IGH WNY 52 February 19 by In Good Health: WNY's Healthcare Newspaper

PRICELESS

Meet Your Doctor Bhuvana Ramkumar, a Roswell Park oncology/hematology physician, talks about practicing medicine in Niagara Falls, Williamsville

BFOHEALTH.COM

Heart Disease

FEBRUARY 2019 • ISSUE 52

One in every four deaths in the U.S. is caused by heart disease, considered one of the most preventable health ailments. Because February is Heart Month, we decided to speak with Buffalo cardiologist Anne Curtis, who offers five simple steps people should take to prevent heart disease. Page 9 Live Alone Columnist: Resolve to enjoy Valentine’s Day

UB Doctor Dispels Myths About the Flu Flu season expected to continue through May

Yoga. Is It Time to Try? 10 Years Smoke-Free Western New York resident wants to be an inspiration to those looking to quit smoking

What’s the Best Diet for 2019? Experts Weigh In Atkins diet, paleolithic diet, DASH diet, Dukan diet, MIND diet, the Beverly Hills Diet — find out what’s the best diet to follow today. Page 2

Raisins

Many athletes consume raisins for the rapid energy they provide. Should you? Page 11

Sex After 65 Majority are satisfied with their sex lives; nearly one in five older men uses medications or supplements, says poll Page 16

What’s the Best Diet for 2019? Experts Weigh In

or many, the start of the new year signals the start of a new diet. But what’s the best way to eat if you want to lose weight? For overall healthy eating, the best diet plan is the Mediterranean diet, according to U.S. News & World Report’s annual diet review. The DASH (Dietary Approaches to Stop Hypertension) diet was ranked second on the magazine’s overall Best Diets 2019 list, followed by the Flexitarian plan. All three plans focus on eating a mostly plant-based diet (veggies, fruits and whole grains), healthy fats and lean protein sources. “I hope these rankings steer people in the direction of doing something healthful,” said nutritionist Samantha Heller of NYU Langone Health in New York City. “I wish though, that we weren’t so obsessed with weight loss and diets, per se. I wish the focus was on adopting a healthy lifestyle, like eating a more plant-based diet, getting regular exercise, getting enough sleep and managing stress, all of which help us live a better quality of life,” Heller said. To that end, she said the top three diets are all similar in their food content, and all can be healthy eating regimens.

The Mediterranean diet has been linked to increased longevity and a decreased risk of chronic illnesses, the report said. The Mediterranean diet was also ranked high in multiple categories including: easiest diets to follow, best diets for healthy eating, best diets for diabetes, and best diets for heart health. If weight loss is part of your plans, here are plans that topped the rankings for the best weight-loss plans: • WW (Weight Watchers) • Volumetrics • Flexitarian diet (tie) • Jenny Craig (tie) • Vegan diet (tie) Feel the need to knock off some pounds quickly? Here are the best fast weight-loss plans: • HMR program • Atkins (tie) • Keto diet (tie) • Optavia (tie) • WW (Weight Watchers) (tie) Heller said that many people feel that they need to kick-start” their weight loss for motivation. The problem with plans that focus on fast weight loss, however, is that they don’t teach you how to eat well every

day. “On these types of diets, you often don’t learn how to manage holidays, stressful days or special occasions. You don’t develop strategies for life,” she said. The magazine asked a panel of nutrition experts to review 41 diet plans. Like Heller, the expert panelists emphasized the importance of well-balanced, sustainable diets that aren’t overly restrictive. These types of diets can help teach lifelong positive eating habits.

Lifestyle diets, such as the Mayo Clinic diet and MIND diet, are healthier and more sustainable than weight-loss plans such as the Ketogenic or Atkins diet are, the panelists concluded. Although the popular Keto diet ranked high for fast weight loss, it landed way down on the Best Diets list — tying for number 38. Other diets at the bottom of the list included the Dukan diet, the Body Reset Diet and the Whole30 diet.

UB Doctor Dispels Myths About the Flu Flu season expected to continue through May By Ernst Lamothe Jr.

he flu season has ravaged the United States once again this year. The Centers for Disease Control and Prevention reported anywhere from six to seven million people have been affected by the flu since late fall. Between 69,000 to 84,000 people were hospitalized from October through January. The numbers are from data from 27 million people. There were widespread flu outbreaks across 31 states, including New York, according to the CDC. The flu season typically runs from October to May with peak season during the middle of winter. “There are so many people who don’t understand the severity of the flu,” said physician Thomas Russo, professor and chief of the division of infectious diseases at the Jacobs School of Medicine and Biomedical Sciences in Buffalo. “There are so many myths that keep permeating through society and people need to understand why we preach every year about getting a flu shot.” Since 2010, CDC estimates that flu has resulted in between 140,000 and 960,000 hospitalizations each year. Russo said many people think if they contracted the flu last year that they can’t get it the subsequent year. “There are multiple strains of the flu from each year,” he added. “ExPage 2

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perts try to predict based on the flu strain that is occurring in the southern hemisphere on what may affect our area. Some years they are very accurate and other years the strain changes after they make the vaccine.” Flu vaccines have been updated to better match circulating viruses. Babies older than 6 months should get vaccinated with a traditional shot. For toddlers aged 2 or older a shot or a nasal spray called FluMist is recommended. Even if someone gets sick with flu, antiviral drugs may be an option, especially for people who are at high risk of serious flu complications, including young children, adults 65 and older and people with certain medical conditions such as asthma, diabetes and heart disease. Women who are pregnant or breastfeeding are encouraged to be vaccinated as well. Flu is more likely to cause severe illness in pregnant women than in healthy women who are not pregnant. Changes in the immune system, heart and lungs during pregnancy make pregnant women, and women who have given birth within the past two weeks, more prone to severe illness from flu, including illness resulting in hospitalization. “A lot of people think if you are young and healthy then it just won’t happen to you. Yes, being healthy

Physician Thomas Russo, professor and chief of the division of infectious diseases at the Jacobs School of Medicine and Biomedical Sciences in Buffalo. helps, but there have been people who have died of the flu who have been both young and healthy before it struck,” added Russo. “The flu is completely unpredictable and it can be life-threatening.” Some of the challenges in counting flu associated with death include the sheer volume of deaths counted, the lack of testing because not everyone that dies with an influenza-like illness is tested for influenza and sometimes deaths are coded differently because of multiple medical problems. Flu vaccine is produced by private manufacturers, so supply depends on manufacturers. For the 2018-2019 season, manufacturers projected they would provide between 163 million and 168 million doses of injectable vaccine for the U.S. market. Other myths that Russo discusses with patients are those who maintain

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2019

they can’t take the flu shot because of their egg allergies. In the past, people with egg allergy were advised to explore egg-free vaccination options. Most flu vaccines administered today are manufactured using chicken eggs and contain trace amounts of a protein called ovalbumin. But studies from Annals of Allergy, Asthma and Immunology found the flu shot to be safe and recommended its use for people who are allergic to eggs. “Some people may get slight hives but nothing serious. We just want to make sure that there are no barriers to people who should be getting their flu shot,” said Russo. “You are always at risk of having the flu and the last two years there have been a tremendous amount of people diagnosed.”

TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.

Partner with Your Provider To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.

Be Heart Smart A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure

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. Source: www.Heart.org.

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WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015

February 2019 •

©WellCare 2015 NA_03_15_WC IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 3

Meet

Your Doctor

By Chris Motola

Bhuvana Ramkumar, MD Play It Safe With Winter Sports

kiing, snowboarding, skating and sledding are great ways to have winter fun, but be sure to take steps to reduce your risk of injuries, experts say. In 2017, U.S. emergency departments, doctors’ offices and clinics treated 68,809 people for skiing-related injuries, 54,349 people for snowboard-related injuries, 52,308 people for ice skating-related injuries, and 4,499 people for toboggan-related injuries, according to the U.S. Consumer Product Safety Commission. “Overexerting yourself on the slopes can lead to injuries ending your run for the season,” said physician Lori Reed, a spokeswoman for American Academy of Orthopaedic Surgeons (AAOS). “Individuals are at an increased risk of injuries such as sprains, strains, dislocations and fractures due to exhaustion,” Reed said in an academy news release. “You can prevent these by staying in good physical condition year-round and listening to your body. Don’t push your body when you are in pain or too tired.” Here are winter sports safety tips from the AAOS: • Stay in shape and condition muscles before starting winter sports. Warm up thoroughly before an activity. Cold muscles, tendons and ligaments are at increased risk for injury. Drink plenty of water before, during and after activities. • Wear several layers of light, loose and water- and wind-resistant clothing. Layering allows you to adapt to your body’s changing temperature. Wear footwear that keeps your feet warm and dry, and has good ankle support. • Take lessons from a qualified instructor, especially in sports such as skiing and snowboarding. Learning how to fall correctly can reduce the risk of injury. Check that equipment is in good working order and wear appropriate protective gear. • Know and follow all rules of the sport. Don’t do a winter sport alone. Monitor for and heed warnings about storms and severe drops in temperature. • Seek shelter and medical attention immediately if you or anyone else develops hypothermia or frostbite. Make sure everyone knows how to get help in the event of injuries.

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Roswell Park hematology/oncology physician enjoys practicing in a community setting; noted for developing positive rapport with patients Q: You primarily specialize in oncology, but you’re board-certified in other specialties, correct? A: Yes, I’m a medical oncologist and hematologist. That’s what I practice right now. I’m also board-certified in internal medicine and hospice and palliative care. So my primary practice is oncology, but I try to incorporate the hospice and palliative care elements as well. Q: What kinds of cancer are you mainly dealing with? A: I treat patients in a community setting in Niagara Falls and Williamsville. I treat different cancers: breast, lung, prostate, blood cancers. So I see a lot of different ones. Q: How do you deliver cancer care in that kind of setting, and what are the advantages to doing so? A: We provide chemotherapy, manage patients’ symptoms and provide support locally so they don’t have to go to the main campus center. They can get the care they need in the community. Q: Cancer-related fatalities have been falling. What do you think is responsible for that? A: The American Cancer Society looked at data from between 1991 through 2015 and there was a significant drop in cancer-related deaths of

around 27 percent. It translates to about 2.6 million deaths. So that’s a lot. I can tell, from looking at 1991 through now, there have been a lot of changes in cancer care. The field has sort of exploded, research, clinical trials, pharma companies getting involved. We’ve had new treatments, new therapies. So we have a lot of different therapies for different types of cancers and we have what are called “targeted agents,” drugs that target the cancer cells without affecting a lot of the other cells. We have oral agents now that can be taken as a pill. And you may only need to be seen once a month, once in three months to get monitored, so it’s a lot more convenient. And there’s a lot of ongoing research being done. Q: Are you involved in any research? A: I’m in a community setting, but the good thing about working with Roswell Park is I have access to clinical trials. If a patient qualifies for a clinical trial, they have to go to the main building at this point. In the future, we are looking at trials that can be done in a local community setting. We don’t have that right now, but it’s coming. Q: Patients seem to respond very well to you. How do you go about building a rapport with someone dealing with as serious a disease as cancer? A: Like I mentioned, I treat different types of cancers, so there are different types of treatments. I think the key elements for any physician, especially any oncologist, is communicating with the patient and involving the family and patient in every step of the way. There’s something we try to do in cancer treatment right now where we want to inform the patient, not tell them what to do but to involve them in their own care. We also try to involve the patient’s family,

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2019

because it’s not one visit and you’re done. It’s going to be a process. It can be a short time, or it can be up until the end of life. So in the beginning and every step of the way, communication is key. I think they appreciate that a lot. That’s basically it. Q: Aside from the more complex medical questions, do you think patients generally have a good idea of what they need? A: I think every patient is very unique. There’s a lot of medical jargon, and it’s not that they’re going to understand all of it, but the point is not to confuse them, and to communicate in language they understand. So when I talk to patients, I try to get a sense of how much they want to know. People read a lot of information now. They’ll go online to sites like the American Cancer Society, so they’ll often have a lot of questions for us before they even come in. So everybody’s different. You need to find out what they want to know. The goal isn’t to give them more information than they can remember or to just tell them what to do. Q: Are there any new treatments coming down the pipeline that you find interesting? A: Immunotherapy has been studied for multiple cancers and we use it with a lot of cancers, and we’re starting to use it on additional cancers, and more advanced cancers. So there are a lot of studies looking into that and how to combine immunotherapy with other therapies like chemo and targeted therapies. Q: How does immunotherapy differ from chemotherapy? A: Chemotherapy basically tries to affect the grow of cells. Immunotherapy, what they’re trying to look at is how to use the immune system to target cancer cells. There are markers and proteins that can be targeted to affect cell growth.

Lifelines Name: Bhuvana Ramkumar, MD Position: Medical director, Roswell Park Hematology Oncology of Niagara; staff physician, Roswell Park Hematology Oncology Northtowns Hometown: Chennai, India Education: The Tamil Nadu Dr. M.G.R. Medical University in Chennai, India; internal medicine internship from The University of Oklahoma-College of Medicine in Tulsa, Okla., and an internal medicine residency at Rochester General Hospital in Rochester, where she received a research scholarship and Best Emergency Room Resident award. She completed a fellowship in hematology and oncology at SUNY Upstate Medical University in Syracuse, where she was elected chief fellow in the hematology and oncology program. She was employed as a dedicated oncology hospitalist at Roswell Park, where she was presented the Best Multidisciplinary Team award Affiliations: Roswell Park Comprehensive Cancer Center; Mount St. Mary’s Hospital Organizations: American Society of Hematology; American Society of Clinical Oncology Family: Husband Swaroop and two daughters, Anika and Riya Hobbies: Playing the piano, cooking, promoting Indian culture with community org. CHAI

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One in 10 Adults Have Food Allergies, But Twice as Many Think They Do

ore than 10 percent of U.S. adults have a food allergy — and nearly double that believe they do, a new study estimates. Researchers found that 19 percent of those surveyed thought they had a food allergy. But when the investigators dug into people’s symptoms, they found that only 10.8 percent reported “convincing” signs of a true allergy. Experts said the findings highlight two important facts: Food allergies are common among U.S. adults, and many mistakenly believe they have one. “There are many misconceptions around reactions to food,” said lead researcher and physician Ruchi Gupta, a professor of pediatrics at Northwestern University, in Chicago.

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According to Gupta, it can be easy for people to assume food-related symptoms signal an allergy. But other conditions can be the real culprit, she said. People with true allergies have an immune system reaction against proteins in a particular food. Those reactions, Gupta explained, can sometimes be severe — including life-threatening breathing difficulties or drops in blood pressure. So it’s critical to get an accurate diagnosis, she noted.

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More Proof High-Fiber Diets Help Prevent Cancers, Heart Disease

large, new analysis helps confirm that eating lots of grains, vegetables and fruit lowers your risk of dying early from cancer or heart disease. When compared with those who consume very little fiber, people at the high end of the fiber-eating spectrum saw their risk for dying from heart disease, stroke, Type 2 diabetes and/or colon cancer plummet by 16 to 24 percent, investigators reported. The team also concluded that more is definitely more: For every additional 8 grams of dietary fiber a person consumes, the risk for each of those illnesses was found to fall by another 5 to 27 percent. “The health benefits of fiber

are supported by over 100 years of research into its chemistry, physical properties, physiology and effects on metabolism,” said study author Andrew Reynolds, a postdoctoral research fellow at the University of Otago in New Zealand. “What really surprised us was the range of conditions that higher intakes of dietary fiber seemed to improve,” Reynolds added. “Heart disease, Type 2 diabetes and [colon] cancers are some of the most detrimental diseases of our time.” The conclusions follow a deepdive into the results of 185 observational studies conducted over the last four decades, alongside the findings of another 58 clinical trials involving more than 4,600 participants.

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MOTHER. SISTER. FRIEND.

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

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In Good Health is published 12 times a year by Local News, Inc. © 2019 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

February 8, 2019 • Lexus Club, Buffalo

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Daniel Meyer, Ernst Lamothe Jr.,George Shannon, Jenna Schifferle, Jana Eisenberg Advertising: Anne Westcott, Amy Gagliano 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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Top Health Stories of 2018

Here are the top stories covered by news media last year

before. Many worry that the sleek “cool” factor of the leading e-cigarette brand, Juul, may be luring the young to take up vaping — which many experts worry is a merely a bridge to traditional smoking. Seeking to reverse these trends, the U.S. Food and Drug Administration in November announced that it would take steps to limit or ban access to flavored e-cigarettes, much favored by teens.

Rates of opioid-linked fatal overdoses nearly double

The scourge of opioid addiction and related deaths cut through American society again in 2018, capturing headlines and making it the year’s top health story. Rates of opioid-linked fatal overdoses have nearly doubled over the past decade and topped 70,000 in 2017, according to data released in November by the U.S. Centers for Disease Control and Prevention. Many of those tragic deaths occurred among young adults and were linked to fentanyl, a synthetic opioid that’s 50 times more potent than heroin. All of this means that for three years in a row, U.S. average life expectancy reversed a long-term upward trend and actually dropped — from nearly 79 years in 2014 to 78.6 years now. “We’ve been talking about the fact that our children will live less long than we will, and that’s clearly coming to pass,” said physician Georges Benjamin, executive director of the American Public Health Association. Other top health stories of 2018,

as compiled by editors at HealthDay, an online business that produces health-related content:

rates soar among the 2.Vaping young Even as smoking rates fell to alltime lows among teens, another form of addictive nicotine intake, the e-cigarette, was poised to take its place. The latest federal data on youth behaviors found vaping among American teenagers rising dramatically in 2018, with nearly two of every five high school seniors (37 percent) reporting they’ve tried an e-cigarette during the past year. That’s up from 28 percent the year

3.A deadly flu season

A virulent dominant strain of influenza, relatively low uptake of the flu shot, and a poor match between the vaccine and the dominant strains of virus combined to make 2017-2018 one of the worst flu seasons in recent memory. Over 80,000 people — many of them the frail elderly or the very young — died from complications of flu, the CDC reported, and hospitals were jammed with patients battling the virus. So far, the new season seems milder, but CDC experts warn that influenza can still bring surprises, so they urge vaccination.

4.Marijuana use rises

By 2018, 33 U.S. states had legalized marijuana for medical use, and neighboring Canada also legalized the drug for recreational use. Aging baby boomers seemed to embrace pot, and in a HealthDay/Harris Poll conducted in July, 85 percent of U.S. adults agreed that pot should be allowed for medical purposes, while 57 percent supported recreational use. One legal marijuana derivative product, medicinal CBD oil, became hugely popular in 2018. A form of CBD liquid, Epidiolex, became the first marijuana-derived drug ever approved by the FDA. It is used to help ease certain forms of epilepsy. Not everyone was happy about widening access to marijuana, however. “The problem here is we’re at the beginning of this massive experiment with unknown outcomes,” said Fred Muench, president and CEO of the Partnership for Drug-Free Kids.

5.Obamacare holds on another year Despite promises by the Trump White House and Republicans in Congress to repeal it, the Affordable Care Act (ACA) — also known as “Obamacare” — kept providing health care to Americans in 2018. In fact, despite pessimistic mid-year predictions, ACA sign-ups for 2018 held steady at near 12 million, and were only down slightly for 2019.

Healthcare in a Minute By George W. Chapman

Consumers Happy with Providers, Not So Much With Their Office Staff

survey by NRC Health, which focuses on researching and providing consumer data to the industry, found that 87 percent of consumers felt their provider treated them with courtesy and respect, but only 67 percent felt the same about the office staff. Seventyseven percent of respondents were generally dissatisfied with waiting times. Yet, while expressing satisfaction with providers on one hand, a staggering 80 percent of the respondents said they would switch

providers for convenience alone. In defense of medical office staff, they are typically the ones who have to explain why the doctor is running behind and then may have to explain why the patient’s insurance doesn’t cover something. Once in the exam room, most patients tend to be more demure with their provider and don’t voice their concerns. Rather than leaving the practice altogether, filing a polite suggestion, (versus an angry grievance), will prove more valuable to the practice and you.

ACA Deemed Unconstitutional

business because the judge issued a declaratory decision versus an injunction. The major healthcare trade associations, including the American Hospital Association, America’s Health Insurance Plans and the American Medical Association have all expressed their disapproval of the ruling. Neither Congress nor the Trump administration has plans for a viable alternative.

A federal judge in Texas has ruled that the Affordable Care Act is unconstitutional by virtue of the individual mandate that requires you to have health insurance or suffer a penalty if you don’t. Because the individual mandate is so essential or “inseverable” to the act, the judge concluded the entire law to be invalid. By striking down the law, components like expanded Medicaid, premium subsidies/tax credits, pre-existing condition protections, value based payments to hospitals and physicians, and cost reductions are also wiped out. There is far more in the ACA than meets the average consumer’s eye. Hospital systems and physicians have invested heavily to comply with the ACA. An appeal may well reach the Supreme Court. The ACA is still law of the land and the exchanges remain open for

Older Americans Worried About Coverage

According to a poll conducted by the University of Michigan, people between the ages of 50-65 are, understandably, worried about their health coverage as they head toward retirement and Medicare. Twenty-seven percent of respondents fear they won’t be able to afford their employer-provided insurance next year and almost half — 45 percent —

fear they won’t be able to afford their insurance after they retire. Thirteen percent said they postponed or delayed a medical procedure because of the related out-of-pocket costs. Twenty percent said they would keep working past 65 to retain employer-sponsored insurance. Researchers found that fears are stoked by the lack of consistent policies from Washington, the constant attacks on the ACA without viable alternatives and threats by Congress to balance the budget by cutting funding for Medicare and Medicaid which most likely means decreased benefits coupled with increased premiums.

Specialty Drug Costs

Insurers say they are disproportionately driving up the cost of care and premiums. According to the California Department of Insurance, specialty drugs accounted for just 3 percent of all prescriptions, but accounted for 50 percent of total drug costs. Major insurers including Aetna, Anthem, Cigna and United spent $606 million on specialty drugs in 2017. That works out to about $81 per member per month or almost $1,000 per member per year. Depending on your plan, that $1,000 is about 16 percent of the total annual premium. On average, specialty prescriptions were $2,361 per script. Brand name scripts averaged $236 and generics averaged just $29 per script. The most frequently prescribed specialty drugs are the HIV drug Truvada, the immunosuppressant drug Humira, the diabetes drug Victoza and the hormonal drug Androgen. Despite the limited audience for these drugs,

February 2019 •

most of us recognize these drugs from the ubiquitous ads on TV.

Dementia/Alzheimer’s

About 5.7 million Americans are afflicted with the disease. It is the sixth leading cause of death in the U.S. and there still is no cure. However, there is some heartening news coming out of a study conducted by the University of Kentucky. Our “cognitive good health” has been expanding further beyond 65, which means any signs of dementia are presenting later and later in life. According to the researchers, about 10 percent of those over 65 will actually contract dementia, or its most common form — Alzheimer’s. About 20 percent to 25 percent of seniors will suffer only mild impairment. The researchers are not sure why the onset is occurring later in life. Here are the common symptoms of Alzheimer’s: trouble completing easy tasks; difficulty solving problems; change in mood or personality; withdrawal from family and friends; problems communicating; confusion about people, places, events; trouble understanding images. 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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Celebrating a successful race is participant Jess Rubin, her mother Vickie Rubin, and RACIN! volunteers Eric Frank, Frank Cammarata and Kevin Penberthy. ta, who serves as executive director for the Erie County Office for People with Disabilities. “I really enjoy the friendships I’ve established and the camaraderie of running in local events with people who in the past may not have been presented the opportunity to participate. It’s awesome.” This past year the RACIN! athletes, their “pushers” and other volunteers from the organization were quite active, training for and eventually running in eight different races. True dedication

On the Road to Diversity, Equity and Inclusion Innovative athletic program known as RACIN!’ assists Western New York athletes living with disabilities By Daniel Meyer

elping people with developmental disabilities experience the thrill of competing in a foot race was what B.J. Stasio, Frank Cammarata and Eric Frank had in mind when they created an organization comprised of dedicated volunteers who continuously support people who are less fortunate. The Rollin’ Athletic Club Inclusion Network, which is better known in the WNY racing community as RACIN!, is made up of like-minded

people who advocate for opportunities that easily allow individuals who are developmentally disabled to participate in area road races. Formed in 2013, RACIN! recruits people with developmental disabilities who want to engage in regular exercise, which has been proven to improve them physically, emotionally and socially. “I love volunteering because it allows me to have the ability to give back and help make a difference in someone else’s life,” said Cammara-

“I helped establish RACIN! and I remain involved because I want people with developmental disabilities to be a part of the local racing scene,” said Frank, who is employed as the principal psychologist for the Western New York Developmental Disabilities Services Office. “I look forward to each race and celebrating our accomplishments after we cross the finish line together.” The chairs used in each race were purchased from a company called Adaptive Star. They are checked prior to every race to ensure that they are in safe working order. Every participant is required to sign a “safe chair use form” and receive explicit and detailed instructions prior to each race on how to manage the chair safely and successfully from the opening gun to the final step across the finish line. Providing recreational opportunities for people with disabilities are vital to ensure these individuals have opportunities to socialize by working toward a shared goal. With the organization continuing to grow in popularity, the need for additional help in 2019 and beyond is increasing. Interested volunteers willing to serve as runners, monetary donors or helping out in another capacity that does not involve running are asked to visit www.buffaloracin.org and submit their contact information. “We have an absolute blast,” said Stasio, a 48-year-old Buffalo resident who has cerebral palsy and works as a self-advocacy coordinator and master trainer at the Western New York Developmental Disabilities Services Office. “I ask people looking to do

something really different to come join us.” “Whether it is a 5K race or a half marathon, it’s all about respect and inclusion,” said Cammarata. Participation produces pure joy Like everyone else in life, the athletes and their dedicated pushers have many duties and responsibilities that must be taken care of both personally and professionally. Scheduling the time to properly train for the races the RACIN! group registers to participate in each year is a challenge, but the determination of those who have competed in the past reflects a united effort to fit regular training sessions into their busy lives. “It’s always important to be completely devoted to this because from an emotional standpoint, it’s something that produces tremendous satisfaction for me personally,” said Tim Marren, who works fulltime as a copywriter for a local advertising agency and runs in dozens of 5K races each year. “The goal of having others experience the pure joy of crossing the finish line is what drives me. To see the smile on the faces of the participants is extremely satisfying and never gets old.” Stasio agrees, pointing out that inclusion athletes like himself and volunteer pushers like Cammarata, Frank and Marren can achieve a sense of accomplishment that he says really cannot be explained without experiencing it first-hand. “I got involved because I was sick and tired of being excluded,” said Stasio. “It was really eating me up and caused an almost sick feeling inside my gut. To be an active part of something instead of just being on the sideline as a cheerleader is exhilarating. What RACIN! does for people with disabilities is provide them hope and a view that life doesn’t have to be experienced within a box. What you do when you enter one of these races or volunteer to help someone like myself is help us become visible and participate as an active member of the community instead of being on the sidelines and feeling invisible. Respect and inclusion are things that some people really can’t explain and put into words, but you can gain respect and feel included when you experience that thrill of competing in a race.”

• To contact RACIN’, call 716-858-6215.

Fit4D and WellCare Partner to Deliver Diabetes Management Solution

it4D, a leading tech-enabled diabetes management company based in New York City, and WellCare of New York, Inc., a WellCare Health Plans, Inc. company, recently announced a partnership to deliver Fit4D’s personalized coaching program to WellCare members living with Type 2 diabetes in the state of New York. Today, more than 2 million New Yorkers are living with Type 2 diabetes — a condition that

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disproportionately affects minorities and low-income households. As a leading provider of managed care in the state, WellCare is committed to helping its members manage their condition, reduce their risk for complications, and improve their overall health and well-being. The Fit4D coaching program combines two important elements: a certified diabetes educator (CDE) who delivers personalized care along with a technology platform that enables scalability. The collaborative

program will connect WellCare of New York Essential Plan members with Fit4D CDEs who will deliver personalized, one-on-one diabetes coaching via multi-channel communications including telephonic, mail and face-to-face coaching. Members will receive education and support to help them with diabetes self-management, including tips and tactics to initiate therapy and improve medication adherence; information about preventive care, nutrition and exercise; and guidance to overcome psychosocial challenges, such as

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2019

depression or anxiety. “At WellCare, we are committed to providing innovative solutions that help our members live better, healthier lives,” said physician Richard Petrucci, chief medical officer, WellCare of New York. “Fit4D’s personalized coaching program complements WellCare’s existing care management resources and will provide yet another avenue to help our members living with diabetes manage their condition and improve their overall health and well-being.”

Things to Know About Preventing Heart Disease One in every four deaths in the U.S. is caused by heart disease, considered one the most preventable health ailments

By Ernst Lamothe Jr.

hile it remains one of the most preventable health ailments, heart disease continues to be the leading cause of death, disability and healthcare spending in the United States for men and women. The most common type of heart disease in the United States is coronary artery disease, which affects the blood flow to the heart. Decreased blood flow can cause a heart attack. About 610,000 people die of heart disease in the United States every year — that’s one in every four deaths, according to the Centers for Disease Control and Prevention. “One of the first steps is knowing your blood pressure because that could be a looming indicator on heart problems,” said physician Anne Curtis, the Charles and Mary Bauer professor and chairwoman of the department of medicine at the University at Buffalo. “Too often people ignore symptoms because they think it will pass.” Curtis talks about five steps to having a healthy heart.

Stop smoking Cigarette smoking is the leading cause of preventable disease and death in the U.S., accounting for more than 480,000 deaths every year, or about one in five deaths, according to the CDC. For years, smoking figures declined. However with the advent of e-cigarettes, smoking has stormed its way to the forefront.

“We have made smoking more difficult because you can’t smoke indoors in restaurants, bars, airplanes and the days where you used to be able to smoke at your desk are gone,” said Curtis. “Making it inconvenient will not only limit second hand smoking issues but we hope discourage people from smoking. I tell my patients smoking is one of the worst things you can do for your heart and lungs and this will always be the case.” Exercise 2. One of the very best gifts you can give your heart is physical

activity. Even something as small as parking your car at the far end of a parking lot or choosing the stairs rather than the elevator can make a world of difference. Exercising lowers your blood pressure and works to slow your heart rate. High pressure is a major risk factor for heart disease. Being physical also is a necessary step to losing weight and keeping the weight off, which also puts less pressure on your heart. “It makes an incredible difference those who are physically fit and those who are not when it comes to maintaining a healthy heart.” said Curtis. “As you get older, it is especially important to keep moving for your heart and joints. We recommend 150 minutes a week of exercise and it doesn’t have to be high intensity. Light or moderate exercise can make a world of difference.”

Diet 3. Being overweight continues to be a risk factor for heart disease

and stroke. Keeping your heart healthy by making healthier food choices isn’t as hard as it sounds. Some of the standard tips Curtis suggests includes choosing healthy fats such as avocados as well as omega-3 fatty acids found in nuts, seeds, tuna and salmon. In addition, whole-grain breads or pastas are higher in fiber and complex carbohydrates. Choose them instead of white breads or regular pastas for sandwiches and meals. “When people are obese, it worsens a lot of other health problems, especially related to your heart,” added Curtis. “Overweight people tend to have higher cholesterol and diabetes. We tell people to take in more proteins, fresh fruits and vegetables because a healthy diet will help you live longer.”

Know your cholesterol 4. Cholesterol is both good and bad. At normal levels, it is an

essential substance for the body. However, if concentrations in the blood get too high, it becomes a silent danger that puts people at risk of heart attack. Total cholesterol is measured as both low-density lipoprotein, which is the bad cholesterol and high-density lipoprotein, which is considered good cholesterol. Typically cholesterol over 200 is a problem. “This is something that you can check with a single blood test,”

Weight Affects Heart Failure Risk By Deborah Jeanne Sergeant

he Centers for Disease Control and Prevention (CDC) states that 5.7 million Americans have heart failure, a condition that contributes to nearly one in 10 deaths. About 50 percent of those diagnosed die within five years. The CDC also reports that research indicates people who have lived with obesity earlier in life but have later lost weight are at higher risk of heart failure than people who have maintained a healthy weight lifelong. Physician Chee H. Kim is board-certified in cardiovascular disease and clinical cardio electrophysiology and sees patients at Great Lakes Cardiovascular, as well as serving as director of the electrophysiology laboratory at ECMC. He said that heart failure happens when the heart cannot meet the body’s needs because of weakness, usually caused by a heart attack. “Because of weakening of the heart muscle, blood flow to vital organs and muscles are compromised leading to symptoms of shortness of breath, fatigue and fluid retention,”

Kim said. “Being overweight increases the likelihood of developing coronary artery disease that results in heart attacks. “Also, the excessive body weight puts more strain on a weakened heart muscle, further straining it.” He added that obesity predisposes people to high blood pressure, which can cause the heart muscle to thicken and stiffen causing diastolic dysfunction of the heart, which is another source of heart failure. While it’s never a bad idea to get back down to a healthy weight, it’s better to prevent obesity to begin with. “They’re more likely to be healthier systemically if their weight is normalized, but it doesn’t eliminate the risk that comes with yo-yo dieting,” said Mary Jo Parker, registered and certified dietitian nutritionist, nutrition therapist and consultant in private practice in Williamsville. “It’s better to take a slow, steady approach when trying to normalize weight.” She said the extremes of many popular diets, such as eliminating entire food groups or dramatically cutting back on calories, isn’t sustainable and can cause health problems. “If you are serious about being healthy, eat a decent enough volume if you’re talking a plant-based diet,”

Parker said. “If they cut back too much or are too limited, they get a limited mix of nutrients. It puts the person at risk longer term to not be able to sustain it.” Any lasting weight loss must become part of the individual’s new lifestyle. John Nizamis, owner at Studio 22 Fitness in Hilton, said that while diet and exercise are keys to keeping weight off, for many people “life gets in the way” of maintaining a consistent regimen. He believes that writing down goals can make them more attainable until they become second nature, along with working to make movement part of everyday life. For example, instead of sitting to watch the children’s soccer game, walk laps around the field. Or instead of watching TV sitting, pedal on a stationary bike. Working out with a friend can also help keep weight off. Losing 50 pounds Accountability to others and emotional support helped Judy Culbertson in Danville lose 50 pounds and keep the weight off for nine years. She’s the area coordinator from Rochester to Buffalo for TOPS,

February 2019 •

Cardiologist Anne Curtis, the Charles and Mary Bauer Professor and chairwoman of the department of medicine at the University at Buffalo. said Curtis. “You want your overall cholesterol to be as low as possible. If you combine a healthy diet and exercising then cholesterol shouldn’t be an issue. That is the reason you should get it checked regularly as you get older so the issue doesn’t surprise you. Some people can get it checked every five years while others should get it checked yearly.” Be careful with stress 5. Stress can be a symptom and consequence of many health

ailments, especially with any change of life situation. “When someone is dealing with the death of a spouse or child or any life-altering event, we see cases of that affecting their heart,” added Curtis. “Stress can also lead to depression and affect your arteries from functioning normally. It can lead to clogged blockage which can lead to a heart attack.”

a weight loss support group. Culbertson oversees a 10-county area of 1,000-plus members for TOPS, which stands for Taking Off Pounds Sensibly. She has been part of TOPS for 16 years. With annual membership of $32 and monthly membership dues of about $4 to $5, TOPS’ affordability is one reason that Culbertson thinks draws members back. But she also credits its efficacy. She had tried other weight loss groups and methods and a few pounds came off; however, she has found the most success in what she describes as the non-judgmental, accountable and supportive environment she has found at TOPS. “It’s a place where people can feel safe expressing what’s going on in their lives,” Culbertson said. “The people there are all experiencing the same. We’re all emotional eaters so we’re understanding and supportive at the same time.” The group also supports those who have achieved their weight loss goals and strive to maintain their loss. Each weekly meeting involves a weigh-in, educational programming and an opportunity to talk about what’s working and what isn’t. Within each group, members can team up with accountability buddies to keep the momentum going all week. TOPS emphasizes an eating plan and exercise, along with the group’s emotionall support.

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10 Years Smoke-Free

A Better Strategy for Quitting Smoking

Western New York resident Tracy K. wants to be an inspiration to those looking to quit smoking

common resolution tops many tobacco-users’ to-do lists: making 2019 the year they finally quit for good. Smoking is an addiction and difficult to overcome, but thousands achieve a smoke-free life each year with support and medication from their healthcare providers and the New York State Smokers’ Quitline. One Western New Yorker knows this very well, as Tracy K. of Blasdell just celebrated 10 years of freedom from nicotine. The 55-year-old said she began smoking as a teen because she wanted to “be with the cool kids” and because her mother smoked. She said quitting is one of the hardest things she ever accomplished but also something of which she’s proudest. Tracy K. twice quit for extended stretches when having children, but became tempted to pick up cigarettes when hanging around others who smoked. “Smoking is such a strong habit and it connects with the activities you do,” she said. “Calling the New York State Smokers’ Quitline, hearing a friendly voice on the other end of the phone and then receiving the nicotine patch finally did it for me. The patch worked to stop the cravings. I stopped feeling the urge to smoke, and that made all the difference. After I received the package and educational materials for free, I felt an obligation not to let the quit coach down. I had to give it a try.” Tracy K. said support from her family members also played a major role in success. She now exercises regularly, in part as a way to replace

old habits but also because she can breathe better and has increased endurance. She said she feels a profound sense of freedom and loves “not smelling like a cigarette” around others. She encourages current smokers to continue trying to quit and to reorganize their existing habits and activities. “Don’t stop trying — you don’t know which attempt will finally be the right time,” Tracy K. said. “It’s like heaven to never think about smoking again. It was a burden, and now I don’t have to carry that weight around. When you quit smoking, you’ll feel like you can do anything.” Prevention The New York State Smokers’ Quitline is available as a free resource for all New Yorkers seeking help to quit smoking. Quit coaches can provide personalized coaching support and check eligibility for a starter kit of nicotine replacement therapy. In addition, the New York State Smokers’ Quitline recommends smokers talk to their healthcare providers about quitting and ask for a prescription for stop-smoking medications — most of which are covered by health insurance plans. “Smoking continues to be the leading cause of preventable death in the world, but many free resources are available in New York State to help smokers quit,” said Kimberly Bank, program coordinator for Health Systems for a Tobacco-Free Western New York, based at Roswell Park Comprehensive Cancer Center in Buffalo. “By combining coaching and

Tracy K. of Blasdell is celebrating 10 years as a non-smoker. “Don’t stop trying — you don’t know which attempt will finally be the right time,” she says. medication, the odds for quitting successfully increase threefold. Healthcare providers play a major role in getting the process started, between prescribing the right medications and making referrals to the New York State Smokers’ Quitline for extra support. Health plans, especially Medicaid, often cover extra nicotine replacement therapy and local cessation classes. Quitting smoking is the best thing you can do for your health, so use all the benefits available to make it happen.” Those interested in quitting should call the New York State Smokers’ Quitline at 1-866-NY-QUITS (1-866697-8487) anytime the journey gets tough for achieving or maintaining a smoke-free life. Quit coaches are available seven days a week beginning at 9 a.m., and additional resources are available online at www. nysmokefree.com.

U.S. Cancer Deaths Continue to Decline Reduced number of smokers, improved treatments and early detection credited as rates in cancer deaths drop

ver the past 25 years, the number of Americans who have died from cancer has dropped dramatically, though racial and economic disparities persist, a new study reveals. Between 1991 and 2016, deaths from cancer dropped 27 percent. In real numbers, that›s almost 2.6 million fewer cancer deaths, according to the American Cancer Society. “The decline in deaths is largely driven by reductions in smoking and improved treatment, as well as earlier detection for some cancers,” said lead researcher Rebecca Siegel, scientific director of surveillance research at the cancer society. This is especially true for the most common cancers, including breast, colon, lung and prostate. But although the racial gap in cancer deaths is slowly narrowing, socioeconomic disparities are growing, she said. Poor counties in particular lag behind, and for some cancers the gap is widening, Siegel noted. “The largest gaps are for the Page 10

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most preventable cancers,” she said. For example, in the early 1970s, colon cancer death rates were 20 percent lower in poor counties, and today they are 35 percent higher, when compared with people living in richer counties, Siegel said. “Differences in wealth lead to differences in risk factors and less access to high-quality care for prevention, early detection and treatment,” she explained. In addition, poor people are less likely to be screened for cancer, and so cancer is likely to be diagnosed at an advanced stage that makes treatment problematic. Plus, care for the poor is not as good as that given to the rich, Siegel said. Where the poor have access to screening, these disparities can be eliminated, she suggested. “We have seen this in Massachusetts and Washington, D.C.,” she said. In addition, more education is called for to help people understand the steps they can take to lower their risk for cancer. “Health literacy is an

issue,” Siegel said. The report was published online Jan. 8 in CA: A Cancer Journal for Clinicians. The new report noted that nearly 2 million Americans will be diagnosed with cancer this year, and more than 600,000 will die of the disease. But the cancer death rate has actually been dropping nearly 2 percent a year, from 215 deaths per 100,000 in 1991 to 156 per 100,000 in 2016. Between 1990 and 2016, deaths from lung cancer among men dropped 48 percent, and deaths from breast cancer among women decreased 40 percent. From 1993 to 2016, deaths from prostate cancer dropped 51 percent, and from 1970 to 2016, deaths from colon cancer plummeted 53 percent, the researchers reported. Siegel noted that “lung cancer still kills more Americans than breast, prostate and colon cancer combined.” Deaths from some cancers,

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2019

uitting smoking is one of the hardest things to do, but studies have found that one strategy in particular can help many people: Start antismoking medication well before your intended quit date. Under traditional prescribing guidelines, people who plan to quit smoking with the help of a medication begin taking their anti-smoking drug about one week before their set quit date. But about 75 percent of people who try to quit go back to smoking within a year. So what’s the solution? Research done at the University at Buffalo, showed that simply starting the drugs four weeks in advance can increase the success rate. One study was done on bupropion, known by the brand name Zyban, and similar research has involved both nicotine replacement therapy and varenicline (Chantix). The idea of taking quit-smoking medication earlier in advance of your quit date stemmed in part from reports of people who were taking these medications for other reasons — bupropion, for instance, is well-known as an antidepressant — and found that they gave up smoking without even trying to quit. Four weeks also provides a good timeframe to mentally prepare to quit smoking. In fact, many study participants started smoking less before their quit date and without experiencing strong cravings or withdrawal symptoms. And their cravings tended to decrease. As for results, over 50 percent of the people who started the drugs four weeks ahead of time remained smoke-free 30 days after quitting, compared to 31 percent who were given the standard oneweek start date. All study participants received smoking cessation counseling as well, which shows that a multifaceted approach brings the best results.

however, rose. For example, deaths from liver cancer increased each year among men and women. Pancreatic cancer deaths rose slightly among men. Brain cancer deaths also rose each year. Other cancer deaths on the rise are soft-tissue cancers (such as heart) and oral cancers linked to the human papillomavirus (HPV). Cancer is the second leading cause of death after heart disease, the researchers reported. But cancer is the leading cause of death in many states and among Hispanics, Asian Americans and people under 80 years of age. For cancers such as leukemia, non-Hodgkin lymphoma, pancreatic and ovarian cancers, death rates vary only slightly between the rich and poor, the investigators found. The study authors also said that cases of melanoma have been increasing, as well as cases of uterine and pancreatic cancer.

SmartBites

The skinny on healthy eating

Boost Energy and Teeth Health with Raisins

he strangest thing happened to a friend of mine, a vegetarian, the epitome of good health. A few months ago, she began dropping things and knocking into furniture. She complained about feeling exhausted and confused. A busy woman, she chalked it up to stress. But finally, she saw a doctor. The diagnosis? She was anemic. Promptly, she began incorporating more iron-rich foods into her diet. To supplement her iron intake, I suggested she also tuck some small boxes of raisins into her purse. Raisins contain more iron than many other types of fruits. While they don’t hold an iron candlestick to meat, shellfish or spinach, they do provide some: a small box delivers about 5 percent of our daily needs. A vital nutrient we can’t live without, iron is essential for making red blood cells and transporting oxygen throughout the body. It also supports our immune system and brain function, and helps maintain healthy skin, hair, and nails. You might be surprised to learn that low iron is the most common nutritional deficiency in the U.S.

Raisins contain “non-heme” iron, the type found in plants that requires multiple steps to absorb it. Since vitamin C nearly doubles the absorption of non-heme iron, it’s a good idea to eat raisins with other vitamin C-rich foods. Many athletes consume raisins for the rapid energy they provide. One small box of raisins (1.5 ounces) provides 130 calories, 34 grams of carbs and 26 grams of sugar. According to several studies, raisins provide the same performance-enhancing benefits as Sports Chews or Sports Jelly Beans — and for a whole lot less money. Because raisins are dried grapes, it’s natural to wonder how the health benefits of raisins compare to grapes. While both are antioxidant superstars, raisin’s star shines about three times brighter, since the drying process concentrates many of these compounds. On the downside, however, raisins contain less vitamin C and resveratrol (a polyphenol that may benefit hearts) than grapes, since this same drying process compromises them. Low in fat, sodium and choles-

terol, raisins are also a good source of potassium (helps maintain a healthy heart) and fiber (promotes regularity; ferries cholesterol and other toxins out; fills us up). Lastly, sweet and sticky raisins may help fight — not cause — cavities. According to researchers at the USA Department of Food and Nutrition, raisins contain chemicals that suppress the growth of oral bacteria associated with cavities and gum disease.

Toasted Couscous with Almonds and Raisins

Adapted from calraisins.org; serves 6-8

1 1/2 cup couscous 1/2 cup slivered almonds 2 cups vegetable or chicken stock 2 stalks celery, diced 1 clove garlic, minced (or, ½ teaspoon garlic powder) ½ teaspoon cumin pinch of cayenne pepper Salt and pepper, to taste 1 cup raisins 2 teaspoons lemon zest, optional

Helpful tips

Give the box or bag of raisins a good shake before buying. If the raisins rattle inside, it means they are dried out. Tightly sealed raisins will last about a month when stored in a cool, dark place and up to a year in the refrigerator. Dried-up raisins can be revived by blanching them in boiling water for 10 minutes. pepper. Simmer about 3 minutes or until celery is slightly softened. Add couscous and raisins to saucepan and stir gently just to mix. Cover pan; remove from heat and allow to stand about 5 minutes or until couscous is tender. Add almonds and lemon zest (if using) to couscous and gently fluff grains with a fork. • Note: Toasting the couscous gives it a rich, nutty flavor. Stir frequently to make sure it browns evenly.

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.

Heat a large nonstick skillet over moderate heat. Add couscous and toast grains, stirring pan frequently until brown and fragrant. Transfer to a plate. Add almonds to the hot skillet and toast them, stirring frequently until light brown. Transfer them to another plate. Bring stock to a boil with celery, garlic, cumin, cayenne, salt and

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 11

Careers in Healthcare

Demand for Community Health Educators Expected to Grow Faster Than Average By Deborah Jeanne Sergeant

erhaps you’re interested in health, but a career in hands-on care isn’t for you. Or maybe you enjoy communicating and sharing information, but teaching isn’t the right fit. Consider the role of community health educator. According to the Bureau of Labor Statistics, the entry level annual salary was $45,360 or $21.81 per hour in 2017 and the employment outlook for growth between 2016 and 2026 is 16 percent, much faster than average. “There’s such a need,” said Susanna Speed, manager, innovation institute, oversees several grants for Trillium Health, which offers health facilities and health outreach projects in Rochester and Buffalo. “There’s so much misinformation out there about health and it’s so fulfilling to get in front of someone” and clear up misconceptions. Speed said that the role can also include prevention education about eating right, healthy sexual behavior, exercising and immunization through programs in county depart-

ments of health, schools, medical centers and hospitals, all of which could be places where community health educators work. They may also collect and analyze data to evaluate where the community needs additional health education. Most community health educator positions require a bachelor’s level program and certified health education specialist credentialing. Master’s level education is also available. The position is growing in part because doctors and nurses lack the time to talk with people about preventive health. Community health educators help people understand the message of prevention in terms they understand, along with actionable steps to make it happen. “The skills are very transferrable,” Speed said. “People who are public health educators are needed in a lot of different places.” In some larger organizations, some degree of specialization may be required, as it may have departments related to immunization, family planning, or sexually transmitted

infections; however, it may require experience as a general community health educator to get to that point. Community health educators can advance to supervising the department at a larger organization, which may mean shifting from delivering the message of health to managing the program. Helpful skills for the position include verbal and written communication, organization, collaboration, and science, along with “compassion, empathy, performing as a team, sharing knowledge and expertise and delivering excellence in service,” Speed said. “When hiring someone, those are values I’m looking for and how they relate to people. When working with the public, there’s no judgment. We all have vices and things that we do.” Theresa McCabe, public health educator and manager of the Healthy Neighborhoods program with Niagara County Department of Health, has always liked the variety involved with health education and working as a generalist.

Human Services Collaborative Gets $1.45 Million in Funding for Shared Space

he Western New York Human Services Collaborative — a group of eight nonprofits providing a wide range of parenting, mental health, developmental disability, and other programs and services throughout Western New York and beyond — has received funding from four of Western New York’s leading foundations totaling $1.45 million. The eight agencies in the Western New York Human Services Collaborative are EPIC – Every Parent Influences Children, Parent Network of Western New York, Learning Disabilities Association of Western New York, Mental Health Advocates of Western New York (MHA), Self-advocacy Association of New York State, Office for People With Developmental Disabili-

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ties(OPWDD) Region One – satellite office, Children’s Mental Health Coalition of Western New York, and Spectrum Health and Human Services – satellite office. Grants were received from The John R. Oishei Foundation ($700,000), KeyBank/First Niagara Foundations ($500,000), The Peter and Elizabeth C. Tower Foundation ($150,000), and Patrick P. Lee Foundation ($100,000). A number of additional requests for support — to foundations, corporations, and government agencies — are pending and the group expects to receive additional commitments in the coming months. Total buildout costs are estimated at $3.75 million to $4.5 million. ”For the past five years, a group of nonprofits has been working on a shared space project, where services,

staffing and programming could be shared, generating additional cost savings and operational advantages, beyond simply sharing space. Two years ago, this group settled on 1021 Broadway, the home of Jericho Road’s third health-care clinic, adjacent to the Broadway Market. This once-vibrant community is in the early stages of a renaissance, similar to the revivals in other parts of Buffalo,” said Ken Houseknecht, MHA executive director. “Happily, in the last six weeks, four of the area’s leading foundations have together invested $1.45 million in the project. Many other funding requests are pending, some of which may materialize early in the new year. Others, hopefully, will follow soon thereafter. More than two dozen organizations have been part of the

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2019

“You have to be very flexible,” she noted. It’s not likely something for people who enjoy specialization or a specific age group of people, since community health educators may speak with eighth graders about food borne illness one day and seniors about hypertension the next day. McCabe has a degree in education and worked in the field, and has also worked in marketing and as a trainer. Those experiences have proven useful in her role in the department of health. “If you’re going to be a public health educator, you have to like people and not be shy,” she said. McCabe has created art and performed on stage in high school and college. Public speaking to crowds doesn’t bother her. She also helps distribute information at festivals and provides presentations to schools. Marketing and writing are also skills McCabe finds helpful, as she usually prepares her own presentations and sometimes her own handouts. “It’s really important for public health educators help people understand things and teach at the level they’re at,” McCabe said. “You don’t have to change the message but the wording. The No. 1 rule of public speaking is to know your audience. If you’re talking over their head, you’re going nowhere or being condescending, you’re going nowhere.” She thinks that anyone who wants to become a community or public health educator should obtain public speaking experience. McCabe said that she feels her career is very rewarding. She recalled a man tell her that she saved his life because he heard her presentation on fire safety and began sleeping with his bedroom door closed. When his home caught fire, he remembered to feel the door first. It was hot, so he kept it closed and sought another route. “A firefighter was able to save his life instead of him being engulfed in flames,” McCabe said. “I like knowing I’m helping my fellow citizens. I’ve always wanted a health career where I’m helping people so it’s a dream come true.”

shared space conversation at various points, and eight are currently planning to move into 1021 Broadway in the fall of 2019. We fully expect that number to grow as the project continues to gain momentum,” said Houseknecht. “This project has the potential to be transformational for the member organizations, the Broadway-Fillmore neighborhood, and the delivery of nonprofit programs and services in WNY. Heartfelt thanks to our Jericho Road partners, our funders, the leaders of the member organizations, and the hundreds of people who have given their time and talent to make this dream a reality,” said Houseknecht. The eight agencies in the Western New York Human Services Collaborative together have approximately 550 employees, annual revenue of $37.5 million, and serve more than 60,000 individuals and families each year.

Golden Years

Unexpected Rewards of Becoming a Caregiver

By George Shannon

t’s true, the life of a caregiver can be demanding, difficult and daunting. I spent seven years of my life in that role, keeping an eye on my wife’s every move. Just about every night, Carol and I awoke from our slumber at least five times to make trips to the bathroom. We spent endless nights in hospitals and long days in doctor’s offices. If given the chance to do it all over again, I would. Those years of being a caregiver constitute the best seven of my life. I learned a ton about myself and my family, became a more fulfilled man, and had the incredible chance to fall in love with my wife all over again. While I could easily list 20 wonderful things about serving in a caregiving role, here are five very important and unexpected rewards:

1.A Better Relationship

When I started being a caregiver, time slowed down. Because the role can be so demanding, you must focus on the person. In the process, you learn what makes them tick — maybe things you hadn’t noticed before. Putting these nuggets of wisdom to use can make that person so happy, which in turns makes you feel good. For Carol it was pancakes. When she needed a boost, a single pancake

could do the trick. Every once in a while, she’d be down in the dumps. The minute I saw this, we were on the way to our local breakfast joint. Carol’s smile would make my day.

2.Precious Moments

Similarly, you get to be a part of some very special moments. Before my wife’s strokes, we’d spend some time together but did our own thing most of the time. After Carol got sick, I spent 90 percent of my time with her and I got to be a part of so many meaningful moments. Her father had come to live with us for a few years during her illness. He was around 90 at the time. Every night the Pittsburgh Pirates played on TV, they stood, held hands and sang “Take Me Out to the Ball Game” every time. You could just feel the love and joy between them. I’ll never forget those moments.

3.Discovering Humility

taking care of her needs. Soon thereafter, I started feeling good when I did things to help her. Then something tremendous occurred, I began to derive sustained joy when making her life better. By the time she died, I’d committed my life to completely serving her and felt total fulfillment. Why? I had become entirely selfless. There may not be a better feeling in the world.

4.A Deeper Relationship

As I gave myself over to her, my wife started to really feel the love. And in turn, she began outwardly show her love and appreciation. A day wouldn’t go by when she would tell me that “You’re too good to me,” or “Thanks for all that you do for me.” I never sought these assurances but when she’d offer them, it would light up my day. It was then I realized that we were falling in love all over again. It was during this rekindled time that we showed our truest selves. From her, I got to see a hidden sense of humor and sharp tongue that often had me belly-laughing. For her, my wife saw a much more tender side and the softer edges of my soul.

This might be the most hidden of rewards. Before my wife became ill, I was a decent man and generally thoughtful of others, but my world had veered toward self-centeredness. A Stronger Family I was set in my ways and had been Only one of my siblings and accustomed to the order in my world. one of our three sons lived in PittsAt first, out of necessity, I began

burgh where I lived when my wife got sick. At first, I felt sort of alone in dealing with her health crisis but that didn’t last very long. The one son who lived the closest moved in for a year. My other two kids came by regularly and showered their mother with love. My siblings came by all the time and called when they couldn’t. I’ve lived my life abiding by the philosophy that what happens to you isn’t as important as how you respond to it. My entire family responded with love, concern, help and support. Each time, their acts and deeds made Carol and I feel wonderful. I took great pride in seeing my family come together. Don’t get me wrong, it wasn’t always easy. Yet, at the end of each day of caregiving, I always received a small gift — a sense of fulfillment. And now, when I look back at those seven years, I am reminded that my life had purpose which is the greatest reward of them all.

George Shannon chronicles his experience caring for Carol in his new book, “The Best Seven Years of My Life: The Story of an Unlikely Caregiver” (December 2018), which he wrote with his son, Chad Patrick Shannon. For more information, visit https:// bestsevenyears.com.

Need a Ride? You Have Options

By Deborah Jeanne Sergeant

alf of non-drivers who are 65 and older stay home because they lack transportation options, according to www. seniorliving.org. This means that they may become more and more isolated, not buy fresh groceries as often as they need them and miss medical appointments. But groups in the Buffalo area are working to support the travel needs of older adults, especially in outlying areas without public transportation and for people who struggle to afford paying for transportation. “There are so many seniors who don’t drive or can’t drive in winter,” said Sandy Preziuso, program coordinator for the Town of Tonawanda Senior Center. Some older adults need rides to see multiple specialists for chronic conditions. Or they may need multiple rides to address an acute issue, such as the up to 10 rides for cataract treatment, including pre-op visits, lens fitting, surgeries and post-op care. For those with working or geo-

graphically distant family members, providing all those rides becomes challenging. The transportation offered from the Tonawanda Senior Center in runs from 9 a.m. to 3:30 p.m. “It’s a great service,” Preziuso said. “Almost every day, it’s filled to capacity.” Medical transportation also provides another chance for social engagement to people who can’t get out much. The service offers precedent to non-emergency medical visits, but other errands are OK, such as grocery shopping, hair appointments and social engagements. Riders make an appointment a week in advance for pick up from Tonawanda or Kenmore, its service areas. When the rider is ready to go home, a call to the dispatch office sends a van out for pick-up. The center has three vans. The cost is $5 each way for a local trip, and $10 outside the area. The cost for a taxi ride round trip can be around $30 or $40 — money that is needed to purchase medica-

tion or fill up a grocery cart for many seniors. Services such as Uber or Lyft may cost less; however, many older adults don’t have smartphones or feel unsafe using a ride summoning app. Erie County residents 60 and older who have no other means of transportation can participate in the Going Places Transportation Program. “Trying to get to the Metro bus stops is too much of a hardship for many of our riders,” said Jim Kelly, program organizer. “We provide curb to curb service.” The program suggests a contribution of $3 per one-way trip or $6 per round-trip; wheelchair service is $8 per one-way trip or $16 per roundtrip. Contributions are always voluntary, and no one is denied service for inability to pay. The rides are offered from 9 a.m. to 3 p.m. on weekdays, except for postal holidays. The program contracts with area senior centers and towns to offer the service, which operates on a first come, first served basis. Riders much register in advance

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and schedule health-related trips two weeks ahead of the day they want a ride. Any non-medical trips should be scheduled one week ahead of the day desired. Kelly said that the rides fill up quickly, a testament to how necessary senior rides have become.

Resources

For more information about senior rides, call Going Places Transportation Program at 716-858-7433 or 716-858-RIDE or 716-858-7433. Erie County Department of Senior Services Information and Assistance unit can also advise on transportation 716-858-8526 or visit www2.erie.gov/seniorservices/index.php?q=transportation To check with the Town of Tonawanda Senior Center, call 716- 875-1029.

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Aging with Grace Both professionals, regular folk reflect on how to age successfully By Jenna Schifferle

rowing older can be difficult. With age comes new life transitions, health issues, and even loss. It can take time before someone accepts physical limitations or learns to cope with memory loss. Aging is an inevitable part of life, and there are certain challenges that arise with that. So, what’s the secret to aging with grace? According to Kenneth Garbarino, the medical director for the Geriatric Center of Western New York at Degraff Memorial Hospital, mindset and purpose are two major factors that come into play in the aging process. “Growing old is tough. It’s about losses. Depending on your mindset, how you look at that sometimes dictates the quality of life you have,” Garbarino said. At the Geriatric Center of Western New York, Garbarino and his staff focus on a holistic approach to elderly care. This includes a multidisciplinary focus on physical changes, psychological problems, social issues, and routine-of-daily-life needs. In conjunction with standard medical care, Garbarino’s staff helps patients learn to cope with their limitations. This may involve getting them connected to a Meals on Wheels program, or having a family member stop by to help the patient organize his or her medication. Not everyone is fortunate enough to have a strong support system around them to help, he says. “You’ve seen a movement where people used to live in the community, and they did their things locally. Their neighbors knew them. The shopkeepers knew them. What’s happened is a lot of people have kind of siloed themselves,” he said. The most successful and resilient patients, he says, are the ones who are orderly with their treatment and care and handle the situation with laughter and gratefulness. On the other hand, when patients get depressed or feel alone, Garbarino says he tries to instill a sense of purpose in them. That may mean encouraging them to get a pet or finding an activity to keep their mind sharp. “If you’re creative enough and you look out there, then there’s something that you can pick to try to challenge yourself so that when you get up in the morning, that’s your Page 14

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Linda Loomis and her husband Arthur. Her advice for successfully aging: “Stay involved with people. Cherish your friends. Do things. Spend your money on experiences, not on things. Hold your friends dear, and stay close to your family,” she says. purpose,” he said. At Elderwood at Cheektowaga, the nursing home staff strives to give patients a sense of purpose. They provide them with a full schedule of activities, from qigong,, an exercise class, to resident council, bowling, and musical performances. Lisa Chamberlain, a registered nurse and supervisor at Elderwood, said people who participate in activities tend to get much more mental stimulation and do much better than those who don’t. They also thrive on companionship. “People thrive when they have attention and compassion from other people,” she said. In her own words In her approximately 30 years of working as a visiting nurse for

VNA Health Care and Kenmore Mercy, Mary Marquette did it all: blood work, wound care, therapy evaluations, errands, or just lending an open ear. During the winter, she would trek through the snow to assist patients in need, often late at night or on short notice — even during the Blizzard of ’77. She helped people from different backgrounds, with different lifestyles and personalities, varying needs and temperaments. Some had huge families, while others had no one. Some didn’t have a penny to their name, while others had countless resources. Her most memorable patients were always the ones who lit up with glee despite their health issues and ailments, and gave thanks for their life. This always brought her a sense of wonder.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2019

“I always thought it was good life training, you know?” she said. Now, at age 76, Marquette finds herself on the opposite side of the equation, navigating new challenges in life. Some mornings, it can be a process to get out of bed. Other days, even small tasks can seem insurmountable. But, like her patients before her, Marquette always tries to focus on the positives. “I think you have to try to find something to be grateful for, even if you have lots of problems. I think you need to not think so much what you don’t have, but what you do have. There’s a big connection between your mental outlook and your body,” she said. For Marquette, an important part of aging has to do with having good friends. She can always count on her neighbors to help her out with tasks, and not a day goes by when she doesn’t call her friends multiple times. They check in with each other and love talking politics. During the summer, Marquette often sits on her porch and chats with people passing by. If you’re lucky enough to get invited to her house to visit, Marquette might even offer you a bowl full of grapes, a hot cup of coffee, and a great conversation. She’ll tell you about her friends from the Philippines or maybe even show you the framed picture she has of her mantra: “Be Kind.” “That’s an important thing with aging —– having good friends and keeping in contact. It’s important to have a sense of humor, too, because life ain’t easy,” she said, laughing. Passion for teaching For 75-year-old Linda Loomis, a Liverpool resident, community also means everything. By day, Loomis inspires young minds as a journalism and creative writing professor at SUNY Oswego. Though she’s been considering retirement for several years, there’s something about teaching that she loves and finds hard to leave behind. “I really love the interaction with the students and being among young people to hear their ideas; to learn what’s important to them. I find that what I might perceive as really, really

important doesn’t even register with them. But then, they know so much that I don’t,” she said. Loomis works hard to stay connected to the people in her life and to stay up-to-date on the news happening around her. When she’s not teaching, Loomis engages herself with her love of music. She’s the classical music reviewer for the Syracuse Post-Standard, and she has recently taken up cello lessons with an old friend of hers. She even set a goal for herself, which was to master “Silent Night” by Christmas. In addition to her blooming community life, Loomis also has a close family, including four grandchildren who have all entered their teenage years. She’s been married for 53 years to her husband Arthur, a thoughtful, caring man she met as a teenager. Together, she and Arthur have been together through all of life’s ups and downs, including his diagnosis of Alzheimer’s disease. Now, Loomis a has become Arthur’s primary caregiver. She recalls the young years of courtship when “Art” was in the Navy, with love letters written back and forth. “He’s always been the sweetest, most kind person in the world, and he remains that,” she said. There are challenges that come with the condition, like having to speak more slowly and briefly to overcome Art’s aphasia. She also has to be stricter and has lost some of the flexibility in her schedule. Despite these challenges, the transition has allowed her to learn new things. Art was once in charge of the house, but everything home related has become her responsibility. She’s delved into learning about finances and organizing projects around the home. Between the people in her life and her passion for learning, Loomis counts herself as lucky. Her advice to others? “Stay involved with people. Cherish your friends. Do things. Spend your money on experiences, not on things. Hold your friends dear, and stay close to your family,” she said.

Golden Years

Yoga. Is It Time to Try? Yoga: It should be fun and make you feel good By Jana Eisenberg

ave you tried yoga? Have you wanted to, but not known where or how to start? If so, you’re like many others who may find the idea intimidating, mysterious or even off-putting. Yoga — the ancient Indian practice that includes mental, physical and spiritual elements — is for everyone. The physical practice, slow and steady, includes movements and positions to engage your entire body. They are called “asanas” but you don’t need to know that, or be fluent in the ancient Indian language of Sanskrit to participate. The mental and spiritual aspects — like controlling your breathing, practicing quieting your mind and being in the moment — take some getting used to, and are as highly adaptable as the physical movements. Yoga has been credited with many health benefits, including decreasing anxiety, depression, high blood pressure, and many types of pain. If you can’t or don’t want to get on the floor, there are many ways of modifying yoga so that it can be done using a chair and other props. Modified yoga still offers all the benefits, and more studios, community centers and senior living facilities are offering classes tailored for seniors. “There is a lot of misunderstanding about what yoga is, or who can do it. It is not only for skinny young girls twisted into pretzel poses,” said yoga teacher Kandy Krampitz, 61. She teaches at the Himalayan Insti-

tute in Buffalo, among other places. “You do not have to stand on your head or be incredibly flexible. People 50 and over may be looking for a sense of themselves, and perhaps a deeper connection to their bodies; whether they’re very healthy or perhaps recovering from surgery, an illness or living with a chronic condition or disease.” “Your life is really your yoga practice,” Krampitz said. “As people get older, they sometimes lose that sense of purpose they had while building their family or career. Some people begin to contemplate how to redefine themselves, ask what will give them spirit and energy. Our minds and bodies are both changing, and we have to figure out what to do.” Feeling the vibe Candace Caprow, 65, has been practicing yoga herself for 25 years. In her classes at Buffalo’s West Side Community Center, she brings a laugh to every class, as well as trying to make sure that no one is experiencing any pain during or from the practice. “Sitting and breathing are part of yoga; it’s meant to be a restorative experience. It can calm the mind and the nervous system,” said Caprow. “Many older people say that after practicing for a while, they notice they can breathe more easily. Having fun contributes to the feeling of well-being.” “Yoga can connect you back to your body in a way that allows an

awareness of what’s happening,” added Krampitz. “It can quiet the inner chatter in our minds, which is frequently critical and not resting. Yoga is about acceptance.” “At every class, I say something like, ‘Yoga is not a competition, it’s a personal practice,’” she added. “We are not here to judge ourselves or others. It is a safe and supportive place. If the teacher asks the class to do something, and you can’t or don’t want to, don’t do it. You know yourself best.” “The mat and chair yoga that I teach is an opportunity for access,” said Caprow. “With the stretching and strengthening, you’re still working with balance and developing core strength, flexibility and joint health.” Other advice when starting yoga is to try a few different teachers because not everyone teaches the same way, and not everyone responds to each teacher the same way. There is no one right or wrong way to teach it or to do it. At the end of every yoga class, the teacher says “namaste” and bows their head with their hands together at heart or head—it’s both an expression of gratitude and a gesture of respect. If you go to a class, and when the phrase comes up, know that you have choices: You can repeat “namaste,” quietly or silently; you may bow your head to your own religious beliefs, to your own strength, to the power of nature, or you can not bow your head at all. It’s up to you.

Could You Have Glaucoma? By Jim Miller

t’s called the “silent thief of sight” for a reason. With no early warning signs or pain, most people who have glaucoma don’t realize it until their vision begins to deteriorate. Here’s what you should know. Glaucoma is a group of eye diseases that can damage the optic nerve and cause vision loss and blindness if it’s not treated. This typically happens because the fluids in the eye don’t drain properly, causing increased pressure in the eyeball. There are two main types of glaucoma, but the most common form that typically affects older people is called open-angle glaucoma. This disease develops very slowly when the eye’s drainage canals become clogged over time, leading to blind spots in the peripheral or side vision. By the time you notice it, the permanent damage is already done. Are You at Risk? It’s estimated that more than 3 million Americans have glaucoma today, but that number is expected to

surge to more than 4 million by 2030. If you answer “yes” to any of the following questions, you’re at increased risk of developing it. • Are you African American, Hispanic/Latino American or Asian American? • Are you over age 60? • Do you have an immediate family member with glaucoma? • Do you have diabetes, heart disease, high blood pressure, migraines or extreme nearsightedness? • Have you had a past eye injury? • Have you used corticosteroids (for example, eye drops, pills, inhalers, and creams) for long periods of time? What to Do Early detection is the key to guarding against glaucoma. So if you’re age 40 or older and have any of the previously listed risk factors (especially if you’re African American), you need to get a comprehensive eye examination every year or two. Or, if you notice some loss of

February 2019 •

peripheral vision, get to the eye doctor right away. If you are a Medicare beneficiary, annual eye examinations are covered for those at high risk for glaucoma. Or if you don’t have vision coverage, check into EyeCare America, a national program that provides free glaucoma eye exams and there are no income requirements. Visit EyeCareAmerica.org or call 877-887-6327 to learn more. While there’s currently no cure for glaucoma, most cases can be treated with prescription eye drops, which reduce eye pressure and can prevent further vision loss. It cannot, however, restore vision already lost from glaucoma. If eye drops don’t work, your doctor may recommend oral medication, laser treatments, incisional surgery or a combination of these methods. For more information on glaucoma, visit the National Eye Institute at NEI.nih.gov, and the Glaucoma Research Foundation at Glaucoma. org.

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Page 15

Golden Years Exercise After Heart Attack Reduces Risk By Deborah Jeanne Sergeant

xercise after recovery from a heart attack may improve longterm survival rates, according to several sources. The American Heart Association says that exercise for those who have recovered from heart attack can help them reduce their risk of a second incident shortly after the first. It may seem counter-intuitive to exercise a recovering heart; however, a Swedish study of 22,227 heart attack patients recently published by the American Heart Association indicates that exercise is helpful. Researchers asked participants about their activity level six to 10 weeks after their heart attack, and about a year later. The follow-up with these patients indicated those who said they were “constantly active” experienced a 71 percent lower risk of death in the two to four years after their heart attack compared with the inactive group. But even those with more moderate exercise regimens during that period experienced a 44 percent decrease risk of a second heart attack. It’s clear that any amount of exercise is beneficial to heart attack survivors, but more regular exercise offers the greatest reduction in subsequent heart attack risk. Recovery all starts with following the cardiologist’s plan. “The benefits of exercise are many, but in survivors of heart attacks, the benefits are life-saving,”

said physician Chee H. Kim, who is boardcertified in cardiovascular disease and clinical cardio electrophysiology. In addition to his duties at Great Lakes Cardiovascular, he is the director of the electrophysiology laboratory at ECMC. Kim explained that after a heart attack, higher levels of a stress hormone, adrenaline, circulate. The longterm effects of high adrenaline levels circulating make the heart weaker and more susceptible to dangerous, irregular heart rhythms that could lead to sudden death. “By exercising regularly, the adrenaline levels decrease, promoting better healing of the heart,” Kim said. Occasionally, a patient doesn’t think that following up with a physician is important; however, Young said that those who ignore their follow-up may find themselves re-admitted to the hospital with another heart attack. Cardiac patients must not jump right back into exercise. To exercise safely, they must obtain a release from a primary care physician or cardiologist to engage in cardiac rehabilitation and complete the program successfully before exercising on their own. Kim Young, cardiology registered nurse at DeGraff Memorial Hospital, said that the rehabilitation program is always under medical supervision with heart monitoring equipment

Sex After 65 Majority are satisfied with their sex lives; nearly one in five older men uses medications or supplements, says poll

new poll busts stereotypes about the sex lives of older Americans — and reveals gender and health-related divides on key aspects of sexual health, while highlighting the need for more people to talk with their health providers about sexual issues. Forty percent of people between the ages of 65 and 80 are sexually active, according to the new findings from the National Poll on Healthy Aging. Nearly three-quarters of people in this age range have a romantic partner and 54 percent of those with a partner are sexually active. Whether or not they have an active sex life, nearly two-thirds of older adults say they’re interested in sex, and more than half say sex is important to their quality of life. And when asked if they are Page 16

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satisfied with their current sex life, 73 percent of the nationally representative sample of 1,002 people polled said they were. The poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and sponsored by AARP and Michigan Medicine, U-M’s academic medical center. The poll explored how older adults might seek help or advice for sexual problems, and if they’ve talked with their doctors or other health care providers about their sexual health. In all, 18 percent of older men and 3 percent of older women say they’ve taken medications or supplements to improve sexual function in the past two years. But only 17 percent of older adults said they have talked with their doctor or other

used so the patient’s heart doesn’t work too hard. “What we do after a heart attack is so important,” Young said. “Some patients are very frightened and anxious about exercise. It helps them knowing someone is watching helps them stay safe.” In time, exercise time increases until patients work out 30 to 50 minutes including a warm-up and cooldown time each session and they engage in three sessions weekly. Patients also learn about their target heart rate, blood pressure and ways to exercise safely. Once they’ve completed cardio rehab, many patients wonder what

to do next. Young said that depends upon their condition, background and age. For many patients, walking provides a good source of exercise, along with light weights. They should also stay within the parameters of their cardiologist or doctor. “Exercise after a heart attack is strongly encouraged,” Young said. “The doctor must clear them for an exercise program and they must work with someone who has knowledge on cardio events. It’s important to exercise, starting with walking initially, under the supervision of a physician.”

health care provider about sexual health in the past two years. Most who had engaged in such discussions said they brought the topic up, suggesting the need for more proactive conversations by clinicians with their older patients. “Sexual health among older adults doesn’t get much attention but is linked closely to quality of life, health and well-being,” says U-M’s Erica Solway, Ph.D., co-associate director of the poll. “It’s important for older adults and the clinicians who care for them to talk about these issues and about how age-related changes in physical health, relationships, lifestyles and responsibilities such as caregiving, affect them.”

with their sex lives. There are also differences within age groups. Those between the ages of 65 and 70 were nearly twice as likely as those in their late 70s to be sexually active. One-third of those in their late 60s said they were extremely or very interested in sex, compared with 19 percent of those in their late 70s. The gender gaps that emerged reveal some differences that may create challenges for relationships. For instance, women were less likely than men to be sexually active — 31 percent overall, compared with 51 percent of men — but were more likely to be extremely or very satisfied with their sex lives. And while 84 percent of older men said sex was an important part of a romantic relationship, 69 percent of older women agreed with that statement. But the biggest gender difference was the percentage of those who said they were extremely or very interested in sex. Half of men aged 65 to 80 said they had this level of interest, compared with just 12 percent of women in the same age range. A key takeaway from the poll, Solway notes, is that there appears to be opportunity for more proactive conversations between providers and their older patients about sexual health.

Gender, age and health status divides Solway notes that the poll finds some sharp differences along health, age and gender lines. For instance, compared with the 45 percent of respondents with excellent, very good, or good health who reported they were sexually active, only 22 percent of those who said they are in fair or poor health were sexually active. Only 28 percent of those with fair or poor health said they were extremely or very satisfied

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2019

Call 716-603-6851 SeanKellyMedicareAdvisor.com When you pick up the phone, so do I!!

Sean Kelly

Local Medicare Professional Turning 65?, New to Medicare?, Questions about Medicare? Call 716-603-6851 SeanKellyMedicareAdvisor.com

When you pick up the phone, So Do I!

By Jim Miller

What You Should Know About Your Aging Parents Finances Dear Savvy Senior, My siblings and I don’t know much about our elderly parents’ financial situation or their wishes if something happens to them. When mom broke her hip last year, it got me thinking we need to be better prepared. What’s the best way to handle this, and what all should we know?

Tentative Daughter Dear Tentative,

Many adult children don’t know much about their elderly parents’ financial situation or end-of-life plans, but they need to. Getting up to speed on their finances, insurance policies, long-term care plans and other information is important because some day you might have to help them handle their financial affairs or care, or execute their estate plan after they die. Without this information, your job becomes much more difficult. Here are some tips that can help. Have the Conversation If you’re uncomfortable talking to your parents about this topic, use this column as a prompt or start by talking about your own finances or estate plan as a way to ease into it. Also see TheConversationProject. org, which offers free kits that can help you kick-start these discussions. It’s also a good idea to get your siblings involved too. This can help you head off possible hard feelings, plus, with others involved, your parents will know everyone is concerned. When you talk with your parents, you’ll need to collect some information, find out where they keep key documents and how they want certain things handled when they die or if they become incapacitated. Here’s a checklist of areas to focus on. Personal & Health Information • Contacts: Make a list of names and phone numbers of their doctors, lawyer, accountant, broker, tax preparer, insurance agent, etc. • Medical information: Make a copy of their medical history (any drug allergies, past surgeries, etc.) and a list of medications they take. • Personal documents: Find out where they keep their Social Security card, marriage license, military discharge papers, etc. • Secured places: Make a list of places they keep under lock and key or protected by password, such as online accounts, safe deposit boxes, safe combination, security alarms,

“Adult Living at its Finest!” SE N

etc.

• Pets: If they have a pet, what are their instructions for the animal’s care? • End of life: What are their wishes for organ or body donation, and their funeral instructions? If they’ve made pre-arrangements with a funeral home, get a copy of the agreement. Legal Documents Will: Do they have an updated will or trust, and where is it located? Power of attorney: Do they have a power of attorney document that names someone to handle their financial matters if they become incapacitated? Advance directives: Do they have a living will and a medical power of attorney that spells out their wishes regarding their end-of-life medical treatment? If they don’t have these documents prepared, now’s the time to make them. Financial Records • Debts and liabilities: Make a list of any loans, leases or debt they have — mortgages owed, car loans, medical bills, credit card debts. Also, make a list of all their credit and charge cards, including the card numbers and contact information. • Financial accounts: Make a list of the banks and brokerage accounts they use (checking, savings, stocks, bonds, mutual funds, IRAs, etc.) and their contact information. • Company benefits: Make a list of any retirement plans, pensions or benefits from their former employers including the contact information of the benefits administrator. • Insurance: Make a list of the insurance policies they have (life, long-term care, home, auto, Medicare, etc.) including the policy numbers, agents and phone numbers. • Property: Make a list of the real estate, vehicles or other properties they own, rent or lease and where they keep the deeds, titles and loan or lease agreements. • Taxes: Find out where they keep copies of past year’s tax returns. For more tips, see the Eldercare Locator publication “Let’s Talk: Starting the Conversation about Health, Legal, Financial and Endof-Life Issues” at N4A.org/files/ Conversations.pdf. 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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Ask The Social

Security Office

From the Social Security District Office

Social Security and Self-Employment

f you are not self-employed, Social Security taxes are typically taken out of your paycheck automatically. You and your employer each pay a 6.2 percent Social Security tax on up to $132,900 of your earnings and a 1.45 percent Medicare tax on all earnings in 2019. You don’t have to do anything extra for the coverage you will one day receive because your employers handle the deduction as well as matching that contribution. Then they send the taxes to the Internal Revenue Service (IRS) and report your wages to Social Security. If you’re self-employed, the process is a little different. You report your earnings for Social Security and pay your taxes directly to the IRS when you file your federal income tax return. You pay the combined employee and employer amount, which is a 12.4 percent Social Security tax on up to $132,900 of your net earnings and a 2.9 percent Medicare tax on your entire net earnings in

Q&A

2019. You are considered self-employed if you operate a trade, business or profession, either by yourself or as a partner. If your net earnings are $400 or more in a year, you must report your earnings on Schedule SE, in addition to other tax forms you must file. Net earnings for Social Security are your gross earnings from your trade or business, minus your allowable business deductions and depreciation. Some income doesn’t count for Social Security and shouldn’t be included in figuring your net earnings. You must have worked and paid Social Security taxes for a certain length of time to get Social Security benefits. The amount of time you need to work depends on your date of birth, but no one needs more than 10 years of work. You can read more about self-employment and Social Security at www.socialsecurity.gov/pubs/EN05-10022.pdf.

Q: I was speaking with my sister and she told me that she receives half of her spouse’s benefit. Why am I not eligible for benefits from my spouse? A: If your spouse is eligible for Social Security benefits, you could be eligible for one-half of their benefit at your full retirement age. However, if you worked and are eligible for Social Security benefits on your own record, your own benefit may be higher than what you could be eligible for on your spouse’s record. If you have questions call 1-800-772-1213.

BlueCross BlueShield Accepting Award pplications Deadline for application is Feb. 4. Last year it awarded $2.7 Million in WNY

lueCross BlueShield of Western New York’s Blue Fund is accepting letters of intent online through Feb. 4 for grants to organizations and initiatives that align with at least one of its key focus areas. These include behavioral health, cardiovascular health, diabetes, health-care workforce development, healthy children and the opioid epidemic. Submitting a letter of intent is a required first step in the grant-making process. Selected applicants will then be invited to submit a full proposal. Blue Fund will consider requests for $100,000 to $500,000 grants from nonprofit organizations in the eight counties of Western New York for initiatives that are ready to implement and demonstrate enhanced and measurable community outcomes. Applicants should demonstrate Page 18

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how the proposed project or initiative will deepen and broaden current work by supporting the expansion or creation of a program, based on the success of earlier work or evidence-based best practices. The region’s largest nonprofit health plan launched the Blue Fund in July 2018, and awarded more than $2.7 million to nine local organizations November 2018 in its first round of grants. Those grants were awarded in addition to the health plan’s current corporate partnerships and sponsorships, which see annual investments of more than $2 million in Western New York charities, community groups and cultural organizations. To learn more about Blue Fund and to submit a letter of intent online for the 2019 grant cycle, visit bcbswny.com/bluefund. Funding decisions will be announced in fall 2019.

H ealth News Eye surgeon joins Eye Care & Vision Associates

ECMC has new VP of information technology

Physician Michael O. Campbell has recently joined Eye Care & Vision Associates (ECVA) as eye physician and surgeon. A board-certified ophthalmologist with more than nine years’ experience in comprehensive eye care in New York and Pennsylvania, Campbell Campbell specializes in wellness, cataract surgery and laser treatments. He is now accepting patients at ECVA’s Orchard Park and Williamsville offices. A native of Orchard Park, Campbell received his bachelor’s degree in biological and biomedical engineering from Cornell University, graduating with honors. He worked as a mechanical engineer at a medical device company before attending medical school. Campbell graduated from SUNY Upstate Medical University in Syracuse in the top 10 percent of his class and completed his ophthalmology residency at the University of Virginia in Charlottesville. Campbell is licensed in New York state and is a member of the American Academy of Ophthalmology, the American Academy of Cataract and Refractive Surgeons, the Medical Society of Erie County and the Medical Society of the State of New York. He currently resides in Orchard Park.

Richard C. Embden Sr. has been appointed as vice president of integrated technology system at Erie County Medical Center (ECMC) Corporation. He will oversee the center’s information technology department and work collaboratively with its partners, including Kaleida Health. Embden Embden has worked in healthcare leadership for 15 years in both provider and payer roles. He has led national and international technical teams spanning five states and offshore. For the past 10 years, Embden served as a nationally recognized senior consultant specializing in the implementation of executive strategy within large healthcare systems in which he was responsible for process improvement/reengineering, planning, business development, technical implementations, optimization, change management, contract management, vendor management and community relations. Among other projects, he contributed to the New Jersey Health Information Technology Commission in preparation for the health information exchange and electronic health record “meaningful use” regulation for hospital and physician practices. He was invited to Washington, DC, to assist the Office of the National

BCN Donation to Help Metastatic Breast Cancer Research

he Breast Cancer Network of WNY (BCN) has recently presented a donation of $10,000 for metastatic breast cancer research to the Research Initiative Fund of the Breast Cancer Coalition of Rochester. The donation will be used to help fund the coalition’s annual grant awards to scientific researchers in Central and Western New York who are specifically studying metastatic breast cancer. BCN’s donation came from a combination of contributions made by local organizations and individuals who requested that their gifts be used for metastatic research. “I discovered the coalition’s research initiative when my wife passed away and she asked me to have people donate to metastatic breast cancer research,” said Rob Jones, executive director of BCN. “They do incredible work in determining their grant recipients and the money is awarded directly to researchers to be used in their projects. It is a unique opportunity to make a donation where 100 percent of your gift goes directly to research.” BCN supports people in all

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2019

stages of breast cancer, including those living with metastatic disease which occurs when the cancer cells spread, or metastasize, from the breast to other organs. Once metastasized, the disease is stage 4 and considered incurable. Metastatic breast cancer causes over 40,000 deaths in the United States each year. “We have a regular schedule of support groups and programming to help support women with this advanced stage breast cancer and it makes sense that we should also help financially with finding a cure. More money needs to be directed to metastatic research and we intend to make this an annual donation,” Jones said. The coalition’s Research Initiative has been in existence since 2003 and since that time, over $700,000 has been awarded to 18 researchers from Roswell Park, Cornell University, and University of Rochester. Its research advisory board is composed of more than 40 researchers, physicians and breast cancer survivor/advocates, including BCN President Bev Jasinski.

H ealth News Coordinator for Health Information Technology / Centers for Medicare & Medicaid Services in the development of the electronic health record curriculum provided to community colleges and universities nationally. Embden received his master’s degree in finance and bachelor’s degree in business management from Nyack College near New York city. In addition, he has maintained his project management professional certification in good standing for more than 10 years.

Roswell’s CEO named to ‘Health Care Power 50’ list Roswell Park Comprehensive Cancer Center President and CEO Candace S. Johnson, PhD, has been named to City & State’s inaugural Health Care Power 50 list. Johnson, who in 2015 became the first woman to lead the cancer center, is number 24. She is the only person from a Western New Candace York institution to be included on the statewide list. “In this special list,” the media outlet writes, “we recognize the 50 most influential health care figures in the world of New York politics. Since we cover politicians on a day-to-day basis, we omitted all but a few officials who are in government, instead identifying those who influence it from the outside. We reached out to insiders and experts to compile this list, ranking each person based on their accomplishments, economic clout, sway in political and policy matters, ties to powerful politicians and the constituencies they represent.” About Johnson, City & State notes: “Shortly after becoming CEO in 2015 of the country’s first cancer center, Candace Johnson led a joint trip to Cuba with Gov. Andrew Cuomo to advance research on a promising lung cancer treatment developed on the island. No doubt the research partnership raised the profile of the Buffalo-based center, prompting Cuomo to observe: ‘New York is forging a path as a leader in modern medical research and advancement.’” In June, Johnson was named to City & State’s Women’s Power 100 list. “It’s no surprise to see Dr. Johnson getting attention for her vision and her record of achievement,” said Michael Joseph, chairman of the Roswell Park board of directors. “She is an engaging leader whose ideas and energy are impacting health care not just in Buffalo and New York State, but nationally and internationally too. She’s a dynamo.” Johnson joined Roswell Park in February 2002 from the University of Pittsburgh Cancer Institute/University of Pittsburgh School of Medicine. She is president and CEO, Wallace

Family chairwoman in translational research and professor of oncology at Roswell Park.

Inspire Dental Group appoints Karen Choi, DMD Dentist Karen Choi recently joined the Inspire Dental Group, a multi-specialty dental practice with offices in Amherst, West Seneca and downtown Buffalo Choi, who practices general dentistry, is now seeing patients at Inspire’s Amherst office, 4330 Maple Road. Choi “Dr. Choi is a compassionate, consummate professional,” said Inspire Dental Managing Partner Ron Sadler, also a dentist “She shares our commitment of ensuring our patients are informed and comfortable with their treatment, so she’s the perfect addition to our staff.” Choi received her bachelor’s degree in predental science from Lehigh University and her Doctor of Medicine in Dentistry degree from The University of Pennsylvania School of Dental Medicine. She pursued advanced education in general dentistry at Lutheran Medical Center, part of The University of Tennessee Health Science Center College of Dentistry. Choi is a member of the American Dental Association, the New York State Dental Society and the Eighth District Dental Society. A native of Cleveland, Ohio, she now resides in downtown Buffalo.

Roswell amog the best employers for diversity Roswell Park Comprehensive Cancer Center has been recognized as one of America’s Best Employers for Diversity 2019. The Buffalo cancer center was ranked 67th among 500 employers and eighth among the 30 employers within the health care sector to be named to the list, which is based on employee surveys. Forbes selected America’s Best Employers for Diversity based on an independent survey conducted in collaboration with the analytics firm Statista among a sample of more than 50,000 U.S. employees working for companies employing at least 1,000 people in their U.S. operations, across 24 different industries. The online surveys asked participants about a number of topics relating to age, gender equality, ethnicity, disability, LGBTQ+ and general diversity concerning their own employer. “The city of Buffalo is the proud home of Roswell Park Comprehensive Cancer Center, and I congratulate them on this most prestigious recognition,” said Buffalo Mayor Byron Brown. “This accomplish-

ment demonstrates the effectiveness of an organization’s commitment to a diverse and inclusive work environment. Roswell Park — an organization fueled by diversity, inclusion, and innovation — is one of the best hospitals for cancer care in the nation. Roswell Park proves that with deliberate policies, thoughtful values, and compassionate outreach, an inclusive workforce accomplishes more.” Roswell Park employs more than 3,400 people at its main campus in Buffalo and affiliate sites across Western New York. The cancer center is the only Buffalo-based employer to be named to this year’s list. “Of all the distinctions and honors Roswell Park has received, this recognition of our diverse and

inclusive team is among those that make me proudest,” said Roswell Park President and CEO Candace S. Johnson, PhD. “It’s based on our employees and what they had to say about their day-to-day experiences as Roswell Park employees. And there’s something incredibly powerful about seeing all these individuals, with all the things that make them unique, coming together to unite around one focus, one mission. We wouldn’t be Roswell Park without that richness.” The full Forbes Best Employers for Diversity 2019 list is available at forbes.com/best-employers-diversity/list.

ECMC Has Record Number of Patients in 2018 Inpatient stays exceed 20,000 for first time in hospital’s history; bariatrics, head and neck, orthopedic and transplant surgery increases contribute to historic year

rie County Medical Center Corporation (ECMCC) recently announced that the hospital in 2018 continued to see a record number of patients. For the first time, inpatient hospital visits exceeded 20,000. Record hospital activity included: • 6.7 percent inpatient increase through 2018 (20,558) compared to 2017 (19,260). • Total surgeries up 5.7 percent, with outpatient surgeries increasing by 11 percent over 2017. The strong growth occurred in bariatric surgeries (26 percent), head and neck surgeries (22 percent), neurological surgeries (17 percent), ENT surgeries (13 percent), orthopedic surgeries (11 percent), and kidney transplants (144 transplants in 2018 compared 138 transplants in 2017). • Additional growth occurred in the hospital’s outpatient clinics, including the Center for Occupational and Environmental Medicine (71.7 percent), neurology (46.9 percent), urology (34.7 percent), cardiology (20.2 percent) and primary care (2 percent). • Additional increases occurred in ECMC’s department of rehabilitation services, with inpatient admissions and outpatient services

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increasing in 2018 over 2017 by 6.5 percent. • Total outpatient services increased 2 percent from 301,773 in 2017 to 307,854 in 2018. • ECMC also saw an increase in the acuity, or level of illness in patients, with a 9.3 percent increase of patients (15,464) admitted through the emergency department versus 14,152 patients in 2017. • And another indicator of its vital role in Western New York, ECMC received 7,428 transfers from other hospitals in Western New York in 2018 marking a 15 percent increase over 6, 446 transfers in 2017. “More and more Western New Yorkers are choosing ECMC for their care because word has spread of the quality of care and the kindness and compassion of our caregivers,” said ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. “Moreover, physicians in the community and nationally have recognized this exceptional culture and many have moved their practices and patients to ECMC to receive exceptional care. Ending 2018 in this way is very fitting as ECMC celebrates its 100th year of service to our community.”

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For many questions, one easy answer: ECMC. The answers to health questions are right at home in Western New York. Because ECMC’s medical campus is home to the services, resources, and facilities that make it a simple choice for patients— including a nationally-accredited bariatric program. Our community’s most accomplished head and neck cancer specialists. The state-of-the-art Russell J. Salvatore Orthopedic Unit. And the shortest wait times in the country for kidney transplant. No matter your health questions or concerns, learn how ECMC can be the answer:

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