in good Meet YourATDoctor TOP DOC BC BS
February 2017 • Issue 28
bfohealth.com
Chief medical officer at BlueCross BlueShield, physician Thomas Schenck, talks about his career, the Affordable Care Act and about perceptions that insurance companies are an impediment to care
Buffalo & WNY’s Healthcare Newspaper
Golden Years Special
Doctor Still Practicing, at Age 89
Nurses: No. 1 For the 15th year in a row, nurses are the No. 1 most trusted professionals. See Healthcare in a Minute inside
Melvin Dyster, a physician at Niagara Family Medicine, has been practicing medicine since 1954. “I love it,” he says. He sees patients most days of the week page 14
Valentine’s Day page 20
Can You Really Die of Broken Heart?
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priceless
Things to Know About How to Age Well
1.3 Million U.S. Adults Identify as Transgender
My Experience as a ‘Big Loser’ Writer Mike Billoni checks himself into The Biggest Loser Resort Niagara page 7
Delicata Squash
This great-for-you veggie is known for its soft texture, its scrumptious flavor (similar to sweet potatoes), its tender skin (edible!) and its bounty of health benefits. Read more in SmartBites.
Best Diet Plan? U.S. News & World Report ranks 38 diet plans. See which one is the winner, seven years in a row page 10
Also in this issue: Is the 6:1 diet plan the worst?
page 11
US Life Expectancy Decreases
Americans who were born in 2015 expected to have shorter lives. See what has caused this trend and why experts are worried about it.
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1.3 Million U.S. Adults Identify as Transgender
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ne of the first comprehensive surveys on the subject estimates that about 1.3 million American adults currently identify as transgender. The new data is based on answers to a 2014 U.S. government survey of more than 151,000 adults conducted across 19 states. Transgender people identify with or express a gender identity that differs from the gender they were born with. Researchers say that 0.53 percent of respondents — about one in every 189 U.S. adults — answered “yes” to the question, “Do you consider yourself to be transgender?” Transgender individuals were
more likely to identify as maleto-female (0.28 percent of adults surveyed) than female-to-male (0.16 percent), the study found. “The transgender population is a racially diverse population present across U.S. communities,” concluded a team led by physician Halley Crissman of the University of Michigan. Transgender adults were more likely to be nonwhite than white, the survey found. Many transgender people face economic hardship. The study found that 26 percent lived below the poverty line, compared to 15.5 percent of non-transgendered respondents. Transgender people
were also less likely to have attended college, the researchers said. These inequalities “have negative implications for the health of the transgender population,” Crissman’s team said. However, in other respects, transgender people’s lives were similar to those of other Americans. About half of both transgender and non-transgender people were
Survey: Cardiology Still a Man’s Field
Women less likely to choose that specialty, and they report more discrimination than males
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ost cardiologists in the United States are men, and many female cardiologists report discrimination in the workplace, a new survey finds. “We need to increase the diversity of our workforce, and find ways to recruit higher numbers of women and underrepresented minorities,” said survey senior author, physician Claire Duvernoy, chairwoman of the Women in
Cardiology Council at the American College of Cardiology (ACC). The council conducted the survey. “We must work to change the culture that allows this to occur in our field,” Duvernoy added. The poll included more than 1,300 male and almost 1,000 female cardiologists. The findings revealed that the percentage of women reporting workplace discrimination fell from 71 percent to 65 percent in
the past 20 years, but that rate is still three times higher than it is among men. Women were more likely to report discrimination related to gender and parenting, while men were more likely to report racial and religious discrimination, the investigators found. Women are still much less likely to choose cardiology than other medical specialties. In 2013,
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Daniel J. Patterson D.O., F.A.C.O.S.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
married, for example, and they had roughly the same levels of employment. The researchers stressed that many transgendered people may not have answered “yes” to the survey question out of privacy concerns or stigma, so the numbers reported may still be an “underestimation.” Still, any accurate representation of what the study authors call this “marginalized” population should further efforts to help improve the lives of transgender Americans, they said. The challenges many transgender people face mean that many need “support for tackling factors deterring [them] from continuing education, including harassment and discrimination,” Crissman’s team said. The findings were published online Dec. 20 in the American Journal of Public Health.
women accounted for 13 percent of cardiologists, compared with more than 35 percent of internists, more than 30 percent of hematologists/ oncologists, 18 percent of general surgeons and more than 50 percent of obstetricians gynecologists. The survey also found a significant increase in the number of cardiologists older than 60 compared with a decade or two ago. Also, the proportion of cardiologists in private practice fell from 73 percent in 1996 to 23 percent. The findings were published Dec. 21 in the Journal of the American College of Cardiology.
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US Life Expectancy Decreases
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Americans who were born in 2015 are expected to have shorter lives compared to previous generations By Deborah Jeanne Sergeant
How to Increase Your Chances to Live Longer
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to please findorout if you For more information, tocontact find outqualify, if you please contact ecently released data from qualify, please contact Southgate Medical Group To improve your healthy longevity, National Center for Health Southgate Medical Group Southgate Medical Group at 712-1004. local experts offer a few tips: Statistics shows that life at 712-1004. • “It’s important to get out, spend at 712-1004. Compensation for time and expectancy for a person born in 2015 time in nature, find a friend and go Compensation for time and travel may be available travel may be available. Compensation for time and is down from 78.9 years to 78.8 years. for a hike. Absorb all of the beauty travel may be available. While that may not seem like a and goodness around you. large decrease, the fact that medical • “Be active. Participate. Help at the advances are not outpacing death library book sale. Tutor a child at the rates for the first time in a decade elementary school. Draw purpose and causes medical experts some explore. concerns — and a hard look at why • “Keep learning. Take a Spanish we’re dying. class, just for the fun of it. Richard Derwald, coordinator • “Do something new, like go of the Erie County Senior Fitness kayaking. program, is 82. He believes that the • “The more positive things you do, “secret” to healthy aging is the more positively it will affect not a secret at all. you.” “All of us really Kandy Svec, registered yoga have the power to age teacher and aruyvedic yoga successfully,” he said. specialist at Himalayan “We know what the Institute Buffalo in Buffalo. problems are and we • “We’ve forgotten about can’t ignore them.” the most important thing is He pointed out that the social aspect of getting rising rates of obesity together with other people play a big role in who are working towards longevity. Obesity the same goal. You raises the risk of see those people cardiovascular performing the way disease, diabetes, you are and you’re and cancer. motivated bySOUTHGATE those ADVERTISER: SOUTHGATE MEDICAL CLINIC SALES SALES PERSON:BUTR22 BUTR22 ID: BUADVERTISER: MEDICAL CLINIC PERSON: ID: “At least 50 in your peer group. START DATE: 01/14/17 START DATE: 01/14/17 percent of chronic • “It’s about DELIVER TO: MMM MAIN NEWS 1/14 & 1/19 DELIVER TO: MMM MAIN NEWS 1/14 & 1/19 disease is caused consistency. It by poor diet SIZE: col col SIZE: doesn’t have to and inactivity,” be a huge amount Derwald said. of activity, but Derwald added just consistent: 30 that stress can also minutes a day of contribute to ill movement brings health, and even people out of their though they may comfort zone and be done with into something the stressors of more strenuous. the working life, Life expectancy for babies born in 2015 It’s like flossing: it retirees encounter has decreased — a first in a generation doesn’t take a lot their own stressors. of time but it really “When you’re older, loss will benefits you if you do it consistently. come into your life more often: loss • “Whatever the individual feels ™† ™† ™† of a spouse, close friend,” Derwald is appropriate for that individual. said. There’s so much information out there In addition to stress’ direct and it changes frequently. If you feel harmful effects on the cardiovascular great after swimming, swim. If you system, busyness edges out healthful feel great after tai chi, do tai chi. pursuits such as exercise and stress • “There’s a huge menu of what reduction. It also contributes to people can do but find a place where substance abuse, as does untreated you have social connections.” mental health issues. Ann Vorburger, director of Health, Fewer older people live with Fitness and Recreation at JCC, or near family members than did a Getzville couple generations ago. According • “I recommend resistance exercise. to the National Institutes of Health, Resistance bands strengthen bones, nearly 70 percent of people 65-plus ligaments, tendons, and muscles and lived with their adult children in the help keep the metabolic rate up. As 1850s. By the end of the 1900s, the we get older, our bodies change. Part figure dwindled to fewer than 15 of the reason is we’re losing muscles percent. and the strength in our ligaments and Derwald said that isolation can tendons. Resistance bands can help affect physical health, and “lead to reverse that. an awful lot of illness. • “Walking is the number one He explained that people who ™ † The denoted marks are trademarks or registered trademarks of their respective companies. cardiovascular exercise. live alone tend to eat more poorly, © 2015 American Medical Systems, LLC. All Rights Reserved. Minnetonka, MN 55343 • “Eat a balanced diet.” engage in less physical and social AMSUS/ED-01642/May 2015 www.AmericanMedicalSystems.com 1-800-328-3881 Richard Derwald, coordinator of the U.S. Use Only an endo international company activity, and ignore early symptoms Erie County Senior Fitness program of physical problems.
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February 2017 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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BU-1
CALENDAR of
HEALTH EVENTS
Feb. 9
Menopause, heart health discussed at a free dinner event Phil Haberstro, co-founder and executive director of the Community Wellness Institute for a Greater Buffalo & WNY. “if you’re going to have a healthy community, you really have to understand the social and environmental determinants that affect health.”
Community Wellness Institute: 27 Years Promoting Health By Tim Fenster
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or the past 27 years, the Community Wellness Institute for a Greater Buffalo & WNY has served as a driving force behind health initiatives from improving walkability to reducing tobacco use to addressing food deserts in lowincome city neighborhoods. Its mission is to create a healthy community in Western New York. But that means more than simply promoting individual physical health and wellness; it means addressing the environmental, social and economic factors that affect a community’s overall health. “When we talk about healthy communities, it’s much more comprehensive [than] being physically active and eating right,” said Phil Haberstro, co-founder and executive director of the institute. “It’s also our community environment, our civic health, this level of social capital … and of course the economic well-being.” Inspired by the Global Healthy Communities movement as well as the USA Healthy Communities movement by the National Civic League, Haberstro founded the nonprofit organization in 1989. Among its earliest initiatives was involvement in the Erie County Tobacco Free Coalition. As a coalition member, it was often the recipient of grant funding for the coalition’s initiatives. Its advocacy helped lead to the passage of the New York State Clean Indoor Air Act, which bans smoking in virtually all workplaces, including bars and restaurants. Another early initiative was the Massachusetts Avenue Project, a nonprofit organization founded to address high unemployment and food security on the city’s West Side. The institute housed the MAP in their early years, helped the Project apply for grant funding, and offered insight and guidance on issues organization members were facing. These days, MAP has its own offices, offers programs such as a mobile food market and farm education, has help improved high school graduation rates and has received numerous awards and honors for their work. “They’re out there every day of the week doing good things to Page 4
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engage young people in leadership development as well as to create more sustainable neighborhoods,” Haberstro said. The institute has also been heavily involved in Complete Streets initiatives to improve city streets and make them safer and more inviting for walkers and bicyclists. The nonprofit pushed the city of Buffalo to open more bike lanes and bike racks, and has advocated for bike paths throughout the area. The efforts have resulted in miles of bike lanes, bike racks throughout the area and on all city buses, and the new Reddy Bikeshare program, in which residents can rent bikes from lock stations. “That is a small thing in some respects, but it’s another piece in that equation of creating that culture that supports people’s ability to use their bikes,” Haberstro said. As for environmental wellness, the institute is supporting soil testing in neighborhoods near the Tonawanda Coke Corporation plant that was cited for spewing the carcinogen benzene into the air. The institute has partnered with the Clean Air Coalition, and has provided volunteers and interns to staff community engagement events on the issue. Other programs and initiatives include job creation programs, workforce health promotions, a citywide falls prevention initiative that aims to help seniors stay physically active and avoid falls, and numerous youth advocacy and leadership programs. All are a part of the institute’s broad mission to improve the overall health and wellness of western New York communities. “There is a lot of good things going on in the community in terms of working to strengthen us socially, economically, and environmentally,” Haberstro said. “All those areas contribute to health and well being. And if you’re going to have a healthy community, you really have to understand the social and environmental determinants that affect health.” For more information, visit www. healthycommunitynetwork.com.
Catholic Health is sponsoring a free community dinner program titled, “Menopause & Heart Health: What’s the Connection?” on from 5:30 to 7:30 p.m. Feb. 9, at Grapevine Banquets, 333 Dick Road, Depew. Join OB-GYN Diane Sanfilippo and cardiologist Rajarshi Parai for an informative look at menopause and heart disease. In addition to answering all your questions on this important topic, they’ll explain what symptoms to look for, and what you can do to lessen your risk and take charge of your heart health. “Menopause & Heart Health: What’s the Connection?” is free and open to the public. A complimentary dinner will be served. Reservations are required by calling Catholic Health’s HealthConnection at 716-447-6205, or by registering online at blog. chsbuffalo.org/events.
March 28
Fibromyalgia group to discuss Chinese medicine The New Fibromyalgia Support Group is sponsoring a workshop that will highlight traditional Chinese
medicine and acupuncture and how they help keep the body healthy. A practitioner will also discuss working with traditional Chinese herbs and medicinal plants to help improve the everyday life of those who suffer from fibromyalgia. This workshop will attendants, especially those suffering chronic pain, the modalities and tools to better work through the stress of it all. The workshop will take place from 6 to 8:30 p.m., Tuesday, March 28, in the meeting room at Westside YMCA, located at 920 Elmgrove Road in Gates. The meeting is free and open to the public. No need to be a YMCA member to participate. Classes are small and registration is needed. Register with a voicemail by calling 585-752-1562. Leave your name and details.
Group offers support to food addicts Food Addicts in Recovery Anonymous, a nonprofit organization with a presence in Buffalo, is offering free weekly meetings to anyone suffering from food addiction, food obsession, obesity, bulimia or under-eating. There are no dues or weigh-ins and they take place every day of the week at several locations in WNY. For more information, visit www. foodaddicts.org or call 585-671-8346.
Don’t Miss the Next Issue
Covering: Men’s Health • Addiction • Cancer Chiropractic Care • Physical Therapy
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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, Tim Fenster, Ernst Lamothe Jr., Michael J. Billoni, Eva Briggs (MD) Advertising: Debra Kells (716-332-0640) Layout & Design: Dylon Clew-Thomas • Officer Assistance: 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.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
Too Much Sitting Ages You Faster
Y
ou might age a lot faster if you sit too much, a new study warns. Researchers who assessed nearly 1,500 older women found those who sat most of the day and got little exercise had cells that were biologically older by eight years than the women’s actual age. “Our study found cells age
faster with a sedentary lifestyle. Chronological age doesn’t always match biological age,” said lead author Aladdin Shadyab. He’s from the University of California, San Diego’s School of Medicine. The women, aged 64 to 95, answered questionnaires and wore a device for seven days to track their activity levels.
The study doesn’t establish a cause-and-effect relationship between accelerated aging and lack of exercise. Still, “discussions about the benefits of exercise should start when we are young, and physical activity should continue to be part of our daily lives as we get older, even at 80 years old,” Shadyab said in a university news release. Specifically, the researchers found that women who sat for more than 10 hours a day and got less than 40 minutes of moderate-to-vigorous physical activity daily had shorter telomeres. These are caps on the end of DNA strands that protect chromosomes from deterioration. Telomeres naturally shorten with age, but health and lifestyle factors — such as smoking and obesity — can accelerate the process. Shortened telomeres are linked with heart disease, diabetes and cancer, the researchers explained in background notes. “We found that women who sat longer did not have shorter telomere length if they exercised for at least 30 minutes a day, the national recommended guideline,” Shadyab said. He and his colleagues plan future studies to examine the link between exercise and telomere length in younger adults and in men. The study was published online Jan. 18 in the American Journal of Epidemiology.
One in Five Young People Lose Sleep Over Social Media
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ne in five young people regularly wake up in the night to send or check messages on social media, according to new research published today in the Journal of Youth Studies. This night-time activity is making teenagers three times more likely to feel constantly tired at school than their peers who do not log on at night, and could be affecting their happiness and wellbeing. Over 900 pupils, aged between 12-15 years, were recruited for the study. One in five reported ‘almost always’ waking up to log on, with girls much more likely to access their social media accounts during the night than boys. Those who woke up to use social media nearly every night, or who didn’t wake up at a regular time in the morning, were around three times as likely to say they were constantly tired at school compared to their peers who never log on at night or wake up at the same time every day.
Healthcare in a Minute By George W. Chapman
F
Most Trusted Profession
or the 15th year in a row, nurses are the No. 1 most trusted professionals, according to Gallup’s annual poll that ranks the honesty and ethical standards of various professionals. Healthcare providers took four of the top five spots. Following nurses are: No. 2 pharmacists, No. 3 physicians, No. 4 engineers, No. 5 dentists. Also ranking high were teachers and police officers.
2016: Some Good Health News
Colon cancer, dementia and heart disease started declining in developed countries. Since 1990, the number of women dying due to pregnancy or childbirth has declined by half. Public smoking bans have improved health in 21 countries and the number of US smokers has declines by 8.6 million since 2005. Harvard scientists are honing in on an antibiotic discovery that could help remedy the growing antibiotic resistance crisis. Homelessness has decreased in the US by 35 percent over the last 10 years. Teenage pregnancies have declined in the US for the 24th year in a row. Large oil spills declined from an average of 25 per year in the 1970s to just two a year now. Charitable donations were at an all-time high, again led by Warren Buffet at $2.9 billion and Bill Gates at $5 billion.
Hospital Mergers
In recent months, both the Federal Trade Commission and the Department of Justice have increasingly intervened to thwart or
block hospital mergers. While one can only speculate what President Trump will do, there is a history of support for antitrust enforcement in healthcare from both parties. The fear is that mergers have tended to drive up costs whether in the same or separate markets. A potential merger between Catholic Health Initiatives and Dignity Health this year would create the nation’s largest system by revenue. The number of Catholicowned or affiliated hospitals has grown by 22 percent since 2001, resulting in control of 17 percent of acute care beds in the US.
States Ranked by Health
United Health Foundation just released its America’s Health Rankings. It takes into consideration 34 measures of behaviors, community, environment, policies and clinical data like smoking, obesity, substance abuse, cardiovascular disease, etc. The five healthiest states are: No. 1 Hawaii, (five years in a row) No. 2 Massachusetts, No. 3 Connecticut, No. 4 Minnesota, No. 5 Vermont. The five unhealthiest states are: No. 50 Mississippi, No. 49 Louisiana, No. 48 Arkansas, No. 47 Alabama, No. 46 Oklahoma. It should be noted four of the five worst states are in the southeast. NYS ranked No. 13.
Choose Hospital Wisely
A study published in the academic journal “Public Library of Science” (PLOS One) found that patients cared for in the “worst” hospitals were three times more likely to die and 13 times more likely to have complications than if cared for in one of the “best”
hospitals. 22 million admissions were studied, using 24 measures of medical outcomes. Researchers found significant differences among hospitals. Under terms of the agreement, in order to get hospitals to participate, the identity of the hospitals were kept confidential. In general, hospitals that treated high volumes of certain conditions fared better than those with low volumes. Most patients have little information about the differences between hospitals. The study raised the obvious question of why don’t we have broader outcomes measurement and transparency around performance available to the public.
Cost of Drugs for Seniors
The AARP Public Policy Institute reports that the price of drugs used most commonly by seniors rose more than 130 times the rate of inflation between 2006 and 2015. The average senior takes four or five different drugs every month which comes to about $26,000 annually if taking only brand name drugs. The median annual income for seniors is about $24,000. While Medicare covers some of the cost through part D, these price increases drive up Medicare premiums and the senior’s copays. Many believe congress should use the purchasing power of Medicare and Medicaid to negotiate drug prices with big pharma in order to contain spiraling drug costs.
Ontario, Canada, Healthcare
Bill 41, or The Patients First Act, is creating more controversy than our ACA because it impacts all citizens. Proponents argue it will streamline
February 2017 •
and integrate healthcare. Opponents argue it does nothing to help overworked physicians and reduce waitlists for services (it can be several months to two years to see some specialists) and only serves to add to the already expensive and redundant bureaucracy. Unlike the US, Canada actually has “unemployed” physicians. The government controls access and expenses by restricting the number of physicians available in each of the provinces. Many of the “unemployed” physicians end up working here in the US. Once there is an “opening,” many return to Canada. On the flip side, compared to the US, the cost of care in Ontario is relatively cheap. We average about $10,000 per person in the US. The budget for 14 million people in Ontario is $50 billion. That comes to just $3,571 per person. While we are spending way too much, and with modest results, it seems that Ontario can afford to put some more physicians to work which would take some pressure off current providers and reduce the ridiculous wait lists for care. Physicians in Ontario have dubbed the bill “Bureaucracy First, Patients Last Act.” George W. Chapman is a healthcare consultant who works with hospitals and medical groups. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@ wchapmanconsulting. com.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Meet
Your Doctor
By Chris Motola
Thomas Schenck, M.D. Chief medical officer at BlueCross BlueShield on his career, the Affordable Care Act and on perceptions that insurance companies are an impediment to care Q: What led you from pediatrics to insurance? A: I started at a local practice called Delaware Pediatrics, which is a great pediatric practice. I wound up as the managing partner there a few years in, then was managing it for the better part of 11 years. I was faced with the challenges that I think most primary care practices face, just in terms of handling the logistics of the practice, including reimbursements. It led me to have interactions with the health plan, which was eye-opening because I didn’t really understand the big picture of how health care was paid for as well as I thought I did. So when there was
an opportunity to have a seat at the policy table, especially with the Affordable Care Act being passed, it seemed like too big an opportunity to pass up. It was an opportunity to have an effect on the community beyond the effect I had on individual patients. Q: What attracted you to BlueCross BlueShield of Western New York? Was it the company’s footprint in the region? The way they operate? A: I wasn’t actively looking to make the shift, but I was trying to be as busy in the community as I could outside of just my practice. I got into working with BCBS on a project called Optimum Physician Alliance. It’s a special project that was a joint venture of BCBS and Kaleida Health and 700 community physicians. My work in that gave me an inside view of BCBS. By Western New York standards, we’re a very large organization, we employ lots of people, we do lots of community work. So it really fit with where I wanted to go. Q: Touching on politics for a moment, with the changes brought about by the Affordable Care Act (ACA) and now Trump’s promise to repeal and replace it, how are you able to pivot and adapt within such a volatile
political climate when it comes to healthcare? A: Even though it feels like changes are imminent, and there likely will be some, they usually take place over some time. At the end of the day, politicians usually understand that industry changes take time. I think there was a tremendous amount of investment and work at all levels of healthcare about how to comply with the ACA. There will likely be an equal amount of effort dedicated to adapting to whatever changes are coming. I think people don’t talk about the cost of swinging from one healthcare approach to another. It’s not just instability, there’s an actually financial cost. It’s an expensive thing to do. I hope it’s done carefully so we head down a path that doesn’t require another major course correction every time the political winds change. There are a lot of good things about the ACA, and it looks like a lot of those things will be maintained. We’ll have to see how it goes. Q: There’s a common perception that insurance is an impediment to care. What role do you think it has to play in improving patient outcomes? A: I’m happy you asked that. A part of what we’re trying to do is try to create a better understanding of how all the pieces of healthcare work together. From my physician point of view — and many others’ — insurance companies are viewed as a barrier, maybe not so much to care, but the ability to make a decision without having to jump through hoops. Now, those hoops are created for a reason. So having switched places, I have a better idea of the role the insurance company plays in what they’re trying to do. So without a doubt, insurance companies aggregate dollars from a pool of people and then pay for the care all those people receive out of that pool of dollars. So there’s an important role to be played in making sure your members get the care they need, but also making sure they don’t get care that they don’t need. That’s a core insurance function. Accreditation, access to care, all of those are core functions that an insurance company do. We’re positioned in an awkward middle ground where we’re vulnerable to criticism from both the public side and the physician side, but we do provide several core functions that keep the whole system running. I’ve joked around with a few doctors about how unbelievably complicated and expensive it is to pay for healthcare. There’s something to be said of having an organization dedicated to handling that. Q: You’ve been appearing on a podcast series BCBS puts out called “Point of Health.” Tell us more about that. A: It’s a bi-monthly series. I’m not sure if it’s ongoing or just a certain number of episodes. I’m not a regular feature, but I was on the first one and one on the ACA and the political transition. It was enjoyable and a lot of fun. Q: Do you think insurance has a role to play in preventive care, particularly in the context of trying to influence patient lifestyles? A: We do. We have a really robust area that does health promotions. We work with employer groups and individual members on
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
In the News Thomas Schenck, the top doctor at BlueCross BlueShield of Western New York, is the first physician featured on a podcast series BCBS puts out called “Point of Health.” He discusses “Six Easy Steps for Better Health in 2017.” To listen to the podcast, go to bcbswny.com/ pointofhealth. precisely that stuff. People can take a health risk assessment to identify behaviors that could lead to medical problems down the road. It could be smoking, or being overweight. We have all kinds of resources that people can access from healthcare to educational materials so they can get an idea of why those factors are important. So there’s definitely a role there. To some extent, you can also build it into benefits with things like wellness cards and gym memberships, but we try to make it a person-to-person interaction to assess whether they’re ready for that kind of thing or to encourage them to move in that direction. Q: How does it end up paying off for you guys? A: So, if you think about how an insurance company works, as the year-to-year business that it is, you could be a BCBS member in 2017, but in 2018, your employer could change your plan or you might go to the health exchange if it’s still around, or whatever. But the fact that people are potentially not going to be a member next year doesn’t mean we don’t try to invest in their health. It’s more of a community investment. Q: If you don’t mind engaging in a little speculation, do you think the healthcare exchanges will be around in the near future? A: I’ll say this. New York state has been very progressive in regulation around healthcare and has its own exchange using the ACA as a framework. So regardless of what happens with Repeal and Replace, the effects will probably be less noticeable here than in other parts of the country.
Lifelines Name: Thomas Schenck, M.D. Position: Senior vice president and chief medical officer at BlueCross BlueShield of Western New York Hometown: Buffalo Education: City Honors High School; Cornell University (BS); University of Buffalo (Medical). Internship and residency at Women & Children’s Hospital of Buffalo Career: Joined BlueCross BlueShield of Western New York in June 2014; served as managing partner at Delaware Pediatric Associates; founding member of the Optimum Physician Alliance (OPA) and has served on the organization’s Physician Leadership Board for more than two years. Affiliations: Catholic Health System; Kaleida Health System Organizations: Buffalo Pediatric Society; March of Dimes; P2 Collaborative Family: Married, one son, one daughter Hobbies: Cooking, reading
Michael J. Billoni of Grand Island enrolled in a one-week weight loss and fitness program at The Biggest Loser Resort Niagara in the Beaver Hollow Conference Center. “This weeklong boot camp gave me the tools I needed to realize the importance of being in peak physical condition,” he said.
My Experience as a ‘Big Loser’ Getting into shape: ‘I needed a real kick in the butt and that’s what I received at The Biggest Loser.’ By Michael J. Billoni
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nspired by my wife Debbie’s disciplined commitment to train daily and eat healthy to achieve peak physical condition, I finally decided to do something very important for myself. After years of start and stop exercise and healthy eating programs, I made the personal commitment to enroll at The Biggest Loser Resort Niagara in the Beaver Hollow Conference Center in Wyoming County. The 5-year-old Biggest Loser Resort Niagara, with Independent Health as its presenting sponsor, is a franchise under the same name as the reality TV show. There is no competition among the participants here but rather, upon arrival on Sunday afternoon for a minimum one-week stay, everyone bonds quickly and encourages each other throughout the training activities during the week. At the end of each week there is a graduation bonfire where the participants share stories about their experiences and whether they achieved the goal they wrote down on day one.
More than anything, the team of fitness and nutrition experts take a personal interest in each client regardless if there are only 12 participants, like there was when I attended the week before Thanksgiving, or an average of 50 during the summer and early fall months. Obtaining peak physical condition and eating properly has been a life-long goal of mine. Selfdiscipline to take care of myself always seemed to come in second and third to my entrepreneurial career and many charitable activities in which my wife and I participate. As a former sports writer for the Buffalo Courier-Express, I spent most of my 20’s working a job that ended at 1 a.m. in a city that promotes chicken wings, beef on weck, pizza and cold beer at establishments open until 4 a.m. It did not get any better when I joined Bob Rich, Jr. and helped to run the Buffalo Bisons from 1983-96 when we all worked 24-7. Since then, I have quit drinking and have concentrated on living a healthier lifestyle. However, I needed a real kick in the butt and that’s what
I received at The Biggest Loser, which is owned by Snyder Corp., owners of the Hyatt Regency Buffalo. You can stay for as long as you like (or need) and my week’s stay began on Sunday with orientation and the first healthy and delicious meal of the week. We eat meals as a group — and the guest rooms are spacious and comfortable. Monday began an aggressive schedule of cardio, weight training, education classes, meals, snacks, goal setting and journaling before you collapse in bed and wait for the early call to do it all over again the next day. Each participant receives a three-ring binder filled with information for the perfect road map to follow once you return home. The staff creates a support system that provides a framework for our success, regardless of our physical or mental conditions when we arrive.
Uncomplicated approach We were taught three major goals with the fitness program, which began with a 45-minute stretch each morning at 6, followed by breakfast before we were back in the gym for a strength training and cardio workout. The fitness goals are simple — education, motivation and accountability. “Just do it” seems to be the overriding message to eliminate the “I can’t do this” mentality that most of us have when it becomes easier to quit than sticking with the program. The resort is on 350 acres of woods with a huge fish-stocked pond. There are three brisk hikes during the week, including one morning when we traveled to scenic and hilly Letchworth State Park. There are also two outdoor one-hour circuit workouts where you walk around the property at a brisk pace with trainers are at selected points to
February 2017 •
lead you through strength training exercises. It was grueling. There is an Olympic-sized pool where we participated in a couple unique and challenging fitness sessions that I have since done at home, along with the daily stretches to begin the day. Nutrition is key to shedding weight and each day we are provided with three delicious spa-cuisine meals, two healthy snacks, a dessert and all the salad and veggies you can eat at lunch and dinner. The resort is also drug, alcohol, smoking and caffeine free. You receive a water bottle when you register and there are plenty of flavored water stations around the property along with several flavors of organic teas. You receive all of the recipes of everything they create and there is a closed Facebook page for alumni to encourage and help others once you leave. Wellness is a huge part of the educational component and trainers Bill Price, Heather Lester and Theresa Armbrust provide the tools to create a lasting, healthy lifestyle. The one-hour classes throughout the week focused on balance, portion sizes, label reading and meal planning to allow us to fully integrate our experience there into our lives at home. For the first time, I finally feel I have a program that I can, and I have, followed upon my return home. For me, this weeklong boot camp gave me the tools I needed to realize the importance of being in peak physical condition. It is really simple to achieve with self discipline needed for portion control, stop eating two hours before you go to sleep, get a good night’s rest and walk or do some aerobic work daily. It also helps when your wife follows her program that gives you incentive to Just Do It!
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Live Alone & Thrive
KIDS Corner
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
How Content Are You? A Quiz
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erriam-Webster defines contentment as “the state of being happy and satisfied.” This dictionary definition of contentment sounds like a nice way to feel, doesn’t it? Oh, if we could just snap our fingers and be happy with who we are and what we have. Wouldn’t life be grand?! I’ve had the privilege of meeting and talking with a lot of women and men who live alone, and our conversations often turn to the subject of contentment: how to find it, how to keep it and how to find it again once it’s been lost. Those on their own often feel a
lack of something in their lives, and many have trouble letting go of a craving for things to be different. I know. I’ve “been there.” For years, after my divorce, I had trouble seeing the good in myself and in my life. But with time, intention and practice, I was able to stop yearning for what I didn’t have and to start appreciating what existed right in front of me. It all began with taking a hard look at myself. It was an important first step, and I created the quiz below to help you assess where you are on your own road to contentment.
How Content Are You? Circle the choice that best answers the questions below: 1. What do you admire most about yourself? If asked, how many positive personal qualities come immediately to mind? A. Five or more B. One to four C. Nothing really comes to mind
2. How would you describe your home? A. Very “me” — I’ve made it my own! B. It’s fine. I keep meaning to redecorate, but just haven’t gotten around to it C. It’s a place to sleep 3. The past is the past. How would you describe your success in letting go of old ways of thinking and of negative thoughts or behaviors that keep you anchored in the past? A. I live in the present; it’s full steam ahead! B. I still go “back there” from time to time C. I can’t let go, I obsess about the past 4. Could you imagine planning a trip by yourself and traveling alone to a favorite destination? A. In a heartbeat! B. Maybe someday C. I can’t imagine that 5. Does the thought of going alone to a cafe for a cup of coffee or grabbing a bite to eat in a local restaurant feels perfectly comfortable, even enjoyable? A. I do it all the time B. Occasionally, but I’m not at ease C. I’m just not ready 6. Are your health and fitness priorities for you? Do you exercise, get enough sleep, and stay on top of health screenings? A. Of course B. I know I should, but I don’t always take care of myself C. I’m too preoccupied to think about my health 7. How often do you reward or pamper yourself by taking some time just for you or by purchasing that little something special you’ve had your eye on? A. As often as I can! B. Sometimes, but I tend to put others’ needs first C. I can’t remember the last time I pampered myself 8. Have you let go of the idea that you need a spouse to be happy and have a good life? A. Absolutely B. Mostly C. No. I feel I need a spouse (or significant other) to be content
To see how you ranked turn to page 16 Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, NY. For information about her Living Alone workshops or to invite Gwenn to speak, call 585-624-7887 or email: gvoelckers@ rochester.rr.com. Page 8
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Families Spend 1.5 Billion Hours Yearly on Special Needs Kids Care provided by parents adds up to nearly $18 billion in lost wages, study says
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amilies in the United States spend 1.5 billion hours each year providing home health care to their chronically ill or disabled children, a new study shows. The hours of health care these parents and other family members provide would cost $36 billion if performed by home health workers who received the going rate — or $12 billion if unskilled workers receiving minimum wage were hired, said senior researcher, physician Mark Schuster. Parents of chronically ill children are asked these days to provide “the kind of care that, if they weren’t there, the system would have to provide home health care or keep the children in the hospital longer,” said Schuster, chief of general pediatrics at Boston Children’s Hospital. He’s also a professor of pediatrics at Harvard Medical School. These time-consuming and sometimes technical health care tasks can include maintaining ventilators, performing physical therapy, tracking medication and changing bandages, Schuster said. “There’s pretty sophisticated stuff that parents are being asked to do once their child gets home,” Schuster said. All this time spent caring for
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
their sick children adds up to $17.6 billion in lost wages for these families — about $3,200 a child every year, the study authors said. One in five U.S. families has a child with special health care needs, according to the U.S. Health Resources and Services Administration. Schuster and his colleagues analyzed data from a survey conducted regularly by the U.S. Centers for Disease Control and Prevention to assess the impact of special health care needs among American children. Muscular dystrophy, cerebral palsy, cystic fibrosis, intellectual disability, epilepsy and head injury or traumatic brain injury were the conditions that required the most hours of family-provided health care at home, Schuster said. The illnesses requiring the most hours are all very complex, he said. “These are conditions that really involve a lot of support,” Schuster said. “These children often need a lot of help from an adult, and the adult at home is usually the parents. “A child with cerebral palsy might not be able to get out of bed, he pointed out. “A child with cystic fibrosis may need a lot of treatments at home.”
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6:1 Diet: One of the Worst?
Diet based on intermittent fasting has proponents (like Coldplay lead singer), but many critics By Tim Fenster
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t the tail end of 2016, the British Dietetic Association labeled the so-called 6:1 diet one of its five worst celebrity diets to avoid in 2017. The diet, which has its most visible champion in Chris Martin, lead singer of the British pop-rock band Coldplay, consists of fasting one day per week. The diet is part of the increasingly popular health trend — intermittent fasting — which has people fasting for any amount of time, from a few hours to the 5:2 diet (the same idea as the 6:1 but with two fasting days per week). Martin claims that the diet not only carries health benefits, but also makes him more creative and improves his voice — claims that the BDA disputes. “Completely fasting, unless properly managed, is likely to lead to a lack of concentration, tiredness and low mood,” states the BDA. “There is no evidence that a diet like this would make you more creative either, and depending on your age, health and lifestyle, fasting could be dangerous.” However, some dietitians say intermittent fasting can work but only when properly managed, and only undertaken by people healthy enough to do so. Nicole Klem, director of the nutrition and dietetics program at Trocaire College, says intermittent fasting diets are something of two-edged sword. The diet may prove useful, she said, for those who desire rapid weight loss, have chronically elevated blood sugar and have insulin and leptin resistance. “Folks [attempting the diet] should be sleeping well, and stress
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BFOHEALTH. COM
should be managed,” Klem said. She also recommends intermittent fasting for those seeking the benefits of daily fasting, but don’t feel ready for the hunger or fatigue that can result from 24 hours without calories. Intermittent fasting often involves limiting eating to a 10-hour window each day, say, from 9 a.m. to 7 p.m. According to Klem, the Klem break can allow cells in the digestive system to switch from cell growth to cell repair, otherwise known as autophagy. “It can be healthy to give your gut a break from working. … [And] you naturally curb some of the calories that might be extra, and it typically doesn’t drastically affect your social life,” she said. Meanwhile, the Trocaire dietitian advises against the diet for anyone who has hormone imbalances, diabetes, is underweight, consistently fails to get enough sleep or has high stress as a result of a life change. It is also not recommended for women who are trying to maximize fertility, or dieters who do not suffer from insulin or leptin resistance. Those who are interested in such diets should be sure to stay hydrated, she said, forego high intensity exercise on fasting days, limit fasting to no more than 24 hours and eat nutritious foods — especially following the fasting period. February 2017 •
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Best Diet 7th Year in a Row: DASH U.S. News & World Report ranks 38 diet plans
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f you’ve resolved to eat healthy and lose weight in 2017, a new report suggests the DASH diet may be your best bet. For the seventh year in a row, U.S. News & World Report has named the plant-based eating plan as the best choice overall, followed by the Mediterranean diet, up from fourth place last year. DASH stands for Dietary Approaches to Stop Hypertension, but its benefits go beyond preventing high blood pressure, the report found. The DASH and the Mediterranean diets, as well as most of the other recommended diets, focus on eating whole grains, fruits, vegetables, low- or no-fat dairy, lean meats, poultry and fish. They also recommend nuts, seeds and legumes (beans). But these diets limit or exclude most fats and sweets, and recommend modest portions, according to physician David Katz. He is president of the American College of Lifestyle Medicine and a member of the expert panel that came up with the rankings.
Food for a Healthy Heart Three experts talk about the best food you can eat to protect your heart By Deborah Jeanne Sergeant
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oncerned about heart disease? What you eat can make a difference regarding your risk. Along with other lifestyle factors, diet can raise or lower your changes of heart disease. Mary Jo Parker, registered dietitian nutritionist in private practice in Williamsville: • “A plant-based diet like the traditional Mediterranean diet is very heart healthy. The way they eat is that primarily increasing the intake of vegetables of all colors and textures.
• “Half the plate should be filled with vegetables and some fruit, onquarter with protein and one-quarter with starch. I tell people to look for lots of variety in the produce section. Page 10
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What they’re getting is a lot of fiber as well as the micronutrients we’re familiar with, and also what we call phytochemicals, which are chemicals naturally occurring in plants. Those are protective as well. Some people think about foods having anti-oxidant and anti-inflammatory properties, and those are foods in these categories as well as whole grains. • “Grains that Parker are heart healthy would be what a lot of people call ‘ancient grains’ and wheat that is the entire kernel, the germ and the bran, to get the healthy oils in those. • “Avoid the processed snacks and sweets. We know that dark chocolate is heart healthy because of the natural flavanoids that provide protection, but dark chocolate is high in sugar. Foods that are full of processed flour, oil, trans-fats or are deep fried, and salty
“Overall, the diets are similar, and that’s what makes this reasonable, because there is really no one diet that’s best. But the question is what approach to eating well is going to work for any individual, and that’s the benefit of this report,” he added. “You can pick the diet that will work for you and your family. The best diet is one that you are actually able to stick to,” Katz noted. The MIND diet, which incorporates elements of the DASH and Mediterranean diets and is touted as a way to keep Alzheimer’s disease at bay, was ranked third in effectiveness. There was a four-way tie for fourth place between the Flexitarian diet, a “casual vegetarian” diet that allows some poultry and fish; the Mayo Clinic Diet, an eating plan to keep you healthy and trim; the TLC diet, a plan that cuts cholesterol and fat by eliminating meats, dairy and fried food; and Weight Watchers, which helps you shed excess pounds. To come up with its list, U.S. News & World Report ranked 38 diet plans in nine categories. The rankings were done by an expert panel of nutritionists, dietary consultants, and doctors specializing in diabetes, heart health and weight loss. Each panelist considered the 38 diets across a number of areas, foods: these are things that are proinflammatory. They’re contrary for heart health. Those would be things that should be kept minimal. • “For beverages, water, low-fat or non-fat dairy or dairy alternatives like soy milk and almond milk. You could also have unsweetened green tea, black or white tea. A little coffee isn’t a problem for the heart. Try flavored water without sweeteners. Typically, I tell people to shy away from soda and from juice because it doesn’t have the fiber. Fruit juice offer a good infusion for flavoring water. Or use Stevia for a sweetening agent. “Herbs and spices can be antiinflammatory, like oregano, basil, black pepper, and certainly garlic and onions. use the powders, not the salts to keep their sodium intake down. Kathryn Townsend, Kathryn, registered dietitian at Neighborhood Health Center, Buffalo: • Foods like chips, frozen meals, canned soups are usually high in sodium. Sodium can lead to high blood pressure, which increases risk of heart attack and stroke. • “Limit alcohol. One drink for women and two for men is proven to be okay, but any higher intake puts you at higher risk. Some research said that antioxidants were thought to be helpful in a glass of red wine but it’s shown that it’s not that helpful. Limit
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
including the likelihood of sticking to the diet, the odds of losing weight in the short- and long-term, and effectiveness against heart disease and diabetes. One reason the DASH diet came in first is that it was developed and tested by the U.S. National Institutes of Health, Katz said. “The evidence for DASH is stronger than it is for some of the other diets, and it includes foods that are familiar to most Americans and can work for real families in the real world,” he said. The U.S. National Institutes of Health agreed. “DASH is not a fad diet, but a healthy eating plan that supports long-term lifestyle changes,” the agency said in a statement early January. “To receive top ratings, a diet has to be relatively easy to follow, nutritious, safe, effective for weight loss, and protective against diabetes and heart disease.” Following the portion size recommended in each diet will usually result in healthy weight loss, Katz explained. “Eating well will help you be leaner and healthier,” he said. In addition to a healthy diet, exercise is necessary for good health, he said. “Food is the fuel for the body -- it’s crucial for your health over a lifetime. But combining it with exercise is also crucial,” Katz said. “You are never going to be as healthy as you could be if routine physical activity is not a part of your life.”
wine. Imbibe if it’s just a special occasion. Erin Burch, registered dietitian and owner of Erin Burch Nutrition in Buffalo: • “Avoid eating a lot of processed foods and junk foods, diet drink, and juices. Sugar is a big contributor to diabetes, and heart disease. • “Limit hydrogenated fats in processed oil, shortening and margarine. I recommend avocado oil and coconut oil. They’re non-oxidized oils which limit inflammation. It’s an inflammatory disease process more than clogging up our arteries with fat. • “Eat lean animal protein: fish, turkey, chicken, and lean cuts of lamb and red meat. Eat nuts and beans. Lean proteins are very important for blood sugar balance. Burch • “Eat protein with every meal to avoid sudden increase in blood sugar spikes which is important even if you’re not a diabetic. • “Try to eat every 3 to 4 hours, about 5 to 6 small meals per day. • “Fiber is important in general for heart health. Good sources are whole grains, like quinoa and oatmeal, beans, fruits and vegetables with their skins, nuts and seeds. They help lower cholesterol and risk of heart disease.”
SmartBites
whole, split lengthwise, or sliced. As mentioned, the nutrient-rich skin is edible, so you can leave it on.
The skinny on healthy eating
Delicious, Nutritious Delicata Winter Squash
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f you haven’t tried delicata squash — an oblong-shaped winter squash with yellow-colored skin and green stripes — steer your shopping cart to the produce aisle. This great-for-you veggie is known for its soft texture (unlike other winter squashes, it can be easily sliced and chopped), its scrumptious flavor (similar to sweet potatoes), its tender skin (edible!) and its bounty of health benefits. On the vitamin front, the delicata, with its orange-yellow flesh, is a vitamin A superstar, providing nearly all of our daily needs in one cup. A nutrient we can’t live without, vitamin A is essential for growth, healthy skin, vision and a well-oiled immune system. Delicata also packs an impressive vitamin C punch. Immune-boosting vitamin C helps the body maintain healthy tissues, heal wounds in a timely manner, and neutralize cell-damaging free radicals that can sow the seeds for disease. Many studies have linked winter squash — delicata included — to a lower risk of certain cancers. Their fiber (perhaps more with delicata because you can eat the skin) and abundant carotenoids help shuttle out inflammatory and potentially cancer-
My Turn
causing substances from the body. Those looking to lose or maintain weight will appreciate delicata’s health cred: half a squash delivers a scant 30-40 calories and is super low in saturated fat, cholesterol and sodium. Moreover, delicata’s slowdigesting fiber helps us feel fuller longer, so we’re not as inclined to reach for those chips. And while delicata squash, like all winter squash, has more carbs than your average vegetable, recent research has made it clear that all starch is not the same: there are “nature-made” good carbs that get absorbed more slowly into our systems and then there are “refined” bad carbs that zip through us licketysplit. Thankfully, delicata is full of good carbs and all the benefits they reap: more stable blood sugar levels, longer-lasting energy, improved digestion and fiber-driven heart protection.
Helpful tips:
Select squashes that feel firm, especially near the stem ends, and that feel heavy for their size. Steer clear of those with blemishes or soft spots. Store delicata squash in a cool, dark, well-ventilated area for up to one month. Delicata may be cooked
Delicata Squash with Quinoa Stuffing Adapted from EatingWell.com Serves 4 2 small delicata squash (12-14 ounces each), halved lengthwise and seeded ¼ teaspoon salt ¼ teaspoon ground pepper 2½ tablespoons olive oil, divided 1 cup water ½ cup quinoa 1½ cups chopped leek (about 2 large), white and light green parts only 1 teaspoon dried thyme 1 teaspoon dried parsley ⅓ cup dried cranberries ⅓ cup coarsely chopped pecans, toasted salt and pepper to taste Preheat oven to 400 degrees. Line a baking sheet with parchment paper. Halve the delicata lengthwise and carefully scoop out the seeds to make four long “boats.” If the boats are too
wobbly, take a very thin slice off the bottom so they’ll sit flat. Brush cut tops with olive oil (1 tablespoon for all 4), season with salt and pepper, and arrange cut-side up on the prepared pan. Bake until they are soft and just starting to char a little, about 25 minutes. Remove from oven and reduce temperature to 350 degrees. While squash is baking, prepare stuffing. Combine 1 cup water and quinoa in a small saucepan and bring to a boil over medium heat. Cover, reduce heat to a simmer and cook until the quinoa is tender, about 15 minutes. Remove from heat, fluff with fork and let stand, covered, for 10 minutes. Transfer to medium bowl. Heat 1½ tablespoons olive oil in a medium skillet over medium heat. Add leek and cook, stirring constantly, until the leek is tender and edges are slightly browned—about 8 minutes. Add the leeks, thyme, parsley, cranberries, pecans, and salt and pepper to bowl of quinoa and stir well. Spoon the quinoa mixture into the squash halves, packing as needed. Bake at 350 degrees until the stuffing is heated through, about 15 minutes. Tasty tip: Seeds may be washed and roasted. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
By Eva Briggs
Can You Really Die of Broken Heart?
Valentine’s Day, love, broken heart
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alentine’s Day is approaching, and thoughts turn to love and also to broken hearts. Can you really die from a broken heart? Yes, and the condition has a name: Takotsubo cardiomyopathy (TCM). The name comes from the Japanese term for octopus trap, because the affected heart assumes the shape of a tako tsubo. If you are curious to see how octopus are trapped and eaten, you can check out this website: http://tinyurl.com/ hvuele8. TCM symptoms resemble those of a heart attack. Patients have chest pain and often shortness of breath. Other common symptoms are palpitations, nausea, vomiting, fainting or shock. But unlike a heart attack, blocked arteries don’t cause TCM. Two-thirds of TCM patients have a preceding physical or mental stress. While heart attacks occur most often in the early morning, TCM is more likely to happen in the afternoon. TCM patients are less likely to have traditional cardiac risk factors of high blood pressure, elevated cholesterol, diabetes, smoking, or a positive family history for heart attacks. The stress that causes TCM can
be psychological, such as the death of a loved one, bad news, legal problems or even positive stress like winning the lottery. Physical stresses include motor vehicle accidents, a newly diagnosed serious illness, worsening of a chronic illness, a stay in the ICU, and surgery. There are four criteria used to diagnose TCM. First, there must be evidence that muscle of the heart’s main pumping chamber, the left ventricle, isn’t moving and contracting properly. Second, the coronary arteries are not blocked. Third, new changes occur in the EKG. And fourth, the symptoms are not due to myocarditis (infection of the heart muscle) or pheochromocytoma (a rare tumor of the adrenal gland.) Post-menopausal women are the most likely to develop TCM. Nearly 90 percent of TCM patients are female. Although the average age is 67, even children and young adults can be affected. Asians and Caucasians are the ethnic groups with the highest incidence. Exactly how stress causes TCM is unclear. One likely theory supports a response to catecholamines; the stress related to “fight or flight” hormones epinephrine, norepinephrine and
dopamine. They’re released in response to a mental or physical shock. These hormones may trigger heart blood vessels to spasm. The hormones may stun the heart muscle, or cause microscopic areas of heart muscle cell death. Healthy heart muscle gets 90 percent of its energy from fat. But when stressed, as during TCM, the heart shifts toward using glucose for fuel. Glucose isn’t as efficient. Evidence implicating catecholamines includes elevated levels of these hormones in the blood of TCM patients compared to levels in heart attack patients. The part of the heart muscle involved in TCM corresponds to the areas that typically contain the highest levels of catecholamines. Scientists can give TCM to rats by physically stressing them. Pretreating the rats with medicines that block catecholamines (alpha blockers and beta blockers) protects them from TCM. Because the symptoms are the same as the symptoms of a heart attack caused by coronary artery blockages, the same kinds of tests are used to make the diagnosis: an EKG, blood tests looking for substances released by injured heart muscle, echocardiogram (a sound wave
February 2017 •
picture of the heart) and angiography (images of the heart arteries). And the treatment involves the same medicines used to treat heart attacks. But since blocked arteries don’t cause TCM, it doesn’t require stents or bypass surgery. Fortunately the prognosis is good. 95 percent of TCM patients fully recover in four to eight weeks. It doesn’t usually happen again, recurring in only 1.5 percent of patients per year. There is a 1 percent risk of death. So this Valentine’s day, don’t go breaking anyone’s heart. Eva Briggs is a medical doctor who works various healthcare centers in the Syracuse region.
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For People with Disabilities New Apps Are Life Savers Apps can help those with visual, hearing or speech impairments deal with routine aspects of life By Deborah Jeanne Sergeant
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hone apps have made many areas of our lives easier. For people who live with visual, hearing and speech disabilities, some apps can offer assistance that’s much more convenient than help offered by a separate device. Since many people already carry smartphones everywhere, the apps are always ready to help. Plus, smartphones — used by people of all abilities — lack the stigma that some people attach to devices such as soundboards used by some people with speech impairment. People with visual impairment can “borrow” others’ vision with Be My Eyes (iOS, Android coming soon; free). The app links volunteers with users to offer them assistance by verbally describing whatever users show them on their smartphones’ cameras, from street signs to instruction booklets. Many people who are visually impaired fold or carry their paper currency in ways that identify it; however, receiving change in paper currency relies upon others’ honesty
and accuracy. But LookTel Money Reader (iOS; free) helps visually impaired people identify and count money instantly. The app can identify numerous nations’ currency, making traveling easier, too. Need something read ASAP? KNFB Reader (iOS; $99.99) can read text aloud, from a single page to several pages. TapTapSee (iOS; free) can verbally identify everyday objects in real time. It reads barcodes and also draws upon cloud-based image recognition technology. People with limited vision can instantly enlarge their view of anything they see with AMagnifiy (Android; free). The app can blow up text or objects around the user, and capture enlarged images, all while maintaining the resolution needed to see the subject more clearly. A similar app, Smart Magnifier (Android; free), works like a digital magnifying glass. Or, users can zoom in on just a portion of what they’re viewing on the screen. As its name indicates, Color Identifier (iOS and Android; free) helps users accurately identify colors and speaks their names aloud for
Fall Prevention Saves Lives
How important is it to prevent a fall? Two older New Yorkers die every day because of a fall, and 223 end up in the emergency room.
Slippery bathroom falls — among many other falls among older seniors — send more than 200 older seniors to hospital every year in New York state. By Deborah Jeanne Sergeant
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ant to live a long, independent, healthy life? Stay on your feet. According to the New York State Department of Health, two older New Yorkers die every day because of a fall, and 223 end up in the emergency room. Among adults 65 and older who are hospitalized due to a fall, 60 percent end up in a nursing home or rehabilitation center, 11 percent suffer a traumatic brain injury, and 27 percent experience a hip fracture. Sadly, the number of fall-related injuries is growing among older New Yorkers. The NYS Department of Health reports that from between 2000 and 2012, the number of fall-related hospitalizations grew from 42,567 per year to 53,270 and deaths increased from 746 annually to 1,059. Falls occur because of internal
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factors and environmental factors. While you can’t eliminate every risk factor, you can nix quite a few of them. Suzanne Gilliam, owner and president of Touching Hearts at Home in Williamsville, said that many people fall because they become out of touch with their physical deconditioning. “They need to assess their physical ability to walk safely,” Gilliam said. “Can they get up unassisted from a seated position? Do they have trouble walking on uneven surfaces or stepping on a curb? Have they had previous falls or are they afraid they might fall again? Do they have trouble seeing during the day or at night? That’s the first step to see if they have the physical ability to walk safely or if they need a device like a walker?” She recommends that seniors receive timely eye exams and ask their doctors if any of their medication may
Be My Eyes is a free application that links volunteers with users to offer them assistance by verbally describing whatever users show them on their smartphones’ cameras, from street signs to instruction booklets.
AutoVerbal is a $19.99-application that helps people with speech impairment communicate by translating text into speech.
TapTapSee can verbally identify everyday objects in real time. It reads barcodes and also draws upon cloud-based image recognition technology. It’s a free application.
users. Dragon Dictation (iOS; free) makes it easier for people who hear to communicate with someone who is hearing impaired. The app turns spoken words into written text. People who read lips understand about 30 percent of their conversations. This app provides word-for-word communication for when accuracy is vital. Virtual Voice (Android; free) and AutoVerbal (iOS; $19.99) help people with speech impairment communicate by translating text into speech. Virtual Voice uses a roboticsounding voice, but is easy to use. AutoVerbal allows users to select the voice’s gender, program custom phrases, and provides “speed dial” buttons for commonly used phrases. Talkitt (iOS, Android; cost
unknown) helps people with speech impairment by translating their speech into clearer speech. By learning the user’s speech patterns, the app can help them use their own voice for communicating. RogerVoice Caption Calls (iOS, Android; free) provides real time phone conversation subtitles and, optionally, text to speech for the sake of the person on the other end. The app requires an Internet connection during use. Learning sign can help improve communication among people with hearing and hearing impairment. Marlee Signs (iOS; free) and Spread the Sign (Android; free) offer comprehensive sign language dictionaries that can help teach anyone sign language.
cause dizziness as a side effect. They may be able to change medication or take it just before bedtime and use a walker when they get up in the night. Gilliam encourages clients to join in an exercise class or to exercise at home three to four times a week to build confidence, muscle mass and balance. She’s a big fan of walking and participating in tai chi. It’s also important to know when it’s time to get help with chores. “My mother was able to stay in her home nine years more because she had someone come in and help her with household chores, check on her, and make sure she’s engaged,” Gilliam said. “People are reactive. They fall Gilliam and then they call us.” Environmental changes can also reduce fall risk. Philip Haberstro, executive director of The Wellness Institute of Greater Buffalo & WNY and City of Buffalo Falls Prevention Coalition facilitator, said that many people can do small home improvements that cost little and greatly reduce the risk of falls. For example, use the brightest light bulbs permitted for a socket to improve visibility. Use night lights. Paint the edges of steps with reflective paint. Eliminate clutter, skidding throw rugs, extension cords and other trip hazards. Wear non-skid, well-fitting shoes. If stairs have become unmanageable, choose a chair lift or live on one level of the home. If you lack a bedroom on the first floor, or need to move the washer and dryer
up from the basement, the expense of the remodeling may be worth it if that spares you from a fall-related injury. Small differences in floor height may cause falls. Installing ramps at one inch per foot of rise to make the difference more gradual. Haberstro said that the bathroom represents a typical location for falls since they often present damp, slippery flooring. Stepping in and out of the tub, raising or lowering to use the toilet and forgoing corrective eyewear while bathing all contribute to bathroom falls. Since bathrooms usually have hard flooring and several hard surfaces in a small area, many people who fall in the bathroom suffer grievous injuries. Haberstro recommended grab bars, walk-in tubs, curb-less showers and raised toilets to provide aging-inplace options that reduce falls. Weighted shower curtains work fine for keeping water in curbless showers and are safer than shower doors, which cannot support an adult’s weight. Selecting from all of these options can seem overwhelming. Discussing home alteration needs with a physical therapist and a social worker can help make decisions easier. Many of these professionals will perform home assessments, which can prove invaluable in finding areas of home improvement that can prevent falls. Outside, use plenty of salt deicer on steps and walks. Haberstro recommends keeping a small bucket of the product near the door as a reminder. “The right footwear and additional, strap-on treads is well worth reducing the risk of falls,” Haberstro said. “It’s also not a sign of weakness to hold someone else’s arm while walking.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
Golden Years
6
Things to Know About How to Age Well
Physician Bruce Troen, professor of medicine and chief of the division of geriatrics and palliative medicine at the University of Buffalo and UBMD Internal Medicine.
By Ernst Lamothe Jr.
L
iving a long life is not the sole goal in life. What’s the purpose of beating back Father Time if you don’t have your health? The good news is that Americans are living longer lives. The bad news is that they are not actually living better lives. “Life cannot simply be about how long we live but it has to be about how well we live,” said physician Bruce Troen, professor of medicine and chief of the division of geriatrics and palliative medicine at the University of Buffalo and UBMD Internal Medicine. Troen, who specializes in geriatrics, talks about the six things you need to know as you get older.
1.
Two important vitamins
While research has been mixed on advantages of taking certain vitamins and supplements, it seems that two vitamins are universally accepted as essential in a person’s life. The first is vitamin D, a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement. It increases the absorption of calcium, magnesium, zinc and iron into the body. “You are going to get most of the vitamins you need through your food if you eat a balanced diet, but many people are vitamin D-deficient,” said Troen. “Vitamin D is not just for your bones but it is supportive for your autoimmune system and your heart.”
The second vitamin is B12, which is important for many aspects of health, including the production of red blood cells. Healthy numbers of red blood cells are critical for delivering oxygen and nutrients to the body’s cells and tissues. “Long term deficiency in B12 can lead to neurological difficulties and anemia,” added Troen.
2.
Improving your nutrition
Nutrition is a moving target. It seems like every week we are finding out something new that was once considered detrimental to us that is no longer — or that what was once considered bad is, actually, good. Fats and saturated fats used to be the No. 1 target of the medical community. Now they have a new focus. “The real problem is excessive carbohydrates and sugars,” said Troen. “If we want to maintain a good weight, we should try to stay away from too many processed foods that have a large amount of both. I’m not advocating that you stay away from foods that have natural sweetness, but added sugar is one of the largest contributors to obesity, which has plagued our country for decades.” Troen recommends simply eating sensibly and avoiding knee-jerk extreme diets.
3.
Watch multiple medications
Even though medication can help seniors, the issue is they often must take multiple medications
Is Running Bad for Your Knees?
everyday. But while one medication may help you lower your blood pressure, the other may bring up some other negative issues. “People don’t understand that as you get older, your response to medication can also change,” said Troen. “That is why recommending something like Benadryl, which helps with allergies, might be a problem because it can cause confusion and slow reaction time for seniors.”
4.
The importance of a geriatric physician
There are more Americans older than 65 than at anytime in history. A geriatric doctor, also known as a geriatrician, is a professional who studies the aging process. Geriatricians also study how to prevent diseases. One of the biggest issues for a geriatrician is to prevent and treat dementia. Older people who have an increase in health problems should seek help from a geriatrician. “I believe that seniors should be treated by a geriatrician or a geriatric nurse practitioner because they are especially aware of the kinds of medication that seniors take and their side effects,” said Troen. “Certain medications can be very powerful and you can lose sight of that when you are not looking at the whole picture. If you don’t have someone looking at the bigger picture than you can’t truly treat the whole patient.”
5.
Regular exercise
Exercising at any age is essential to good health. It becomes even more paramount as you get older because you are fighting the uphill battle of aging. Troen recommends regular exercise even as simple as taking regular walks. “Moderate exercise really is the key to moving forward in life,” said Troen. “It all has to make sense. We are not encouraging seniors to run marathons, but it’s common knowledge in the medical community that exercise and proper body regime can help with a lot of medical conditions.”
6.
Improving your memory
We know there is often increasing cognitive issues as we get older. There is no cure for Alzheimer’s disease or vascular dementia, which is a common form of dementia caused by an impaired supply of blood to the brain that may be caused by a series of small strokes. Troen also recommends challenging the brain with learning a new language or taking an online class. “Your brain is a muscle and you have to exercise it vigorously in ways that truly challenges it,” he said.
Study suggests it may slow development of osteoarthritis
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verybody believes running can leave you sore and swollen, right? Well, a new study suggests running might actually reduce inflammation in joints. “It flies in the face of intuition,” said study co-author Matt Seeley, an associate professor of exercise sciences at Brigham Young University in Provo, Utah. “This idea that longdistance running is bad for your knees
might be a myth.” Seeley and his colleagues reached their surprising conclusion after analyzing the knee joint fluid of several healthy men and women between the ages of 18 and 35. The researchers looked for signs of inflammation in chemical markers before and after a 30-minute run and found little difference. “What we now know is that
for young, healthy individuals, exercise creates an anti-inflammatory environment that may be beneficial in terms of long-term joint health,” lead author Robert Hyldahl said in a university news release. Hyldahl is an assistant professor of exercise science at BYU. The researchers said the study suggests running could actually delay development of degenerative joint
February 2017 •
diseases like osteoarthritis. “This study does not indicate that distance runners are any more likely to get osteoarthritis than any other person,” Seeley said. “Instead, this study suggests exercise can be a type of medicine.” The study was published recently in the European Journal of Applied Physiology.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Golden Years
Still Practicing Medicine at Age 89
Physician Dyster with a patient, Renee Willard-Larson. Photo by Angie Lucarini.
Melvin Dyster, a physician at Niagara Family Medicine, has been practicing medicine since 1954. “I love it,” he says. He says he wants to work until age 95 By Deborah Jeanne Sergeant
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hile many in the health field retire early for a variety of reasons, some practitioners continue working long after the standard retirement age. One of them is Melvin Dyster, board-certified family practice physician at Niagara Family Medicine. Now age 89, Dyster has been practicing medicine since 1954 because, “I love it,” he said simply. After he completed medical school in 1952, he served full time in the US Army for two years, then passed the board examination in family medicine. He continued to serve in the military training doctors and practicing. He retired from service as a colonel and continued to practice family medicine. A few years ago, Dyster transitioned into what he calls “semiretirement” but he still sees patients Tuesdays and Thursdays, works with residents Mondays and Wednesdays and makes house calls to see patients on Fridays. “I could have retired 26 years ago but I like it,” Dyster said. Passing on medical expertise is yet important to Dyster. “I still spend half my time Page 14
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teaching young doctors how to be family doctors,” he said. “It’s important they’re doing it for the patients. “I tell residents, ‘You’re probably higher IQ than most the people you see. The good Lord gave that to you to help people, not to make money.” His perspective on the medical industry has remained constant; however, many changes in medical practice have disappointed Dyster. He feels that the government and insurance companies have eroded the doctor/patient relationship. When he sends patients to specialists, they cannot always get the care he recommends because their insurance won’t pay for it. “I’m so disgusted so many others put their noses in medicine to make money and, as doctors, we are just trying to make patients better. I’d like to go back to the old days when I’d make only house calls and people would go get a tin from the cupboard and say, ‘How much is that?’” He feels that at present, insurance companies hold too much control over the choices physicians and patients make. He would like to have care decisions in the hands of families and their doctors. Dyster is big on families, both in his medical practice and personally.
He and his wife, Mary, had 10 children — all who graduated college — and 18 grandchildren. A few of his children work in the medical industry. Dyster described wife Mary as “a pretty little Irish girl” he noticed while he was working his way through college. Mary, a student nurse at the time, asked him to help her with her work. That turned into his invitation to dinner. “She was the only girl I dated twice,” Dyster said. Mary died 19 years ago. She, too, was active in the medical field, working as a nurse and also mentoring others. The Mary C. Dyster Women’s Pavilion at Niagara Falls Memorial Medical Center was named for her. In his spare time, Dyster enjoys operating a radio as an amateur and he has a pet bird. But he has described medicine as “one of the two loves of my life” with Mary as the other. “I just enjoy working with people,” Dyster said. “On a day off, I work on the computer but I don’t get feedback from a computer. It’s so gratifying to work with people and help them feel better.” He likes to hear patients say when they see him out and about, “There’s my doctor.” He even gives patients his cell
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
phone number but asks that they don’t call between 8 and 8:30 when he’s at church every morning. Dyster said that no one abuses the privilege and that patients feel better just knowing they can call. “That’s the doctor/patient relationship.” Dyster advises medical students to go into family medicine in locations where they’re needed, not in a large city. Dyster recently had a physical and was told he can work until he’s 95. He attributes his personal longevity to eschewing tobacco, limiting his alcohol to a glass of red wine twice weekly and “I try not to cuss and swear,” he added. “I enjoy people, particularly children. I love kids. I’m so lucky that God gave me this opportunity to help people.” In an era when many physicians retire early, he has continued practicing because he has remained patient-focused, despite the changes in the medical industry. “If you keep that in mind, you can swallow a lot of junk to help patients,” he said. “I take care of people as they come. I don’t worry about ordering more tests or visits to get paid more. The pay you get is from the gratitude of the patients. You can’t buy that.”
Golden Years
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Experts: Yoga Greatly Benefits Seniors Practice helps support good bone health, balance, mobility, they say
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By Deborah Jeanne Sergeant
Y
oga may seem like an activity for lithe, young women; however, many seniors are finding that yoga benefits them in many ways, regardless of the state of their health. Most seniors notice that their flexibility decreases as they age. While it may not initially bother them much, its cumulative effect can hamper activities of daily living eventually. Carrie Jacobson, certified yoga instructor and manager of East Meets West Yoga in Buffalo, said that yoga can help otherwise sedentary people get moving. “That is a huge benefit,” Jacobson said. She also recommended yoga to help support good bone health, as it is weight-bearing exercise. Chair yoga can help people with mobility and balance issues get more movement into their days, according to Kandy Svec, registered yoga teacher and ayurvedic yoga specialist at Himalayan Institute Buffalo in Buffalo, who teaches an arthritis class and a chair yoga class. She said that quite a few older clients find that yoga helps them improve balance, posture, breathing and sleep. She also thinks that it can help decrease instances of falls since it can help seniors improve their posture and gait. “If they have one or two days when they start feeling terrific, they start having more days,” Svec said. “They continue to come back to yoga, eat better and feel better.” David Drost, owner and certified yoga teacher at Evolation Yoga in Buffalo, believes that many people have lived sedentary so long that their bodies’ lack of movement has caused imbalance and limited range of motion. “As you progress through life, those imbalances begin to become glaring,” Drost said. “They’re not irreversible. The internal body systems can be healed. It needs to be in motion to do so.” Thankfully, it doesn’t require eight-hour yoga sessions daily. Drost recommends an hour three or four times weekly. Though many online and pre-recorded yoga sessions can help out at home, Drost recommends a class setting at least initially to learn the proper alignment and, for people who tend to live isolated, for the group setting at class offers. “Being with others is key to emotional stability,” Drost said. We’re emotional and need to be with others. When you practice willingness, acceptance and action, you manifest them in your physical body and bring
South Towns Surgical Associates Providing General, Laparoscopic and Robotic Surgery them into mental and emotional life, understanding things are the way they are and we can have the power to change what we’re doing at that moment.” Depression strikes many older people as they ruminate on losses and regrets. Anxiety can also take hold as they consider their future, especially if they fear losing control of their independence. In addition to the emotional stress caused by depression and anxiety, these affect physical health as well. Drost believes practicing yoga can help. “Immobility can cause depression, as in, ‘My loved ones are gone. I’m just going to stay here,’” Drost said. “Just get out there and live. you can’t separate the willingness and acceptance in the body from the willingness and acceptance in emotions.” Drost added that many seniors find that the camaraderie when practicing yoga can make pursuing exercise both more fun and easier to stick with. How to Choose the Right Yoga Class Try these expert tips for picking the right yoga class: “A good teacher will know how to adjust the practice for any individual who walks through the door. You want to not only look for a class that’s appropriate for your skills (call and talk to the teacher or owner at the studio to make sure it’s the right place) but a good teacher will have no problem adjusting the class to individual needs. You won’t be asked to do a crazy pose, but practice on a level that’s appropriate to you.” • Carrie Jacobson, certified yoga instructor and manager of East Meets West Yoga in Buffalo. “As I teach, a couple points I make is there’s no competition, no judgment, and each of us is in our bodies, where we are today. They are respectful and forgiving and understanding of each other. Knowing other people have some of the same issues.” • Kandy Svec, registered yoga teacher and ayurvedic yoga specialist at Himalayan Institute Buffalo in Buffalo.
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Blood Shortage Prompts Red Cross Call for Donations
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lood donations to the American Red Cross have slumped recently, so donors are desperately needed, the organization says. “Hospital patients need lifesaving blood this winter, and they’re relying on the generosity of volunteer donors to provide hope in the days and weeks ahead,” said Chris Hrouda, executive vice president of Red Cross Blood Services. “The Red Cross is doing everything it can to ensure blood products are available on the shelves when patients need it, but we can’t do it alone,” Hrouda said in a Red Cross news release. “We need eligible individuals to give blood and platelets as soon as possible.” In the U.S., the Red Cross is responsible for about 40 percent of the blood supply. However, roughly 37,000 fewer donors gave during November and December,
February 2017 •
the agency said. Along with the hectic holiday season, severe weather hampered donations and forced blood drives to be cancelled, the agency said. What’s needed now: About 14,000 blood and platelet donations a day to meet the needs of about 2,600 hospitals and transfusion centers across the United States. Donations of platelets, a part of blood that’s key to clotting, can help patients with cancer and other illnesses and injuries. Donors can also make donations of a component of blood called plasma, which can treat burn patients, those who have experienced trauma, and those whose blood does not clot properly. According to the Red Cross, people as young as 17 may be eligible to give blood. Eligible donors can schedule donations by going to redcrossblood.org or by calling 1-800-REDCROSS (1-800733-2767).
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Live Alone & Thrive
The Social Ask Security Office
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Continued from page 8
From the Social Security District Office
Your Scorecard
Give yourself: 3 points for each answer in column A 2 points for each answer in column B 1 point for each answer in column C
8 points
Contentment may feel elusive at the moment – beyond your grasp. But it can be found. You may benefit from talking with a professional or your pastor. Help and encouragement might also be found in grief support groups and other gatherings that offer emotional support.
9-16 points
You experience feelings of contentment, but you know there’s more to be found. Continue to stretch yourself. Reach out to others. And “try on” healthy pursuits outside your comfort zone. Success and achievement breed contentment. You might also find inspiration and a needed “jump start” in workshops, classes and lectures devoted to personal growth and development.
16+ points
What you have is precious. Being content with yourself opens up all kinds of possibilities. It enables you to feel peace and joy, whether you are alone or with others. It is an invaluable inner springboard on which you can launch all things imaginable! How did you do? What did your score reveal? I’d love to hear your story. Please share it with me by email: gvoelckers@rochester.rr.com
Joints Achy? Don’t Blame Mother Nature
Study disputes weather’s role in knee and back pain
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ou might want to think twice the next time you’re ready to blame the weather for your aches and pains, researchers say. Some people swear that changes in humidity, temperature, air pressure and the like trigger back pain and arthritis. But a team at the George Institute for Global Health in Newtown, Australia, said it found no evidence to support that theory. “The belief that pain and inclement weather are linked dates back to Roman times. But our research suggests this belief may be based on the fact that people recall events that confirm their pre-existing views,” said Chris Maher, director of the institute’s musculoskeletal division. The study included nearly 1,350 Australians with either lower back pain or osteoarthritis of the knee. The study participants’ pain flare-ups were compared with weather data. There was no association between back pain/knee arthritis and temperature, humidity, air pressure, wind direction or precipitation, the investigators found. “Human beings are very
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2017 Brings Changes to ‘Full Retirement Age’
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very worker’s dream is having a secure retirement to enjoy the fruits of their labor. Social Security is here to help you secure today and tomorrow. Part of that commitment is ensuring you have the most up-to-date information when you make your retirement decisions. “Full retirement age” refers to the age when a person can claim their Social Security benefits without any reduction, even if they are still working part or full time. In other words, you don’t actually need to retire from your work to claim your full benefits. Also note that waiting until you’re 70, if you can, will bring you a higher monthly benefit. The choices you make will affect any benefit your spouse or children can receive on your record, too. If you claim benefits early, it will reduce their potential benefit as well as yours. As the bells rang in a new year, they also rang in changes in 2017 for people considering claiming Social Security retirement benefits. For people who attain age 62 in 2017 (i.e., those born between Jan. 2, 1955 and Jan. 1, 1956), full retirement age is 66 and two months. Full retirement age was age 65 for many years. However, due to a law passed by Congress in 1983, it has been gradually increasing, beginning with people born in 1938 or later, until it reaches 67 for people born after 1959. You can learn more about the full retirement age and find out how to look up your own at www. socialsecurity.gov/planners/retire/ retirechart.html. There are some things you should remember when you’re
Q&A susceptible so it’s easy to see why we might only take note of pain on the days when it’s cold and rainy outside, but discount the days when they have symptoms but the weather is mild and sunny,” Maher explained in an institute news release. Maher is also a professor of physiotherapy at the University of Sydney. Back pain affects up to one-third of people worldwide at any one time. Nearly 10 percent of men and 18 percent of women over the age of 60 have osteoarthritis, the study authors said in background notes.
Q: I found out that my daughter submitted incorrect information about my resources when she completed my Application for Help with Medicare Prescription Drug Plan Costs. How can I get my application changed now to show the correct amount? A: You can call 1-800-772-1213 (TTY: 1-800-325-0778) and let us know. We will match information on your application with data from other federal agencies. If there is a discrepancy that requires verification, we will contact you. For additional information about Medicare prescription drug plans or enrollment periods, visit www.medicare.gov or call 1-800-633-4227.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
thinking about retirement. You may start receiving Social Security benefits as early as age 62 or as late as age 70. The longer you wait, the higher your monthly benefit will be. Your monthly benefits will be reduced permanently if you start them any time before full retirement age. For example, if you start receiving benefits in 2017 at age 62, your monthly benefit amount will be reduced permanently by about 26 percent. On the other hand, if you wait to start receiving your benefits until after your full retirement age, then your monthly benefits will be permanently increased. The amount of this increase is two-thirds of 1 percent for each month — or 8 percent for each year — that you delay receiving them until you reach age 70. If you decide to receive benefits before you reach full retirement age, you should also understand how continuing to work can affect your benefits. We may withhold or reduce your benefits if your annual earnings exceed a certain amount. However, every month we withhold or reduce increases your future benefits. That’s because at your full retirement age we will recalculate your benefit amount to give you credit for the months in which we reduced or withheld benefits due to your excess earnings. In effect, it’s as if you hadn’t filed for those months. You can learn more at www.socialsecurity. gov/planners/retire/whileworking. html. If you pass away, your retirement date can affect the benefit amount your surviving loved ones receive. If you started receiving retirement benefits before full retirement age, we cannot pay the full amount to your survivors. Their benefit amount will be based on your reduced benefits. Q: How do I know if I meet the eligibility requirements to get Social Security disability benefits? A: To qualify for Social Security disability benefits, you must have worked long enough in jobs covered by Social Security (usually 10 years). You must also have a medical condition that meets Social Security’s strict definition of disability. We consider an adult disabled under our rules if he or she has a medical condition, or combination of medical conditions, that are expected to last for at least one year or result in death, and that prevent the performance of any type of work. If you think you may be eligible to receive disability benefits and would like to apply, you can use our online application at www. socialsecurity.gov/applyfordisability
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Tax Help for Caregiver of Elderly Parents Dear Savvy Senior, Are caregiving expenses tax deductible? I provide a lot of financial support to my elderly mother and would like to find out if I can write any of it off on my taxes. Supporting Son Dear Supporting,
There are actually several tax deductions and credits available to adult children who help look after their aging parents or other relatives. Here are your options along with the IRS requirements to help you determine if you’re eligible to receive them.
Dependency Deduction
If you’re paying for more than 50 percent of your mom’s living costs (housing, food, utilities, medical and dental care, transportation and other necessities), and her 2016 gross income (not counting her Social Security benefits) was under $4,050, you can claim your mom as a dependent on your tax return, and reduce your taxable income by $4,050. Also note that your mom doesn’t have to live with you to qualify as a dependent, as long as her income was under $4,050 and you provided more than half her financial support. If your mother does live with you, you can include a percentage of your mortgage, utilities and other expenses in calculating how much you contribute to her support. IRS Publication 501 (see irs.gov/pub/irspdf/p501.pdf) has a worksheet that can help you with this. To receive this, or other IRS publications or forms via mail, call 800-829-3676.
Shared Support
If you share the financial responsibility for your mom with other siblings, you may be eligible for the IRS multiple-support declaration. Here’s how this works. If one sibling is providing more than half the parent’s financial support, only that sibling can claim the parent. But if each sibling provides less than 50 percent support, but their combined assistance exceeds half the parent’s support. In that case, any sibling
who provides more than 10 percent can claim the parent as a dependent. But only one sibling can claim the tax break in any given year. Siblings can rotate the tax break, with one claiming the parent one year, and another the next. The sibling who claims the parent as a dependent will need to fill out IRS Form 2120 (irs. gov/pub/irs-pdf/f2120.pdf) and file it with his or her tax return.
Medical Deductions
If you can’t claim your mom as a dependent, you may still get a tax break for helping pay her medical costs. The IRS lets taxpayers deduct money spent on a parent’s health care and qualified long-term care services, even if the parent doesn’t qualify as a dependent. To claim this deduction, you still must provide more than half your mom’s support, but your mom doesn’t have to be under the $4,050 income test. And the deduction is limited to medical, dental and longterm care expenses that exceed 10 percent (or 7.5 percent if you’re 65 by Dec. 31, 2016) of your adjusted gross income. You can include your own medical expenses in calculating the total. See the IRS publication 502 (irs.gov/pub/irs-pdf/p502.pdf) for details.
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Dependent Care Credit
If you’re paying for in-home care or adult day care for your mom so you are free to work, you may also be able to claim the Dependent Care Tax Credit, regardless of whether or not your mom qualifies as a dependent on your tax return. This credit can cut up to $1,050 off your tax bill for the year. In order to claim it, you must fill out IRS Form 2441 (irs.gov/ pub/irs-pdf/f2441.pdf) when you file your federal return.
Check Your State
In addition to the federal tax breaks, more than 20 states offer tax credits and deductions for caregivers on state income taxes too. Check with your state tax agency to see what’s available. For links to state tax agencies see taxadmin.org/state-taxagencies.
• Free Heat/Water/Cable • 24 Hr. Maintenance • Elevator Service • Salon/Exercise Room • Social Activities • Indoor Mail/Laundry …And More!
Saturday February 4th: 11am - 1pm Thursday February 16th: 11am - 1pm PLANNED ACTIVITIES
• 55+ adult community • Rent includes heat, water and Time Warner Cable • Van Service, Beauty Salon & Fitness Center
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Health News ECMCC board chairwoman to serve on state board Erie County Medical Center Corporation (ECMCC) Board Chairwomen Sharon L. Hanson has been appointed to the governing board of the Healthcare Trustees of New York State (HTNYS). The HTNYS board is composed of 25 trustees who represent 500 hospitals, continuing care organizations, and health systems from all regions across the state. “I am honored to join representatives from other healthcare organizations across the state on the governing board of the Healthcare Trustees of New York State,” said Hanson. “I am particularly Hanson proud to represent the thousands of caregivers from our ECMCC family, advocating on their behalf as well as other healthcare providers in Western New York and across New York, who are committed to providing the best healthcare services to the patients who seek our care.” “This is a tremendous honor for Sharon and recognition of ECMCC’s stature as a valued and important healthcare organization,” said ECMCC President and CEO Thomas J. Quatroche, Jr. “Sharon’s selection to serve on the HTNYS board is a testament to her dedication to ECMCC, and her healthcare knowledge and experience that comes from her many years of service on the ECMCC board. We are thrilled that Sharon will be representing ECMCC on this prestigious board and we congratulate her!”
P² Collaborative has new board members for 2017 The P² Collaborative of WNY board of directors voted to approve the addition of three community members to its 2017 board of directors. They are: • Elyse Burgher, field nutritionist with the Just Say Yes to Fruits and Vegetables program at the Food Bank of Western New York. She teaches food pantry clients healthy eating techniques and food resource management. • Elizabeth “Betsy” Lansing, the manager for Associate Well-being Initiatives at Rich Products. Lansing oversees all programs and approaches to workplace health promotion and wellness-related initiatives. • Don Lee, president for Glide Health, LLC, is a recognized Health IT thought leader and social media influencer. Lee brings his passion Page 18
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for driving change in the healthcare system and moving towards the Quadruple Aim. In addition of these members, the full 2017 board of directors is comprised of physician Michael W. Cropp, Independent Health; physician Michael Edbauer, Catholic Medical Partners, Catholic Health System; physician John Fudyma, State University of New York at Buffalo; Richard D. Hague Jr., Mount Erie Baptist Church, George Nicholas, Lincoln Memorial United Methodist Church, Nancy Nielsen, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Robert Patterson, Bond, Schoeneck and King, PLLC; Patrick Reen, consumer; physician Thomas Schenk, BlueCross BlueShield of Western New York; Jeffrey Streb, Ingram Micro; Franca Trincia, consumer; Arthur Wingerter, Univera Healthcare.
BlueCross BlueShield launches “Point of Health” BlueCross BlueShield of Western New York has recently launched “Point of Health”, a free audiocast featuring thoughts from leaders in health care and the health insurance industry. The audiocast, the first of its type in Western New York, will offer listeners a variety of perspectives on key topics and issues in the rapidly changing healthcare industry. Listeners can access 15-minute episodes of “Point of Health” bimonthly by visiting bcbswny.com/ pointofhealth. Research suggests that podcasting is now the fastestgrowing means of communication on the Internet with one in five Americans now listening to a podcast monthly, a 23 percent increase between 2015 and 2016. About 88 percent of those individuals listen to most or all episodes in a series. The premiere episode of “Point of Health” features “Six Easy Steps for Better Health in 2017,” with insights from physician Thomas Schenk, senior vice president and chief medical officer at BlueCross BlueShield of Western New York visi.. “For 80 years BlueCross BlueShield has been in Western New York, and “Point of Health” allows us to share information and connect with listeners on trends and issues in the ever-changing health care and insurance industry,” said Point of Health’s host and BlueCross BlueShield’s vice president of corporate relations, Julie R. Snyder.
ECMC awarded Gilead Sciences “focus grant” Erie County Medical Center (ECMC) has been awarded a $351,289 grant from Gilead Sciences, Inc., to develop a replicable model program that embodies best practices in HIV and/or hepatitis screening
and linkage to care. The biopharmaceutical company Gilead researches, develops, manufactures and markets human pharmaceuticals for certain diseases, including the hepatitis C virus (HCV), hepatitis B virus (HBV) and the Human Immunodeficiency Virus (HIV). Gilead will provide these funds to ECMC through its Frontlines of Communities in the United States program to financially support these efforts. “We are thankful to Gilead for this grant, which will enable ECMC to better serve patients and improve their quality of life,” said ECMCC President and CEO Thomas J. Quatroche Jr. “The Centers for Disease Control and US Preventive Services recommendations, backed by this key support from Gilead, will help our caregivers to more effectively address the health and wellness needs of these patient populations throughout Western New York.” ECMCC Immunodeficiency Program Manager Ellen O’Brien said, “We are grateful to Gilead for granting these funds. These dollars will enable us to develop a program structured to deal with the current gap in care caused by the inability to identify and ultimately treat many HIV-, Hep C- and Hep B-infected
Behavioral Health Organizations to Merge Child & Adolescent Treatment Services and Lake Shore Behavioral Health to become Bestself Behavioral Health The boards of directors of Child & Adolescent Treatment Services and Lake Shore Behavioral Health recently announced that their merged organization will be called BestSelf Behavioral Health, serving individuals, families and the community. Employing more than 540 people, the new organization will be one of the largest communitybased behavioral health organizations in Western New York, offering family-focused, quality mental health and substance abuse services for children and adults. The target date for finalizing the merger is April 1, pending approvals by all necessary regulatory and legal authorities. “This merger is not about being bigger. It’s about being better. It’s about taking the necessary steps to create the most comprehensive mental health and substance abuse resource in the region,” said Ellen Bieler, board chairwoman of BestSelf Behavioral Health. “It’s about providing our community with the best programs and the best services in the best way we possibly can.” For more than three years, the board of directors and organizational leadership of the two organizations have been working to
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2017
individuals.”
BlueCross and Roswell Park announce agreement BlueCross BlueShield of Western New York and Roswell Park Cancer Institute recently announced a three year (2017-2019) contractual agreement that ensures BlueCross BlueShield’s membership will continue to have uninterrupted access to Roswell Park and the comprehensive cancer center’s affiliated physicians. BlueCross BlueShield members can continue to access comprehensive treatment and oncology services for all types and stages of cancer, including complex or advancedstage cancer, at Roswell Park, which is designated as a Blue Distinction Center for Transplants and a Blue Distinction Center for Complex & Rare Cancers by the BlueCross BlueShield Association. BlueCross BlueShield continues to offer the largest hospital and physician network in the region including Roswell Park, CCS Oncology, Cancer Care of Western New York and other leading cancer care providers. Although terms of the agreement were not disclosed, Ron Mornelli, BlueCross BlueShield senior vice president, chief network officer, said explore all of the possibilities and taking the necessary steps to form a new organization whose mission is to provide continuity of care to individuals across the age spectrum and their families, driving better outcomes in the short and long term. “It has been a long journey however in 2017 we will finally see our efforts come to fruition — as we become one, unified organization that can serve more people, more ways, in more places than ever before,” said Howard Hitzel, president and chief executive officer at BestSelf Behavioral Health. “As both organizations finalize the process of officially coming together, we are committed to working hard to create an innovative organization that will serve individuals and families each day and continue to work toward reducing the stigma of mental illness and substance abuse disorders,” Hitzel said. The United Way of Buffalo & Erie County provided financial support when the affiliation between the two organizations became formal three years ago. In addition to that continued support, the local foundation community is working together to provide significant financial support for the merger. To date, $650,000 has been raised from the John R. Oishei Foundation, Peter and Elizabeth C. Tower Foundation, Community Foundation for Greater Buffalo, Garman Family Foundation and other supporters.
Health News that the new agreement reflects the insurer’s focus on shifting away from traditional fee-for-service reimbursement based on volume of care delivered to a value-based model that rewards quality and focuses on improving outcomes. “In order to address the rising health care costs that drive insurance premiums for employers and members, we are working with valued health care providers in the community, like Roswell Park, to change the way health care is financed,” said Mornelli. “Roswell Park is a long-standing and important provider of cancer care in our network and we are pleased to continue the next phase of our relationship.” “This agreement provides us with new opportunities to provide outstanding care for cancer patients,” said Roswell Park President and CEO Candace S. Johnson. “Our continued collaboration ensures that BlueCross BlueShield of Western New York members will have access to expert oncology care, the newest therapies and state-of-the-art medical care provided by more than 300 physicians across all three Roswell Park locations and the Institute’s five affiliated community practices.”
In 2016 ECMCC had busiest year ever The year 2016 was the busiest year in the history of Erie County Medical Center Corporation (ECMCC), according to a recent announcement. From emergency room visits to outpatient visits to both inpatient and outpatient general surgeries, the key categories for measuring ECMC’s operations
in good
demonstrated strong, positive growth. “2016 proved to be ECMC’s best year, which is a testament to our extraordinary caregivers who, through their dedication, empathy and skill, have transformed ECMC to the hospital of choice for Western New York,” said ECMCC President and CEO Thomas J. Quatroche Jr. “While still meeting the important healthcare needs of our region’s citizens and trauma patients, our hospital, working collaboratively with key partners like Kaleida Health, the University at Buffalo and community providers, has established itself as a true regional hospital that is well equipped to provide high quality services in a variety of areas, including orthopaedics, transplantation and kidney care, bariatrics, behavioral health, head and neck oncology and primary healthcare. These results highlight the incredible commitment of our over 3,000 exceptional and compassionate healthcare professionals, ensuring that our patients receive the highest quality care and their families and loved ones are treated with dignity and respect.” Physician Samuel Cloud, 2016 president of ECMC’s medical-dental staff, said, “ECMC is a truly regional hospital, serving the residents of Western New York with a high level of quality healthcare that is supported by a strong culture of physicians, dentists, advanced practice providers, and nurses who are focused on the very best outcome for the patients who seek our care. Through strong collaborations across multiple disciplines, ECMC’s caregivers focus on providing the best care and outcomes for our patients.”
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