IGH WNY #39 January 2018 by In Good Health: WNY's Healthcare Newspaper

in good On the Fast Lane Joshua J. Lynch, an emergency doctor and medical director for Mercy Flight of Western New York, shares experience of how he and his team deal with opioids patients who land in the ER

How Bad is It in the Healthcare Industry?

Health Trends to Watch

New Year’s Resolution Moving past the weight loss plateau. Local experts weigh in on the subject

Special: Two Stories of Cancer Survivors

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January 2018 •  Issue 39

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WNY’s Healthcare Newspaper

What to Eat This Winter How do we stay warm and happy, fit and healthy during the winter months?

Run Strong All Winter Long Maintaining a running routine during the cold and snow? Yes, it’s possible

Grapefruit Don’t look to the grapefruit to melt fat, but do look to this mouth-wateringly tart fruit for a host of other health benefits. See three reasons you should eat more of it

Who’s More Distracted Behind the Wheel? Men or Women? And what’s the most common source of distraction? You’ll be surprised. It’s not texting or talking on the phone.

Doctor-Patient Relationship

Patients React Poorly When Docs Say ‘No’

atients used to see doctors as kindly-but-firm professionals, experts who knew what they were talking about and whose advice should be heeded, even if it wasn’t necessarily welcome. But these days, people have become demanding health care consumers, and they don’t respond well when a doctor disagrees with them, a new study shows. The researchers found that two-thirds of patients arrive at their doctor’s office with a specific medical request already in mind — seeking a drug or a test or a referral. When their doctor turns down that request, they’re more likely to be offended and to trash the doctor on a patient satisfaction survey. Satisfaction scores plummet when doctors deny patients’ requests for nearly anything, but especially when patients have asked for a drug prescription or a referral, the study found. The problem for doctors is that their pay has become increasingly tied to their patient satisfaction scores, said the study’s lead researcher, Anthony Jerant. He’s a professor of family and community medicine with the University of California, Davis School of Medicine.

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“A lot of physicians are tempted to just acquiesce and give them the pain medication or give them the test, even though they know it’s really not that likely to be helpful,” Jerant said. “We really need to rethink reimbursing physicians partly on their satisfaction scores.” For this study, Jerant and his colleagues reviewed 1,319 visits to 56 family physicians at the UC Davis Family Medicine Clinic. The visits were made by 1,141 adult patients. The patients were asked to fill out a questionnaire after their visit. Patients came into their doctor’s office with a specific request 68 percent of the time, the researchers found. They most often asked for a lab test (34 percent), a referral (21 percent), pain medication (20 percent) or some other new medication (20 percent). About 85 percent of the time, the doctors fulfilled their patients’ requests, the findings showed. “In general, doctors will listen to patients and, if they think the request is reasonable, will say sure,” Jerant said. “But some of those requests maybe should not have been fulfilled.” Today, people in doctors’ waiting rooms are much more likely to have

learned about a new drug from a TV ad or to have searched “Dr. Google” about their symptoms, said Cynthia Smith, vice president of clinical programs for the American College of Physicians. “Chances are, people have already tried to troubleshoot their problem by searching the internet,” Smith said. According to Joseph Ross, an associate professor at the Yale School of Medicine, “Patients may have multiple reasons for requesting a service or referral. They may have seen an advertisement for the service on TV or have a friend or family member who’d received it in the past who experienced a good outcome. Or

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

perhaps they are already unsatisfied or concerned with how their care is being managed and want a referral to a specialist.” When doctors turn down patients’ requests, the patients react poorly, the investigators found. Satisfaction scores plummeted an average of 20 points when doctors denied a request for a referral or new medication, and 10 points when they said no to a painkiller prescription, according to the report. Doctors also got worse evaluations when they turned down requests for lab tests and imaging screenings.

Season’s Greetings and Happy New Year Ask me how you can get more from your Medicare benefits. Jason Hollister Sales Manager

1-716-846-7900 www.WellCareNow.com

WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. You may enroll in the plan only during specific times of the year unless you qualify for a Special Election Period (SEP) or Initial Coverage Election Period (ICEP). 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) 。 January 2018 •

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Who’s More Distracted Behind the Wheel? Study finds that “fiddling with the radio” was the most common source of distraction while driving

exting, talking on cellphones, eating, drinking — distractions such as these are a driving hazard, and are more likely to occur among young men, new research shows. People most prone to distracted driving also often tend to think it’s “no big deal” and it’s socially acceptable, the Norwegian study found. These drivers often also felt that they had little control over being distracted. On the other hand, older women, and people who felt they could control their distracted behaviors, were most able to keep their focus where it belongs — on the road ahead. “I found that young men were among the most likely to report distraction,” said study lead author Ole Johansson of Norway’s Institute of Transport Economics. “Others more prone to distraction include those who drive often, and those with neurotic and extroverted personalities.” According to the study authors, the World Health Organization estimates that more than a million lives are lost on roadways each year due to distracted driving. And it only takes two seconds of looking away from the road for risks of an accident to rise significantly, the researchers noted. There was good news, however, from the survey of Norwegian high school students and adults: Overall rates of distracted driving were low, and “fiddling with the radio” was the most common source of distraction. The study was published Nov. 17 in the journal Frontiers in Psychology. One way to reduce distracted driving may be to have drivers devise their own prevention plans, Johansson said. For example, simply presenting people with information about distracted driving made people aware of the problem. Interventions like those “could focus on at-risk groups, such as young males with bad attitudes to distracted driving and a low belief that they can control their distraction,” Johansson said in a journal news release.

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Meet

Your Doctor

By Chris Motola

Joshua J. Lynch, D.O. Emergency doctor and medical director for Mercy Flight of Western New York shares experience of how he and his team deal with opioids patients who land in the ER Q: What does your day-to-day look like? A: I’m an emergency physician and I also do emergency medical services, like pre-hospital care stuff. I work at a variety of hospitals, mainly for Kaleida Health and Erie County Medical Center. My clinical practice reaches from community hospitals to downtown hospitals. I’m also an assistant professor at the University of Buffalo. I’m also the assistant medical director for Mercy Flight. We also have five helicopters and a Learjet. We do inter-facility transports. I’m also working a lot on addictions and the opioid crisis. Those are kind of my main things. Q: In what capacity are you usually dealing with opioid patients? A: I’m seeing them in the ER mostly. So most of them will be coming in with withdrawal symptoms or they’ve overdosed. The way I look at it, the people I’m seeing usually aren’t the ones in counseling or in treatment, so this might be the only opportunity this person’s had to interact with a medical professional, especially if they’ve overdosed. So I take that time that I have with them very seriously and try to affect some change on them. So I’ll offer them some medical advice, but also try to offer them an opportunity to get connected to a treatment provider to help continue their care. Q: Are they mostly abusing prescription drugs? A: That’s how most of it starts, although people get into heroin or fetanyl pretty easily. Actually, the majority of cases lately are people injecting fetanyl, thinking it’s heroin.

Q: What are you able to do for these patients, in terms of interventions? A: Traditionally there’s been a cocktail of medicines that targets some of the symptoms they have with opioid withdrawal. But really, medications that are gaining popularity are buprenorphine and suboxone. That’s called medicationassisted treatment. So we’re trying to find ways to incorporate them into emergency rooms around Western New York. Q: Beyond the intervention itself, what kind of impact do you think you can have on them? A: The big picture is getting people to realize the severity of their illness. The fact they’ve overdosed can be a wake-up call, if there is such a thing. So I think we can be pretty effective so long as we have a way to get them on the right track right away, like getting them linked with a provider right as they leave the ER, as well as giving them medicines that will make them feel better right away. Q: How do you help someone who has overdosed? A: We’ve worked very hard to get Narcan out in the community. We’ve put it in the hands of police officers, firemen and first responders. So Narcan is pretty available. The good news is that most overdoses have been treated with Narcan before they get to us. Now, occasionally patients will come in unconscious or require resuscitation here. In that case we can put them on a

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

ventillator or whatever else we need to do. Q: Is this something a particular hospital in the area is specializing in? A: It’s more the group, UBMD Emergency Medicine, which staffs seven hospitals, than any particular hospital. Erie County Medical Center has kind of been known as the addiction’s place for awhile now. That is because they have inpatient detox, psychiatrists that work there, as well as drug and alcohol counselors who work right in the ER. They’ve kind of led the charge. We’ve realized that someone should be able to get similar treatment even in hospitals that don’t have these kinds of resources. So we’ve tried to have our emergency medicine doctors to be able to provide this kind of care no matter where they’re working. Q: How do you go about training first responders to use Narcan, particularly the ones who aren’t medical professionals? A: I’ve held courses for police officers and firemen in the use of Narcan. Basically, we train them to recognize the signs of an overdose and how and when to use it appropriately. Q: Let’s talk about Mercy Flight. A: It’s one of the few true nonprofit helicopter companies left in the U.S. We provide air and ground critical care transport across Western New York and Northern Pennsylvania. We also have a jet for transportation all over the country for critically ill patients. We’re happy to be able to provide the service as a nonprofit and keep things reasonable for patients. We’ve been around for 36 years and Doug Baker, our founder, still works there almost every day. Q: Are most of the flights bringing patients to Buffalo? A: Yes, or Rochester. These are trauma patients, or patients who are having heart attacks or strokes. So if you have a heart attack and you live far away from a hospital we can, in theory, land a helicopter in your backyard and take you to a specialist right away. People usually think of helicopter lifts as being just for trauma, but we do a lot more than just that. Q: How do you prioritize who gets an airlift? A: In most cases the first responders decide. If a police officer gets to an accident scene and thinks it’s bad enough, for example.

Lifelines

Name: Joshua J. Lynch, D.O. Position: Emergency physician and director of aeromedical operations for UBMD Emergency Medicine; system medical director for Mercy Flight of Western New York Hometown: Buffalo, NY Education: University of Buffalo; Lake Erie College of Osteopathic Medicine Affiliations: Kaleida Health, Erie County Medical Center Organizations: 100 Club of Buffalo; American College of Emergency Physicians, Air Medical Physician Association Family: Wife, three children Hobbies: Music, skiing, travel, spending time with his children

By George Chapman

Health Trends to Watch

The State of Healthcare in the US: Where We Stand Going into 2018

Cost of Care Everyone agrees it is just too expensive. We spend much more per capita on healthcare (about $10,500) than any other developed country in the world. Healthcare is now 19 percent of our GDP and costs are rising faster than our economy grows. The federal budget is about $3.65 trillion. Healthcare accounts for the biggest chunk of the federal budget at 28 percent or $1.022 trillion. To put that into perspective, pensions account for 25 percent; defense, 21 percent; welfare 9, percent; interest on debt, 7 percent; education, 3 percent; protection, 2 percent; transportation 2 percent and other 2 percent miscellaneous; and finally general government, 1 percent. Premiums for 2018 are hard to project because of the uncertainly in the market created by the White House. The actual cost for care will increase around 12 percent due to factors like medical inflation, aging and morbidity adjustments, and the ACA tax to cover the medically indigent. Experts warn that the conflation of terminating the individual mandate (everyone buys insurance), terminating the subsidies for the indigent (who buys insurance on the exchanges), and just general uncertainty over what Washington is doing could cause rates to jump another 17 percent.

Coverage or Who Pays Almost half of all Americans, 156.8 million people or 49 percent, are covered by their employer. On average, employers pay for about two thirds of the employee’s premium. The other half is covered by some sort of government program. 64 million people, or 20 percent of us, are covered by Medicaid. Medicare covers 44.8 million seniors or 14 percent of us. 22.4 million or 7 percent of us are covered by nonemployer groups. The 7 million people who purchase individual coverage on the exchanges are part of this group. The VA and federal employment cover 6.4 million or 2 percent of Americans. The

‘The average profit for healthcare insurance companies is just 3.2 percent for health insurance companies. The average profit margin for drug manufacturers is 20.8 percent; medical instruments and supply companies average 12.5 percent; medical appliance and equipment sellers average 9.5 percent. Hospitals’ profit average is 3.7 percent.’ remaining 26.6 million of us (or 8 percent) are still uninsured. If the federal government follows through on cutting the subsidies on the exchanges, most likely the uninsured rate will climb.

The Culprits Our costs are high mainly because of prices, (particularly for drugs and implantable devices), administration, inefficiently delivered and unnecessary services, fraud and emphasis on treatment versus prevention. All told, it is estimated that the above “culprits” cost us around $765 billion per year. Ironically, a contributing culprit could be we don’t see/use our physicians enough. We average 4.1 doctor visits a year. People in developed countries with far lower costs and better health status see doctors more often: Australia, 6.7 times a year; Canada, 7.4; France, 6.8; Germany, 9.7; and the U.K., five visits a year. Our high deductible plans may be keeping us from seeing the doctor when we should. Drugs developed in the US are cheaper in most other countries. For example, in 2015 the heartburn medication Nexium sold in the US for about $215. It was $60 in Switzerland, $58 in Spain, $42 in England and $23 in the Netherlands.

Profit Margins Most people believe the insurance companies are making the big money. Highly publicized CEO salaries and the president threatening to “cut the subsidies to greedy insurance companies” may contribute to this belief. The average profit margin for insurance companies is 3.2 percent.

The ACA actually capped how much of the premium an insurer could retain for operations at 15 percent. If an insurer spent only 80 percent on claims, retaining 20 percent, they had to refund 5 percent of the premium to consumers. The 15 percent covers marketing, reserves, administration and profit. So, after covering their operating expenses, the average profit was just 3.2 percent for insurance companies. The average profit margin for drug manufacturers is 20.8 percent; medical instruments and supply companies average 12.5 percent; medical appliance and equipment sellers average 9.5 percent. Hospitals average 3.7 percent. While profits are quite healthy for the drug and manufacturing companies, medical debt is the No. 1 for personal bankruptcies for people with insurance and without insurance. 62 percent of filings for personal bankruptcy are due to medical bills. Job loss, excess credit, divorce and unexpected expenses round out the top 5 reasons for personal bankruptcy.

Performance Ever since comparisons have been made, our healthcare system pales when compared to other developed countries. Based on a variety of measurable and accepted factors, the highly reputable World Health Organization ranks the US No. 37. Ahead of us are countries like France, Italy, Spain, Japan, the U.K., Germany, Canada, Australia, Greece, Norway, Ireland and Sweden. The Commonwealth Fund compared 11 countries on things like: prevention, safety, coordination, accessibility, affordability, timeliness,

January 2018 •

administrative efficiency, equity throughout all income levels and nine measures of healthcare outcomes or status. We came in dead last behind No. 1 U.K., No. 2 Australia, No. 3 Netherlands, No. 4 New Zealand, No. 5 Norway, No. 6 Sweden, No. 7 Switzerland, No. 8 Germany, No. 9 Canada and No. 10 France.

Hospitals There are about 5,500 hospitals in the US with almost 900,000 staffed beds admitting 35 million of us per year. 80 percent of hospitals are nonprofit. In NYS, all 195 hospitals are nonprofit. 1,800 hospitals are located in rural communities and they are the most vulnerable financially in an increasingly competitive and volatile market. Hospital consolidation, through mergers and acquisitions will save many of the at-risk rural and smaller suburban hospitals. The Accountable Care Act was the catalyst for increased merger and acquisition activity, encouraging larger, integrated, comprehensive and more efficient delivery systems. It will very be rare in the near future to find an independent stand-alone hospital. Most will become cogs in a huge clinical wheel. The FTC is keeping a wary eye on hospital consolidation. So far, consolidation has saved some failing hospitals and improved recruitment of physicians but it has not resulted in lower prices for consumers. If consolidation ultimately results in a virtual monopoly that won’t negotiate price with insurers, the FTC will step in and break it up.

Physicians More than half of all active physicians are now employed by a hospital or healthcare system. As the business side of medicine becomes more regulated, confusing and complicated, the trend away from the hassle of private practice will continue. Depending on your source, the number of active physicians varies significantly. According to the Kaiser Family Foundation, there are about 923,000 professionally active physicians. According to the Association of American Medical Colleges, there are about 861,000. Dire predictions of a severe shortage of physicians seem

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‘In 2015 the heartburn medication Nexium sold in the US for about $215. It was $60 in Switzerland, $58 in Spain, $42 in England and $23 in the Netherlands.’ to highly exaggerated. If you split the above difference in the number of active physicians and call it 900,000, that would be about one physician per 360 of us. (US population: about 323,000,000). About half the active physicians are in primary care. That would still be just 720 of us per primary care physician which seems more than manageable despite our aging population. Some of these self-serving predictions fail to account for or minimize the impact of 88,000 physician assistants, 160,000 nurse practitioners, technology, telemedicine and increased consumer involvement in our care.

The Leading Killers The average life expectancy in the US is 79 years. 75 percent of all deaths can be attributed to just 10 causes. Heart disease is the No. 1 killer at 23 percent of all deaths. Cancer is No. 2, causing 23 percent of all deaths. Chronic lower respiratory disease (COPD) is No. 3 causing 5.6 percent of all deaths. The rest are: No. 4, accidents; No., 5 strokes; No. 6, Alzheimer’s; No. 7, diabetes; No. 8, flu and pneumonia; No. 9, kidney disease; and No. 10, suicide. Moving quickly up the top killer list is overdose from opioid/heroine. 140 people a day or 51,000 a year die from overdosing on oxycodone, fentanyl, codeine, hydrocodone, etc. Once the prescription expires, addicts turn to cheaper heroine.

Good Health 50 percent of good health is impacted by your “life.” That includes factors such as income, disability, education, social exclusion, social safety net, gender, employment or working conditions, race, diet, housing and sense of belonging to your community. 25 percent of good health is impacted by your healthcare, including access to care, the system you choose and wait times. 15 percent of good health is affected by your biology and genetics. Finally, 10 percent of good health depends upon air quality and civic infrastructure. Of the factors you can control, keeping in contact with your primary care physician is the best thing you can do to reduce or mitigate, if not completely prevent, untoward health events.

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. Page 6

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Critical 12 Hours That’s how much time it took to move 125 mothers, children and babies from Women and Children’s Hospital of Buffalo to the new John R. Oishei Children’s Hospital in November. The doctor in charge of the transition: Stephen Turkovich, chief medical officer

hen John R. Oishei Children’s Hospital opened in early November, physician Stephen Turkovich, chief medical officer, was a very busy man. The entire transition from Women and Children’s Hospital of Buffalo to the new facility took only 12 hours to execute, but endless hours to effectively plan, including 12 mock moves leading up to the big day. As 125 mothers, children and babies were being moved to the Oishei Children’s Hospital, Turkovich was in charge at the command center located at Women and Children’s Hospital of Buffalo, overseeing the proceedings. “I ensured tight communication and team work among the clinical teams, AMR, emergency preparedness, IT, facilities, security and our partners from the community and governmental agencies to ensure that our patients were transported safely to the new hospital,” Turkovich said. All of those preparations led patients and practitioners to a new facility with a host of improved features. Located on the Buffalo Niagara Medical Campus, the new Children’s Hospital is directly connected to Buffalo General Medical Center through a second and third floor skywalk to enable quicker access for at-risk adult patients. The new facility also features an ambulatory surgery center, two new MRIs as well as two new CTs, larger operating rooms, single rooms in the NICU, and an enhanced air filtration system, to name a few. “The moms, children and infants of our community will have access to the absolute best care in a stateof-the-art facility right here in the heart of downtown Buffalo. We’ll be positioned to attract the best and brightest physicians and nurses, enhance care for our patients, foster an environment that promotes healing, recovering and overall well-being, pursue research and discovery and invest in education, advocacy, and outreach throughout our community,” said Turkovich. The new hospital is more than just that for the Orchard Park native and self-described proud Buffalo resident. “I am proud and thrilled about our move to the new John R. Oishei Children’s Hospital. It’s another key milestone in the city’s ongoing renaissance and for the families of Western New York,” he said. “Our new hospital is a beautiful example of the Buffalo renaissance, demonstrating the endless possibilities and exciting opportunities for our region.” Turkovich completed his undergraduate schooling in the honors program at the University at Buffalo and received his degree in anthropology. He remained in the area to complete his doctoral degree from the Jacobs School of

Physician Stephen Turkovich was in charge of the process of moving patients from Women and Children’s Hospital of Buffalo to the new John R. Oishei Children’s Hospital opened in early November. “The moms, children and infants of our community will have access to the absolute best care in a state-of-the-art facility right here in the heart of downtown Buffalo,” he said Medicine and Biomedical Sciences at the University at Buffalo and went just up the road for his residency in pediatrics at Golisano Children’s Hospital in Rochester. Before being named chief medical officer in 2014, Turkovich was a clinical assistant professor of pediatrics at the University at Buffalo and a hospitalist with UBMD Pediatrics at Women & Children’s Hospital of Buffalo. In 2008 he was appointed the quality and patient safety officer for Women and Children’s Hospital. Although he has been with Women and Children’s Hospital for nearly a decade, the chief medical officer said he never gets bored. “No two days are ever alike. My primary responsibility is to ensure that we provide the highest quality and safest care possible to all of our patients and their families,” he said. “By far the most rewarding aspect of working at Oishei Children’s

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

Hospital is watching our patients transition home with heart-warming smiles on the road to recovery.” Not every day is all smiles, however. Turkovich noted that the hardest days come when families and patients need help healing and recovering from devastating and traumatic circumstances. On good days and bad, he said, he takes a holistic approach to medicine and hopes to lead a facility which serves as a crucial resource to the community he loves. “I’ve always had a passion for advocacy, teaching and the biologic sciences. The medical field allows me to help and empower my patients and their families make healthy choices; advocate for children; and build a healthier community. Anthropology taught me how cultural beliefs, human interactions, and socioeconomic forces impact health and wellbeing,” he said.

Sexual Harassment in the Healthcare Industry Power, pay and reputation: How sexual harassment affects the medical community By Julie Halm

t seems that these days, more than ever before, women are feeling empowered to speak out regarding sexual harassment, whether it took place recently or decades in the past. The national eye has turned toward a number of politicians, entertainers and TV celebrities who stand accused of such misconduct, and it seems that the issue is rampant in those particular career fields. But what of the medical field? Are employees of hospitals subject to harassment at a higher rate than in other industries? According to the Equal Employment Opportunity Commission, sexual harassment includes unwelcome sexual advances, requests for sexual favors and other verbal or physical harassment of a sexual nature in the workplace or learning environment. A new ABC News-Washington Post poll released in October, found that more than half of all women in all industries had experienced unwanted and inappropriate sexual

advances at some point and 30 percent of those women said that they had been harassed while on the job. While hard numbers on an industry-to-industry basis are difficult to come by, according to Buffalo-based lawyer Lindy Korn, who focuses on illegal employment discrimination, sexual harassment and retaliation, some conditions in the medical field lend themselves to just this kind of issue. According to Korn, sexual harassment is more likely to take place when there is a power differential between the two parties involved. “Sexual harassment is about power and the abuse of power and so I think that doctors in particular have a very high status in the United States. They’ve always been revered and respected and I think they’re better paid than some other jobs and that all goes toward some definition of power,” said Korn. According to Korn, the work conditions of medical facilities,

particularly hospitals, might also cause such an issue to arise. The long hours and high-stakes nature of the jobs which are undertaken by doctors and nurses can create strong bonds between co-workers. These bonds and close personal relationships can cause boundaries to become blurry and open the door for unwanted conduct to take place. “What I’m trying to say is, it’s not just doctors, but doctors have the right ingredients,” said Korn. Recently, a social media campaign took place where participants — primarily women — posted #metoo in order to denote that they have been a victim of some type of sexual harassment or assault. The campaign went viral and many experts, including Korn, think that it has the potential to be a very positive message. “I think this national conversation is powerful and it is necessary. It’s really a catharsis and it’s wonderful,” she said. Betty Preble, president of the Buffalo branch of American Association of University Women, agrees wholeheartedly, whether a woman is observing or participating in the campaign, it can bring hope and a sense of justice. “I think that’s terribly empowering for a woman who has been suffering for 30 or 40 years with this emotional trauma,” she said. The AAUW works on a variety of issues and fronts, from providing scholarships to supporting legislation and equal pay is high up on that list. According to the Henry J. Kaiser Family Foundation, roughly 34 percent of physicians in the country are female, whereas just over 83 percent of professionally active nurses are female, making the issue of equal pay a prominent one in this field. According to Korn, in addition to pay, the issue of reputation can cause a power differential, and a problematic situation for a victim of sexual harassment in the instance of a well-known medical practitioner. “Allegations go to the heart of someone’s reputation and beyond and so sometimes there unbelievable in the public’s eye because the person seemed to be so talented, so kind, everything good, that they couldn’t possibly have this side to them,” said Korn. Whether in the medical field or not, Preble noted that the best course of action for someone who feels they are being harassed is to document everything they possibly can.

Almost 30% of Women in Medicine Experience Sexual Harassment

ew research shows that while 4 percent of men in academic medicine endure sexual harassment, nearly 30 percent of women in the same field do, according to Reuters. The finding comes from a study in the Journal of the American Medical Association (JAMA), released in May 2016. Researchers surveyed 1,719 individuals who had received the National Institutes of Health’s K08 and K23 grants — which give career support to young researchers — between 2006 and 2009. Around 1,000 recipients responded. Here are three findings from the study and its related

background. Thirty percent of females 1. reported experiencing sexual harassment of some kind — whether

through unwanted sexual comments, attentions or advances — at some point in their career. Nearly 50 percent of these females claimed the experience had negatively impacted their career. According to the JAMA study, 70 percent of women said they’d seen gender bias in the workplace, and 66 percent said they’d personally endured it. Comparatively, 22 percent of males noticed a gender bias in the workplace. Only 10 percent of men said they’d personally experienced it.

A similar 1995 study found 3. 5 percent of males and more than 50 percent of females in

academic medicine faculty positions had experienced sexual harassment. Physician Reshma Jagsi, tthe lead author of the study, pointed out that the women in 1995 had started their careers when less than 10 percent of medical school classes were female. “I really thought that harassment would be much less commonly experienced by women in our sample, who went to medical school when the proportion of women among medical students had exceeded 40 percent,” Jagsi said. Source: Becker’s Hospital Review

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OB/GYN Practice Offers Weigh Loss Program Audubon Women’s Medical Associates in Williamsville is offering its 2018 “New Year’s Resolution 10 Week Weight Loss Program,” designed for women who want to lose weight, increase energy, identify and reduce sugar cravings and create healthier eating habits. The workshop will be led by Kim Fenter, a certified health nutrition coach. Meetings will take place from 6:30 to 8 p.m. every Wednesday starting Jan. 10. The group will meet at Audubon Women’s Medical Associates, 2240 N. Forest Road in Williamsville. For more information, call 716-639-4034 ext. 513 or email Kim.fenter@audubonwomens.com.

ECMC Trauma Center Gets $1 Million Grant From Oishei Foundation Erie County Medical Center (ECMC) Corporation will receive a $1 million grant for the hospital’s future trauma center/emergency department from The John R. Oishei Foundation. “The John R. Oishei Foundation, recognizing the vital role ECMC plays in the delivery of quality healthcare services for the residents of Western New York, particularly through the hospital’s trauma center/emergency department, is very pleased to help fund a project that will benefit for many years the residents of our region,” said Robert D. Gioia, president of The John R. Oishei Foundation. Erie County Medical Center Corporation plans to relocate its existing trauma center/emergency department into a newly-constructed ground floor facility on its Grider Street health campus. As the region’s busiest and only level 1 adult trauma center and emergency department serving the 1.5 million residents of the eight counties of Western New York, officials say it is imperative to expand to meet current and future demands for appropriate trauma and emergency care. The trauma center/emergency department serves patients for trauma, emergency psychiatric conditions and traditional medical conditions. It’s also best suited to handle mass casualty and disasterrelated circumstances.

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New Diabetes Drug Gets FDA OK Under ‘Abbreviated’ Pathway

dmelog (insulin lispro), a short-acting form of insulin, has been approved by the U.S. Food and Drug Administration to treat people with either type of diabetes, for patients aged 3 years and older. It’s the first drug approved as a “follow-up” product based on an abbreviated new process dubbed 505(b)(2), the agency said Monday in a news release. A new drug approved this way relies on the agency’s finding that “a previously approved drug is safe and effective, or on published literature to support the safety and/or effectiveness of the proposed product, if such reliance is scientifically justified,” the FDA said. The abbreviated process “can reduce development costs, so products can be offered at a lower price to patients,” the agency explained. “In the coming months, we’ll be taking additional policy steps to help to make sure patients continue to benefit from improved access to lower cost, safe and effective alternatives to brandname drugs though the agency’s abbreviated pathways,” said FDA Commissioner Scott Gottlieb. Admelog was approved under the new process in part due to its similarity to the diabetes drug Humalog, the agency said. Admelog itself was evaluated in clinical trials involving about 1,000 people. The most common side effects included hypoglycemia (low blood sugar), itching and rash. A less common but more serious adverse reaction could include life-threatening allergic reaction, including anaphylaxis, the FDA said. Admelog should not be used by people with hypoglycemia, or by people who are “hypersensitive” to the drug’s active ingredient insulin lispro, the agency warned. And people at risk of too much blood potassium (hyperkalemia) should be monitored carefully while taking Admelog. Short-acting insulin products are typically given just before meals to help control blood sugar after a person eats. This type of drug is more likely to be used by a person with Type 1 diabetes than a person with Type 2, the agency said. Admelog is produced by the French firm Sanofi-Aventis, whose U.S. headquarters is based in Chattanooga, Tenn.

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Run Strong All Winter Long Maintaining a running routine during the cold and snow. Yes, it’s possible By Kyra Mancine For many runners, their running season ends when the cold, dark days of winter are upon us. For others, they continue running, even when the snow falls and temperatures tumble. How and why do they do it? It’s All About Attitude Winter runners look at their outdoor runs as a chance to enjoy the beauty of the season. “I love running in the winter. I’ve always enjoyed the change of seasons,” said Matt Dow, who coaches high school crosscountry, indoor and outdoor track at St. Joseph’s Institute in Buffalo, and has been a runner for more 30 years. “I would rather be a bit cold than hot. Once you start running, your body really does warm up quickly.” It’s Better Than “The Dreadmill” “Running indoors on a treadmill is so tedious to me — I can’t take it for more than a couple of miles,” Dow said. “I really enjoy going out in the cold, crisp air. I like the sound of the crunching snow, especially early in the morning when everything is still quiet.” Molly LaPrade, an avid runner from Seneca Falls, echoed similar sentiments. “It doesn’t get any better than getting in a good run on a snowy winter day. Mentally, I need to get outside to get some fresh air. I also enjoy running in winter if the sun is out. I just check the temperature, and, if it’s not too cold, I‘m up for it. “ Be Prepared It’s important to be ready for the conditions. Is it going to be windy? Is it slippery? What is the temperature going to be during the run? The answers to these questions dictate how you should dress. Start off by wearing layers. Dow prepares by “wearing multiple layers on my legs and upper body. If it’s really snowy, I’ll throw on my trail shoes for a little extra traction.” LaPrade prepares by “always wearing a wicking material that is closest to my body. Then, I can take as many layers off as I need to feel comfortable.” Be mindful to not overdress though, otherwise you risk overheating. You want to dress as if it’s 15 to 20 degrees warmer than it is outside. Fabrics that wick sweat are ideal, because they can vent moisture as you warm up during your run. You also want to make sure to wear a hat and protect your face from frostbite. Expert Advice Ellen Brenner, vice president of three Fleet Feet Sports in Buffalo, advises runners to cover all exposed skin, including neck, ears and even the ankles, which can easily be overlooked if you wear capris or

three-quarter length running pants. “Stick to polyester or wool for your base layer — no cotton, which stays wet and can add to your chill. Even your underwear should be a fabric other than cotton.” To help run in snow and icy conditions, Brenner recommends traction/cleat type devices (such as such as Yaktrax or STABILicers) that runners can slip on over their shoes. You can even have metal studs inserted into running shoes to help with traction and stability on snowy roads or trails. If snow is deep, trail shoes are recommended because they have deeper treads like a snow tire. Whatever footwear you choose, “don’t ignore the conditions — be logical,” Brenner said. “Runners still need to be cautious and shorten their stride, no matter what type of shoe they’re wearing. “ If you’re running early in the morning or at night, be sure and wear reflective or fluorescent gear, a headlamp or other attire with a light source. Some runners also run with flashlights. Remember, your phone doubles as one as well. There are many other products to make your outdoor run safe and more comfortable. Check out your local running store, and don’t be afraid to ask the staff for advice. Most of them are runners too!

runners. If you’re looking for support and encouragement, Fleet Feet offers a free Winter Warrior ‘Winterventure’ program (Jan. 3 to Feb. 18), where runners collect points and track mileage through weekly workouts, special events and races. This program is intended to keep runners committed throughout the winter months. For more information, visit www.fleetfeetbuffalo.com/training/ winter-warrior Be Realistic Don’t expect to be as fast as you are in warmer conditions. Accept that you aren’t going to beat any personal records. You never want to risk injury just to get a run in. And, yes, there will be times when the best choice is to skip that outdoor run. With a little preparation and the right mindset though, outdoor running can be an invigorating way to enjoy the weather this winter.

Pre- and Post-Run Besides being dressed appropriately, it’s also important to warm up before you start out. Being a bit chilly before a run is OK, but getting your heart rate up indoors (by doing a few jumping jacks or jumping rope for instance) before heading outdoors can help take away the initial shock of the cold to your system. In addition, changing out of sweaty, wet garments post run is extremely important. Having a hot beverage after a run is beneficial too and gives you something to look forward to as well. Camaraderie counts The bonding and team feeling that comes with engaging in the sport can be a big motivator for cold weather

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

Matt Dow, who currently coaches high school cross-country, indoor and outdoor track at St. Joseph’s Institute in Buffalo. “I really enjoy going out in the cold, crisp air. I like the sound of the crunching snow, especially early in the morning when everything is still quiet.” Photo courtesy of Sarah Anderson.

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Things You Should Know About STDs By Ernst Lamothe Jr.

ew cases of sexually transmitted diseases in the United States reached an all-time high in 2016, according an annual report from the U.S. Centers for Disease Control and Prevention, which was released late last year. There were 1.6 million cases of chlamydia, 470,000 cases of gonorrhea and 28,000 of syphilis reported in 2016. “We are seeing cases of increase rates of syphilis, gonorrhea and HIV nationwide,” said Gail Burstein, Erie County Department of Health commissioner. “The issue is that we don’t know for sure if that is because we are doing more testing for these diseases or if people’s behaviors are getting risky. It may be a combination of both.” Erie County itself had 5,201 chlamydia cases in 2006 along with 1,874 gonorrhea cases and 134 syphilis cases. Burstein recently offered five thoughts about sexually transmitted diseases.

716 .427.774 4

Testing Burstein said there has been an increase in incidence of sexually transmitted diseases among gay men but the rates are consistent to those affecting other groups. She suggests that the key to stopping the trend will always be testing. And testing has expanded in several ways to make the process simpler for people, including being available in emergency room departments and being covered for by the Affordable Care Act. “You don’t need a pelvic exam or any painful swab. Many of the tests can be done as a urine sample,” said Burstein. “Women can even do a selfcollected vaginal swab for that to get tested.” If left untreated, STDs can lead to serious health problems such as infertility, life-threatening ectopic pregnancy, stillbirth and increased risk of HIV infection. Recent numbers from the CDC

“We are seeing cases of increase rates of syphilis, gonorrhea and HIV nationwide. The issue is that we don’t know for sure if that is because we are doing more testing for these diseases or if people’s behaviors are getting risky. It may be a combination of both.” Gail Burstein, Erie County Department of Health commissioner. reported that gay men had a higher risk for syphilis and HIV than heterosexual couples. Burstein said it’s essential to have the correct test associated with the sexual act such as having a rectal test if you had anal sex and oral exam if you engage in oral sex. You can even go to your local drug store for an HIV testing kit, where you send the samples to a lab for results. “There really is no excuse for not getting tested. It is just the mindset that has to change,” she said. “While HIV is not curable, you can live with it in the same way people live with diabetes.

App sex Burstein and other medical officials believe the situation has worsened in the last decade or so thanks to social media apps and online sites where heterosexual and gay individuals can find a sexual partner easier than ever before. “You can go on these apps and sites and people don’t have to give their real names and they really don’t know who they are having sex with,” said Burstein. “They are having sex in town and out of town and it is difficult to investigate and see how the STDs spread from community to community.”

Youth movement The highest rates among sexually transmitted diseases, especially gonorrhea and

chlamydia, are among people under 25 years old, especially women. Young people aged 15-24 and men who have sex with men are at highest risk for STDs and can drive new HIV infections. Young people face unique barriers to services, including stigma, confidentiality concerns and provider resistance to sexual health discussions and testing. Physician and health providers recommend that anyone under 25 get tested once a year. Medical officials recommend that anyone over the age of 13 who is sexually active have an HIV test. “In New York, you do not need parental consent to have an HIV or STD test,” Burstein said. “It is confidential. People don’t have to worry about their information coming out.”

Myth Medical professionals are encouraging people to increase their health literacy, which is the ability to obtain, process and understand basic health information and services needed to make appropriate health decisions. “A lot of people think you have to exhibit classic symptoms like burning or irritation,” said Burstein. “That is simply not true. Most sexual transmitted diseases don’t always exhibit in obvious forms. You might be exposed to an STD in a place that is not visible. But if you don’t get tested it can cause inflammation in various areas of the body that you

January 2018 •

Gail Burstein, Erie County Department of Health commissioner. “People who are about to enter sexual relationship cannot be shy about talking about this issue,” she says referring to sexually transmitted diseases. won’t discover until it is too late.”

Talking It’s a simple step but often the first one ignored. Having a frank and candid discussion with your partner, partners and physicians about the issue can be uncomfortable. However, not as uncomfortable as actually having a sexually transmitted disease. “People who are about to enter sexual relationship cannot be shy about talking about this issue,” said Burstein. “One idea that I have heard is that before a couple gets sexually active they should both go together and get tested so if someone does need to be treated they can have a fresh start.”

Note: Erie County Department of Health staffs a year-round clinic at the Jesse Nash Health Center, 608 William St., in Buffalo. Anyone can access confidential STD screening tests learn how to prevent transmission of STDs, and access comprehensive sexual health care, including family planning.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Build a Home in Your Heart in 2018 “Build thy home in thy heart and be forever sheltered.” – Anonymous

love this saying. It captures so beautifully what I practice every day and what I preach in my Live Alone and Thrive workshops — that the relationship with ourselves is the most enduring of all and that it is worth nurturing. Most of the women and men whom have made peace with living alone are busy leading interesting lives and making it their own. They have challenged, as have I, the age-old and deeply held belief that marriage, as it has been traditionally defined, is the only state in which we can be happy, fulfilled, secure and successful. We have come to consider our time alone as a gift, not a burden. Whether divorced or widowed, we are not spending this precious time bemoaning our fate. We have overcome adversity and we are the stronger for it. We have taken our lives into our own hands and have embraced the choices and possibilities that living alone has to offer. This is what we know . . . Living alone doesn’t mean being alone. All you need to do is pick up the phone, text a friend or email a colleague.

Accepting party invitations is worth doing, even if it’s a party with mostly couples. Keep in mind that guests often separate into groups of women and men, so singles blend right in. Traveling solo is an adventure in self-discovery. Whether it’s Paris or Peoria, striking out on your own will expand your horizons and build self-confidence. Figuring out how to replace the flapper valve in your toilet — all by yourself — can be very rewarding! The stereotyped images of single women and men as desperate and miserable are exaggerated and just plain untrue. Recent studies on the subject bear this out. Rediscovering your “true self” and identifying those things that bring meaning and joy into your life can turn living alone into an adventure of the spirit. Pursuing a new career or college degree in midlife can be liberating and fun.

5. 6. 7.

Doing a “random act of kindness” is a great antidote when you’re feeling lonely and sorry for yourself. Friends matter. Reach out. Nurture your friendships. Honor your commitments. Accepting a dinner invitation does not obligate you to anything. Paying your own fair share on a date can feel good and empowering. Loneliness is not a “state of being” reserved for single people. Were you ever lonely in your marriage? Letting go of the idea that you need to be married to have any chance of being happy and fulfilled is essential. This idea will only keep you mired in self-pity. Treating yourself well builds esteem. Prepare and enjoy decent meals at home. Get enough sleep. Exercise. You’re worth it. Tell yourself so by taking good care of yourself. Your children are your first priorities, even in the face of an enticing romance. Getting out of your comfort zone is worth the discomfort. Try something new — dancing, a book club, golf lessons… whatever. It’s a great way to have fun and meet people. Isolating on holidays, birthdays, Sundays, etc. is no good. Solitary confinement is punishment for criminals, not single people. Make plans. Comb your hair. Lose the sweat pants. Put a smile on your face. It’s important to create your own positive feedback. Looking good tells people you value yourself. It will draw people (and compliments) to you. Who doesn’t

9. 10. 11. 12. 13. 14. 15. 16. 17. 18.

need and want that? There’s no shame in asking for help. It’s not a sign of weakness. On the contrary. Self-confidence and humor are powerful aphrodisiacs; neediness and desperation are not. Doing anything alone means you enjoy life and your own company; it does not mean you are a loser. Expanding your definition of love beyond “romantic love” will stand you in good stead. Embrace “passionate friendships” — those relationships in which you can be yourself and feel completely comfortable. Hanging out with negative people is a real downer. Put yourself with people who make you feel good about yourself and about life. Living alone takes practice. Know that there is always someone you can call or something you can do to improve your situation. So there you have it, two dozen tips for building thy home in thy heart. I’ll end as I started, with another quote I love. This one is by Gilda Radner:

19. 20. 21. 22. 23. 24.

“Whether you’re married or not, whether you have a boyfriend or not, there is no real security except for whatever you build inside yourself.” Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive,” empowerment workshops for women held throughout the year in Mendon. For information or to contact Voelckers, call 585-624-7887 or email: gvoelckers@rochester.rr.com.

s d i K Corner

Tech at Bedtime May Mean Heavier Kids Study shows that use of electronic gadgets in bed disrupts children’s sleep

ids and their smartphones aren’t easily parted, but if you want your children to get a good night’s sleep and to stay at a healthy weight, limiting bedtime screen time appears key, new research suggests. Parent surveys revealed that using a smartphone or watching TV at bedtime was tied to a greater body mass index (BMI). BMI is an estimate of body fat based on height and weight. And using any technology at bedtime — cellphones, TVs, laptops, Page 10

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iPads and video games — was linked to getting about an hour less sleep, poorer sleep and, not surprisingly, morning fatigue. The one bit of good news from the study was that technology use didn’t seem to increase the risk of attention problems. “Parents should have a conversation with their child’s pediatrician about age-appropriate use of technology,” recommended the study’s lead author, Caitlyn Fuller. “You want kids to be getting a

good amount of sleep, so ask kids to shut off their technology before bed. And don’t let the cellphone be next to them while they sleep,” advised Fuller. She is a medical student at the Penn State Hershey College of Medicine. It’s important to note, however, that while the study found associations between technology use at bedtime and some negative outcomes, the study wasn’t designed to prove a cause-and-effect relationship. About 40 percent of youngsters have their own cellphone by fifth grade, according to background notes in the study. And there are now electronic and tablet-based children’s toys for even younger kids, the study authors noted.

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

Children who watched TV or used their cellphones at bedtime were more than twice as likely to be overweight or obese, the study findings showed. Unsurprisingly, kids who played more sports or played outside more often were less likely to be overweight. Also, kids who watched TV or played video games at bedtime got about 30 minutes less sleep nightly than those who didn’t watch TV, according to the study. The video gamers also had more trouble staying asleep. In general, kids who used their phones or computers at bedtime lost about an hour of sleep each night compared to those who put their technology away earlier.

What to Eat This Winter How do we stay warm and happy, fit and healthy during the winter months? By Anne Palumbo

ome winter — a season of short days, long nights, chilly temps and lavish holiday spreads — it’s easy to make some unhealthy food choices. We’re cold; we’re bored; we’re tempted; we’re restless. And some of us, no thanks to the decrease in sunlight, may also feel seriously down in the dumps. Compound all of the above with dry, itchy skin and a cold that won’t relent, and it’s no wonder we’re reaching for that second helping of mashed potatoes. Of course, we may also be reaching for that second helping simply because it’s winter and our appetite is heartier for comfort foods: stews, mac ‘n’cheese, pancakes, pies. While some experts suggest our cravings are a throwback to the days when we needed an extra layer of fat to survive the cold, most say it’s just physiology. “When outdoor temperatures drop, your body temperature drops, and that’s what sets up a longing for foods that will warm you quickly,” says nutrition expert and registered dietitian Kristin Herlocker. “Carbohydrate-rich foods provide the instant ‘heat’ boost your body is longing for.” So, how do we stay warm and happy, fit and healthy during the winter months? Read on for healthy food choices that are easy to implement.

If you’re gaining weight, reach for better snacks Studies indicate that the average person gains 1 to 2 pounds during the winter months, with those who are already overweight likely to gain more. Nutritionists suggest that consuming sugary, starchy fillers between meals may be the culprit, as these foods often don’t satiate us the way harder-to-digest foods do. Instead of snacking on chips or candy, eat a high-protein, high-fiber snack between meals — a snack that

keeps you feeling fuller longer and your blood sugar steadier — like peanut butter on celery sticks, lowfat cheese on whole-grain crackers, or some nuts. Nutritious snacks will fuel the body’s heat mechanism — and the toastier we stay, the less we crave carbs. What’s more, healthy snacks are typically much lower in calories than unhealthy snacks. For example: One cup of unbuttered airpopped popcorn—30 calories; one cup of potato chips — 150 calories; one cup of strawberry halves — 50 calories; one Snickers bar — 250 calories.

If you’re feeling blue, try these mood-boosting foods Being cooped up during the coldest, darkest days of the year can make us feel so listless and down. Is it any wonder our sweet tooth flares during the wintertime? Oh, if only that cookie were a legit fix! Unfortunately, a steady diet of simple carbs is the last thing our moods need in the winter. What we need, according to experts, is to consume foods with proven mood-boosting nutrients and fatty acids, such as vitamin D, the sunshine vitamin (found in fortified dairy products, eggs and mushrooms); folate, a B vitamin, that may help lessen depression (abundant in spinach, asparagus and lentils); and omega-3s, brain-building fatty acids believed to stabilize moods (found in salmon, walnuts and flaxseed). And chocolate? Many studies support that consuming chocolate can help improve your mood, especially dark chocolate, which stimulates the production of endorphins, chemicals in the brain that create feelings of pleasure. Dark chocolate also contains serotonin, a mood-boosting antidepressant. The key with chocolate, however, is moderation.

If you’re susceptible to colds and coughs, fortify your body with these superstars Most of us come down with something over the winter months, no matter how rigorous our handwashing, no matter how sterile our environment, no matter how dutifully we’ve instructed those around us to sneeze into a tissue. But we can lessen our chances, experts say, by keeping our immune system healthy. While the jury is still out on which nutrients strengthen our immune system most, there is some evidence that foods rich in vitamins A, B, C and E (all powerful antioxidants), as well as zinc, iron, folate and selenium, do an immune system good! In other words, a balanced diet that’s high in a variety of fruits, vegetables, nuts and whole grains. A few superstar recommendations: broccoli, dark leafy greens, almonds, oatmeal, sweet potatoes, pumpkin seeds and garlic. Will loading up on vitamin C during the cold months keep you sniffle-free? Doubtful. Studies, so far, have found no evidence that vitamin C prevents colds. What some studies have found, however, is that higher doses taken at the onset may help shorten the length of your cold and reduce the severity of symptoms. How much vitamin C? The National Institutes of Health suggests that adults consume no more than 2,000 mg each day, as too much vitamin C may cause kidney stones, nausea and diarrhea. To pack the ultimate vitamin C punch, think outside the OJ carton and load up on these fruits and vegetables (which have more C than an orange): red and green bell peppers, broccoli, cauliflower, strawberries and kiwis. And what about Grandma’s favorite cold remedy: chicken soup?

January 2018 •

There’s hard science that supports Granny’s claims! Research shows that chicken soup can ease your symptoms and may help you get well sooner — thanks, in part, to an amino acid in chicken that helps thin mucous to calm your cough and stuffed up nose. Welcome news for those pressed for time: Store-bought soups are just as effective.

If your skin is dry and itchy, add these skin-boosters to your diet From the wind chill outside to the dry air inside, winter is not your skin’s best friend. Thankfully, the right foods can alleviate some common cold-weather skin woes by providing the nutrients needed to help skin cells stay strong, supple and hydrated. When it comes to relieving dryness, foods containing healthy fats are the ultimate power food for skin. Healthy fats — from the omega-3 fatty acids found in salmon to the monounsaturated fats found in nuts and avocados to the polyunsaturated fats found in corn oil — are known to strengthen skin membranes by locking in moisture and protecting skin cells. Eating a variety of colorful fruits and vegetables also promotes optimum skin health. Loaded with skinprotecting antioxidants and vitamins A, C, and E, fruits and vegetables help fight dry skin by keeping it renewed, elastic, and plump. Of course, water is a must and probably one of the most important nutrients you can consume to keep your skin hydrated and itch-free. Note: The foods suggested throughout are merely recommendations, the tip of the iceberg when it comes to healthy eating. You know best what foods work for you.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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SmartBites

The skinny on healthy eating

What’s So Great About Grapefruit? E ver since the infamous Grapefruit Diet made its debut — back in the l930s to help starlets lose weight — grapefruits have been associated with weight loss. Fans claim it contains enzymes that help burn off fat. Some studies have shown that people who eat half a fresh grapefruit or drink grapefruit juice before each meal lose more weight than people who do not. But not all studies have shown the same weight-loss benefit; and scientists can’t say if the weight loss was specifically due to the grapefruit or to filling up on a lowcalorie food in general. Final word from nutritionists: Don’t look to the grapefruit to melt fat, but do look to this mouth-wateringly tart fruit for a host of other health benefits.

Great factor No. 1:

All grapefruits pack a hefty dose of vitamin C, with the red and pink ones providing a good dose of vitamin A, too. A powerful antioxidant, vitamin C plays a vital role in the formation of collagen, may speed wound healing, and has even been linked with wrinkle reduction. An equally essential nutrient, vitamin A promotes good vision, normal bone growth, and all-around good health. Both vitamins work hard to keep our immune systems humming, which is especially important during flu season.

Great factor No. 2:

Grapefruit can help lower “bad” cholesterol. Numerous studies have shown that grapefruit eaters, particularly those eating red, had a notable drop in LDL cholesterol. While researchers can’t pinpoint why grapefruits have this affect on cholesterol, they do suggest its cholesterolclearing fiber, high

concentration of antioxidants and beneficial phytonutrients may all contribute to this heart-healthy benefit. More good news for your heart: Grapefruit appears to lower levels of triglycerides, another type of “bad” fat that can clog up arteries.

Great factor No. 3:

Grapefruit may lower blood pressure. Grapefruit, especially grapefruit juice, provides enough potassium to be included in the DASH (Dietary Approaches to Stop Hypertension) Diet, a healthy diet plan that was developed by the National Institutes of Health to lower blood pressure without mediation. Numerous studies suggest that boosting your potassium intake, while curbing salt and sodium, can significantly reduce your risk of stroke and heart disease. A grapefruit’s high vitamin C content may also reduce blood pressure, according to research that links vitamin C with this positive effect.

Not-so-great factor:

Grapefruit and grapefruit juice can seriously interfere with some prescription medications. Because these interactions can cause potentially dangerous health

Helpful Tips

Select grapefruits that are firm, smooth, heavy for their size and yield to light pressure. The thinner the rind, the sweeter the grapefruit. Go for the imperfect-looking grapefruit with a discolored rind: they’ll be sweeter than those with uniform color. Store grapefruits at room temperature for up to a week or refrigerate for up to three weeks. Bring refrigerated grapefruits to room temperature for maximum flavor. Rinse grapefruits under cool water before you dig in.

problems, experts recommend you ask your pharmacist whether your medication interacts with grapefruit.

Grapefruit, Kale and Toasted Walnut Salad

Adapted from Health.com

1 bunch kale, rinsed 2 pink grapefruit 1 shallot 1/4 cup fresh lemon juice 1/2cup plain yogurt 2 to 3 tablespoons extra-virgin olive oil 1/2 teaspoon kosher salt 1/4 teaspoon coarse black pepper 1/2 cup toasted walnuts

Remove the tough ribs from the kale; discard. Chop the kale leaves into small, bite-sized pieces and transfer to a mixing bowl. Sprinkle the kale with a dash of salt and use your hands to massage the kale by scrunching up the leaves. Peel and segment grapefruit, reserving 2 tablespoons of the juice for the dressing. Cut shallot in half, horizontally: mince half; slice other half into thin rings. In small bowl, whisk together minced shallot, reserved grapefruit juice, lemon juice, yogurt, oil, salt and pepper. Add more oil if dressing tastes too tart. Toss dressing with kale. Top with shallot rings, grapefruit, and toasted walnuts.

Anne Palumbo is a lifestyle

columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorieconscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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

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New Year’s Resolution: Moving Past the Weight Loss Plateau See what two local experts have to say about overcoming weight loss plateaus By Deborah Jeanne Sergeant

as your New Year’s weight loss resolution hit a plateau? Don’t worry. According to the Centers for Disease Control and Prevention, people who lose weight steadily and slowly — about one to two pounds per week — tend to keep it off successfully. One pound of body weight equals roughly 3,500 calories, so to lose weight, a body needs to negate 500 to 1,000 calories per day by eating less and burning more to achieve the goal of one to two pounds lost weekly. If a couple weeks pass and the scale won’t budge, take heart, try these tips from area experts: Tips from Deanna DeSimone, certified precision nutrition coach with UBMD Orthopaedics & Sports Medicine, part of the yoUBwell Nutrition program: • “Take a look at your diet. As you lose weight, you will need to eat less food than before because caloric needs are based in part on what you weigh. You may need fewer calories than before you began losing weight. • “Try an app like My Fitness Pal or talk with a dietitian. You can see if you’re eating too many calories or too much of a nutrient. The apps are really useful as you can easily keep track of calories and nutrition, all on your phone. Many phones come with an app or you can get many of these fitness and nutrition apps free. • “Look at added sugar. If there’s food you could replace with a healthier choice, do so. Don’t shy away from naturally occurring sugar in fruits and vegetables. Take the grams of sugar in a food and divide by four. That gives you the teaspoons. That’s a measurement that’s more understandable. Eliminate added

sugar. • “If the diet’s in great shape, you may need to increase the weights or decrease the rest time or increase the intensity. High intensity interval training (HIIT) may be something to try as well. Online workouts can be done in-home. For HIIT, perform lots of repetitions of a movement at high intensity with short rests in between.” Tips from Joanne Wu, an integrative and holistic medicine and rehabilitation physician who specializes in wellness and practices in Buffalo: • “Many people, when they work on weight loss, work on only one part. It should include what you eat, well being, stress management and exercise — what they do for movement. • “Set reasonable goals and take steps toward them. If you still plateau, we look at what we can refine. • “’Muscle confusion’ means you change the type of exercise you do. That challenges muscles to exercise at a different rate and pace, which strengthens different muscles and enhances weight loss. If all you do is one type of exercise, you can face overuse injuries, which can mean you can’t exercise as much, and you don’t build as much muscle. You can tone more and work on different muscles in a healthy way. • “Don’t just look at the New Year to make short-term changes, but a long-term wellness program for mind, body and soul. You want to enhance a healthy lifestyle. If we always approach weight loss with that approach, we’re much more consistent at weight loss.”

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The Survivors Women’s HEALTH Cancer Patient Turned Oncology Nurse: a Positive Attitude No Matter What Diagnosed with cancer at age 24, Lindsey Freeland Gold turns life around — she now cares for cancer patients at Roswell By Jana Eisenberg

indsey Freeland Gold was in college, studying for a degree in fine arts, when, at 24, she was diagnosed with stage four Hodgkin’s lymphoma. Since that surreal day over 10 years ago, the young woman has healed, matured and completely changed her life. She now holds a Bachelor of Science in Nursing degree, and is a registered nurse specializing in oncological care at Roswell Park Cancer Institute. It’s the same hospital where she went through treatment, and where she received the welcome news that she was in remission. Those times and that experience gave her a variety of motivations for wanting to become a nurse, as well as a unique understanding of what her patients may or may not need. When she thinks about those times, she remembers the shock, the difficulty of grasping that her life was suddenly and literally threatened. “At that age, you don’t think about a cancer diagnosis,” said Gold. “I had ignored symptoms — when you get the diagnosis and your plan of what you have to do to save your life, your life turns upside down all at once. You follow the plan…but the loss of control is crazy.” The best piece of advice came from her aunt. “She said it is so important to stay positive,” said Gold. “I said, ‘What if there are some days when I don’t feel like being positive?’ She just said it’s so important no matter what. So I don’t know how; all the information you Page 14

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are given feels overwhelming, and sometimes it seemed impossible, but thinking positive became the way I dealt with things.” An example she gives when she learned that her treatment would cause hair loss. “I thought when I lost my hair, I’d lose my identity,” she said. “When you lose your hair, people look at you like you are sick; they feel bad for you. My choice was to wear wigs all the time — sometimes fun ones, like bright pink. They would make me smile, and would make other people smile. It was one thing that I could control.” After eight months of chemotherapy, and a month of radiation, she achieved remission. The whole experience was life-changing, and caused her to undertake deep reflection. “I wanted to do the most with my life,” she said. “I thought a lot about how great my nurses had treated me during such a terrifying time. I wanted to make other patients feel the way they made me feel. I had never considered nursing at all, but now it’s completely the right fit.” She’s been a nurse at Roswell for about four years. While she shares her story with patients, she does so with sensitivity, and only when appropriate. “I usually feel it out; I’ll share if it’s somebody I’ve met a few times, and we get talking,” she said. “Especially younger people who I can relate to from what I went through, and if they seem very afraid.” “I know which treatments

Lindsey Freeland Gold, a cancer survivor and a registered nurse specializing in oncological care at Roswell Park Cancer Institute. made me feel certain ways, what treatments made me feel better. A patient may tell me that they feel like crap and that I don’t get it. I’ll say, ‘I do get it.’ When they know I’ve been through it, it can help me connect with someone who might be feeling physically sick or emotionally overwhelmed. It’s rewarding to connect on that level, and to inspire hope,” added Gold. The nurse oncologist says that not everyone needs to hear about her personal experience. “Patients are going through so much — I don’t want to take away from anything they’re experiencing, and also want to give them the attention they need. Some don’t have emotional support and comfort while they’re going through chemo,” she said.

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

In addition to working as a nurse, giving comfort and care with an extraordinary attitude, Gold also does volunteer work and fundraising for the causes of both finding a cure for cancer, and supporting patients who are going through it. “With Camp Good Days, we do things like take sick kids to concerts — you’d be surprised to see little kids who had chemo that day; they’re exhausted, but up and dancing and having a great time,” she marveled. “And we’ve raised thousands of dollars through the Ride for Roswell. It’s an amazing event for my family. We celebrate life, and family members who have lost their lives. I never want to lose sight of what I went through and feel grateful for.”

Women’s HEALTH Multiple Cancer Diagnoses: A Woman’s Incredible Spirit Surviving cancer with faith, family and great doctors By Katie Coleman

t seems like a miracle that Amherst resident Charise Nowatzki, 56, is still alive. When she told me she’s survived breast, ovarian, abdominal and brain cancer I was shocked that she still had a smile beaming on her face. “No, this is not going to get me,” Nowatzki told herself when she was first diagnosed in 2000 after experiencing a painful pop under her arm while lifting weights with her sister, Michelle Moshenko, who had had a double radical mastectomy and was exercising as part of her recovery. Thinking she’d torn a muscle, Nowatzki put her hand under her right armpit and felt a lump the size of a grapefruit. Two days later she took Moshenko to her doctor’s appointment at Buffalo Medical Group, and spoke to Moshenko’s doctor about the lump. Nowatzki was sent in for testing and was diagnosed with stage 4B medullary carcinoma of the breast at 38 years of age. “After seeing what Michelle and other family members went through with cancer I was scared,” Nowatzki said. She had lost her mother, father and one sister to cancer. Nowatzki underwent rounds of chemotherapy and had a double radical mastectomy at Buffalo Medical Group under the care of physician Robert Moskowitz. After completion, she went back for her second round of chemotherapy and spots were found on her liver and kidneys. The spots were cancerous tumors and she was told she’d probably live for another three months. “Mentally, to be told I was going to die and get diagnosed with multiple cancers was tough,” Nowatzki said. Trying to find joy and being festive was a huge part of her survival. “I wasn’t sure if I’d make it to Christmas that year so I brought Christmas to me. I put up my tree, decorated my whole house and haven’t taken the tree down since.” Nowatzki said. “Now I decorate my tree differently for all the holidays.” Becoming her own advocate and having strong faith was critical for Nowatzki at the time; she said that no one in Buffalo would treat her for her liver and kidney spots because they thought it was hopeless, and told her to enjoy the time she had left. She started doing research and making phone calls until she found physician William O’Malley, at Highland Hospital in nearby Rochester. O’Malley performed a gastric bypass surgery to remove her tumors and protect her liver and kidneys from further damage.

Physician Meeghan Lautner is an assistant professor in the UB Department of Surgery and sees patients at General Physicians, PC Breast Care.

When Should I Start Getting Mammograms? By Meeghan Lautner, M.D.

Charise and her oldest brother, David Nowatzki, standing by their Christmas tree

Cancer Diagnoses

ince the year 2000, Amherst resident Charise Nowatzki, 56, has been diagnosed with the following types of cancer: • stage 4B medullary carcinoma of the breast • cancerous tumors on her liver and kidneys • meningioma brain tumor • abdominal carcinoma cytosis • pituitary adenoma • ovarian cancer “My doctors can’t believe it,” she says. “To conquer so many cancers is so much more than what anybody expected. I mean, who survives this?”

Nowatzki said she couldn’t imagine going through all this without her family and friends, who have helped her through what she calls the “silent scream,” a feeling she says cancer patients understand well. “One night I had vertigo so badly, but I was trying to get downstairs for my medication and an ice pack,” Nowatzki said. “My brother, David, found me on the stairs — everything was spinning — and he went and got what I needed and sat with me. The next morning I

woke up and he’d put a fridge in my bedroom.” After enduring the past diagnoses, Nowatzki was diagnosed with a meningioma brain tumor, which required a gamma knife surgery. And then came three more diagnoses in 2016: abdominal carcinoma cytosis, pituitary adenoma (a second brain tumor) and ovarian cancer. She said oncologist David Dougherty at Buffalo Medical Group told her he’d have to focus on treating one cancer at a time. “When it comes to pain I try and get to a happier place,” Nowatzki said. “Sometimes I’m in so much pain I can’t move, but I refuse to let it consume me.” After many more rounds of chemotherapy and treatments, Nowatzki’s recent blood tests showed that her levels for ovarian tumor/cancer markers have gone down drastically- from 7,000 to 14and she’s still surviving. The tumors in her brain are present but minute, so they are being watched now. “My doctors can’t believe it. To conquer so many cancers is so much more than what anybody expected. I mean, who survives this?” Nowatzki said, adding that she is grateful for her family, friends and excellent team of doctors. “My heart goes out to people that don’t have a strong support system. To go through just one cancer treatment without family and friends is heartbreaking,” Nowatzki said.

January 2018 •

s a breast surgeon, this is one of the most difficult questions for me to answer. National guidelines have changed recently and there is a lot of criticism, not to mention confusion. This is a result of large organizations like the U.S. Preventive Services Task Force, the American Cancer Society and the American College of Obstetricians and Gynecologists trying to decide the earliest age when a mammogram will save the most lives, but not cause undue stress and anxiety because of multiple biopsies that turn out to not be cancer. One thing all guidelines do agree on is that screening recommendations should be a “shared, informed decision-making approach.” This means, that every woman should discuss her plan for screening mammograms with her doctor. This includes when to start, how often and when to stop. For some women, it may also include adding other tests such as an ultrasound or MRI. All guidelines emphasize that screening recommendations vary based upon a woman’s risk of developing breast cancer. Risk factors for breast cancer include family history, menstrual history, pregnancy history, exposure to radiation as a child, obesity, smoking, alcohol use and the list could go on. Considering these risk factors, each woman is different than the next and so are her recommendations for when to start screening mammograms. All that said, screening mammograms should be considered by every woman and her doctor at age 40. After starting at age 40, the guidelines vary between yearly mammograms and every other year mammograms. Again, this plan should be individualized for each patient taking into consideration their risk factors and other medical problems. Breast cancer is much easier to treat if found early.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Women’s HEALTH Hot Flash Relief By Deborah Jeanne Sergeant

hances are, if you’re a perimenopausal woman, you experience hot flashes as one of the 75 percent of American women who do, according to the North American Menopause Society. “Some hot flashes are easily tolerated, others are annoying or embarrassing and others can be debilitating,” the organization’s website states. Women should discuss with their doctors all medication that has been shown to reduce hot flashes — including hormone replacement therapy. Concerns about hormone replacement therapy have been overblown, according to physician Vanessa M. Barnabei, president of UBMD Obstetrics-Gynecology and professor and chairwoman of the Department of Obstetrics and Gynecology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo. “For most women, it’s quite safe

and the best treatment,” she said. “The North American Menopause Society adjusted their viewpoint on hormone therapy. Younger women get the most benefit.” She said that many women seeking medicinal relief for symptoms don’t know about antidepressant medication that has been recently formulated and FDAapproved at lower dosages for treating women with hot flashes “They work pretty well,” Barnabei said. Women should also look at environmental changes that can improve matters. Managing stress, layering clothing — instead of wearing one heavy layer — and avoiding other triggers as they become evident can help women keep their cool. Though exercising heats the body, it also decreases stress levels. So working out by swimming or in another cool environment can help women beat hot flashes. Exercise such as hot yoga, for example,

would exacerbate the problem. But snowshoeing while wearing layers of clothing would provide a means of cooler exercise. Keeping the bedroom cooler at night, wearing light, moisture wicking clothing to bed — made from fabric such as silk or “performance” materials often used in athletic clothing — and layering bed coverings can help prevent discomfort at night. Barnabei said that as long as they’re not contraindicated because of other health issues, women should feel free to try alternative modalities if they want, though she added that little medical literature offers scientific evidence that they help. Ashlyn Pardee, licensed acupuncturist and owner of Acupuncture Buffalo in Buffalo, focuses on treating women’s health issues with Chinese medicine. She said that regulating female hormones represents “a dynamic balance between yin and yang. “Yin is everything that is relatively cool, moist and thick or heavy,” she continued. “Yang is what seems warm, drier, and lighter. As women get older, yin starts declining and we start to see more heat and dryness, and less moisture and coolness.” In Chinese medicine, acupuncture, diet and Chinese herbs help smooth this decline in yin for women in menopause.

Physician Vanessa M. Barnabei, president of UBMD ObstetricsGynecology.

She said that deep, abdominal breathing can improve the core strength, which includes the pelvic floor. “Many of us are poor breathers,” she said. “We tend to breathe up top with the chest, which leaves out all the areas in the abdominal area. With many of my patients, I start with breathing to get some movement in the pelvic floor area.” She said that once they gain movement in the pelvic floor through deep breathing, they begin to experience better urinary control. Marzec added than some people don’t present with urinary incontinence right away, but pelvic floor weakness manifests with back or hip pain. “If we address pelvic weakness early enough, we can prevent urinary incontinence and other issues later,” Marzek said. “It’s very overlooked. Most doctors don’t have the resources available. It’s not something most women go to their doctor to say, ‘I’m leaking’. And most doctors wouldn’t know what to do

about it. Most people feel it’s part of aging but it definitely doesn’t have to be. It’s preventable and, in a lot of women, reversible.” For some women, performing Kegel exercises, which tighten and relax the pelvic floor muscles, makes a difference. To find the right muscles, try to stop a flow of urine while on the toilet and then engage those muscles elsewhere throughout the day, increasing the time holding the muscles for each repetition. Physician Leila Kirdani is board-certified in both metabolic medicine and family practice. She operates Quality of Life Medicine in Rochester. She recommends Kegels. “Do them throughout the day until you work up 50 or 100 a day,” Kirdani said. Of course, women need to wait until they’re cleared for exercise and have healed from delivery. Older women may benefit from balancing their hormones. Kirdani said that low estrogen can affect urinary control but topical, over-thecounter estriol cream can help.

“The insomnia, anxiety, hot flashes and night sweats tend to improve fairly quickly,” Pardee said. She also recommends dietary changes, such as eschewing “hot” foods, which include alcohol, wine, and coffee — even decaffeinated coffee. It’s not necessarily the literal temperature of these beverages, but the effect they have on the body, she said. Instead, Pardee suggests to clients to drink half their body weight in ounces throughout the day and to replace “hot” drinks with beverages such as sparkling water, for example.

Gotta Go. Fast… Treating women’s incontinence By Deborah Jeanne Sergeant

f you’re a woman experiencing urinary incontinence, you’re like many other American women. The National Institutes of Health estimates that about 20 to 30 percent of young adult women experience urinary incontinence; that rises to 30 to 40 percent of middle-aged women and then to 30 to 50 percent of elderly women. Urinary incontinence involves urge incontinence — the feeling of needing to urinate — and stress incontinence, which occurs when the patient sneezes, coughs, laughs or otherwise moves in a way that causes urine to leak. The leaks are significant enough to cause health or social problems. Several factors relate to why women experience urinary incontinence, including childbirth. During pregnancy, the body decreases support in the pelvic floor and produces hormones that relax the connective tissues to make birthing easier. The growing baby places pressure on the bladder and can stretch tissues as well. Maternal weight before and during pregnancy affects the chances of urinary incontinence after delivery, according to Francie Marzec, physical therapist and owner The Real You Page 16

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Physical Therapy in Clarence. “Being overweight, even if you never had a child, or having a larger baby, can stretch those pelvic floor muscles,” Marzec said. “Women tend to hold stress there and tighten those muscles. Just because they’re tight doesn’t mean they’re strong nor that you have control.” Advanced maternal age also increases the risk, as women in their mid-30s have experienced more wear and tear on their pelvic floor. That’s also the age at which people begin losing muscle tissue. Genetics may also play a role. The more children a woman bears, the greater risk she has of urinary incontinence, but the risk doesn’t increase much more after the third or fourth pregnancy. This applies to both vaginal and C-section births. Despite the difference in delivery method, both experience the months of hormonal changes that result in lax connective tissues and the pressure of carrying a baby. Most women recover from childbirth-related urinary incontinence within three months of delivery. Especially for those who don’t, physical therapy can help. Marzec helps women learn movements that strengthen the core muscles, such as proper breathing.

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

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Recognizing and Treating Depression in Retirement Dear Savvy Senior, Since retiring a few years ago, my husband has become increasingly irritable and apathetic. I’m concerned that he’s depressed, even though he may not admit it. Where can we turn to get help with this, and what, if anything, does Medicare pay for?

Concerned Spouse Dear Concerned, Depression is unfortunately a widespread problem among older Americans, affecting approximately 15 percent of the 65-and-older population. Here’s what you should know, along with some tips and resources for screening and treatments, and how Medicare covers it.

Identifying Depression

Everyone feels sad or gets the blues now and then, but when these feelings linger more than a few weeks, it may be depression. Depression is a real illness that affects mood, feelings, behavior and physical health, and contrary to what many people believe, it’s not a normal part of aging or a personal weakness, but it is very treatable. It’s also important to know that depression is not just sadness. In many seniors it can manifest as apathy, irritability or problems with memory or concentration without the depressed mood. To help you get a handle on the seriousness of your husband’s problem, a good first step is for him to take an online depressionscreening test. He can do this for free at Mental Health America, a national nonprofit organization that offers a variety of online mental health screening tools at MentalHealthAmerica.net — click on “Take a Screen” in the menu bar. Or at HelpYourselfHelpOthers.org, which is offered by Screening for Mental Health, Inc. Both of these tests are anonymous and confidential, they take less that 10 minutes to complete, and they can help you determine the severity of your husband’s problem.

Get Help If you find that he is suffering from depressive symptoms, he needs to see his doctor for a medical

evaluation to rule out possible medical causes. Some medications, for example, can produce side effects that mimic depressive symptoms — pain and sleeping meds are common culprits. It’s also important to distinguish between depression and dementia, which can share some of the same symptoms. If he’s diagnosed with depression, there are a variety of treatment options including talk therapy, antidepressant medications or a combination of both. Cognitive behavioral therapy (CBT) is a particularly effective type of talk therapy, which helps patients recognize and change destructive thinking patterns that leads to negative feelings. For help finding a therapist who’s trained in CBT, ask your doctor for a referral, check your local yellow pages under “counseling” or “psychologists,” or check with the Association for Behavioral and Cognitive Therapies (FindCBT. org), or the Academy of Cognitive Therapy (AcademyofCT.org). And to search for therapists that accept Medicare, use Medicare’s Physician Compare tool. Go to Medicare.gov/physiciancompare and type in your zip code, or city and state, then type in the type of profession you want locate, like “psychiatry” or “clinical psychologist” in the “What are you searching for?” box.

Medicare Coverage You’ll be happy to know that original Medicare currently covers 100 percent for annual depression screenings that are done in a doctor’s office or other primary care clinic. They also pay 80 percent of its approved amount for outpatient mental health services like counseling and therapy services, and will cover almost all medications used to treat depression under the Part D prescription drug benefit. If you and your husband get your Medicare benefits through a private Medicare Advantage plan, they too must cover the same services as original Medicare but they will likely require him to see an in-network provider. You’ll need to contact your plan directly for the details.

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Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. January 2018 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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The Social Ask Security Office

From the Social Security District Office

Rosie The Riveter: Working Women’s Icon By Deborah Banikowski

“

Rosie the Riveter” is an American icon representing women working in factories during World War II. These women learned new jobs and filled in for the men who were away at war. They produced much of the armaments and ammunition to supply the war effort. They also paid FICA on their wages, contributing to the Social Security program. These “Rosies” embodied the “can-do” spirit immortalized in a poster by J. Howard Miller. Both the image and the spirit live on today. If you asked Rosie about Social Security, she would use her rivet gun to drive home the value of Social Security for women. More Rosies work today, and nearly 60 percent of people receiving benefits are women. Women tend to live longer than men, so Social Security’s inflation-adjusted benefits help protect women. You can outlive your savings and investments, but Social Security is for life. Women provide their own basic level of protection when they work and pay taxes into the Social Security system. Women who have been married and had low earnings or who didn’t work may be covered through their spouses’ work.

Today’s Rosie will turn her “cando” spirit to learning more about Social Security and what role it will play in her financial plan for the future. She focuses on our pamphlet called “What Every Woman Should Know.” available at www. socialsecurity.gov/pubs/10127.html for a game plan. She rolls up her sleeves and sets up her “my Social Security” account (www.socialsecurity.gov/myaccount) to review her earnings and estimates. If she finds an incorrect posting, she’ll locate her W-2 form and quickly contact Social Security to correct it because she understands these are the earnings used to figure her benefits. She dives into understanding benefits at our planner pages at www.socialsecurity.gov/planners. She examines how marriage, divorce, death of a spouse, work, and other issues might affect her benefits. She studies our fact sheet “When to Start Receiving Retirement Benefits” at www.socialsecurity.gov/pubs/ to help her decide when it’s time to lay down the rivet gun. And when the time is right, she will file for retirement benefits online at www.socialsecurity. gov/retire. Whether it was keeping the war effort production lines humming or discovering what is available to her from Social Security, Rosie symbolizes the motto: “We Can Do It.” Rosie and millions like her rely on the financial protection provided by Social Security in assembling their own financial futures.

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In Good Health is published 12 times a year by Local News, Inc. © 2017 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Nancy Cardillo, Julie Halm, Catherine Miller, J’Leise Sosa, MD, Kimberly Blaker Advertising: Anne Westcott (716-332-0640.) Tina LaMancusa (716-946-2970) Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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Health News Gates Vascular adds system to treat acid reflux Buffalo General Medical Center / Gates Vascular Institute (BGMC/GVI) recently acquired and successfully implanted the LINX Reflux Management System, a small implant used to treat gastroesophageal reflux disease (GERD). The device is comprised of interlinked titanium beads with magnetic cores and is designed to strengthen the lower muscle at the end of the esophagus, which is the main cause of acid reflux or GERD. “This is a real game changer for people who suffer with constant heartburn with little to no relief in sight,” said physician Aaron B. Hoffman, division chief of general surgery at University at Buffalo (UB) and program director of UB’s minimally invasive surgery fellowship program. “One in five people suffer from gastroesophageal reflux disease and are told medication is the only solution. With the LINX system, patients feel immediate relief and can begin enjoying foods that were once forbidden due to the associated discomfort of reflux disease.” The device, the size of quarter, is implanted through a standard minimally invasive laparoscopic procedure. The magnetic attraction between the beads augments the existing esophageal sphincter’s barrier function to prevent reflux.

Sisters of Charity among best for ortho surgery Sisters of Charity Hospital was nationally recognized by Healthgrades, the leading online resource helping consumers make informed decisions in order to find the right doctor, the right hospital and the right care. Both of Sisters Hospital campuses, Main Street and St. Joseph, received multiple 2018 Specialty Excellence awards including One of America’s Best Hospitals for Orthopedic Surgery, Orthopedic Surgery Excellence Award and a Joint Replacement Excellence Award. Additionally, both campuses also received multiple five-star awards in the orthopedic category for the third year in a row, including total knee replacement, total hip replacement and hip fracture treatment. Healthgrades evaluates hospitals solely on risk adjusted mortality and in-hospital complications. Its analysis is based on approximately 40 million Medicare discharges from more than 4,500 hospitals for the most recent three-year time period available. A five-star rating is based on lower than expected complication rates for patients who have an orthopedic surgery in a hospital while the excellence award recognizes only the top 10 percent of hospitals in the nation. Both accolades are a reflection of Sisters Hospital high quality, team based, patient-centered care.

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

“Quality ratings are one of the most important resources people should use when seeking out a physician referral and hospital for procedure performance outcomes,” said Christina Kane, vice president of musculoskeletal service line service for Catholic Health “It’s the gold standard by which everyone in the healthcare industry should be measured and should strive to achieve. Sisters Hospital orthopedic team is giving patients care they can trust and an experience that they deserve.” “Our commitment to consistently providing the highest quality in care and safety for our patients is reflective in our positive outcomes,” said Martin Boryszak, president and CEO of Sisters of Charity Hospital. “The Healthgrades Excellence Awards, including being among the nation’s best hospital for orthopedics, and five-star ratings, are a reflection of the dedication, skill and hard work of every member of the hospital staff. They all deserve our thanks and congratulations for this outstanding achievement.”

ECMC awards $56K to nursing development The Erie County Medical Center Corporation (ECMCC) and ECMC Foundation recently awarded $56,000 in scholarships for the ECMC Foundation Nursing Professional Development Fund for ECMCC staff to establish or further careers in nursing. The scholarship funds provide financial support for ECMCC employees who met specific guidelines to establish or further their careers in nursing. The one-time grants of $1,000 per person were awarded to 56 qualifying ECMCC employees who are pursuing their registered nursing degree or registered nurses who are pursuing their Bachelor of Science in Nursing (BSN) degree. “ECMC Foundation is proud to provide this key support to our dedicated employees who wish to further their career in nursing,” said Jonathan A. Dandes, chairman of ECMC Foundation. “Having met the criteria of this program, we know that these worthy individuals will continue to make great contributions to the healthcare needs of our patients and strengthen the overall functions of ECMC.” Thomas J. Quatroche Jr., president & CEO, ECMC Corp. said, “ECMC’s frontline staff truly cares about the work they do for our patients, caring for them no matter the circumstance, and this program will further assist these dedicated caregivers to reach their dreams and goals to care for others. We thank the foundation for developing this program and we are proud we can play a part in helping our ECMC family members achieve their career ambitions.”

H ealth News ECMC Unveils Renderings of New Russell J. Salvatore Atrium Entrance Medical center names new hospital front entrance after Buffalo restaurateur/philanthropist who made a $1 million donation to ECMC’s Trauma Center/ Emergency Department Capital Campaign Erie County Medical Center in December revealed architectural renderings of the future atrium that will become the hospital’s new main entrance. The atrium will be named after restaurateur/philanthropist Russell J. Salvatore, who earlier last year donated $1 million toward the hospital’s new trauma center / emergency department project. Designed by the architectural firm Clark Patterson Lee, work on the new entrance will commence in the spring. “I know personally what a remarkable hospital ECMC is, with the most talented and dedicated doctors, nurses and support staff,” said Russell J. Salvatore in a news release. “This new entrance to the hospital, which I am very proud to support, will provide an inspiring and welcoming environment to everyone who enters. As our community’s regional hospital, providing quality, life-saving care to all, the new Russell J. Salvatore Atrium will contribute positively to each patient’s experience at ECMC.” ECMCC Chairwoman Sharon L. Hanson said, “We are honored and very grateful to Russell Salvatore for his generosity and support of ECMC and on behalf of my fellow board of directors at ECMCC we thank him for his continuing kindness toward our staff and the patients they serve. This new main entrance to ECMC will serve as a warm and welcoming area for everyone who enters the hospital. It is a truly beautiful expression of Russell Salvatore’s remarkable love and appreciation for ECMC.”

WNY STEM, Danceability to Receive Award from CommunityCare Grant UBMD Orthopaedics & Sports Medicine has announced the recipients of its third-annual CommunityCare Grant: WNY STEM and Danceability. Each program will receive $5,000 toward their respective missions for the Western New York community. “In evaluating the numerous applications we received this year, we were drawn to the mission and impact of both WNY STEM and Danceability,” said Amanda Clark, physician relations and marketing manager at UBMD Orthopaedics & Sports Medicine. “Our company’s values of innovation, collaboration and compassion are reflected in the organizations we chose as recipients of this grant.” WNY STEM’s goal is to create awareness and partnerships in accessing STEM/STEAM learning and careers for those of all ages. “We bring together like-minded entities to advance STEM learning to advance our region’s economy,” says Cherie Messore, WNY STEM’s executive director. This program

focuses on exposing urban-centered middle school and high school students to careers in medical technology and human anatomy. The $5,000 grant will support WNY STEM’s Hand in Hand program, which works to design and fabricate prosthetic hands using 3-D printers and other tech tools. Recently, three fully operational prosthetic hands were donated to children in WNY and a fourth to a child in India. “When we heard about the Hand in Hand program, it was a no-brainer. This is the sort of initiative we want to be a part of,” said Robert Ablove, hand and upper extremity surgeon at UBMD Orthopaedics & Sports Medicine, and program director of the hand fellowship at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. “Some of our most complex cases involve patients who have suffered a trauma to their hand. These accidents are life-changing, so it’s important that organizations like WNY STEM are out there providing viable options

for those with hand injuries.” The second recipient of the CommunityCare Grant is Danceability, a Cheektowagabased dance and movement program serving students of all ages with special needs. The program mimics traditional dance studio programming, but caters to those with special needs such as Down syndrome, cerebral palsy, autism, seizure disorders, mental/ psychiatric challenges and more. “We plan to put 100 percent of this grant toward our new building, which hopes to open next year,” said Robin Bishop, co-founder of Danceability. The new building will include three studios, two offices, a large waiting room and a teacher/ volunteer lounge. “Our hope is that this new space will not only help us to serve even more dancers and their families, but will also improve the quality of our services.” Pediatric orthopaedic surgeon Robert Galpin dedicates his time to the care and treatment of children with orthopedic ailments, including

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children and adults at the Robert Warner Rehabilitation Center, located at the Conventus building on the Buffalo Niagara Medical Campus. “Throughout the years, I’ve witnessed medical miracles take place because of a patient’s positive attitude and support system. Danceability is the kind of organization we want to support because they encourage fun and safe exercise, and introduce a community of caring individuals,” said Galpin. “We’re happy to give back to those that give so much to our patients and the Western New York community.” The CommunityCare Grant, now in its third year, gives up to $10,000 to local, nonprofit 501(c) (3) agencies in areas such as health and wellness, sports and fitness, activities for the mentally disabled and geriatric health. Recipients are chosen based on economic need, the mission of the organization and fund utilization goals.

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Yesterday.

Today.

Tomorrow.

Celebrating a Century of True Care In our 100 years of taking care of Western New York, much has changed within the world, the community, and even within our own walls at ECMC. But even as we prepare for our next century of delivering true care for patients and families, we know the most important thing—compassionate care for everyone who turns to us—hasn’t. And never will.

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