WNY IGH #42 April 18 by In Good Health: WNY's Healthcare Newspaper

PRICELESS

Transgender Surgeries Up

BFOHEALTH.COM

Gender-affirming surgeries increase nearly fourfold since 2000. Page 5

Chiropractic

Students pursuing chiropractic degrees have every reason to look forward to a satisfying, solid career. Page 16

Toughest Healthcare Jobs to Fill

Savvy Senior: How to Choose a Memory Care Unit

Things You Need to Know: Prevalence of Autism

Interview with neurologist Michelle Hartley-McAndrew

APRIL 2018 • ISSUE 42

WOMEN’S HEALTH SPECIAL ISSUE

How women can address hair thinning Heart disease: 10 things women should know When sex is a real pain • Monthly tracking apps Four myths about midwives

PLUS: For the First Time, Women Outnumber Men in Med School Page 17

Taking the Plunge

The Gotta Bike? Advantages GObike Buffalo! of Aquatic Therapy Group that promotes bike use in Buffalo gearing up for high season, major May 20 event

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Eat Brown Rice While white rice certainly has some nutritional merit — as it’s enriched with some of the nutrients it loses in the milling process — it pales in comparison to its tawny cousin. SmartBites. Page 14

Which Medications Work Best to Deal with Your Spring Allergies? Page 14

What’s a Bigger Threat: Wolves, Bears, Sharks…

or the Family Dog?

ogs, farm animals and insects — not wild animals — are the cause of death for most U.S. residents killed by animals, according to a new study. The study reported that 1,610 people in the United States were killed by animals between 2008 and 2015. “Importantly, most deaths are not actually due to wild animals like mountain lions, wolves, bears, sharks, etc.,” said the study’s lead researcher, Jared Forrester, a physician. Rather, they’re “a result of deadly encounters with farm animals, anaphylaxis from bees, wasps or hornet stings and dog attacks,” said Forrester, who’s with Stanford University’s Department of Surgery. “So, while it is important that people recreating in the wilderness know what to do when they encounter a potentially dangerous animal, the actual risk of death is quite low,” Forrester said. Forrester made his remarks in a news release from the journal Wilderness & Environmental Medicine, which published the study in its March issue.

The death rate overall from animal encounters “has remained relatively stable” from the last time this analysis was performed, covering 1999-2007, he said. Nonvenomous animals accounted for 57 percent of the deaths in the latest analysis. Most of those cases involved what the researchers classified as “other mammals” including cats, horses, cows, other hoof stock, pigs and raccoons. Previous research has shown that most deaths from “other mammals” occur on farms, and that horses and cattle account for 90 percent of such farm accidents. “Preventing potentially fatal farm animal encounters should be a better-promoted and -supported public health initiative,” Forrester said. “Farming remains an industry with a deficit of work-related injury reporting, and opportunities exist to improve safety measures and injury reporting on farms in the U.S.” Dogs were the second most common cause of nonvenomous animal-related death, the study found. Children younger than 4 years had the highest dog-related death rate, at

4.6 deaths per 10 million people. That rate was almost two times higher than the next most vulnerable group — people older than 65 — and four times higher than other age groups. “The burden of fatality upon young children after dog encounters remains troubling,” Forrester said. “These are preventable deaths.” Venomous animals accounted for about 86 deaths a year during the study period. Most of those were caused by wasps, bees and hornets.

To reduce these deaths, Forrester said, people who know they’re allergic to insect stings should carry a portable epinephrine delivery device with them at all times. “With an estimated 220,000 annual visits to the emergency department and nearly 60 deaths per year due to stings from hornets, wasps and bees, effective and affordable treatment [for severe allergic reactions to stings] is critical,” he said.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

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 April 2018 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 3

CALENDAR of

HEALTH EVENTS

New Masthead

e’re excited with the new masthead of In Good Health. This is the first change we’ve made since the inception of the paper in Western New York in November 2014. Newspapers don’t change mastheads frequently but we thought this was a great time to introduce something new, fresh, more contemporary, something that better reflects the paper’s mission of disseminating news related to health, the healthcare industry and wellness. We believe the new masthead has the power to generate some new interest for In Good Health. It is cleaner than the one it replaces, more visually appealing and we hope will help draw more readers who see the paper at hundreds of high-traffic locations, including all Wegmans and Tops Friendly Markets’ locations. We’re pleased that Melanie Watson accepted our invitation to come up with new ideas for the masthead. Watson has been a professional graphic designer for more than 25 years and has extensive experience in designing publications, logos, marketing collateral and a number of other products. In nearly two decades on the design team at Rochester Business Journal, Watson received nearly 20 awards from the New York Press Association and the Alliance of Area Business Publishers. Watson submitted not one or two ideas. In a matter of a day — we thought it would take at least a week — she was able to come up with seven designs for the masthead. Even better, all seven were outstanding. It was tough to pick the winner from among her ideas. “When designing the logo for In Good Health, I was focused on what the paper’s demographic might be attracted to,” she explains. “I was showing health as a lifestyle instead of a medical-only issue. And the bold font simplifies the message.” We highly recommend Watson for any design work readers might need. Some of her work can be viewed at melaniewatsondesign.com. Please drop me a note, let me know what you think. If you have any story ideas, please feel free to drop me an email. And, please, consider In Good Health for advertising. We reach tons of people in the community. Wagner Dotto is In Good Health’s publisher and editor. To contact him, send an email to wagnerdotto@ gmail.com.

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April 7

Conference to focus on social factors in health promotion A community leader on social factors that impact health and a panel discussion by health promotion experts in the Buffalo Niagara region will be featured at a professional development conference being hosted by Daemen College. The conference, “Beyond Biology: Social Determinants in Health Promotion,” will take place from 9 a.m. to 2:30 pm. April 7 in Daemen’s Wick Campus Center Social Room. Being held during National Public Health Week, the one-day conference is free and open to high school and college students interested in community-level health promotion, career exploration, or networking with community leaders. A keynote address scheduled for 1 p.m. will be given by physician Raul Vazquez, founder and primary care physician at Urban Family Practice and president/CEO of G-Health Enterprises. He also formed the Greater Buffalo United Accountable Healthcare Network to provide coordinated, person-centered care for Medicaid recipients with multiple chronic medical conditions. The morning conference schedule will include a panel discussion at 9:30 a.m. by local leaders from Community Access Services, the Community Health Worker Network of Buffalo, the Population Health Collaborative of Western New York, the Wellness Institute of Greater Buffalo, and the Western New York Peace Center. Conference sessions at 11 a.m. will cover a range of topics, including community health education and outreach, health policies and systems, and social justice. The conference, which includes lunch, is co-sponsored by the Daemen Office for Academic Affairs and the Health Promotion and Public Health departments, the Wellness Institute of Greater Buffalo and the D’Youville College CRPASH (Center for Research on Physical Activity, Sport and Health) .For student registration, go to tinyurl.com/beyondbiologyregistration. More information is available at www.daemen.edu/ beyondbiology or by calling 716-8398556.

April 18

Catholic Health offers osteoporosis support group

Osteoporosis, a disease in which the bones become weak and brittle, affects about 10 million people throughout the United States each year. Another 44 million have low bone density, placing them at increased risk. And while women are more susceptible to bone loss after menopause, men can also develop osteoporosis, which commonly results in fractures of the hips, spine

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

and wrists. To help area residents diagnosed with osteoporosis live their healthiest life, Catholic Health hosts an osteoporosis support group from 10 to 11:30 a.m. the third Wednesday of every month in the Beechwood Residence Auditorium, 2235 Millersport Highway at North Forest Road, Getzville. The meetings for the remainder of the year will be held April 18, May 16, June 20, July 18, Aug. 15, Sept. 19, Oct. 17, Nov. 21 and Dec. 19. The osteoporosis support group is free and open to all. The meetings feature guest speakers discussing various topics of interest to help people living with osteoporosis or at risk for developing the condition, live safely and comfortably. New members and walk-ins are welcome. For more information, call Catholic Health’s HealthConnection at 447-6205.

April 19

Sips, Suds & Sweets to benefit Senior Wishes

Senior Wishes, an organization dedicated to honoring WNY’s lower-income seniors by bringing their wishes to fruition, is hosting its fifth annual Sips, Suds & Sweets fundraiser from 6 to 9 p.m. on Thursday, April 19, at Fox Run at Orchard Park. Presented by M&T Bank, with additional support by dozens of other caring community organizations, this year’s event will include samples of beer, wine, spirits, desserts and appetizers provided by local businesses. Music will be performed by Michael Ross Nugent. Tickets for Sips, Suds & Sweets are $50 pre-sale, and can be purchased at www.seniorwishes.org. Any remaining tickets will be sold at the door for $60. Attendees can participate in a silent auction, basket and wagon of cheer raffles, and a wine pull. A complimentary candy buffet is offered to guests, along with a photo booth and chocolate fountain. Free valet parking is available. Wendy Backman, executive director, says this event is crucial to the organization’s mission: “Sips, Suds and Sweets is our main fundraiser for the year. Funds raised from event guests, auction supporters and sponsors will help us continue to fulfill wishes and further our mission. When you attend Sips, Suds and Sweets, you’re helping people who have dedicated their lives to their families and communities, but now find themselves isolated, physically challenged or financially strapped.”

Online

@ bfohealth.com

For more information, contact Wendy Miller Backman at 716-5082121 or visit www.seniorwishes.org.

Mobile mammography available in April Windsong Radiology Group has scheduled a new round of mobile mammography 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, Wyoming, Niagara, Orleans and Genesee) who had limited or no access to breast cancer screening, will now have access to the high-quality services that Windsong provides. The new dates are as follows: • 8 a.m. to 4 p.m., April 11, at 595 Clymer-Sherman Road, Clymer • 10:30 a.m. to 6:30 p.m., April 18, at Jasper Parrish, Buffalo; • 8 a.m. to noon, April 21, at the YMCA, 525 William St., Buffalo • 9 a.m. to 4 p.m., April 25, at 239 S. Main St., Albion; • 10 a.m. to 6 p.m., April 27, at Salamanca MHA, 69 Iroquois Drive, Salamanca.

Free yoga classes at the museum BlueCross BlueShield of Western New York recently partnered with the Albright Knox Art Museum to offer “Art of Yoga,” a series of yoga classes at the museum. There are a number of health benefits that individuals gain through the practice of yoga, especially for older adults, age 65 and up. Unique to the area, gentle yoga is specifically designed for seniors. Classes will be led by influential local yogi, Steve Procknal, and his fellow instructors at Power Yoga Buffalo. Practitioners of all ages and abilities are welcome to the program. The schedule is as follows: • Gentle yoga for seniors at 3 p.m. the third Tuesday of every month; • Alternating meditation and yoga in the galleries on the third Thursday evening of every other month. Each of these events will be accompanied by a brief tour. • One free summer yoga event on the Elmwood Avenue Portico, with a second event in the winter pending Sculpture Court availability. • Gentle yoga: April 17, May 22, June 19, July 17, Aug. 21, Sept. 18, Oct.16, Nov. 20 • Art of yoga/meditation: April 26, June (date TBA), Aug. 16 and Oct. 18. Art of Yoga is open to all individuals and the cost is $10. Individuals can visit the Albright Knox website to register online: www.albrightknox. org/events/gentle-yoga-41718 or call 716-270-8292.

Senior Living Community Embrace Seasons Past... Begin Life Anew! • Stimulating Social, Educational and recreational activities

he number of transgender people in the United States who’ve had gender-affirming surgery has risen with the expansion of insurance coverage for the procedures, a new study finds. There are an estimated 1.4 million transgender adults in the United States. Their gender identity differs from their biological sex, prompting some to seek hormone treatments, facial contouring and genital and breast surgeries, researchers from Johns Hopkins Medicine explained. The researchers found that more than 4,100 such surgeries had been done between 2000 and 2014, according to their analysis of medical records in a nationwide database. They also found that the number of gender-affirming surgeries increased nearly fourfold during that time. How people paid for these surgeries changed over time, according to the study. About half of those who had gender-affirming surgery from 2000 to 2005 paid out of pocket. That rose to 65 percent from 2006 to 2011. However, from 2012 to 2014, that percentage dropped. Just 39 percent paid out of pocket in 2014, with the rest covered by Medicare, Medicaid or private insurance. The Affordable Care Act banned discrimination on the basis of gender identity, leading to an increase in insurance coverage for gender-affirm-

ing surgeries, the researchers said. The data also showed that no deaths from gender-affirming surgeries had been recorded. That finding challenges critics who say the surgeries are not safe, the researchers said. The study was published Feb. 28 in the journal JAMA Surgery. Before this research, little was known about how many of these procedures take place and how they’re paid for, according to Brandyn Lau, director of research for the Johns Hopkins Center for Transgender Health in Baltimore. “Without data specific to transgender patients, we can’t tell what we’re doing right and what we need to improve, and this study was an attempt to address that problem with the best data we have available now,” Lau said in a Hopkins news release. As more data is collected, he said, researchers will be able to assess outcomes and disparities among transgender patients in the same way that they can now make assessments by age, race and sex. “Eventually, we can move from bean counting about how many gender-affirming surgeries have been done to patient- and clinic-reported outcomes,” said fellow researcher Joseph Canner, co-director of the Hopkins Center for Surgical Outcomes Research. That would “put these procedures in the same sphere as virtually all other types of surgeries.”

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Meet

Your Doctor

By Chris Motola

Thomas J. Madejski, M.D. Buffalo-area doctor, elected president of Medical Society of the State of New York, wants to focus on preventive care to curb obesity, diabetes FDA Approves First Home Test for Breast Cancer Genes The first consumer test for three BRCA gene mutations associated with breast, ovarian and prostate cancer risk has been approved by the U.S. Food and Drug Administration. The three gene mutations are most common in people of Ashkenazi (Eastern European) Jewish descent, but are not the most common BRCA1/BRCA2 mutations in the general population. The test, from 23nMe, analyzes DNA from saliva collected by clients, the FDA said in an agency news release. It noted that the test only checks for three of more than 1,000 known BRCA mutations and that a negative result does not rule out increased cancer risk. The three mutations detected by the test occur in about 2 percent of Ashkenazi Jewish women, but only 0 to 0.1 percent of other ethnic groups, according to the U.S. National Cancer Institute. “This test provides information to certain individuals who may be at increased breast, ovarian or prostate cancer risk and who might not otherwise get genetic screening, and is a step forward in the availability of [direct-toconsumer] genetic tests. But it has a lot of caveats,” said Donald St. Pierre, acting director of the Office of In Vitro Diagnostics and Radiological Health, in the FDA’s Center for Devices and Radiological Health. “While the detection of a BRCA mutation on this test does indicate an increased risk, only a small percentage of Americans carry one of these three mutations and most BRCA mutations that increase an individual’s risk are not detected by this test,” St. Pierre added. “The test should not be used as a substitute for seeing your doctor for cancer screenings or counseling on genetic and lifestyle factors that can increase or decrease cancer risk,” he said. The test should also not be used by consumers or health care providers to decide on any treatments, including anti-hormone therapies and preventive removal of breasts or ovaries. Such decisions require thorough testing and genetic counseling, the FDA added. Page 6

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Q: What’s the transition like, becoming president of the Medical Society of the State of New York? A: We have a pretty wellestablished succession plan, so people work their way through the organization and get elected to various offices. And then if you get into the presidential track, you sort of get designated to be president within a couple years. You spend a year as vice-president, then as presidentelect, then as president. So the three of us sort of work together in the office of the president. The president is the main guy, but the other two help him out. Part of the idea is that we have knowledge about what’s going on when we come in. Q: What do you see as the primary mission of the society? A: There’s an actual mission statement, which I’ll paraphrase as “to represent the interests of patients and physicians in New York state and promote the betterment of public health.” So it’s about the way healthcare is delivered, new technologies, how specialties evolves. So we have members with different expertise and we come up with policies that we think helps make the care and health of people in New York better. We do that through a committee structure. When we get an issue that comes before us, if it’s not something that can be resolved very easily, we’ll assign it to a committee. The committee will do some research on it. They’ll make some recommendations and then it’ll eventually come before our house of delegates, which is like a small congress that meets annually. We go through the different issues, debate on them, and come up with policy. The rest of the year, the officers try to implement those policies. Q: Obviously, doctors can’t unionize in the traditional sense, but in what ways would you say the organization is similar to a union? A: We don’t do collective bargaining for individual practices, but we do work on issues that affect the practice environment and care of patients. The first year or two I was on a reference committee and there was a lot of activity around HIV at the time; this was the early ‘90s. There was conflict between privacy protections for patients and then being able to identify people you could intervene with to hopefully prevent infection. One of the issues was whether you could test mothers for their HIV status so you could treat their babies as they were delivering so that they would

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

not contract the virus. That was difficult to do, but we made some recommendations to move forward on that. More recently one thing that’s been difficult is getting drugs paid for and to patients, particularly with the interference or interaction of pharmacy benefit managers and insurance companies. They may change what they consider to be an allowable medicine for someone. You’ll have someone who may be very stable on a medication, but the insurer will decide they don’t want to pay for it anymore. Over the last couple years, we have done what is called a step therapy bill and that has allowed us to provide protections for patients so they’re not having their medications changed willy-nilly. Q: Given the lopsided population density of New York state and its distinct regional characteristics, how do does the medical society deal with those differences? Or is it not that big a deal? A: The society is around 212 years old now and that’s been a problem since fairly early on. Back before we had the ease of communication that we have now, the leaders identified the issue and created a rotational model. This goes back to the model of the office of the president that I described earlier where there are three officers involved. We break the state into three clusters: New York City, the areas surrounding New York City, and Upstate. So each of those three people are from a different region. I’m the Upstate guy. The last president, Dr. Rothberg, was from the suburban region, and the incoming president-elect is from the Queens County Medical Society. Those three areas are

roughly balanced in terms of members, maybe slightly more Downstate, but not that much. But we believe in keeping the whole state engaged. There is a geographic component, but it’s very much a meritocracy. We like to think we’re getting the best people from each region. Q: What do you think the state does well with medicine, and where is it weakest? A: They’re kind of related. One of the things the state does really well is medical education. We have the most medical schools in the country and train the most medical students and residents. It gives us the potential for a great physician workforce. Yet we, in most surveys, rank either 50th or 51st in desirable places to practice. We train the most residents, but keep less than half of them, which leads to access issues. Q: What’s the main reason cited? A: The economic environment, the cost of practice. Some of that isn’t unique to physicians; New York is an expensive state to do business in. Also reimbursement rate, particularly Upstate, is some of the lowest in the country. And we have one of the most expensive liability systems in the country. Q: To what degree does the state government seem sympathetic? And if not, how do you work around it? A: We try to put together different coalitions to work on different problems. Sometimes we’re successful, sometimes we’re not. For the most part, we have a good relationship with the health department, the legislature and the governor’s office in terms of hearing us out, but sometimes there are differences of opinion. One recent example is medical marijuana. It’s an interesting issue with legitimate concerns about how it’s been implemented since it’s circumvented a lot of the processes we usually use. But we continue to work with the state on that issue. Q: What do you want your legacy to be as president? A: I hope to have some impact on the general health of the state in terms of improving people’s health. We’re trying to emphasize more preventive health, particularly with the obesity crisis and the number of diabetics. We also want to have an effect on improving the practice environment so we can get more physicians in the state to help take care of patients.

Lifelines

Name: Thomas J. Madejski, M.D. Position: In addition to his internal medicine practice with General Physician, P.C., he is the past president of the medical staff at Medina Memorial Hospital. He is also medical director of the Orleans County Nursing Home, Absolut Care of Gasport, and Hospice of Orleans County. Hometown: Buffalo Education: SUNY Health Science Center (SUNY Upstate) Affiliations: Medina Memorial Hospital Organizations: Medical Society of the State of New York (President); American Medical Association  Family: Wife, five children Hobbies: Golf, hunting, fishing, camping, hiking

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Healthcare in a Minute By George W. Chapman

Survey Shows Toughest Healthcare Jobs to Fill

f the top 10 hardest jobs to fill in the U.S., half are in health care, according to CareerCast, which took into consideration Bureau of Labor forecasts, trade association data, graduation rates and their own job listing database. No. 4 is home health aide. No. 6 is medical services manager. No. 7 is nurse practitioner. No. 8 is personal care aide. Coming in at No. 9 is physical therapist.

Top US Hospitals. None from NYS IBM Watson Health just released its top 100 hospital list. A total of 2,840 hospitals were graded on publically available clinical, operational and patient satisfaction data to create a balanced scorecard. The 100 best hospitals outperformed the rest of the pack in survival rates, complications, infections, length of stay, ED wait times, patient satisfaction and expenses. Ohio led the way with 15 hospitals in the top 100. Texas was second with nine hospitals, followed by third place Illinois with eight hospitals making the top 100. New York state had no hospitals in the top 100. Value-based medicine In a move toward paying physicians for outcomes or value versus just plain volume, new Health and Human Services Secretary Alex Azar proposed a four-point plan. 1. Give control of the patient’s record to patients. Poor interoperability among the many electronic record systems out there makes it almost impossible for the patient to have control of their own information. 2. Establish

incentives for providers to be more transparent about their fees. Because of higher deductibles and out-ofpocket expenses, consumers are more price-conscious. 3. Use Medicare and Medicaid to drive change. Commercial insurance companies are not getting it done and Azar knows they tend to mimic/follow Medicare’s lead. 4. Reduce regulatory burdens. Frankly, most providers would be thrilled if the government would simply stick to a set of regulations rather than constantly changing them. Another huge merger Not to be outdone by the announced but unapproved merger of Aetna and CVS, Cigna has announced it will buy Express Scripts for $67 billion. The companies in both mega mergers are promising more services for consumers at thousands of locations; increased collaboration and coordination of care with providers; and additional opportunities for personalization via data analytics. Insurance companies are aggressively taking matters into their own hands, virtually wresting control away from providers.

Top exercises Running is tough on both joints and digestive system. The Harvard HealthBeat Newsletter suggests five other types of exercise, three to four days per week, for losing weight, strengthening muscles and improving mental health. 1. Swimming, considered the perfect exercise, for 30-45 minutes per day. 2. Tai chi. 3. Strength training using weights or your own body weight. 4. Walking 30 to 45 minutes. 5. Kegel exercises. VA in NYS Veterans are allowed to receive care from community providers when timely care cannot be received from the VA system. But according to a survey of 746 community providers by the RAND Corp, only 2 percent of civilian or private providers say they can accommodate veterans in timely manner. NYS ranks fifth in the number of veterans served. Spending for NYS veterans exceeds $6 billion annually. There are over 900,000 vets living in NYS. ACA hanging in Despite repeated attempts to repeal or sabotage the Affordable Care Act, it remains the only viable option for individuals seeking health insurance. A recent poll by the Kaiser Foundation found that 54 percent of us have a favorable view of the ACA. Currently, about 20 million people are covered by the ACA. Seven million purchase private insurance on the exchanges and 13 million people are eligible through Medicaid. Seventy percent of survey respondents feel non-disabled Medicaid recipients should be required to work. Meanwhile, a bipartisan congressional committee is scrambling to stabilize the insurance market that has been disrupted by the repeal of the mandatory requirement to have insurance

April 2018 •

and the continued uncertainty in the marketplace. Insurance companies have until this summer to decide if they will continue to participate on the exchanges in 2019. Healthy Cities WalletHub used 40 metrics to grade US cities on healthy lifestyles. According to them, the top 10 healthiest cities are: No. 1 San Francisco. No. 2 Seattle. No. 3 Portland, Ore. No. 4 San Diego. No. 5 Washington, D.C. No. 6 Burlington, Vt. No. 7 Scottsdale, Ariz. No. 8 Honolulu. No. 9 Irving, Calif. No. 10 Denver. The top 10 unhealthiest cities are: 1. Brownsville, Texas. No. 2 Laredo, Texas. No. 3 Augusta, Ga. No. 4 Shreveport, La. No. 5 Gulfport, Miss. No. 6 Fort Smith, Ark. No. 7 Detroit. No. 8 Jackson, Miss. No. 9 Corpus Christi, Texas. No. 10 Memphis. Telemedicine/telehealth Congress has passed a law, whose acronym is CHRONIC, expanding Medicare reimbursement to providers for telemedicine. The committee that drew up the law felt Medicare was far behind when it came to embracing available the technology which will both save money and get critical services to remote rural areas. It is expected that most commercial plans will follow suit.

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

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

April Showers Bring May Flowers... and So Much More!

h, the promise of spring! The warmer weather makes me want to bust open my windows and break out my spring cleaning supplies. I’m ready to pull on my rubber gloves and get busy. But scrubbing my tubs is only part of it. Creating a clean, soothing and safe haven for myself after my divorce was an essential part of starting my life over as a woman on her own. Intuitively, I knew I needed to walk through my new front door and into my very own “warm hug,” a place where I would be embraced and inspired by all things familiar and friendly. So I set out to create a retreat — a personal sanctuary where I could feel safe, sound and at peace. It was what I needed at the time. Now, years later, my home has evolved into much more than just a nurturing place. My living space became a pallet of personal expression where I gained a true appreciation for the value of having space to create and live freely, as Virginia Woolf

explored in her enlightening book titled, “A Room of One’s Own.” With yourself as your sole guide and decorator, your kitchen, living room and bedroom can become portraits of your values, your loves, and your life. Making a home your own becomes an adventure in autonomy and a chance to explore and express — perhaps for the first time in your life — your own tastes unleashed, without compromise. It can be liberating. Energizing. Even healing. One of the first things I did when I bought my own home (after I tore out the grass-green shag carpet!) was to frame and display photographs of my family and friends. I wanted to see their faces when I entered a room and to be reminded of good times and the love that surrounds me. This was just the beginning of a series of decisions that made living alone in my own space not just pleasant, but lovelier and more wondrous than I could have imagined. Paying attention to your sur-

roundings can have an immediate and lasting impact on how you feel about yourself and about living alone. What better time than now to put out the welcome mat and make your home your own. Here are some tips: n Follow your heart. You’re on your own now. There’s no one around to second guess your decisions or rain on your preferences. You are free to express yourself in the colors you choose, the fabrics, the art and the accessories. Don’t know where to start? Look at your wardrobe. There, you’ll find a reliable reference for your style and tastes in color. n Decorate with your senses. Is the hollow sound of loneliness bouncing off your walls? Is there a musty smell wafting up from the basement? Are your counter tops sticky to the touch? When I started paying attention to more than just visual aesthetics, my home became even friendlier territory. Transform your solitary space by creating a beautiful atmosphere filled with lovely music, pleasing aromas, and clean surfaces. n Banish the negative. If something makes you feel bad when you look at it, either get rid of it or repair it. Ratty dishtowels, old lampshades, faded curtains: Their very existence in your home can dampen your mood and erode your self-esteem over time. Don’t underestimate the negative power of unsightly or outdated objects. n Exhibit the positive. On the other hand, surround yourself with images and objects that lift your spirit and reinforce who you are or want to become. Photos of loved ones work for me. So do fresh flowers and original pieces of art I collect on my travels.

I believe in the symbolic nature of objects and find inspiration in what fills my home. n Reduce the clutter. Closets crammed with forgotten clothing, drawers loaded with useless stuff, dark corners made darker by a tower of boxes — all of these contribute to negative energy, according to the tenets of feng shui, the ancient Chinese practice of organizing space to achieve harmony and balance. In the same vein, the Danish philosophy of hygge promotes a way of life that embraces coziness and well-being. Similarly, Sweden advances the virtues of moderation and balance in a new lifestyle trend call lagom, which captures the Goldilocks principle of “not too little, not too much, just right” for any given moment, gathering or situation. I’m intrigued by all these concepts and have incorporated bits and pieces of each into my life. It’s made a positive difference; I encourage you to check ‘em out. Your home can become an oasis of independence and autonomy — a place that’s unconditionally yours, absent of compromise. Claim it. Fill it with who you are. Because once you make your personal space your own . . . there’s no place like home!

University of Tubingen in Germany. “Student characteristics and behaviors were rewarded in high school and led to higher educational attainment, which in turn was related to greater occupational prestige and

income later in life,” she said in a journal news release. “This study highlights the possibility that certain behaviors at crucial periods could have long-term consequences for a person’s life,” she said.

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 her to speak, call 585-624-7887, email gvoelckers@ rochester.rr.com, or visit www.aloneandcontent.com.

s d i K Corner

Success in High School, Success Later in Life

eing a good student in high school seems to translate into a better job and higher pay down the road, a new study suggests. “Our research found that specific behaviors in high school have long-lasting effects for one’s later life,” said study lead author Marion Spengler. Those behaviors and achievements included being a responsible student, being interested in school and having good reading and writing skills. The results? Occupational success decades later. Specifically, having a better job both 11 years and 50 years after high school, the study found. The finding came from an analPage 8

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ysis of data on Americans who were high school students in 1960, including follow-ups on nearly 82,000 of them in 1971 and on about 2,000 people again in 2010. The study found that positive high school factors were associated with higher income 50 years later, regardless of the person’s IQ or their parents’ income. The findings were published Feb. 26 in the Journal of Personality and Social Psychology. “Educational researchers, political scientists and economists are increasingly interested in the traits and skills that parents, teachers and schools should foster in children to enhance chances of success later in life,” said Spengler, who’s from the

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

Amherst Friends Organize Fundraising for a (Rare) Cause Rally for Rohleder in Amherst to raise funds to support patient with rare, aggressive blood cancer condition By Katie Coleman

eing diagnosed with an extremely rare and aggressive form of cancer last year changed Keith Rohleder’s life very quickly. Last March when doctors told Rohleder he had blastic plasmacytoid dendritic cell neoplasm (BPDCN), he was given between 12 and 22 months to live. At 54 years of age, Rohleder is at 23 months since his diagnosis. Rally for Rohleder, a fundraiser to support Rohleder and his family and to raise awareness of the disease, is being held on April 15 at Classics V Banquet Center in Amherst. His only treatment option is in Boston, 500 miles away from their home in Maryland, and is experimental. The financial burden and time away from work are taking a toll and his wife’s Tricia’s best friend, Laura Matre, and her sister, Marian Pilecki, started planning the fundraiser in Buffalo after they heard the news. Money raised will help cover the cost away from work, treatment and travel. The Rohleder used to live in Buffalo and Tricia still has family here. “We knew we had friends and family but we’re really feeling it now. It’s a big blessing. We are overwhelmed with the donations they’re giving away,” Tricia said. “An afternoon on a sailboat, an afternoon of charter fishing, rinks of ice donated and signed hockey sticks from the Sabres.” Rohleder works for the US Marine Corp, and Tricia, an elementary school teacher, quickly learned there is no established treatment that results in long-term remission for BPDCN, and little data on the disease is known. Initially, small spots started appearing all over Rohleder’s skin, a symptom common in 80 percent of diagnoses. He went to a dermatologist and had a skin biopsy, which confirmed BPDCN. His father, William Rohleder, is a retired marine captain who was stationed at Marine Corps Base Camp Lejeune in Jacksonville, N.C., in the ‘50s and ‘60s. Rohleder was born at the base hospital and lived there about four years. According to the U.S. Department of Veterans Affairs, in 1982, volatile organic compounds were found in wells that supplied Camp Lejeune’s drinking water — mainly trichloroethylene, a metal degreaser; perchloroethylene, a dry cleaning agent; vinyl chloride; and benzene. The contaminants are estimated to have been in the water from the mid‘50s until February 1985 when the wells were shut down. According to the Center for Disease Control’s Agency for Toxic Substances and Disease Registry Public Health Assessment for Camp Lejeune, “One million military and civilian staff and their families might

Tricia and Keith Rohleder during a hiking trip. “I have a lot of support and I rely greatly on my wife. She’s my rock and we both rely on family,” said Keith Rohleder. He was diagnosed with a rare type of disease, blastic plasmacytoid dendritic cell neoplasm (BPDCN). have been exposed to the volatile organic compound-contaminated drinking water during a 30-plus year period. However, because during the early 1980s these contaminants were unregulated, base officials took relatively few drinking water samples to measure chemical contaminants at the base’s water treatment plants; therefore, the extent and duration of exposure was unknown.” Three years ago, Rohleder and Tricia received a packet in the mail disclosing that there was contaminated drinking water at Camp Lejeune during the time he lived there with a list of deadly diseases potentially caused by exposure. Rohleder’s mother died of colon cancer at 60, and his father has been surviving multiple cancers for the past two decades.

If You Go… Rally for Rohleder will be held from 1 to 5 p.m., Sunday, April 15, at Classics V Banquet Center, 2425 Niagara Falls Blvd., Amherst, NY 14228. Admission is $20. There will be food and refreshments, entertainment, theme baskets, specialty raffles and 50/50 split. For more information, contact Laura Matre at 716-4301075, or Marian Pilecki at 716572-5154.

They sent a claim in to the military and it was sent back requesting more proof of residency, even though the Rohleders sent in a copy of Rohleder’s birth certificate and dates and addresses of where he had lived on the base. According to the family, they don’t know anyone who has received compensation for the deadly diseases caused by the contaminants. The Rohleders, along with many others, have been looking to the military to take active responsibility for the contaminated water and financially compensate those affected, both with their medical expenses and treatment, as well as for those who have already lost a loved one due to one of the deadly diseases caused by exposure. According to The Dana Farber Cancer Institute, BPDCN is a rare, aggressive disease of the bone marrow and blood cells typically diagnosed in people between 60 and 70 years old. There are few effective treatment options, and with a wide range of symptoms and little data, BPDCN is frequently misdiagnosed and underreported. It decreases the red blood cells, white blood cells, and platelet counts in the body and can evolve to the bone marrow and spleen. Symptoms vary but include skin lesions, enlarged lymph nodes, fatigue and stomach pain. Director of BPDCN Center at the Dana Farber in Boston, physician Andrew Lane, is administering Rohleder’s treatment. According to a letter Lane wrote on behalf of Rohleder, “He may have been exposed to toxins in the drinking water, including benzene, trichloroethylene, tetrachloroethylene, dichloroethylene, and vinyl chloride. Some of these chemicals are associated with an increased risk of cancer, including leukemia. In my opinion, it is possible that these exposures could have contributed to his current disease. The VA Hospital does not offer any known cure for this type of leukemia, nor the experimental drug that has proved the most successful.” Rohleder started the first phase of treatment, SL401, in May, which is experimental and in its third leg trial before the FDA reviews it for approval. After that, he had full-body radiation, and then a stem-cell transplant where his immunity was eradicated and replaced by his sister’s, who was his donor. Now, he has her immunity. “In Boston, they’ve treated the most people with BPDCN, and they’ve saved one person. We are planning on my husband being the second,” Tricia said. Although Rohleder is not part of any support groups he said he certainly has support. “I have a lot of support from my wife and I rely greatly on her. She’s my rock and we both rely on family,” Keith said.

April 2018 •

Blood Pressure Check? There May Soon Be an App for That

omeday soon, a simple touch of a finger to a smartphone case might be enough to provide instant, accurate blood pressure readings. That’s the promise of new technology detailed by developers in the March 7 issue of Science Translational Medicine. Researchers say they’ve invented a special phone case, using high-tech 3-D printing, that contains an embedded optical sensor on top of a “force” sensor. When the user presses a finger onto the sensor embedded in the case, “it provides measurable pressure on an artery in the finger in the same way that a blood pressure cuff squeezes an artery in the arm,” according to a journal news release. That information is then fed to a smartphone app that converts the data to a real-time blood pressure reading, displayed on the phone, says a team led by Ramakrishna Mukkamala of Michigan State University. The researchers tested the usability of the device on 30 people, and found that about 90 percent could position their finger correctly and get consistent readings after only one or two attempts. Two heart specialists said the device might one day be a game-changer. “An accurate blood pressure measurement technique is critical for making helpful decisions in the management of hypertension,” said physician Joseph Diamond. He directs nuclear cardiology at Long Island Jewish Medical Center, in New Hyde Park. He stressed, however, that more rigorous testing must be done before any new blood pressure measuring technology becomes standard.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 9

Things You Need to Know About Prevalence of Autism

By Ernst Lamothe Jr.

revalence and awareness don’t always go hand in hand. More than 3.5 million Americans, including one in 68 children, live with an autism spectrum disorder (ASD), according to the Centers for Disease Control and Prevention. However, the condition is still unfamiliar to many. The American Academy of Pediatrics in 2007 recommended that all children be screened for ASD at their 18-month checkups, and then again at either 24 or 30 months of age. “It’s essential that people understand autism spectrum disorder because there are people who are affected every day of their lives that you likely come in contact with,” said physician Michelle Hartley-McAndrew, clinical assistant professor of pediatrics and neurology at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. “Whether you interact with people at the grocery store, work or at school, the better you understand what individuals with autism are experiencing, the better interaction it will be.” McAndrew offered five facts about autism because she believes many people still have too many stereotypes about the condition. You can’t get it through vaccines

Because of a research study by physician Andrew Wakefield in the United Kingdom — that has since been debunked — there are still people who believe vaccination contributes to autism. Some research states that autism

tends to run in families and many environmental factors are being examined as possible contributing factors or “causes” of autism. Changes in certain genes increase the risk that a child will develop autism. If a parent carries one or more of these gene changes, they may get passed to a child. However, many research studies show that vaccination is not the cause. “What we do know for sure is that there is an incredible reduction in preventable diseases for those children who do get vaccinated,” said said McAndrew. “We will always recommend to parents that their children get their vaccinations. The American Academy of Pediatrics has compiled a comprehensive list of research regarding autism and vaccine safety that can be found on www. healthychildren.org.”

Behavior is often ways of communication

Parents and other caregivers that encounter someone who has autism should understand that they may have difficulty with expressing themselves through language. Because of this, behavior is a key component for communication. Behavioral changes can indicate a need to express something. They might engage in aggression or atypical behavior because there is an element in their surroundings that overwhelms them.” “Parents have to work on interpreting the behavior before they can put together a plan of action,” said McAndrew. “Often parents have to be like a detective to determine

the needs of their child or cause of the behavior before it will change. Behaviors may be more common if the child is hungry, tired, sick or overwhelmed. Understanding that behavior is communication can prompt someone to look behind the behavior at the source.”

Sensory sensitivity

Ordinary smells and sights that most people don’t notice can be somewhat painful and irritating to someone with autism. Even a crowded area might be too hectic, which can cause someone to prefer not only quiet but isolation. It may cause individuals to feel defensive. “For example, if there are too many people in a store causing commotion or too much light, it can be irritating to a person with autism spectrum disorder,” said McAndrew. “It can be all too overwhelming. Even certain sounds or fabrics may be extremely bothersome.”

Visual learners

Those who have autism tend to be more visual learners. Often the best way to teach them is to show them what is expected through pictures, demonstrations and gestures instead of simply telling them what to do. For children on the autism spectrum, walking over to a seat and physically sitting down as a demonstration could work better than just telling them to sit down. “Also, consistency and repetition are helpful,” said McAndrew. “When things are on a visual picture sched-

Physician Michelle Hartley-McAndrew, clinical assistant professor of pediatrics and neurology at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. ule that they can refer back to, they can anticipate change or see what is expected of them and it eases their stress. It makes learning and communicating a little easier.”

Range of strength and challenges.

As the term spectrum would suggest, there are symptoms that will occur along a continuum. Some people with autism spectrum disorder can perform excellently at a traditional school, while others may need a little more help. “Dr. Stephen Shore who has autism once said ‘if you have met one person with autism then you have met one person with autism’ meaning that’s why we call it a spectrum because there is no one type of person with autism.”

After Knee Replacement, Play On

nee replacement patients can continue to enjoy sports — such as skiing, tennis and dancing — without worrying that high-impact activities might compromise their new joint, a small, new study finds. The researchers tracked patients for between five and 15 years after knee replacement surgery, known as total knee arthroplasty. They found that sports participation had no significant impact on the longevity of artificial knees. Historically, knee replacement patients are advised against high-impact activities to preserve the new joint. “Patients were coming back for their annual review . . . and were participating in a range of ‘prohibited’ activities. There were patients competing in downhill skiing and tennis, but there was no wear, no dislocations, no loosening and no revisions,” said study author Samuel Joseph, an orthopedic surgeon at Linacre Private Hospital in Melbourne, Australia. “Yes, there are patients running marathons and participating in triathlons after knee replacement surgery,” he added. Page 10

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More than 600,000 knee replacements are performed each year in the United States, according to the U.S. Agency for Healthcare Research and Quality. The procedure replaces the natural joint with a prosthetic version made of metal and plastic. It’s typically done because of severe arthritis, trauma or other joint damage. Joseph and his colleagues identified 355 knee replacement patients who continued to participate in sports after surgery, more than 100 of whom did high-impact sports. Another 139 knee replacement patients in the study did not participate in regular sports. In the sports group, three patients underwent further operations on the knee area, though none to modify the new joint. In the nonsports group, three patients underwent surgery to modify or replace their artificial knee because the joint loosened. Physician Elizabeth Matzkin is an assistant professor of orthopedic surgery at Harvard Medical School and wasn’t involved in the new research. She said she wasn’t surprised by the findings. “I think as we collect more data,

we’ll see the tide turn a little bit,” said Matzkin, who is also chief of women’s sports medicine at Brigham and Women’s Hospital in Boston. “The goal is to keep patients active.” Matzkin pointed out that knee replacement patients who desire to return to high-impact sports are likely motivated and strong. Additionally, she said, they’re probably not obese, a condition that typically threatens the longevity of an artificial knee. “I think we need to follow large [groups] of patients and their activity levels and how that plays out,” Matzkin added. “This is a pretty small study, and we need big, multi-center studies to look at these patients over the long term. But this was a fantastic starting point.”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

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Aquatic Therapy:

The Healing Power of Water By Kyra Mancine

ou don’t even need to know how to swim to participate. Aquatic therapy is a way for people with a variety of conditions to rehabilitate, relieve pain and improve mobility, strength and coordination. The buoyancy of the water — combined with soothing, warmer water temperatures and gentle, low impact exercises (done with or without equipment) — makes it one part of an overall treatment plan for individuals with orthopedic issues or other injuries. The treatment Programs vary, but most sessions include resistant exercises done in a therapeutic pool heated to 85 degrees Fahrenheit or above. Some pools have lifts so the patient won’t have to walk down steps to enter or exit the pool. In select locations, an underwater treadmill is available. During the course of the session, which can range from 30 to 60 minutes, you complete a variety of movements intended to improve balance, strength, range of motion, endurance and coordination. Because of the resistance of the water, you can get a better workout in a shorter period of time, without the risk of injury. All you need prior to your session is a swimsuit and, in some cases, goggles or water shoes. How to get started In most cases, individuals are referred by their doctor for these programs and evaluated by a licensed therapist who customizes a treatment plan. This plan could also include land-based exercises. Typically, the physical therapist will screen potential candidates and recommend a course of therapy appropriate for their needs. Insurance often covers the therapy, but always check with your provider before you begin any course of treatment. A pool with a treadmill floor At the Smolinski Family Sports Medicine Center at the University of Buffalo, athletes can rehabilitate in one of two Hydroworx pools. These small, specialty in-ground pools have a treadmill floor. As the floor moves, jets shoot out water to create greater

What about our furry friends? Not to be undone, there’s even aquatic therapy for dogs available at SandDancer Canine Swim Therapy & Fitness in Orchard Park. Yes, even four-legged friends benefit from this therapy. If you find yourself sidelined by an injury or illness where regular, land-based workouts or traditional exercise equipment use isn’t an option, consider exploring the possibilities and benefits of aquatic therapy at one of the local providers in the Western New York area. Who Benefits From Aquatic Therapy According to several sources interviewed for this story, patients with the following conditions can benefit the most from aquatic therapy: • Orthopedic conditions • Shoulder / lower back / sciatic pain • Athletic / sports related injuries • Sprains, strains, knee / hip / ankle injuries • Pre/post joint replacement • Neck / shoulder pain • Multiple sclerosis and Parkinson’s disease • Chronic ailments such as fibromyalgia and lupus.

resistance, creating a safe, but challenging recovery workout. Underwater cameras record a patient’s stride. You may not be a Division 1 athlete, but you can find other local facilities to participate in various forms of aquatic therapy. Where to Go According to Physical Therapist Lindsay Bilson of the Buffalo Rehab Group, aquatic therapy is “the best of both worlds — less pain during your rehab program and maximal functional recovery.” Their East Amherst location has warm water pool access right in the clinic for patients to use, and their Williamsville location (inside the YMCA) has some pool access from the use of the Y’s pool as well. Bilson explains that people who have chronic problems like back or leg pain can benefit from the off-loading of their joints, making movement much more comfortable. “It can also help those who have had hip, knee, and ankle surgeries recover much faster,” Bilson said. “Young, old, athletic, tall or short, you may benefit from being submerged. Performing strength exercises that were otherwise painful on land can be pain-free in water.”

Other providers include Orthosports Physical Therapy where clients receive individualized programs offered to one or two people per session. Pool temperature is a soothing 90 degrees. There’s also a pool at Catholic Health that’s heated to 94 degrees and has an underwater treadmill as well as stairs with railings, grab bars and resistance devices. Advanced Care Physical Therapy of Western New York has two full size, heated aquatic therapy pools with an endless swimming current as well as two underwater treadmills. Looking for a group class? The JCC of Greater Buffalo offers over 40 aquatic-based classes in soothing 83 to 85-degree water. These classes feature Hydrorider Spinning Bikes. These unique aqua bikes have adjustable paddle wheels, allowing patients to increase or decrease resistance and difficulty level, making them perfect for aquatic conditioning. Patients can also find aquatic therapy classes offered twice a week at Advanced Care Physical Therapy Center in Niagara Falls. Each session has four to six patients, lasts one hour and may include land-based exercises as well.

April 2018 •

Where to Go for Aquatic Therapy Select places where aquatic therapy is available in Western New York: • Advanced Care Physical Therapy of Western NY, Alden • Advanced Care Physical Therapy Center, Niagara Falls • Buffalo Rehab Group (two locations), East Amherst and Williamsville • Catholic Health, Buffalo • GreenFields Health & Rehabilitation Center, Lancaster • Jewish Community Center (JCC) of Greater Buffalo • Orthosports Physical Therapy, Amherst and Williamsville • SandDancer Canine Therapy & Fitness (for dogs), Orchard Park

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 11

Many Americans Think Docs Order Too Many Tests, Meds

ew older Americans believe ordering more tests and drugs is the way to better health care, a new survey finds. Of the more than 2,000 respondents aged 50 to 80, just 14 percent thought that “more is better,” according to the National Poll on Healthy Aging. In fact, 54 percent said they believe that health care providers often recommend tests, medications or procedures that patients don’t really need. For instance: • One in four poll participants said their health care providers often order tests or prescribe drugs that aren’t necessary. • One in six said this had happened to them in the past year. • About half said they’d had the test or filled the prescription. However, about 10 percent said their doctor or other health care provider had told them that a test or medication they’d asked for wasn’t needed. Most said the provider explained why, but 40 percent didn’t completely understand the explanation. The poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation. It was sponsored by AARP and Michigan Medicine, the university’s academic medical center. “The new findings suggest patients and providers need to work together more to prevent overuse of health care services that provide the least value to patients,” physician Jeffrey Kullgren said in a university news release. He designed the poll and analyzed its results. “Patients should speak up when they aren’t sure if a test or medication recommended to them is needed,” he said. “And providers need to communicate about how a particular service will — or will not — affect the patient’s health, both when they’re recommending it and when a patient has requested it.” Alison Bryant, AARP’s senior vice president for research, seemed to agree. “These survey results show us that more attention needs to be focused on improving communication between patients and doctors,” Bryant said in the news release. “Encouraging patients and doctors to routinely discuss the need for recommended procedures and medications should help prevent unnecessary treatments and cut health care costs,” she said.

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GObike’s most popular annual events include its signature SkyRide, a fundraising bicycle tour that includes a scenic ride over the 100-foot-high Skyway. The event this year will take place May 20. Photo provided.

Gotta Bike? GObike Buffalo! Group that promotes biking gearing up for major May 20 event By Nancy Cardillo

here are many health benefits to riding a bike: increased cardiovascular fitness, muscle strength and flexibility, decreased stress levels, improved posture, coordination and brain function and weight loss, just to name a few. But did you know cycling is also one of the best ways to see and experience your community? Justin Booth knows about the benefits of biking, and that’s why he started GObike Buffalo a decade ago. While working for the Wellness Institute of Greater Buffalo, Booth stumbled on a program in New York City that taught kids how to fix their own bikes, learn the rules of the road and experience the fun and benefits of riding a bicycle. “The program got kids interested in riding while teaching them about environmental issues,” says Booth. “I thought it was a great program and wanted to start something similar in Buffalo.” So he began collecting discarded bikes — and soon found himself with a garage full of them. Booth started Recycle-A –Bicycle in 2002, taking bikes into Buffalo schools for kids to fix. That grew into hosting workshops about fixing bikes, bike safety and more. “We wanted to get bikes into the hands of more people who wanted them or needed a mode of transportation, who were interested in riding but maybe couldn’t afford a bike of their own,” he says. Eventually, Booth’s efforts evolved into GObike Buffalo which, today, has grown into a nonprofit organization (and a full-time job for Booth) that promotes all aspects of biking and that has had a significant impact on building a thriving, dynamic and connected Buffalo. The organization currently has seven full-time employees and a dozen part-timers.

Justin Booth started GObike Buffalo a decade ago after he stumbled on a program in New York City that taught kids how to fix their own bikes, learn the rules of the road and experience the fun and benefits of riding a bicycle. “Our goal is to be as intuitive as possible,” says Booth. “Our mission is pretty simple: to get people to ride bikes. You hear our name and you immediately know what we’re all about. “Buffalo is a great city for biking. Its radial street grid makes it easy to reach your destination using side streets rather than busy main streets, and it’s relatively flat around here, so it’s easy to navigate,” he says. “And while you’re riding, you’re enjoying gorgeous architecture and a beautiful landscape.”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

Booth is quite proud of the impact GObike Buffalo has had, not only in getting more people out riding, but also in the local community. “The dialog is no longer IF we’re going to have bike lanes but, rather, ‘how can we make the streets safer, more accessible and convenient for all modes of travel and for pedestrians,’” he says. “It’s been proven that when you reallocate space on streets for bikes and pedestrians, it actually helps traffic move faster and more safely and reduces accidents, parking issues and pollution, creating a better quality of life for all.” GObike’s most popular annual events include its signature SkyRide, a fundraising bicycle tour that includes a scenic ride over the 100-foot-high Skyway May 20, Slow Roll Buffalo, a social group bicycle ride that meets every Monday night (May through October) at different venues and takes a unique route throughout the city, and the annual Tour de Farms, a 35-mile bicycle tour of urban and rural farms, held in collaboration with the Massachusetts Avenue Project (Sept. 15). All events are open to riders of any level — from newbies to road warriors to commuters — who have a bike and a helmet. Donate Bikes, Volunteer If you have a bicycle you’d like to donate to GObike Buffalo, you can drop it off at GObike’s community workshop, 98 Colvin Blvd. (during business hours) or call GObike at 716-218-7161. GObike is also always looking for volunteers, members, sponsors and partners. You can find more information on GObike’s website at https://gobikebuffalo.org/getinvolved/get-involved-overview

Meet Your Provider

Lina Kennedy: Why You Need a Sugarist ‘We have developed and pioneered a unique and innovative process for the removal of unwanted hair’ How often do you check up on your skin? Chances are, if you wash with a brand-name soap and use lotion you’re doing pretty good. Most people don’t wake up thinking “today’s a good day to evaluate my skin’s condition!” But what if you did? Alexandria Professional® is the pioneer of modern body sugaring, a technical art of hair removal and skin conditioning passed down from ancient Egyptian. Our brand and professional technique have revolutionized the way sugaring is performed worldwide for the last 25 years We’ve held true to the natural formulations of sugar paste while innovating the precision of hair removal and skin conditioning. Our global network of distributors and practitioners help us provide the gold standard of hair removal experiences and results

Why should you put sugar on your body? Sugar pastes only stick to dead

skin cells as opposed to live ones. This means that during the process of hair removal, sugaring will not only remove your unwanted hair but, at the same time, offer a safe and gentle exfoliation treatment. The Alexandria Professional® body sugaring technique uses a lukewarm paste, molded onto the skin, and then removing the paste in the direction that your hair grows. This is the key to the most pleasant hair removal experience and truly lasting results. Our body sugaring technique extracts the hair instead of breaking it. With continuous treatments, paired with the award-winning products in our Full Circle of Skin Conditioning® program, we guarantee reduced hair growth on any area of your body. When talking about post-hair removal reactions and overall client satisfaction, that fact that our sugar pastes stick only to your dead skin is a very important feature to consider. Essentially, this means that the redness and mild irritation that sometimes occurs with other hair removal

methods are dramatically reduced and disappear much more quickly. Since body sugaring won’t harm live skin cells, our treatments can be performed as often as needed — even daily — which means you can reach hair refinement and growth reduction faster.

What makes body sugaring so appealing? It comes from the earth We like to keep it simple. AP sugar pastes are made of organic sugar, lemon juice and water. Our formulations are free of “nasties” such as parabens or urea and are also hypoallergenic and non-comedogenic, meaning they won’t clog your pores. All Alexandria Professional® products are certified cruelty-free as well as vegan and gluten-free so they’re 100 percent safe and effective for all hair and skin types.

What’s the catch? Caring for your body is a matter of personal choice. Choosing us for your skin and hair removal needs means

Lina Kennedy is the president of Alexandria Professional. you’re choosing to go beyond the status quo. Our long and successful history in the beauty world has changed the lives of our customers and salons. So please, take a moment to do a body check-up. You might realize that you can have your sugaring, and eat it too!

Alexandria Professional®

www.alexandriaprofessional.com • 1-800-957-8427

High on Beans and Nuts: Mediterranean Diet Ranks Best Overall By Katie Coleman

f you’re considering a healthier lifestyle, experts say the Mediterranean diet is a great pathway to achieving overall health. Convened by U.S News & World Report, a panel of experts made up of nutritionists, health specialists and other experts in human behavior, heart health, weight loss and diabetes recently ranked the Mediterranean diet the No. 1 best overall diet. They ranked 40 diets overall in categories including long and shortterm weight loss, nutrition, safety and how easy the diet is to follow. “We continue to see more robust research suggesting its benefits for weight loss, heart and brain health, cancer prevention and diabetes prevention and control,” said Angela Haupt, assistant managing editor of health at U.S. News & World Report. Eating healthy fats, whole grains, beans, nuts, fish, olive oil, fruits and veggies, small amounts of meat, dairy, poultry and red wine characterize the Mediterranean diet, although that varies from region to region. The diet was influenced by different civilizations that lived and gathered along the Mediterranean Sea throughout history and in part reflects food patterns of Crete, Greece and southern Italy. The social and physical elements of the Mediterranean lifestyle are important for the overall health

of the region, where emphasis is on eating as a social occasion with friends and family, and frequent activities like walking and getting outside after meals. Allyson Odachowski, registered dietitian and the media representative for the NYS Academy of Nutrition and Diatetics, has been a dietitian for 18 years and runs a private practice, Custom Diatetics, in Williamsville. She works with patients oneon-one to achieve their health and nutritional goals, including diabetes monitoring, weight management and dealing with food allergies. She offered up valuable advice on the Mediterranean diet and achieving goals safely and successfully. “What tends to work best in my patients who have long-term success is that they set small and realistic goals and they have a way to track their progress,” Odachowski said. “And having someone to help them along, whether that’s a friend, family member or a professional.” Using an app on your phone, Apple Watch, Fitbit, or writing a food log are different ways to track your food intake when making a healthy switch, and Odachowski stressed that in partnership to a healthy diet, physical activity is critical for your overall health goals. When it comes to tailoring what the right amount of poultry or dairy intake is, there are many factors at

play for each person: age, gender, health status, weight and activity level. “The Mediterranean way of eating has a general kind of pattern, but if people are looking for very specific recommendations, they should really talk to someone who can walk through that with them,” Odachowski said. Target foods She explained the different components of the diet and offered up expert advice: n Healthy fats: “Fat needs to be in your diet and it’s a healthy part of it,” Odachowski said. “It’s not about low fat, but choosing the right type. We want people to focus on omega-3 and monounsaturated fats.” Healthy fat sources include avocado, olive oil, fatty fish, olives, nuts, chia and flax seeds. n Fish: “Fish is very lean and a great protein source but the type of fat salmon has sets it apart. Tuna fish and steak would probably be second on the list in terms of beneficial fat, being accessible and something people are comfortable eating,” Odachowski said. n Whole grains: “When you eat whole grains, you’re getting the whole grain the way it was grown in nature versus when refined. A

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lot of times vitamins and minerals are added back but you lose the benefit of eating that whole food,” Odachowski said. “Certainly the better choice is the whole grain because you’re getting that food as it was grown in nature and that’s really what we want to do and not have them be so processed.” Recommendations include eating brown rice, whole grain couscous, bulgur and quinoa. n Beans: “Beans are great because they’re a complex carbohydrate and a plant-based source of protein. You’re getting sustainable energy, fiber and they’re great for lowering cholesterol,” Odachowski said. Incorporate a variety of beans into your diet such as black beans, lentils, chickpeas, pinto and kidney beans. n Nuts: “I encourage patients to choose a variety of nuts,” Odachowski said. “Don’t necessarily just have one type. Walnuts have the highest amount of omega-3 fat, so that’s something unique about them.” There are many nuts to choose from, and dry roasted nuts are a healthy alternative to nuts roasted in oil. n Fruits and veggies: “The key once again is variety. I see people get into a rut when they eat a small rotation of the same few vegetables and fruits. What people don’t realize is they’re limiting their nutrition profile,” Odachowski said. She recommends switching up the fruits and vegetables you purchase once a week, or whenever you take your next grocery trip.

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SmartBites

The skinny on healthy eating

Brown Rice Bursts with Health Benefits Is Greek yogurt better than the regular one?

ike many baby boomers, I grew up on white rice — at home, in restaurants, at the school cafeteria. And since I saw it as a backdrop to whatever was ladled on top, I never thought twice about its nutritional value, besides being starchy and filling. These days, I always consider what I consume, which is why, when it comes to rice, I only eat the wholegrain version: brown rice. While white rice certainly has some nutritional merit — as it’s enriched with some of the nutrients it loses in the milling process, like thiamine, folate, and iron — it pales in comparison to its tawny cousin. Brown rice, which hasn’t been stripped of its husk, bran and germ, is a good source of fiber, providing about 3.5 grams of fiber per cup (comparable to oatmeal). Current research shows fewer incidents of heart disease, diabetes and cancer in people who eat diets high in fiber. What’s more, people who eat more high-fiber foods tend to be thinner than those who don’t and also have lower blood pressure and cholesterol counts. Health-promoting antioxidants, which abound in the bran portion of a whole grain and help thwart the damage caused by free radicals, reign supreme in brown rice. According to the Harvard T. H. Chan School of Public Health, abundant evidence suggests that eating whole fruits, vegetables,

Administration has set a limit on the amount of inorganic arsenic allowed in infant rice cereal, they have not set a limit on the amount of rice adults should eat, recommending instead that adults maintain a diet that includes a variety of whole grains to minimize any health risk. Many experts agree that the levels of arsenic in rice are only a concern if you’re eating multiple servings of rice every day.

and whole grains — all rich in antioxidants — provides protection against cell-damaging free radicals that contribute to many chronic diseases, including cancer, heart disease, Alzheimer’s, and vision loss. Brown rice is an outstanding source of manganese, an essential mineral that plays an important role in bone health, energy production, nutrient absorption and bloodsugar regulation. A powerhouse antioxidant with anti-inflammatory properties, manganese is a widely known remedy for the treatment of sprains and arthritic symptoms, despite no reliable evidence as yet to indicate that it actually helps. Can you eat rice if you’re watching your carbs or have diabetes? Although no rice can really be considered a low-carb food (one cup of cooked brown rice has about 45 grams), whole-grain brown rice is healthier than refined white rice. Thanks to its fiber and protein, which both slow the absorption of glucose into the blood, brown rice contributes to more stable blood sugar levels. Switching to brown rice may also lower your risk of developing Type 2 diabetes, according to a Harvard School of Public Health study. All rice is contaminated with inorganic arsenic (a carcinogen), whether brown, white, organic or conventional. Brown rice has the most, however, which is something to consider if arsenic concerns you. While the Food and Drug

Helpful Tips

Brown Rice Salad with Crunchy Vegetables Adapted from the Naked Food cookbook; serves 6 2 cups brown rice 4-5 scallions, thinly sliced, including light green parts 1 red pepper, chopped 1 green pepper, chopped 1-2 carrots, shredded 1 cup slivered almonds, toasted 1/2 cup flat-leaf parsley, finely chopped Dressing: 1-1/2 tablespoons olive oil 1 tablespoon sesame oil 1 tablespoon soy sauce 2 tablespoons lemon juice 1 tablespoon balsamic vinegar 1-2 garlic cloves, finely chopped Crumbled feta (optional) coarse black pepper and salt, to taste.

Which Medications Work Best to Deal with Your Spring Allergies? And how much do you need to take to be effective?

ow much suffering is too much when it comes to spring allergies? Anyone who has moderate to severe seasonal allergies knows that when you reach a certain point — when your itchy red eyes, runny nose and sneezing become overwhelming — you need relief. But what does relief look like and how do you get there? “Bottom line, very few people suffer from the same allergies or symptoms,” says allergist Bradley Chipps, president of the American College of Allergy, Asthma and Immunology (ACAAI). “You have to Page 14

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create a personal treatment plan by first avoiding the things you’re allergic to, and then treating your specific symptoms. The question for many people is whether over-the-counter remedies are enough, or if prescription medications are needed.” According to a new practice guideline from the Joint Taskforce on Practice Parameters, more medications aren’t necessarily the way to go. Nasal steroid sprays are extremely effective and easy to get. They’re also relatively inexpensive and don’t have a lot of side effects. They are a good place to start for those over the age of

Place the rice into a sieve and rinse under cold running water; drain. Put rice and 4 cups of water in a large saucepan and bring to a boil over medium-high heat. Reduce heat to low and simmer, covered, until the rice is tender and most of the liquid has been absorbed, about 45 minutes. Let stand 10 minutes, then fluff with a fork. For the dressing, put all the ingredients into a glass jar and shake well to combine. Combine the cooled rice and remaining ingredients in a large bowl. Add the dressing and mix well. Let stand for at least 15 minutes for the rice to absorb all the flavors. Taste; adjust seasonings; add more oil, if needed.

12, according to the guidelines. “The guidelines recommend nasal steroid sprays as the first line of defense instead of an oral antihistamine,” says allergist physician Dana Wallace, past ACAAI president and co-author of the guideline. “The task force didn’t find evidence of better results if oral antihistamines were added to treatment along with the nasal steroid sprays. And oral antihistamines can cause sleepiness.” For people with moderate to severe seasonal allergies who are older than 12, the guidelines suggest adding an intranasal antihistamine

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

Those concerned about arsenic levels should (1) first rinse their rice; (2) cook their rice in six times the normal amount of water, which reduces the arsenic level by about half, according to the FDA; and (3) buy brown basmati rice from California, India or Pakistan, according to Consumer Reports. Store uncooked brown rice in the refrigerator or freezer in an airtight container: brown rice should last 6 months in the fridge and up to 2 years in the freezer. Store cooked brown rice in the fridge for up to 3 days.

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.

spray to treatment along with a nasal steroid inhaler. The additional medication provides added benefit for those with more severe allergies. Allergists advise people to start taking medication two to three weeks before symptoms normally start. According to ACAAI, if you begin your allergy medications before the worst symptoms hit this spring, your suffering won’t be as bad. Although people think spring starts in April, symptoms can begin earlier in warmer areas. Keep in mind when your symptoms normally appear and start your medication well in advance. Many people go in search of “natural” remedies. They might not know that immunotherapy — in the form of allergy shots and tablets — is a very natural treatment. During allergy shots, you are given gradually larger doses of your exact allergens. The slow increase causes your immune system to become less sensitive, which reduces future allergy symptoms. Allergy tablets, taken under the tongue, are available to treat pasture grasses, ragweed and house dust mite and, to be effective, must be started 8-12 weeks before the allergy season starts.

Participants at April Woolley’s Tuesday night POUND class at the Fisher-Price Fitness Place in East Aurora. POUND has become the new trend in exercising in Western New York

POUND Your Way to Better Health

Photo: Top, from left, are Lynn Martin, Lisa Shall, Katie Judge, Carolynne Cuffney, Michelle Callan, Dale Schultz and Jaycie Fontaine. Bottom, from left: Tiffany Martin, April Woolley, Kelly Wiskup and Donna Leary.

New workout trend is catching on fast in Western New York; area has already more than a dozen registered instructors By Jenna Schifferle

pril Woolley raises two lime green Ripstix above her head and begins to tap. She tucks her shoulders behind her, straightens her back and reminds the room of approximately 12 people to do the same. Yoga mats line the floors and mirrors cover the back and side wall. The music starts to take off, and Woolley moves with it, drumming along to the rhythm and taking everyone along for the ride. As she leads, they follow, pounding the floor and air in rapid succession — everyone’s a rock star in their own right. The beat rises and so does their pulse. “There are no mistakes; there are only drum solos” says Woolley as she kicked off Woolley’s Tuesday night POUND class at the Fisher-Price Fitness Place in East Aurora. By day, Woolley works as the high school band director for Pioneer Central School; by night, she inspires people of all ages to connect to fitness through music. As a certified POUND Pro,

Woolley’s goal is to make people forget that they’re working out, and she believes that creating rhythm is the best way to do that. The drumstyle workout also has the added bonus of playing into Woolley’s love for making music. “When you have a bad day and you can hit the floor as hard as you can, it’s an emotional release … when people can connect to the beat, that’s when the magic happens.” Two drummers and former college athletes discovered that magic in 2011 when they had to stand during one of their performances. They spent the night without a stool, squatting over their drum kits, only to realize the next morning that they’d gotten a great workout. Seven years later, this revelation has turned into a nationwide trend, and the world’s taking notice — especially in Buffalo. There are more than a dozen registered POUND instructors in Western New York, and classes are popping up in more than 50 countries worldwide, according to

the POUND Fit website. Venues all over Western New York, from rSpace in Colden to Brierwood Training & Wellness Center in Hamburg to World Gym in Tonawanda, have picked up on the trend and integrated POUND into their regular fitness schedules. Jill Gregory, a safety engineer at Harlan Electric Company and a Concord resident, first learned about POUND from a sign she saw while walking her dog in 2015. Later that night, she found herself at the community center in her town, gripping Ripstix and following Woolley’s lead. One class was all it took — and Gregory was hooked. She has always been a self-proclaimed fitness buff with five sprint triathlons under her belt. Coordination and dance moves never came easily for her, though, and she never got into trends like Zumba. But POUND was different for her. Unlike Zumba, POUND is rhythmically driven and less focused on dance steps, she said, and because of this, the class quickly became a passion. “You’re making noise, you’re making movement, and burning calories. Instead of fumbling to remember the moves, you still can make noise and have fun and burn calories all at the same time.” Gregory decided to take her passion one step further by becoming a certified POUND Pro in 2016. After an eight-hour course at Queen City

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Cycling in Buffalo, Gregory started teaching at Glistening Sky Fitness & Wellness in Delevan. Now, she teaches at rSpace on Saturdays, and she makes sure she doesn’t miss a day. People of all ages and abilities attend her class, from young children to participants in their 70s. The routines allow each person to modify the moves to meet their abilities. Gregory also likes to remind her students that “halfway is OK,” meaning you don’t always have to pound at ground level. A typical POUND routine incorporates approximately 70 moves and can burn up to 900 calories, according to the POUND Fit website. The movements target the whole body and include a mix of cardio, conditioning, strength training, yoga and Pilates. Despite the rigorous workout, the class focuses on the music and rhythm as a distraction technique to make you forget you’re working out. For anyone considering their first class, Gregory has two pieces of advice. First, don’t be afraid to modify the moves. Second, laugh about it and have fun. “When I would be completely off beat, April would be on target, on the beat. I would be beating to my own drummer. Just laugh about it, and know you’ll get it eventually. Have fun until you do.” To find a class near you, visit: https://poundfit.com/find-a-class/

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Could Your Coffee Habit Lengthen Your Life?

rinking three to four cups of coffee a day is not only safe for most people, it might protect against heart disease or an early death, a new review suggests. The finding, which applies to so-called “moderate” coffee drinking, stems from a review of more than 200 previous studies. The fresh analysis also linked moderate coffee drinking to a lower risk for developing prostate, endometrial, skin and liver cancers, Type 2 diabetes, liver disease, gout, gallstones and dementia. Some of the studies in the review also showed a lower risk for Parkinson’s disease, depression and Alzheimer’s. However, the review did not prove that coffee drinking caused these health risks to drop. And it also found that coffee may be somewhat problematic for pregnant women and slightly increases the risk for fracture among all women. The review was led by physician Robin Poole, a specialist registrar in public health at the University of Southampton in England. He collaborated with researchers from the University of Edinburgh in Scotland. The review suggested that drinking coffee in moderate amounts seemed to reduce the chances of dying from any disease, compared with those who didn’t drink coffee at all. The biggest benefit was linked to consuming three cups a day. Drinking more than that was not linked to any harmful effects, but it also was not associated with substantially increased health benefits. One heart expert said the findings should give coffee lovers reasons to smile. “Many people have felt that abstaining from coffee is associated with being healthy, but this meta-analysis shows this is not necessarily true,” said Suzanne Steinbaum, director of Women’s Heart Health at Lenox Hill Hospital, in New York City. “Drinking up to three cups a coffee a day can be part of living a healthy life, not only reducing heart disease, but also not increasing the risk of neurologic diseases, such as Alzheimer’s or Parkinson’s.”

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Chiropractic: A Promising Career Doctors of chiropractic have a variety of professional opportunities in the healthcare field By Deborah Jeanne Sergeant

tudents pursuing chiropractic degrees have every reason to look forward to a satisfying, solid career. D’Youville College in Buffalo represents one of two institutions in New York state offering chiropractic education. Jeffrey Ware, doctor of chiropractic, heads the department and has worked in chiropractic as a practitioner and now in education for a total of 30 years. He has no regrets pursuing chiropractic and sees a bright outlook for chiropractic graduates. “At this time, chiropractic grads could be a solo practice in their own office or associates in another office. There are job opportunities at the VA, military bases Ware and at multidisciplinary clinics,” Ware said. Chiropractors are part of a growing field. Many people wary of prescription pain medication and want an alternative approach to their pain relief. For those whom chiropractic is appropriate, issues often resolve more quickly than through rest alone. “We are definitely holistic, natural and hands-on,” Ware said. “A lot of people are looking for this. We’re a drugless profession for the treatment of pain which is important because of the opioid crisis. “Chiropractic profession is very satisfying as a profession,” Ware added. “We have the No. 1 patientdoctor satisfaction rating.”

Chiropractor J. Todd Knudsen, vice president of institutional advancement and special projects at New York Chiropractic College in Seneca Falls, represents other chiropractic educators in the state. “Alumni of our doctor of chiropractic [DC] program have a wide variety of professional opportunities from which to choose,” he said. “A DC graduate can also pursue residency training and specialize in additional areas like nutrition, sports medicine, diagnostic imaging, orthopedics, neurology, pediatrics, teaching, or spine care.” Over the past 10 years, chiropractic has developed and advanced over in many ways, including public perception. Knudsen, who is also a diplomate of the American Chiropractic Board of Radiology (DACBR) — a certified specialist in diagnostic imaging who can order and interpret advanced imaging such as a CT scans, Knudsen MRIs and ultrasounds — said that a “strong body of scientific research” shows the value of chiropractic care as an effective alternative to taking medication and undergoing surgery for the issues it treats. “Chiropractors have the very rewarding experience of making a difference in the lives of their patients by increasing the patients’

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

quality of life and bringing relief to suffering, often when relief has been unavailable through traditional medicine,” Knudsen said. While medical doctors usually work on-call hours, chiropractors typically set their own hours if they operate their own practice. For some, forming or joining an integrative practice with massage therapists and other types of practitioners enables them to minimize overhead to make up for low reimbursements. Others forgo working with insurance companies so they can charge more realistic rates and spend the time with patients that they need. Median Salary for Chiropractors in WNY: $63,380 Tuition and fees at NYCC for the standard 10 semesters costs $122,820. At D’Youville, the cost is $150,000 for 11 semesters. The Bureau of Labor Statistics’ outlook for chiropractors is 12 percent job growth nationwide from 2016 to 2026, compared with 7 percent for all jobs. The median pay nationwide was $67,520 in May 2016. New York’s annual mean wage for chiropractors is $90,570. In Western New York it’s $63,380; in the Rochester area, it’s $67,880. Jeffrey Ware, who heads the chiropractic department at D’Youville College in Buffalo, said that the statistics do not reflect solo practitioners, who can command higher rates than those working in a group practice.

Women’s Health For the First Time, Women Outnumber Men in Med School

‘Notable milestone,’ says president of Association of American Medical Colleges By Deborah Jeanne Sergeant

n 2017, more women entered medical school than men for the first time, according to the Association of American Medical Colleges (AAMC). Last year, women represented 50.7 of new medical school enrollees, compared with 49.8 percent the year before. “We are very encouraged by the growing number of women enrolling in U.S. medical schools,” physician Darrell G. Kirch, AAMC president and CEO, said in a press release. “This year’s matriculating class demonstrates that medicine is an increasingly attractive career for women and that medical schools are creating an inclusive environment. While we have much more work to do to attain broader diversity among our students, faculty, and leadership, this is a notable milestone.” This somewhat holds true locally at University at Buffalo. While the number of first-year women medical students remains 50 percent, it has risen from 46.9 percent in 2014, indicating some progress. “This is something we’re happy to see,” said David Milling, a physician serving as senior associate dean for student and academic affairs at UB, referring to the growth in the number of women entering medical school. “It helps to have a diverse population based upon gender and any other way so we can take care of the populations in our community. We hope it continues.” Milling attributes the effect to changes in the field of medicine that make practicing it more of a profession than a lifestyle.

“Women are more comfortable in terms of entering the profession, feeling they are also able to do everything else that comes along with life in being primarily responsible for families and having children,” Milling said. “That’s less and less of a concern as medicine has evolved.” Milling added that in recent years, more women picture themselves as physicians. Encouraging girls to become involved in science, technology, engineering and math (STEM) means, eventually, more women doctors, he said. “It is absolutely phenomenal,” said Marcia C. Brogan, president of the Buffalo Niagara Chapter of the National Association of Women Business Owners and an insurance agent with Niagara National Insurance in Buffalo. “Women are obviously understanding their potential in the science and medical fields and are able to empower themselves to reach levels that were challenging themselves in the past.” Women equally represented in medical school shows the benefits in promoting positive female role models. She believes that for a long time, medicine has been a hierarchy. Women taking a bigger role shows the work in promoting gender equality in middle schools, high schools and colleges. Brogan also believes that women bring a lot to the emergency room, exam room and operating table. “Women have a different way of looking at things and are more

collaborative with men and women,” she said. “They’re easier to work with anyone. “Women bring a new perspective. They look at things differently than men and are empathetic. They look at the particulars in a different manner.” Kimberly DeSimone is a professor at St. Bonaventure, where she teaches strategic leadership and diversity. She also believes that women’s soft skills greatly enhance the medical community; however, they haven’t been much appreciated until now. “What’s going to distinguish the doctor is the soft skills,” she said. She said that patients don’t have to rely upon their doctors as their only source of health information. Traits that make women stand above their male peers is their ability to provide compassionate care, active listening, and creative solutions. “If you look at traditional characteristics ascribed to men and women, and there’s some validity to them, that can provide an opportunity for women to be more successful,” DeSimone said. Still a long way to go Women have come a long way — from a rarity at medical school to more than 50 percent — but in some areas, they still need to break through barriers. DeSimone said that though the number of women entering medical school is promising, they haven’t all completed medical school. Plus, that doesn’t mean that an equal number of women are taking respected roles

Marcia C. Brogan such as lead surgeons, researchers and professors. She wants more women in leadership roles in the medical field so they can better reflect their communities. A more diverse group of leaders can offer input that better resonates with those they serve. “In general, women make so many healthcare decisions, including for men,” DeSimone added. “The more diversity of thinking, the more creative solutions will come.” She believes that since men have dominated in the medical field for so long, they have an easier time receiving promotions. DeSimone said that men are more successful with linear career paths, where women are more like kaleidoscopes, fulfilling many different roles. “Women have always had to use the kaleidoscope path because the traditional trajectory hasn’t worked for them,” she said. “Women often have to take years off for childbirth or care for elderly relatives and other social requirements men don’t have to deal with.” The male work ethos of commitment to the job doesn’t mesh with women’s usual role of maintaining the household and family. “We’re at least overcoming barriers so that women are believing they can achieve success in maledominated fields,” DeSimone said. “Equity needs to be judged from the top down.”

10 Things Woman Should Know About Heart Disease

early every minute, a woman dies from heart disease in the United States — it is the No. 1 killer of women, causing one in three deaths each year, according to the American Heart Association (AHA). When it comes to heart disease, women experience unique causes, symptoms and outcomes compared to men. In addition, certain conditions appear to increase heart disease risk in women, including preeclampsia and eclampsia, gestational diabetes, migraine headaches with aura, early onset menopause and autoimmune diseases such as lupus and rheumatoid arthritis. Physician Holly Andersen, at the Ronald O. Perelman Heart Institute at NewYork-Presbyterian/Weill Cornell Medical Center, and Jennifer Haythe, a cardiologist specializing in cardiac health during pregnancy

at NewYork-Presbyterian/Columbia University Irving Medical Center, say more work needs to be done. Here’s why: Women are more likely to die from heart disease than men, according to the AHA. Despite outreach efforts, a Women’s Heart Alliance survey of more than 1,000 women between 25 and 60 years of age found that 45 percent of women still don’t know that heart disease is the leading cause of death for women in the United States. Women are less inclined to call 911 when they believe they may be experiencing heart attack symptoms. Cardiovascular disease complicates up to 4 percent of pregnancies, and that number has been increasing.

1. 2.

3. 4.

Women’s heart attack symptoms are often different from men’s. They may experience shortness of breath, nausea, palpitations, jaw discomfort or overwhelming fatigue, according to the AHA. Women are less likely to be referred for cardiac rehab after a heart attack. Women’s heart disease is under-researched: only 35 percent of participants in clinical trials of cardiovascular disease are women, and just 31 percent of the studies report outcomes by gender. Pre-eclampsia is an independent predictor of developing cardiovascular disease later in life. Women who have had pre-eclampsia should be mindful of having their blood

6. 7. 8.

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pressure, fasting glucose and cholesterol checked annually. Women are less likely to receive bystander CPR in public than men (45 percent in men versus 39 percent in women). Learning hands-only CPR can help save a life. Recent blood pressure guidelines from the American College of Cardiology recommend all people to have a blood pressure target of 120/80 or lower. Additionally, after the age of 65, hypertension (high blood pressure) is more common in women. Stay up-to-date on your annual physical and have your doctor check your blood pressure and other cardiovascular disease risk factors.

9. 10.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Women’s Health

When Sex is a Real Pain Many factors may cause women to feel pain during sexual intercourse. Doctor: ‘Sex should never be painful’ By Deborah Jeanne Sergeant

or a variety of reasons, many women experience pain with sex. Sexually transmitted diseases, vaginal infections, low hormone levels, vulvar skin issues, very tight or weak pelvic floor muscles, endometriosis and unknown issues can cause women pain during sex, for example. Age matters as well. Physician Vanessa Barnabei, PhD, president and CEO of UBMD Obstetrics and Gynecology, explained that for post-menopausal women, it’s most often due to lower estrogen levels which cause vaginal dryness and thinning of the vaginal tissue. “That decreases the level of natural lubrication in the body, which makes sex very uncomfortable,” said the professor and chairwoman of the department of obstetrics and gynecology at Jacobs School of Medicine & Biomedical Sciences. Women of any age may experience chronic pain, vulvodynia, which means an unexplained pain or discomfort in the vulvar area during intercourse. Some older women experience the pain constantly, but it could be related to other bodily issues. “Sex should never be painful,” said physician Pebble Kranz, owner of Rochester Center for Sexual Wellness. “It is always an issue that should be investigated by a healthcare provider and sometimes it takes a long time to get to the root of these issues and to find a

provider who is skilled in evaluating and treating sexual pain, but one shouldn’t lose hope.” Sometimes pain during sex causes a vicious cycle of exacerbating the issue. As the woman experiences pain, she becomes more fearful of intercourse, according to Kranz. When the fear causes her body to tense up, the pain worsens. Libido can taper off. “This is made worse because many women keep the problem hidden, even from their partners, and feel shame about it,” Kranz said. She added that many care providers minimize women’s complaint and are not aware of sexual medicine as a specialty that includes physical and mental health. Treating sexual pain can include medication, physical therapy for the pelvic floor, mental health, relationship counseling and education. “It’s really important that these women get referred to physical therapists who have specific training in the pelvic floor,” Barnabei said. “It’s very different from shoulder or knee pain. Not a lot of physical therapists have that level of training.” Kranz recommends a book by physicians Irwin Goldstein, Andrew Goldstein and Caroline Pukall, “When Sex Hurts: A Woman’s Guide to Banishing Sexual Pain.” “It is not only a great overview of the problem, but also helps women advocate for themselves within their

relationships and with their medical providers,” Kranz said. For further reading, “Sex Rx” by Lauren Streicher explores how decrease in estrogen levels can cause vaginal and vulvar thinning and dryness, among other reasons for sexual pain. “[Decrease in estrogen levels] is the most common cause for sexual pain for women past menopause,” Streicher said in an interview with In Good Health. She is a physician who serves as assistant clinical professor at Northwestern University’s Feinberg School of Medicine in Chicago. About half her patients experiencing sexual pain are younger women. More of those seem eager to seek treatment. Streicher said that many mature women don’t seek treatment because of stigma or belief that painful sex is a normal part of aging. “Everything is fixable,” Streicher said. “That’s not what women are hearing from their doctors.” For some, finding a good lubricant solves their problem. Personal lubricants include many formulations, so trying a few may be warranted. If the over-the-counter types don’t work, a doctor can prescribe medication to help. Some could relate to trauma of the muscular-skeletal structures or the soft tissue. During pregnancy, the tissues receive more blood flow and can become more sensitive. During the last trimester, the uterus can sit so low that sex hurts. After delivery and recuperation, moms may experience pain during intercourse for other reasons. Breast feeding women can experience tissue atrophy as they have high progesterone levels. In only the most rare cases does a patient need surgery to resolve her

Mothers Helping Mothers: Local Support Group Addresses Postpartum Challenges By Julie Halm

hen a mother is dealing with the tremendous changes that the birth of a child brings, who is better able to provide her with support than other mothers who implicitly understand the triumphs and pitfalls of the experience? Licensed mental health counselor Amy Creamer saw a need for more of that type of connection in the Buffalo area and so she founded the No Mother Left Behind support group a year and a half ago. The group, which meets monthly, provides professional advice in addition to peer support. The group welcomes all mothers who are experiencing difficulties following the birth of a child, whether or not they have been diagnosed with postpartum depression or anxiety. Page 18

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While it is an opportunity for mothers to unload some of their struggles, Creamer says that she aims to provide women with more than just a vent session. “I would say one of the central points is self-compassion. It’s a huge skill that we’re really crappy at in this culture,” said Creamer. Creamer Specifically, she cites social media sites such as Facebook and Pinterest for allowing motherhood to be portrayed in an unrealistic way and created an unhealthy standard for women to hold themselves to.

Creamer said that the group also focuses on mindfulness and understanding that even during the toughest moments, each point in parenthood is nothing more than a passing phase. “You’re going to struggle at every phase,” she said. “But we need to enjoy where we’re at, when we’re there instead of getting caught up in the rat race and the negativity.” While postpartum depression and anxiety the latter of which is, in fact, more common will pass with time, they can also strike mothers when they aren’t anticipating it. According to Creamer, these conditions can present any time in the first year and also effects moms who have already had children, and first-timers, alike. Being a mother to another child is always a new experience, complete with new challenges, she added.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

Physician Vanessa Barnabei, PhD, president and CEO of UBMD Obstetrics and Gynecology. sexual pain issues. Streicher recommends that women experiencing painful intercourse seek help from an expert in sexual pain or a menopause expert. “I’ve yet to have a woman with painful sex for whom I wasn’t able to alleviate the problem,” Streicher said. “Get yourself in the hands of someone who can help you. It may be a general gynecologist and maybe not. “If someone says there’s no solution, don’t believe it. Or if they’re dismissive and says, ‘This is a normal part of menopause,’ or that it’s normal after cancer of is a part of diabetes, don’t believe it.” Particularly since so many conditions can contribute to pain during intercourse, it’s important for physicians to take their time to fully evaluate the patient to determine the cause(s). While crying at the drop of a hat is, perhaps, the signature symptom, postpartum depression and anxiety can also cause irritability, loss of appetite, loss of interest in activities a person previously enjoyed and even insomnia. “I try not to pathologize,” said. Creamer. “If you’re a new mom, there’s a place for you to come.” No Mother Left Behind meets at 6 p.m. on the fourth Thursday of each month in the Piver Conference Room, 2121 Main St., Buffalo. Creamer encourages those interested in attending to join the Facebook group which can be found at www.facebook.com/nomotherleftbehind/ and to check that page for updates prior to each session. For moms in need of further support Creamer notes that her group meets at opposing intervals to the postpartum support group held from 7 to 8 p.m. on the second Thursday of every month in the Cancer Care Conference Room at Millard Fillmore Suburban Hospital, 1540 Maple Road, Amherst. Those looking for further information on No Mother Left Behind can contact Creamer at 862-1678.

Women’s Health Photos of a patient from A Natural Image Hair Studio in Buffalo. The business is one of several in Western New York that provides hair loss solutions. Photo courtesy of A Natural Image Hair Studio.

Women Can Address Hair Thinning Hair loss affects more than 40 percent of American women; problem may be more than an appearance issue, says dermatologist By Deborah Jeanne Sergeant

any men with thinning hair shave their heads or just accept thinning hair as part of middle age. For women, the social stigma surrounding hair thinning and hair loss can make the experience emotionally devastating. Forty percent of Americans with hair loss are women, according to the American Hair Loss Association. For most of them, it’s overall thinning, not the horseshoe-shaped pattern of baldness common to men with male pattern baldness. But they don’t have to resign themselves to thinning. “Female pattern hair loss is often one of the hardest things to deal

with,” said Melissa Mele-Delgado, an American Nurses Credentialing Center-certified nurse practitioner. Mele-Delgado has a doctorate of nursing practice degree and practices adult health at Neiman Dermatology in Williamsville. “It can be genetic, autoimmune or thyroid-related,” Mele-Delgado added. “The first part is to know if it’s organic problem or if it isn’t. If it’s organic, we find out what in the body is causing it and try to fix that underlying problem.” Causes could include physical stress, eating disorders, thyroid or hormonal disorders and childbirth. Discussing these possible factors could help find ways to decrease

Baby Yourself!

Discover local support systems to ease your way into parenthood By Jennifer Aline Graham

hile being a new parent can be terrifying, there are ways to find support in Western New York. Between putting together the crib, forcing your eyes open at night for feedings and squeezing in time for your own relaxation, parenthood can be more than overwhelming. Many new parents are unsure of how they can face their own anxieties while caring for their newborn and, at times, it may seem nearly impossible. What many new parents do not know is there are local groups they can easily connect with to help them build relationships with other parents and find support. By connecting with others who are new parents themselves, you can share advice, stories and find ways to support one another. Western New York has many different groups, events and meetings that allow new parents to show support to those facing a similar set of worries. “They host a lot of great events,” Jess Wheeler of Buffalo said regard-

ing the local group, WNY Mothers of Multiples. She has found this group to be an extremely helpful support system during her transition into parenthood. “In addition to play dates, they have ‘Mom’s Night Out,’ family activities, and monthly meetings. As a mom to twins, it’s hard to find people who get it like we do.” Like WNY Mothers of Multiples, there are many other groups you can simply find through social media outlets such as Facebook. Since some new parents are homebound after their baby’s arrival, cabin fever sets in and utilizing social media groups can sometimes be the best, and easiest, way to find support. “My Facebook app is the one I use most to access my favorite groups and link me with local parents. Gentle Parenting of WNY is my favorite,” said Kristen Macneil of Hamburg, a mother to two children. “It has been incredibly helpful in navigating behavior and development with my children.” Local groups and events are

shedding. Some types of medication may also cause thinning. Asking about alternatives could help slow shedding and restore what was lost. Androgenetic alopecia, commonly called female pattern hair loss, involves thinning on the top of the head. Women may notice their part seems wider than it used to. Usually, this happens gradually; however, an abrupt case can indicate a hormonal change. Mele-Delgado recommends minoxidil, available over the counter. “It maintains what is there,” she said. “In a small number of cases, there’s an increase with treatment like that. Propecia is specific to males, but some are dabbling in using it female populations. We don’t have a lot of literature so we’re not going there yet.” As another option, hair transplantation involves taking a strip of hairs from the back of the head, where the hair is thicker, and implanting them in the places where the hair is thin, Mele-Delgado explained. Another option to help those with female pattern hair loss is lightbased technology, delivered with a comb or cap to stimulate re-growth. Blood platelet injections have also shown good success, as a patient’s own blood cells are injected into the scalp skin to stimulate growth. Alopecia areata, an autoimmune disease, causes patchy hair loss on the head. Alopecia totalis bares the entire head and alopecia universalis causes all of the body’s hair to fall out. Some people see patchy regrowth and even times of remission with substantial re-growth. MeleDelgado said that the patchy hair

loss of alopecia is often treated with steroid injections into the places missing hair. Joanie Kumiega, licensed cosmetologist, member of the American Hair Loss Counsel and owner of A Natural Image Hair Studio in Buffalo, encourages patients to see a doctor to explore a medical possibility for their hair loss. She said that her office provides several types of hair loss solutions. They start with a scalp “facial” which she said, “is invigorating for the scalp. With continued use, you can definitely see hair re-growth.” The office also suggests taking biotin supplements to promote strength to the hair, although it won’t re-grow hair where the follicle has died. “A lot of people think a wig is the only option,” Kumiega said. “There are different options and many are much smaller and much more natural to non-surgically replace that hair.” Her office provides hairpieces made of synthetic or human hair, ranging from partial to full coverage, with temporary, semi-permanent and permanent bonding. Permanent models are bonded to existing hair, similar to how hair extensions are applied. Prosthetic adhesives ensure they cannot come off. Semi-permanent pieces are removed every three to six weeks for servicing and temporary ones may be removed by clients. A Natural Image offers private rooms for clients. “Every person has a story and they’re all beautiful human beings who deserve to be happy,” Kumiega said.

especially helpful when you have no one nearby to lean on or if you have recently moved to the area. The idea of exploring a new town or city can be terrifying. Adding the aspect of being a new parent in a new city only adds to that feeling of fright. Connecting with others who are in the same shoes allows you to feel more at ease during your transition into parenthood as well as your transition to a new city.

or at Sisters of Charity Hospital in Buffalo. She has had the opportunity to work with many new mothers and help guide them through the crazy ups and downs of parenthood. She also has had the privilege to be involved with the breastfeeding baby café at the hospital. “Baby cafes are a great resource for pregnant or breastfeeding moms. It is a drop-in, free program provided by lactation specialists who give moms the support in any aspect of breastfeeding. It can be a helpful tool for any mom,” Anderson explained of the very supportive atmosphere at the Sisters of Charity Baby Café. These types of social gatherings not only connect you with other supportive moms and professionals, they can inform you on up-to-date research about breastfeeding and other practices that can help you during your venture into parenthood. For more information on baby/ breastfeeding cafes, visit www. babycafeusa.org; or www2.erie.gov/ health/sites/www2.erie.gov. for Buffalo’s baby café’s Calendar.

They get it “I love having local women who have gone through my same struggles who can answer questions that are specific to our area,” said Abbe Michele of Amherst. Michele is the mother of 4-year-old twin boys and has found local groups, such as WNY Mothers of Multiples, to be helpful when learning to navigate Buffalo for parenting events and supports. Many parents utilize these kinds of groups to find pediatricians, hospitals or birth classes because members will give genuine, honest responses. Along with community groups and groups through social media, you also can find gatherings through your hospital and other support services — such as Women, Infants, and Children. Many hospitals and support service sites have breastfeeding or baby cafés where parents meet and discuss popular topics many can relate to. Jacquelyn Anderson is a registered dietitian and lactation counsel-

April 2018 •

Finding Them on Facebook Local groups that can be found through Facebook: — WNY Mothers of Multiples: www.facebook.com/groups/wnymothersofmultiples — Gentle Parenting of WNY: www.facebook.com/groups/gentleparentingwny

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Women’s Health Go with the Flow Painful menstruation cycles? Experts suggest way to cope with the problem By Deborah Jeanne Sergeant

en out of every 100 women experience menstrual pain that’s so intense that they cannot perform normal activities, according to the National Center for Biotechnology Information, U.S. in Bethesda, Md. But women can take steps to make menstruation easier. Knowing when it’s going to happen can help women plan ahead and stay prepared with products to deal with flow and cramps. The average cycle is 28 days long; however, it’s perfectly normal for a cycle to be as long as 36 days. To help anticipate the next period, Clue, Eve, Pink Pad, Flo, Period Tracker and other apps (all on iOS and Android) remind users of when to expect their period, along with other helpful tips. Raffaella Marcantonio, naturopathic doctor and co-owner of Natural Health Choices in Kenmore, advises women to eat a “Mediterranean” diet, rich in vegetables and low in estrogenic foods, which she said are sourced from animals. “There’s hormones in it because it comes from an animal, even if it’s

organic,” she said. “When you raise estrogen levels in the diet, you have a thicker lining in the uterus and women see more pain and bleeding.” Marcantonio said that quite a few supplements and herbs may ease symptoms. Magnesium can help take the edge off menstrual cramp pain, for example. “Magnesium is a terrific mineral,” she said. “One of the signs of low magnesium is cramping, like eye twitches, leg cramps and bad menstrual cramps. It also helps for anxiety and stress. We say to take magnesium, ‘to bowel tolerance’, so it’s better to have 600 to 750 mg. of the supplements throughout the day in small amounts.” Some recommend omega-6 and omega-3, evening primrose and milk thistle to also help with cramping, along with wild yam and black kohash. Women commonly take contraceptives to minimize menstruation, but Marcantonio advises against the practice. “By not shedding the lining, they’re raising the risk of cancer,” she said. Joseph A. De Nagy, doctor of

Boost Your Energy Busy routine has brought you down? Try a few things to get your energy back By Deborah Jeanne Sergeant

any women from their mid40s and older experience chronic low energy and

fatigue. Aside from the aging process, the responsibilities at work and home seem to peak around the 40s and 50s. School-aged children and teens need lots of time, as do elderly parents. Women are also in the most demanding part of their career as they’ve risen through the ranks but maybe not to the level where they have a personal assistant. At home, many women still perform the majority of household care and managing the family’s social life. “It does get harder with age to have lots of energy,” said Deanna DeSimone, nutritionist with UBMD Orthopaedics & Sports Medicine in Cheektowaga. “You get a cumulative effect with everything that’s going on.” While usually not immediately life threatening, fatigue can be related to stress, anxiety and depression. DeSimone said that it’s important to speak with a health care provider. That conversation should include discussing medication which can Page 20

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cause fatigue. Fatigue could signal a medical condition such as anemia, thyroid or autoimmune diseases. Better self care can help women reclaim their energy levels to better face everyday challenges and feel healthier. Of course, eating a variety of colorful produce, mostly whole grains, modest portions of healthful fat and sufficient protein is the first step in improving nutrition; however, DeSimone wants more women to stop skipping meals and relying on sugary coffee drinks for a morning boost. “Nutrition is good for energy levels,” she said. “All you put in your body is what you’ll have to run on. It sustains you.” Blasting through the midafternoon slump with an energy shot, fancy caffeinated drink or candy bar may work short-term, but it’s not healthful. “Limit the sugar and creamer you put in black tea or coffee,” she said. “Don’t do above two cups per day. Limit the size. If you go to Starbucks and get a latte, that might

osteopathy with UBMD ObstetricsGynecology and assistant professor in the department of obstetricsgynecology at the Jacobs School of Medicine and Biomedical Sciences at UB, said that using an oral contraceptive “does a very good job of controlling bleeding. With current formulations, women can skip their periods for several months with no ill effects.” He said that because the medication minimizes the growth of the uterus lining, there’s less to expel. An intrauterine device, a T-shaped piece of plastic inserted in the uterus, causes 20 percent of users to not bleed or experience menstrual cramps. One example, Mirena, is FDA approved for contraception and period control. It lasts up to five years. “It has fewer side effects than previous contraceptives and it does a wonderful job,” Nagy said. “Many women with it don’t have any noticeable period and no cramping. I prescribe more for bleeding management for women in late 30s and 40s than for birth control.” A non-hormonal medication that’s new to the US is tranexamic acid. Nagy said that it works by stopping the breakdown of blood clots to slow the bleeding of heavy periods. For women who want better means of dealing with flow, menstrual cups may provide an easy way to get long-lasting protection. Brands such as Luna Cup or Diva are made of medical-grade silicone. Users fold the cup in half length

wise, insert, and let it go so it resumes its previous shape while it forms a seal that prevents leaks and odors. The cup catches menstrual flow rather than absorbing it like tampons and pads. Many women can wear a cup up to 12 hours, depending upon her flow, without emptying it instead of changing a pad or tampon every few hours. Cups are reusable and longlasting, which saves both money and landfill space. “They’re a beautiful thing,” Nagy said. “They work well for women comfortable with the idea. Like any menstrual product, don’t leave it in too long. You also have to clean it between uses.” Nagy said that taking over-thecounter pain medication in advance of the period can lower inflammatory response. Using heating pads or microwavable rice bags may ease pain. While it may seem a good time to curl up on the sofa hugging a pillow, exercise may improve symptoms, since exercise releases endorphins, the body’s “feel good” hormone. A little pampering is also appropriate. Websites such as www.mylola.com and www. theperiodstore.com provide mailorder subscriptions for products helpful during menstruation; however, The Period Store includes both utilitarian and luxury items to make this time of month a little easier.

be not as great of a choice.” It’s important to remember that a serving of coffee or tea is eight ounces, not the giant cups offered by many restaurants. Instead, complex carbohydrates like oatmeal with fruit or eating protein and a vegetable, like carrots and hummus, provide a nourishing boost. In addition, most people need seven to nine hours’ sleep per night, a goal DeSimone said that most women don’t get. While exercising seems counterintuitive to people who have little energy, its effects include renewed energy. DeSimone said that exercise releases naturally occurring chemicals in the body that help women stay more relaxed and better able to sleep and Desimone sleep more deeply. “Generally, I tell clients to reduce stresses in their life,” DeSimone said. “That can play a role in maintaining weight or losing weight and feeling stressed can be exhausting. If you’re always worrying or on edge, that can reduce energy.” DeSimone is also a big believer in good sleep hygiene, including eschewing electronics before bedtime. Activities like watching stimulating shows or surfing the

internet right before bed can keep the mind busy so the body doesn’t sleep well. Low thyroid or adrenal issues can cause low energy. Raffaella Marcantonio, naturopathic doctor and co-owner of Natural Health Choices in Kenmore, said that eating seaweed can help improve thyroid function. Taking a B-complex supplement can also help improve energy, focus and concentration. Over-the-counter supplements ashwaganda and rhodiola can reduce inflammation. “Both of those have a calming effect. These women can start being irritable,” Marcantonio said. “Other adrenal herbs require a physician who knows what he’s doing, as there may be interactions.” By calming the body, women can get better sleep and feel more energized.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

Don’t miss the May issue of In Good Health. Golden Year’s Special

The Olear Team

Senior Real Estate Specialists

By Jim Miller

Sally Ball Conover, SRES, CBR

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How to Choose a Memory Care Unit Dear Savvy Senior, My mom has Alzheimer’s disease and has gotten to the point that she can’t live at home any longer. I need to find a good memory care residential unit for her but could use some help. Any suggestions?

Exhausted Daughter Dear Exhausted, Choosing a good memory care residential unit for a loved one with Alzheimer’s disease is a very important decision that requires careful evaluation and some homework. Most memory care units, sometimes called special care units, are housed within assisted living or nursing home facilities. At their best, they offer staff extensively trained in caring for people with dementia, individualized care that minimizes the use of dangerous psychotropic drugs, a home-like environment and activities that improve residents quality of life. But at their worst, they can offer little more than a locked door. Here are some steps that can help you find a good facility and avoid a bad one. n Make a list: To identify some good memory care residential units in your area ask your mom’s doctor for a referral, and use the Alzheimer’s Association online tool at CommunityResourceFinder.org. Make sure the facilities on your list are close to family members and friends who can visit often, because residents with frequent visitors usually get better care. n Research your options: Once you’ve made a list, contact your local long-term care ombudsman (see LTCombudsman.org). This is a government official who investigates assisted living and nursing home complaints and can tell you which facilities have had problems in the past. If you’re looking at a memory care unit within a nursing home facility, use Medicare’s nursing home compare tool (Medicare.gov/nursinghomecompare), which provides a 5-star rating system. n Call the facilities: Once you’ve identified a few facilities, call them to find out if they have any vacancies, if they provide the types of services your mother needs, what they charge and if they accept Medicaid.

n Tour your top choices: During your tour, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the current resident’s family members, if available. Also, find out about staff screening and training procedures, their turnover rate, and the staff-to-resident ratio. They should have at least one staff member for every five residents. Make sure the facility offers quality activities that can keep your mom engaged, even at night when she may be awake. Ask how they respond to residents who may wander or become aggressive. If the answer is locked doors and antipsychotic drugs, that’s a red flag. Because transitions can be unsettling for dementia suffers, make sure that your mom will be able to remain at the facility for the foreseeable future. And find out what, if any, health conditions might require your mom to leave the facility or move to a higher and more expansive level of care. It’s also a good idea to make multiple visits to the facility including an unscheduled visit at night or on weekends when the staff is more likely to be stretched thin. To help you evaluate your visit, the Alzheimer’s Association offers a checklist that you can access at ALZ. org/residentialfacilities. n Paying for care: The national average costs for memory care within an assisted living facility is over $5,000 per month, and over $7,500/ month for nursing home care, but costs can vary widely depending on your location. Since Medicare does not cover long-term care, most residents pay for care from either personal savings, a long-term care insurance policy, or through Medicaid (if available) once their savings are depleted. To help you research your financial options, visit the National Clearinghouse for Long-Term Care Information website at LongTermCare.gov.

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.

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For a private tour, call Kim 693-0420 705 Sandra Lane North Tonawanda, NY IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 21

Ask The Social

Security Office

From the Social Security District Office

What You Should Know About Enrolling in Medicare Parts A & B

nderstanding Medicare isn’t as difficult as you might think. It’s a benefit most working Americans can count on. Here are some facts you might not know about the program. n Can I still get Medicare at 65? Yes, you’re still eligible for Medicare starting at 65, no matter what year you were born. If you or your spouse worked and paid Medicare taxes for at least 10 years, you’re eligible for Part A (hospital insurance) at age 65 for free. Part A helps pay for inpatient care in a hospital or skilled nursing facility following a hospital stay. It also pays for some home health care and hospice care. You’re also eligible for Part B (medical insurance) if you choose to get it and pay a monthly premium. Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services. If you are receiving Social Security benefits already, you will be automatically enrolled in Medicare Parts A and B at age 65. Because you must pay a premium for Part B, you can choose to turn it down. However, if you don’t enroll in Part B when you’re first eligible for it, and choose to enroll later, you may have to pay a late enrollment penalty for as long as you have Part B coverage. If you’re not receiving Social Security benefits, you have a seven-month period (your initial enrollment period) to sign up for Part B. Generally, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after your birth month. n If you are covered under an employer group health plan, you may have a special enrollment period for Part B. If you are 65 or older and covered under a group health plan, either from your own or your spouse’s current employment, you may have

a special enrollment period during which you can sign up for Medicare Part B. This means that you may delay enrolling in Part B without having to wait for a general enrollment period and without paying the lifetime penalty for late enrollment. Additional rules and limits apply, so if you think a special enrollment period may apply to you, read our Medicare publication at www.socialsecurity.gov/pubs/, and visit the Centers for Medicare and Medicaid Services at Medicare.gov for more information. n To avoid a tax penalty, you should stop contributing to your Health Savings Account (HSA) at least six months before you apply for Medicare. If you have an HSA when you sign up for Medicare, you can’t contribute to your HSA after you your Medicare coverage begins or you may have to pay a tax penalty. Premium-free Part A coverage begins six months before the date you apply for Medicare, but no earlier than the first month you were eligible for Medicare. To avoid an unwanted tax penalty, you should stop contributing to your HSA six months before you apply for Medicare. You can withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses like deductibles, premiums, coinsurance, or copayments. If you’d like to continue contributing to your HSA, you shouldn’t apply for Medicare or Social Security benefits. n How Much Does Part B Coverage Cost? You are responsible for the Part B premium each month. Most people will pay the standard premium amount, which is $134 in 2018 if you sign up for Part B when you’re first eligible. This amount can change every year. You can find up-to-date premium amounts on Medicare.gov. You can learn more about Social Security and Medicare at www.socialsecurity.gov/benefits/medicare.

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Health News Anzalone named community outreach for St. Francis Park

Catholic Health announced the appointment of Wendy Anzalone to the position of community outreach liaison for Catholic Health’s new independent living facility for seniors, St. Francis Park in Hamburg. She will be responsible for business development and leasing the Anzalone St. Francis Park studio suite apartments. Prior to joining Catholic Health, Anzalone worked as the community relations coordinator and admissions marketing manager for Elderwood Administrative Services. She has more than 25 years of healthcare experience in the areas of senior housing, admissions and marketing for geriatric medicine, skilled nursing and subacute/ rehabilitative medicine. Anzalone received her Bachelor of Science degree in business management and economics with a concentration in healthcare administration from Empire State College. She is a resident of Lockport.

ECMC: Best for orthopedics, bariatric surgery Erie County Medical Center (ECMC) Corporation has been named as one of America’s best hospitals for bariatric surgery and orthopedics by the Women’s Choice Award. The bariatric surgery award signifies that ECMC is in the top 9 percent of 4,812 U.S. hospitals reviewed. The orthopedics award signifies that ECMC is in the top 11 percent of 3,230 U.S. hospitals offering orthopedic services. “These awards for bariatric surgery and orthopedics from the Women’s Choice Award affirm ECMC’s commitment to providing quality healthcare for those who seek our services.” Said ECMC Corporation President and CEO Thomas J. Quatroche Jr., Ph.D. “Reliable, quality care and positive patient experiences are our highest priorities, demonstrated by our more than 3,000 exceptional and skilled caregivers who are dedicated to providing true care to our patients.” The methodology for the bariatric surgery award is unique in that it combines national accreditations, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results and hospital outcome scores with primary research about women’s healthcare preferences. It is the only award recognizing excellence in bariatric surgery based

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2018

on robust criteria that consider patient satisfaction and clinical excellence. ECMC is one of 422 award recipients representing the hospitals that have met the highest standards for bariatric surgery across the U.S. ECMC achieved the America’s Best distinction by meeting the following criteria: accreditation by the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery joint-sponsored Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP); at least 72 percent of patients reporting on the HCAPHS survey that they would definitely recommend the hospital; a high patient safety ranking based on 11 Centers for Medicare and Medicaid Services’ measures of infection and complication rates. Regarding orthopedics, ECMC is one of 357 award recipients representing the hospitals that have met the highest standards for orthopedic care in the U.S. by the Women’s Choice Award. The methodology used to select ECMC as one of America’s Best Hospitals for Orthopedics evaluates Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results along with primary research about women’s healthcare preferences. Award recipients are also measured on their incidence of surgical complications and infections, including: a wound that splits open after surgery; accidental cuts and tears; deaths from serious treatable complications; rate of complications for knee or hip replacement patients; catheter associated urinary tract infections; methicillin-resistant Staphylococcus aureus (MRSA) infections. A hospital must have arthroscopy, joint replacement and spine surgery orthopedic services available to patients, onsite physical therapy, and an MRI in order to qualify for the award. It is the only award recognizing excellence in orthopedics based on robust criteria that consider patient satisfaction and clinical excellence.

Villa Maria College president to retire After 50 years of ongoing service to Villa Maria College and its thousands of students, faculty and alumni, Sister Marcella Marie Garus has announced her upcoming retirement, effective June 2018. A Buffalo native, Garus served for 40 years as Villa Maria College president, making her one of the longestGarus tenured presidents of a higher education institution both in both Western New

H ealth News York and across North America. Garus’ legacy at Villa Maria College began in 1968 through the role of business administrator, a position she held until her appointment as president in 1978. In this leadership role, her dedication to faith, education, student and faculty experience, community impact and continued institutional viability was a hallmark of her service. Some of Garus’s most notable accomplishments include: the transformation of Villa Maria College from an associate’s degree-granting college to a bachelor’s degreegranting institution—adding six associate degrees and 14 bachelor’s degrees; the leadership of college fundraising efforts resulting in millions of dollars raised to benefit students, and; launching of the college’s visionary plan, which yielded a 30 percent growth in enrollment and a 10 percent increase in retention. “Sister Marcella’s enormous contributions to Villa Maria College will be forever felt by so many within this community, and we’re incredibly thankful for all of her years of passionate, effective work,” said Catherine Grantier Cooley, partner, Hodgson Russ, LLP, and chairwoman of the Villa Maria College board of trustees. “Sister Marcella is a generational visionary, and the improvements she has continually made have not only kept the college going, but also primed us for future growth. As the search for our next president begins, we’re confident that the coming years will be bright.” “Villa Maria College was very fortunate to have such a dedicated leader at its helm for four decades,” said Robert D. Gioia, president of The John R. Oishei Foundation. “Sister Marcella’s vision to create a nurturing, student-focused, creative learning environment will make a positive impact on many Western New York lives for years to come. We believe the college will continue to prosper because of the strong foundation that Sister Marcella has laid.”

Ralph C. Wilson, Jr. Foundation launches Built to Play The Ralph C. Wilson, Jr. Foundation recently announced Built to Play, an initiative designed to give children and youth across Western New York and Southeast Michigan more opportunities for free play through the creation of new, interactive public play spaces. To fund and operate the initiative, the foundation will invest up to $5 million in each region over the next several years, to provide grassroots groups and nonprofits with support to create and maintain these play spaces within their neighborhoods. The foundation has partnered with the Tony Hawk Foundation, an organization focused on promoting high-quality, public skate parks in low-income areas throughout the

U.S., and KaBOOM!, a national nonprofit dedicated to giving all kids great, safe places to play, to work with communities across its two regions of focus on the development of various uniquely designed spaces. Tony Hawk Foundation has helped build more than 500 skate parks across all 50 states, while KaBOOM! has built more than 3,000 playgrounds throughout the country. The need for more safe, outdoor play options for youth in both rural and low-income neighborhoods throughout Western New York and Southeast Michigan was a key finding in the State of Play reports released in June 2017 by the Aspen Institute’s Sports & Society Program, in partnership with the Ralph C. Wilson, Jr. Foundation. The Built to Play initiative was developed as a response by the foundation to help answer that need by providing more access to free play through the development of innovative play spaces and skateparks. “Our vision with Built to Play is to create more opportunities and places of recreation that are owned and embraced by the kids and families they serve,” said Jim Boyle, vice president of programs and communications at Ralph C. Wilson, Jr. Foundation. “The Tony Hawk Foundation and KaBOOM! are experts in their respective fields and will do a wonderful job leading these collaborative efforts in our regions. We look forward to the day that more children within these communities can make active play a part of their daily life through these play spaces and skateparks.” Over the next several months, KaBOOM! and Tony Hawk Foundation will begin to immerse themselves in both regions to engage potential applicants to help guide them through the process and steps to create these spaces. The Ralph C. Wilson, Jr. Foundation is a grantmaking organization dedicated primarily to sustained investment in the quality of life of the people of Southeast Michigan and Western New York. The two areas reflect Ralph C. Wilson, Jr.’s devotion to his hometown of Detroit and greater Buffalo, home of his Buffalo Bills franchise. To learn more about Built to Play and the application process and eligibility for each opportunity, visit RWBuiltToPlay.org.

Catholic Health hospitals recognized for maternity care Catholic Health’s Sisters of Charity Hospital and Mercy Hospital of Buffalo have been named Blue Distinction Centers for Maternity Care as part of BlueCross BlueShield of Western New York’s Blue Distinction Specialty Care program. This designation recognizes birthing centers that deliver quality specialty care safely and effectively, based on objective, transparent measures of patient safety and health

ECMC Celebrates a Century of Care “Celebrating a Century of True Care” is the theme of the Erie County Medical Center Corporation celebration event held March 19 to celebrate 100 years of care for the hospital at 462 Grider St.. ECMC opened its doors March 19, 1918 as the Buffalo City Hospital. The hospital’s 100-year history is marked by three distinct phases corresponding to its three different names: (1) Buffalo City Hospital — 21 years (1918-1939); (2) Edward J. Meyer Memorial Hospital — 39 years (1939-1978); and (3) Erie County Medical Center — 40 years (1978-present). The original hospital consisted of three buildings of four floors each. Other buildings were added in successive years: three in 1922, an acute communicable disease building in 1923, a new psychiatric building in 1951, and the ECMC tower was erected in the 1970s. “We are honored and privileged in 2018 to commemorate the 100th anniversary of the hospital, recognizing all of the thousands of remarkable physicians, nurses and support staff who established the Buffalo City Hospital, nurtured it through the era of Meyer Memorial Hospital and today have continued the tradition at ECMC of delivering quality health care services for outcomes that were developed with input from the medical community. In addition to labor and delivery services and perinatal testing, the birth center at Sisters Hospital includes a Level III neonatal intensive care unit (NICU), while the center at Mercy Hospital includes a Level II NICU. Nearly four million babies are born in the U.S. annually, making childbirth the most common cause of hospitalization, and cesarean sections the most common operating room procedures, according to National Centers for Health Statistics and the Agency for Healthcare Research & Quality (AHRQ). In 2017, more than 6,000 babies were delivered in Catholic Health, with Sisters Hospital delivering more babies than any other hospital west of Syracuse. “There is a reason more families deliver their babies at Catholic Health than any other local provider,” said Aimee Gomlak, vice

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every patient who comes into our care,” said ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. “Ours is a remarkable history, punctuated by groundbreaking medical care and cutting-edge medical education that distinguish ECMC as a leading hospital for our region, state and beyond. We are pleased and honored to celebrate ECMC’s tremendous historical legacy.” The then-new Buffalo City Hospital included 415 beds and the resources to provide special care for tuberculosis patients and those with acute communicable diseases. And so began the century of health care services being delivered from ECMC’s campus on the East Side of the City of Buffalo. In planning for the future hospital in 1916, the architects Green & Wicks wrote in the publication The Modern Hospital, “The ideal hospital… will be so arranged, constructed, and administered as to make each patient realize on leaving that [their] stay has been made as comfortable and pleasant as possible”—a philosophy of care practiced each day by ECMC Corporation staff members throughout the organization and emphasized in its tagline—the difference between healthcare and true care.

president of women’s services for the Buffalo-based health system. “It’s about the quality and safety of the care provided by our skilled and caring doctors, nurses, midwives, and support staff; and the specialized services we offer all of which go into being named a Blue Distinction Center for Maternity Care.” The Blue Distinction Centers for Maternity Care program evaluates hospitals on quality measures for vaginal and cesarean delivery. “We are pleased that Catholic Health’s Mercy Hospital and Sisters Hospital have been recognized for their maternity care,” said physician Thomas Schenk, senior vice president and chief medical officer at BlueCross BlueShield of Western New York. “Having these nationally recognized centers in our BlueCross BlueShield network ensures the members we serve have access to high quality care.”

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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.

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