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APRIL 2022 • ISSUE 90
HOW TO SLEEP BETTER Researchers at the University at Buffalo School of Nursing and Roswell Park Comprehensive Cancer Center are conducting an insomnia study to help cancer patients get a better night’s sleep. PLUS: Writer Anne Palumbo, author of SmartBites, lists seven types of food that can help you sleep better. PAGES 19 AND 20
GOING ON A
WEIGHT GAIN JOURNEY TREMORS, PARKINSON’S DISEASE Daniel Sirica is an UBMD neurologist. He discusses tremor, Parkinson’s disease — and how deep brain stimulation can help improve some motor symptoms. P. 4
MENTAL HEALTH n Signs you need mental health help n Poor body image affects teens’ mental health n How poor mental health can decrease longevity
Most diets are geared toward losing weight. Less often do we hear about individuals trying to gain weight. An estimated 462 million adults worldwide are underweight. Writer Amanda Jowsey of Tonawand talks about her journey to gain weight. P. 10
U.S. Traffic Deaths Rise to Highest Level Since 2007
E
ven though Americans drove less in the early days of the COVID-19 pandemic, close to 39,000 lives were lost on U.S. roadways in 2020 — the highest death toll since 2007, the U.S. National Highway Traffic Safety Administration (NHTSA) reports. Fatal collisions spiked almost 7% between 2019 and 2020, the safety administration revealed in its annual crash report. “The tragic loss of life of people represented by these numbers confirms that we have a deadly crisis on our nation’s roads,” said Steven Cliff, NHTSA’s deputy administrator. “While overall traffic crashes and people injured were down in 2020, fatal crashes and fatalities increased,” Cliff said in an agency news release. “We cannot allow this to become the status quo.” In 2020, the fatality rate per 100 million vehicle miles traveled rose to 1.34, a 21% increase from 2019. When many Americans were in lockdown, road deaths increased even though total vehicle miles traveled fell by 11% from 2019 to 2020, the data showed. Risky behaviors contributed to many of these tragedies: In 45% of fatal crashes, drivers of passenger vehicles were either speeding, impaired by alcohol or not wearing a seat belt. Other major findings from the 2019-2020 data: • Deaths involving drunk driving jumped 14%. • Deaths of people in passenger
cars increased 9%, and deaths of unrestrained people in passenger vehicles rose 14%. • Motorcyclist deaths rose 11%, reaching the highest number since data was first collected in 1975. • Bicyclist deaths increased more than 9%, hitting the highest number
declined 1.3%. • Police-reported crashes declined 22%. • Number of people injured fell 17%. “This sudden uptick of lives lost in preventable crashes is caused by a combination of factors,” said Pam Shadel Fischer, senior director of external engagement with the Governors Highway Safety Association. “The safety of all road users must be the top priority when it comes to roadway design. We continue to face an ongoing safety crisis threatening people walking, biking, scooting and rolling. Drivers are still engaging in risky behaviors that put all road users at risk,” Fischer said in an association statement. “The U.S. Department of Transportation has established a national framework for action in its new National Roadway Safety Strategy based on the Safe System approach. However, more action is clearly needed on the federal, state and local levels,” Fischer said. The DOT strategy calls for safer roads, safer people, safer vehicles, safer speeds and better post-crash care. “The rising fatalities on our roadways are a national crisis; we cannot and must not accept these deaths as inevitable,” U.S. Transportation Secretary Pete Buttigieg said. “People should leave the house and know they’re going to get to their destination safely,” Buttigieg added in the NHTSA news release.
since 1987. • Fatalities in cities rose almost 9%, and pedestrian deaths approached 4%, the highest number since 1989. • Deaths in hit-and-run crashes jumped 26% • Deaths in large-truck crashes
CELEBRATE NURSES WEEK WITH IN GOOD HEALTH In Good Health will once again highlight Nurses Week in a special section with several articles on the nursing profession, education, and more. Let your nurses know what an incredible job they’ve done throughout the year. Say “thank you” with an ad!
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4:58 PM3 April 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper3/21/22 • Page
Meet
Your Doctor
By Christopher Motola
Daniel Sirica, MD
UBMD neurologist expert in movement disorders discusses Parkinson’s disease — and how deep brain stimulation can help improve motor symptoms Q: So you specialize in movement disorders? Yes, correct. I did my neurology residency and then I did a one-year fellowship in movement disorders. Q: What kinds of conditions would fall under the category of movement disorders? It’s pretty wide-ranging, but the majority of patients I see have Parkinson’s disease. Tremors are also very common, specifically essential tremor disorder. But there are other, more wide-ranging movement disorders like dystonia, ataxias and diseases where there’s abnormal involuntary movements. Q: What causes movement disorders? Do the problems originate in the brain or another part of the nervous system? With Parkinson’s disease, there’s a loss of dopaminergic neurons that receive a neurotransmitter called dopamine. As they degenerate over time, patients will begin to experience the symptoms of Parkinson’s disease. With some other movement disorders we deal with, we don’t always know the true pathology behind it, but with Parkinson’s we do know it’s related to dopamine and we know what part of the brain is affected. Q: I understand you have an interest in something called deep brain stimulation. How does that work? So far [with] Parkinson’s disease, we try to split it up into two categories. One is motor symptoms, the other is nonmotor symptoms. Early on in the disease, the motor symptoms are the most troublesome. We do have medications that can help with symptoms. None of our medications, unfortunately, slow down the progression of the disease, but they can be very helpful for symptom control. Everyone is a little bit different, so it’s important to have individualized approaches for determining
Page 4 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
which medications may be more helpful than others, what type of dose is appropriate, or how frequently the medication should be taken. It’s important that it can be adjusted over time as well. There are also some nonmotor symptoms. Things like mood, cognition. With a select few patients we’re able to have them undergo deep brain stimulation. We target an area of the brain where we can provide electric activity, which can result in improved motor symptoms. There’s a pretty comprehensive evaluation, and we try to pick patients who it will help the most. Q: You mentioned there wasn’t currently any way to stop the progression of Parkinson’s disease. Are there any promising treatments on the horizon? Currently we do not have any medication that slows the progression, but there is a lot of research being done. We’re constantly looking for biomarkers and things we can measure to see what changes and how much during disease progression, and to find disease-modifying agents. Hopefully we’ll undercover one. Q: You’re originally from Buffalo and have ended up practicing here. What are some of the things you like about practicing neurology here, specifically? I think just being from Buffalo, having these resources in my backyard, has been great and very rewarding. I’ve been lucky enough to have a lot of mentors and people within neurology who have helped with my training and given me career advice. It really was a no-brainer for me. I have family here. I want to help patients in Buffalo and my community, so it’s been a great start. Q: What is dystonia? It’s a large group of disorders. It’s pretty much
diseases of abnormal muscle contractions. They can affect one area of the body or be generalized. One type I often see is cervical dystonia. We can provide treatment with botulinum toxin injections, which can help with this disorder. There are also some medications that can be helpful for these patients. Q: How does botulinum toxin help? Does it paralyze the muscles being targeted? The goal of it is to try to weaken overactive muscles and make them more balanced. Sometimes there are tremors involved with the muscle contractions and it can help with that. Basically we use it to try to improve the patient’s quality of life. Q: Generally speaking, are movement disorders age-related? It depends on the disorder. Parkinson’s tends to affect people over the age of 50. Essential tremor disorder can affect patients when they’re younger, even in their early adult life, but it can also can start later in life as well. So there’s a heterogenous population, but typically with Parkinson’s it’s more late onset. Though you do see early onset here and there. Q: How do you go about diagnosing a disease like Parkinson’s before it’s progressed to an advanced level? With Parkinson’s disease there’s no blood test or imaging that will detect it. So a lot of it is based on clinical examination. We look for certain features like tremors. When does the tremor occur? We look at the speed of movement, how the patient walks. And we try to piece it all together. Sometimes in their history there are some features that tend to go along with Parkinson’s disease. So it’s important to get a very good history and perform a complete neurological exam. Q: How can patients maintain the health of their neurological systems? For our patients aerobic activities are very helpful. We also encourage exercise that strengthens core muscles for balance. We want to keep our patients ambulatory and independent for as long as possible, and to help them avoid damaging falls. I think it’s also important with Parkinson’s disease to have a very strong support system, to network and to not have a sedentary lifestyle. One thing that’s rising in popularity is Parkinson’s boxing. Having better balance and control of big movements can help patients. Q: So is that meaning learning actual boxing movements? You’re not actually boxing someone, but it does involve putting on the gloves and get taught different types of movements that may be helpful for balance. And learning to move more smoothly with bigger amplitude movements. There are a couple places in Buffalo that do it, and there are a lot of places throughout the country.
Lifelines
Name: Daniel Sirica, M.D. Position: Assistant clinical professor of neurology at UBMD Hometown: Buffalo, born and raised Education: University at Buffalo Affiliations: Kaleida Health Organizations: American Academy of Neurology; Movement Disorder Society Family: Wife; one child on the way Hobbies: Golf; Bills fan
NIAGARA COUNTY DEPARTMENT OF HEALTH CLINICAL SERVICES
IMMUNIZATION CLINICS
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Niagara County Department of Health provides all required and recommended vaccines per the Advisory Committee on Immunization Practices (ACIP) guidelines. We offer vaccines to prevent the following diseases: • • • •
COVID-19 Chicken Pox Haemophilus Influenza Hepatitis A and Hepatitis B
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*For Travelers Let us assist you in making your international travel safe and healthy. Niagara County Department of Health is an authorized Yellow Fever Vaccine Administration Center. We will provide you with an International Certificate of Vaccination.
COVID-19 • Free COVID-19 testing on Monday and Fridays at our Niagara Falls office from 9:00am to 12:00pm for Niagara County residents. Registration is encouraged.
• For our community based COVID-19 vaccination clinics, please visit: http://www.niagaracounty.com/health/Services/Nursing-Division or scan the above QR code.
GET YOURSELF TESTED AT THE NIAGARA COUNTY SEXUAL HEALTH CENTER STI TESTING CLINICS Trott Access Center, 1st Floor, 1001-11th St., Niagara Falls, NY 14301 Reopening April 5th Tuesdays and Thursdays, 9:00am to 3:00pm 716-278-1900 No appointment needed. Confidential testing, treatment and counseling also available for anyone 12+. Parental consent is not necessary.
Scan with your smartphone for the SEXUAL HEALTH CENTER webpage. April 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 5
2022’s Most Obese Cities in the U.S.
T
he personal-finance website WalletHub recently released its report on 2022’s Most Overweight and Obese Cities in the U.S., as well as accompanying videos and expert commentary. In order to call attention to the communities where weight-related problems are most prevalent, WalletHub compared 100 of the most populated U.S. metro areas across 19 key metrics, used to determine a total score out of 100 (see chart at right). The data set ranges from the share of physically inactive adults to projected obesity rates by 2030 to healthyfood access.
Key Stats • The McAllen, Texas, metro area has the highest share of obese adults, 44.90%, which is 2.4 times higher than in Asheville, North Car-
olina, the metro area with the lowest at 18.50%. • The McAllen, Texas, metro area has the highest share of physically inactive adults, 36.90%, which is 2.7 times higher than in Grand Rapids, Michigan, the metro area with the lowest at 13.90%. • The El Paso, Texas, metro area has the highest share of diabetic adults, 16%, which is 2.6 times higher than in Reno, Nevada, the metro area with the lowest at 6.20%. • The Jackson, Mississippi, metro area has the highest share of adults with high blood pressure, 40.60%, which is 1.8 times higher than in San Jose, California, the metro area with the lowest at 22.80 %. To read the full report and your city’s rank, visit: https://wallethub. com/edu/fattest-cities-in-america/10532.
MOST OVERWEIGHT & OBESE CITIES
01 02 03 04 05 06 07 08 09 10
McAllen, Texas Total Score: 84.78 Memphis, Tennessee Total Score: 83.94 Knoxville, Tennessee Total Score: 83.92 Mobile, Alabama Total Score: 83.04 Jackson, Mississippi Total Score: 82.94 Birmingham-Hoover, Alabama Total Score: 82.91 Little Rock-Conway, Arkansas Total Score: 82.82 Shreveport, Louisiana Total Score: 82.76 Augusta, Georgia Total Score: 82.42 Baton Rouge, Louisiana Total Score: 81.91
11 12 13 14 15 16 17 18 19 20
WALLETHUB, MAR. 2022
Chattanooga, Tennessee Total Score: 80.50 Lafayette, Louisiana Total Score: 80.28 Myrtle Beach, South Carolina Total Score: 78.39 Youngstown, Ohio Total Score: 78.24 Huntsville, Alabama Total Score: 78.24 Winston-Salem, North Carolina Total Score: 78.06 Wichita, Kansas Total Score: 77.95 Nashville, Tennessee Total Score: 77.65 New Orleans, Louisiana Total Score: 77.54 Fayetteville, Arkansas Total Score: 77.29
Healthcare in a Minute
By George W. Chapman
Alexa, Please Connect Me with My Doctor…
D
epending on where you stand, the corporatization of healthcare is either an unnecessary and unwanted intrusion into your healthcare or a welcome improvement. Amazon, the corporate giant with seemingly unlimited resources, has partnered with Teladoc, an online 24/7medical service, to provide virtual on demand, nonemergent care. On the surface, 24/7 on demand care provided by out-of-network providers is not new. The twist here is you contact the provider through an echo device like Alexa. As crazy as it sounds, several hospital and physician systems have already signed up, including Boston Children’s,
Cedars Sinai and Houston Methodist. It remains to be seen how well out of network Teladocs can be successfully integrated into comprehensive hospital and physician systems that are in the midst of organizing to accept reimbursement from insurance companies based upon value added or overall outcomes. Alexa type Teladoc services can relieve the pressure on overworked hospital and their network providers and certainly offer consumers convenience. Unless these services are effectively integrated into hospital and physician systems, they will be perceived as intrusions upon and leakage from value-based care.
Telemedicine in Jeopardy
reimbursement. And consumers, who have come to embrace telemedicine, will be denied a convenient way to access and maintain their care. President Biden has threatened to veto the bill.
They say necessity is the mother of invention. When it came to telemedicine, the necessity created by the pandemic didn’t exactly invent telemedicine, but it certainly expanded its use to the point where it is now firmly entrenched in healthcare delivery. When a public health emergency was declared two years ago to combat the virus, Congress and Medicare authorized both the expanded use of telemedicine and enhanced reimbursement to providers. Providers are paid the same for in-person and virtual visits. Telemedicine proved to be a critical and effective tool to combat the virus, protect staff from infected patients and not harm providers financially. The senate just voted 4847, along party lines, to terminate the PHE. It now goes to Congress. If passed, it could virtually kill telemedicine. Providers cannot afford to offer telemedicine if there is a return to pre-pandemic inadequate
More COVID-19 Money The Office of Management and Budget is requesting another $22.5 billion from Congress to continue the fight against the virus. Just over half of the new funding would go toward buying more medicines, vaccines, boosters, oral anti-virals and monoclonal antibodies to treat those infected. Roughly $2 billion is for testing and much needed financial support for inundated commercial and public health labs. $1.5 billion will provide coverage for the uninsured and a similar amount is slated for research on next generation vaccines. The bill contains no additional relief for hospitals and physicians who have absorbed both financial and staffing losses fighting
Page 6 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
the virus over the last two years. To add insult to injury, a moratorium on a bill that would reduce their reimbursement by 2% expires in April.
CVS Philanthropy? The retail drug giant announced it invested $185 million in 6,600 affordable housing units in several cities throughout the US. Poor or lack of safe housing is a social determinant that negatively impacts both access to and outcome of care. Residents of the CVS subsidized housing now have access to a variety of services conveniently provided by CVS-like pharmacies, durable medical equipment and clinics. Kudos to CVS. Right? Last year, CVS revenues were $77 billion, resulting in net cash flow of an astounding $13 billion. The $187 million “investment” in affordable housing is a paltry 1.4% of their $13 billion net cash flow. It is virtually nothing compared to $77 billion in revenues. So, is there an ulterior motive? You be the judge. Hospitals and physician healthcare systems can’t afford to provide subsidized housing to improve the care provided to their patients. Their reimbursement is fixed by Congress and Medicare and commercial insurers typically follow suit. Drug prices continue to escalate unregulated or encumbered by Congress andMedicare, so CVS and other drug giants can easily afford to reinvest their profits and capture market share.
Physician Shortage Addressed Aging baby boomers and early retirement due the pandemic have increased fears of an impending physician shortage. Certainly, the unencumbered increase in nurse practitioners and physician assistants has helped mitigate the shortage. But there has not been an increase in the number of encumbered physician
residency slots in decades. Congress and Medicare finally authorized the funding of an additional 1,000 residency slots in teaching hospitals with emphasis on hospitals serving health professional shortage areas which are typically inner city and rural. Medicare pays hospitals for resident salaries and related teaching expenses. The biggest change in residency slots will be a preference among hospitals for primary care versus specialty slots.
Cost of Insulin Diabetes is one of our most pervasive, but treatable, chronic conditions impacting the lives of millions. President Biden vowed to cut the cost of insulin when he addressed the union in early March. One in four insulin users cannot afford to use the drug as prescribed, which inevitably will result in other serious conditions. Since not one for-profit insulin manufacturer has offered to help, not-for-profit drug manufacturer Civica Rx is partnering with BlueCross BlueShield and health system giants Intermountain Health, Trinity Health, and Kaiser Permanente to develop and distribute affordable insulin at about $30 a vial by 2024. The price will be based solely on the cost of development, production and distribution. It will be interesting to see if this competition causes current manufacturers to lower their prices. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
Arthritis Is a Scourge Worldwide Arthritis cases worldwide up 113% —from 247.5 million people in 1990 to 527.8 million in 2019
O
steoarthritis has become increasingly common in recent decades, and authors of a new study say preventive steps are needed to bring numbers under control. “The disease burden ... is formidable,” said co-senior author physician Jianhao Lin, of Peking University People’s Hospital in China. “Due to population expansion, aging and the epidemic of obesity, one would expect such a burden would increase in the near future.” The chronic joint disease, which causes pain, disability and loss of function, is a major worldwide public health concern, according to the authors. Their analysis includes data collected as part of an ongoing effort that involves more than 7,000 researchers in more than 156 countries and territories. It found that arthritis cases worldwide rose from 247.5 million in 1990 to 527.8 million in 2019. That’s an increase of more than 113%. Age-adjusted rates of arthritis rose for knee, hip and other joints but decreased for arthritis of the hand. Arthritis prevalence rose with age and was higher in women than in men. It was also higher in more developed countries. Arthritis of the knee contributed the most to the overall arthritis burden, while arthritis of the hip had the highest estimated annual percentage increases in most regions, according to the findings published March 2 in the journal Arthritis & Rheumatology. “Primary and secondary prevention, including refraining from overweight or obesity, preventing knee injury, and avoiding heavy repeated joint-loading activities are effective measures in alleviating the burden,” Lin said in a journal news release. “In addition, exercise therapy could delay functional loss and should be recommended as core treatment” for arthritis of the knee, he added.
Arthritis prevalence rose with age and was higher in women than in men. It was also higher in more developed countries.
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One group of expert emergency physicians. It takes a lot to provide excellence in emergency care. It takes quick and easy access to care, state-of-the-art technology, and most importantly, it takes physicians who have dedicated themselves to achieving excellence every single day. Physicians who have seen it all and know how to handle essentially anything. That excellence can be found at the Emergency Center at DeGraff Medical Park (formerly DeGraff Memorial Hospital). Our physicians are second to none and combined with our highly-trained nurses and staff, they all share one goal – to provide patients with outstanding medical care. In fact, they’re the same physicians who provide emergency care at Millard Fillmore Suburban Hospital.
Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Brenda Alesii, Daniel Meyer, Jenna Schifferle, Ernst Lamothe Jr., Jana Eisenberg, Amanda Jowsey Advertising: Anne Westcott, Amy Gagliano Layout & Design: Joey Sweener • Office Manager: Kate Honebein 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.
Where excellence is. DeGraffEmergency.org April 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 7
‘Diabetes is the number one factor [for kidney disease] because uncontrolled blood sugar is harmful to kidney function. Hypertension is number two. Q. It seems that so many other diseases are consistently in the spotlight and that kidney-related issues are not as prominent even though the kidney is the most transplanted organ and also the most needed. Is that the case? A. Yes, kidney disease is globally underrecognized and Western New York is no different in that way. We want to educate people about risk factors, many of which are not known. For example, a person can lose 90% of kidney function before recognizing that something is wrong.
Q A &
with Jeremy Morlock
Kidney Foundation of WNY’s executive director highlights need for organ donation, says kidney disease is underrecognized By Brenda Alesii
A
s the calendar turns to April, there are plenty of notable days to acknowledge: Ramadan, Passover and Easter, along with some days we may not find quite as appealing like tax day. Among the most notable milestones in April is Donate Life Month, observances to raise awareness and a way to honor individuals who selflessly save lives through the gift of donation. Jeremy Morlock, director at the Kidney Foundation of WNY since 2019, chatted with In Good Health about community awareness and patient support in the eight area counties they serve. ———
Q. What is the mission of the Kidney Foundation and how big is your organization? A. We are a small foundation, consisting of two full-time employees, including me, and many volunteers. We work closely with ConnectLife, which provides us with office space and administrative support. We also partner with the transplant center at ECMC and with dialysis centers. Our mission is to improve kidney health, increase awareness of kidney disease, and support those suffering from disease. While we are most active in Erie and Niagara counties, we strive to improve outreach in all areas, especially rural communities.
5K
Q. What are the main risk factors? A. Diabetes is the number one factor because uncontrolled blood sugar is harmful to kidney function. Hypertension is number two. High blood pressure places extra stress and strain on the tiny, sensitive filters of the kidneys. When the kidneys are subjected to extreme conditions, they don’t filter well and more toxins build up. Other significant risk factors include obesity, heart disease and a family history of kidney disease. With advanced kidney disease, an individual may experience chest pain, dry skin, itching, loss of appetite, muscle cramps, headaches, fatigue and increased or decreased urination. Q. What if blood is spotted in one’s urine? A. Some forms of kidney disease can cause microscopic amounts of blood to be present in urine. Injuries to the kidneys from contact sports can cause blood that is visible in urine or it can be caused by a urinary tract infection or other medical issue. It may not be kidney disease, but it is definitely a reason to see a doctor. Q. What about risk factors for kidney cancer and renal pelvis cancers? A. Smoking is the most import-
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Page 8 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
ant risk factor. The others are those that we discussed as well as the following: taking certain medications for a long time, having a long-lasting infection with hepatitis C, having kidney stones, having sickle cell trait, which is associated with a rare form of renal medullary carcinoma. Another risk factor is exposure to a chemical called trichloroethylene, used to remove grease from metal. Q. What groups are most at risk? A. African Americans, Hispanics, Native Americans and Pacific Islanders. More women are affected by kidney disease caused by lupus than men. Q. What does an individual do if interested in donating a kidney or other organ? A. Anyone 16 or older can sign up with the New York State Donate Life Registry, to be an organ, eye or tissue donor after death. Many people sign up when they get a driver’s license, or you can register online at donatelife.ny.gov. Someone interested in becoming a living kidney donor can contact a transplant clinic to be evaluated. ECMC’s transplant team number: 716898-5001. We’re also working with the National Kidney Donation Organization, which has mentors for prospective living kidney donors and shares information about living donation at www.nkdo.org. Q. Does your organization participate in community outreach programs? A. We sure do. It’s a wonderful way to talk to people about risk factors, disease, prevention, and treatment options like medication and dialysis. We appreciate the volunteers—doctors, nurse practitioners, other medical personnel—who help at the outreach centers by conducting free screenings, BMI calculations, blood pressure, blood sugar and urine analysis. We discuss what it means to have kidney disease, explain about dialysis options, and transplantation. Q. How is your foundation funded? A. Our biggest fundraiser is the Walk for Kidney Health, which will be held at the Outer Harbor on Aug. 21. That is a strategic date because Sundays are the only day that people do not undergo dialysis. Other funding sources come from donations, grants and we receive some financial support from Connect Life. Q. How can people reach you? A. Our website: www.KFWNY. org or call us at 716-529-4390.
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Going On a Weight Gain Journey
… and bringing 462 million adults worldwide who are underweight
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By Amanda Jowsey
aining weight has always been one of my biggest challenges. It’s one of the most conscious efforts I’ve ever had to make. I was built to be small. It takes a complete lifestyle change for me to put on any weight.
By Amanda Jowsey
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ost diets are geared toward losing weight. Less often do we hear about individuals trying to gain weight. An estimated 462 million adults worldwide are underweight. When on a weight gain journey, it’s important to practice healthy and sustainable ways to put on some pounds. Being underweight contributes to malnutrition, a weakened immune system, fragile bones, fatigue, low mood or depression and poor concentration. It can be caused by an underlying medical issue, difficulty finding time to eat healthy meals or a loss of appetite caused by stress. You may be malnourished if you unintentionally lose 5–10% of body weight within three to six months or your BMI is less than 18.5. Emily Wood, registered dietitian and course instructor for the T. Colin Campbell Center for Nutrition Studies, part of Cornell University in Ithaca, has some tips on how to naturally gain a healthy weight. “Diet and lifestyle choices are huge contributing factors. I don’t think people realize how powerful their diet and lifestyle choices really are,” she said. “It’s so much harder to gain weight than for people to lose weight. It’s a lot more difficult than people think. The biggest thing is that you cannot expect immediate results. We get impatient and we quit too soon. You have to be patient, persistent and prepared.” Eat a healthy balanced diet and drink plenty of water. Just avoid too much water before meals as it can make you feel too full to eat. Wood stressed the importance of planning, of knowing what you’re going to eat. “When you leave it to the last second, that’s when we grab for the unhealthy things,” Wood said. Individuals trying to gain weight
The Struggle to Gain Weight
Emily Wood, registered dietitian and course instructor for the T. Colin Campbell Center for Nutrition Studies, part of Cornell University in Ithaca: “If you’re struggling to gain weight, don’t be afraid to consult a nutritionist or dietitian.” should eat healthy calorie-dense foods. “You really want to focus on nuts and seeds, avocado, olive oil or some of the healthy oils, and add in plantbased protein powder in a smoothie or a shake (that’s always a good way to sneak in some extra protein and calories),” Wood suggested. Smoothies are also a great way of getting a highly nutritional boost of calories. Wood makes smoothies every day. “I always recommend a cup of leafy greens (spinach or kale), a banana to add creaminess and calorie density, a frozen fruit of your choice, a few tablespoons of a nut butter, plant-based protein powder, nondairy milk, and flax seed or chia seed. If you make a smoothie out of all those things, you’re going to get a really big bang for your buck as
far as protein and calories are concerned.” When exercising, individuals on a weight gain journey should focus more on strength and resistance training because it will strengthen that metabolically active muscle tissue, which requires calories even when at rest. Whereas cardio will contribute to a greater loss of calories. Try to gain gradually until a healthy weight is reached. “You’re making a lifestyle transition,” Wood said. “It’s not something that’s going to happen overnight.” It is a process. It is about making the choice to take care of your body and committing to it. Making a change to daily habits challenges our basic biology. Our brains are wired to default to routines and patterns created long ago. “Our brain wants to take those old pathways and ingrained routes because it takes less energy for the brain. So basically it chooses those old routines, those old choices. When we’re trying to create these new brain pathways by creating these new habits, our brain is more resistant because it takes a lot more energy to take these new routes,” Wood said. If you’re struggling to gain weight, don’t be afraid to consult a nutritionist or dietitian. “Don’t get discouraged. Don’t be afraid to seek out help. There are so many great dietitians, especially in this area, who could really be of help and support,” Wood added.
Page 10 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
For someone who was built skinny and naturally does not gain weight as quickly as I lose it, eating feels like a chore. It’s hard and sometimes exhausting trying to take care of myself. I’m bombarded with information online. The pressure I feel to eat healthy balanced meals– as often as I should–plus snacks and water. I’m overwhelmed. About two months ago, I started this journey to gain weight. I wanted to feel better. I had very little energy, was frequently cold, and irritable (we can partially thank Buffalo winters for that). My doctor ruled out any underlying medical conditions. Then I realized how poorly I had been eating. I couldn’t find time as a busy mom to take care of myself the way I take care of my daughter. It became all about the healthiest, easiest ways for me to gain weight, to find easy ways to remember what I should be eating, and to make it work in my schedule. This article shares some of the best tips I’ve learned along the way so far. Amanda Jowsey is a freelance writer for In Good Health. She lives in Buffalo with her husband and daughter.
SmartBites
(regular, light, or mix of both)
The skinny on healthy eating Nutritious Potatoes Worth Digging Into By Anne Palumbo
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he average American eats four to five potatoes a week. Surprised? Join the group. Even though this tasty spud is America’s most popular vegetable, it’s also dogged by enough myths to put some of us on the fence about consuming it. Myth #1: Potatoes are starch bombs that cause weight gain. It’s true, potatoes have more starch than most vegetables. And, yes, starch, especially refined starch (think donuts, cookies, cakes), can zip through your body and leave you hungry in no time. But here’s the good news about a potato’s particular starch: It’s a special type of starch known as “resistant starch,” which means it can’t be fully digested or absorbed by the body, much like fiber. Instead, it reaches the large intestine where it becomes a source of nutrients for the beneficial bacteria in your gut. Research has linked resistant starch to many health benefits, including better blood sugar control and improved health of the digestive system.
Myth #2: Potatoes have no nutritional value. Why do we think potatoes are dietary deserts? Is it because they’re pale? A welcome mat for caloric toppings? Too common? Who knows why, but this humble spud deserves its day in the nutritional sun. Drum roll, please: One medium baked potato with the skin has 4 grams of heart-healthy fiber and more than a fourth of our daily needs for three essential nutrients: vitamins C and B6 (both boost the immune system) and potassium (supports healthy blood pressure). Perhaps another drum roll is in order for potatoes being sodium-, fat-, and cholesterol-free! Myth #3: Diabetics can’t eat potatoes. Starchy vegetables such as potatoes can be included in the diet of a person with diabetes, according to the American Diabetics Association. Although most potatoes have a high glycemic index, the effect of potatoes on an individual’s blood glucose level is highly variable and depends on a number of factors, including the kind of potato, how it is prepared, the portion size, and what it is consumed with. Ideally, waxy potatoes (small new potatoes, fingerlings) that have been cooked (and cooled) and then consumed in moderation with a protein or healthy fat would elicit a lower glycemic response. Myth #4: A potato’s skin has all the nutrients. The majority of the nutrients are found within the potato itself, not the skin. The potato’s skin contains about half the total dietary fiber.
Could the Keto Diet Help People With MS?
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he keto diet is a low-carb lover’s dream, but a new study suggests the popular eating plan may also improve some symptoms of multiple sclerosis (MS). MS is an autoimmune disease that occurs when your body attacks
the insulation wrapped around its nerves, causing numbness, fatigue, bladder problems, mood issues and mobility problems that can interfere with daily life. There is no cure for MS. But there may be a way to ease symptoms. In the study, when folks with MS ate a keto diet for six months, they reported less fatigue and depression and an improved overall quality of life. “Our study provides evidence that medically supervised ketogenic diets are safe and tolerable when studied over a six-month period, and convey clinical benefits to persons living with MS,” said study author physician J. Nicholas Brenton. He is the director of the Pediatric MS & Related Disorders Clinic at the University of Virginia in Charlottesville. Keto diets restrict your intake of
Myth #5: A baked potato has 250 calories. Yes and no. Yes, a baked potato laden with butter or sour cream or cheese can have up to 250 calories (or more!). But, no, a plain baked potato has only 110-120 calories.
Helpful tips Look for smooth, firm potatoes with no cuts, bruises or discoloration. Store potatoes in a cool, dark place such as a pantry, away from onions (proximity accelerates spoiling for both). Don’t refrigerate potatoes before cooking because it turns the starch to sugar and ruins the flavor. Potatoes with sprouts can still be used. Just remove the sprouts and cut away any green areas. Stored properly, most potatoes last about a month.
Preheat oven to 400F and lightly oil a 7 by 11 inch baking dish. Slice potatoes thin (about 1/8 inch thick) and layer half of the potatoes on the bottom of the dish, in overlapping layers. Heat 1 tablespoon butter in a medium saucepan over medium heat. Add onion and sauté for about 5 minutes until soft, stirring often. Add garlic, thyme, salt, pepper, cayenne, and flour, stirring until combined, about 1 minute. Slowly whisk in milk and bring to a low simmer, stirring until the sauce thickens and bubbles, about 3 to 5 minutes. Remove from heat and add in 1/3 cup of the cheddar cheese and stir to melt. Pour half of the cheese sauce over the first half of the potatoes and spread out with a spoon. Layer the rest of the potatoes over the top and then pour the remaining cheese sauce on, spreading evenly with a spoon. Top with the remaining grated cheese and bake for 40-45 minutes, until golden brown and bubbly.
Healthier Scalloped Potatoes with Garlic and Thyme Adapted from erinliveswhole.com Serves 6-8
2 lbs. Yukon Gold potatoes (about 3 medium) 1 tablespoon butter 1 small onion, diced 3 cloves garlic, minced 1 teaspoon dried thyme 1 teaspoon salt ½ teaspoon coarse black pepper pinch of cayenne (optional) 1¼ tablespoons flour 1¼ cups reduced-fat milk 1 cup shredded cheddar cheese
Anne Palumbo is a lifestyle colum-
carbs while increasing fats and protein. The goal is to shift from burning blood sugar for energy to a fat-burning state (ketosis), producing weight loss. Exactly how a keto diet improves symptoms of MS isn’t fully understood yet, but the researchers have their theories, starting with the weight loss it induces given the emerging role of obesity in MS. Ketogenic diets may also reduce inflammation and help rebalance the bacteria in the guts of people with MS. Certain gut bacteria create more inflammation in the body and this has been observed in some people with MS, Brenton said. The study included 65 people with relapsing-remitting MS, the most common form of the disease. It is marked by periods of flares followed by remissions. Patients ate a strict keto diet for six months. Researchers measured ketones in their urine each day to see if they were sticking to the diet. (Ketones are produced by the body when it is burning fat for fuel.) Fully 83% of participants adhered to the diet for the six-month study period.
Those who followed the diet had less body fat and showed about a 50% decline in fatigue and depression scores after six months. What’s more, their quality of life and mental health scores improved over the course of the study. They also performed better on tests measuring MS disability. Specifically, study patients walked an average of 1,631 feet on a six-minute walking test at the start of the study, compared to 1,733 feet after six months on a keto diet. Levels of inflammatory markers in their blood also improved through the study period, Brenton said. So, should everyone with MS start eating a keto diet? Not necessarily, Brenton said. There is no one-size-fits-all MS diet. “What works for some patients may not work for others, and accumulating evidence suggests that there are numerous benefits to diet interventions in patients living with MS,” he said. “My current advice is to eat a healthy, well-balanced diet and to maintain a healthy weight, as both of these aspects likely play a positive role in MS.”
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
April 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 11
Jenna Schifferle is a writer from Tonawanda. She runs to stay healthy, challenge herself, and collect new stories to write about.
Writer on the Run By Jenna Schifferle
jenna.schifferle@gmail.com
Petrina Bursie: From Empty Nest to Success
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everal years ago, Petrina Bursie ventured out into the elements on a 7-degree day in Buffalo and started running for the first time ever. A recent empty-nester, Bursie, now 49, had joined a Learn to Run group at Fleet Feet on Delaware Avenue. It was her way of keeping herself busy after her two daughters left home. “I put my running clothes on, laced up and started my journey,” she said. “It was hard and rough, but I met some really fun people. We trained and got it done together.” A lot has changed since Bursie’s foray into running. Today, she serves as race director for the Harriet Tubman 5K, a race she co-founded with a friend. It took place in March. She also sits on the board of the Officially Unofficial Sunday Run group and teaches yoga with a focus on trauma sensitivity at Heart Fire Yoga. She’s run seven half marathons and is a part of at least five different running and fitness groups, including Black Girls Run, Snyder Run Club, Body of Wealth, Fleet Feet, Yogis in Service and November Project. To top it off, Bursie will soon receive her Master of Business Administration degree, an achievement that comes as her oldest daughter, Telliah, graduates with her MBA and her youngest daughter, Ayana, graduates with her bachelor’s degree. Bursie pursued her degree while working full-time as a finance manager at Sodexo and participating in many different fitness groups. Being part of the running community has gotten Bursie outside and helped her discover a deeply rooted love of nature. One of her favorite running routes cuts through Williamsville and ends at Glenn Falls, where she soaks in the sight of her favorite waterfall, the perfect way to end a meditative workout. It’s those
‘When you run, you zone in. There’s just something about being alone, listening to your thoughts, feeling your body move and noticing the concrete underneath you.’
small moments in nature that help Bursie reset and clear her mind to stay centered in her day-to-day life. “When you run, you zone in,”
she said. “There’s just something about being alone, listening to your thoughts, feeling your body move and noticing the concrete underneath
you.” As for what’s next? Bursie has big plans in store in honor of her 50th birthday this January. She’s planning to run a destination race in Miami or someplace warm to mark the milestone. Leading up to that day, she’ll be working on getting faster with a goal of bringing her 5K time down. You’ll see her on the Buffalo Marathon course in May, too. She’ll be running the 5K and then handing out water and nutrition to athletes alongside her fellow Yogis in Service. Look for her toward the end of the course, around mile 11. Through it all, the Buffalo resident remains humbled by the life she leads and eager for all that lies ahead. Her best advice to new runners and athletes is: Have patience with the process and stick with it when things get tough. “Every run has a story. Today’s run may not look like yesterday’s run, but there’s a story behind it, so enjoy it while you’re doing it,” she said. The yogi in her added, “And remember to breathe.” Interested in getting involved? Reach out to the admins of these groups on Facebook to learn more: Officially Unofficial Sunday Run Group, Snyder Run Club Black Girls RUN! Buffalo and Rochester, Body of Wealth, November Project Buffalo, Yogis in Service and Fleet Feet Buffalo.
Mental Health Advocates to Host 60th Anniversary Gala, Honor Advocates
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he Mental Health Advocates of WNY (MHA) will host its 60th Anniversary Gala from 6 to 9 p.m. Wednesday, April, at the Atrium @ Rich’s. This diamond anniversary celebrates 60 years of service to the WNY community. It also serves as the nonprofit agency’s largest annual fundraising event. The event will also recognize individuals and organizations who are making a difference in the mental health community in WNY. • The Buffalo Urban League’s NY Project Hope will be presented with the Community Impact Award. NY Project Hope has made an impact in WNY with respect to mental health issues. This program has made a significant impact by addressing the emotional needs of individuals who are struggling with mental health issues during the COVID-19 pandemic.
• The Suicide Prevention Coalition of Erie County will receive MHA’s Advocacy Award for shedding light on mental health issues and helping to reduce the stigma associated with mental illness. The coalition has worked hard to educate the community on suicide prevention and increase the awareness and understanding of critical mental health issues. • Physician Victoria (Tori) Brooks, clinical assistant professor and medical director of the Comprehensive Psychiatric Emergency Program (CPEP), at Erie County Medical Center, will receive the Professional of the Year Award for her outstanding Tori Brooks
Page 12 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
commitment to the mental health community in WNY. • Stephen Tyrpak of the PQE Group will receive the Courage to Come Back Award for his resiliency and ability to rise above his mental health challenges and share his personal experiences to help individuStephen Tyrpak als who are going through similar situations. After a failed suicide attempt, he began an outreach program to help normalize mental health. He has advocated for policy changes within our government and healthcare systems to better serve those who are hurting. • Jamie Shaner, former member of MHA’s board of directors,
is being honored as Volunteer of the Year. Shaner served on the MHA board of directors for the past 10 years, serving on both the executive committee and development Jamie Shaner committee. • Robin Raphael, a dedicated court appointed special advocate (CASA) volunteer, will be honored as volunteer of the year.
Robin Raphael
MENTAL HEALTH
Mental Health Issues Can Decrease Longevity
Depression, anxiety, schizophrenia can shrink lives of people by 25 years By Deborah Jeanne Sergeant
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eople with bipolar disorder or schizophrenia have “a substantially reduced life expectancy compared with the general population,” according to a study published by the National Institutes of Health. As many as 25 potential years could be lost compared with someone without a disorder. Further studies link depression and anxiety to shorter lifespan and not only because of raised risk of death by suicide. Although risk of
suicide increases with depression and is a very important issue, that risk is statistically minimal compared with other risk factors for decreasing longevity. Mental health’s effect on longevity stems from multiple issues. Although stress may play a role in the decrease in lifespan, Judith Hoeflschweiger, licensed clinical social worker through Employee Resources, Inc. in Buffalo, said that systemic differences in brain chemistry is likely more of a factor, along with “any medications that they may be using” to treat their mental health
Andrew Wilton, licensed clinical social worker in private practice in West Seneca.
Signs You Need Mental Health Help Don’t be afraid to seek help if needed By Deborah Jeanne Sergeant
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veryone occasionally feels blue, upset, worried or “off” emotionally. Feeling in a funk for a couple of days does not necessarily mean you need professional mental healthcare A chat with a friend, taking time to rest or indulging in a favorite hobby may restore your normal mood. But just as physical healthcare
providers check for vitals like breathing, pulse, temperature and blood pressure, a few mental health vital signs can indicate something serious is going wrong. “If you’re not eating well, either under [or] overeating,” said Andrew Mattle, licensed mental health counselor and director of CMH Counseling in Buffalo, as one example of a mental health vital sign. “Or, if you’re not sleeping well or having
problems. “Any of our emotional issues are chemically based beyond day-to-day stressors,” she added. Increased risk of substance use and alcohol abuse among people with untreated mental health issues can contribute to reduced lifespan. Some self-treat mental health with substances or alcohol instead of or in addition to seeking mental healthcare. “Some people are dually or triply diagnosed,” said Andrew Mattle, licensed mental health counselor at CMH Counseling in Buffalo. “They could be dealing with post-traumatic stress disorder and substance abuse and bipolar. It’s not always a oneand-done or one issue.” Substance abuse can contribute to liver and pancreatic diseases and cancer. People not receiving needed mental healthcare are less likely perform vital self care such as eating a balanced diet, engaging in physical activity regularly and monitoring chronic physical health issues. Many of these outcomes stem from lack of self-care and preventive medicine. Untreated depression and other mental illnesses can leave people feeling unmotivated to take basic steps to improve their health or misguided on how to improve their health. “Many mental health problems we identify medically in a diagnostic way are not necessarily neurological in origin,” said Andrew Wilton, licensed clinical social worker in private practice in West Seneca. “They
come from difficult circumstances. It influences people differently.” Resilience—the ability to bounce back—varies among individuals. Some people seem quite resilient; others possess little resiliency. “When we see people with higher adaptability and flexibility, they can move through less predictable and uncertain times in a healthy way,” Wilton said. “It’s about moving through it, not getting over it.” He said that a very small percent of the population has a serious, diagnosable mental health condition. However, someone with a chronic mental health condition that interferes with aspects of daily living should receive professional and personal support. Seeking this support can help mitigate negative effects of mental health issues on longevity. Unfortunately, stigma still presents a barrier to care for many people struggling. “There’s the connotation that seeing a therapist means ‘I’m crazy,’” Mattle said. “People don’t understand bipolar or severe depression if they haven’t experienced it. For them, it can seem a sign of weakness.” Nonetheless, professional sessions, group therapy or medication can reduce the risk of shorter longevity and increase quality of life as well. “It’s important to be aware that mental health and physical health are very closely tied,” Mattle said. “It’s hard to treat one without the other.”
increased struggles at work. Withdrawing can represent another vital sign. Holing up to sleep or engage in activities that are mind-numbing or distracting can indicate an issue. While everyone needs some “me time” to rejuvenate, this goes beyond a typically helpful among of alone time. Dropping typical self-care is only one sign. Someone who normally dresses nicely looks fresh out of bed, for example. Housekeeping and car care may drop off. Formerly enjoyable hobbies may be forgotten, especially if they involve other people. “Communication with others can become difficult,” Mattle said. While many of these factors can present while grieving, a persistent down mood—especially for no apparent reason—they can also indicate help is necessary. Mattle said that a period of grieving differs in that it is situational. Once the person heals from the loss, they start feeling and acting like themselves. Most people have felt down about the changes occurring during the pandemic and have acted in ways they might not normally but employing a healthy coping mechanism can help mitigate that effect. For someone requiring professional care, that mental health first aid isn’t helping much anymore. “For some people, it’s not situational,” he said. “It’s long-term. Maybe it ebbs and flows but it’s always present.” Self-medicating with substances to numb the effects of mental health problems indicates a problem. These include alcohol, illicit drugs or misused over-the-counter or prescription medication.
Feelings of satisfaction with life may be absent. As most regular activities have resumed, some people may wish that they could continue isolating at home. The levels at which people feel comfortable socializing and interacting varies. However, it should not curtail necessary interactions or harm healthy relationships. If mental health struggles interfere with tasks of daily living, such as shopping at the grocery store or maintaining desired relationships, such as meeting a friend for lunch, professional help is warranted. Andrew Wilton, licensed clinical social worker in private practice in West Seneca said that people should be able to answer positively to the question, “Are these areas of my life going the way I want them: family life, social life, work life?” He added that thoughts of selfharm or harm to others can indicate a mental health emergency and the need to call a hotline, 911 or admitting to an emergency room. Another important mental health vital sign is excessive fear and/or worry. While current events certainly have challenged mental health for the past two years, if healthful coping mechanisms are not keeping anxiety under control, Judith Hoeflschweiger, licensed clinical social worker at Employee Resources, Inc. in Buffalo, said that outside help can make a difference. “Especially in the past two years, people feel anxious, disjointed and overly cautious because they’re now unsure of their environment,” she said. “That’s the kind of thing where you’d find a therapist, social worker, psychologist or addiction counselor possibly.”
April 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 13
MENTAL HEALTH
Poor Body Image Affects Teens’ Mental Health Body image in particular for females has always been an ongoing problem By Deborah Jeanne Sergeant
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eens who view their body image negatively experience an increased risk of low self-esteem, depression, nutrition and growth issues, eating disorders and having a higher body mass index of 30 or higher, according to the Mayo Clinic. Some may try to control their weight by smoking, diet pills, taking supplements to increase muscle mass or change their appearance through cosmetic procedures. Oftentimes, teens base their ideal body image on what they see in the media—only now instead of just movies, magazines and television, teens can access media anytime, anywhere. “Social media, for better or worse, contains so much information, some of which is accurate and positive and some of it is inaccurate and negative,” said Joshua Russell, child and adolescent psychiatrist with UB. “It projects unrealistic expectations.” Via social media, anyone has the ability to post and see unrealistic images and videos that portray perfect lives. The software used to improve posts is ubiquitous. Unfortunately, young people tend to view these posts as reality and the ideal to
which they should aspire, whether that’s a svelte figure, chiseled abs or high cheekbones. “It gets harder as kids get older and they have more autonomy,” Russell said. “One of parents’ roles is to have a sense of what social media platforms kids are using, what kind of content is on there, for younger kids, it’s reasonable for parents to have access to passwords to sites to make sure kids are safe and looking at appropriate things. Day to day take a more nonchalant focus on how kids dress and things like that.” Russell likes the positive messages offered by the new Disney movie, “Encanto,” which parents can use to draw attention to different body types. The movie features Mirabel, a teen with a typical body type, and Luisa, a supporting character whose physical strength is her special magi-
HABIT STACKING FOR YOUR HEALTH Little things can add up to big health benefits By Deborah Jeanne Sergeant
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hile not a new concept, the term “habit stacking” was developed by motivation speaker James Clear, to describe of using basic habits to reach larger goals. Most people have at least one health improvement goal, like drinking more water, getting fitter, building more muscle, eating more produce. It’s easy to chalk up their inability to achieve their goal to a lack of willpower. However, busyness and distraction are more likely the reasons. How hard is it to chug a few more glasses of water? But in the hubbub of a frantic day, the water tumbler goes dry and so do the chances of forming that hydrating habit.
Habit stacking can make a new habit stick for good. “From a behavioral psychology perspective, this technique works because a strongly established habit acts as a cue to engage in the new behavior making it part of a routine rather than a standalone change,” said Alison M. Vargovich, Ph.D., clinical psychologist with UBMD Internal Medicine and assistant professor at Jacobs School of Medicine and Biomedical Sciences, University at Buffalo. “This strategy is effective because change is hard and people are busy. It allows for there to be less effortful thought needed to engage in a new behavior. It may take some planning to determine the best way it fits into a person’s life, but once established it is easier. “For example, if I want to eat more fruit, I might place a fruit bas-
cal power. Luisa’s body composition befits her power, as she is tall and muscular. Neither is like the clichéd Disney female with a slim, willowy body type. “It’s useful for parents to not necessarily point out the bodies of those characters, but the positives you see from the characters,” Russell said. “A lot of it is about taking a general approach and expectation that all body types are acceptable. Look at the achievement and hard work that people have done and it has nothing to do with body size and type.” Children should take breaks from social media and to spend more of their down time engaging in activities that build their confidence. Accomplishing goals allows teens to develop a sense of worth outside of their physical appearance. Building meaningful relationships, both ket next to my coffee maker. Every morning, after I get my coffee, I will grab a piece of fruit. This helps to streamline the new habit, until eventually it is part of my routine.” Most people would not skip brushing their teeth. If their goal is to drink more water, setting out a glass near the toothbrush would serve as an easy reminder and readily facilitate getting in extra servings of water. “The key is designating the time to being successful,” said Ariel Wachowiak, licensed acupuncturist, Diplomate of Oriental Medicine, Chinese medicine practitioner and owner of Northeast Integrative Medicine in Buffalo. One of her health goals was to drink more water. She began drinking one glass of water she sees per patient each workday and it works well for her. “If there’s a task that you do several times a day, pick a habit to attach to that task,” she said. “Don’t set goals too ambitiously. Pick one habit at a time to focus on, then build from there after about three months.” She also suggested setting alarms as task reminders. By forcing the new habit to piggyback on one already established, people are less likely to forget. Instead of waiting idly by the coffeepot waiting for the first cup, getting in a few reps with free weights will build more fitness into the day, thanks to the sight of the dumbbells on the countertop. Eventually, picking up the weights
Page 14 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
familial and among friends, can help teens’ self-image, too. Leading by example is how Rodrick Davis, pediatrician at Portland Pediatric Group in Rochester, wants more parents to help their children develop a healthy body image. “If parents are careful to not judge by body size and to recognize that people have different looks and are built differently, that helps,” he said. “Start early on to help them recognize that not everything is within the normal range. If she’s 15, it may be too late. When they’re younger is the ideal time to start.” Parents should praise their children for character and other traits beyond appearance. Modeling healthy behavior can also help children develop a better body image. For example, complaining about one’s weight, going on extreme diets, calling food “bad” or “good” or making derogatory comments about appearance can contribute to body image issues. Instead, parents should emphasize improving health, such as exercising regularly and eating a healthful, balanced diet. Regular exercise does not have to be a gymbased regimen but can include enjoyable physical activities and sports. No foods are “bad” or “good,” but a healthful diet focuses on plenty of fruits and vegetables, whole grains, lean sources of protein, dairy and a few healthful fats, but with minimal processed foods. In addition, a pediatrician can discuss healthy body weight during a well child visit. becomes part of that routine. “The key is to keep it simple and not try to do so many things at one time,” said Mary Jo Parker, registered dietitian in private practice with nutrition and counseling services in Williamsville. She encourages clients to make SMART habit changes: specific, measurable, achievable, relevant and timebound. “Getting in shape” is too vague. However, “moving up to one larger dumbbell” is specific. The new habit should be measurable, like lifting 10 more pounds while performing arm curls. Achievable refers to both the likelihood of accomplishing the goal and the practicality of the habit stack. For example, “I’ll do 25 jumping jacks while waiting for the copier” may prove distracting in an office. But “I’ll pace in my office while on the phone” could work. Relevance refers to your health needs and not some new habit that only sounds good. Timebound references how long it will take to form your new habit. Most experts agree that it takes about three weeks. “When you’re in the kitchen cleaning up dinner, pack your lunch for the next day,” she said. That habit can help you save money and calories and consume more healthful lunches than dining out. With a little strategy, habit stacking can make health goals reality.
Early Signs of Autism Experts offer tips on what to look for
By Deborah Jeanne Sergeant
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utism expert, physician Stephen Shore, once said, “When you meet one person with autism, you’ve met one person with autism.” The oft-quoted comment underscores the uniqueness of any person, including those with autism. While every person is an individual, parents should be aware of traits that could indicate that their children could be on the autism spectrum. • “The autism diagnosis age and early signs vary widely. Some infants show hints in their first few months. Others’ behaviors are more obvious at age 2 or 3. Not all children show all the signs; some with autism show a few. That’s why a professional evaluation is recommended. • “What can show a child is at risk is if the child exhibits shows loss of previous acquired speech, loss of babbling, persistent preference for solitude, avoidance of eye contact, lack of understanding of others’ feelings, repetition of words, resistance to minor changes, narrow range of
interests, repetitive behavior like rocking, flapping or spinning, unusual or intense reaction touch, sounds, texture, taste, lights and or colors. • Not all children with these have autism, not all children with ASD have these. • “Before preschool, as early as 2 or 3 years, a young child’s brain is still forming and is more malleable. Because of this plasticity, the treatment is more effective and skills gained are more automatic.” — Physician Michelle Hartley-McAndrew, an autism spectrum disorder specialist with UBMD Pediatrics and clinical associate professor of Pediatrics at Jacobs School of Medicine and Biomedical Sciences, University at Buffalo and medical director of the Children’s Guild Foundation Autism Spectrum Disorder Center at Oishei Children’s Outpatient Center. • “At an early age, it’s hard because typical toddler behavior can look like it’s behavior on the spectrum. • “If they’re far behind on words, that can be a sign. • “Some will avoid eye contact
Autism Diagnosed in 1 in 44 Kids
Autism may be more prevalent among American children than believed, a new U.S. government study shows
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ne in 44 children at age 8 in the United States have been diagnosed with the developmental disorder, a jump from the previous estimate of one in 54 children, the U.S. Centers for Disease Control and Prevention report found. But a second study offered more heartening news: After looking at 4-year-old children in the same 11 communities analyzed in the first report, researchers found there was progress in the early identification of children with autism. These children were 50% more likely to receive an autism diagnosis or special education classification by age 4 when compared to the 8-year-olds. “The substantial progress in early identification is good news because
the earlier that children are identified with autism, the sooner they can be connected to services and support,” said physician Karen Remley, director of the CDC’s National Center on Birth Defects and Developmental Disabilities. “Accessing these services at younger ages can help children do better in school and have a better quality of life,” Remley said in an agency news release. Still, why autism rates have climbed in recent years remains a mystery, one expert said. “The findings from these two new reports of [autism] prevalence — with varying results across different geographic settings and sociodemographic groups — reflect the many
and socializing. • “Some line things up over and over to the exclusion of playing in other ways. • “My son at 2 stopped eating everything he had liked. • “There are so many variations. As a parent, go with your gut if things don’t seem right. Early intervention is key when you have an early diagnosis. Getting the therapies in early is the best thing anyone can do. Sometimes parents have an idea or the school will say they might be on the spectrum. Sadly, some parents say, ‘I don’t want my child to have a label,’ but without those therapies, you do that child an extreme disservice. None of us want our child to have an illness or disability but when there is a problem, you have to do the best you can to help them. That’s early intervention.” — Debbie Cordone, founder and president of Fantastic Friends of WNY, Cheektowaga. • “For some of the early signs/ symptoms, parents notice differences as early as 18 months to 2 years. • “Some of the core features we see are impairment in social communication, language impairment, impairment in cognition skills and emotional-behavioral challenges. We see differences in sensory and feeding challenges. • “We look at things like joint attention. When you are sharing the focus of two or more people on the same object, like a favorite toy. If you want the baby to engage with a toy and they’re not paying attention. • “There’s no interest in interacting with others. It’s not unusual that at some point kids have to have mom and dad do everything. But there should be some acknowledgement of others, even if they’re afraid of people outside their family. • “They don’t understand if others are happy or sad. • “If you don’t see a word by 12 months, that’s a red flag. • “Also, get a hearing evaluation. Typically, a first word is a person in the child’s environment or a favorite challenges that researchers and public health officials have in trying to determine the true prevalence of [autism],” said physician Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center, in New Hyde Park, on Long Island. “It is important to note that there are significant variations across locations in terms of how and when children with [autism] are evaluated, and it is unclear to what extent these differences reflect true differences in the prevalence of [autism] versus a consequence of the evaluation process,” he added. “These two new reports from the CDC about the prevalence of [autism] among preschool and grade school children raise as many questions as they answer with respect to the many differences that were noted across the eight different geographic settings and the various sociodemographic groups examined.” The new rate was based on 2018 data from 11 communities in the Autism and Developmental Disabilities Monitoring (ADDM) network. Autism rates in those communities ranged from one in 60 (1.7%) in Missouri to one in 26 (3.9%) in California. These differences could be due to how communities identify children with autism, according to the CDC, which noted that some communities
toy. If a child does approximation for words, I’d think to get a speech language evaluation. • “Play issues include interacting with age-appropriate toys in a typical fashion or functional way. If they’re taking blocks and throwing them, that’s not a functional use, or if they’re mouthing items more than anything or trying to ingest them. • “If they’re doing repetitive motions, like spinning the truck’s wheels instead of rolling the truck, that can be a sign. They may have a favorite truck they take everywhere, but they’re using it on the floor, not fixating on the wheel and anything else that spins. When a child is sensory stimming on an item, the attention is very fixated. A wheel just keeps spinning. They could do it for hours. It obsessively catches their interest. • “Things are less obvious like modulating the volumes. They might talk very low or soft. Some kids almost have robotic sounding speech. They have trouble understanding nuances like sarcasm. Kids on the spectrum are very literal speakers. • “When transitioning to table foods, they may be very restricted in foods they’re willing to eat, like they will not eat crunchy foods or like only bland or spicy foods. Some will eat nothing but chicken nuggets. Check with your pediatrician to rule out anything medical. Some kids have eating issues and difficulty with chewing and swallowing. Others just don’t like the texture although they can manage it. • “A child on the spectrum will not exhibit every item on the list. That’s why you should follow up if you’re concerned. Early intervention for kids age 0 to 3 is so critical. The sooner you can intervene, the better the long-term outcome. Any parent who wants an early intervention evaluation should check with their county health department.” — Tracy A. Panzarella, licensed speech-language pathologist, director of Clinical Services, Autism Services, Inc., Amherst. also have more services for children with autism and their families. Study co-author Deborah Bilder, a professor of child and adolescent psychiatry and pediatrics at Huntsman Mental Health Institute at University of Utah Health, said the findings give doctors and families a better road map for diagnosis and treatment. “Early autism diagnosis and treatment optimizes children’s ability to learn, engage with others and develop independence,” Bilder explained in a university news release. “That’s why these studies are so important,” she stressed. “They not only help us get a better idea of the growing prevalence of autism, but can also help us improve policies, services and research directed toward helping children and their families affected by autism.” The reports were published Dec. 2 in the CDC’s Morbidity and Mortality Weekly Report. Researchers also found persistent racial and ethnic differences in the diagnosis of autism. In several of the 11 communities, fewer Hispanic children were diagnosed with autism than Black or white children. Also, Black children with autism were more likely to be diagnosed with an intellectual disability than white or Hispanic children with autism.
April 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 15
Lessons Learned from the Global Pandemic COMMENTARY
‘Hopefully we won’t repeat the same mistakes in the future should we once again face a major public health emergency’
By Daniel Meyer
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e recently entered the third year of the COVID-19 pandemic, a worldwide public health crisis that impacted everyone’s day-to-day routines and claimed the lives of countless innocent souls. I recall in late February 2020 learning about increasing concerns about the “novel coronavirus” and a potential public health emergency. Before we all knew it there was an incredible focus on pandemic preparedness plans but still much uncertainty about what was about to unfold. So much occurred over the past two years that it is difficult to compartmentalize everything. While the rapid development of vaccines and some forms of therapeutics went surprisingly well, other things have gone horrifically wrong and given us all fodder for long-term lessons from the pandemic so we hopefully won’t repeat the same mistakes in the future should we once again face a major public health emergency. I personally experienced heartfelt anguish following the deaths of family members and friends from complications caused by COVID-19. The gut-wrenching agony of what
happened to those victims has dulled somewhat for me as days became weeks and then months and we are fast approaching the one-year or twoyear anniversaries of their deaths. I often compile lists to help me better comprehend most everything I’ve experienced in life. The pandemic completely upended our daily lives, so I believe what would benefit us all would be to take inventory and learn from the experience. Here are four lessons I’ve learned over the past two years. • Vaccines are powerful tools: Preventing disease and avoiding contraction of any illness should be the goal of every human being. The attention that the COVID-19 vaccine received will hopefully motivate everyone to keep up with all their vaccines. Diseases such as measles, chicken pox, shingles and other viruses are preventable. We also learned that a vaccine is not a magic bullet, but having faith and trust in science we should have a medical industry that can build on the strengths we learned from the recent vaccine development strategies that led to the development of multiple vaccines for COVID-19.
Health Careers: Genetic Counselor Annual wage for a genetic counselor in Buffalo: $75,851.
Understanding How Genetic Information Impacts Lives By Deborah Jeanne Sergeant
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any people think of genetic counselors as only pertaining to couples having a baby. However, their work spans the lifetime and can take place in many different settings. Genetic counselors help families understand their health history for managing their own conditions and understanding how it can affect their family. They may work in a clinic, lab or research facility. The most hands-on setting is in a medical clinic, which can include prenatal genetics, pediatric genetics or adult genetics. The least hands-
on setting is in a lab, which is where the testing takes place. Genetic counselors perform the tests and advise medical personnel on how to interpret them. In education, genetic counselors research genetics and teach others who desire to enter the field. Patients seek genetic testing for very serious reasons. What interventions may my baby need? Do I carry a gene mutation indicating a predisposition to a disease? How will my genetics affect my cancer treatment? “You have to have empathy and be able to put yourself in patients’ shoes,” said Jessica Salamone, who holds a master’s in science and is a
• Mental health matters: Now more than ever, highlighting the importance of being aware of any possible cognitive disorders or signs of depression is an issue that must be continuously addressed. Behavioral neurologists and psychologists have presented plenty of research that mental health disorders were already on the rise before the pandemic and have since surged as countless people struggle with some symptom related to either anxiety, depression or post-traumatic stress disorder. By mere virtue of necessity, as a society we can no longer ignore or outright dismiss the key component mental stability has in our overall health and well-being. • Human connection and community collaboration is crucial: Not having some type of support from other people makes for difficult times for most. When you are an active member of your community you have a better sense for the importance of human connection. Even if there are periods of time where faceto-face interactions are not possible and your only choice is to use some form of technology to communicate with others, avoiding long stretches of isolation helps overcome loneliness, which can actually lead to negative impacts on the immune system and become a precursor to some health ailments. Staying connected and finding peace and joy through shared experiences is something we cannot take for granted when given the opportunity to connect with other human beings. • We all have the capacity to be resilient: No matter how much suffering and tremendous difficulty some of us faced over the past two years,
we have learned that it is possible to be resilient during a crisis. Practicing self-care in various ways by adjusting to entirely different work schedules, changing socialization routines and seeking new strategies to cope with stress made me become an absolute believer in the concept of resilience. As difficult as things were at times for all of us during the pandemic, sometimes it is easy to forget how our ancestors persevered through natural catastrophes, world wars and similar public health challenges that included plagues and famines. I also believe that inherently we each have the fortitude and means to deal with and overcome any crisis or major hardship because resilience is part of our psyche that we can develop and strengthen by learning from the COVID-19 global pandemic and all that it presented to us in completely changing our everyday lives. By learning to cope with a flurry of emotions that can include anger, fear, frustration and loneliness, we hopefully developed coping mechanisms that taught us all about the power of perseverance during a two-year stretch that forever changed history while testing our resiliency with a drive to never stop believing that better days always exist in our future.
certified genetic counselor and director of genetic counseling and cancer risk assessment at Elizabeth Wende Breast Care. “You have to have difficult conversations with patients, once-in-a-lifetime conversations. Ten to 12 times a day, you’re doing this.” Elizabeth Wende Breast Care operates offices in Batavia and other locations in Western New York. Most patients know little about genetics, so genetic counselors must know how to help make complex facts simple. Adapting to meet various patients’ communication styles represents a continual challenge for genetic counselors. They must also act as detectives at times. Salamone said that many people do not know much about their grandparents’ or even their parents’ health. Many will not bring up information that they think is irrelevant but is actually important. “You have to pull out information,” Salamone said. Genetic counselors communicate with patients, their primary care providers, lab personnel and insurance representatives. The field is also challenging because the science on genetics changes quickly. As with most medical fields, continuing education credits and periodic exams are required to maintain board certification. Genetic counselors can promote to managerial roles. “It’s incredibly fulfilling,” Salamone said. “I don’t go home wondering what I did for the world. You change people’s lives and that’s an every day, every moment feeling. It doesn’t mean it’s all rainbows and sunshine, but you know you’re impacting people positively. People are thankful that you’re meeting them in
the middle of a crisis. You see some of the weight come off as they know what is going on and they will have a plan. “I’m very proud of the work I do as difficult as it is. It’s a privilege to sit in that sacred place where patients trust you.” The required degree to be a genetic counselor is a Master of Science in genetic counseling. “The specific prerequisite courses differ for each school, but typically include some courses in genetics, organic chemistry, biochemistry, biology, statistics, and/or psychology,” said Mystimarie Geiger, genetic counselor with Wilmot Cancer Institute’s hereditary cancer screening and risk reduction program. A knack for science is helpful. After earning the master’s degree, the candidate must pass the American Board of Genetic Counseling national certification exam. Geiger added that a background in counseling, patient care or other hand-on role can help prepare a candidate. “Genetic counselors are one of the few medical providers who have the time in their schedule to really sit down and speak with a patient,” she said. “Most genetic counseling sessions take about an hour, and the genetic counselor will spend a good portion of that time educating their patient and providing them with psychosocial support.” According to the Bureau of Labor Statistics, a genetic counselor in New York state makes an average mean wage of $96,850 annually. Regional data was not available. Ziprecruiter. com estimates the annual wage in Buffalo as $75,851.
Page 16 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
Daniel Meyer is a lifelong resident of Western New York. He is the former editor of the Hamburg Sun newspaper and is currently the deputy press secretary for numerous departments that comprise the government of Erie County.
South Pointe Senior Apartments • Hamburg 1 & 2 Bedroom Apartments Pet Friendly • Elevator Emergency 911 Pull Cords Central Heat & A/C Indoor Mail • Laundry • Trash
By Jim Miller
What to Do with Cremated Ashes
— Planning Ahead
Dear Planning, There’s no shortage of options when it comes to handling or disposing of your cremated remains after you’re gone. Your family can keep, bury or scatter them in a variety of imaginative ways that reflect your life and personality. Here are some different options to consider. Scatter them: The most popular option is to have your ashes scattered at a location you loved to be, a favorite fishing spot, camping area, golf course, beach, park or at home. If you choose this route, keep in mind that some places, such as national parks, require a permit. And many public areas, like parks or sports stadiums may prohibit scattering. Store them at home: Many families choose to keep their loved ones close, by storing them at home. If you and your family choses this option, you can purchase a decorative urn through your funeral provider or online at Amazon.com. Or you may want to use an old cookie jar or favorite container that reminds your family of you. Bury/inter them: The burial option is good if you wish to have a special place for your family to visit. This is also the only option for cremated ashes sanctioned by the Catholic Church, which specifies that ashes of the dead should be kept in sacred places like a cemetery or a columbarium and not kept at home or scattered. Plant them: If you’re the environmental type, you can have your ashes planted with a tree. There are companies that offer living urns — like TheLivingUrn.com or UrnaBios. com — that mix your ashes with other nutrients that can be used to grow a plant or tree in your yard or a place of your choosing. Scatter them at sea: If you love the water, there are many businesses that offer ash scattering services at sea, especially close to coastal areas,
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A while back I saw an article on different ways to scatter a person’s ashes after they’re cremated, but I’ve misplaced it. Can you help me with this? I’m preplanning my funeral and would like to include instructions on what to do with my remains.
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or your family could rent a boat and do it themselves. There are also companies like EternalReefs.com that offer reef memorials so your ashes can rest on the ocean floor. Scatter them by air: This option will scatter your ashes into the sky so the particles can be taken by the wind. To do this, they could hire a private plane, helicopter or hot air balloon service, or use a balloon scattering service like Mesoloft.com. Or they could even send your ashes into outer space with Celestis.com. Turn them into a record: If you love music, a UK company called Vinlyly (Andvinyly.com) will turn your ashes into a vinyl record. You supply the music (or voice recording) and cover image, and the company creates a memorial that your family can listen to for years to come. Turn them into jewelry or glass: If you love jewelry or glass trinkets, there are companies – like CloseByMeJewelry.com, SpiritPieces. com and ArtFromAshes.com – that will turn your ashes into wearable jewelry or glass art memorials. Go out with a bang: If you’re a hunter or a gun lover, a company called Holy Smoke (MyHolySmoke. com) will create loaded ammunition out of cremated remains. Your family could store the ammo in the engraved wooden box it comes in, or they can send you off in a gun salute. Turn them into art: If you love art, arrange for an artists or family member to paint your portrait, or a picture, with some of your ashes mixed into the paint. Or, if your family is into tattoos, many tattoo artists will mix some ashes with ink to create a memorial tattoo. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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April 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 17
Health News Mental Health Advocates: new board member, new director Mental Health Advocates of WNY (MHA) elected Alexander (Alec) J. Vandenbergh, CPA, to its board of directors. Vandenbergh is a supervisor with the firm Dopkins & Company, LLP certified public accountants and consultants. A member of the firm’s assurance services group, he performs audit and review services, Alec Vandenbergh with special interest in serving health and human services clients. Prior to joining Dopkins & Company in 2018, while attaining his M.B.A., Vandenbergh served a multiyear term with a local charter school in the AmeriCorps VISTA program. He began his career at the school as a resource developer, where he was instrumental in various program, development, and community partnership initiatives, with a particular focus in building supports for students of immigrant and refugee backgrounds. He stayed on with the school after his AmeriCorps service to assist with bookkeeping and other special projects. Vandenbergh received both his Bachelor of Arts and Master of Business Administration in professional accounting from Canisius College. During his time at Canisius, he also completed internships in government and with a local refugee resettlement agency. Amy Szefel Starck joins MHA as director of development, a newly created position. Starck has more than 25 years of nonprofit experience forwarding the missions of educational institutions, health care organizations Amy Starck and social services agencies. She has led several successful major gifts campaigns and fundraising events, including Buffalo Academy of the Sacred Heart’s $4.5 million capital campaign, the Buffalo Brewfest, and the Dennis J. Szefel, Jr. Memorial Golf Tournament to benefit Roswell. Starck holds a Bachelor of Arts in public communications from University at Buffalo and is a graduate of Canisius College Essentials of Fund-Raising Class. In 2012, she completed the Independent School of Management Academy Program. She is a resident of the Elmwood Village and in her free time she enjoys time with her family, traveling and volunteering in the community.
Daemen College is now Daemen University
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he New York State Education Department Board of Regents in March approved an amendment to Daemen’s charter to make the institution a university under the state’s recently revised definition. The name change takes effect immediately. The college will now be known as Daemen University. “We are proud finally to be able to call ourselves what we are — a university,” said President Gary Olson. “In every sense except in name, Daemen has been a university for many years.” Olson added, “I cannot think of a better way to demonstrate Daemen’s growth and sophistication than by reaching this major milestone during our 75th anniversary year.” Daemen was established in 1947 as Rosary Hill College by the
Rehab specialist at Roswell Park earns national award Roswell Park Comprehensive Cancer Center’s Andrew Ray, a rehabilitation specialist, associate professor of oncology in cancer prevention and control, has been recognized by APTA Oncology with the organization’s 2021 Research Award for enduring and outstanding work in Andrew Ray oncologic physical therapy. APTA Oncology, an Academy of the American Physical Therapy Association, is a national group of professionals dedicated to managing the rehabilitative needs of cancer patients and survivors. Research Award recipients have demonstrated “meaningful contribution” to the profession through their studies. The Research Award was presented during APTA’s Combined Sections Meeting Feb. 4. Ray’s research interests include respiratory muscle training, helping to strengthen breathing muscles that may be weakened from disease and surgery. He is currently working on a study funded by a five-year, $3 million R01 grant from the National
Sisters of St. Francis of Penance and Christian Charity. In the 1970s, the private institution became coeducational and independent, and changed its name to honor Magdalen Damen, the founder of the sisters’ order. Now a multi-campus university based in Amherst — with a branch in Brooklyn — Daemen offers undergraduate and graduate programs in the health sciences, liberal arts and other disciplines enrolling more than 2600 students each academic year. The college offers 57 baccalaureate, 31 masters, and 4 doctoral programs. In 2018, the Carnegie Classification of Institutions of Higher Education elevated Daemen to its highest tier: doctoral universities — making the institution one of only three in the region to earn this national designation.
Cancer Institute in which lung cancer patients participate in both physical and respiratory therapy before undergoing surgery, to prevent pulmonary complications after surgery. “Fueled by a personal connection to cancer, Dr. Ray deeply cares about the physical well-being and outcomes of our patients,” said Christine Ambrosone, PhD, chairwoman of the department of cancer prevention and control at Roswell Park. “We are thrilled to see his research be recognized on a national level.” Ray earned his doctorate and physical therapy degrees from the University at Buffalo. In addition to APTA, he is a member of the American College of Sports Medicine and the National Strength and Conditioning Association.
Newsweek names Roswell Park among world’s best Roswell Park Comprehensive Cancer Center has been named to another prestigious ranking of top cancer centers: the “World’s Best Specialized Hospitals for Oncology 2022,” compiled by Newsweek in collaboration with the respected research firm Statista, based on a global peer survey of healthcare professionals. Roswell Park is the only Upstate New York center listed within the top 50 centers in oncology, and the only Buffalo-area center to be included on the full list of 250 top cancer hospitals
Page 18 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
internationally. Newsweek and Statista invited experts all over the world to participate in their online surveys across 10 areas of specialty, collecting data from June to August 2021. Roswell Park was ranked 39 in a listing of international cancer centers based on that survey of more than 40,000 doctors, health care professionals and hospital managers across the world. The questionnaire did not suggest a list of hospitals, and Statista checked all data to prevent self-nomination. “We are proud to see our accomplishments stand out even across a global field of esteemed centers,” said Roswell Park President, CEO and M&T Bank Presidential Chair in Leadership Candace S. Johnson, PhD. “Innovation and successful stewardship of life-changing science have been at the core of Roswell Park’s culture throughout our history, and that legacy shines in the high-impact clinical and research advances that earn our center recognition today.” Newsweek’s goal in compiling these rankings is to provide for patients and providers worldwide “the best data-based comparison of hospital reputation and performance across countries.” “Consistency in excellence is the hallmark of these institutions,” said Newsweek Global Editor-in-Chief Nancy Cooper. “What has set the world’s leading hospitals apart is their continued ability to deliver the highest-quality patient care and conduct critical medical research even as they focused on battling COVID.”
Trocaire College features new ultrasound equipment Students in Trocaire College’s diagnostic medical sonography (DMS) program are now training on the latest ultrasound equipment thanks to a grant from James H. Cummings Foundation. The $110,000 grant covers the cost of new ultrasound machine, training on the equipment, and three years of equipment maintenance. “Our DMS program is at full enrollment and with the pandemic causing changes in healthcare settings, more of our students were using our on-campus equipment to meet their required scan time,” said Jaime White, director of imaging programs, Trocaire College. “It’s important that we offer our students the latest equipment that they will be exposed to in the clinical setting. Thanks to the generous support of Cummings Foundation, we can meet this increased student demand, providing them with more hands-on experience for clinicals and future career opportunities.” James H. Cummings Foundation recognizes the technology and equipment needs of quality healthcare training and education for those entering medical professions and has been a strong supporter of Trocaire and its students for five decades. Most recently, Cummings Foundation funded Trocaire to purchase and implement the SonoSim Ultrasound Training Solution in late 2019, which enabled students to successfully complete their course of study virtually amidst the pandemic.
BETTER SLEEP FOR CANCER PATIENTS, AND EVERYBODY ELSE A UB-Roswell Park study for cancer survivors with insomnia aims to help everyone sleep better By Jana Eisenberg
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ost of us know that exercise, nourishing food and enough sleep are important for good health. But, what about when you can’t sleep well? According to recent statistics from the American Sleep Association, more than 70 million American adults have a sleep disorder; insomnia is the most common form. Its main characteristics are difficulty falling or staying asleep, as well as waking up too early. Aside from being tired, poor sleep can have devastating effects on health, function and well-being. Insomnia is even more prevalent in cancer survivors. According to recent National Cancer Institute statistics, there are an estimated 16.9 million cancer survivors in the United States; that number is projected to increase to 22.2 million by 2030. And an estimated 40% of them report sleep disturbances, sometimes even years after completing treatment. Little research exists on strategies to effectively reduce insomnia in cancer survivors. That is part of the reason why researchers at the University at Buffalo School of Nursing, in partnership with Roswell Park Comprehensive Cancer Center, are conducting an insomnia study for this group. The study is actively recruiting eligible participants—survivors of colorectal, prostate or lung cancer in the Western New York area who have trouble sleeping. Lead investigator Grace Dean, a professor at UB, and Donna Tyrpak, a study coordinator, posit that with minimal education, anyone with insomnia can learn how to sleep better. Notably, this nonpharmacological intervention, or treatment does not include any drugs or medication.
Lead investigator Grace Dean (left), a professor at UB, and Donna Tyrpak (right), a study coordinator, posit that with minimal education, anyone with insomnia can learn how to sleep better. Rather, the study is behavior-based, testing two different educational programs. One is a brief behavioral treatment for insomnia (BBTI) through which participants are taught and encouraged to adapt healthier sleep behaviors. The second, for comparison, is a healthy eating program. Participants are randomized—that is, selected randomly—into one of the two groups. Both programs may be beneficial to improve sleep; the research team is comparing to see which one is more effective. “In the approximately one-hour training session, a nurse-interventionalist talks with participants about what helps and what hurts in terms of getting better sleep,” said Tyrpak. “There are four steps to the BBTI: One, don’t go to bed unless you
are sleepy. Two, don’t stay in bed unless you are asleep. Three, wake up every day at the same time. And four, reduce your time in bed,” said Dean, a former oncology nurse at Penn Medicine Center of Sleep and Circadian Respiratory Neurobiology in Philadelphia. “The last one can seem counter-intuitive, but lying in bed waiting or trying to fall asleep can create an unhealthy relationship with sleep.” The healthy eating group also gets a one-hour training and a fourstep process. “Our graduate students designed an easy-to-follow program that we could compare to the BBTI group,” she added. “Food—what we eat and drink, and when—can affect your sleep. So we teach participants ‘PASS.’ That’s (1) pay attention, (2) advanced planning, (3) small steps,
and (4) substitute healthier foods. We track whether people follow the steps, and they become more mindful if they’re, for example, having caffeine or chocolate too close to bedtime, or if they are feeling too full in the evening.” The five-year, $2.2 million study, officially titled “Efficacy of Nurse-Delivered Brief Behavioral Treatment to Self-Manage Insomnia in Cancer Survivors,” is funded by the National Institutes of Health. Participants can receive the education in person or via Zoom; study participation also involves a yearlong follow-up, where participants communicate with the study team about their sleep and other health factors. “Our goal is to reach people that we can help; that’s why we are offering the option to participate virtually, with no in-person visits, if that’s a person’s preference,” said Dean. “We want to make it easy for people who are seeking help with sleep problems.” Studying the technique in cancer patients was a sensible place to start, said Tyrpak. “About half of the cancer survivors we’re working with had sleep problems before their diagnosis,” she said. “But you don’t have to have cancer to have this technique work.” If you are interested in seeing if you may be eligible, contact Karen Larkin at 716-829-3405 or klarkin2@ buffalo.edu
NEXT PAGE: How certain foods will help you sleep
April 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 19
sleep time. Scientists believe that the sleep-promoting effects of kiwi may be attributed to its high antioxidant levels, along with its ability to boost serotonin levels. Since a good night’s sleep is often linked with greater happiness, it’s no wonder the 2020 World Happiness Report ranked New Zealand — a top consumer of kiwi — as one of the top 10 happiest places in the world.
PREVIOUS PAGE: HOW CANCER PATIENTS CAN SLEEP BETTER: STUDY
GOOD EATS TO HELP YOU
SLEEP BETTER
ALMONDS
By Anne Palumbo
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hen I was a teen, I looked out the window one night and saw my dad gardening in the dark, guided by a headlamp. My reaction then: cuckoo! My reaction today: resourceful! You see, I, too, am a poor sleeper and have been for most of my life. This past COVID-19 year, my spotty sleep has only gotten worse. But I’m not alone. A report from the National Institutes of Health highlighted a study early in the pandemic that revealed “high rates of clinically significant insomnia.” It’s so widespread, in fact, it now has a name: “coronasomnia.” What and when you eat can affect the quality of your sleep. Eat a big meal after 7 p.m. and your body may be so involved in digestion it can’t even focus on shut-eye. Drink too much alcohol and you may fall asleep quickly only to wake up later in the night. Indulge in an after-dinner cappuccino and sleep may elude you for hours. Years ago, I looked to diet for solutions to my sleep woes, not finding a whole lot. Since then, researchers, including nutritionists and sleep experts, have continued to conduct studies to try to identify the best foods for sleep. While the studies are not conclusive and more research is needed, they do suggest that certain foods and drinks can make you sleepy or promote better sleep. On that note, here are some foods and drinks that may enhance the quality of your sleep.
the sleep-promoting chemical that helps control your body’s sleep and wake cycles. In a small study, adults with chronic insomnia who drank tart cherry juice twice a day for two weeks reported longer and better sleep quality compared to when they didn’t drink the juice. Since the extra dose of melatonin can send a signal to your body that it’s time to go to sleep, it’s best to save cherries or tart cherry juice for an after-dinner snack.
TURKEY AND OTHER HIGH-PROTEIN FOODS
FATTY FISH BANANAS The world’s favorite fruit benefits slumber time in more ways than one. Ever suffer from nighttime muscle cramps? Restless legs syndrome? Grab a banana before bedtime. Brimming with two natural muscle relaxants — potassium and magnesium — bananas may quell those troublesome twitches. More magnesium has also been linked to reduced stress, and since stress is one of the leading causes of insomnia, a banana may be your ticket to dreamland. Lastly, bananas also contain some tryptophan, an amino acid that gets converted to serotonin and melatonin, two chemicals that promote sleep. WARM MILK
CHERRIES OR TART CHERRY JUICE Cherries are one of the few natural foods that contain melatonin,
most experts agree on this fact about warm milk: The routine of drinking a glass of warm milk often brings back soothing childhood memories which then help us drift off. Warming up your milk, especially at night when your metabolism decreases, makes it easier to digest and results in less bloating.
A handful of almonds a day may keep insomnia at bay, so say many sleep experts. Almonds are a ready source of two properties that make them a beneficial food to eat before bed: melatonin, which regulates your internal clock and preps you for sleep, and magnesium, which boosts better sleep by quelling inflammation and by helping to reduce levels of cortisol, a stress hormone known to interrupt sleep. Prefer walnuts? They too are rich in melatonin; what’s more, they’re a top source of the kinds of fatty acids that may enhance serotonin production.
A cup of warm milk is one of the most common go-to sleep remedies around. But is there any hard science to back this remedy? Some say yes: milk has enough tryptophan, an amino acid that encourages the production of serotonin and melatonin, to improve sleep. Others say no: the amount of tryptophan in milk is too negligible to count. Either way,
My friend, who consumes salmon twice a week, is a notoriously sound sleeper. All that salmon might be giving her a nocturnal boost. Fatty fish — salmon, tuna, mackerel, sardines, and trout — are notably high in two nutrients that may promote sleep: vitamin D and omega-3 fatty acids. The unique nutrient combo, a healthy merger that increases serotonin production, may be this food’s silver-sleep lining. Serotonin plays an important role in sleep because the body uses it to synthesize melatonin, the hormone that governs the entire sleep-wake cycle. In one study, men who ate salmon three times a week for six months fell asleep about 10 minutes faster and slept more deeply than men who ate chicken, beef, or pork. KIWI Good news kiwi-lovers: Research has found that eating kiwi on a regular basis may substantially improve sleep. In a four-week study, participants who ate two kiwis one hour before bedtime fell asleep over 35% faster, slept more soundly, and experienced about a 13% increase in total
Page 20 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2022
Turkey is known as the “sleepy meat” and there’s a good reason why: It tops the charts in tryptophan. Tryptophan, as mentioned, induces tiredness by boosting serotonin and melatonin. But turkey has another property that some think influences sleep quality more than tryptophan: Its abundance of protein. Multiple studies demonstrate that higher-protein diets have been associated with improved sleep compared to low-protein diets, and that consuming a moderate amount of protein before bed may help you wake up less throughout the night. Other lean proteins that are also high in tryptophan: chicken, fish (including canned tuna), tofu, and many dairy products. Again, while some of the foods mentioned here may enhance the quality of your sleep, there isn’t strong scientific evidence that identifies any particular food as being the best for sleep. Eating a healthy and balanced diet that provides all the nutrients your body needs may ultimately be your best bet for a long and peaceful night’s sleep.
Anne Palumbo is the author of SmartBites, a column that’s published every month in In Good Health newspaper.