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Meet Your Doctor Physician Richard Charles, chief medical officer at General Physicians P.C., describes himself as the Energizer bunny. It’s not hard to figure out why
Clinical Trials There are more than 100,000 clinical trials conducted in the U.S. every year. Some websites can help find the right one
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Tips to Increase Male Longevity
Daith Piercing
SEPTEMBER 2018 • ISSUE 47
Special Needs Issue Starts on page 13
Exercise Really Can Chase Away the Blues … to a Point Page 2
Can it reduce migraine pain? Some say yes, but what do experts say?
Why You Should Eat Pears
Besides how refreshing and delicious a crisp pear can be, pears are a super source of fiber and a goldmine of phytonutrients
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Medicare, Explained Confused about all the options available through Medicare?
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Exercise Really Can Chase Away the Blues … to a Point E
xercise is good for your mental health, as long as you don’t overdo it, researchers say. An analysis of data from 1.2 million people in the United States found they reported 3.4 days a month of poor mental health on average. But those who were physically active had 1.5 fewer “down” days a month than those who were not active. Being active for 45 minutes three to five times a week was associated with the biggest benefit. Exercise had the greatest impact on people with diagnosed depression, the findings suggested. In this group, those who exercised had 3.75 fewer days of poor mental health a month than those who were inactive — 7.1 days versus 10.9 days. “Depression is the leading cause of disability worldwide, and there is an urgent need to find ways to improve mental health through population health campaigns,” said study author Adam Chekroud. He’s an assistant professor of psychiatry at Yale University. The study included 75 types of physical activity — from sports and exercise, to childcare, housework and lawn mowing. Team sports, cycling, aerobics
and going to the gym were associated with the largest reductions in poor mental health days, possibly because they reduce social withdrawal and isolation, the study authors noted. People who were active three to five times a week had better mental health than those who exercised more or less, according to the study published Aug. 8 in The Lancet Psychiatry. Thirty to 60 minutes of physical activity was associated with the biggest reduction in down days (about 2.1 fewer days each month). But exercising more than three hours a day appeared to be worse for mental health than not exercising at all, the researchers said. The associations seen in the study don’t prove a cause-and-effect relationship, however. “Previously, people have believed that the more exercise you do, the better your mental health, but our study suggests that this is not the case,” Chekroud said in a journal news release. Exercising more than 23 times a month or for more than 90 minutes at a pop was linked to poorer mental health, the researchers said. The links appeared to be universal.
“Exercise is associated with a lower mental health burden across people no matter their age, race, gender, household income and education level,” Chekroud said. “Excitingly, the specifics of the
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
regimen like the type, duration and frequency — played an important role in this association.” Researchers hope to use the information to personalize exercise recommendations.
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. 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)。
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
BlueCross BlueShield of Western New York Announces Blue Fund No Wait at This ER
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ired of spending hours in a stuffy, overcrowded emergency department waiting room? Kaleida Health has the solution: Online emergency department check-in, and it’s reinventing the way to access ER care. Now you can check in for your projected treatment time at www.kaleidahealth.org, arrive at DeGraff Memorial Hospital or Millard Fillmore Suburban Hospital at your designated time, and be promptly seen by a healthcare professional using an innovative online service. “Our patients deserve more respect for their time in the emergency department,” said Darcy Craven, president of DeGraff Memorial and Millard Fillmore Suburban Hospitals. “Once a prospective patient receives a projected treatment time online at www. kaleidahealth.org, he or she can wait in the comfort of their own home rather than sitting in the waiting room. Once they arrive, it’s our commitment to make sure they are promptly seen by a healthcare professional.” Online emergency department check-in is not an appointment or reservation service, as the nature of ER triage does not allow for the scheduling of medical treatment. Online emergency department check-in estimates treatment times based on facility conditions and allows its users to wait from the comfort of home, rather than the waiting room. Online check-in users do not skip the ER wait, nor will they be seen ahead of individuals in the waiting room. In the event of a projected treatment time delay, online check-in users are sent real-time notifications via phone call and email so they can continue waiting at home. “Online check-in is only intended for individuals with non-life-threatening medical conditions,” Craven added. “It’s a simple and convenient way for people with busy lives and busy families to conveniently access care for minor medical needs. If you’re in doubt about the severity of your condition, you should always seek immediate care.” The system is designed to flag symptom keywords that may indicate life-threatening or debilitating medical conditions. Those patients are prompted to dial 911 or go immediately to the nearest ER. Furthermore, symptoms are continually reviewed by a healthcare professional at Kaleida Health during the check-in process.
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Grant giving will focus on health, children and education for clinicians
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lueCross BlueShield of Western New York recently announced the creation of the Blue Fund, a new health-focused grants program. The Blue Fund will award major grants in Western New York, totaling approximately $1 million to $3 million annually, to organizations and initiatives that have a positive impact on key health areas. These include behavioral health, cardiovascular health, diabetes, health care workforce development, healthy children and the opioid epidemic. The leadership team at the health plan working closely with the BlueCross BlueShield board of directors determined these areas have the highest impact on the overall health and well-being of the community. The decision was based on public health studies, the health plan’s own claims data and input from community leaders. The Blue Fund, which is part of an expanded giving strategy based on the board’s recommendation, the stability of the health plan and a strong reserve position, serves as a new source of grants that will enhance BlueCross BlueShield’s longstanding corporate citizenship of partnerships and sponsorships. Blue Fund grants will invest necessary dollars to programs and projects that align with the focused health
areas, are ready for implementation, and will demonstrate enhanced measurable outcomes for community health metrics. Grants will also serve to enhance visibility for awarded programs and projects by leveraging the important role BlueCross BlueShield serves in the region as the longest-standing and strongest health plan. The Blue Fund will complement, and not replace, the current corporate giving program of partnerships and sponsorships which saw community investments of more than $2 million in Western New York in 2017. “At BlueCross BlueShield of Western New York, we’re proud of our longstanding commitment to our community,” said David W. Anderson, BlueCross BlueShield president and CEO. “The Blue Fund gives us another tool to make meaningful and impactful investments in projects and initiatives that build on the tremendous momentum in our region and improve the health and sustainability of our community.” In conjunction with the establishment of the Blue Fund, BlueCross BlueShield of Western New York announced that Michael Ball, a seasoned community development leader, will lead the launch and overall management of the health plan’s initiative.
A lifelong Western New York resident, Ball joins BlueCross BlueShield from Empire State Development (ESD) where he most recently served as regional director. He also served as executive director of the Western New York Regional Economic Development Council, and was charged with strategic planning and local implementation of the state’s annual funding competition. Prior to joining ESD, Ball served as director of planning and implementation and director of the Healthy Communities Initiative for the Buffalo Niagara Medical Campus. Ball received a master’s degree in urban planning and certificate of specialization in economic development planning from the University at Buffalo, and a bachelor’s degree in political science and urban studies from Canisius College. Inaugural Blue Fund recipients as well as the 2019 grant cycle submission and selection process will be announced prior to the end of 2018 at bcbswny.com/bluefund. For information on the health plan’s current guidelines for corporate giving (sponsorships and partnerships), visit bcbswny.com/ communitysupport.
ECMC Kidney Transplantation Gets $1.2 M Grant
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he U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) has awarded a $1.2 million grant ($400,000/ year for three years) to ECMC’s Regional Center of Excellence for Transplantation and Kidney Care for social and behavioral interventions to increase solid organ and tissue donation. “This important HRSA grant will further enhance ECMC’s Regional Center of Excellence for Transplantation and Kidney Care ability to provide the gift of life to patients seeking a critically important kidney transplant,” said Thomas J. Quatroche Jr., Ph.D., president and CEO at Erie County Medical Center (ECMC) Corporation. To date this year, 90 kidney transplants (seven living donor; 83 deceased donor) have been performed at ECMC compared to 71 kidney transplants (nine living donor; 62 deceased donor) through Aug. 1 last year. It’s expected that the total number of kidney transplants performed at ECMC in 2018 will exceed last year’s total. “We greatly appreciate this grant from HRSA,” said physician Liise Kayler, program director. “Living-donor kidney
Physician Liise Kayler transplantation is the most successful form of renal replacement for patients with kidney failure. Despite increasing availability of information about living kidney transplantation and donation, there remains a vast chasm between what professionals know and what patients understand. We intend to close the information gap by developing an effective means of communication and explanation that we anticipate will result in improved understanding and informed decision-making about organ donation that could benefit eligible patients whose lives can be saved through kidney transplantation,” said Kayler. A significant barrier to transplant
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
is the shortage of donated kidneys. Adults with kidney failure have two treatment options for survival: dialysis (a machine that filters harmful wastes, salt, and excess fluid from the blood) or a kidney transplant. For those who are eligible, a kidney transplant allows patients to live longer and healthier lives compared to dialysis. Patients are encouraged to find a living donor for their kidney transplant because a kidney from a living donor typically lasts significantly longer than a kidney from a deceased donor. While a live donor kidney transplant is the best option, many patients have difficulty asking others to consider being a living donor. Developing innovative ways to inform and empower kidney failure patients and their close relations (relatives and friends) can equip them with essential knowledge and self-efficacy to fully understand the benefits and risks of living kidney transplantation and donation to make informed decisions. The goal of this grantfunded project is to develop a comprehensive, understandable, literacy-appropriate video module that improves informed decisionmaking among kidney failure patients and their close relations, according to ECMC.
Ranked 3rd Largest Medical Group in 2018 by Buffalo Business First
www.gppconline.com
Helping You Live Your Best Life.
Providing comprehensive health care for you and your family.
Convenient locations all across Western New York Richard Charles, MD Internal Medicine Office: (716) 248-1420 11 Summer St., 2W Buffalo, NY 14209 Office: (716) 248-1420 5959 Big Tree Rd. Orchard Park, NY 14127 Maritza Baez, MD Family Medicine Office: (716) 248-1420 237 Linwood Ave., Floor 2 Buffalo, NY 14209 Thomas Cumbo, MD Internal Medicine & Infectious Disease Ashley Kremer, DO Osteopathic & Family Medicine Kierann Toth, MD Family Medicine Office: (716) 631-8400 705 Maple Rd., Ste. 300 Williamsville, NY 14221 Thomas Dilamarter, MD Jennifer Yerke-McNamera, MD Family Medicine Office: (716) 260-1593 5959 Big Tree Rd., Ste 107 Orchard Park, NY 14127 Eugene Kalmuk, MD Internal Medicine Office: (716) 608-6116 290 Center Rd., Ste 206 West Seneca, NY 14224 Kathleen King, MD Marcy Masyga, DO Family Medicine Office: (716) 592-3600 230 S. Cascade Dr. Springville, NY 14141
Christian Lates, MD Ritu Sood, MD Internal & Family Medicine Office: (716) 626-5840 2701 Transit Rd., Ste. 143 Elma, NY 14059 Tat Sum Lee, MD Richard Milazzo, MD Family Medicine Office: (716) 363-6960 3898 Vineyard Dr., Ste. 1 Dunkirk, NY 14048
Esfandiar Mafi, MD Family Medicine Office: (716) 932-7776 1000 Youngs Rd., Ste. 106 Williamsville, NY 14221
Office: (585) 591-2186 3325 East Main Street Attica, NY 14011
Anthony Perna, MD Internal Medicine Office: (716) 874-4060 1430 Colvin Blvd. Buffalo, NY 14223 Jennifer Ruh, MD Internal Medicine Office: (716) 508-4040 3725 N. Buffalo Rd. Orchard Park, NY 14127 Nisha Sharma, MD Lauren Steinmetz, MD Family Medicine Office: (716) 646-5500 5844 Southwestern Blvd., Ste. 500 Hamburg, NY 14075 Rohini Thodge, MD Pediatrics Office: (716) 363-6960 3898 Vineyard Dr., Ste. 3
Dunkirk, NY 14048
New patients welcome For more information visit www.gppconline.com September 2018 •
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James Panzarella, DO Family Medicine Office: (716) 833-2200 1208 Niagara Falls Blvd. Tonawanda, NY 14150
Thomas Madejski, MD Internal Medicine Office: (585) 798-3345 100 Ohio St. Medina, NY 14103 Office: (585) 589-1322 243 South Main St., Ste. 105 Albion, NY 14411
Ripple Marfatia, MD Internal Medicine Office: (585) 493-9230 5596 Route 19A Castile, NY 14427
Leia Ince-Mercer, MD Internal Medicine Nicholas Masyga, DO Osteopathic & Family Medicine Office: (716) 646-2590 5470 Camp Rd., Ste. 200 Hamburg, NY 14075
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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8/20/18 11:47 AM
Meet
Your Doctor
By Chris Motola
Number of Opioid-Addicted Women Giving Birth Quadruples
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he number of pregnant women addicted to opioids as they give birth has more than quadrupled since 1999, a disturbing new report shows. In 2014, for every 1,000 hospital deliveries, 6.5 were mothers who arrived at the hospital with opioid use disorder, up from 1.5 per 1,000 in 1999, the U.S. Centers for Disease Control and Prevention researchers found. This increase is likely linked to America’s ongoing opioid epidemic, said study co-author Jean Ko, an epidemiologist with the CDC’s division of reproductive health. “With the opioid overdose epidemic, it’s natural to see increases in opioid use disorder among the general population,” Ko said. “Our data tell us that women presenting for labor and delivery are no different.” Opioid use during pregnancy has been tied to maternal death during delivery, stillbirth and preterm birth, the CDC researchers noted. Even babies born healthy might have to go through opioid withdrawal, a condition known as neonatal abstinence syndrome (NAS). Babies with NAS can experience tremors, convulsions, seizures, difficulty feeding, breathing problems, fever, diarrhea and trouble sleeping, according to the March of Dimes. The CDC study used data from the Agency for Healthcare Research and Quality, focusing on 28 states with at least three years of data available for analysis. Between 1999 and 2014, all 28 states saw significant increases in opioid-addicted pregnant women entering labor. Vermont and West Virginia had the most cases of opioid-affected pregnancies in 2014. Vermont had 48.6 cases for every 1,000 deliveries; West Virginia had 32.1 cases per 1,000. On the low end, Nebraska had 1.2 cases per 1,000 and the District of Columbia had 0.7 per 1,000. The average annual rate increases were highest in Maine, New Mexico, Vermont and West Virginia. Those states all had growth of more than 2.5 cases per 1,000 each year -- six times higher than the national average of 0.4 cases per 1,000. The states with the lowest increases were California and Hawaii, with fewer than 0.1 new cases per 1,000 each year.
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Richard Charles, M.D. Chief medical officer at General Physicians — describing himself as the Energizer bunny — talks about electronic medical records, how his group is advancing community’s health, and how he juggles administrative and clinical duties Q: Can you give a rundown of what General Physicians, PC is? A: General Physicians is an employed group of physicians with Great Lakes Health, which includes Buffalo General and ECMC. We have some association with the University at Buffalo. We are in most of the eight counties of Western New York with a special emphasis in cardiology and primary care. We also have gynecology, orthopedics, oncology, pulmonology and we’re expanding rapidly into our subspecialities. So we’ve had a tremendous period of growth since I took over as chief medical officer in June 2015. I think the idea of an employed group of physicians that is in place to support outpatient initiatives of the Great Lakes Health System and what’s in the best interests of the community’s health. What you see with our organization is a group of docs and administrators who are about achieving goals that advance the community’s health. We’re physician-led but patient-centered. Q: You’ve played a role in how your group handles electronic medical records (EMRs). What changes have you made? A: When I started, we had one electronic platform which we spent a great deal of time optimizing for our docs. It’s now become the goal of the system to have one electronic platform across as much of the community as possible, so across Great Lakes, across UBMD, Kaleida. So if you come into one of my offices and then go to Buffalo General, they’re able to get your information seamlessly. So we’re an integral part of that process. I’ve been reviewing the new EMR for over a year. I think it’s in the community’s interest to have one platform. It improves the patient experience and avoids duplication of services, so it’s just a very exciting thing for the community. Q: Is this being spurred by the state’s move toward health
homes? A: Our organization and all of our locations are certified patientcentered medical homes. This is kind of a different thing, but it will make this process easier. Another office that uses a separate EMR and wants that patient’s weight will have a delay. I may not know in real time what’s going on. Honestly, what we’re working on now is what I thought EMRs were going to be when they were put in place 20 years ago. We have 28, 29 platforms in our community. And even the one we have, there are versions of it that don’t communicate. We’re doing all this electronic stuff and none of it communicates. To think that we’re going to have one platform for as many offices as want to participate is just a very exciting thing to me. Q: I imagine this fragmentation leads to a lot of duplication of services. A: There’s no question. Think about how helpful it is, say, for your eye doctor to have all your labs, your consults available. It’s just an exciting opportunity to improve your overall health. Q: I understand that the trend is for new physicians to join group practices like yours. What would be your sales pitch to those doctors? A: I think there are a couple unique things we have. The EMR is one of them, but I think it’s also just leadership. If you look at the Great Lakes Health leadership, you see a group of leaders who are committed to doing the right thing for the community. I think we take a lot of business backend off, the business end of things. We’re here to support the docs. There’s just more ability to do things when you’re supported by a hospital system. We’re
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
providing services for practices. So you can make a real difference and focus on patient care when you’re not worried about the backend. Q: What got you interested in an administrative role? A: I think it was the Great Lakes leadership. These are guys who just seem like they’re trying to do the best for their community, trying to bring a clinically integrated network, which is GLIN (Great Lakes Integrated Network) where you have this shared common EMR. You have a collaboration between health care systems and university involvement, you have a great unified approach to managing patient care. So it’s a very exciting opportunity to be a part of that, as a provider who has been practicing 20 years. It’s really cool. Q: Were you with the General Physicians from the start? A: No, interestingly the company was started on the small end with a couple practices. It was a way for Kaleida to support some remote practices that needed some help. And the decision was made to really move into this venue as an integrated network. So it’s kind of been an evolution. We’ve just hit a critical mass where we can really make a difference. Q: Do you see this as a model for other communities across New York? A: So if you look at Rochester, Cleveland, Pittsburgh, the model has moved into this employed model, where the hospital systems support the major practices. But now as a major practice, we’re able to go into the outlying communities and support practices there. We pushed cardiologists down into Bradford. We’re getting engaged with Dunkirk and eastern Niagara. We’re just a small piece of the outpatient support system. Q: How are you dividing your time between administration and practice? A: It’s not so much dividing. I love practicing, so I practice all day, every day. I’m kind of like the Energizer bunny. When I get done talking to you, I’ll be doing other phone calls. I’ve been going since about 4 o’ clock this morning. Q: You must! You’ve got a big family too. My understanding is that you have five children. A: I enjoy being a dad as well. I dropped my son off at 5 o’clock this morning to go summer camp up in the Adirondacks. My family is my hobby, as my wife would say. I feel really blessed.
Lifelines
Name: Richard Charles, M.D. Position: Chief medical officer at General Physician PC. Also serves as chief medical informatics officer and chief quality officer, as well as a fulltime practicing board-certified internal medicine physician Hometown: Akron, NY Education: University at Buffalo (School of Medicine and School of Pharmacies) Affiliations: Great Lake Health Organizations: Erie County Medical Society Family: Married, three children, two stepchildren Hobbies: Investing in his nephew’s ice cream store
U.S. Murder, Suicide Rates Climbing Again
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fter a period of steady decline, homicides and suicides are on the rise again in America, new statistics show. Experts believe the opioid addiction crisis may be at least partly to blame. Researchers tracked data from a national injury-reporting database and found that, especially between 2014 and 2016, the homicide rate climbed sharply for blacks, while suicide rates rose steadily for whites. Rates of deaths from accidental injuries -— things like traffic fatalities or falls — have also charted a steady rise in recent years, said a team led by physician Angela Sauaia, of the Denver Health Medical Center. “The data demonstrate alarming upward trends in both violent and unintentional injuries,” her team
reported Aug. 1 in the journal JAMA Surgery. There were “large, significant increases from 2014 to 2016, reducing survival gains observed since 2001,” the researchers added. The study authors couldn’t pinpoint reasons for the trends, but one expert who has seen the tragic results of violence offered up his theory. “The opioid epidemic may play at least part of the role for the increase in murders and suicides observed from 2014-2016,” said Robert Glatter, an emergency department physician at Lenox Hill Hospital in New York City. “The increase seen in fentanyl-laced heroin may explain some of the uptick seen in firearm murders, suicides as well as unintentional injuries, he said. According to the new study,
America’s homicide rate was actually on a slow but steady decline until about 2014, when that trend reversed and began a sharp rise among blacks. Early in 2014 the homicide rate for blacks was about 18 deaths per 100,000 people, but by the end of 2016 it had jumped to about 23 per 100,000, the study found. While homicide rates remained relatively unchanged among whites (about three deaths per 100,000), suicide rates for this group have seen a steady, significant rise, Sauaia’s team reports. From a low of 12 suicide deaths per 100,000 in 2000, these tragedies rose to almost 17 per 100,000 by the end of 2016. Suicide deaths remained largely unchanged between 2000 and 2016 for blacks and Hispanics, however, at about 6 per 100,000, the study found.
The researchers noted that two-thirds of homicides and about a half of suicides involved guns, and gun-related deaths have spiked in recent years. “The continued availability of access to guns, and spikes in violence associated with drug trafficking could be behind the uptick in murders and suicides,” Glatter said.
Healthcare in a Minute By George W. Chapman
Investments Show Telehealth Growing — and It’s Here to Stay
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f insurance companies are investing in or partnering with telehealth companies, then you know telehealth or virtual medicine has arrived. Historically, physicians have been somewhat reluctant to embrace telehealth primarily because of low reimbursement. However several factors are contributing to a change of heart including an aging and less mobile population, consumer preference, improved IT security, the continuing shortage of physicians and value or outcomebased reimbursement from Medicare, Medicaid and commercial carriers.
CIGNA and Health Care Service Corporation just invested $50 million with telehealth company MDLive, and Anthem has invested $365 million in Samsung and American Well telehealth companies to make virtual visits available on Galaxy mobile phones. Insurance companies are lowering copays and fees for telehealth/virtual visits to cut into expensive and often unnecessary visits to urgent care centers and emergency rooms. They are focused on providing their members with choice, personalization and affordability.
Senior bankruptcy Three percent of seniors will file for bankruptcy this year, and it is a steadily increasing percentage of all bankruptcies. There are several factors for this: more people are retiring from companies that no longer provide pensions, credit card debt, bad investments, lack of planning and an unforeseen calamity. But the looming reason behind most senior bankruptcies is medical debt. Medicare covers 80 percent of physician claims and some drug costs. A chronic condition, serious illness, accident and outof-pocket drug expenses can easily wipeout hard-earned savings. Focus on patients As the industry transitions to value/outcome based payments, hospitals and physicians are transitioning from being “treatment-centric” entities to “patient centric” entities. Their focus is on attracting, engaging, managing and retaining patients. In order for this to succeed, as patients, we must bear more responsibility for our care. Providers are implementing strategies to make it easier for us to stay in touch, be informed and be
proactive versus passive in our care. Patient portals, wearable devices, telehealth, patient education programs, specifically targeted information sent directly to your phone, navigators and digital apps are all there to strengthen the relationship. In addition to a patient focus, healthcare systems must eliminate wasteful practices, many of which were driven by fee-for-service or volume incentives, and rely more on data and analytics to manage their patients and their bottom lines. Fewer docs feel overworked According to a recent survey of 3,700 physicians sponsored by two large MD staffing agencies, fewer physicians feel overworked or are considering retiring early compared to just two years ago. While the survey is somewhat heartening, physician burnout is still a serious issue. • 56 percent of respondents said they feel overworked; • 55 percent say they have less free time than when they first started practicing; • 48 percent of physicians said they spend less time with patients
now than when they first started; • 74 percent of the physicians responding said they recognize the signs of burnout in their colleagues; • 40 percent said burnout effects their job satisfaction and family life; • Only 17 percent of physicians suffering burnout have sought help. The study did not attribute the slight “improvement” in results to anything. One reason for the improvement could be that physicians are getting used to and less frustrated with electronic medical records. Many physicians report spending several hours after work and on weekends keeping their records up. Market consolidation Bigger is better, especially at the negotiating table. In order to get the upper hand at the negotiating table, hospitals are merging with other hospitals while insurers are merging with other insurers. In order to preserve competition and protect consumers from monopolistic pricing, the Department of Justice must approve and then monitor all mergers. While the common justification for both hospital and insurance mergers is cost reduction, it hasn’t always been the case. The DOJ has split apart mergers when the larger hospital or insurer proceeded to take advantage of their newfound clout in the market and raised prices. According to the Commonwealth Fund, 90 percent of metropolitan statistical areas (MSAs) are either “highly” or “super” concentrated provider (hospital) markets and that 54 percent of MSAs were highly concentrated insurance markets. Provider concentration was higher than insurance concentration in 58 percent of MSAs. Premiums have increased and provider choices have decreased across the board for most Americans, not just those covered by the ACA. Millennial caregivers A recent article in the Wall Street Journal presented an alarming trend. As the US population grows older, accelerated by aging baby boomers, the age of the average care giver
September 2018 •
grows younger. An estimated 6.2 million millennials account for 24 percent of unpaid caregivers, averaging 21 hours a week caring for an elderly parent, grandparent or in-law. One-third of millennials are caring for someone with dementia. By 2050, it is estimated that potential caregivers will increase by only 13 percent while those requiring their care will increase by 160 percent. The places a tremendous personal and financial burden on younger generations who are building their careers and starting their families. Short-term health plans Under the Affordable Care Act, short-term plans were limited to just three months. They were offered primarily to bridge the time one had to wait until the next open enrollment period. The Trump administration has recently finalized a rule allowing insurers to offer short-term plans covering 12 months and then renewable for two more years. These purported “affordable plans” do not have to cover pre-existing conditions or the essential health benefits that were the hallmarks of the ACA. So buyer beware. According to HHS Secretary Alex Azar, “Under the ACA, Americans have seen insurance premiums rise and choices dwindle.” The problem with that statement is health insurance premiums have risen and choices have dwindled for all Americans. Just ask any employer that pays for most of the premium. The ACA is simply a microcosm of the entire health insurance industry. 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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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Don’t just survive on your own ... THRIVE! Here are six success strategies for living alone and finding contentment
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o you live alone? If so, here’s a follow-up question for you: Are you just surviving or are you thriving? There’s a huge difference, of course. Merriam-Webster defines surviving as “continuing to exist.” Thriving means “to grow and develop well and vigorously.” Fear of change or the unknown can keep you stuck in survival mode. Or perhaps it’s lethargy or out of habit that you find yourself just putting one foot in front of the other to make it through your day. That was the case for me after my divorce, until I got tired of the same ol’ same ol’ and wanted to get more out of life. I wanted to experience more, to feel more and to connect more with others. I wanted to find meaning and purpose in my life. Is there something bigger and better out there for you? Inspired
by the word “THRIVE,” here are six success strategies for living alone and finding contentment. Think differently Your beliefs determine the life you have. If you don’t like the results you are getting in your life, take a look at changing the beliefs that are producing those results. You have a choice. Choose to focus on your strengths, your gifts, and this unique opportunity to define what you want out of life and then to create a life that is consistent with your goals and values. Help yourself When you live alone, you need to become your own “nudge,” your own motivator and cheerleader. Setting goals is a wonderful and very effective way to give your life direction and purpose. Goals can put passion into
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everyday existence. Goals should be written down; expressed in positive, affirming language; assigned a deadline; be achievable; and reviewed regularly. Rediscover and reconnect A key to living alone successfully is to determine who you are and what you really want for your life. No “shoulds” or other people’s agendas. Identify those things that fully engrossed you as a child or that today completely consume you — those things that make you feel whole, as though nothing is missing. These are your “loves” and they reveal your true self. When you live your life consistent with these loves, you’ll feel less alone, more energized and alive. Invest in your future On your own or with help, there’s no time like now to find out where you stand financially and where you want and need to go. Start today to align your spending with your values, to “find your stuff,” and to create a plan to protect your future. Peace of mind and a sense of empowerment are the rewards for those who come out from under the covers, ask for help if they need it, and get their financial house in order. Vow to banish negative thinking Negative thinking can get in the way of your goal to feel better and to have the life you want. Take deliberate action when negativity creeps into conscious thought: (1)
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just turn it off, or (2) give yourself a limited amount of time to dwell on a negative thought and then move on, or (3) replace a negative thought with a positive one or (4) repeat a personal and positive affirmation. Letting go of old ways of thinking, of a negative self image, of anger, of regret or any self-limiting thought or behavior will free you up to embrace your new life and the possibility of feeling whole and complete on your own. Embrace the possibilities You have an opportunity in front of you — an opportunity that many people never have the chance to experience. Today you can, perhaps for the first time ever, fashion a life that reflects your dreams, your style, and your true self. It can be a precious gift — this time of rediscovery and renewal. Embrace it. When that happens, living alone becomes secondary to living fully. Surviving becomes thriving!
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Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women held throughout the year in Mendon. To purchase her new book “Alone and Content” visit Amazon.com. For information about her upcoming workshops or to invite her to speak, visit aloneandcontent.com, call 585-624-7887, or email gvoelckers@ rochester.rr.com.
s d i K Corner
School Prep Includes Planning Allergy, Asthma Management
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llergies and asthma can make the start of the new school year a challenge for kids who aren’t prepared to deal with flareups, an allergist warns. “Every age group is different in how much they can handle when it comes to protecting themselves from flare-ups due to allergies and asthma while at school, as well as severe allergic reactions from food allergies,” said physician Bradley Chipps. He is president of the American College of Allergy, Asthma and Immunology (ACAAI). “But every student wants to feel good and be free from their triggers when they’re away from home,” he added in an ACAAI news release. Here are tips from the organization that can help: Page 8
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• Children from pre-kindergarten to fourth grade. These young students need their parents to speak on their behalf. Talk with your child’s teachers before school starts to inform them of your child’s allergies and the kind of reaction they might have to allergens in the classroom. Meet with the school nurse and administrators to create a health plan for your child. Also, tour the classroom to identify possible allergy triggers, such as wall-to-wall carpeting or a class pet. • Children in grades 5 to 8. At this age, children can likely speak up for themselves about possible allergens in the classroom, cafeteria or other areas of the school. But when you fill out your child’s school
registration, be sure to note if they have allergies or asthma, need to carry medications or need to avoid certain foods. All states allow students to carry and use medications for asthma and severe allergic reactions. Your child should know how to use these medications in an emergency. • High school students. Teens probably know how to handle their allergy and asthma medications, but they may be too self-conscious to carry or use them.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
Parents of high school students should encourage them to regard self-care as a “next step” in their journey toward independence. • Going off to college? Young adults will have to assume much more responsibility for managing their allergy or asthma. For example, he or she might need to contact school administrators to discuss necessary arrangements for dorm living and meals. Students who will be living far from home may have to find a new allergist and pharmacy.
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Tips to Increase Male Longevity
Men’s Health
“Stress management helps 8. us maintain optimal adrenal function. It’s population-based data.
People who stay stressed tend to develop chronic diseases. “I’m skeptical that any supplement or pill is likely to increase longevity. A few preventive dietary supplements can help maintain better health. I recommend co-enzyme Q10, fish oil, a multivitamin, and vitamin D in winter for healthy people. Taking these increases the likelihood of staying in good health, but not longevity. They likely decrease morbidity but don’t decrease the mortality rate.” • Physician Sanford Levy, practices integrative medicine in Buffalo.
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By Deborah Jeanne Sergeant
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he average New York male has a life expectancy of 77.92 years, according to www.worldlifeexpectancy.com, compared with 82.79 for women. It’s understandable that men’s life expectancy tends to be shorter than women’s. Many maledominated occupations such as commercial fishing, forestry, farming, construction and electric line workers tend to be high risk occupations. Men also tend to engage in riskier hobbies at higher rates than women and riskier behavior in general, such as performing stunts, smoking and using illicit drugs. Men don’t tend to maintain regular doctor visits and ask about health screenings. Three local doctors offer suggestion for a longer and healthy life
Work on cancer prevention. One out 1. of nine men are diagnosed with prostate cancer and that can impact
men’s health because of chronic morbidity and coping with the disease aftermath. Healthy weight and diet are important for cancer prevention. A few anti-inflammatory things can help, like improving vitamin D and vitamin E levels. Eat enough eggs, fish and fortified foods like milk. Relatively safe exposure to sunlight helps with D. Lypocenerich foods like tomatoes, watermelon and apricots show good association
with improving men’s help and suppressing things that stimulate cancer growth. “Omega-3 fatty acids show variable evidence at this point in reducing risk of heart disease and prostate cancer. There’s low relative risk in taking it. “Try to see what you can do to improve mental health. Many articles talk about the rise of depression and suicide, and not necessarily only men. Mental health for men is still very under-served. Men need to be more open about it to talk with loved ones and with primary care providers. Depression affects sleep and ability to function at work and their ability to feel motivated to eat well and exercise. The mind/body connection is very, very strong. If we don’t correlate mental health with physical health, we’re not whole. “Maintain a good weight through exercise and nutrition, as it’s good for health. It decreases risk of arthritis, improves cardiovascular health and wellness and decreases cancer risk. • Joanne Wu, is an integrative and holistic medicine and rehabilitation physician who practices in Buffalo.
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“It’s lifestyle. The tenets of a 5. healthy lifestyle are optimal nutrition, sufficient exercise,
Men: Building Muscle Size Vs. Strength Adding variety to a workout helps people achieve their goals By Deborah Jeanne Sergeant
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ome men hit the gym to build muscle size. For them, it’s about the bulging biceps and pectoral muscles, ripped abs, and thick legs. For others, gaining more strength could help them perform better at their sport, but increasing size may inhibit them, such as runners. But to reach either goal, guys need to use different resistance training methods, according to several sources. Tim Reed, certified personal trainer and owner of Adventures in Fitness, Inc. in Cheektowaga, said that to increase size, it’s important to lift weight heavy enough to perform only six to eight repetitions per set and to complete two to three sets. “It will increase the size quicker because it’s more strenuous,” Reed said. To get stronger without gaining as much bulk, lift lighter weights for more repetitions, about 15.
“You won’t get much size with a workout like that,” he said. Either way, it’s important to lift smoothly, with a full range of motion, and to lift to the point of muscle exhaustion. “Your form must be correct,” Reed said. “You shouldn’t be raising the weight up if you can’t do the exercise correctly. Nine times out of 10, the form gets sloppy and you’ll hurt yourself and you won’t be able to do
Avoid cigarette 10.“Have smoking. moderation in 11. alcohol. “The two most
adequate sleep, social connections, stress management and an attitude of gratitude. “Getting adequate sleep boosts the immune system function. Deprivation tends to be linked with increases in diabetes and weight gain. It’s based upon data. The ability to manage stress tends to increase as someone gets adequate sleep. “As for social connections, good data says dementia is less likely in someone with a robust social connection. Cancer outcomes are better for people with a robust social connection, too.
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anything. “Younger guys want to put mass on, so they lift heavier and heavier weights and form goes out the window.” It’s also important to eat a balanced diet and take rest days between resistance training days. On the rest days, a light aerobic exercise can keep you moving, such as walking, bike riding or swimming. Or, you can work a different muscle group per day, such as upper body one day and lower body on alternating days. So which resistance training equipment is best? They all bring different pros and cons. For example, weight machines with cables tend to encourage more fluid movements than free weights, but it’s mostly seated. Novices tend to rely on gravity and momentum to move free weights instead of keeping them in control throughout the entire range of motion. But free weights can encourage more creative means of incorporating weights, such as enhancing body weight movements. Those can help keep you with the program, since you can do them anywhere; however, for guys trying to build size, Reed said body weight exercise won’t challenge your body enough if size is your goal Kettle bells’ irregular shape work the core muscles more, giving more value to each workout. But they can be unwieldy and bulky to store for home workouts.
September 2018 •
12. important things for men to consider is if they have a family
history of cardiac disease to see their doctor regularly. The other is prostate cancer. It is common in men. Talk with their physician or urologist about any changes in urination. Have their prostate checked regularly, especially if they have any family history of prostate cancer. Men aren’t as good at following through with medical issues unless there’s a problem, compared with women. Women need to encourage their men to see their physicians.” • Physician Kent Chevli is the president of Western New York Urology Associates.
Resistance bands are both portable and easy to store; however, like body weight exercises, they may not offer enough challenge. Reed encourages resistance trainers to vary the workout with different types of equipment and movements. “If you do the same thing over and over, you’re not tricking the muscle and it gets used to it,” Reed said. “The more variety the better.” John Jarosz, certified personal trainer and owner of Apex Personal Training, provides training at Steel Mill Gym in Buffalo, among other venues. “Use different types of movements for same muscle group,” he said. “Getting in a rut is the worst thing people could do, just going through the motions. That’s where you hit plateaus. “Sometimes you see people in the gym five years and they look exactly the same. Your body will adapt to something eventually.” Remember that gaining muscle also gets tougher the older you get because testosterone levels decrease. That’s the hormone that helps men pack on--and retain — muscle tissue. “Most men are unaware that once they reach 40, testosterone production drops 1 percent per year,” said Linda Ann Taylor, board certified adult nurse practitioner for Invision Health in Williamsville. “If we get their testosterone levels up, that can help them have better lean muscle mass.”
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Men’s Health
New Dads Can Get the Baby Blues, Too
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ostpartum depression isn’t limited to moms. Rates of depression among new fathers are similar to those among new mothers, and more needs to be done to help these men, two psychologists say. “Recent research has shown that roughly 10 percent of new dads experience postpartum depression, and up to 18 percent have some type of anxiety disorder,” said Dan Singley, of the Center for Men’s Excellence in San Diego. “Unfortunately, few psychologists receive focused training regarding identifying, assessing or treating common men’s issues in the period from conception to a year or so post-childbirth,” Singley said in a news release from the American Psychological Association. Men tend not to seek mental health services during this period, so theres a lack of scholarly attention to this vulnerable group, Singley added. Singley’s work on male postpartum depression was scheduled for presentation Thursday at the annual meeting of the
American Psychological Association in San Francisco. Sara Rosenquist is also addressing dads’ postpartum depression at the meeting at the same time. “The predominant narrative has attributed these experiences to hormonal changes and fluctuations specifically related to pregnancy and birthing,” said Rosenquist, of the Center for Sexual and Reproductive Health Psychology in Cary, N.C. “It is highly unlikely that the hormonal disruptions of pregnancy and birthing would explain the whole picture if fathers and adoptive parents all experience postpartum depression at the same rates,” added Rosenquist. Factors that could trigger anxiety and the baby blues” in new fathers include sleep deprivation, exhaustion, time away from work, gender role conflict and concerns about being a good parent, the psychologists said. New and expectant fathers should be screened for signs of depression, Rosenquist and Singley believe.
However, identifying depression in men can be a challenge because they can have different symptoms than women, Rosenquist said. “Women are more likely to report feelings of sadness and frequent crying, whereas men are more likely to feel irritable and
socially disconnected,” she said. One thing that can help men avoid postpartum depression is support from friends, Singley said. “Fathers who maintain solid social support networks experience a buffer from the conflicts and demands associated with parenting,” he said.
Daith Piercing: Can It Reduce Migraine Pain? By Deborah Jeanne Sergeant
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ost people get body piercings because they like the style; however, a few seek a specific piercing because it’s believed to help reduce the symptoms of migraine headaches. Anecdotally, piercing the daith (some pronounce it to rhyme with “goth”; others rhyme it with “faith”) is said to lessen the pain, nausea, light sensitivity and other migraine symptoms. Those who use it claim that piercing the ear in its innermost fold of cartilage just above the ear canal turns off migraine pain in a similar way to acupuncture. Andrea Schilling, licensed acupuncturist at Acupuncture Works in Williamsville, said that she has explored the daith piercing for a patient. “It seems there’s no correlation with acupuncture points,” Schilling said, “but I do believe just like anything it may be a placebo effect, because I have patients that have benefited from this.” Medical research into daith piercings would likely be difficult because so many different factors can affect migraine headaches, including the placebo effect. Herbert Lau, licensed acupuncturist at King’s Acupuncture & Wellness Center in East Amherst, Page 10
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said that daith piercing is just a fad. “About four to five years ago, they came up with daith piercing for weight control,” he said. “They said it had to do with digestion. It’s not an acupuncture point.” People performing the piercing most likely have no training in treating migraines or in acupuncture. “If you believe it will work, you can do acupuncture, not piercing,” Lau said. “We do acupuncture, but not at that point on the ear.” He added that the piercing is a permanent placement and can cause scarring, unlike acupuncture needles. “Daith piercing is done in a tattoo parlor, not a medical setting,” he said. “It’s not as clean and there’s chance of infection. Lau said that sometimes stress, hormones and other factors cause migraines. By eliminating other factors in conjunction with acupuncture and Chinese herbs, Lau said he offers a holistic treatment for migraine. As for those who claim they received relief from a daith piercing, he said that it’s likely a placebo effect. “There’s no acupuncture basis for daith piercing in Chinese medicine,” Lau said. “There’s no point in the ear that’s good for migraine headaches.
Daith piercing involves the innermost fold of ear cartilage. Some believe it can prevent migraine. Photo by Deborah Jeanne Sergeant. It’s a fad. We do points on the scalp and head in acupuncture, not the ear.” Before obtaining a daith piercing, it’s also important to realize how different it is from standard earlobe piercing. Many shopping mall jewelry stores perform only lobe piercing because of its low rate of infection and other complications but refuse to pierce cartilage because it’s more complicated — and painful. People seeking a daith piercing must go to a stand-alone piercing business. The daith piercing is tricky to keep clean because for many people,
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
their hair touches the piercing more often and because it’s tucked into the innermost crease of the ear. The position also makes turning the piercing stud difficult. Piercing studs must be turned to facilitate healing. Should the daith piercing not help reduce migraine pain, the earring may be removed to allow the piercing to close; however, it will likely leave a scar. Before undertaking a daith piercing, discuss the possibility of complications with a health care provider.
SmartBites
whisk in oil. Season dressing to taste with salt and pepper. Toss greens in large bowl with enough dressing to coat. Divide greens among six plates. Top with pear slices, dividing equally. Sprinkle with cheese and walnuts. Drizzle lightly with remaining dressing and serve.
The skinny on healthy eating
Pears: A Sweet Treat You Should Eat
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hy reach for a pear? Besides how refreshing and delicious a crisp pear can be, pears are a super source of fiber and a goldmine of phytonutrients — those beneficial compounds found in plants that are thought to have health-protecting qualities. One medium pear — with its skin on — boasts nearly 6 grams of fiber, which, for many, is about a quarter of our daily needs. Conveniently, pears deliver both soluble and insoluble fiber. Pears’ soluble fiber — pectin — helps regulate blood glucose levels and lower cholesterol, while pears’ insoluble fiber promotes regularity. A well-run system improves bowel-related health problems, like constipation, hemorrhoids and diverticulitis. Adequate intake of fiber is a long-established factor in reducing our risk of both heart disease and Type 2 diabetes; and in the case of pears, this benefit may be even more pronounced due to the helpful combination of both kinds of fiber. Like most fruits and vegetables, pears come packed with important
Helpful Tips
phytonutrients that help to quell inflammation and mop up cell-damaging free radicals. Many experts believe that the work of these naturally occurring compounds may thwart the development of certain cancers and other life-threatening diseases. Nicely low in calories — about 100 per medium pear — pears can help with weight maintenance and loss. In fact, studies support that the more fresh fruit and vegetables someone eats, the less likely they are to gain weight. Modest calories notwithstanding, a pear’s high fiber and water content may also contribute to weight control, as both nutrients help us to feel fuller longer. Although pears contain natural sugars in the form of fructose, they have a low glycemic index (GI), according to the American Diabetic Association. The GI is a scale from one to 100 that ranks how foods affect blood sugar. Because of their impressively high fiber content, pears unleash sugar into the bloodstream slowly, providing us with a steady stream of energy. What other nutrients do pears
bring to the table? Pears are a good source of immune-boosting vitamin C, bone-building vitamin K, and energy-producing copper.
Pear, Walnut and Gorgonzola Salad Adapted from Bon Appetit-Serves 6
3 tablespoons fresh lemon juice 1 tablespoon Dijon mustard 1 tablespoon minced shallot 1 teaspoon dried thyme 1/3 cup olive oil salt and pepper to taste 5-6 cups of mixed greens 2-3 medium, ripe pears: halved, cored, thinly sliced lengthwise 1 cup crumbled Gorgonzola 1 cup walnuts, toasted, coarsely chopped Whisk first four ingredients in small bowl to blend. Gradually
If you want a ripe pear to eat immediately, press a finger gently into the top of the pear where the stem joins the fruit. If it yields to pressure, the fruit is ripe. A ripe pear will last in the fridge about three to five days. If you want to eat the pear in a few days, the top should be hard. Hard pears, stored at room temperature, will ripen in a few days. You can speed things up by placing the pears in a paper bag with a ripe banana or apple. Whenever possible, eat the nutrient-rich skin. If you eat canned pears, choose versions packed in 100 percent fruit juice (versus sugary syrup).
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.
A Walk to Beat Parkinson’s! Saturday, September 22 Gates at 9 AM - Walk at 11 AM Richardson-Olmsted Campus
www.MovingDayBuffalo.org Register Today!!!
Judy’s Pair-A-Dice Tours September Line Up Sept 3-6 Atlantic City Harrah’s Casino Sept 10 Double Header Allegany and Presque Day trip Sept 13 Sprague’s and Allegany Casino Sept 18-20 Caesar’s Windsor Casino Free shuttle Sept 18 Presque Isle Casino to the boardwalk where Sept 24 Dellago Game Show you can check out the 2 new casinos
Call 716-568-2222 or book on line at judystours.com Judy’s Pair-A-Dice Tours - PO Box 377 East Amherst NY 14051
Our focus is on individuals age 16 to 23 years of age; who may have or be at risk for developing a substance use disorder. Our non-clinical approach provides young people alternatives to a destructive lifestyle. Our hope is that the community they build within the Clubhouse will help foster stronger community ties as a whole. Fun activities that we offer are: Health and Wellness Classes, Culinary skills, Community integration, Gaming and more. Meals are provided daily with transportation being available.
Hours of Operations: Monday-Friday 3pm to 9pm Every First and Third Saturday 10am to 6pm Contact Person: Marsha West, CASAC Program Manager PHONE: 716-832-2141 ext. 217, 212 or, 242 66 Englewood Ave Buffalo NY 14214
September 2018 •
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RSI staff and volunteers dance at the Flash Mob annual awareness event at the Central Library in Buffalo in May.
Restore and Rebuild Organization seeks to stifle stigma associated with mental illness By Michael J. Billoni
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s chief executive officer of Restoration Society, Inc. (RSI), a peer-operated agency that offers recovery-based, personcentered services to those suffering from a mental illness or addiction, Nancy Singh has set a challenging goal for the organization — to end the stigma associated with mental illness. “Eradicating the stigma of mental illness is a difficult challenge,” Singh said. “Stigma and discrimination against those suffering from a mental illness continues to have crippling effects on those with mental health conditions. Suicide is the 10th leading cause of death in the United States and 90 percent of those who die by suicide have an underlying mental health condition.” RSI, founded 45 years ago in Buffalo, follows its mission of illuminating pathways toward opportunities, possibilities, wellness and independence for its customers. It achieves its goals through programs that embrace lifecoaching strategies that facilitate the customer’s personal life direction, development and fulfillment. RSI, through its peer specialists, assists individuals to achieve and maintain personal satisfaction in their overall quality of life. It helps customers integrate into self-selected communities and attain basic life needs, while reducing reliance on professional support. RSI values an individual’s natural supports to be present because it is key to gaining and maintaining their recovery, a spokesperson said. Page 12
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“RSI has built a reputation of achieving great results working with a hard-to-serve population, or those individuals who were unsuccessful in other traditional programs,” explains Michelle Scheib, RSI director of peer services. “Although one in four of our population has a diagnosable mental health condition, most people can fully recover and learn how to manage their symptoms every day, particularly if they receive help early on,” Singh added. “Of those
with long-term health conditions, individuals with a mental health condition are least likely to find work, live in decent housing, secure steady supportive relationships, and experience social inclusion. Stigma worsens mental health by delaying the time one seeks help and delaying recovery.
Who is in real danger? “It is so unfortunate that many in society fear those with mental
A ribbon cutting event in July to celebrate RSI’s Renewal Center on Elk Street, which is part of its crisis diversion program at Restoration Society, Inc. From left: Nancy Singh, CEO, Restoration Society, Inc.; Joe Woodward, Housing Options Made Easy; Tara Karoleski, Erie County Dept. of Mental Health; Michael Ranney, Erie County Commissioner of Mental Health; Jon Grieco; Maura Kelley, Mental Health Peer Connection.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
health conditions, feeling they are dangerous or violent and that is often exacerbated by the media,” he said. “However, a person with a mental health condition is at greater risk of being victimized or harmed rather than harming others.” RSI, which has its administrative offices, Housing Solutions office and The Clubhouse at 66 Englewood Ave., Buffalo, operates Empowerment Academy and ACE Employment Services at 327 Elm St. and Harbor House Resource Center, 241 Genesee St. They have many success stories among customers. Gerry, a long-standing RSI member, explains, “The Empowerment Academy is a great place to recover your life and work on personal goals. The staff assists with your rehab and helps with personal issues in your life. There are always daily activities, workshops and trips to different places with historic value. What I like most is the staff is always there for you.” Katherine, another customer, spoke about RSI’s ACE Employment service: “When I had no confidence in myself, I found them to be there for me. I had several good jobs, but it seemed like my anxiety was making it impossible for me to keep a job. I was starting to think that someone with my condition could never work again fulltime. But the job coaches at ACE believed in me and helped me focus on my strengths. Once I gained confidence and coping skills, ACE helped me land a great full-time job that I now love.” RSI and other mental health organizations recently hosted the sixth annual Flash Mob and a Mental Health Awareness Information Fair at the Downtown Buffalo & Erie County Library. “Our goal was to increase the public’s knowledge and understanding of mental health and help to break the stigmas attached to it,” said Michelle Scheib, the RSI director of peer services. “We had a great reception from a large audience and it is wonderful to see this event continuing to grow.” The Friendship Foundation is the development board that supports RSI. Brian Rusk is president and Jack Gustafario is chief executive director and former executive director of RSI. The Friendship Foundation’s premier fundraiser is its third annual Courage to Come Back Awards banquet, presented by Russell J. Salvatore and supported by Entercom Radio of Buffalo. It will be held Thursday, October 18 at Samuel’s Grande Manor in Clarence. Among the honorees will be National Football League Hall of Famer Thurman Thomas and his family, former Super Bowl champion and Sweet Home High School graduate Keith O’Neil, and Dan and Stacy Gagliardo, owners of D’Avolio Olive Oils, Vinegars and More. “As more celebrities, business leaders and family members become public about their mental illness, people will begin to feel comfortable seeking treatment and will stop blaming themselves as having a character defect and acknowledging it is merely an illness no different than any other that can be treated,” Singh said. For more information on RSI or the event, visit www.rsiwny.org or www.friendshipfoundationbflo.org.
Special Needs
Is Autism on the Rise or Are We Better at Catching It? Latest CDC autism figures from April show 15 percent rise
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he latest analysis published by the Centers for Disease Control and Prevention concludes that autism might be more prevalent than previously estimated. They are now calling for more effort to be made toward early detection. Autism spectrum disorders (ASD) are conditions that affect development. They impact the ways a person interacts with other people and alter how they perceive the world. And, though every case is different, the most common symptoms include delayed speech development, trouble interacting with peers and repetitive behaviors. As for prevalence, in 2016, the Centers for Disease Control and Prevention (CDC) estimated that it affected one in 68 children — about 1.5 percent of all children. However, as of April this year, they updated this estimate. The revision comes off the back of the CDC’s Autism and
Developmental Disabilities Monitoring (ADDM) Network. This tracking system follows more than 325,000 8-year-old children, which accounts for around 8 percent of all 8-year-olds in the United States. The ADDM assesses the young participants for any characteristics of ASD. It is the largest network of its type and the only one that also follows the health and education of each child. The data come from 11 communities in Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin. The new results were published in April. According to the analysis, in 2014, one in 59 children — or 1.7 percent — had ASD. That represents a 15 percent rise from two years ago. Also, boys were four times more likely to receive a diagnosis than girls. Why has the figure changed?
There are many potential ways to explain why the percentage of children with ASD may have risen. For instance, improvements in the identification of ASD in minority populations could be part of the answer. Although, ASD is still more likely to be diagnosed in white children than Hispanic or black children. Physician Stuart Shapira, an associate director for science at CDC’s National Center on Birth Defects and Developmental Disabilities, explains: “Autism prevalence among black and Hispanic children is approaching that of white children. The higher number of black and Hispanic children now being identified with autism could be due to more effective outreach in minority communities and increased efforts to have all children screened for autism so they
More Families Willing to Adopt Special Needs Kids By Deborah Jeanne Sergeant
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t may seem like children with special needs would wait longer for a permanent home; however, according to Michael Hill, associate director at Adoption Star, Inc., an increasing number of potential adopting families express interest in adopting a special needs child. Hill said that the 2012 adoptive placements comprised of 73 percent healthy newborns, 15 percent at risk for developing special needs, and 12 percent born with special needs. In 2017, the agency placed 63 percent healthy newborns, 26 percent at risk for developing special needs and 11 percent born with special needs. He explained that in general, the agency has a larger pool of children who have or may potentially have special needs, in part because of the opioid epidemic exposing babies to drugs in the womb and causing them to be addicted to opioids. The agency has also made mandatory an adoptive parent training weekend. “Part of that is sharing a lot of information about kids at risk for special needs or who have special needs,” Hill said. “Because everyone has to come for classes, we can talk all about situations where a pregnant woman has pre-identified issues and that may affect the child. We can share uniform, consistent information
on parenting a special needs child. Being able to educate people on the topic makes families more open to adopting a special needs child.” While that’s good news for the agency and children they serve, Hill wants more families to understand the differences between general adoption and special needs adoption. Adoption Star is based in Amherst, Western New York, but places kids statewide. “Particularly over the course of the last five years, we’re finding at our agencies there are more and more prospective adoptive families who are willing to adopt a special needs child or one who potentially will have special needs,” Hill said. The agency’s Shining Star program offers financial assistance to help cover special needs adoption costs so adoptive families can allocate more funds toward their new child’s needs. Some may need early intervention services, specific medical care or additional assistance for home health or child care. The Family Star program helps link adoptive parents to the resources that can help them meet their child’s needs, providing information, referrals and support groups for parents. New York state also provides regional permanency resource
centers. These state-funded centers provide post-adoption support services, which include respite care, support groups, medical care, and, as needed, referrals. Hill encourages prospective adoptive parents to do their own research on the children they may parent, both into the child’s medical records and history as provided by the adoption agency, and how these can affect the child’s development. “It’s important to collect and review that information,” Hill said. “Go into parenting with eyes wide open, regardless of whether you’re adopting or it’s your biological child. Pre-natal records and medical history of the biological family help you understand the potential challenges that may exist.” Hill said that some pediatricians can help prospective parents review the records and understand their implications. Sites such as March of Dimes (www.marchofdimes. org), Mayo Clinic (www.mayoclinic. org), and the American Academy of Pediatrics (www.aap.org) may also help. Once a family is thoroughly
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can get the services they need.” Improving diagnostic services in minority communities is vital; the earlier ASD is caught, the more successful interventions tend to be. If children are put in contact with support services at an early age, they are more likely to reach their full potential. Interestingly, autism rates across the 11 communities varied. Five regions had similar levels (1.3–1.4 percent), but the highest rate was seen in the New Jersey community, which hit one in 34 (2.9 percent). The researchers believe that this disparity might be due to differences in the way that autism is documented and diagnosed in different areas. After the 2016 results were published, many concluded that the rise in ASD had paused. Now, some
screened and matched with a child and the child approves that family for a potential adoption, “we try to give as much information as we can,” said Sharon Hoelscher, director of Adoption and Family Wellness for Erie County Foster/Adoptive Family. “We like full disclosure so the foster parent knows exactly what the child’s needs are and to plan with them before placement what services are available to put in place to assist them. If we narrow it down to a family, they have the full information.” She added that the agency helps families find the outside resources that will help them best meet their children’s needs. Bridges to Health and Health Homes, both funded by the federal and state governments, are examples of resources that can help. Adoption and Family Wellness for Erie County also partners with other agencies to ensure children and their new families receive the help they need. “Everyone in New York state has to go through a training period, what can ‘normally’ be expected from children who were traumatized, except a child who’s placed at birth,” Hoelscher said. All foster children receive Medicaid, which becomes a subsidy once they’re adopted through age 18. At that point, the children can still receive a subsidy until age 21 as long as they work at least part-time, go to school or have a disability that prevents them from working. “It takes a special person to come forward and be that person the children can really count on,” Hoelscher said.
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Special Needs
Nicole LaMonte-DeGolier with husband Ted DeGolier and their three kids: Bella, on mom’s lap, Teddy and Jack. Photo provided.
Family Takes on Autism By Julie Halm
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aising a child on the autism spectrum is not always easy. Nicole LaMonte-DeGolier knows that first hand. What she also knows, however, is it can be a beautiful and rewarding experience. “Our house is literally a three-ring circus, and I say that endearingly,” she said. “Everyone that comes to our house knows that you’ve got to be ready for some chaos.” LaMonte-DeGolier’s eldest son, Teddy, is autistic. He recently celebrated his sixth birthday, marking roughly four and a half years since his mom and dad, Ted DeGolier, learned that their son was not neuro-typical. For the first year of Teddy’s life, the then first-time parents did not notice anything atypical about their son. “He was developing very typically until he was about 12 months,” she said. “He was walking and had about 50 words. From about 12 to 15 months, we saw that he was kind of turning inward. By 15 months, he was silent. He became more withdrawn; he’d play in the corner by himself. He used to not acknowledge my husband when he came home. It was really hard.” Teddy has what is known as regressive autism and is considered to be in the moderate-to-severe realm. Not all children with autism will experience a similar timeline of events. Some will demonstrate delayed development of motor skills or sensory issues from the beginning. Autism spectrum disorder refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. The symptoms are present from early childhood and affect Page 14
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daily functioning, according to the National Institute of Neurological Disorders and Stroke. “The term ‘spectrum’ refers to the wide range of symptoms, skills, and levels of disability in functioning that can occur in people with ASD. Some children and adults with ASD are fully able to perform all activities of daily living while others require substantial support to perform basic activities,” states the institute. The young family was living in California when their first son was born, away from family and friends. The experience was a challenging one, as their baby was colicky, or at least that’s what they thought. “We didn’t know what parenthood was going to be like. He pretty much screamed for the first six months of his life and had to be in motion all of the time,” remembered LaMonte-DeGolier. “But we could play the theme song from ‘Dr. Who’ and he would instantly stop crying.” In retrospect, that may have been related to his autism, but as most first-time parents will openly admit, it’s impossible to know what to expect from such a new and daunting experience. When Teddy was 3 months old, the trio moved back to Western New York and a simple play date changed the course of the family’s future. LaMonte-DeGolier was spending time with a childhood friend and her children when a difficult subject was broached. There was something on her friend’s mind, but she didn’t want to be upsetting. “She said, ‘I think you need to call early intervention for Teddy. I think there’s something going on with him,’” recalled LaMonteDeGolier. “When she said that, I was kind of awestruck, and I was really grateful.” Teddy was 15 months old when the conversation and resulting evaluation took place. By the time
he was 18 months, he had a formal diagnosis and a bevy of professionals ready to help. “I just jumped in with both feet and within a month and a half of him being evaluated, he was in 23 hours of therapy a week and we just went full immersion,” she said. Teddy’s week includes speech, occupational and physical therapy and a traveling special education teacher. He is also a participant in a medical trial based in North Carolina.
Concern for siblings The hectic schedule is made busier by the fact that Teddy is now the older brother of Jack, 4, and Bella, 1. Both of the other children seem to be neuro-typical, and although statistics vary, it is commonly accepted that children with an older sibling on the spectrum are more likely to be diagnosed. Boys are also significantly more likely to be autistic than girls. When LaMonte-DeGolier was pregnant with her middle child, Teddy had not yet been diagnosed, and that was a bit of a blessing. “It was a different pregnancy with Bella,” she said. “It’s a heavy thing.” Although Jack does not appear to be on the spectrum, autism is just a part of life and family for the young boy. “Jack knows nothing but autism,” said LaMonte-DeGolier. Jack has attended countless therapy sessions. He is often shown as an example of typical social behaviors for his brother and has made many concessions over his young life to help accommodate the needs of his big brother. It isn’t always easy for Jack or for his parents, but they work as a team to make sure that everyone gets what
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
they need. “We have a saying in our family that no one gets left behind,” LaMonte-DeGolier said. “So we work together constantly. I’m so grateful that Jack is a kind, caring and compassionate individual.” The road has not always been easy, but the payoffs have been immensely rewarding. Teddy participates in a double blind medical trial being conducted at Duke University in Durham, N.C. By chance, his parents decided to bank his umbilical cord blood when he was born, due to medical challenges his mom had faced when she was young. That would later be one of many things that allowed him to be eligible for the trial. “It was really just fate,” said LaMonte-DeGolier. “He’s in phase two of the trial and they’re entering phase three and it has changed his path in life. August was the last month of the program and the changes we’ve seen this year have been nothing short of a miracle.” Nothing is perfect, and it has taken many years to make the strides, but for Teddy’s mom, it’s more than worth it. While Teddy was once nonverbal, he can now communicate orally, although it sometimes takes a couple of tries and a lot of concentration. “He’s not a fluent speaker, but he can get the point across if you pay attention to him,” said his mom. His social interactions have improved as well. “When you walk in your son’s room and he says, ‘Hi, Dada’ for the first time or walks over to his brother and starts playing with him, I still get a little weepy sometimes, because we didn’t know if that was ever going to happen,” she said. LaMonte-DeGolier has taken her experience, with all of its many highs and lows, and decided to help other parents of children with special needs by starting a support group in her community of Akron. The support of family and friends has let the family “stay functional,” she said. A diagnosis can be difficult for a parent to hear and adjust to, as she knows. A poem she often shares titled, “Welcome to Holland,” describes the experience as being akin to planning a fabulous trip to Italy, only to disembark in Holland. It is not what was expected. You will have to adjust. The dream will change and there will be disappointments. But there will be beautiful experiences — tulips and windmills — and the journey will not be a lesser one, only different. Sharing her family’s story and helping others is a path that LaMonte-DeGolier has chosen and is happy to be on. “This is who we are, and we’re not ashamed of it,” she said. “We embrace Teddy for his uniqueness. He has been my greatest teacher. He has changed my perspective of the world. He has made me more compassionate and more caring, and he has taught me to find awe and inspiration in the smallest of things. Everything is celebrated around here. We don’t squander the small moments in this family.”
Special Needs
Few Providers Offer ‘Special Needs’ Dentistry By Deborah Jeanne Sergeant
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ew people relish a visit to the dentist. For patients with physical, intellectual or emotional disabilities, professional oral health care can become even more difficult. Only a few providers in the area offer “special needs” dentistry to ensure they receive proper care. Paula Sepanik, dental director and clinical dentist at Baker Victory Services in Lackawanna, said that the most important aspect of her office’s care is employing staff with experience as direct care aides to help as assistants who don’t provide care but comfort. “They’re accustomed to how to talk with special needs individuals,” Sepanik said. “A lot of it is attitudinal. You view individuals with special needs not as a burden but as part of the general population. They are individuals who deserve the best care you can give them. We do see on occasion people who are referred from private dentists who are overwhelmed.” About one-third of Sepanik’s patients have special needs, so her office is not only accessible, but specially set up. They feature large exam rooms to allow parents or caregivers in; external bitewing X-ray equipment so they won’t have to hold media in their mouths; and freestanding exam and cleaning equipment so they can receive
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treatment in their own wheelchair, if that’s easier for the patients. The hygienists receive on-the-job training to serve special needs clients. Her staff’s soft skills include patience to take more time, developing a special plan for them, discovering their triggers, and working with parents to find ways to improve the whole experience. Sepanik earned a dental sedation certificate so she can help individuals who have uncontrollable muscle movement to safely receive treatment. “Dental care is far more comfortable and they can tolerate care,” Sepanik said. She’s a member of a New York state taskforce for special care dentistry, which includes training on desensitization for patients and safe and effective, medically necessary immobilization. “You can hold the person so it’s safe for the person and stabilizing their heads,” Sepanik explained. “We use anything from specialized mouth props to additional staff to help with procedures. We can accomplish the treatment they need in a way that is effective for them.” Some accommodations are simple. Some patients feel overwhelmed by too much stimulation, so scheduling their visits as the first of the day means they won’t have to sit in the waiting area. Others enter by the back
stairs “and there’s not the opportunity to become agitated,” Sepanik said. “We have patients who come in with devices that just soothe them. They may need just that.” She’s also used small gift cards as incentives for special care patients. Patrick Anders, assistant professor in the UB School of Dental Medicine, also treats special needs clients. He said that most of them can receive their dental care in a traditional environment with a few accommodations; however for the 5 to 10 percent who can’t, general anesthesia is available. Like Sepanik’s office, Anders uses strategies such as timing visits to meet patients’ needs, and scheduling longer visits. “Also, if we don’t interrupt a person’s schedule like with a dayhab or work situation, they tend to receive treatment more willingly,” Anders said. “One thing that we have found is that people with developmental disabilities don’t do as well if they’re reclined fully. It’s a very vulnerable position. We tend to treat in an upright position.” He acclimates patients unfamiliar with dental care by starting with the easiest procedure, such as cleaning. By telling patients what they plan to do, showing what they plan
to do and then doing it, patients know what to expect. Personnel also praise desirable behavior and ignore the rest. “We try to tailor the approach to the reason for the behavior,” Anders said. Some enjoy distractions like favorite DVDs, electronic games, comfort toys or conversation; others prefer no stimuli. Some autistic patients enjoy the feeling of pressure on their bodies, so using the office’s lead apron — even if not doing dental X-rays — provides a comfort measure without restraining them. Anders’ office uses conscious sedation, medical immobilization and protective stabilization as needed. “It’s not forceful holding,” Anders said. “It requires training, consent and a plan. Some patients do well under those circumstances; it’s more like a reminder.” He offers on-the-the-job training for much of the special needs care his staff provides, since most dental schools don’t offer much training. “There’s a great need and the need is growing,” Anders said. “It’s a real problem because there are many, many barriers to care and a fairly limited number of providers who will and can provide care.”
Reversing Autism with a Cancer Drug
esearchers may have found a promising new treatment for a genetic form of autism. Using experimental cancer drugs, scientists reversed the condition in mice. According to the most recent estimates, one in 59 children in the United States have an autism spectrum disorder (ASD). Over 7 percent of these cases have been tied to chromosomal defects, suggesting that many of the impairments in social communication, movement, sensory perception and behavior that characterize the syndrome are down to genes. Specifically, some people with ASD are missing a piece of their chromosome 16. Known as 16p11.2 deletion syndrome, this chromosomal defect often leads to neurodevelopmental disability and language skills impairment. Now, researchers may have found a way to reverse this genetic
form of ASD. Scientists led by Riccardo Brambilla — a professor at Cardiff University in the United Kingdom — used experimental drugs that were initially developed to treat cancer to restore normal brain function in mice with ASD-like symptoms. The findings are now published in The Journal of Neuroscience. “The human 16p11.2 microdeletion,” explains. Brambilla is one of the most common gene copy number variations 56 linked to autism.” But the mechanisms that link the chromosomal defect with the neurodevelopmental condition are poorly understood. So, the team designed a mouse model of this chromosomal deficit to examine its pathophysiology. The mice that had the defect displayed a series of behavioral and molecular abnormalities. These included hyperactivity, dysfunctions in their maternal behavior, and problems with their olfactory
perception. Moreover, the researchers found that mice with 16p11.2 deletion also had higher levels of a protein called ERK2. ERK2 has been recently emerging as a target in cancer therapy, explain the researchers. This prompted the scientists to test the effect of experimental cancer drugs on mice with 16p11.2 deletion. The drugs stopped ERK2 from reaching the rodents’ brains, which reversed the ASD-like behavioral, neurological, and sensory symptoms in the mice. “Importantly,” the authors write, “we show that treatment with a novel ERK pathway inhibitor during a critical period of brain development rescues the molecular, anatomical, and behavioral deficits in the 16p11.2 deletion mice.” “By limiting the function of the protein that appears to cause autism symptoms in people with the chromosome 16 defect,” explains Prof. Brambilla, “the trial drug not
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only provided symptomatic relief when administered to adult mice, but also prevented genetically predisposed mice from being born with the form of ASD.” This occurred as a result of administering the experimental drugs to the mother during gestation. The researcher explains what this means for humans. “While it wouldn’t be feasible to treat pregnant women who have been screened for the genetic abnormality, it could be possible, in principle, to permanently reverse the disorder by treating a child as early as possible after birth.” “In the case of adults with the condition, ongoing medication would probably be required to treat symptoms,” he adds. In the future, the scientists hope to replicate the findings and ultimately test the drugs in clinical trials for people with ASD.
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Special Needs
Autism Services Encourages Art, Community Involvement By Deborah Jeanne Sergeant
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f you see a piece of locally made artwork at an area business, it may have been created by participants of the art program at Autism Services, Inc. in Amherst. “We have a huge emphasis on the arts,” said Veronica Federiconi, CEO of Autism Services. “We do a lot of community art exhibits.” For the past 15 years, the organization has offered art as a creative outlet. Some autistic children crave repetition and order, even to the point where it becomes meaningless or distracting from the rest of the world. “The arts meet the need of repetition,” Federiconi said. “They can do the repetition in art.” Federiconi said that Autism Services celebrates — not changes — the people it serves. “We celebrate autism,” she said. “We’re not an agency that tries to change our folks. They deal with challenges and we want to support them in any way. We’re never going to eliminate all the challenges they have, so we build an environment to support them. “These kids go through life with therapy; it’s their whole life,” she added. “I wanted the arts to be a free time where they can express themselves.” She reflects that philosophy in her hiring methods, as she brings on board teaching artists, not art therapists, because she wants participants to know their art is salable and not only meant as
therapy. Autism Services maintains an art lending program, which keeps their art in the public eye on display at area businesses. It raises awareness and also instills a sense of pride in “these people who are fully capable who happens to have autism,” Federiconi said. “We call them artists because they truly are.” The artwork helps people at Autism Services feel more part of the community. “Community members want to own it,” Federiconi said. “One saw the artwork in their dentist’s office. They commissioned work. People are choosing and requesting our artists. That program is really about freedom. I give them space and opportunity and someone there to support them. They can communicate on canvas or another medium.” Overall, Autism Services emphasizes self-advocacy. “We have a lot from the art program who sit on committees of the organization,” Federiconi said. “We want them part of everything we’re involved in.” Beyond the art program, Autism Services provides certified special education programs for children 5 through 21 and services beyond that age, including a site-based day habitation program and Dayhab Without Walls. The organization works with job readiness skills that can help them obtain employment. Autism Services also operates 13
residential group homes throughout Western New York, provides adult services, social support groups, recreation programs and respite services, both at home and at Autism Services’ facilities. The after-school programs help families who have to work late. The vacation camp helps children stay in a structured environment during summer break. “The kids are so conditioned to coming to school, it’s very difficult for them during break,” Federiconi said. “Parents who both work can continue to work because their kids are coming to camp.” As its name denotes, Autism Services serves only the autistic population and their families. As an independent organization, it’s
tougher to stay solvent as there’s no national organization helping out. Federiconi said that autism awareness isn’t a big emphasis for Autism Services, as the public seems aware of autism; however, “there are still fears out there because our folks communicate in different ways,” Federiconi said. “Some have a voice and choose not to use it. Some use communication devices that appear foreign to people.” Helping autistic people become more involved in the community has been improving the general public’s perception of autism. “They may express themselves in different ways, but we’re trying to teach them and teach the community,” Federiconi said.
All in the Language rather that autistics just part of So...is it “person-first” the general population, like deaf language or what? people. For a couple decades, In general, Autism Services professionals working with people uses “our folks” or “recipients” with disabilities have described of their services, and “people” those they serve with the person primarily. Words like “patient” first and the disability second, or “client” sound clinical, which such as “a person challenged implies that autism with autism” or “someone on the Examples of person-first is a condition that needs a curative autism spectrum.” language: treatment. “Honestly, • “person with autism” Though they don’t like • “individual challenged by a every person is person-first developmental disability” an individual, language,” Examples of identity-first those served by Federiconi said. language: Autism Services “They don’t want may share similar to be referred to • “autistic person” life experiences with person-first • “developmental disabled and challenges as language.” person” well. Identifying Federiconi with other autistic people can feel said that the change originates empowering. in the thought that autism isn’t a sickness that needs healing, but
Back to School: Heads Up on Head Lice By Deborah Jeanne Sergeant
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bout 6 million to 12 million head lice infestations occur annually among U.S. children 3 to 11 years of age, according to the Centers For Disease Control and Prevention. “Head lice are not a health hazard, a sign of uncleanliness or a vector for disease,” states the National Institutes for Health on its website. Upon their child’s diagnosis of head lice — usually at school or the pediatrician’s office — many parents head to the drugstore to buy an over-the-counter remedy, some of which contain pesticide; others contain dimethicone, a silicone-based product that smothers the lice and prevents them from managing water. But they have other choices. Marnie Murray co-owns Naughty Nits in Williamsville, part of a national chain that also operates in Rochester and Syracuse areas. “The pesticides are designed Page 16
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to kill the bugs, but not the eggs,” Murray said. “The resistance rate is high after 40 years. ‘Super lice’ are resistant to permethrin-based treatments.” Stronger preparations are available by prescription. But Naughty Nits uses a different method. Instead of killing with chemicals, the company uses AirAlle FDA-approved medical device that dehydrates the lice and eggs. With a 30-minute treatment, followed by a 30-minute comb-out, the client should be lice-free. “It’s a silver bullet,” Murray said. “It’s relaxing, stress-free and chemical-free but deadly to lice and eggs. It has a specifically designed, one-use tip.” She said that the device has more than 500,000 uses worldwide without incident. Naughty Nits doesn’t take insurance; however, Murray said some people have submitted their itemized receipts with mixed results.
“People think they can use the blow dryer, but that can burn the scalp,” Murray said. “AirAlle is similar to a blow dryer, but it’s gentle. It has a similar sensation but it’s different technology.” She said parents don’t have to go crazy cleaning their home; however, items that have come into direct contact with their child’s head should be cleaned with hot water. Items that can’t be cleaned with hot water may be sealed in a plastic bag for two weeks to kill the lice. Naughty Nit’s most expensive treatment is $169. The facility also offers an “express” treatment for $119 and a DIY topical treatment that’s less. The company also sells a line of organic preventive items that contain tea tree, rosemary, mint, citronella and eucalyptus which Murray said ward off bugs to prevent reinfestation after a bout of lice. “They have 93 percent efficacy
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
in clinical trials,” she said. “When you’ve had head lice they leave pheromones on your head that’s very difficult to get off that’s imperceptible to humans. You have to have something in your hair that’s a different scent to mask that.” Don’t share Physician Joanne Wu, boardcertified in integrative and holistic medicine lives in Rochester and Buffalo. She recommends oil of tea tree, lavender and eucalyptus used in a carrier oil for both treating and preventing head lice. A few small studies seem to indicate at least a measure of efficacy in essential oils, she said. “The important thing is don’t share implements,” she said. “Any materials that come in contact with the child’s head should be cleaned.” All household members and those in close contact should be checked for head lice, too.
The Buffalo Autism Project Early intervention and connection prove fruitful in treating autistic children By Katie Coleman
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aura and Brian Moeller’s son was diagnosed with autism spectrum disorder right after his second birthday. ASD is a developmental disability that affects communication and behavior. It’s considered a spectrum disorder because of its wide range of symptoms and behaviors. The biggest indicator that Cameron had autism was that by age 2, he was completely non-verbal. As a result, he went to different specialists and doctors for evaluation. Cameron, who has a little brother, Max, is now 5 years old and is starting kindergarten. He loves wearing red, Mickey Mouse and is a great little swimmer. He doesn’t like big crowds or too much noise, and works really hard in his speech therapy at school and home. “There are so many resources, schools and different kinds of therapies for ASD out there, so I didn’t really know where to go after Cameron was diagnosed,” said Laura, who started reaching out to friends and family for help. She eventually connected with Rachael Schneider, the senior clinical director of Autism Learning Partners in Buffalo. It’s a group of licensed behavior analysts that specialize in applied behavior analysis (ABA), one of the targeted therapies for autism. “ABA is evidence-based tools and resources to change and improve behaviors and applied specifically to autism. It’s where we work on the main core deficits — language, social skills and repetitive behaviors,”
Schneider said. “We take data, monitor progress, and change the environment to help a child learn and succeed.” As Schneider helped Laura explore local treatment options for Cameron, they started realizing how helpful it would be if Western New York families could be linked to the many providers and resources available in one place. That’s how Buffalo Autism Project was founded in 2017, with Laura as its president and Schneider on the board of directors. As a nonprofit organization, its mission is to provide WNY families with the best resources and information available on ASD, raise awareness and acceptance, and host local fundraising events. “Our team is so excited and passionate about what we’re doing. We just felt like there were a lot of people in the community who needed the help and the resources like I did,” Laura said. “One of the biggest things for me is raising more awareness in the community of what ASD looks like. There are so many kids affected by it.” One of the biggest factors in Cameron’s success has been early intervention in getting diagnosed and receiving ABA therapy every day at school, and three nights a week at home, his mother said. Systematic approach Meghan Hodgkin is a behavior technician at Autism Learning Partners, and has been working one-on-one with children and teens diagnosed with ASD and other
Head Lice?
Doctor Recommends OTC Permethrin
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hysician Bridget Messina, who works at the division of general pediatrics at UBMD Pediatrics & Oishei Children’s Hospital, said that the main treatment the hospital is approved in children older than 2 months: permethrin. “It’s made from a natural chrysanthemum extract, though it’s synthetic,” she said. Lower-concentration permethrin is available over the counter. Messina said that permethrin has low toxicity, though some children may be a little sensitive. She’s not convinced hot air treatments are effective. “One study was done fairly recently that showed an effect, but it wasn’t blinded,” she said. “The people knew they were getting the treatment. It leaves way for some interpretation bias. The study wasn’t big enough to say whether it works
or not.” She thinks that the combing performed after the hot air treatment is what’s working. Physician Gale R. Burstein, commissioner of health for Erie County Department of Health, said that she doesn’t see how dehydrating lice and eggs would work. “The American Academy of Pediatrics literature lists recommendations for lice treatments and I have not seen that as one of them [offered by Naughty Nits],” Burstein said. “It’s not as evidence-based.” She said most pediatricians recommend over-the-counter preparations and if they’re ineffective, they move on to prescription drugs, which can kill newly hatched lice so there’s no need to repeat treatment. “Don’t do home remedies,” Burstein said. “They don’t work. Don’t use general pesticides; it’s just a bad idea.”
Brian and Laura Moeller’s son, 5-year-old Cameron (right) was diagnosed with autism spectrum disorder right after his second birthday. At his left is Max, his younger brother. Laura is president of Buffalo Autism Project. developmental disabilities for almost three years. She teaches skills in the community, at schools and in-home settings. Each of Hodgkin’s clients has unique goals and needs, so sessions are individually tailored. One ABA practice she utilizes is through reinforcement. “If I were trying to teach a child a new skill, I would pair a preferred item, an activity, or praise as a reinforcer for successful completion of a step in that skill,” Hodgkin said. “Eventually, as they grow confident in completing that skill, they no longer need the reinforcer. This can be used in helping a child feel comfortable in social situations as well, and is just one of the many strategies that fall under the umbrella of ABA.” Hodgkin has found many joys through her work as a behavior technician. “My biggest joys are improving the livelihood of the children and families I work with, and to see specific goals being met,” Hodgkin said. “The rewards of the work definitely outweigh the challenges.” According to recent statistics from the Centers for Disease Control and Prevention’s autism and developmental disabilities monitoring network, about one in 59 children has been identified with ASD. It’s about four times more common among boys than girls and can be diagnosed as early as age 2; however, most children aren’t diagnosed until 4. Buffalo Autism Project recently held Buffalo Autism Linked Resource Fair, which connected attendants to about 40 local service providers in the area, offered resources on ASD and had activities for kids like sensory tables, fire trucks and service animals. The fair is one of its concerted efforts to grow annually with help
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from fundraising efforts. Its second annual “Crawl-oWeen” will take place from 2-8 p.m. Oct. 20 in East Aurora to continue fundraising efforts. Participating taverns include Barbill, 189, Rookies, Griffon Gastropub and Aurora Brew Works. Participants are encouraged to dress up and prizes will be awarded. Presale tickets are $15. For more information on the Buffalo Autism Project, visit buffaloautismproject.org or facebook. com/BuffaloAutismProject. Reach them directly at BuffaloAutismProject@gmail.com. For more information on Autism Learning Partners, go to autismlearningpartners.com.
Common Indicators Your Child May Have ASD Although these are not solid indicators, a child who has ASD will show a range of symptoms: • Speech delays or no speech at all • Repeating words and phrases • No babbling by 12 months • No words by 16 months • No two-word phrases (not including repeating or imitating) by 24 months • Loss of speech, babbling or social skills at any age • Difficulty understanding others’ feelings • Inability to make friends and build relationships • Very narrow or intense interests • Need for routines and sameness • Hand flapping and rocking
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Making a Difference in the Lives of Deaf Students With 100 students enrolled, St. Mary’s School for the Deaf boasts a 91 percent attendance rate and a 100 percent graduation rate, with students going on to become engineers, social workers, accountants and more By Nancy Cardillo
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hen Lauren and John Bronneberg’s daughter, Julia, was born, she passed all her newborn screening tests, including the hearing tests. But Lauren and John, who had a healthy 5-year-old son at the time, knew something wasn’t right. It would be three and a half years before they got the correct diagnosis: Julia had no auditory nerve. She was profoundly deaf, and would never be able to detect sound at all. Lauren and John had been working with Buffalo Hearing and Speech Center, and the staff recommended the Bronnebergs contact St. Mary’s School for the Deaf. “Tim Kelly, who was St. Mary’s director of pupil personnel services at the time, gave us a tour in June of 2007,” said Lauren. “My husband immediately said to me, ‘Our daughter will graduate from this school!’ I was a bit more hesitant, but once I had a confirmed diagnosis, I was all in. St. Mary’s truly was what was best for Julia, and in just a few weeks after being enrolled there, she was able to communicate with us via sign language. She was 3 1/2, and it was our first real experience communicating with our daughter. We were thrilled.” Lauren, her husband and son all learned American Sign Language at St. Mary’s soon after. Julia is now 14 and still attends St. Mary’s as a day student. “She loves school and she is thriving,” says Lauren, who serves on the school’s board of trustees and is a member of the Parent Teacher Organization. “She calls St. Mary’s her ‘happy place,’ and looks forward to going there every day. We live in Cattaraugus, which means over an hour’s bus ride for her each way.” “People ask us why we didn’t mainstream Julia,” says Lauren. “That would have involved a special teacher of the deaf as well as an interpreter, and she still wouldn’t be able to communicate with everyone. At St. Mary’s, she can communicate easily with all the faculty, staff and students, and everyone’s treated the same. I don’t know what we’d have done if we hadn’t found St. Mary’s.” Over a century of service to the deaf community. St. Mary’s School for the Deaf was founded in 1853 by Buffalo’s Bishop Timon. Originally located on Edward Street (at Elmwood), the school moved to its present location on 12 acres at 2253 Main St. (near Dewey) in 1898. It was the first Page 18
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St. Mary’s School for the Deaf students Julia Bronneberg (left) and Elise Watson participated in the 2018 4201 School Association’s Advocacy Day in Albany, where they met with state officials. Photo provided. academic high school for the deaf in the country, and one of the first to have a preschool program for the deaf. The 2018-2019 academic year marks St. Mary’s 166th year serving the deaf community as a private, state-supported school. Currently, there are 100 students enrolled at St Mary’s, which serves the eight counties of Western New York. Thirty are residential students, living on campus Monday through Friday. The other students commute daily, most via buses provided by their school district. “We work directly with more than 50 school districts throughout Western New York,” says Timothy
Kelly, who was promoted to superintendent of the school in 2009. “We are a ‘Child First!’ school, meaning every decision we make is made in the best interest of our students. Period. We are fortunate to have a highly qualified dedicated staff committed to ensuring each student reaches his or her fullest potential — while they’re at St. Mary’s and once they graduate.” “There is no tuition charge for our students. We have been statefunded since 1874,” says Kelly. “The school districts pay for students to attend our school and are reimbursed by New York state.” The criteria to attend St. Mary’s
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
include a minimum 80-decibel hearing loss (55 for infants). Twenty decibels is the norm for hearing individuals and, as an example, the noise from a lawnmower is 80 decibels and an airplane taking off is 115 decibels. Programs for children of all ages. St. Mary’s offers academic programming for students from birth through age 21. Its comprehensive curriculum aligns with all New York state learning standards, and it is one of just 24 deaf programs in the country to receive national accreditation. St. Mary’s offers a language-rich environment by providing students the necessary tools to think, learn and communicate through American Sign Language and English. The school embraces all methods of communication, including amplification (hearing aids, cochlear implants and assistive technology); speech; auditory training; sign language; speech reading; voice; written English and visual imagery. This approach affords all students 100 percent communication access. Students are assessed on a regular basis at St. Mary’s, which boasts an 8:1 student/teacher ratio. “We work closely with each student,” says Scott Gentzke, associate principal and dean of students/director of residential services, who is deaf. “If they want to go to college, we’ll help them get there. If they want to be a chef, we’ll help get them into a culinary program.” St. Mary’s boasts a 91 percent attendance rate and a 100 percent graduation rate, with students going on to become engineers, social workers, accountants and more. In addition to its academic curriculum, St. Mary’s also offers athletic, after-school and summer programs. Students are also encouraged to participate in community service projects. “At St. Mary’s, we believe all children can learn, and that deaf students have the right to a warm, safe, healthy and positive environment at school, and we work hard every day to inspire all our students to achieve their personal goals while striving for excellence,” says Kelly. Julia Bronneberg is an example of St. Marys’ success. Not only is she on the honor roll and at the top of her class, she’s on track to graduate at age 18 and plans to go to college. “She’s overcome the obstacles of living in the hearing world,” says Lauren. “She’s exceeded every expectation, and is a smart, sensitive, well-rounded young lady. We are very proud of all Julia’s accomplishments. She has a wonderful future ahead of her, and we will always be grateful to St. Mary’s. This school will always be part of our family.”
Deaf Awareness Week is September 24-30 For a list of events taking place at St. Mary’s School, for more information about St. Mary’s School for the Deaf or to learn more about its free hearing evaluations, visit www.smsdk12. org or call 834.7200.
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How Medicare Covers Diabetes Dear Savvy Senior, How well does Medicare cover diabetes? I’m 66 years old and was recently told by my doctor that I have prediabetes. If it progresses to full-fledged diabetes what can I expect from Medicare?
Recently Retired Dear Recently, Medicare actually provides a wide range of coverage to help beneficiaries who have diabetes, as well as those who are at risk of getting it — but it doesn’t cover everything. Here’s a breakdown of what Medicare covers when it comes to diabetes services and supplies along with some other tips that can help you save. Screenings — If you have prediabetes or some other health conditions that put you at risk of getting diabetes — such as high blood pressure, high cholesterol and triglycerides, are overweight, or have a family history of diabetes — Medicare Part B (medical insurance) will pay 100 percent of the cost of up to two diabetes screenings every year. Doctor’s services — If you’re a Medicare beneficiary, Medicare will pay 80 percent of the cost of all doctor’s office visits that are related to diabetes. You are responsible for paying the remaining 20 percent after you’ve met this year’s $183 (for 2018) Part B deductible. Prevention program — Just launched in April, the Medicare Diabetes Prevention Program provides lifestyle change programs offered by health professionals to help you prevent diabetes. This is available for free to all Part B beneficiaries who have pre-diabetes. Self-management — If you have diabetes, Medicare covers 80 percent of the cost of self-management training to teach you how to successfully manage your diabetes. Supplies and medications — Medicare Part B covers 80 percent of the cost of glucose monitors, test strips (100 per month if you use insulin, or 33 per month if you don’t), lancets, external insulin pumps and insulin (if you use a pump), after you’ve met your deductible. If, however, you inject insulin with a syringe, Medicare’s Part D prescription drug benefit will help pay your insulin costs and the supplies needed to inject it — if you
have a plan. Part D plans also cover most other diabetic medications too. You’ll need to check your plan for coverage details. Nutrition therapy — Medicare will pick up the entire tab for medical nutrition therapy, which teaches you how to adjust your diet so you can better manage your condition. You’ll need a doctor’s referral to get this service. Foot care — Since foot problems are common among diabetics, Medicare covers 80 percent of foot exams every six months for diabetics with diabetes-related nerve damage. They will also help pay for therapeutic shoes or inserts as long as your podiatrist prescribes them. Eye exams — Because diabetes increases the risks of getting glaucoma and diabetic retinopathy, 80 percent of dilated medical eye exams are covered each year, but eye refractions for glasses are not. For more information, see “Medicare’s Coverage of Diabetes Supplies & Services” online booklet at Medicare.gov/Pubs/pdf/11022Medicare-Diabetes-Coverage.pdf.
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If you have a Medicare supplemental (Medigap) policy, it may pay some of the costs that Medicare doesn’t cover. Call your plan’s benefits administrator for more information. Or, if you’re in a Medicare Advantage plan (like an HMO or PPO), your plan must give you at least the same diabetes coverage as original Medicare does, but it may have different rules. You’ll need to check your policy for details.
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Financial Assistance If you’re income is low, and you can’t afford your Medicare out-ofpocket costs, you may be able to get help through Medicare Savings Programs. To find out if you qualify or to apply, contact your state Medicaid program. Also, find out if you are eligible for “Extra Help” which helps Medicare Part D beneficiaries with their medication expenses. Visit SSA. gov/prescriptionhelp or call Social Security (800-772-1213) to learn more.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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September 2018 •
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Ask The Social
Security Office
From the Social Security District Office
Medicare, Explained
S Here’s What Makes Seniors Feel and Act Younger
A
pair of new studies points toward two potential paths to the fountain of youth. When older adults feel more control of their lives and get more exercise, they feel younger — and that improves their thinking, overall quality of life and longevity, the studies say. One study included 116 older adults (aged 60 to 90) and 106 younger adults (aged 18 to 36). For nine days, the participants kept track of how much control they felt they had each day and how old they felt. Among the older adults, there was a significant link between perceived level of control and how old they felt, according to the findings presented at a recent meeting of the American Psychological Association, in San Francisco. “Shaping the daily environment in ways that allow older adults to exercise more control could be a helpful strategy for maintaining a youthful spirit and overall well-being,” study presenter Jennifer Bellingtier said in an APA news release. She is a postdoctoral researcher at Friedrich Schiller University of Jena in Germany. “Some interventions could be formal, such as a regular meeting with a therapist to discuss ways to take control in situations where individuals can directly influence events,
and how to respond to situations that they cannot control,” Bellingtier said. “Smartphone apps could be developed to deliver daily messages with suggestions for ways to enhance control that day and improve a person’s overall feeling of control,” she added. The second study, also presented at the APA meeting, found that increasing physical activity can help adults feel younger. It included 59 adults, aged 35 to 69, whose daily step counts were tracked. After five weeks, those with greater increases in their step counts felt younger. “Our results suggest that promoting a more active lifestyle may result in a more youthful subjective age,” study presenter Matthew Hughes said in the news release. Hughes is a postdoctoral scientist at the Adult Cognition Lab at the University of North Carolina, Greensboro. “As this was part of a pilot study, our sample size was small,” he noted. “While the results suggest that walking may contribute to feeling younger, further research with a larger sample in a more controlled setting is needed to confirm.” Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.
Serving Western New York A monthly newspaper published by Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region In Good Health is published 12 times a year by Local News, Inc. © 2018 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Julie Halm, Nancy Cardillo, Michael J. Billoni , Katie Coleman • Advertising: Anne Westcott, Amy Gagliano, Angela Rosa Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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ocial Security and Medicare have a few things in common. Both programs help safeguard millions of Americans as well as improve the quality of life for our family and friends. Although both programs are household names, many people may not be familiar with the details of Medicare. Medicare is our country’s health insurance program for people aged 65 or older. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care. You have choices for how you get Medicare coverage. If you choose to have original Medicare coverage, you can buy a Medicare supplement policy (called Medigap) from a private insurance company to cover some of the costs that Medicare does not. Medicare has four parts: • Medicare Part A (hospital insurance) helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay). Part A also pays for some home health care and hospice care. • Medicare Part B (medical insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services. • Medicare Part C (Medicare Advantage) includes all benefits and
Q&A
Q: How much will I receive if I qualify for Supplemental Security Income (SSI) benefits? A: The amount of your SSI benefit depends on where you live and how much income you have. The maximum SSI payment varies nationwide. For 2018, the maximum federal SSI payment for an eligible individual is $750 a month and $1,125 a month for an eligible couple. However, many states add money to the basic payment. For more information, go to www. socialsecurity.gov/ssi. Q: My child, who gets Social Security, will be attending his last year of high school in the fall. He turns 19 in a few months. Do I need to fill out a form for his benefits to continue? A: Yes. You should receive a form, SSA-1372-BK, in the mail about three months before your son’s birthday. Your son needs to complete the form and take it to his school’s office for certification. Then, you need to return page two and the certified page three back to Social Security for processing. If you can’t find the form we mailed to
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
services covered under Part A and Part B. Some plans include Medicare prescription drug coverage (Medicare Part D) and other extra benefits and services. • Medicare Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs. Some people with limited resources and income may also be able to get Extra Help with the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan. The Extra Help is estimated to be worth about $4,900 per year. You must meet the resources and income requirement. Medicare’s different parts are further explained inthe publication at www.socialsecurity.gov/pubs/EN05-10043.pdf. If you can’t afford to pay your Medicare premiums and other medical costs, you may be able to get help from the state. States offer programs for people eligible for or entitled to Medicare who have low income. Some programs may pay for Medicare premiums and some pay Medicare deductibles and coinsurance. To qualify, you must have Medicare Part A and have limited income and resources. You can learn more about Medicare, including how to apply for Medicare and get a replacement Medicare card, at www.socialsecurity.gov/benefits/medicare.
you, you can find it online at: www. socialsecurity.gov/forms/ssa-1372. pdf. Q: How can I get proof of my benefits to apply for a loan? A: If you need proof you get Social Security benefits, Supplemental Security Income (SSI) and/or Medicare, you can request a benefit verification letter online through your personal my Social Security account at www. socialsecurity.gov/myaccount. This letter is sometimes called a “budget letter,” a “benefits letter,” a “proof of income letter,” or a “proof of award letter.” You even can select the information you want included in your online benefit verification letter. Q: I’m reaching my full retirement age and thinking about retiring early next year. When is the best time of year to apply for Social Security benefits? A: You can apply as early as four months before when you want your monthly benefits to begin. To apply, just go to www.socialsecurity. gov/applytoretire. Applying online for retirement benefits from the convenience of your home or office is secure and can take as little as 15 minutes. It’s so easy.
Alexa with her dad Tom and mom Stacey at her wedding last year. Alexa was a student in Boston in 1999 when she was was raped at knifepoint in her dormitory. She later formed a foundation to help victims of sexual assault.
‘It Happened to Alexa’ Local foundation holds fundraising to assist sexual assault victims By Julie Halm
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eing the victim of rape can cause severe emotional and physical trauma. Survivors often spend years, if not lifetimes, doing their best to recover. The fallout that often goes overlooked, however, is the financial strain that can come with taking an attacker to trial. That is the premise on which the organization It Happened to Alexa was founded.
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Besides how refreshing and delicious a crisp pear can be, pears are a super source of fiber and a goldmine of phytonutrients
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A $15,000 grant recently awarded by the Garman Family Foundation administered by the Community Foundation for Greater Buffalo will help with the purchase of a colposcope to be used by the Erie County Medical Center Sexual Assault Nurse Examiner Response
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Alexa Branchini was raped at knifepoint by a man who sneaked into her dorm just 10 after she had arrived at her college campus in Boston. She immediately called authorities and the man was apprehended before he could leave campus. The ensuing trial took place in Boston, several states away from Alexa’s hometown of Lewiston,
Maine. It was two years from the time of the incident until the conviction, and Alexa as well as her parents spent 27 days in Boston in order to testify. “Her being there is undoubtedly what helped with the conviction,” said Kate Fowler, executive director of the organization. In 2001, Alexa’s assailant was sentenced to 40 to 44 years without parole. While her family was able to undertake the expense in order to support their daughter, they realized that not everyone was in the same position. Fowler notes in addition to the upfront costs of travel, families looking to support their loved ones must also pay for items such as food, rental vehicles, hotels and care for other children. Often, families also face a loss of income for time spent away from work. Victims may also have to pay for medication after the fact. They may also lose income due to time taken while dealing with trauma. For college students who do not return to school, their tuition lost is an additional expense. “They founded this organization so that no survivor would have to make the decision whether they could testify based on their finances,” said Fowler. While some states provide help with travel expenses for the victim to be at the trial, there is no instance in which a support person is provided. This can be critical for a person who has recently undergone trauma and is then asked to relive that experience by testifying in a courtroom setting. “If they don’t testify, it increases the opportunity for dismissed cases or lower sentences,” said Fowler. The conviction rate in cases in which the organization has provided help is 84 percent, compared to a national average of below 30 percent. While It Happened to Alexa has come to the aid of more than 800 people in these situations, assisting with expenses is not the organization’s only mission and the organization recently teamed up with a local hospital to apply for additional funding.
You’re Not Alone Half of Americans are trying to slim down
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Team as well as other resources to help assault victims recover. Following an assault, victims’ injuries must be photographed and this has typically necessitated a medical professional being in close proximity with the genital area. For a person who has just experienced sexual trauma, that can be nearly impossible to cope with. The colposcope is a camera that is able to document the injuries from a distance. It Happened to Alexa is also endeavoring to bring a small bit of comfort to victims while they are in the hospital. In April, the organization donated 175 comfort kits to the Erie County Medical Center. “When an assault survivor goes to the hospital, their clothes are taken for evidence,” said Fowler. For victims without someone to call to bring them a change of clothes, that can mean being discharged in a hospital gown. “In Alexa’s case, she was discharged in a hospital gown. We don’t want anybody to leave the hospital in a gown,” said Fowler. Comfort kits include not only soft, clean clothing, but toiletries, as a rape kit can take as long as four to eight hours. The simple measure of brushing one’s teeth or taking a shower can bring comfort after a traumatic experience. The hope of repeating the project of donating the kits annually was one of the factors in applying for the recently received grant. The funds will also help purchase books to be given to survivors in order to aid their recovery. Unfortunately, there is great need for such kits and resources. According to Fowler, 400 sexual assaults are reported between Erie and Niagara counties annually. If that is not alarming enough, it is estimated that half of all assaults go unreported. “The statistics are that one in five women and one in six men have been or will be assaulted,” said Fowler. “Whenever I start a presentation, I tell people that whether you know it or not, you know someone who has been assaulted.” To help move the mission forward, It Happened to Alexa will host the annual Raising the Stakes Gala at 7 pm. Sept. 29 at the Sheraton at the Falls. For more information and to purchase tickets, visit www. ithappenedtoalexa.org/events/ raising-stakes-gala.html.
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Tips to Increase Male Longevity
SEPTEMBER 2018 • ISSUE 47
Special Needs Issue Starts on page XX
Exercise Really Can Chase Away the Blues … to a Point
Daith Piercing
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Can it reduce migraine pain? Some say yes, but what do experts say?
Why You Should Eat Pears
Besides how refreshing and delicious a crisp pear can be, pears are a super source of fiber and a goldmine of phytonutrients
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H ealth News Ronald A. Raccuia appointed president at ECMC Foundation Ronald A. Raccuia has been named chairman of ECMC Foundation board of directors. President of ADPRO Sports and executive vice president of licensing & branding with Pegula Sports & Entertainment, Raccuia has been member of the ECMC Foundation board since 2014. In addition, Douglas Baker (president, Mercy Flight, Inc.), Judy Jack Lewis (licensed associate broker, Hunt Real Estate) and Michael R. Raccuia Militello (president, MRM of Buffalo, Inc.) have also been appointed to ECMC Foundation’s board. ECMC Foundation’s board of directors is a nonprofit organization comprised of leaders in business, education, healthcare and many other industries. It works to ensure that ECMC can consistently offer the best and most caring support to patients from throughout Western New York.
Sisters Hospital opens metabolic center Catholic Health recently announced that Sisters of Charity Hospital, St. Joseph Campus, will be home to the newly formed Sisters Metabolic Center for Wellness, Comprehensive Rehabilitation and Bariatric Services. With an emphasis on wellness, the 6,000-sq.-ft. facility is the first of its kind in Western New York and features state-of-the-art equipment and clinical space for bariatric and nutrition support services; cardiac rehab phase II; occupational therapy; physical therapy; industrial rehab and speech therapy. This unique facility will play a key role in Catholic Health’s leading bariatric surgery program, according to a hospital news release. Bariatric (weight loss surgery) patients will be able to use the facility for physical therapy, nutrition counseling and other support services before and after their procedures. Sisters’ bariatric program, ranked among the best in the northeast, is a Blue Center of Distinction. Endocrinology services, an important part of the metabolic and bariatric program, will be provided at the Caritas Building, located adjacent to the St. Joseph Campus, later this year. “The services and care offered in the Metabolic Center for Wellness will be a valuable resource for patients to not only recover from various procedures/conditions, but also to better prepare for their surgeries,” said Martin Boryszak, president and CEO of Sisters Hospital. “With a highly skilled and compassionate care team in place, we are able to provide our patients with Page 22
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holistic and personalized services to support their health and wellness goals.”
CEO Randy Gerlach joins leadership program Randy Gerlach, president and CEO of Schofield Care, has been chosen by the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) as a future leader in long-term and post-acute care (LTPAC). Gerlach will join the association’s future Gerlach leaders program, a year-long program that offers training and guidance for LTPAC professionals. “At AHCA/NCAL we are always searching for the future leaders of our profession. After a thorough review, we have selected Randy Gerlach as one of our future leaders,” said Mark Parkinson, president and CEO AHCA/NCAL. “Randy Gerlach has already made a positive impact on the lives of older people in their community and we are excited to be a part of their future.” Said Stephen Hanse, president and CEO of the NYS Health Facilities Association and the NYS Center for Assisted Living: “New York’s long term care and post-acute providers and residents are truly fortunate to have Randy Gerlach chosen as an AHCA/NCAL future leader. Randy’s extensive knowledge and experience are well known and highly regarded in New York.” Gerlach has more than 30 years of experience in healthcare management and nursing home operations both locally and throughout New York. He is the vice chairman of the New York State Health Facilities Association and has served as president of the WNY district 10 for five years. The future leaders program covers the latest theories and practical applications in quality management, customer satisfaction and leadership. The year-long program kicks off with a two-day symposium, “Future Leaders of Long Term Care in America,” held in Washington, D.C. This year’s symposium will take place Sept. 26 - 28.
Bariatric surgery at ECMC gets accreditation The Synergy Bariatrics/Center for Bariatric and Metabolic Surgery at Erie County Medical Center (ECMC) has recently been accredited for a second consecutive three-year period as a “Comprehensive Center” under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a joint program of the American College of Surgeons (ACS) and the
Roswell Park Among Top Cancer Hospitals Roswell Park Comprehensive Cancer Center ranks among the top 3 percent of cancer centers nationwide, as assessed by U.S. News & World Report. The center moved up three spots, to 30, on the media outlet’s annual list of 50 Best Hospitals for cancer. It was also recognized as high-performing within two subspecialties: colon cancer surgery and lung cancer surgery. One of only five New York state centers to make the top 50, Roswell Park once again stands as the only facility in all of Western and Central New York to be named a Best Hospital for cancer. The annual Best Hospitals rankings, which are based on factors including hospital volume, nurse staffing and other aspects of the hospital environment, are designed to help patients make informed decisions. In compiling the 2018-19 Best Hospitals–Cancer list, U.S. News compared data for 889 eligible cancer hospitals. Only 158 hospitals among more than 4,500 centers evaluated nationwide were ranked in even one of the 16 main specialties this year. Roswell Park received the maximum scores in areas including patient survival, advanced
technologies and patient services. “You have to be good at a lot of things to even place among the top 50, so for Roswell Park to keep moving up the list affirms that we are providing care that measures up to the highest national standards,” says the cancer center’s President and CEO Candace S. Johnson, PhD. “Across many different metrics and factors relating to clinical care, you see that Roswell Park continues to constantly improve, year by year,” says physician Stephen Edge, a national expert on healthcare quality measurement who serves as vice president of healthcare outcomes and policy at the cancer center. “We evaluate our care very closely through the lens of ‘How can we get even better? How can we make our patients’ overall experience as good as it can be?’ ” Roswell Park has been honored by many organizations for the quality of its care. In addition to its status as a U.S. News Best Hospital for cancer, the cancer center has been recognized by the BlueCross BlueShield Association as a Blue Distinction Center for Cancer and received Guardian of Excellence Awards for patient satisfaction from Press Ganey Associates for each of the past three years.
American Society for Metabolic and Bariatric Surgery (ASMBS). This accreditation extends from 3/27/18 to 3/27/21. Patients seeking surgical treatment for severe obesity and its related conditions have a highquality choice for receiving treatment at a nationally accredited program that meets the highest standards for patient safety and quality of care in the Western New York region. The MBSAQIP Standards, outlined in the Resources for Optimal Care of the Metabolic and Bariatric Surgery Patient 2016 ensure that bariatric surgical patients receive a multidisciplinary program, not just a surgical procedure, which improves patient outcomes and long-term success. The accredited center offers preoperative and postoperative care designed specifically for their severely obese patients. To earn the MBSAQIP designation, ECMC Synergy Bariatrics/Center for Bariatric and Metabolic Surgery met essential criteria for staffing, training and facility infrastructure and protocols for care, ensuring its ability to support patients with severe obesity. The center also participates in a national data registry that yields semiannual reports on the quality of its processes and outcomes, identifying opportunities for continuous quality improvement. The standards are specified in the MBSAQIP Resources for Optimal Care of the Metabolic and Bariatric Surgery Patient 2016, published by the ACS and ASMBS. “We are pleased that we have
received this designation for a second consecutive three-year term,” said ECMC Synergy Bariatrics/ Center for Bariatric and Metabolic Surgery Director Joseph A. Caruana. “Everyone involved worked extremely hard for this accreditation. The notification of this accreditation, as explained by the MBSAQIP, means that ECMC’s bariatric program is of the highest quality and properly centered on the patient.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2018
New leadership at Eastern Niagara Hospital Anne E. McCaffrey, who served as mayor of Lockport until Aug. 8, has been named president and chief executive officer at Eastern Niagara Hospital (ENH). McCaffrey has nearly 20 years of health care management experience, having served in leadership roles at Lake Shore Behavioral Health from 1991-2010. While at Lake Shore, she held various positions including director of vocational services, director of rehabilitation services as well as coordinator of development and community relations. She was mayor of Lockport since 2014. McCaffrey “Anne is a proven leader with great experience and a demonstrated track record in both the public and private sector,” Jody L. Lomeo, president
and CEO of Kaleida Health. “She is the right choice to lead Eastern Niagara Hospital as it starts its new chapter with the Kaleida Health affiliation. Anne understands the needs of Lockport, Newfane and the surrounding communities and will work hard to enhance healthcare for the residents of eastern Niagara County.” In addition to this, David J. DiBacco has been appointed chief operating officer for Kaleida Health’s northtowns facilities, which include Millard Fillmore Suburban Hospital, DeGraff Memorial Hospital, and now, Eastern Niagara Hospital (ENH). DiBacco has been the Eastern Niagara Hospital chief operating officer (COO) since 2004. He has served as interim CEO at the site since May 2018. “We are pleased to welcome Dave to the Kaleida Health family,” said Lomeo. “He has made a significant impact on ENH during the past two months while serving as the interim CEO. Dave’s leadership and talent were Dibacco immediately recognized by us; and his expertise as a strong operations leader will help Kaleida Health coordinate care across
all of our northtowns sites.” McCaffrey was the 57th mayor of the city of Lockport and is a lifelong city resident. After graduating from DeSales High School and Nazareth College of Rochester, she went on to obtain a master’s degree in public policy analysis from the University of Rochester. McCaffrey worked for Lake Shore Behavioral Health in Buffalo for nearly 20 years, where she held several management positions. In 2011, she decided to focus her efforts on the city of Lockport and was elected to alderwoman of the Second Ward. She was reelected in 2013 and was appointed Common Council president. She became mayor in February 2014 upon the resignation of the former mayor. McCaffrey was subsequently elected to a full four-year term as mayor, which began in January 2016. DiBacco has more than 30 years of experience in the health care industry. Prior to joining ENH, he served in senior leadership and operations positions at Niagara Falls Memorial Medical Center and Mt. St. Mary’s Hospital. DiBacco is a resident of Lewiston. He holds two bachelor’s degrees from Niagara University, one in accounting and one in business/commerce. He is active in the Niagara County community, volunteering his time with various community, business and sports organizations.
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ECMC: Record Patient Growth For Third Year In A Row Through the first six months of 2018, growth continues across all patient care categories, maintaining and exceeding previous recordsetting activities set in 2016 and 2017; emergency department receiving increased transfers from other hospitals throughout Western New York Erie County Medical Center Corporation recently announced that through the first six months of 2018, Western New Yorkers continued to make ECMC their hospital of choice, as the institution continued record patient volume activity that first reached new heights in 2016 and has been maintained through June of this year. Through June, volume increases from the previous year included: inpatients (4.5 percent increase); total surgeries (5.6 percent increase); ED visits (1.6 percent), and outpatient visits (3.4 percent increase). In addition, area hospitals continue to partner with ECMC to transfer patients to the emergency department for high-level, specialized care. In 2017, ECMC received 6,446 transfers to the emergency department. Through the first six months of 2018, ECMC has received 4,027 transfers vs. 3,203 transfers in the first six months of 2017. Additional ECMC quality achievements to date this year include: • Receipt of the national the national Women’s Choice Award for both bariatrics and orthopedics. 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. • Successful five-year reaccreditation by The Centers for Medicare and Medicaid Services (CMS), part of the Department of Health and Human Services (HHS) of Transplant program, housed in ECMC’s Regional Center of Excellence for Transplantation and Kidney Care. • Medical Intensive Care Unit (MICU) awarded a silver-level American Association of Critical Care Nurses (AACN) Beacon Award for Excellence, which is a three-year designation highlighting the unit’s achievement of exceptional care through improved outcomes and greater overall patient satisfaction. • ECMC’s Synergy Bariatrics / Center for Bariatric and Metabolic Surgery was accredited for a second consecutive three-year period as a comprehensive center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) – a joint program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS). “ECMC continues to be a place of choice for physicians, employees and patients in Western New York. Thanks to the dedication and skilled professionalism of our over 3,000 caregivers — at every level — ECMC continues to serve as our region’s community hospital, providing high quality care to all that seek our services. We thank the community for entrusting us with their care,” said ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. said.
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By acting today, we can heal tomorrow’s traumas.
Nicholas Ball Trauma Patient
Karen Beckman-Pilcher, RN, MSN Clinical Nurse Specialist of Emergency Services
Amy Terpening Traumatic Brain Injury Survivor
Michael A. Manka Jr., MD Chief of Emergency Medicine
Donna Oddo, RN, BSN Nursing Care Coordinator Emergency Department
As Western New York’s only Level 1 Adult Trauma Center, the future of healthcare at ECMC is clear. With a steady rise in patient volume, we know that more of our neighbors will depend on our lifesaving trauma and emergency care more than ever before. And with your support, they’ll receive it in a new facility with state-of-the-art technology, more space and privacy, and designed for better experiences and outcomes for patients and their families.
The difference between healthcare and true care
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