In Good Health: WNY #87 - January 2022

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JANUARY 2022 • ISSUE 87

DIETS TO CONSIDER IN 2022 From classics like W.W. (formerly Weight Watchers) to new trends like keto, we discuss the pros and cons of 13 diets — which one is right for you? Local experts weigh in. P. 10 ALSO INSIDE: PFIZER VS. MODERNA: Which One Has the Edge? P. 5 OBESE: Almost 1 in 3 College-Age Americans is Now Obese. P. 2 LIVE ALONE & THRIVE: Flying Solo at 73. P. 6

CANCERS OF THE FEMALE REPRODUCTIVE TRACT Physician Stacey Akers, chief of gynecologic oncology at Great Lakes Cancer Care Collaborative, discusses cancers of the female reproductive tract

FIVE THINGS YOU SHOULD KNOW ABOUT ARTHRITIS STUDY: LESS SEX EDUCATION IN SCHOOLS

The WNY Winter Hiking Challenge Has Begun

Winter blues got you down? Postholiday pounds have you feeling sluggish? Join the WNY Winter Hiking Challenge, now in its third year. P 13

Almost 1 in Every 3 CollegeAge Americans is Now Obese

Prevalence of obesity on U.S. campuses from 1976 to 1980: just over 6% — in 2017 to 2018

I

t’s probably fair to say that most people know of the so-called “Freshman 15” — the weight that college students are often said to gain when they’re away from home for the first time.

But in recent decades, matters have gotten much worse in the United States. A new study using national data for people aged 18 to 25 found that while the prevalence of obesity was just over 6% in 1976 to 1980, it neared 33% by 2017 to 2018.

“We know that these are the trends that we’ve seen in children, adults, all age groups, but we were a little bit surprised by the magnitude of the increase,” said study author, physician Alejandra Ellison-Barnes.

She is an assistant professor of medicine at Johns Hopkins University School of Medicine, in Baltimore.

“We don’t know if it’s significantly higher than in children because we didn’t conduct that analysis, but it seems to be higher. And we were surprised that the mean BMI [body mass index] in this age group is now in the overweight range,” Ellison-Barnes said.

While it’s not news that experts are concerned about obesity across most age groups, finding solutions for this age group might offer a huge public health opportunity, the researchers suggested.

The study concluded that this

age group may be a key target for preventing obesity, given that habits formed during this period often persist throughout a lifetime.

These young adult years are critical for adult development, filled with some major life transitions, Ellison-Barnes noted. It is also a time that scientists see obesity emerging.

Researchers are working to figure out why, she said, including studying whether cultural trends in terms of education or workforce over the past several decades may be contributing to these changes.

“Weight loss in general, and particularly the maintenance of weight loss, is notoriously challenging,” Ellison-Barnes said. “Studies in the past have shown that even those — and this is applied to all adults not just emerging adults — but even those who are successful at losing weight often regain the majority of it within five years. We’re hoping that we can look at emerging adulthood as potentially a critical period for preventing the establishment of overweight and obesity that would theoretically persist into adulthood, because it is so hard to reverse once it’s established.”

Some precedence exists for adolescents with emerging obesity reversing that course as young adults, she said, and it may help provide information about reversing the trend in emerging adults.

The findings were published Nov. 23 in the Journal of the American Medical Association.

The study results are consistent with other data she’s seen, said physician Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston.

“The rate of obesity in every single age group is higher than it used to be,” Apovian said.

Theories why include that it’s the food supply and that perhaps people who are genetically predisposed are reacting to diets of ultra-pro-

WHAT READERS ARE SAYING ABOUT

cessed foods, storing it as fat when someone predisposed to being lean might burn those same foods, she added.

Some believe that modern, well-controlled thermostats have kept bodies from working hard to maintain their core temperatures in cold and heat, she noted. It may also be that the ingredients in ultra-processed foods are affecting people’s reward centers and making them want more of certain unhealthy foods. There could also be endocrine disruptors in the food supply.

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January 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 3

Meet

Your Doctor

By Christopher Motola

Fear Keeps Some Cancer Patients From Getting COVID Vaccine

C

ancer patients are at risk for serious COVID-19 illness, but some are still afraid to get vaccinated against the virus, new research shows.

Study authors surveyed nearly 200 high-risk cancer patients at the Mays Cancer Center in San Antonio, Texas. Only 56% said they’d received at least one COVID-19 vaccine dose, compared to the community vaccination rate of 76%.

The three most common reasons patients gave for not getting vaccinated were: “My doctor has not told me to get the vaccine,” or “I do not think it is safe for me because I have cancer,” or “I’m afraid of the side effects.”

Patients were given six options to select for declining the vaccination. Aside from the three top reasons, other options included, “I already had COVID, so I don’t think I need the vaccine” and “I want the vaccine but have not been able to schedule an appointment.”

“We concluded that the reasons cancer patients declined the COVID-19 vaccination can all be addressed by improving patient-physician communication regarding the known safety of the COVID-19 vaccines,” said study lead author, physician Kate Lathrop. She’s a medical oncologist and breast cancer specialist at the cancer center and associate professor of medicine at University of Texas Health San Antonio.

“The COVID-19 pandemic has created many challenges and barriers to care for patients on active cancer treatments,” Lathrop noted in a UT Health news release.

The Mays Cancer Center — home to UT Health San Antonio MD Anderson Cancer Center — implemented a system to remind patients about COVID-19 vaccines.

The study found that before discussing it with their oncologist, 45% of high-risk cancer patients had not received at least one COVID-19 vaccine, but that fell to 20% after a reminder.

The patients were surveyed when they arrived at an outpatient infusion clinic between May and June 2021. The survey results are being presented this week at the San Antonio Breast Cancer Symposium. Studies presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Stacey Akers, M.D.

Chief of gynecologic oncology at Great Lakes Cancer Care Collaborative discusses cancers of the female reproductive tract Q: Tell us a bit about your practice.

A: I’m a gynecologic oncologist. I treat cancers of the female reproductive tract. So that would be ovarian cancer, fallopian tube cancer, uterine cancer, endometrial cancer, cervical cancer and vaginal cancer.

Q: How treatable are these cancers, generally speaking?

A: For uterine and endometrial cancer — they’re probably the most common cancers we treat in the female reproductive system. About 75% to 85% of these patients are diagnosed with early-stage disease because they present with the symptom of bleeding. For ovarian cancer, the majority of those patients, 70% to 80%, present with advanced stage disease. And that’s because the symptoms are a bit vague and non-specific. They often present with bloating and abdominal pain, which can easily be chalked up to constipation or dietary changes. They’ll often see their primary, get referred to a gastroenterologist, eventually get imaging and then finally get diagnosed. So their prognosis is not as good, unfortunately.

Q: Do we screen for these cancers during OBGYN visits?

A: The screening that we do have for the female reproductive system is cervical cancer. The pap test is a good screening tool for that. For the other cancers? There isn’t a very good screening for those.

Q: Generally what age group are you dealing with?

A: We deal with young women who develop cancers up to women in their mid-to-late 80s. So there’s definitely a big age range for the types of patients that we see. Oftentimes we’ll treat even pre-malignant conditions like cervical dysplasia.

So that population will be a little bit different than that of our uterine and ovarian cancers.

Q: Is gynecologic oncology a surgical subspecialty?

A: We do surgery. It’s actually the only specialty that does both surgery and chemotherapy. So if they need both for a female reproductive tract cancer, they could see us for both.

Q: Do you feel that gives you some unique perspectives on cancer treatment?

A: I’d say you develop a very unique relationship with your patients. You get to know them, you often get to operate on them.

And then those patients that need treatment beyond surgery, you’re able to give them chemotherapy.

So you might spend a lot of time together and get to know each other and develop a close relationship with those patients. It helps them be able to trust you and your clinical judgments as opposed to getting your surgery from one physician, then going to have to get your chemotherapy from another physician. So it’s unique in that regard. It’s also one of the things that drove me to this specialty.

Page 4 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2022

Q: Is there any particular reason the specialty developed that way where others didn’t?

A: It’s probably because it’s a very niche specialty. It’s just GYN and it’s just chemotherapy for GYN. Whereas with other kinds of oncology they’ll often treat different disease sites.

Or for surgical oncology they’ll operate on many different types

of cancers. So I think it’s just because it’s so specialized.

Q: Has COVID-19 affected your specialty’s ability to diagnose cancers in a timely manner?

A: When the first wave hit in 2020 it was really challenging. We didn’t have a lot of understanding of COVID-19. We didn’t know how it would affect patients who were getting chemotherapy. So in the beginning there was a little bit of a delay in operating on patients. Now with the arrival of the vaccine and our better understanding of the disease, it’s not really hindering our treatment and care of patients.

Q: Does chemotherapy have an effect on a patient’s ability to recover from COVID-19?

A: If a patient on chemo did develop a COVID-19 infection their immune system isn’t as strong as a patient’s who isn’t on chemo. But in our experience, we haven’t seen any patients have unusually severe reactions if they’re on chemo and get COVID-19.

Q: Since there aren’t screening tests for many of these cancers, what symptoms should women be concerned with?

A: For cervical cancer, getting the screenings and pelvic examinations involving the vulva and vagina. If there’s abnormal bleeding outside of their menstrual cycle or are post-menopausal and have bleeding, that’s really a red flag. And then people that develop these weird bloating abdominal fullness, or have a distended abdomen and can’t get their pants on even though they’re losing weight, those are some symptoms you should look out for. And of course patients know their own bodies best. So they should advocate for themselves if they feel something is wrong. Advocate for a thorough examination and work-up.

Q: You’re fairly new to Kaleida. What made you want to join up with them?

A: I was just looking for a new opportunity to improve and bring my experience to the community outside of a cancer institute.

Q: How do they differ?

A: Access to clinical trials is a big one. I keep my working relationships with the institute to make sure I can refer them to someone who can get them in a clinical trial even if I can’t get them in myself.

Lifelines

Name: Stacey Akers, M.D. Position: Chief of gynecologic oncology at at Great Lakes Cancer Care Collaborative Expertise: Specializes in gynecology oncology, does surgeries at Millard Fillmore Suburban Hospital. She is part of General Physician PC, UBMD and Great Lakes Cancer Collaborative Hometown: Birmingham, Alabama Education: University of South Alabama College of Medicine Affiliations: Kaleida Health System; Catholic Health System Organizations: Society of Gynecologic Oncology; Erie County Medical Society; Buffalo OB-GYN Society Family: Husband, four children Hobbies: Skiing, baking

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Pfizer vs. Moderna: Which One Has the Edge?

W

hich coronavirus vaccine is best at beating COVID-19 — Moderna or Pfizer?

New research hands that honor to Moderna: In what is billed as the first head-to-head comparison of the two shots, researchers analyzed the health records of nearly 440,000 U.S. veterans who received one of the two vaccines between early January 2021 and mid-May 2021. All were followed for 24 weeks.

While both vaccines were highly effective in preventing infection, hospitalization and death, the Moderna vaccine conferred a 21% lower risk of infection and a 41% lower risk of hospitalization.

“Both vaccines are incredibly effective, with only rare breakthrough cases,” said research team member J.P. Casas, an epidemiologist and associate professor with Brigham and Women’s Hospital and Harvard Medical School. He is also executive director of the U.S. Department of Veterans Affairs (VA) Million Veteran Program for genetics and health research.

“But regardless of the predominant strain — Alpha earlier and then Delta later — Moderna was shown to be slightly more effective,” Casas noted in a VA news release.

The infection rate during the follow-up period was 4.52 per 1,000 in the Moderna vaccine group and 5.75

per 1,000 in the Pfizer group. Those in the Pfizer group also had higher rates of symptomatic COVID-19 (0.44 more per 1,000), hospitalization (0.55 more per 1,000), ICU admission (0.10 more per 1,000), and death (0.02 more per 1,000) than those in the Moderna group.

An additional phase of the study covering the period when Delta was the main strain in the United States showed that the risk of infection was still higher among those in the Pfizer group (6.54 more per 1,000) than in the Moderna group.

The findings were published Dec. 1 in the New England Journal of Medicine.

“Given the high effectiveness of both the Moderna and Pfizer vaccines, confirmed by our study, either one is recommended to any individual offered a choice between the two,” said study first author Barbra Dickerman, an epidemiology instructor at the Harvard T.H. Chan School of Public Health.

“However, while the estimated differences in effectiveness were small on an absolute scale, they may be meaningful when considering the large population scale at which these vaccines are deployed. This information may be helpful for larger decision-making bodies,” Dickerman said in the release.

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January 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 5

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Flying Solo at 73: My Neighbor Has Found Her Wings

I

t’s been five years now since my former neighbor Karen lost her beloved husband to cancer.

Initially devastated by her loss, she understandably retreated into the safety and security of her closest family and friends.

And then COVID-19 hit.

It’s been years since we’ve seen each other, so I was delighted when I bumped into Karen at the grocery store last week. I asked how she was doing and she declared with a touch of hesitancy, but noticeable pride, that “I’m more resilient than I thought.”

Then she quickly added with a good-natured smile, “Did you hear?

I moved into a smaller home in that new housing development near the village.”

I could tell that Karen had taken the time to grieve and grow into the next phase of her life. And I was pleased when she readily accepted my invitation to share a little bit about her journey.

We met in her charming patio home for a heart-to-heart about what it’s been like since her husband of 49 years died in 2016.

Karen and Jim were high-school sweethearts. They married right after college and started a family soon thereafter, two daughters and a boy.

“Jim was my rock,” said Karen. “He did repairs around the house, mowed the lawn, kept our cars running, and so much more. We were good partners. And best friends.”

She stared into the distance, “I still miss him.”

They shared a conventional marriage, with responsibilities drawn

along traditional lines: Jim took care of the finances and maintenance projects, while Karen managed the household and tended to the children. “It was a happy marriage,” said Karen, “and we had an active and fulfilling social life.”

And then, unexpectedly, Jim (a non-smoker) was diagnosed with lung cancer. He died four and a half years later. For Karen, his death felt very sudden, despite his long and brave battle. “I guess I wasn’t facing reality,” she confided.

Karen’s next few years were consumed with grief and mourning.

But slowly and steadily she began to feel a return to normalcy. “I could talk about Jim without crying,” she shared.

As Karen regained her footing, she was also becoming more aware of her surroundings. Absent Jim’s care and attention, the house had fallen into disrepair. There was water in the basement, peeling paint and long overdue maintenance. “It was overwhelming,” Karen revealed. “I couldn’t sleep for worrying about the house, the finances and the long, never-ending list of chores.”

Below, Karen talks about how she got through the toughest times.

Q: How did you carry on after the love and support you had enjoyed for years was suddenly gone?

A: It wasn’t easy. Getting a handle on financial matters was one of my first priorities. Thankfully Jim had made good provisions for our retirement and made sure I knew what was what before he died. That was a

What’s Behind Unexplained Epilepsy in Kids?

G

enetic testing can help guide management and treatment of unexplained epilepsy in children, new research suggests.

“A genetic diagnosis impacted medical management for nearly three out of four children in our study,” said study author Isabel Haviland.

She’s a physician and a postdoctoral research fellow in neurology/neurobiology at Boston Children’s Hospital and Harvard Medical School.

In the study, Haviland’s team examined the medical records of 152 children with epilepsy who were

tested between 2012 and 2019 at one U.S. institution and received a genetic diagnosis.

For 72% of the children, genetic testing affected at least one of four areas of management of their condition: care coordination, meaning they were referred to specialists or for diagnostic testing because of health issues related to the genetic finding (48%); treatment (45%); prognosis, or outlook for the course of their epilepsy (28%); and diagnosis (1%).

Among the children whose treatment was affected by genet-

blessing. Still, though, you wouldn’t believe how much there was to learn and do after Jim’s death.

My saving grace was our financial adviser. He helped me make sense of all the accounts, the transfers, the documents . . . everything.

Looking back, I don’t know how I got through it. It took time, but now I feel more in control of things. I even enrolled in online bill paying. I know that’s commonplace these days, but for me it was a big leap.

Q: Beyond finances, what other challenges did you face and how did you overcome them?

A: The emotional ups and downs were my biggest challenges. I could be going along just fine and then a wave of deep grief would wash over me out of nowhere. Or I would get overcome with fears about the future.

Thank goodness for my adult children. They were my emotional anchors and I didn’t hesitate to call on them. When I was feeling sad and scared, they would scoop me into their arms and remind me that I wasn’t alone.

On a more practical level, my children also helped me with the new house. My daughters showed me how to change the furnace filter, my son mowed the lawn, and I’ve taught myself how to make some basic repairs around the house. Thank goodness for “how to” videos on YouTube! If needed, I’ll hire contractors to tackle the big stuff.

Q: What are your challenges today?

Is loneliness an issue?

A: Today? Oh, my challenges are very different. (Karen is smiling.) A challenge might be choosing between two equally inviting options: Walking with friends or playing Mahjong with my foursome. I think I’ll do both!

My life is very full; I don’t struggle with loneliness. I have my piano, my books, my friends and my adorable cat Lucy. I love curling up with her and a good mystery novel

by Louise Penny. ic testing: 36% had an impact on anti-seizure medication choice; 10% were eligible for gene-specific clinical trials or experimental drug use; 7% were started on gene-specific vitamin or metabolic treatments, such as the ketogenic diet; and 3% were treated with a drug not yet approved for their type of epilepsy.

The findings were presented in December at the American Epilepsy Society annual meeting, in Chicago. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

“We found the impact of a genetic diagnosis was even higher in children whose epilepsy began before they turned 2 years old,” Haviland said in a meeting news release.

“About twothirds of pediatric epilepsy is unexplained, and genetic testing should be offered in these cases because of the significant potential impact on

Page 6 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2022

Q: And what about romance?

A: I doubt I’ll marry again. I’ve come to enjoy my independence. If I feel like eating cereal for dinner, that’s what I have. If I want to wear purple and pink together, that’s what I wear. I take pleasure in that freedom. Would I welcome a male companion for walks, movies or a dinner out? Sure, I’m open to that. I like to stay active.

Q: What advice do you have for others?

A: Maintain your friendships.

My friends carried me through the tough times and now they carry me through the good times.

I don’t wait for people to call me.

I pick up the phone. I invite people over and make plans. And, while I don’t consider myself computer savvy, I use email and Facebook to stay in touch with friends and family.

We share videos and jokes, and make arrangements to get together. My friends make all the difference!

As more women like Karen embrace the challenges and opportunities that come with living alone, they are finding their wings and the ability to fly solo with confidence and creativity. They learn first-hand, just as I did, that life goes on, that life can get better.

Even with the inevitable turbulence, living alone can lead to meaningful new relationships, surprising and satisfying self-discovery, and a renewed love for this precious, ever-changing life we live.

Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com management, including on clinical treatment and eligibility for clinical studies,” Haviland suggested.

Changes in treatment can make a significant difference for a child with epilepsy, according to Haviland.

For example, vitamin B6 is important for brain development but some genetic disorders affect its pathway in the brain. Supplements or related vitamins may partially correct the problem and treat the epilepsy.

“Genetic testing should be part of the standard evaluation of children with unexplained epilepsy,” Haviland concluded.

chief of infectious disease in the department of medicine at the Jacobs School of Medicine & Biomedical Sciences. He treats patients at the VA Medical Center.

In Good Health talked to Russo about navigating life in a pandemic.

Q: After nearly two years of the pandemic, how do you feel about vaccines, their efficacy and the vaccination hesitancy controversy that continues to roil?

A: The vaccines, including the boosters, are a small price to pay to keep a potentially lethal and global virus at bay. I know a significant minority of people have refused the vaccine. In the short term, if they get infected and if they survive, they do have a degree of protection. But we don’t know how long that protection will last and if there will be the long-term effects from COVID. Your best strategy is to get vaccinated and boosted so that you can minimize your risk of infection.

Q A &

with Thomas Russo

Physician and Infectious diseases chief at UB: Clearing up misinformation about the pandemic

By Brenda Alesii

A

native of Boston, Massachusetts, Thomas Russo moved to Western New York in 1994. A SUNY distinguished professor, Russo, a familiar presence in local radio,

TV and print media, is a go-to source for the latest analysis and updates about COVID-19.

It’s no wonder with credentials like Russo’s. He is a professor and

Less Sex Education in Schools

Q: What about people who are so dug in and adamantly refuse to get vaccinated?

A: It can be described in four different buckets. In Bucket One, people are misinformed about the safety and efficacy of the vaccine. They believe things that aren’t true: the vaccine will cause infertility, that Bill Gates implanted a chip in the vaccination, it was developed too fast so it can’t be safe, etc. None is true.

Bucket Two contains young, healthy people who have an invincibility syndrome. They might be professional athletes and people who work out regularly with an “I-cantake-COVID-on” attitude. In the past, suicide, drug overdoses and trauma were the leading cause of death in people ages 24–40. Now, it is COVID. We also don’t know the long-term neurological —fatigue, brain fog, loss of taste and smell — cardiac, renal, pulmonary and other effects of COVID. It is more than a respiratory virus; all organs can be involved.

Bucket Three reflects people who have a distrust of the government. It includes a significant number who believe in a conspiracy between big pharma and the government to make money.

In Bucket Four, there are those who say, “no one is going to tell me what to do” and some feel that vaccine requirements violate their con-

S

ex ed has been a staple of public education for decades, but new research shows that only half of American teens are getting instruction that meets minimum standards.

“The findings show that most adolescents are not receiving sex education that will enable them to manage their sexual lives,” said study author Leslie Kantor, chairwoman of the department of urban-global public health at Rutgers School of Public Health in New Jersey.

Kantor and her team analyzed data from nearly 8,000 U.S. adolescents in the National Survey of Family Growth from 2011-2015 and 2015-2019. They found that in both periods, about half the youths received sex education that met national standards. More than 75% of teens received instruction about “how to say no to sex,” while only about 60% received information about birth control.

In 1995, more than 80% of teens received information about birth

stitutional rights, which, of course, is not true. It’s a Western ego-centric argument, meaning decisions are ours to make. That’s what makes this country great, but it doesn’t work in a pandemic. If you get infected, it affects others. In Scandinavia, for example, citizens there have the least mistrust of their government. They have the best vaccination rate in the world, excellent financial resources and the scientific wherewithal to deal with the virus. Citizens here have not embraced vaccinations to the extent that Americans are on a par with countries like that. It is important to note that people who are not vaccinated and refuse to wear masks when appropriate continue to be the major drivers of this pandemic.

Q: What do you say to people who have become virtual recluses, afraid to engage in most of life’s activities because of COVID-19 fear?

A: Everyone has different levels of risk aversion. Going out may produce anxiety, but if one is optimally protected by vaccination, which includes a booster and wearing a mask in public venues when the community burden of disease is high since our vaccine are not perfect, that you can live your life in relative safety.

Further, you can also get together for social gathering with others who are also vaccinated and boosted.

Q: You told me you came to WNY in 1994 and consider Buffalo home now.

With your seven-day-a week schedule and all the media appearances, how do you decompress?

A: I like to have a nice quiet meal with my wife. [Russo and his wife are the parents of three adult children, a dog and two cats]. She and I like to relax and watch a couple of our favorite shows. We were scheduled to go on a Baltic cruise, but we went to Hawaii instead. I’ve got three shots in my arm. We enjoyed outdoor dining in 90-degree weather; used our masks, and felt safe.

Physician Thomas A. Russo is chief of the division of infectious diseases in the Jacobs School of Medicine and Biomedical Sciences at UB. He treats patients at the VA Medical Center.

control.

Another concerning finding was that a significant percentage of teens do not receive any information about protecting themselves against sexually transmitted diseases before they begin having intercourse.

The researchers also found notable gender and racial disparities in adolescents’ access to comprehensive sex education. Females are more likely than males to receive instruction in waiting until marriage to have sex, while males are more likely than females to be taught about condom use.

Fewer Black and Hispanic males than white males are instructed about birth control, HIV and STI (sexually transmitted infections) prevention, and saying no to sex. Queer youth are less likely than straight youth to be taught about HIV and STI prevention and where to get birth control.

The study was published Nov. 4 in the Journal of Adolescent Health.`

January 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 7

Rural Hospitals’ ERs Just as Effective as Urban Ones: Study

I

f you live the country life, new research brings a reassuring finding: Your chances of surviving a heart attack, stroke or other potentially life-threatening medical emergency at a rural emergency department are

similar to odds at a city ER in the United States.

Researchers analyzed more than 470,000 outcomes among Medicare beneficiaries treated at rural and urban ERs between 2011 and 2015.

Overall 30-day death rates were 3.9% in rural ERs and 4.1% in urban ERs, according to the study. However, patients with symptoms that did not result in a specific diagnosis had higher death rates at rural ERs than urban ERs. The researchers also found that patients in rural ERs were much more likely to be transferred than those in urban ERs, 6.2% versus 2%.

“The rural emergency department system functions well for discrete conditions that can be quickly diagnosed and approached for treatment and, if necessary, transferred,” said senior study author, physician Keith Kocher, an associate professor of emergency medicine at Michigan Medicine-University of Michigan.

“We initially expected to see a more significant difference in mortality, as rates for inpatients are often higher at rural hospitals. However, the findings indicate these critical points of access for care are doing well for the patients they serve, even though they are frequently not resourced like peer institutions in

metropolitan areas,” Kocher said in a university news release.

“Arranging timely transfer of patients from a rural hospital can often be very challenging and has been made even more difficult due to the COVID-19 pandemic,” added study lead author, physician Margaret Greenwood-Ericksen. She’s a graduate of Michigan’s National Clinician Scholars Program at the Institute for Healthcare Policy and Innovation.

“These findings further highlight how impressive it is that we found rural hospitals produced the same outcomes despite these challenges,” she said in the release.

The study was published Nov. 19 in the journal JAMA Network Open.

The researchers noted that more than 100 rural U.S. hospitals have closed since 2010, depriving their communities of emergency care.

“This work demonstrates the critical importance of rural emergency departments,” Kocher said, stressing that policymakers should focus on ensuring access to these ERs.

Healthcare in a Minute

By George W. Chapman

Vaccine Saga Continues: 90-95% Compliance from Healthcare Workers

N

YS has already mandated all NYS healthcare workers must be vaccinated by early this past December 2021.

While many workers chose to quit rather than get the vaccine, most NYS healthcare facilities and physician offices report compliance rates in the 90% to 95% range.

Not all states issued a vaccine mandate. So, the federal government issued its own mandate ordering all healthcare workers in all states to be vaccinated by Jan. 4. Rather than comply, 14 states chose to sue. In December, a federal court in Louisiana granted them a temporary hold on the federal mandate. As the delta variant once again surges and the

omicron variant begins to spread, more and more people are getting vaccinated. Ninety-nine percent of patients who end up hospitalized, and possibly in the ICU on vents, are unvaccinated. Consequently, 99% of deaths are among the unvaccinated. Meanwhile, surveys of non-healthcare employers reveal 60% have mandates or are about to implement one. The major healthcare organizations, (AHA, AMA, ANA, etc.) remain fully supportive of vaccine mandates to protect both their members and their patients.

The administration is going to require health insurers to fully cover COVID-19 testing at your physician’s office and at home.

Women as Health System CEOs

supply costs and a workforce that is overworked, overwhelmed, underappreciated and demoralized.

To make matters worse, in the middle of the war, Medicare was about to impose salt- in- the- woundthanks- for- your- service cuts to their reimbursement effective Jan. 1. This is tantamount to cutting a soldiers pay and supplies in the middle of a war. The overall cut would be 10% while medical inflation is currently running around 10%. So it’s a 20% slash.

Physicians were to be cut 4% and clinical labs, performing all kinds of pandemic-related testing in addition to routine testing would be cut 23%.

Hospitals and nursing facilities were to be chopped as well. And to top it all off, the cuts come at a time when physician visits and hospital procedure declined. Granted, most of the cuts were planned pre-pandemic. But why did it take a last ditch effort by Congress to postpone (not cancel) the cuts? Didn’t anyone see this coming?

The very least we can do to support our “troops” and win the war is to get vaccinated and be patient

Forty percent of practicing physicians are women. This has been steadily increasing over the past two decades as there are now more females (52%) than males in medical school. Ninety percent of nurses are women. But according to a survey of more than 250 healthcare systems and national insurers, reported in the AMA Journal, in an industry dominated by women, only 15% of respondents had a female CEO. Female representation was slightly better in other senior suite positions like COO, CFO, etc. Maybe as a consequence, only 25% of the respondents had a female chair of the board. By comparison, various surveys of top US corporations reveal only 5% to 10% are headed by a woman.

Really Bad Timing Hospitals, nursing facilities, clinics and physician offices are the veritable front lines in the pandemic war. They are saddled with labor shortages, skyrocketing labor and

and appreciative when we seek care.

Sadly, the cuts to reimbursement was passed by Congress.

Death Rate Increased The overall death rate in the US increased 17% from 2019 to 2020. NYS ranked No. 1 with a 29% increase. Much of the national overall rate is due to preventable COVID-19 and overdose-related deaths. COVID-19 disproportionately impacted minorities, including American Indians, Blacks, Hispanics and Pacific Islanders. COVID-19 was the No. 3 leading cause of death.

Again, most of those deaths were preventable. Out of the 38 countries studied, the US ranked low (No. 33 for infant mortality) in most metrics.

Once again the US claimed No. 1 for most spending per capita. In sort of good news, the number of us with three or more chronic conditions decreased and the per capita spending on public health was up 33% to $116 per capita. Unfortunately, most of the public health spending increase was to put out fires like COVID-19.

Opioid Epidemic Overshadowed by the COVID-19 pandemic, more than 100,000 people died of a drug overdose the year between March 2020 and April 2021, and 75% of all drug overdoses were caused by opioids.

Drug overdoses killed more of us than car crashes and guns combined. Fentanyl-laced opioid pills (more kick) helped fuel the continuing epidemic. COVID-19 exacerbates the situation by causing relapses in addicts suffering from anxiety, depression and isolation. More must be done to battle this ongoing epidemic which impacts mostly rural teens and young adults. Naloxone reverses opioid overdoses. We need to expand the supply of, access to and affordability of Naloxone. Use telemedicine to reach isolated and rural areas where the epidemic is at its worst.

MAT (medically assisted treatment),

Page 8 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2022

which combines medication management and counseling, works well virtually.

To get a dramatic glimpse into the opioid problem, I suggest watching “Dopesick” starring Michael Keaton on Hulu. It focuses on the notorious Sackler family which developed and marketed OxyContin via their company, Purdue Pharma.

Having been sued by dozens of state attorneys general, the Sacklers agreed to a one-time settlement of $4.5 billion to be released over nine years. The average victim would be compensated between $3,500 and $48,000 which seems paltry. The Sackers never admitted guilt nor expressed remorse. All future profits from Purdue Pharma will be diverted to addiction centers. The Sacklers remain one of the wealthiest families in the world.

ACA Enrollment Open enrollment in the Affordable Care Act programs began Nov. 1, 2020, for new participants. As of early December, 4.6 million people had enrolled though either federal or state exchanges. Ninety-five percent of the new enrollees are eligible for tax credits which subsidize their monthly premiums. These enrollees are just above the poverty line and make too much money to qualify for Medicaid. Consequently, they can purchase commercial insurance online at a graduated discount based on income. The ACA now covers 32 million people, or one in ten citizens.

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.

5

Things You Should Know About Arthritis 4. do.

Treatment

Don’t hesitate to seek the care of a provider if develop symptoms

By Ernst Lamothe Jr.

Physician K. Keely Boyle is a clinical assistant professor of orthopedics at the University at Buffalo who practices at UBMD Orthopaedics & Sports Medicine.

A

rthritis has an immense level of impact on people of all age groups.

It affects the joints and tissues which can cause severe pain and swelling. Arthritis is a progressive disorder, which means that it typically starts gradually and gets worse with time.

“Once your cartilage starts to wear and you lose that protective layer, you begin getting bone on bone. And once you hit bone on bone, you start feeling extreme pain and limited mobility begins,” said physician K. Keely Boyle, clinical assistant professor of orthopedics at the University at Buffalo who practices at UBMD Orthopaedics & Sports Medicine.

Boyle talks about five aspects of arthritis.

1.Hip joint arthritis

The hip joint consists of the ball-shaped end of the thigh bone which fits into the hip socket. The inside of the ball-and-socket joint is lined with smooth cartilage to help the joint move easily. If this smooth cartilage wears away, the remaining rough surfaces of the ball-and-socket grind against each other.

“While everyone is a little different, many people complain about the intense pain that happens in the hip area when arthritis sets in,” said Boyle. “Patients can see mobility decrease when putting on their shoes and trying to tie them up as well as experiencing pain getting in and out of their cars.”

2.Knee arthritis

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage

that cushions the ends of the bones wears down over time. It can affect various areas of the knee joint.

“You hear people say they have a hard time going up and down the stairs. They feel a sharp and stabbing pain in their knees that is a deep ache,” said Boyle. “It doesn’t go away for some people and it can feel worse and flare up in the morning when they take their first few steps and can disrupt their sleep.”

3.Causes

Arthritis can be a complicated condition that has many factors.

Experts say both environmental, controllable and uncontrollable factors lead to the problem.

Smoking rates in the U.S. have declined in recent decades. However, about 15.5% of the population, or about 37.8 million adults, smoke cigarettes according to the latest numbers from the Centers for Disease Control. And with the popularity of e-cigarettes, which are battery-operated devices that people use to inhale an aerosol that typically contains nicotine, the issue is not going away.

Smoking is an issue that leads to disease and disability and harms nearly every organ of the body and is the leading cause of preventable death.

“One of the worst things you can do for your joints is smoke,” said Boyle. She also said what you chose to fuel your body can affect your bones. “I tell people that some of your medical conditions can be attributed to eating too many pre-packaged processed foods along with sugar which is a huge contributor to arthritis.”

She suggests eating anti-inflammatory foods such as lean proteins, fruits, nuts, leafy greens, whole grains and good fats such as avoca-

With arthritis, many orthopedic doctors treat the condition nonsurgically first, using braces for knee and hip problems. The brace helps stabilize the joint, especially for those who experience falls. There are also ways to strengthen core and back muscles to help with the joints.

“The whole point is to decrease inflammation which can also be done with anti-inflammatory pills such as Advil and ibuprofen,” said Boyle.

Experts also suggest low-impact exercise activities such as biking, swimming and gentle yoga.

“You don’t want to do anything that involves high-impact on your joints or twisting. I know a lot of my patients who are golfers have flare ups with their arthritis because of that twisting motion,” said Boyle.

She said the research is still too light for her to recommend stem cell injections. Stem cells are the body’s raw materials, which are cells from which all other cells with specialized functions are generated. Many times insurance doesn’t cover stem cell injections.

Platelet-rich plasma therapy uses injections of a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. In this way, PRP injections use each individual patient’s own healing system to improve musculoskeletal problems.

“These procedures have been known to work with relatively good results. It is often the first line of defense for knee issues after braces,” said Boyle.

Another way to prevent bone and joint issues is regular exercise.

Exercise is the easiest way to build muscle mass, increase strength, and improve balance and coordination.

“Getting an exercise routine tailored to fit personal health problems is the best way to improve your bones,” said Boyle. “Sedentary older people are more likely to have bone and joint issues compared to active older adults.”

5.Myths

Whether it is home remedies, inaccurate internet fixes or just plain personal opinions, there remains many myths about how to turn back the clock on arthritis. Some think that it will simply get better on its own which incorrectly has caused many patients to delay needed joint replacement surgery where they have lived in pain for years unnecessarily.

“People come to my office and they tell me that they believe cartilage can heal itself. Arthritis might get better through nonsurgical options and supplements; but you cannot regrow cartilage,” said Boyle.

“Science has not evolved to that level yet. If anything, it will get worse without intervention to the point where you may need joint replacement.”

Another myth is that arthritis is a senior citizen condition, which could not be farther from the truth.

“It is not only a 60-year old disease at all. We are seeing more younger patients with problems with their joints,” said Boyle. “You have men and women in their 30s and 40s who have what we call bone death, which is the deterioration of the bones because of lack of blood supply to the area. It can lead to arthritis in the joint.”

Nearly 3 in 10 U.S. Adults Say They Have a Disability

A

growing number of American adults say they have a physical or mental disability, a new study finds.

Of more than 400,000 adults who responded to a 2019 U.S. Centers for Disease Control and Prevention survey, 27% reported a disability. That’s a 1% increase since 2016, and represents about 67 million Americans, according to researchers at Johns Hopkins University who analyzed the data.

Moreover, about 12% said they had more than one disability. The most common types were: mobility; cognitive or mental; independent living (requiring help for daily tasks and outings); hearing; vision; and self-care (needing help with bathing, dressing and other personal care tasks).

To reduce discrimination and create more inclusive communities, “our country must be equipped with data on the prevalence of disabilities and who is most impacted by them,” said study co-author Bonnielin Swenor, director of the Hopkins Disability Health Research Center and an associate professor of ophthalmology at the school of medicine, in Baltimore.

An aging population may have contributed to the increase in disabilities since 2016, Swenor said in a Johns Hopkins Medicine news release.

The researchers also found racial and social disparities in disability rates.

Disabled adults were more likely to be older, female, Hispanic, have less than a high school education, and have low income. They also had higher odds of being unemployed, bisexual, transgender or gender nonconforming, the findings showed.

Black women were more likely to have a disability than women of other races. However, gay or bisexual Black adults were less likely to have a disability than gay or bisexual adults of other races.

The findings were published online recently in JAMA Network Open.

The data used in the study was collected before the COVID-19 pandemic, so the percentage of U.S. adults with disabilities may be even higher now due to long-term effects of COVID-19, Swenor noted.

January 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 9

calories and helps you learn whether they are helping you lose weight or not.

• Why it works: It also offers the support of coaches for accountability, along with facing the cold, hard nutrition facts. People who like technology can find this very convenient. Noom can help you learn about food, which can result in lasting changes.

• Caveats: You can fudge about your consumption of fudge and other foods. No one will ever know. Also, it can seem a hassle for people who do not like using technology.

13 Popular Diets for 2022 Here are the facts about several options

7 Pescatarian Diet

By Deborah Jeanne Sergeant

L

osing weight represents a top New Year’s resolution. Considering the obesity epidemic, it is a good idea. Many people turn to a popular eating plan or “diet” to shed pounds.

The following are some of the plans popular in 2022:

1 5:2 Diet / Intermittent Fasting • How it works: With 5:2, you eat as normal five days a week and restrict yourself to 500-600 calories on the two other days. With standard intermittent fasting, you eat only during an eight-hour window every day.

• Why it works: You are not restricted on what you eat, which helps you feel satisfied and not deprived. The calorie depravation days will result in overall calorie reduction. Most people think this is easier to stick with longterm.

• Caveats: You are not restricted on what you eat, which means you can eat a lot of unhealthful foods. You may also really overdo it when you do eat.

2 Sirtfood Diet • How it works: Initially, you drink a lot of green juice smoothies. Then,

So, What Do the Experts Say?

A

my Shults, registered dietitian and nutritionist is also a certified diabetes care and education specialist. She owns AMS Nutrition Counseling, PLLC in Lockport.

“I think that ‘diet’ is a four-letter word,” she said. “An ‘eating plan’ is maybe a better term. It has merit.

Weight loss can be helpful for a lot of people for a lot of different reasons. The vast majority of people who go on a ‘diet’ don’t keep the weight off. They need to find something sustainable. That’s extremely important.”

As indicated above, many eating plans have caveats that make

you eat primarily foods that contain sirtuin proteins, such as kale, parsley, red wine, onions, strawberries, soy, matcha tea, salmon and mackerel.

• Why it works: The initial phase restricts calories and the second phase includes foods many people enjoy.

• Caveats: It can be hard to stick with the smoothie phase and with the second phase, it can be challenging to eliminate many favorite foods. You also need nutrients from foods not on the list.

3 The Mayr Diet • How it works: You reduce high acidity foods and mindfully consume high-alkaline foods like vegetables and fish.

• Why it works: You are not eating as many calories by boosting the intake of low-calorie foods.

• Caveats: It is difficult to sustain long-term as it eliminates entire food groups. You can also miss nutrients found in certain foods.

4 The New Keto • How it works: You eat as minimal sugar and carbohydrates as possible and eat moderate amounts of healthful fat and high levels of protein diet (the standard keto diet limited protein them difficult to follow. Customizing it to fit one’s life and needs can make it doable. Shults is also a fan of eating plans that offer some flexibility.

“You should be allowed to eat all the food groups,” Shults said.

“If some are completely off-limits, that’s a red flag. You should eat a wide variety of foods: fruits, vegetables, whole grains and lean protein.

Those are going to be important.”

Some “diets” include numerous pre-packaged meals and snacks.

Shults is wary of those, as “ultra-processed foods and those with lots of added sugar can be part of a healthful diet, but should be limited.

Prepackaged things are convenient, but you can’t do it long-term.”

She believes that an eating plan that is hard to stick with — “cheat

• How it works: You eat mostly produce, along with seafood. Its focus is on whole, natural foods, eschewing processed foods. Grilling is an important part of food preparation.

• Why it works: By reducing calories, you will lose weight. Whole foods are also healthful source of nutrients.

• Caveats: Cooking with so few ingredients and methods of preparation is tough. It can take considerable time ensuring you are obtaining all the nutrients you need from such a limited number of foods. to 20%).

• Why it works: Minimizing consumption of sugar and carbohydrates will reduce caloric intake and force the body to burn stored calories (fat).

• Caveats: It demonizes good sources of nutrients and can be hard to commit to long-term.

5 Meal Kits/Ready-to-Eat Meals • How it works: A company ships you packages of ingredients to prepare as your meals or completely prepared meals.

• Why it works: You have the convenience of home-cooked meals without the time commitment. Restaurant food can be high in fat and calories.

If you fix it yourself, you may save calories. The portions of meal kits/ ready-to-eat meals may be lower than at restaurants as well.

• Caveats: Unless you select a company with dietary considerations built in, you may not save as many calories as you think. This is also expensive and could be repetitive (most companies have a limited number of entrees and may not vary them often), which can make it hard to stick with.

6 Noom • How it works: The app tracks your days” seem to happen more and more frequently — is not sustainable. Or if the rest of the family cannot follow it, so the individual trying to lose weight has to prepare two meals.

“If it negatively affects your mental health, social life or finances where you have to make sacrifices elsewhere, you can’t sustain that,” she added.

She said that the Mediterranean and DASH diets are not necessarily weight loss-oriented but can cause weight loss if the user consumes appropriate portions.

Danielle Meyer, registered dietitian, and clinical director of the clinical nutrition dietetic internship in the department of exercise and nutrition sciences at UB, doesn’t like the term “diet,” either. She said that

Page 10 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2022

8 Mediterranean Diet • How it works: You eat healthful fats and, about twice a week, fish, along with beans, produce, whole grains and, in moderation, cheese and red meat.

• Why it works: Recuing your caloric intake will result in weight loss. It also offers some benefits by nixing simple carbohydrates. The food is delicious and easy to stick with for weight loss.

• Caveats: Eliminating food groups is tough. This can make it hard to stick with for life.

9 Paleo Diet • How it works: You eat only food that would have been available in the wild to people: nuts, seeds, fruits, vegetables and lean cuts of meat.

• Why it works: By cutting out processed foods, you cut a lot of calories.

Many of the foods are tasty and appealing.

• Caveats: Entire food groups like dairy, grains, beans and legumes are eliminated, making it hard to stick with long-term. These food groups offer nutrients you miss.

10 DASH Diet (continued on next page) of the most popular eating plans, the Flexitarian makes the most sense since it is less restrictive.

“I believe that as people tire of incredible restrictive eating patterns, the idea that they could have some flexibility is very reasonable,” Meyer said.

People who do not want to give up eating the occasional burger can still have one.

“There is room for most or all foods in someone’s eating pattern,” Meyer said.

Eating plans that include pre-package meals or meal kits can help picky eaters branch out to new foods with little risk. Meyer said that this strategy can be costly but help people expand their palate to new flavors and ways to eat healthfully.

Popular Diets

(continued from previous page) • How it works: The Dietary Approaches to Stop Hypertension (DASH) Diet was meant to help people reduce their blood pressure by reducing sodium intake. You eat fruits, vegetables, whole grains and low-fat or nonfat dairy products, while limiting saturated fat and dietary cholesterol.

• Why it works: Eliminating processed and fatty foods helps reduce calorie intake. You would also feel better by lowering the body’s inflammatory response. This can make it easier to stick with.

• Caveats: You should still be mindful of calories, even while eating very healthful foods. Some people may feel deprived not eating treats occasionally.

11 Volumetrics Diet • How it works: You focus on foods that offer the most nutrition for the least among of calories by dividing foods into four categories, from least to most energy dense and then eat more of the lower-density foods as you can.

• Why it works: Filling up on low-calorie foods will reduce overall caloric intake. The plan will also help you stay satisfied as you eat the most nutritious foods most of the time, yet occasionally can have treats.

• Caveats: It can be difficult to determine what is low-calorie and higher calorie for some people, so Volumetrics does present a learning curve. It also requires constant scrutiny to stick with it.

12 W.W. (formerly Weight Watchers) • How it works: With this still-popular classic, you follow a program that assigns points based upon calories and nutrition.

• Why it works: By keeping the calorie count low, you lose weight. It can be easy to stick with as you can eat as much as you like of zero-point foods.

You can sign up for a point tracking app and get access to meetings. The accountability makes a big difference.

• Caveats: WW can be tricky to learn.

Members with budgetary constraints may find it expensive to maintain at more than $500 per year to join (although WW offers some free information online). Plus, to keep weight off, they will have to learn how assess foods.

13 Flexitarian • How it works: You gradually reduce the amount of meat you eat while eating more vegetables and fruits until you eat no meat five days out of seven a week. On the days you do eat meat, you consume no more than nine ounces of meat and select organic, free-range poultry or pasture-raised, organic, lean cuts of beef. Processed foods and sugars are limited.

• Why it works: Sticking with more produce and less meat reduces calorie intake. It’s also beneficial that the Flexitarian diet is easy to follow, with no calorie counting, little label reading and few rules to remember. Most people find it easier to stick with this eating plan.

• Caveats: It is still possible to consume too many calories while eating as a Flexitarian. Adherents still must watch portion size and learn to cook so they eat better at home and when dining out.

SmartBites

By Anne Palumbo

The skinny on healthy eating

Our Body’s Most Important Nutrient? Water!

Every January, like so many, I make a nutritional resolution: Consume more calcium! Eat more whole grains! Up my protein intake!

This year’s resolution? Drink more water! The deluge of benefits from this nutrient, some new to me, are simply too important to ignore.

Water’s obvious benefits — prevents dehydration, produces sweat to regulate body temperature, flushes out waste, promotes regularity — are well known. What may come as a surprise are all the other important benefits that warrant their day in the blistering sun, too.

Referred to as the “WD-40” for joints and bones, water helps lubricate, cushion and protect your joints, spinal cord and tissues. Since it hydrates the padding between your joints, its consumption makes it easier to move around and may lessen discomfort caused by conditions like arthritis.

Proper hydration is the key to keeping your brain sharp and your mood bright. Research confirms that not getting enough water can negatively affect focus, alertness, shortterm memory and mood. Moreover, you don’t even need to be seriously dehydrated for this to happen: less than four cups of water daily in a 150-pound person. Got a long drive ahead of you? An important test? A long-awaited family reunion? Drink up!

When it comes to digestion and getting the most out of your meals, water is your best friend. Drinking water before, during and after a meal helps your body break down the food you eat more easily. Water also helps with nutrient absorption by dissolving vitamins, minerals and other nutrients from your food and then delivering those health-bombs to the rest of your body for use.

Finally, water is a main component of saliva, which is where digestion begins.

Why do hearts, kidneys and skin love water? Your ticker swoons when you drink enough water because it doesn’t have to work as hard. Skimping on water, which leads to less blood in your body, can lower your blood pressure and raise your heart rate. Kidneys count on this all-important nutrient because it helps them filter waste more efficiently, as well as prevent kidney stones and urinary tract infections. And skin shines, literally, with adequate water intake. Even mild dehydration can cause skin to lose its luster, plumpness and elasticity.

Last but certainly not least, water could help you lose weight. It’s 100% calorie-free; it can help you burn more calories (the colder, the better); it takes up space in your stomach so you feel more full; and it may even suppress your appetite if consumed before meals.

Strawberry, Kiwi, and Lime Infused Water 5 cups sparkling or regular water 1 cup ice cubes 1 kiwi, peeled and cut into slices ½-1 cup sliced strawberries 1 lime, sliced

Anne Palumbo is a lifestyle colum-

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

Pour water into a pitcher. Add ice, kiwi, and strawberries. Squeeze lime slices to release some of their juice into the water before adding them in. Stir to combine flavors. Refrigerate. Infused water tastes best on the day it is made.

Helpful tips According to many experts, most generally healthy people need about eight cups of water a day; but even a healthy person’s needs vary if water is lost through exercise or by being outside in the heat. All beverages containing water contribute to your daily needs, including caffeinated beverages or those containing alcohol. While both do make you urinate more, the water from these beverages still

makes a positive contribution to total fluid consumption. To drink more water throughout the day: Fill a large water bottle to the top and make a dent every time you walk by; drink a glass of water before every meal and after every bathroom break; keep water in your car and drink up at stoplights. And know that you also get fluids from water-rich foods, such as fruit and vegetables.

January 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 11

Health Career

to learning how different things are in real life.”

In addition to outpatient clinics like SportsFocus Physical Therapy, physical therapists can also work at hospitals, rehabilitation centers, nursing homes, schools, early intervention centers, burn units and home care.

Greg Ford, a doctor of physical therapy and the head of the physical therapy department at Daemen College, said that physical therapists have many options for career development.

“It has moved to a medical model whereby there are residency and fellowship programs for physical therapy grads,” Ford said. “These are not required. You could graduate from an entry level program and go right into practice. You could work side by side with an expert in the field. That field could be so many different things: orthopedics, neurology, cardiopulmonary. These advanced, board-certified specialists can springboard your career beyond the entry level.” recovering. With other doctors, it’s Physical therapists can advance less often than once a month.” to leading as a senior physical He also thinks that physical ther- therapist with more administrative apists should be a natural at problem responsibilities, director of a physsolving as they have to figure out ical therapy clinic, hospital physiways to help patients to continue cal therapy department or college their recovery at home where they department. may not have access to all the re“You can go anywhere,” Ford sources they need. said. “Travel physical therapy is Will Tso, physical therapist at popular for our new graduates. You SportsFocus Physical Therapy in Buf- can sign up with a travel company falo, enjoyed sports while growing and do a three-month contract and up. But, since just a tiny percent of be licensed in a state and travel the youth athletes make it a profession, country if you choose. You could do Tso felt that working as a physical four states a year until you choose to therapist would allow him to remain settle down.” connected with sports in a meaningThe physical therapy program at ful way.

Daemen is one of 271 nationwide. It “I meet a lot of people involved boasts a 100% employment rate within sports and I stay active,” Tso said. in one year’s time for graduates. Ford He sees about 10 to 20 patients a believes that the demand for physical day for up to 30 minutes each. therapists will remain strong.

“We try to see the source of their “The aging population isn’t like trouble and prescribe movements it once was,” he said. “It’s more of an that will help with that,” Tso said. active aging population than it ever “We have the patients work on the was. They want to do hobbies and exercises at home and they come sports; that’s where physical theraback with pists come more feedin.” back.”

Since Rethe healthmaining care open to industry learning is moving and feedAt any age, any stage, UBMD toward back has a more OBGYN can provide comprehensive helped him find success as a physiwellness and prevention-oriented care. cal therapist. He realized this early model, the role of physical therapists on, as “nothing presents like it was may expand in the future to include Whether coming to us for a routine described in the books,” Tso said. more injury prevention and exercise aging concerns or will “When I first walked throughexam, the pregnancy, guidance.

Insurance coverage between, withfactor you.behind door, I was shocked and howanything differ- inlikely be thewe’re driving ent things were. You have to be open this trend.

Market for Physical Therapists to Increase by 21%

By Deborah Jeanne Sergeant

M

ost people’s familiarity with physical therapy involves a healthcare professional helping in the recovery after a sports injury or accident. However, physical therapists work in a large variety of settings and to address numerous health issues.

The Bureau of Labor Statistics estimates the physical therapist occupation will grow by 21% between 2020 and 2030, compared with 8% for all occupations. The annual mean wage for Buffalo-area physical therapists is $77,590.

Entry to the field must have earned a Doctor of Physical Therapy degree, pass the National Physical Therapy licensing exam, administered at the state level, and obtain a license.

Therapists who move to another state must go through the credentialing process in that state.

Every three years, a physical therapist must renew the license and take 36 units of continuing education credits.

In addition to the education, astute skills in science and math are important, according to Andrew Willis, physical therapist at Advanced Care Physical Therapy in Niagara Falls.

“You also have to be good with people,” Willis said. “You’re always dealing with patients who are in pain to some extent. Because of that, you’re seeing them two to three times per week. You could be their main source of interaction while they’re

The annual mean wage for Buffalo-area physical therapists is $77,590.

“We have a course in our curriculum specific to health, wellness and prevention,” Ford said. “Insurance companies haven’t caught up with that yet. But as a profession, we think we can ward off the pathology or comorbidity for quality of health including diabetes, obesity and arthritic changes in joints. We often talk about it as ‘pre-hab’ in advance of when it comes.”

By their definition, physical therapists are movement and exercise specialists, treating the body holistically to keep the body’s systems functional to improve quality of life across the lifespan.

The variety and human connections made through providing physical therapy makes the career worthwhile to Andrew Perilli, physical therapist and owner of Advantage Physical Therapy in Lockport.

“I really enjoy it because I can run a business and treat patients how I want to,” Perilli said. “I can be profitable and help as many people as I want to in the right way.”

He encourages anyone interested in physical therapy to consider the earning potential of operating a practice versus working as a staffer, but also the aspects of business operation that they will need to know and do.

“There’s a lot of work, but you’re working for yourself,” Perilli said.

“There’s a lot of earning potential over a staff physical therapist.

“School doesn’t prepare you for owning a business in any way, shape or form. Do your own research. I did some training with an outside agency that trains private practice owners.”

He added that resources from the Small Business Administration of Niagara County helped him both develop the business and obtain a loan for the business.

“I took out an SBA loan. The SBA of Niagara County provided me with free resources as far as making a biz plan and drafting a bank loan proposal, marketing,” he said.

Here come the holidays!

Obstetrics & Gynecology With the holidays approaching, it’s important to keep your health a priority. When you take care of yourself, it benefits not only you but your loved ones, too.

This holiday season, don’t let your health take a backseat.

Our providers and staff understand that everyone has busy schedules to keep and can see you quickly and safely at one of our two convenient locations.

Williamsville Office: 1020 Youngs Road, Suite 110 | Williamsville, NY 14221

Andrew Willis is a physical therapist at Advanced Care Physical Therapy in Niagara Falls.

•General OBGYN for adults, seniors, pediatrics or adolescents •Complex contraception & family planning •Pelvic health •Reproductive endocrinology & infertility •Minimally invasive & reconstructive surgery •Minimally •Menopause management & hormone therapy •Menopause •And more!

•And

Buffalo Office: 1001 Main Street, 4th Floor | Buffalo, NY 14203

Page 12 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2022

716.636.8284 UBMDOBGYN.COM

The WNY Winter Hiking Challenge Has Begun Looking for some great activitivies this winter?

Hit the trails with the members

Members of the WNY Hiking Challenge, organized by the Outside Chronicles, explore the outdoors in Western New York.

Photos courtesy of Outside Chronicles

By Catherine Miller

W

inter blues got you down?

Post-holiday pounds have you feeling sluggish? Now is the perfect time to get outdoors and enjoy exercising in the cold temperatures, which can help you lose weight, improve your mood and reap many other health benefits.

A great way to get motivated is by joining the WNY Winter Hiking Challenge.

Michael Radomski, founder of the challenge, began the event to promote hiking in the Western New York area and get people to take advantage of the beautiful Buffalo winters.

An avid hiker and outdoorsman, Radomski wanted to bring hikers together and, as an added bonus, raise funds for conservation causes in the area.

“The WNY Winter Hiking Challenge has brought a lot of people together,” Radomski said. “Some people have begun to hike with family members, some have found new

friends through the challenge.”

Now in its third season, hikers for this winter’s challenge can register online at “Outside Chronicles” and download the challenge materials. Hikers are then able to complete eight of the 16 pre-set trails before March 20, the first day of spring. The trails vary in length and difficulty levels to pique the interest of new winter walkers and avid trekkers alike. Each trail has a unique trail landmark and hikers take a photo of the landmark, or a selfie with it, when they reach that destination and then upload the photo as proof of that trail’s completion. Hikers who complete the eight-trail challenge will be awarded a patch and sticker to display on their gear and will of course, have bragging rights.

Exercising in cold weather is beneficial to your health. Your body raises your metabolic rate in the colder temps, which stays elevated even after you return indoors.

Safe Winter Driving Tips

About 46% of auto crashes involving bad weather happen in the winter

By Ken Sturtz

Walking in the snow utilizes different muscle groups which aids in strengthening surrounding joints. In addition, you’ll experience improved cardiovascular performance and get a healthy dose of Vitamin D on those sunny winter days.

“We began the WNY Winter Hiking Challenge at the onset of the pandemic last year,” Radomski said.

“And, many of our hikers mentioned that it helped with depression and anxiety, along with helping them with weight loss.”

Whatever your reason for hiking, there is natural beauty abounding just outside your door waiting for you to explore. The trails on the challenge will take you to the eternal flame at Chestnut Ridge and Holcomb Pond at Zoar Valley. Other trails will have you passing unique trees and ruins. If you want to travel farther from home and make a day of it, you can trek the Osgood Trail at Alleghany State Park or journey

W

hen motorists head out on the roads during winter it’s important to be extra careful. After all, approximately 46% of crashes involving bad weather take place during winter, according to AAA of Western and Central New York.

With that in mind follow these tips from AAA to make sure you get where you’re going safely.

• Stay inside. If there’s inclement weather and you don’t absolutely have to venture out on the roads, consider staying put. Even if you follow best practices for safe driving, that doesn’t mean everyone else on the road will.

• Slow down. It may seem obvious, but many winter drivers make the mistake of assuming that their vehicle will handle the same on snow or ice as it does on dry pavement.

Reduce your speed and apply the gas slowly to avoid spinning your tires or skidding.

• Increase your following distance.

On a normal day you should maintain a following distance of 3-4 seconds. In bad winter weather, however, you want to increase that

through Darien Lake State Park.

Hiking in the snow can be tricky.

You may want to use snowshoes or micro-spikes for traction. And, don’t forget to properly layer clothing.

Once you are accustomed to dressing appropriately using cold-weather apparel, winter hiking becomes a walk in the park.

Registration can be completed at: www.outsidechronicles.com. The registration fee is used to cover the cost of the prizes and expenses. All proceeds for this winter’s hike will be donated to the Beaver Meadow Audubon Center.

There is no need to hunker down this winter with so many magical places to venture to. A perfect way to get motivated is the check out “Outside Chronicles” website and sign up for this winter’s WNY Winter Hiking Challenge. Then grab some family members and friends, pack the hot cocoa and get moving.

following distance to 8-10 seconds.

That leaves you a longer distance to stop.

• Avoid braking and turning at the same time as it can cause your vehicle to lose traction and skid out of control.

Brake first and then turn if necessary.

The preferred way to stop is by using the ball of your foot to apply firm, steady pressure on the brake.

• When road conditions are poor, don’t use cruise control. It can reduce traction and prevent you from feeling if your tires are slipping.

• Don’t stop while going up a hill. It can be difficult to drive up hills when it’s snowy or icy, so try to get a little inertia going before the hill to help carry you to the top. Once you reach the top, reduce your speed and go downhill slowly, but avoid slamming on the brakes.

• If you get stuck, try clearing a path several feet long in front of your wheels by driving forward and backward or by shoveling. Point your wheels straight and gently press the gas to avoid spinning the tires. Spinning the tires generally just digs the vehicle deeper into the snow or ice.

January 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 13

Physician William Cance is chief medical and scientific officer for the American Cancer Society.

Chemotherapy: Not the Cancer Treatment Go-To New treatments offer more options for cancer patients

By Deborah Jeanne Sergeant

C

hemotherapy used to be the standard treatments for many types and stages of cancer.

However, in recent years, newer treatments have emerged, offering physicians more options.

“It’s a good sign,” said physician William Cance, chief medical and scientific officer for the American Cancer Society. “First, they’re not getting chemo and second, they’re getting more precision target therapies like immunotherapy.”

The movement away from chemotherapy began as researchers started to discover what drives a cancer to grow, spread and develop.

Cance said that led to the development of drugs that can target that abnormality. Chemotherapy attacks any rapidly multiplying cell, whether malignant or healthy, which is why it causes so many miserable side effects and lasting health issues for patients.

“We’re seeing more and more of those drugs based on the genetics of the patient’s tumor,” Cance said.

“That’s led to a plethora of drugs that target the ‘engines’ of those cells.”

Immunotherapy works by training the person’s immune system to attack the cancer cells. Cance said that cancerous tumors camouflage themselves to hide from the immune system.

“We’re getting good at turning on the patient’s immune response against the cancer,” Cance said.

The gamechanger in developing new treatments has been merging the biological, physical and digital facets of cancer treatment. In the past, research was based upon limited information. Now scientists can perform “complex analytics of who got what drug, what characteristics were in their tumor and their own characteristics,” Cance said. “Through big data approaches with artificial intelligence and machine learning, we’re starting to get more detailed analytics.”

Researchers are also beginning to look at the influence of the gut microbiome, the naturally occurring, beneficial bacteria living in the

gut. Cance said some may affect the patient’s response to immunotherapy or chemotherapy.

Though immunotherapy works more like a sharpshooter instead of a machine gunner, it doesn’t mean that it causes no side effects. They can disrupt how the body’s immune system works and cause it to attack itself, a phenomenon known as an autoimmune disease.

“A key part of the immune system is it recognizing normal cells as normal and others as foreign,” Cance said. “When you take the brakes off the immune system, it can attack various tissues such as thyroid, gastrointestinal system and others.

You’re shifting the balance towards a more reactive immune system that can react against the body.”

The autoimmune effects resolve once treatment is over, but damage done to organs, such as the thyroid, may not be reversible. Most of those effects are manageable. Cance hopes that with further research, fewer long-term effects will manifest.

Researchers are also helping discover ways to become more precise in treatment and systematic as to who needs which type of treatment.

In addition to easier treatments, cancer patients also enjoy greater longevity with immunotherapy.

The next big step is making diagnosis even earlier, which increases the chances of effective treatment.

“We will get to a day where you’ll see your primary care provider for your cholesterol or whatever and get a multi-cancer early detection test,” Cance said. “Multiple companies are involved with this.”

He explained that cancer cells make their presence known by secreting DNA, waste and protein into the blood. By testing the blood for the presence of these materials, providers can determine if further testing and treatment is warranted.

While Cance does not envision a “magic bullet” for curing cancer, he does foresee a time when cancer will be more like a manageable chronic disease.

‘We will get to a day where you’ll see your primary care provider for your cholesterol or whatever and get a multi-cancer early detection test.

Multiple companies are involved with this.

Physician William Cance is chief medical and scientific officer for the American Cancer Society.

Lung cancer used to be treated with chemotherapy as a matter of routine. Now oncologists have other options. In addition to or instead of chemotherapy, care providers can offer immunotherapy, according to physician Roberto Pili, associate dean for cancer research and integrative oncology and professor and chief of the division of hematology/oncology in the department of medicine in the Jacobs School of Medicine and Biomedical Sciences at UB. “Some cancer, like lung cancer, may benefit from targeted therapy if they have a specific mutation,” Pili said.

The patient’s medical team would need to discuss with the patient the options available for their type of cancer and what would best address it. For example, Pili said that immunotherapy may be contraindicated for people with poorly controlled autoimmune diseases, since they are already in an inflammatory state. The chances of experiencing bad inflammation as a side effect is only 1.5% in the heart, kidneys and liver and 10% in the lungs. About 30% of patients experience fatigue.

With chemotherapy, about 80% of patients experience fatigue, nausea

Page 14 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2022

Physician Roberto Pili is chief of the division of hematology/oncology in the Jacobs School of Medicine and Biomedical Sciences at UB. and drop in blood counts.

Chemotherapy is still used for those who may not be candidates for immunotherapy and also sometimes coinciding with or alternating with immunotherapy.

“Chemotherapy has been the main therapy for lung and breast cancer,” Pili said. “There are selected patients who cannot respond to hormone therapy. There is immunotherapy that’s been approved with or before chemotherapy. Chemotherapy is still there as a very important therapeutic option.”

Learning more about the genomics of cancers will help providers better tailor therapies to benefit patients.

“The sooner we know about the genomic signature in tumors, the better it is with the patients,” Pili said.

“Some patients benefit from immunotherapy early on rather than when they’re at a more advanced stage. I think it is exciting to have these new modalities that can go with chemo and in some cases, instead of chemotherapy.”

Whether used for lung cancer, bladder cancer, melanoma or other cancers, immunotherapy is increasing longevity for patients, as is hormone therapy for breast cancer and other hormone-driven cancers.

UB is beginning a new study on how nutrition impacts patients receiving chemotherapy and immunotherapy. Early animal research has shown that calorie restriction and reducing the consumption of animal-sourced protein may boost the immune system and increase the response of chemotherapy while reducing its side effects.

“In animals, we’ve seen a slowdown in tumor growth when changing the diet,” Pili said. “Diet and exercise make a difference in not only preventing cancer, but in helping patients who are receiving treatments.”

How to Build and Support a Strong Immune System Avoid stress, eat well and be well

By Deborah Jeanne Sergeant

T

he pandemic has brought greater attention to the importance of maintaining a strong immune system. While receiving vaccinations helps improve immune response to communicable illnesses like the seasonal flu and COVID-19, supporting immune system health is also important for lowering risk for these and other illnesses.

Here’s what area experts recommend:

as well. The massage helps with the chiropractic care. When your body is working right, it eliminates toxins because you’re relaxed. It puts you into a relaxed state. I try not to have a clinical setting here so people feel more relaxed. It benefits your health.

I rent offices from a chiropractor.”

— James Ligammare, licensed massage therapist and owner of Healing Hands Massage Therapy in Niagara Falls

• “In these trying times with COVID-19, everyone is stressed and on edge but massage is very beneficial for relieving stress, muscle tension, improving range of motion, pain relief, and on the immune system which increases the activity of white blood cells that helps our body fight diseases and helps with the reduction of cortisol which over all helps to maintain homeostasis within the body.

• “I think massage therapy definitely helps with the immune system and your body all around.

When your body is moving and working properly, everything goes smoothly. I work with chiropractors

• “In this whole COVID epidemic, people should really reconsider vitamin nutrition for disease prevention protocol. The recommendation now is zinc, vitamin D (because in the Northeast, we’re low in that), vitamin C and echinacea for an immune system improvement.

• “One thing we’ve come across in the past few years for people who have the mindset of an immune boost is elderberry. It’s a very powerful immune system stimulant.”

— Steve Giroux, pharmacist at Middleport Family Health Center, Middleport • “Lifestyle things you can do

are adequate sleep, exercise and manage stress. In addition, diet can potentially help. Eating a well-balanced, nourishing diet with adequate calories can help. Malnourishment and insufficient calories weaken the immune system.

• “It’s unlikely that a specific food will boost immune health. But a large portion of your immune system is in your gut. We want to make sure you have a happy, healthy gut so feed that microbiome the right stuff: high fiber, minimal refined and processed foods. If you drink, alcohol only in moderation.

• “Antioxidants can be helpful, so eat a lot of fruits and vegetables.

Eating a variety of color in your fruits

Routine Dental Visits Important for Health The sooner issues can be addressed, the more likely they can be treated

By Deborah Jeanne Sergeant

I

f your strategy for oral health is to seek a check-up only when something is painful or broken, you should rethink your approach to dental health. Routine check-ups with a dental cleaning every six to 12 months offers patients many benefits; and not only to their teeth.

“We engage in patient education at each appointment,” said Michael Marrone, dentist and owner at Michael J. Marrone Dentistry in Niagara Falls. “We’re actually getting training this week on a whole new way of providing that care and disclosing where patients may not do as well with their oral hygiene and perfecting their technique. We’re preventing periodontal disease by reducing the bacterial load.”

He looks for cavities, staining, deep grooves or fissures that are not

cavities but can put patients at risk for developing cavities. Wear on the enamel may also be a cause for concern. Anyone with fillings, crowns or dentures will also receive an examination of these features.

Dentists look at the hard and soft tissues of the mouth for things that may be asymptomatic and/or difficult to detect. The sooner issues can be addressed, the more likely they can be treated effectively. They check the surrounding structures, looking for enlarged nodes, pain or discomfort with the jaw area, limitation of motion or clicking.

Dentists also look at X-rays periodically for issues that would otherwise remain undetected.

Waiting to go to the dentist only when experiencing pain may cause a patient to experience “a more ad-

vanced or involved treatment involving root canal, extractions,” Marrone said. “If they came in more regularly and had a more regular exam and screening X-rays, things can be diagnosed and treated at much less state of disease.”

Beyond cavities and gum disease, Marrone treats for sleep apnea and tooth grinding.

He views oral health as related to systemic health, though it is not causal.

“Routine visits can lead us to determining if they have for example periodontal disease, gingivitis and inflammation,” he said. “Inflammation can lead to other issues. There’s a relationship between inflammation and cardiovascular health and diabetes.”

Some patients see their dentists

and vegetables ensures you have a variety of antioxidants in your diet.

• “Eat healthy fats. The omega-3 fatty acids in salmon and tuna may help with immune function.

• “Vitamin D does play a role in immune health. Most people in Western New York are deficient in vitamin D unless supplementing.

Talk with your healthcare provider about getting your vitamin D level checked. Sunshine is a great source, but we have a limited supply of that this time of year.”

— Amy Shults, registered dietitian and nutritionist, certified diabetes care and education specialist and owner of AMS Nutrition Counseling, PLLC in Lockport more often than their physicians, which is one reason Marrone also screens patients for blood pressure and other health issues that may be referred to their primary care providers.

Marrone also looks for lesions in the mouth. The worst case scenario is oral cancer. While it may seem like something easy to detect on your own, it often is not.

Smoking, alcohol consumption and certain viruses raise the risk of oral cancer.

Advanced gum disease, known as periodontitis, not only leads to tooth loss but can lead to other issues.

“It’s among the risk factors for other systemic diseases like cardiovascular disease, respiratory disease and diabetes,” said Steven Speroni, chief of dentistry for the VA Finger Lakes Integrated Healthcare System.

“There’s literature about a link to increased risk of Alzheimer’s. What goes on in the mouth can indicate more serious conditions people may be susceptible to and we can prevent the oral condition from deteriorating over time.”

Like Marrone, he views the oral condition as a window for systemic health throughout the body. In addition, his staff screens from blood pressure and look for signs of a nutritional deficiency or swallowing disorder.

A routine visit also allows patients to bring up any oral health concerns with the dentist or hygienist, such as sensitivity, discoloration, cracks or pain. Hygienists can also provide oral care education for patients such as proper brushing, flossing and other tips.

“If they let symptoms drive the day, it leads to more advanced and costly treatment,” Speroni said. “Regular prevention is an essential part of overall healthcare.”

January 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 15

How a Young Buffalo Woman Learned to Embrace Hearing Loss

“I was like, ‘how have I functioned while I was missing all this stuff?’”

By Ken Sturtz

A

decade ago, when a doctor informed Rebecca Witkin that she was partially deaf and should be wearing hearing aids, she was stunned.

An active and healthy college student, she’d never imagined needing hearing aids. When she pictured herself with them, all she could think of was a pair of hulking devices hanging from her ears, plainly visible to everyone.

“Now that I know what hearing aids can do for you it wouldn’t matter,” she said. “But at the time I was young and vain and I was very against it at first.”

Witkin said she dealt with feelings of shame and embarrassment and was afraid to be vulnerable enough to talk about her hearing loss or the hearing aids she wore on a daily basis. She hid her condition from friends and co-workers when she could.

As she matured and reflected on how much hearing aids had improved her quality of life, Witkin’s outlook gradually changed. She became more comfortable with her deafness. The pandemic, which has been especially challenging for the hearing impaired, led her to be more open in discussing her condition.

Witkin’s issues with hearing began at an early age. She was born two months premature with underdeveloped ears and needed nearly a dozen sets of drainage tubes during childhood. That caused a significant amount of scarring and a permanent perforation in one ear.

Each time the students at her school lined up at the nurse’s office for the standard vision and hearing tests, her parents would get a call notifying them she had a hearing deficiency. She saw a pediatric ear, nose and throat (ENT) specialist.

Although she was aware she didn’t hear quite as well as her classmates, she watched television and listened to music with the volume up, she didn’t think about it much.

Witkin is unsure if her hearing worsened as she got older or if she started having more trouble functioning with her hearing loss. But the problem slowly began creeping up on her a decade ago while attending SUNY Oswego.

She sat closer to the front of lecture halls and struggled to hear friends in noisy settings such as bars, but it was after becoming involved in student government that she realized something might be wrong. In meetings Witkin noticed she couldn’t hear what people were saying. She’d miss things others picked up on.

Sometimes it seemed like the person speaking was mumbling. She particularly struggled to hear the voices of older people in meetings, such as deans and department chairs.

“It slowly dawned on me,” she said. “I thought maybe I had an ear infection or drainage problem.”

Her mother urged her to have her ears checked. So, while home on break she made an appointment with an adult ENT. After testing the doctor informed her she had 20% hearing loss in her right ear and 70% hearing loss in her left ear, which had the perforation.

“And very casually he was like you should be wearing hearing aids,” Witkin said. “I was kind of just like ‘excuse me?’”

The doctor referred her to an audiologist at Hearing Evaluation Services of Buffalo to be fitted for hearing aids. Witkin was reluctant, but her outlook brightened when she met physician Rebecca Witter. She connected with Witter who — aside from sharing the same name and being just half a dozen years older than Witkin — took a softer approach.

She assured Witkin that hearing aids would improve her quality of life significantly and that the devices weren’t very noticeable.

When she tried her hearing aids, Witkin realized how much she’d missed.

“It was like all of these little

things that I had been missing,” she said. “It was pretty surprising at the time because I was like how have I functioned while I was missing all this stuff?”

She began noticing sounds such as the whooshing of cars going by, the hum of her refrigerator and the tapping of her metal bracelets on the chair in her audiologist’s office.

She was startled at first. Witkin had known the sounds were there, but now they came through louder and clearer.

She also began to pick up on jokes and conversations that she had previously missed.

“It pretty much just changed my awareness,” she said. “I was missing a lot and I was still functioning, but not to the capacity that I guess I could have.”

As excited as she was about the benefits she reaped from wearing hearing aids, Witkin was initially still self-conscious. She used her hair to obscure them and avoided talking about her hearing loss. A colleague, for example, worked with Witkin for almost three years and never knew she wore hearing aids.

Hearing problems affect people of all ages Witkin said her reluctance to discuss her condition partially stemmed from the public misconception that only older people wear hearing aids.

Gradual hearing loss is common as people age; nearly half of Americans older than 65 have some degree of hearing loss. And it was Ronald Reagan, then the oldest president, who contributed to widespread acceptance of hearing aids by the public by openly wearing them in the White House.

But hearing loss isn’t concentrated solely among older people.

For every 1,000 children in the U.S. as many as three are born with a detectable level of hearing loss. And approximately 15% of people older

Page 16 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2022

Above Rebecca Witkin owns Nickel City Athletics in Buffalo. She makes it a point to tell clients that she wears hearing aids.

Left Rebecca Witkin poses during a camping trip south of Buffalo last summer. She and her boyfriend converted a 2019 Promaster into a camper. Witkin spent years hiding her deafness before opening up about it. than 18 report some trouble hearing.

Hearing loss may affect people of all ages, but Witkin learned they didn’t necessarily lend themselves to her ultra-active lifestyle. The 29-yearold’s interests include weight-lifting, running, cycling, climbing and skiing. She also enjoys hiking, camping and boating, activities that can mean getting close to water.

“It’s really hard to have $7,000 worth of technology in your ears that you know can’t get really wet,” she said. “It’s like a constant battle.”

Running in 5Ks also presents a challenge. If she wants to wear headphones for music, she has to take her hearing aids out and tuck them in a bag or leave them in her car.

Over time, Witkin opened up to her friends, who have been supportive. She owns Nickel City Athletics in Buffalo and that setting can be noisy, especially if there’s music playing in the background. She makes it a point to tell clients that she wears hearing aids. That proves especially helpful for group settings, such as fitness classes when Witkin has to rely more heavily on body language to make sure she isn’t missing anything.

Although she’d gradually become more open about her hearing loss, the challenges posed by the pandemic pushed her to be more vocal.

“Masks and hearing aids do not get along,” she said. “Collectively it was really difficult.”

Countless times during the pandemic she would load groceries into her car after leaving the store, take her mask off and accidentally fling a hearing aid into the trunk. Not being able to see people’s mouths as they speak has been hard. Witkin never learned lipreading, but uses people’s mouths to help understand conversations.

In a sign of how much Witkin has changed, earlier this year when she received a new set of hearing aids, she posted a photo of them on Instagram alongside photos of her running in 5Ks and standing atop mountains.

“It was nothing to be embarrassed about is what I realized,” she said. “There’s no reason for me not to talk about it and be open about it because who knows, it could help; someone might realize it’s not uncommon and there are resources out there.”

By Jim Miller

Senior Alert: Your Old Cellphone May Not Work in 2022 Dear Savvy Senior,

Come grow with us!

— Searching Daughter

Yes, it’s true! If your dad’s mobile phone is more than a few years old, he will probably need to upgrade it in the very near future.

Why? Because all of the major cell phone carriers — AT&T, Verizon and T-Mobile — are shutting down their older 3G networks in 2022 to free up airwaves for 5G and other advanced services. So, if your dad is using an old 3G phone, like millions of other older Americans, he’ll need to get a new device if he wants to make calls, text or reach 911.

But you should also know that it’s not just older cellphones that will be obsolete. Older home security systems, medical devices and personal emergency response systems that still harness 3G will also be affected.

Adding to the confusion, older 4G phones that don’t support modern cellular voice technologies, such as Voice Over LTE or HD Voice, are impacted, too. Those customers may need a software upgrade or a new phone.

Here are the timelines for the 3G shutdowns: AT&T: Feb. 2022; T-Mobile: July 1, 2022; Verizon: Dec. 31, 2022; Sprint (which is owned by T-Mobile): March 31, 2022; and Sprint LTE: June 30, 2022. Other smaller carriers like Tracfone, Cricket, Boost and Straight Talk, will also be affected, because they rely on airwaves from the big three.

Is Your Phone Affected?

Cellphone carriers say they have been alerting customers who use older phones that services are ending, sending a combination of texts, letters, phone calls and emails. If you’re not sure about your dad’s phone, contact his carrier or check their website for a list of affected devices.

Another way to see if your dad’s phone is 3G is to look up his international mobile equipment identity number which can be found by pressing *#06# on his keypad. Once

If you are a breast cancer patient or survivor, you are eligible for free legal help, regardless of where you receive your health care. elderjusticeny.org (716) 853-3087

My 80-year-old father has an old flip phone he carries around with him for emergency purposes, but I’ve heard that these devices will soon be phased out. Is this true? If so, how can we know if his phone will be affected, and where can I find him a simple new one that he can operate.

Dear Searching,

Free Legal Assistance

you have it, go to www.imei.info and type it in the search bar to get the phone’s details. If his phone has a frequency of 900 megahertz (MHz) or 2100 MHz, it’s 3G. You can also look for a “3G” icon at the top corner of his phone, but not all 3G phones have that icon.

How to Upgrade If you find that you do need to upgrade your dad’s cellphone, carriers are offering discounts and special promotions on replacement devices.

If you’re worried about your dad having to learn your way around a new device, you’ll be happy to know that there are plenty of modern new flip phones available that work on the next-generation networks.

Or, if your dad decides that he would rather forge ahead without a phone than upgrade, then he will need to cancel the service. Most carriers will let you cancel your plan without any penalty. However, if he forgets to cancel his phone plan and doesn’t upgrade to a working device, the company won’t automatically stop charging him just because he isn’t able to access their network.

How to Recycle If your dad does have to replace his old cellphone, the best way to dispose of it is to recycle it. Large retailers, such as Best Buy, offer recycling programs for old electronics.

Or you can search for local recycling programs on websites like Call2Recycle.org and Earth911.com.

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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January 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 17

Health News Seven UBMD Physicians Named 2021 Unsung Heroes Submitted by UBMD Physician’s Group

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he American College of Emergency Physicians (ACEP) have named seven UBMD emergency medicine physicians as 2021 New York ACEP Unsung Heroes for their dedicated clinical care.

As an unsung hero, this award recognizes those physicians who go “beyond simply being the embodiment of what it means to be an emergency physician,” according to the NY ACEP announcement. Those recognized are “deeply committed to the mission of the emergency department, their colleagues, co-worker and patients. The unsung hero is always willing to help a colleague — within the clinical environment or not. They are the trusted individual who is known to bring comfort and a smile to the faces of all those around.”

This year’s awardees are: • Scott Belote, MD Assistant Clinical Professor, Jacobs School; Wyoming County Community Hospital Belote has worked for many years in the field of emergency medicine throughout Western New York. He is currently employed with UBMD EmerScott Belote gency Medicine. He is an physician who always stays up to date on current medical practice and consistently works on improving his practice despite being an experienced veteran in the field.

He has worked administratively for the group in the past and currently is in charge of all physician scheduling for the UBMDEM Community Division, which is close to 40 physicians.

• Samantha Bordonaro, MD Assistant Clinical Professor, Jacobs School; VA Medical Center, Buffalo As the medical student clerkship director for the University at Buffalo’s Department of Emergency

ECMC doctor to co-chair Chronic Liver Disease Foundation committee Erie County Medical Center (ECMC) Corporation Hepatology Medical Director Anthony Martinez was recently appointed co-chairman of the Chronic Liver Disease Foundation HCV (HepaAnthony Martinez titis C Virus)

Medicine, Bordonaro is responsible for educating and guiding the next generation of emergency medicine physicians. Due to the COVID-19 pandemic, local hospitals were suddenly forced to pause medical student rotations.

Her reassuring manner helped concerned medical students adjust to the unexpected changes in their Samantha Bordonaro curriculum.

She quickly developed high-quality, distance-learning opportunities. As conditions improved, she worked to return students, safely and efficiently, back into the local emergency departments. In recognition of her outstanding support of medical student education, she was awarded the Louis A. and Ruth Siegel Awards for excellence in teaching. This award is especially meaningful because it is bestowed by a committee of medical school students.

• Jennifer Caldwell, DO Assistant Clinical Professor, Jacobs School; Erie County Medical Center Caldwell has quickly established herself as a leader in emergency medicine residency program Jennifer Caldwell and currently serves as an associate program director. She has helped to develop innovative educational programs in simulation and ultrasound that have benefited both the residency and the department as a whole. Caldwell’s positive “get it done” attitude permeates throughout the emergency department during even the most challenging of circumstances. Her outstanding clinical care, in addition to teaching and willingness to step

committee.

The Chronic Liver Disease Foundation, Inc., based in Clark, New Jersey, is comprised of leading hepatology specialists committed to raising awareness of the effects of chronic liver disease (CLD) and sharing latest insights and analyses with the global healthcare community and patients.

Physician Martinez is medical director of the Center for Hepatology Care at ECMC where he cares for patients with liver disease and addiction disorders, including opiate dependency, viral hepatitis, alcoholic and fatty liver disease.

His clinic “La Bodega” has been recognized both nationally and internationally as a novel co-localized model for the management of viral

up in any situation, makes her an exceptional role model for our resident physicians.

• Andrew J. Eckert, MD Assistant Clinical Professor, Jacobs School; Millard Fillmore Suburban Hospital Eckert loves coming to work for every shift and he shows it. He always shows up to work with a Andrew Eckert smile despite an over-crowded ER facing him.

Andy has excellent bed side manners and his patients often express their happiness with his care and demeanor. His clinical skills are excellent and his is eager to care for the sickest of patients to help them through the health challenges they face. Eckert puts the patient first and always advocates for those he cares for.

Throughout the pandemic, he has been an excellent and supportive colleague to work with. Western New York is lucky to have such a nice, empathetic and talented young physician caring for the population. He has a long, bright and prosperous future, and I am glad to say that Andy Eckert is my friend and partner.

• Christopher Schwarz, MD Assistant Clinical Professor, Jacobs School; Eastern Niagara Hospital Schwarz is a dedicated emergency medicine physician with a bright future. He is an advocate for everyone in the department: physicians along with nursing staff, support staff and our EMS partners. His willingness to help in whatever way possible, along with his easy-going manner, is greatly appreciated by colleagues and patients alike. He is approachable and naturally puts others at ease, helping to foster stronger relationships among everyone who works in the ED. His demeanor keeps the department calm even during the most chaotic of times.

As one of our department’s primary night docs, Schwarz has formed a bond with the night staff, who truly see him as a friend in addition to a leader of the department.

hepatitis and addiction disorders.

His team’s work has been presented at the annual liver meeting of the American Association for the Study of Liver; the annual conference of the International Network On Viral Hepatitis in Substance Users; and at the International Liver Congress.

Martinez is also associate professor of medicine at University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, where he was awarded the clinical faculty for scholarship and nominated for the Siegel Award for Teaching Excellence.

Martinez has lectured around the world on hepatitis C management among people with substance use disorders. His research involves improving hepatitis C treatment in pop-

Page 18 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • January 2022

• Mark Sieminski, MD Clinical Assistant Professor, Jacobs School; Buffalo General Medical Center The COVID-19 pandemic has created unprecedented challenges to the health care system. PhysiKyle Westerholt cian Sieminski has provided invaluable leadership in response to these challenges as the associate emergency department director at the Buffalo General Medical Center in Western New York. In an effort to mitigate emergency department overcrowding, Sieminski led initiatives such as the provider-in-triage programs, ensuring patients are seen quickly and efficiently during times of increased demand. He is always willing to advocate for the patients, nurse staffing and hospital flow. He is an excellent bedside teacher for the residents and medical students because he leads by example and engages in every aspect of a patient’s care.

• Kyle Westerholt, MD Assistant Clinical Professor, Jacobs School; DeGraff Memorial Westerholt is one of those emergency physicians you always hope is on the schedule with you. Even in the beginning Mark Sieminski of his residency, he was quickly known as someone who is always there to help his peers out, provide a quick joke and a laugh, share stories of his interesting travels, and be a shoulder to lean on.

He is adored amongst the nursing staff, environmental service workers, patient care assistance and everyone in the department who he goes out of his way to get to know. He’s often found going out of his way to help patients and his own colleagues.

Westerholt is the physician that you call when your family member needs help and you need someone you can trust to care for them.

ulations disproportionately affected

by HCV, particularly people who inject drugs. He has been a primary and co-investigator on numerous clinical trials related to new therapeutic agents for hepatitis C and fatty liver disease, and he is board-certified by the American Academy of HIV Medicine. A fierce advocate, he works to eliminate hepatitis C treatment restrictions throughout the United States and in Europe. D Martinez is a fellow of the American Association for the Study of Liver Disease where he serves on the HCV special interest group steering committee; the European Association for the Study of The Liver; and the American Society of Addiction Medicine.

Health News Dr. Kayler receives Top Clinical Research Achievement Award University at Buffalo Clinical and Translational Science Institute (CTSI) has selected physician Liise Kayler, program director of Regional Transplantation and Kidney Care Center of Excellence at ECMC, to receive the Top Clinical Research Achievement Award.

The research subLiise K. Kayler mission, “Hardest-to-place Kidney Transplant Outcomes in the United States” involves the study of the best treatment for kidney failure. The results of the study determined that the best treatment for kidney failure is kidney transplantation.

Over 100,000 people in the United States are currently waiting for a kidney donation. Yet 20% of kidneys recovered for transplantation are discarded every year.

Kayler’s study asked the ques-

tion: Why discard kidneys when so many people are waiting for one?

Kayler and her team wanted to know if the kidneys that were discarded could have been transplanted with good outcomes. They looked at national data of kidneys that were almost discarded and computed their survival. They found that the kidney survival was only slightly worse than easy-to-place kidneys, meaning that some discarded kidneys could have been valuable for transplantation. They also wanted to see how transplant center report cards would fare if the center was good at utilizing kidneys. They found that transplant centers that are good at utilizing kidneys may be unfairly penalized. The research findings determined that transplant centers should utilize more kidneys and stop discarding so many.

This research project was submitted to the sixth annual CTSI Clinical Research Achievement Award competition.

“I am grateful to CTSI for this recognition,” said Kayler. “Our hope is that this award helps to increase awareness of the need for policy makers to make their grading system fair to incentivize transplantation to enable us to save more lives of those individuals suffering from end stage renal disease.”

Rochester Regional Health appoints new CEO

R

ochester Regional Health has selected Richard “Chip” Davis, Ph.D. its next CEO. He will assume his new role on March 7. He succeeds physician Eric Bieber, who announced his retirement in mid 2021.

A native of the Finger Lakes, Davis comes to Rochester Regional Health from the Henry Ford Health SysChip Davis tem in Detroit, Michigan, where he currently serves as senior vice president and CEO of Henry Ford Health System’s South Market and Henry Ford Hospital.

With more than 33,000 employees, Henry Ford Health System is the fifth-largest employer in metro Detroit and among the most diverse.

Davis’ responsibilities as a CEO at Henry Ford included providing strategic leadership and direction over the clinical operations of the market and leading new clinical, academic, and commercial partnerships.

He worked closely with clinical

and service line leaders to enhance coordination between primary care networks and specialty services. He had oversight of more than 100 care delivery locations, including two hospitals (totaling 1,240 beds) and over $2.5 billion in net patient revenue. Henry Ford Hospital has one of the country’s largest post-graduate medical education programs with over 1,000 medical students, 517 residents, 165 fellows, and 900 nursing students.

“I am very excited to become the next CEO at Rochester Regional Health and look forward to working with all team members, the provider community, and patients and family members to continue the legacy of excellence during these challenging times,” said Davis.

Prior to joining Henry Ford, Davis spent more than 25 years with Johns Hopkins Medicine (JHM) in various positions, most recently as president and CEO of Sibley Memorial Hospital, a nonprofit hospital in Washington, DC. He was on faculty at The Johns Hopkins School of Medicine, School of Public Health, and Business School.

Davis received his Ph.D. in public health from Johns Hopkins University. He also has a master’s degree in counseling and consulting psychology from Harvard University and a bachelor’s degree in psychology from the University of Michigan.

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