuillan added that other countries have seen a similar de-
training, doctors view live surgery being performed by other surgeons. Often, this includes real-time instruction at the same time. Surgery observation can take place before or after teaching discussions. This gives surgeons a chance to ask any questions they have about the equipment. After observing several robotic surgeries, surgeons can try the tools out themselves with a surgeon already trained on the instrument. “We undergo training courses on how to use robotics and that includes the entire surgical team,” said Schwaitzberg. “We also perform in-service training on how to position the robot’s arms, how to bring it to the patient safely in the operating room and how to clean it.”
5.
Smaller incision and scarring
Even with successful surgeries, people sometimes complain about scarring. When it comes to procedures such as rectal and other cancers near the pelvis, previously it might require large incisions. But with robotics, the camera and instruments are introduced through ports that allow access to the inside of the patient. “Slowly, people are understanding the benefits of robotic surgery,” he said. “It really helps the surgeon focus on cases that depend on exact precision. Cancers that are in the lower pelvis region are perfect examples because the robotic arms allow for better movement in that location.”
6.
Better health Doctors stress that good healthy habits can go a long way for not even needing surgery. But also, being cline in the past two decades, and “improvements in living conditions, better hygiene and less crowding” may explain that drop. Health experts suggested the findings aren’t entirely unexpected. “Though many factors may be at play, probably the largest impact is that young people are choosing to begin to be sexually active at later timeframes,” said physician Matthew Hoffman. As evidence, he pointed to a 2015 report that indicated that 44 percent of teen girls and 47 percent of teen boys had had sexual intercourse between 2011-2013. Those figures represent a 14 and 22 percent drop, respectively, over the last 25 years. Hoffman was not part of the
Physician Steven D. Schwaitzberg, chairman of the department of surgery at the University of Buffalo. in better health can help ensure you are eligible for surgeries and that starts with avoiding bad habits like smoking. By now, we all know the information about smoking being bad for individuals and the overall population. While statistics are encouraging with the number of young smokers dropping with each year, issues persist because other elements have filled in the void of tobacco. “A patient who is a good candidate for general surgery is a good candidate for robotic surgery,” said Schwaitzberg. “We tell our patients they should refrain from smoking.” In addition, exercising is key. Exercising at any age is essential to good health. It becomes even more paramount as you get older because you are fighting the uphill battle of aging. Physicians recommend regular exercise even as simple as taking regular walks. Even 20 minutes of activity a day, three times per week, provides benefits. Thirty minutes every day is even better. CDC study team, but serves as chairman of the department of obstetrics & gynecology with the Christiana Care Health System, in Delaware. Blacks faced the highest risk for genital herpes, while Asians faced the lowest risk, the findings showed. “Though this report is a positive trend, it continues to reflect that there is a very significant burden of disease with lots of affected people,” Hoffman said. “Moreover, we need to continue to work to develop strategies that are effective in preventing the further dissemination of the disease.” The findings were reported in the February issue of the CDC’s NCHS Data Brief.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
Men’sHealth
“I Survived Prostate Cancer” Lancaster man shares his survivor’s story By Deborah Jeanne Sergeant
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oe Magiera of Lancaster has refereed hockey locally for decades when not serving as director of project management for Birdair, Inc. a fabric roof structure manufacturer in Amherst. The 55-year-old enjoys running, spending time with his grandchildren and wife, Joanne. He’s also a prostate cancer survivor. Before cancer, Magiera hardly ever visited a doctor. But when he turned 50, his primary care doctor recommended a PSA as part of a routine annual physical. “I had zero symptoms before my PSA,” he said. “Nothing.” The numbers fell in the normalto-just-higher-than-normal range. His doctor referred Magiera to a urologist to look at the findings closer. “He was keeping an eye on it and wasn’t overly concerned,” Magiera recalled. “As luck would have it, my urologist retired and I chose another doctor. His credentials were good. He looked at my numbers and he sent me for a MRI. They saw something that looked suspicious.” Within a few months of his first visit with the new urologist, Magiera received a positive prostate biopsy. The cancer was contained within the prostate and Magiera’s urologist said that by removing the organ, he could eliminate the cancer. “That appointment was shocking,” Magiera recalled. “I didn’t think that would be it. You could’ve knocked me over with a feather when he said I had prostate cancer. Since the prostate gland is the
size of a walnut, the tiny lump in Magiera’s prostate was undetectable without the PSA test. His cancer was slow growing, so Magiera could have opted for radiation or the wait-andsee approach to see if the cancer would spread. His doctor felt that he was a good candidate for robotic surgery. Magiera had to wait eight weeks for the biopsy site to heal and underwent surgery in September 2016. “It went very well,” he said. Within two weeks, he returned to work and after seven weeks, he resumed running. “I was thankful and grateful it was contained,” Magiera said. “I came out of the surgery pretty easily.” Although radiation and chemotherapy possibly could spare his prostate, Magiera did not want to live in uncertainly, dreading the cancer’s return. He liked the finality of surgery and assurance that all the cancer was removed from his body. “The down side is the adjustment with having the prostate removed,” he said. “But it’s done. There’s no more what-ifs. There were no guarantees with the other options. I had the luxury of getting it over with. I thought that was more important and the better way to go.” He said that post-surgery, he had to re-adjust to urinating again, but unlike many long-term prostate cancer patients, he didn’t experience incontinence. He avoided caffeine and alcohol, which irritate the bladder, and
Reasons to See a Urologist When should you see a urologist? Area urologists weigh in. By Deborah Jeanne Sergeant Physician Teresa Danforth, UBMD Urology, Buffalo: • “Blood in the urine. • “Urinary tract infections. • “Kidney stones. • “Urinary incontinence. • “Vasectomy.” Physician JC Trussell, associate professor of urology at Upstate University Hospital: • “Weak erections. • “Curved erection (Peyronie’s disease). • “Slow urine stream or post void dribbling. • “Blood in the urine or ejaculation. • “Leakage of urine with coughing or standing. ª “Birth control (vasectomy is saf-
er and fails less than a tubal ligation). • “If a dad or brother has a history of prostate cancer.” Jeanne O’Brien, professor of Urology and Male Infertility at URMC Urology: • “Infertility. For men, being unable to conceive for six months to a year is a reason to see a urologist. One-third of cases of infertility involve the male partner. Another third is women and the remaining third is mixed or unknown. Often, men who are coming to see me for infertility, it’s their first doctor visit since their last pediatrician visit. • “Patients should come in to voice issues like testicular masses, lumps, and bumps. • “See us about things like the
planned when he would need the restroom to ensure he had immediate access. A physical therapist helped him restore “about 98 percent of where I was before,” Magiera said. “I can live with that.” He said that he didn’t bank sperm, unlike younger men who still want to have children. Within six to eight weeks, he was released to resume his regular life. “It wasn’t very long before I was back to normal,” Magiera said. “I was lucky. You try to eat well and maintain your weight and it pays off. My doctor said if I were overweight,
that robotic surgery option may not be available.” He tells other prostate cancer patients to listen to their doctors and follow through with physical therapy to make recovery better and faster. “You’ll want to feel better and do things sooner than you should, but you need to give those eight weeks to recover,” he said. He also encourages patients to ask their doctors plenty of questions and find out what treatments are available. The doctor/patient relationship is crucial, as patients need to feel they can trust their doctor’s judgment. “For us, it worked out,” Magiera said. “Explore your options. It gives you a good avenue to find out what questions to ask. “Those PSA tests are lifesavers. I’ve asked more guys than I can remember since my surgery, ‘What is your PSA score?’ If they don’t know, I tell them they need to find out. It’s a simple blood test. It’s so valuable.”
Joe Magiera of Lancaster, a prostate cancer survivor. inability to urinate.” Physician Kent Chevli, president of Western NY Urology Associates, Buffalo: • “Urology is a very broad and diverse field. We take care of men, women and children and the elderly. It covers the entire gamut. • “There is a specialty of pediatric urology. For adolescent or older, generally, urology manages them. • The conditions involve the bladder, kidney, prostate, including many forms of cancer. Urologists diagnose 25 percent of all cancers, more than any other field. Prostate, bladder and kidney cancers are all diagnosed by urologists and they’re in the top 10 of all cancers for prevalence. No other field covers three of the top ten. Urologists are almost always cancer doctors as part of our training. • “We also take care of kidney stones, troubles urinating for men and women, including bladder control problems or inability to urinate. • “We take care of fertility problems in men. • “We want to see men about their kidney pain or flank pain.”
March 2018 •
Urology: Not Just for Men According to Urology Care Foundation: “Urology is a part of health care that deals with diseases of the male and female urinary tract (kidneys, ureters, bladder and urethra). It also deals with the male organs that are able to make babies (penis, testes, scrotum, prostate, etc.). Since health problems in these body parts can happen to everyone, urologic health is important. “Urology is known as a surgical specialty. Besides surgery, a urologist is a doctor with wisdom of internal medicine, pediatrics, gynecology and other parts of health care. This is because a urologist encounters a wide range of clinical problems. The scope of urology is big and the American Urological Association has named seven subspecialty parts: • Pediatric Urology (children’s urology) • Urologic Oncology (urologic cancers) • Renal (kidney) Transplant • Male Infertility • Calculi (urinary tract stones) • Female Urology • Neurourology (nervous system control of genitourinary organs)”
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Men’sHealth
Do women get more depressed than men or men just hide their emotions? By Deborah Jeanne Sergeant The lifetime prevalence of major depression is 20 to 26 percent for women and 8 to 12 for men. But those numbers may be skewed by a few factors, according to the Journal of the American Medical Association. “Men may be less likely to be introspective and consider their feelings,” said physician Horacio A. Capote, director of the neuropsychiatry division at Dent Neurologic Institute and part of the network of G-Health Enterprises in Erie County. “In addition, men are more likely to present with anger or irritability as their emotional expression of depression rather than sadness. Culture also plays a role, as men are conditioned to remain quiet about feelings and not express feelings in healthy ways. “Men are encouraged by society to be stoic. Men seem to experience more shame with regards to their depression. They see depression as a threat to their role as breadwinner. They are less likely to identify hormonal changes decreasing testosterone levels as a trigger for depression. They often see depression as an admission of weakness.” Instead, turning to “self medication” such as alcohol and drugs, or relieving stress through
angry outbursts or irresponsible behavior represents unhealthy ways men cope. “It’s essential to have a support network, but a lot of times, men don’t have it,” said Kathy Calabrese, licensed marriage and family systems therapist, neurofeedback clinician, and founder and CEO of The Brain-Body Health Technology Institute, LLC in Buffalo. Calabrese She said that even while socializing, men seldom discuss what’s really going on with them. While that provides some benefit, “for someone who’s really struggling, it’s not enough,” Calabrese said. When men do contact mental health providers, it’s usually because of a crisis, such as a DUI conviction, infidelity or divorce. But Calabrese is beginning to see a shift. “Men are becoming more open and vulnerable when they become dads, for example,” Calabrese said. “I see things changing but it’s slow.” Some male clients want to
better understand themselves and why they’re no longer happy. They usually don’t want medication to take care of their issues. Calabrese said that anti-depressants and antianxiety medication don’t offer longlasting relief and cause “horrendous” side effects. Michael P. Santa Maria, Ph.D. and board-certified neuropsychologist at DeGraff Hospital in North Tonawanda, said that many men find relief through a “combination of good social support from friends and family, religious organization and neighbors, Maria and more formal treatment like counseling and/or anti-depressant medication. In year’s past, it might be medication alone.” Many men feel reluctant to take time off from work for therapy, both because they need the money and because they fear the stigma of needing mental health help. “If the individual doesn’t have insurance and is working two part-
time jobs and we add in one more thing to do, that may adversely affect income or time with family, Santa Maria said. “That can be associated with increased stress.” Or, if they live in a rural area, finding help may be more difficult because of their location. Websites such as that of Psychology Today (www.psychologytoday.com) or Good Therapy (www.goodthearpy. org) can help people find a therapist close to home or work. Any person contemplating harming himself or others should seek immediate professional help by calling 911 or going to the closest hospital emergency room.
Depression at a Glance • Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older, in a given year. (Archives of General Psychiatry, June 2005 . • While major depressive disorder can develop at any age, the median age at onset is 32. (U.S. Census Bureau Population Estimates by Demographic Characteristics, 2005) • People with depression are four times as likely to develop a heart attack than those without a history of the illness. After a heart attack, they are at a significantly increased risk of death or second heart attack. (National Institute of Mental Health, 1998) From the website of Depression and Bipolar Support Alliance (www.dbsalliance.org):
Pain Meds May Affect Sperm Count Study says Tylenol, Motrin, Advil and other pain relievers may cause a reduction in sperm count By Deborah Jeanne Sergeant
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ant to be a dad? Consider cutting back on certain drugs. A recently released study in the journal Proceedings of the National Academy of Sciences indicates that over-the-counter pain relievers aspirin, acetaminophen (branded as Tylenol) and ibuprofen, (branded as Motrin and Advil), may hamper fertility. French and Danish researchers found that the ubiquitous painkillers disrupted participants’ testosterone levels, affecting their ability to produce normal levels of sperm. Low sperm count, also known as oligospermia, represents a common reason for male infertility. Male fertility matters. Male issues account for about onethird of infertility cases, women’s issues cause another third and the remaining third have unknown or a combination of causes. Physician Qiang Li, assistant professor of oncology in the Page 16
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department of urology at Roswell Park Comprehensive Cancer Center, said that the study doesn’t show “direct evidence of the link between ibuprofen use and sperm production/fertility.” But Li added that “given the effect of ibuprofen on male hormone levels, men experiencing infertility should be cautioned of possible antiandrogenic side effects and avoid OTC ibuprofen.” Since painkillers disrupt hormone levels, it’s worth abstaining from them to increase the chances of fertility. It may not be as simple as blaming over-the-counter pain medication. The reason for taking the medication — inflammation caused by a painful injury — may also hold some blame. “Inflammation will damage the testes, along with every organ of the body,” said physician Rob Kiltz, MD, who is a diplomate of the American Board of Obstetrics and Gynecology
and is board-certified in reproductive endocrinology and infertility. He founded and operates CNY Fertility in Buffalo. Kiltz said that diet can contribute to inflammation, starting in the gut. He recommends the ketogenic diet, which eliminates sources of carbohydrates and processed foods. “The standard American diet is high in carbohydrates,” he said. “A lack of natural fats contributes to inflammation and high carbohydrates contribute to inflammation, too.” Men can improve their sperm count through many other means, too. Kiltz advises men to stop smoking cigarettes, drinking excessive alcohol and using marijuana or other illicit drugs. Some prescription medication may interfere with sperm count, so men should consult with their care providers. Kiltz added that chemical exposure, such as herbicides used in
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
Physician Qiang Li. agriculture, may affect sperm count, too. Men should also seek treatment for any sexually transmitted diseases, manage stress, lose weight and control blood pressure and any other illnesses such as diabetes. “I recommend slowing down and reducing the excess exercise,” Kiltz said. “Yoga, massage, meditation, hypnosis and prayer are necessary to heal our bodies. But the fight or flight exercise activity causes increase in cortisol, friction and heat and stress in our bodies that hurt every cell of our body.”
Andrew Gibson of Buffalo
I’ve survived
Testicular Cancer
Survivor urges men to heed warning signs
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ndrew Gibson of Buffalo was 26 years old when he was diagnosed with stage 4 testicular cancer. By the time he received his diagnosis, the cancer had metastasized to his lungs, liver
and stomach. His treatment was difficult and lengthy, starting with surgery and followed by four cycles of chemotherapy. It concluded with another surgery lasting seven hours
Risks and Signs of Testicular Cancer By Deborah Jeanne Sergeant
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stimates for testicular cancer are approximately 9,310 new cases diagnosed and 400 deaths, according to the American Cancer Society. About one out of every 250 men will develop testicular cancer at some point during their lifetime. Unlike many cancers, it strikes mostly young and middle-aged men at an average of age 33. Only 6 percent of cases are in children and teenagers and men over age 55 comprise only 8 percent. Also uncommon is its high likelihood of successful treatment. As with most cancers, early detection and treatment improves the chances of good outcome. “Some men may notice a painless lump or swelling in either testicle,” said Kent Chevli, urologist and president of Western NY Urology Associates. “There’s sometimes discomfort, pain or heaviness without any swelling. Occasionally, patients have build-up of fluid in the scrotum or lower abdominal achiness.” He added that rarer forms of testicular cancer secrete hormones
that can cause breast tenderness or growth. Only advanced testicular cancer can cause pain elsewhere, including the back and chest, and shortness of breath. “It’s not uncommon for a man to think he hurt himself by bumping a testicle and it still hurts, but a tumor is what causes the discomfort,” Chevli said. Chevli added that it’s more than 95 percent curable overall. “We’re very fortunate that this has a very high cure rate, that it will never come back,” he said. “With most men, we do find them early, but even at later stages, they’re highly curable.” The reason is that testicular cancer is very sensitive to chemotherapy, even in the advanced stage; however, the severity and cost of treatment increases if the disease has advanced. Most doctors recommend removal of the diseased testicle, as European doctors have attempted testicle-sparing approaches with little success. Sparing the testicle increases the chances of the cancer spreading
— but it didn’t have to be that way. Gibson said he ignored signs that something was amiss in the year leading up to his diagnosis and now he has a message for other young men. “Do not be afraid to say something, no matter what,” said Gibson. “Don’t be afraid to come forward about something even though it may be a little personal. Go get checked immediately and don’t be embarrassed.” Nearly a year prior to his diagnosis, Gibson noticed a small irregular bump on his testicle. He did what so many do and searched his symptom on the Internet. While the possibility of cancer did come up in that search, Gibson said he immediately wrote off the notion. Five months later, that small bump had grown and resulted in major swelling. He began to experience stomachaches. Despite a gut feeling that something was terribly wrong, Gibson remained silent on the topic. “Typical guy, I was like, ‘It’ll go away,’” he said. Then one evening, while hanging out with his friends, Gibson got a stomachache and the pain exceeded what he had felt when he had previously required an appendectomy. He called his father and went to seek emergency care. After testing, including an ultrasound and a CAT scan, Gibson was sent to Roswell Park Cancer Institute in Buffalo. There, he was told that test results showed signs consistent with cancer.
Uphill battle Despite the inconclusive wording, Gibson knew that a difficult path lay ahead of him. He experienced what any person might — the feeling that he had been to the lymph nodes. Chunkit Fung, oncologist with Wilmot Cancer Institute in Rochester, listed long-term side effects to include hearing impairment, increased risk of metabolic syndrome, cardiovascular disease, peripheral neuropathy and infertility. “We always talk with the guys about the potential side effects,” Fung said. “The challenge is you can modify the dose of chemotherapy. There’s nothing we can do at this point to avoid these side effects.” For some early-stage testicular cancer, patients may receive surgery without undergoing chemotherapy or receive radiation instead of chemotherapy. Although men can still father children with one testicle, the chemotherapy may cause infertility, and it can affect the nerves that cause semen to ejaculate (although erections still occur). Risk factors include a nondescended testicle at birth, a factor for one out of 1,000 boys. Fung said that the testicle that had not descended is at exceptionally higher risk than in other patients and even the normal testicle has an elevated risk. Caucasian ancestry is also a risk factor. A man with a previous testicular cancer has a higher risk in developing cancer in the remaining testicle, which is why banking sperm is a good idea for men who still hope to father children after treatment for
March 2018 •
sucker punched — and questioned why this was happening to him. “When you hear the words, ‘You have cancer,’ death is the first thing you think of,” he said. After meeting with the staff at Roswell Park Cancer Institute, Gibson says his attitude changed. Once a plan was in place, he said he was confident and began to feel all right, even thankful that it was his battle and not one he had to witness a family member or friend undertake. His first surgery was to remove a testicle in order to better understand what Gibson and his doctors were up against. His first three cycles of chemotherapy were not easy. Gibson lost his hair and the treatment put a halt to the classes he had planned to start on the day he was diagnosed. Three semesters passed before he was able to get back into the classroom. Nausea was not an issue in the first cycle and gradually increased in the second and third. A change in treatment to prevent damage to his lungs during the fourth cycle came around Christmas time and brought with it major side effects. “It was just hell,” he said. Non-stop vomiting sent Gibson to the emergency room but he was told there was nothing to be done but ride it out. When those treatments had concluded, surgery was performed to get one lingering tumor behind Gibson’s stomachache, and while the operation was taking place, doctors found a second tumor that they had been unaware of. The procedure lasted seven hours and took a month and a half to fully recover. Today, Gibson is cancer free with a less than 1 percent chance of recurrence. (By J. H.)
Oncologist Chunkit Fung.
testicular cancer. “I think that they are ashamed,” Fung said. “They let the problem go on too long, and not talk with their doctor about any swelling or enlargement. Some have a 15 centimeter mass in the testicle they’ve told no one about. “I don’t want them to be ashamed of this but get medical attention as early as they can. It’s a very curable cancer. The earlier you find it, the less aggressive treatment you will need.” Both Chevli and Fung recommend monthly self exams, which like women’s self breast exams, can be easily performed in the shower with a soapy hand. Any bumps, irregularities, increase in size or hardness should be seen by a health care provider.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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TRENDS
Number of Men in Nursing Schools Steadily Growing A profession once dominated by females is gradually getting more diverse, despite a lingering gender bias among patients and health care administrators By Deborah Jeanne Sergeant
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icture a nurse. Did an image of a kindly faced woman in white or scrubs come to mind? Decades-long female dominance in nursing has contributed to the gender stereotype of women nurses. While women still outnumber men in nursing, more men have joined the ranks. “The numbers of male nurses have been consistently increasing, from a low of about 2.6 percent in 1970 to a reported high of anywhere from 10 to 13 percent today,” said Cheryl Nosek, chairwoman of Nosek the department of nursing and a nursing professor at Daemen College. She said that ongoing nursing shortages, along with stepped-up recruitment, has helped increase the number of men in nursing in
recent decades. Men also want the good pay, job security, flexibility and opportunities for advancement, too. “Men often look to nursing as a second, more secure profession when downsizing and lay-offs in other fields lead to loss of employment,” Nosek said. She sees endless opportunities in the nursing profession, from many clinical areas of care in numerous settings, with all age ranges and in managerial and educational roles. “Opportunities for advancement are also available through continuing education options,” Nosek said. Nurses can specialize in an area of medicine and obtain a bachelor’s, master’s or doctoral degree. David Goede, doctorate nurse practitioner and lead APP (advanced practice provider) manager for cardiovascular service line at University of Rochester Medical Center, remembered that in 1985 when he earned his associate’s degree in nursing, men represented only 2 percent of nurses. “I had often encountered the question as why I chose nursing as a
Man Enough? Gender lines becoming blurred in nursing field By Katie Coleman
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ursing is reportedly one of the fastest growing jobs in the health care industry. As the demand increases to support the aging baby boomer population, whether or not men are readily entering into the field is something to consider. American society’s long-held belief that women provide care in superior ways to men has created a stereotype that nursing is a feminine role in the health care industry. As of 2015, only 13 percent of nurses in the United States were men, according to the Washington Center for Equitable Growth. That number has been rising since 1960 when only 2.2 percent were men. The authors, Elizabeth Munnich and Abigail Wozniak, wrote that, “Increasing educational attainment, rising labor demand in health care, and liberalizing gender role attitudes explains around 50 percent of the growth.” University at Buffalo’s School of Nursing Student Services’ third week Page 18
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snapshot of its fall 2017 student body reported that out of 446 graduate and undergraduate students enrolled, 83 were men. I interviewed two men in the program about their experiences and perspective on the idea that their career paths are non traditional. Seth Wagner, 28, is a registered nurse at Jericho Road Community Health Center and a graduate student at UBSON. After graduation in May, he plans to be a family nurse practitioner. With so many different cultural perspectives in Buffalo, Wagner said gauging attitudes on gender roles and what’s “normal” or “appropriate” is complex. “When I wanted to start nursing school, I had an associate tell me, ‘Don’t bother, because you’ll never be as loving, caring or nurturing as a woman’,” said Wagner, who hasn’t experienced any adverse reactions on the job. However, he did say certain aspects of nursing are a challenge due to cultural perspectives that can create barriers between a nurse and
career,” he said. “As I contemplated this question, the next question that was usually asked is, ‘Are you working on becoming a doctor?’ I have always had difficulty trying to understand the basis of these questions. Do we ever ask female physicians why they chose to be a physician and not a nurse? To me, these comments exemplify bias of career choices based on gender.” Goede also serves as acute care nurse practitioner, cardiac surgical service at Strong Memorial Hospital; assistant professor of clinical nursing at University of Rochester School of Nursing; and regional director Region 2, Nurse Practitioner Association of New York State. David “Grant” Hewitt, nurse practitioner and instructor of nursing at Monroe Community College, said that in 2008,5.7 percent of fall nursing students were men. In 2017, it was 26 percent. Hewitt said that men can leverage their usually greater strength for the tasks nurses face, such as moving patients. “Men also tend to go into highstress nursing situations, like the ICU or the ER,” Hewitt said. “Maybe it’s adrenaline; they like it.” Like women, men also have opportunities to seek further education to obtain supervisory roles, work in education or, in the case of nurse practitioners with more than 3,600 hours of clinical experience, practice without a collaborative agreement with a physician. Hewitt said that men get hired for management roles in nursing “much faster” than women. They also receive better pay, on average. He said that it’s not uncommon for patients to call male nurses patient, such as gynecology care and obstetrics. When it comes to barriers that are keeping the male to female ratio disproportionate, Wagner said stereotypical gender roles are the biggest barrier. “But that’s changing with the advent of the nurse practitioner and family practice nurse,” Wagner said. “Nurses are becoming leaders in health care as opposed to simply supportive to medical doctors.” Kwasi Adusei, 26, is a teaching assistant at UBSON and teaches clinical skills and conducts mental health lectures. He’s currently in UBSON’s mental health nurse practitioner program studying to specialize in psychiatry and get his Doctor of Nursing Practice degree. Adusei thinks the ratio of men to women in nursing is changing. He said that shifting language, as a culture, is an important step to change the way people think. Instead of branding men as “male nurses”, just call them nurses. Even assigning a new name to the role could have a profound impact. “When you say ‘nurse’, in your head, because of conditioning, you see a female. When you say the word ‘medic’ that may not be the case,” Adusei said, who thinks that calling nurses hospital medics could shift society’s perspective toward a more gender-neutral way of thinking. “As a culture, gender-normative roles are shifting where our society is looking at gender in drastically
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
“doctor” because they feel sure that nurses are female. Or to insist that they do not want a male nurse helping them. Sometimes, Hewitt kindly asks if they would feel the same way about a male doctor. Hewitt said that despite lingering gender bias among patients and health care facility administration, he wants more high schools to promote nursing as a good career option for all students. “This is a great job,” he said. “Nursing isn’t female anymore. You’ll always have a job, so there’s great job security. I think that’s part of the reason it’s changing.”
Men Were the First Nurses According to Cheryl Nosek, chairwoman of the department of nursing and professor at Daemen College: • “Men were actually the first nurses. The first recorded nursing school in 250 BC only admitted men because ‘only men were pure enough to become nurses.’ • “Religious orders of men provided nursing care from about the 5th century through the 1800s. • “Florence Nightingale, who took a group of female nurses to care for soldiers in the Crimean War in 1853, referred to male nurses as orderlies. She believed that it was women who had the caring qualities necessary to become a nurse. This, among other factors, led to the growth of nursing as a female profession.”
Kwasi Adusei, a teaching assistant at University at Buffalo’s School of Nursing, helps teach clinical skills and conduct mental health lectures. different ways. This is a generation that fully accepts and embraces gender-neutral bathrooms, and men staying at home and taking care of the kids,” Adusei said. “It would be nice having more men in nursing and more diversity, but I accept that the field is feminine-dominated and that’s absolutely OK.” He grew up surrounded by women working in the health care industry, which he said undeniably influenced his life direction. Consistent with Wagner, Adusei thinks stereotypical gender roles and the language society is conditioned to use are the biggest reasons nursing still has a feminine connotation in the health care industry.
Why You Should Donate Blood Photo courtesy of Unyts.
Registered nurse Seth Wagner speaks at a University at Buffalo School of Nursing event. “When you see women entering male-dominated fields, they are almost looked up to for being proficient and able to survive. When you see men entering femaledominated careers, the switch is sort of flipped and some have the opposite reaction,” Adusei said. However, despite the fact the number of men in nursing is still low, he still thinks he’s had advantages in the field as a result of being male. “When I interviewed at Roswell Park Cancer Institute to be a nursing assistant, I was still a student and in my interview they said they were viewing me as a manager on that floor at some point,” Adusei said. “Granted, I went into that interview with a lot of leadership experience, so it could just be my perception, but I think that being male influenced their perception of who I’d become.” Some schools are actively recruiting and providing mentorship for students entering non-traditional career paths. Trocaire College in Buffalo recently launched a professional mentorship program for nontraditional students for the spring semester. Students eligible include men in health care programs such as nursing, massage therapy and medical assisting, and women in programs such as computer network administration and health information technology. Catherine Griswold, dean of Trocaire’s Catherine McAuley School of Nursing, is at the head of a mentoring program designed specifically for male students in its nursing program. Griswold said providing support, mentorship, opportunities and services is the key to breaking the stigma and leading students toward success. “I think the stigma is slowly going away,” Griswold said. “We still have work to do. We need to stop calling them ‘male nurses’ and just call them nurses.” Griswold focuses on inclusive language and art that can help socialize culture toward gender-neutral ideas about the health care industry. Trocaire has seen an increase in the number of male students, mostly new or coming back for a second degree. “The numbers are still low for underrepresented minorities across racial and financial divides,” Griswold said. However, buoyed by a federal grant Trocaire received this year to work with underrepresented nursing students, the school is focused on increasing opportunities, support and ultimately the number of men in its nursing programs.
The need is great and only 6 percent of the population actually takes the time to do it By Nancy Cardillo
I
t takes just about one hour to roll up your sleeve and help save lives. And if you’ve never donated blood or platelets, now is the time since the demand continues high. “One car accident victim uses, on average, 100 units [pints] of blood,” says Patty Corvaia, external communications manager for American Red Cross. “Each day, the Red Cross distributes approximately 750 units throughout New York state and 10 counties in Pennsylvania. We are also part of the national network
and help wherever we can. You never know when blood will be needed or who will need it. It’s important to keep up the supply levels, particularly for urgent, unexpected trauma needs. Those who donate blood provide a huge, vital service to the community.” Yet while most people can donate blood, less than 6 percent of the population actually does. Why is that? “The number one reason people don’t donate is that they haven’t
been asked,” says Amanda Farrell, director of blood recruitment for Unyts, an organization that supplies 35,000 units of platelets, red cells and other byproducts to several local hospitals and medical centers. “There’s not enough awareness of how much blood is needed, how easy it is to donate and how far a donation can go in helping others.” Roswell Park Cancer Institute annually transfuses approximately 15,000 blood products at its 100-bed facility that’s more than all of the other Western New York hospitals combined. “Cancer patients require a lot of transfusions,” says Maria Turner, marketing and communications manager for Roswell’s department of pathology and laboratory medicine. “The demand is always so high that it’s a challenge to keep up. In addition to having a donor center onsite here at Roswell Park, we also receive blood products from vendors across the country to ensure our patients always have what they need.” Richard Casseri is a 76-yearold retiree who has been donating blood and platelets for over 45 years. He donates through Roswell Park Cancer Institute 24 times per year. Why does he do it? “I’ve been blessed with good health and I’m happy to share it,” says Casseri. “I don’t need a pat on the back, but it’s always very nice to hear how the platelets I donate helps others. It touches me, and makes it really worth it to help others.”
THINKING OF BECOMING A BLOOD? DONOR? Here are the answers to some commonly asked questions about donating blood:
Who can donate blood?
In general, anyone 16 or older can donate throughout their lifetime, assuming they meet the eligibility requirements. If, however, you’re sick with a cold or the flu, have specific health conditions, have traveled to certain locations, had a tattoo within a year or are on certain medications, you won’t be eligible. “All blood banks are regulated by the Food & Drug Administration, so there are strict guidelines for donating,” says Corvaia. “Potential donors must be screened, which keeps the entire process safe for everyone involved.”
What can be donated?
A person can donate whole blood, double red cells or platelets. Donating whole blood takes about 45 minutes and can be done every 56 days. Donating double red cells or platelets takes about one hour. Double red calls can be donated every 112 days; platelets can be donated every seven days, up to 24 times per year. A typical donation is one unit, which amounts to approximately one pint.
Is donating blood safe?
“Donating blood is extremely safe for everyone involved,” says Farrell. “Before someone donates blood, we check their iron levels, temperature, pulse and blood pressure. We use only single-use needles and before
the blood is distributed, it’s subjected to a battery of tests.”
What is most needed?
O-negative is the hardest-tocome-by blood type, as just 7 percent of the population has it (O and A positive are the most common blood types). Platelets, which are utilized by cancer patients during chemotherapy, are always in high demand.
What happens when I donate blood?
Depending on where you choose to donate, you will either fill out a pre-screening application online or in person. You will need a photo ID when you donate. Once approved, your vitals will be checked and then you’re ready to donate. The actual collection takes 5-15 minutes, during which time you can read, use electronic devices or simply relax. Once you’re done, you’ll be asked to sit for a while to ensure you’re feeling well. You’ll be given juice and snacks at that time.
How will my blood be used?
Donated blood products are used in many ways: to treat patients with blood disorders, such as leukemia, or chronic illness, such as sickle cell anemia; for trauma patients, such as car accident victims; burn patients; during surgery and for organ transplant and cancer patients.
Do I need to prepare to donate blood?
“We recommend you drink plenty of water in the days leading up to your donation. Eating iron-rich food and getting plenty of rest is also a good
March 2018 •
idea,” says Corvaia. After you’ve donated, you can simply go about your day, though it’s recommended you avoid strenuous activity for 24 hours.
Why is it important to donate blood?
“There is no substitute for human blood,” says Farrell. “Donated blood must be used within a certain time period after donation, and you never know when it will be needed. It’s important to stay ahead of the demand.”
Where can I donate blood? Western New Yorkers have several options for donating blood. The Red Cross: go to redcross.org, type in your zip code and donation sites and blood drives near you will pop up. You can register online or call 1-800-REDCROSS. Unyts: Unyts has four neighborhood donation centers in the area and annually conducts 800 blood drives in Erie, Wyoming and Niagara counties. Visit Unyts.org, search by date, zip code, etc., to find the most convenient location. Appointments can be made online, by phone or as a walk-in. Roswell Park Cancer Institute: donations can be made through the Donor Center (www.roswellpark.org/ donor-center), which is located on the ground floor of the hospital. The Center is open six days a week; appointments can be made online, via phone or email – or as walk-ins.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Ask The Social
Security Office
From the Social Security District Office
Your Contributions Help Millions
Income Tax Filing Requirements for Retirees By Jim Miller
W
hether or not you are required to file a federal income tax return this year will depend on how much you earned last year (in 2017), and the source of that income, as well as your age and filing status. Here’s a rundown of this tax season’s (2017) IRS tax filing requirement thresholds. For most people, this is pretty straightforward. If your 2017 gross income — which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately — was below the threshold for your filing status and age, you probably won’t have to file. But if it’s over, you will. Here are the thresholds: • Single: $10,400 ($11,950 if you’re 65 or older by Jan. 1, 2018). • Married filing jointly: $20,800 ($22,050 if you or your spouse is 65 or older; or $23,300 if you’re both over 65). • Married filing separately: $4,050 at any age. • Head of household: $13,400 ($14,950 if age 65 or older). • Qualifying widow(er) with dependent child: $16,750 ($18,000 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see IRS. gov/pub/irs-pdf/p554.pdf.
Online
@
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Check Here Too
There are other financial situations that can require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment in 2017 of $400 or more, or if you’re receiving Social Security benefits and half your benefits plus all other income, including tax-exempt interest, exceeds $25,000 (or $32,000 if you are married filing jointly), you’ll probably need to file. To figure this out, the IRS offers an interactive tax assistant tool on their website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. It takes less than 15 minutes to complete. You can access this tool at IRS. gov/filing – click on the “Do I Need to File?” button. Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See IRS. gov/localcontacts or call 800-8291040 to locate a center near you.
Check Your State
Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. In New York, if you earned more $4,000 you have to file. For more information, check www.tax.ny.gov/ pit/file/do_i_need_to_file.htm
Tax Preparation Help
If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit IRS.treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at around 5,000 sites nationwide. To locate an AARP Tax-Aide site call 888-227-7669 or visit AARP.org/ findtaxhelp. You don’t have to be an AARP member to use this service.
S
eeing taxes taken out of your paycheck can be confusing when you get your first paycheck. But understanding how important your contribution is can help. Your taxes are helping millions of Americans — wounded warriors, the chronically ill and people with disabilities — as well as protecting you and your family for life. You can take pride in knowing you’re making an important impact with each paycheck. By law, employers must withhold Social Security taxes from a worker’s paycheck. While often referred to as “Social Security taxes” on an employee’s pay statement, sometimes the deduction is labeled as “FICA” which stands for Federal Insurance Contributions Act, a reference to the original Social Security Act. In some cases, you will see “OASDI” which stands for Old Age, Survivors, and Disability Insurance. The taxes you pay now translate to a lifetime of protection — for retirement in old age or in the event of disability. And if you die, your family (or future family) may be able to receive survivors benefits based on your work as well. Because you may be a long way from retirement, you might have a tough time seeing the value of benefit payments that could be many decades in the future. But keep in mind that the Social Security taxes
Q&A
Q: Can I delay my retirement benefits and receive benefits as a spouse only? How does that work? A: It depends on your date of birth. If you were born on or before Jan. 1, 1954, and your spouse is receiving Social Security benefits, you can apply for retirement benefits on your spouse’s record as long as you are at your full retirement age. You then will earn delayed retirement credits up to age 70, as long as you do not collect benefits on your own work record. Later, when you do begin receiving benefits on your own record, those payments could very well be higher than they would have been otherwise. If your spouse is also full retirement age and does not re-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
you’re paying can provide valuable disability or survivors benefits now in the event the unexpected happens. Studies show that of today’s 20 year olds, about one in four will become disabled, and about one in eight will die before reaching retirement. If you’d like to learn a little more about Social Security and exactly what you’re building up for yourself by paying Social Security taxes, take a look at our online booklet, How You Earn Credits, at www.socialsecurity.gov/pubs/10072.html. If you have a friend who lost a parent when they were a child, they probably got Social Security survivors benefits. Social Security helps by providing income for the families of workers who die. In fact, 98 of every 100 children could get benefits if a working parent dies. And Social Security pays more benefits to children than any other federal program. You can learn more at www.ssa.gov/benefits/survivors/. Do you prefer videos to reading? Check out the webinar, “Social Security 101: What’s in it for me?” The webinar explains what you need to know about Social Security. You can find it at www.socialsecurity.gov/ multimedia/webinars/social_security_101.html as well as on YouTube at www.youtube.com/watch?v=5hkLaBiavqQ. Social Security is with you through life’s journey. You can learn more at www.socialsecurity.gov. ceive benefits, your spouse will have to apply for benefits and request the payments be suspended. Then you can receive benefits on your spouse’s Social Security record. If you were born on or after Jan. 1, 1954, and you wish to receive benefits, you must file for all benefits for which you are eligible. The Social Security Administration will determine the benefits you are eligible for and pay you accordingly. For individuals born on or after Jan. 2, 1954, there is no longer an option to select which benefit you would like to receive, even beyond your full retirement age. Widows are an exception, as they can choose to take their deceased spouse’s benefit without filing for their own. For more information, please visit www.socialsecurity.gov.
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Dear Savvy Senior, I’ve heard that hearing aids will soon be available over-the-counter and will be much cheaper than they currently are. What can you tell me about this? My husband desperately needs hearing aids but we simply can’t afford them.
Searching Spouse Dear Searching, Unfortunately, for many years the high cost of hearing aids has kept millions of Americans with hearing loss from getting hearing aids because they can’t afford them. Hearing aids — typically sold through audiologists’ offices — are expensive, usually ranging between $1,000 and $4,000 per ear, and are not typically covered by private insurance or traditional Medicare. But there’s good news on the horizon. Last summer President Trump signed the Over-the-Counter Hearing Aid Act of 2017 into law. This will allow people with mild to moderate hearing loss to buy hearing aids without consulting an audiologist, and the devices could sell for between $250 and $300 at drugstores and other retailers. The only problem is that it will be a couple more years before these OTC hearing aids are available to consumers. So in the meantime, here are some tips that can help you find some affordable options.
Check Your Insurance
While most private health insurance companies do not cover hearing aids, there are some that do. For example, Aetna members can purchase aids at a discount through certain suppliers, and United Healthcare offers hearing aids to their beneficiaries through HealthInnovations for $799 to $999 each. You should also know that some federal workers, as well as residents of Arkansas, Connecticut, New Hampshire, and Rhode Island can get their hearing aids covered by health insurance, as can eligible veterans through the Department of Veterans Affairs. Or, if your husband is a Medicare recipient, about half of all Medicare Advantage plans offer at least partial coverage or discounts on hearing exams and devices. So, be sure you check your husband’s insurance coverage to see if it offers any type of
A new law will allow people with mild to moderate hearing loss to buy hearing aids without consulting an audiologist, and the devices could sell for $250 to $300 at drugstores. Problem is, these OTC hearing aids will only be available to consumers in about two years. hearing aid benefit.
Shop Around
To help you save money, consider shopping at Costco, which offers no-cost screenings at certain locations, as well as very competitive prices. Hearing aids at Costco range between $500 and $1,500 each. You can also shop online at websites like EmbraceHearing.com and Audicus. com, which can save you up to $2,000 per pair. Then visit a local specialist to make any necessary adjustments. Another option worth a look is over-the-counter personal sound amplification products (or PSAPs). Unlike hearing aids, the Food and Drug Administration does not regulate PSAPs. And PSAP manufacturers are not allowed to call these products hearing aids or claim that they help hearing. But these devices are very effective for people with mild to moderate hearing impairment, and typically cost between $350 and $450 each. To find a wide variety of PSAPs see assistive listening sites like Harris Communications (HarrisComm.com, or call 866-476-9579).
Look For Assistance
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Three Ways to Cut Hearing Aid Costs
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If your income is low, there is a number of national, state and independent groups that can help you pay for hearing aids or offer discounts. To find them, visit the American Speech-Language-Hearing Association website at ASHA.org/ public/coverage/audfundingresources. Or, call the National Institute on Deafness and Other Communication Disorders at 800-241-1044, and ask them to mail you their list of financial resources for hearing aids.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. March 2018 •
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progresses. While some aging issues may cause small vision changes in your pet, minor visual issues are natural. If your pet shows signs of rapid vision loss such as bumping into walls or furniture, difficulty finding his toys, becoming startled easily or even general clumsiness, check with your doctor immediately. It could be a sign of another health-related issue. Acute blindness itself can sometimes be corrected with prompt treatment. Many dogs that do go blind accommodate to their surroundings with a bit of time and patience.
Seven-year-old beagle mix Carter.
Is neutering a no-no in older animals?
Your Aging Pet: When to Get it to the Vet Arthritis, hearing loss, poor vision are some of the signs your dog is getting old By Catherine Miller
L
ike people, pets can benefit from a yearly exam to check their overall health. But there are times between the regular exam time that your pet may be acting a bit off and make you wonder if a vet is needed. Aging animals are especially prone to increased medical issues, and it’s often difficult to determine which issues are due to the natural changes of aging and which changes are something that require medical attention. So how do you decide when to get Fido into the car and jaunt him over to his favorite veterinarian? A bit of basic animal medical knowledge can help you watch for warning signs.
Watch the Water
Water intake is necessary for all animals, including your household pet. But watch for changes in your dog or cat’s regular drinking routine. “Many diseases whether metabolic or infectious cause our pets to drink more water,” said
veterinarian Lucas Kandefer of Southtowns Animal Hospital in West Seneca. “Withholding water can cause severe illness, worsening of disease or even death. If you notice an increase in water intake, prompt intervention from your veterinarian can help identify and manage many conditions.”
Dietary Changes
Anyone who has promptly changed their pet’s food probably already knows this is not a good idea. Rapid changes in diet can affect the stomach of any pet and older pets can be less tolerant to changes with resultant intestinal issues. To avoid issues, make all changes to the diet of your pet slowly. As your pet ages, his caloric intake needs change also. Decreased activity and slowing metabolisms begin to take place after the age of 7, and any increase in weight could add to any arthritic changes that your aging pet is experiencing. You may wish to consider a “senior” version of your favorite pet food to keep those
extra pounds at bay. Weight loss on an aging animal may also be a medical warning sign. Your pet should not lose weight just because he is aging. If your pet has a healthy appetite, but is losing weight, talk to your veterinarian immediately. Many medical conditions could create such issues, and early detection is key to diagnosing and stabilizing the underlying cause.
Vision and Hearing Issues
Vision and hearing naturally degenerate with age — regardless of species. Hearing loss is especially common in aging pets. You may notice that your older cat or dog does not come as readily when called. Hearing loss is difficult for your vet to diagnosis and treat. It is recommended to begin to use hand signals when your pet is young. Canines especially benefit from the use of hand singles, and as they age this allows for continued interaction with your pet even if hearing loss
Simply put — cats and dogs can be neutered at any age. Age itself does not increase the risk of anesthesia. Your vet will likely examine your animal to check for medical issues prior to the procedure, but even aging pets can benefit from being neutered. Neutering may even be a good idea for your older pet. Intact female dogs are at risk for uterine infections and mammary cancer that increase each time they go through heat. Neutering can help with behavioral issues of male dogs and may decrease their risk for prostate disease and testicular tumors.
Urinary Incontinence
While urinary incontinence is most often seen in spayed female dogs as they age, there are often medical therapies that can help to improve the condition. If you find puddles of urine in the area where your pet has been lying, talk to your vet, who may be able to offer advice. If your cat has trouble making it to the litter box, it could be a behavioral issue or medically related. Talk to your vet to rule out medical problems, then place a number of litter boxes to make the trek to the box a bit easier.
Arthritis
Like humans, older pets, especially larger breed dogs, are prone to arthritis as they age. Your pet may show signs of difficulty standing, limping and trouble with stairs. You may find that your cat no longer is jumping up and down on the furniture with ease, and prefers to stay on one level of the house. This would be the time to talk to your vet regarding pain management, rehabilitation or possibly even acupuncture. “Older pets, just like older people, are more prone to illness and diseases that can significantly affect comfort and quality of life,” said vet Kandefer, “Early intervention from your veterinarian can often greatly reduce the severity of many of these issues and improve comfort and quality of life for our aging pets.” Overall, watch for changes in your pet’s routine and seek medical help when you are unsure of the causes of changes that you observe.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2018
H ealth News Windsong Radiology doctor to present study Physician Cynthia Fan will present the findings from a retrospective study conducted by Windsong Radiology Group and Windsong Breast Care at the 28th Annual Interdisciplinary Breast Center (NCBC) Conference this March. The study shows that 3-D tomosynthesis (3-D mammomgraphy) detects smaller cancers, and more cancers with architecture distortions, which can be very difficult to see in 2-D digital mammography (mammo) only. “This project was designed to demonstrate how tomosynthesis (tomo) assists with tumor detection, whether through smaller tumor size or any particular imaging characters,” Fan said. “We are very excited to share our findings at the conference.” Each year the NCBC brings together medical and industry professionals from around the globe who share ideas, methodologies and treatment options that improve quality of care and outcomes for patients diagnosed with breast diseases. According to a news release, multiple peer-reviewed articles have demonstrated that 3-D tomosynthesis has superior tumor detection over 2-D digital mammogram (mammo), and decreases the recall rate, although most of these studies were performed in academic centers. Windsong is a communitybased radiology practice affiliated with a breast center, and this study echoes what previous studies from academic centers have reported: 3-D tomosynthesis is superior to 2-D digital mammograms at detecting smaller cancers, according to toi
Windsong. The study evaluated all the breast malignancies detected through screening exams at Windsong Radiology Group in 2010 (pre-tomo era, mammo only) vs. 2014 (when all of its four imaging centers were fully equipped with Hologic Dimensions tomosynthesis systems). Over 60,000 screening exams were performed in each time period. Tumor sizes, pathologies and imaging characters were analyzed. “The conclusion of the study showed that in Windsong’s community practice setting, adding 3-D tomosynthesis (3-D mammography) to the screening exam helps to detect smaller cancers, and more cancers with architecture distortions, which can be very difficult to see in 2-D digital mammograms only,” Fan said. Windsong Radiology Group is the largest freestanding radiology facility in Western New York and one of the busiest in the nation, performing over 400,000 imaging exams last year, according to the organization.
Sharon Hanson elected to AHA policy board Erie County Medical Center Corporation (ECMCC) Board Chairwoman Sharon L. Hanson was recently elected by the American Hospital Association’s board of trustees as an at-large alternate delegate and member of AHA’s Regional Policy Board 2, which covers covering New Jersey, New York & Pennsylvania. “It is an honor to represent ECMC on AHA’s Regional Policy Board,” Hanson said. “I look forward to participating in the development of healthcare policy
recommendations for AHA’s board of trustees and providing insight on a range of healthcare issues, particularly those faced by safety net hospitals like ECMC.” ECMCC President and CEO Thomas J. Quatroche, Jr., Ph.D. Hanson said, “This prestigious appointment will enable Sharon to actively participate on behalf of ECMC in discussions that will lead to formal positions on national policies from one of our country’s most influential healthcare organizations. This appointment, in connection with Sharon’s 2016 appointment to the Healthcare Trustees of New York State Board of Governors, also provides an excellent opportunity for ECMC to now more actively participate in critically important healthcare policy issues on both the state and national level.” According to the AHA, representatives from the section for health care systems serve on all nine of AHA’s Regional Policy Boards (RPBs), which meet three times a year to foster communication between the AHA, its members and state hospital associations. The RPBs provide input on public policy issues considered by the Board of Trustees, serve as ad hoc policy development committees when appropriate, and identify needs unique to a region and assist in developing programs to meet those needs. Throughout her many years of volunteer service to ECMC, Hanson, in various leadership positions at the hospital, has been instrumental in
working with the dedicated ECMCC caregivers, the ECMCC board and the broader community guiding ECMCC to great success.
Population Health Collaborative has six new members In December, the board of directors at Population Health Collaborative, formerly the P² Collaborative of Western New York, voted to approve the addition of six new members for 2018: • Paula Conti, director of clinical transformation with Catholic Medical Partners. • Sherry L. DelleBovi, CPA with Lumsden & McCormick, LLP. • Physician Stephen B. Edge, vice president for healthcare outcomes and policy with Roswell Park Comprehensive Cancer Center. • Joseph V. Fritz, Ph.D., chief executive officer with Dent Neurological Institute. • Physician Thomas F. Hughes III, chief medical officer with Optimum Physician Alliance. • Sriram (Sri) Vilayanoor, entrepreneur. The Population Health Collaborative (PHC) is a regional health collaborative that serves the eight-county area of Western New York. Its mission is to “align resources to measurably improve health and healthcare delivery, increase access to care, and reduce health disparities in Western New York.” The Population Health Collaborative was initially supported through a number of Robert Wood Johnson Foundation grant programs, and has been recognized for its work as a leading neutral convener in our region.
ECMC Celebrates 5-Year Anniversary of Terrace View Long-Term Care Facility
Residents, staff members and health officials recently celebrated five-year anniversary of Terrace View LongTerm Care Facility. In front (seated) is Paul Anthon, president, Resident Council, Terrace View. Standing, from left are Anthony DePinto, administrator; Jonathan A. Dandes, board chairman, ECMCC; Sharon L. Hanson, immediate past board chairwoman, ECMCC; Thomas J. Quatroche Jr., president & CEO, ECMCC; Jody L. Lomeo, president & CEO, Great Lakes Health System of WNY and Kaleida Health; Bishop Michael A. Badger, board officer, ECMCC; physician Kathleen Grimm, board member and president of medical-dental staff, ECMCC; physician Brian M. Murray, chief medical officer, ECMCC. March 2018 •
Erie County Medical Center Corporation recently celebrated the five-year anniversary of the opening of its Terrace View Long-Term Care Facility. The 390-bed nursing home on the ECMC Health Campus on Grider Street formally opened Feb. 8, 2013. The facility, named for the design feature of its multiple terraces providing outside areas for residents, replaced the then 87-year-old Erie County nursing home in Alden. Terrace View also combines in one location long-term care beds previously housed within the Medical Center. The move from Alden to the ECMC Health Campus focused on providing higher quality, stateof-the-art care for residents. It also moved residents closer to family, increased access to employment by staff residing in Buffalo and its immediate suburbs and reduced operating costs for ECMC Corp. In line with New York State Department of Health recommendations, there was a 332-bed reduction to the new facility from the 722 beds in the Alden facility. Terrace View, for which current residents had design input, is 275,500 square feet on five levels. It contains three floors of 96 skilled nursing beds each; one floor containing 66 sub-acute rehab beds; a 20-bed ventilator unit and 16-bed behavioral intervention unit – for a total of 390 beds.
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Yesterday.
Today.
Tomorrow.
Celebrating a Century of True Care In our 100 years of taking care of Western New York, much has changed within the world, the community, and even within our own walls at ECMC. But even as we prepare for our next century of delivering true care for patients and families, we know the most important thing—compassionate care for everyone who turns to us—hasn’t. And never will.
©2017 ECMC
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