In Good Health: WNY #89 - March 2022 by In Good Health: WNY's Healthcare Newspaper

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KIDS’ HEALTH Special Issue

BFOHEALTH.COM

MARCH 2022 • ISSUE 89

Children have been through an awful lot in the past two years: online classes; social isolation; constant stress from family finances, work and school changes; plenty of negative news media coverage; ever-shifting COVID-19 protocols; and fear of the virus itself. For kids and teens, it’s been hard to go back to the conventional way of doing things STORY ON P. 14.

ALL ABOUT KIDS Physician Lucy D. Mastrandrea, chief of pediatrics and endocrinology at UBMD Pediatrics discusses career, her work as physician and how managing diabetes in children has improved. P 4

FIVE THINGS TO KNOW ABOUT COLON CANCER We spoke physician Jessica Martinolich, affiliated with UBMD Surgery. P. 7

LIVE ALONE: ‘BEWARE THE IDES OF MARCH’...OR NOT!

Stretching Your Limits for Better Health StretchLab in Blasdell is a new wellness facility dedicated to helping people get in their prime physical shape. It can help you be more flexible, pain-free and a lot more relaxed. P. 5

Humans’ Sense of Smell May Be Getting Duller Your sense of smell may not be as good as that of your ancestors.

new study that tested volunteers’ perceptions of various smells — including underarm odor — adds to growing evidence that people’s sense of smell is declining, little by little. “Genome-wide scans identified novel genetic variants associated with odor perception, providing support for the hypothesis,” the researchers said in a news release from the journal PLOS Genetics. The study was published there Feb. 3. Individuals experience smells differently, and the same scent may be pleasant, too intense or undetectable to various people. By combining differences in scent perception and people’s genetics, scientists can identify the role of various scent receptors. In this study, researchers in the United States and China analyzed the genomes of 1,000 Han Chinese people. They were looking for genetic variations associated with how individuals perceived 10 scents. The investigators then repeated the experiment for six odors in an ethnically diverse group of 364 people. From these experiments, they pinpointed two new scent receptors — one that detects a synthetic musk used in fragrances and another for a compound in body odor. Study participants had different versions of the receptor genes for musk and underarm odor, and those variations affected how they perceived the scents. These findings and previous

research show that people with ancestral versions of the brain’s scent receptors tend to find the corresponding odor more intense. Ancestral versions are those shared with non-human primates, the team explained. The researchers, led by Joel Mainland of the Monell Chemical Senses Center in Philadelphia and Sijia Wang of the Chinese Academy

of Sciences in Shanghai, said it all supports the theory that our sense of smell has weakened over time due to gene changes. This study also confirmed three reported links between genes for scent receptors and specific odors. Those earlier studies included primarily Caucasian participants. The new findings from East Asian and diverse groups suggest that genetics

WHAT READERS ARE SAYING ABOUT

underlying the ability to detect odors are constant across people of different backgrounds.

More information For more on the sense of smell and smell disorders, visit the U.S. National Institute on Deafness and Other Communication Disorders.

In Good Health

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Page 2 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2022

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Deadly Type of Stroke Increasing in Young and Middle-Aged

ew cases of a debilitating and often deadly type of stroke that causes bleeding in the brain have been increasing in the U.S., growing at an even faster rate among younger to middle-aged adults than older ones, new research shows. The findings show an 11% increase over the past decade and a half in intracerebral hemorrhage strokes, referred to as ICH strokes. “From a public health perspective, these results are troubling and indicate risk factors are not being well managed in young adults in the U.S.,” said physician Karen Furie, chief of neurology at Rhode Island Hospital and chairwoman of the department of neurology at Brown University’s Warren Alpert Medical School in Providence. Furie was not involved in the research. “Earlier onset of this disease is very alarming and indicates we need to be more aggressive with primary prevention,” she said. ICH strokes occur when blood vessels in the brain rupture and bleed. They are the second most common type, accounting for 10%-15% of the estimated 795,000 strokes each year in the U.S. Globally in 2020, 18.9 million people had an intracerebral hemorrhage, according to the AHA’s most

recent heart and stroke statistics report. They are more deadly and more likely to cause long-term disability than other types of stroke. Smaller previous studies have reached conflicting conclusions about whether the rate of ICH has been rising or falling in the U.S. In the new study, researchers found an 11% increase in the rate of ICH among U.S. adults over the 15-year study period. ICH increased at a faster rate for adults under age 65 compared to those 75 and older. The rate of increase also varied by region, climbing faster in the South, West and Midwest than it did in the Northeast. ICH stroke rates were 43% higher for men than women. Among those who had ICH strokes, the percentage of people who had high blood pressure also rose, from 74.5% to 86.4% over the study period. High blood pressure is a major risk factor for an ICH stroke, as is increasing age. The findings are alarming, Furie said, because they suggest blood pressure is so poorly controlled among younger adults that they risk losing the most productive years of their lives. “ICH occurs after decades of vascular damage from unmanaged high blood pressure,” she said. “It’s terrible that this is occurring.”

Mental health, autism, integrative medicine... Don’t miss the next issue of In Good Health

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

Meet

Your Doctor

By Christopher Motola

Lucy D. Mastrandrea, MD, Ph.D. Chief of pediatrics and endocrinology at UBMD Pediatrics discusses career, her work as physician and how managing diabetes in children has improved

Almost All Americans Are Now Within 1 Hour of Good Stroke Care

ine in 10 Americans now live within an hour of lifesaving stroke care, researchers say. That’s up from about 80% a decade ago, due to an increase in hospitals with specialized staff, tools and resources, as well as expanded use of telestroke services that use the internet to link small and rural hospitals with stroke specialists in large facilities. “Investments in improving stroke systems of care have been successful, and we are seeing improved access to stroke expertise and improved health care for patients who are remote from centers of expertise, so it’s a message of hope,” said study lead author, physician Kori Zachrison, an associate professor of emergency medicine at Massachusetts General Hospital and Harvard Medical School in Boston. The analysis of 2019 and 2020 national data showed that 91% of the U.S. population can reach an acute stroke ready hospital or center within an hour by ambulance. That rises to 96% if telestroke-capable emergency departments are included. “There is a narrow window of time for delivering disability-reducing stroke treatments,” Zachrison said in a meeting news release. “Improving poststroke outcomes for patients depends on a patient’s ability to access that care,” she said. “With increased implementation of telestroke, optimal stroke care has been made possible for an estimated 96% of the U.S. population, which is remarkable, considering the geographic span of our country.” The findings were presented at a conference of the American Stroke Association, held in New Orleans and virtually, Feb. 8-11.

Q: What does your patient base look We’ve improved insulins to control like? blood sugars. We have better technolA: I’m the division chief of pe- ogy for measuring blood sugar in a diatrics and endocrinology. For our real-time fashion. We also have better division, we take care of patients up insulin pumps that can communicate to age 22. About 50% of our practice with those monitoring devices, which is diabetes, with the bulk of that be- can improve the overall glucose coning Type 1 diabetes. But we also do trol. take care of a fair number of children with Type 2 diabetes. The other 50% Q: There have been some stories of our business is taking care of all about some kind of connection between kinds of endocrine conditions. And COVID-19 and diabetes in children. Have that includes thyroid disease, growth, you observed any connection? kiddos with early or delayed puberA: Well, what I will say is that, ty, kids with vitamin D or calcium based on the early part of COVID-19, problems. We also do a fair amount of 2020 and into early 2021, we did see weight and obesity management. an increase in the number of diagnoses, particularly on the Type 2 diabeQ: Is it easier to address endocrinolog- tes side. It was not that much differical issues when they present at a young ent than the past few years and going age? back, maybe, eight to 10 years in A: It depends what you mean by terms of absolute numbers. However, “easier.” For each patient we need to what we did notice is that the patients have a workable diagnosis. Some- came in to hospital a little bit sicker. times patients and parents just need And probably because parents were some counseling and education. nervous about coming to the hospital Sometimes they’re going to need and weren’t necessarily recognizing medication. For instance, a child who the signs and symptoms because of is diagnosed with under-active thy- everything else that was going on at roid will require thyroid hormone re- home with kids home from school placement. That involves taking a pill and watching other children — those every day and frequent blood kinds of things. In 2021, I think our work to make sure the levnumbers both in terms of Type 1 els are normal and that diabetes and Type 2 diabetes, the child continues are a little bit decreased from to grow well. I the previous year and are guess that’s closer to being consistent also fairly typwith what we’ve seen in ical of what the past years. That’s in you’d see terms of the number of in the adult diagnoses in the Western world, but New York community. it’s a little bit different. Q: What advice would Children you give parents now for don’t generalkeeping their kids healthy, ly enjoy getting especially with all the disrupfrequent blood tions to normal life? work and continA: It’s usually a matter uous physician visits. of making sure your children are eating a healthy Q: What kind of strides diet and getting have we made recently exercise. in managing diaThey can betes in chilw o r k dren, parwith ticularly their Type 1? genA: eral pedi-

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

atrician to get a sense of what that means for their child. And also being really in tune with their child so they know when there are any changes in their sleep habits, in their moods, so that they can work with their general pediatrician to address problems before they get too large. And then to refer them to subspecialists when needed. Q: Are there any tricks you’ve discovered over the years to getting children to eat more healthily? A: I think most of it is listening to what they’re doing. Helping to guide them to healthier substitutions. That’s a major thing to do. And a lot of it is educating families on what qualifies as a healthy diet. We don’t ask parents to completely eliminate a food group or particular food, but we encourage them to incorporate it into their meals throughout the day so that they can maximize the enjoyability of the food without overdoing it. And, of course, we’re mainly talking about sweets and processed foods. Q: What drew you toward administration? A: I guess it was more a case of my falling into it. I’m a fairly organized person, so I was doing a lot of the organizational administrative aspects for the division. And so as I took on more of those roles, it started to seem like an easy fit for me to step into that role. So I was invited by the chair at the time to apply for the position here at UB. Q: What kind of impact do you hope to have on the department, ultimately? A: So my priorities right now are: number one, that my team does a really good job of serving the pediatric patients of Western New York with endocrine and diabetes disorders. And the second is to make sure my team is supported and receives as many resources as they need to do their jobs well. I will say that is always a challenge, to have those resources. And number three, it’d be really wonderful to continue to grow the division with respect to our teaching mission and research mission. That’s in addition to our clinical mission. Q: What are some of the challenges you face in achieving those goals? A: The challenge is that running a busy practice requires a lot of handson communication with parents and making sure that we can return all those phone calls and get back to people in a timely fashion so they feel like they’re being served. It’s always a challenge to have enough money in the bank to be able to pay people and support them and to recruit top talent to Buffalo so that we can provide quality care to our patients here.

Lifelines

Name: Lucy D. Mastrandrea, M.D. Position: Division chief of pediatrics and endocrinology and University at Buffalo Hometown: Columbia, Maryland Education: University at Buffalo School of Medicine Affiliations: John R. Oishei Children’s Hospital of Buffalo; Kaleida Health Organizations: American Academy of Pediatrics; Pediatric Endocrine Society; American Diabetes Association Family: Husband, three daughters Hobbies: Running, reading, knitting

Stretching for Better Health StretchLab in Blasdell can help you be more flexible, pain-free and a lot more relaxed By Catherine Miller

Visit StretchLab

magine a place where you could increase your flexibility and mobility, decrease chronic pain, increase your energy level, decrease blood pressure and improve your posture, all in less than an hour and without breaking a sweat. Well, that place does exist and it’s within reach at the StretchLab. The StretchLab is a new wellness facility dedicated to helping people get in their prime physical shape by, you guessed it, stretching. StretchLab, located at 3860 McKinley Parkway in Blasdell, opened in October and has assisted everyone from teens to senior citizens become more flexible and pain-free than they ever thought possible. Operated by co-owners Carrie Klauk and Melanie Allessi, the StretchLab flexologists work oneon-one with their clients to perform stretches that aid in releasing tension from ligaments and muscles, increase blood circulation and improve overall posture and mobility. “I personally owned a stretching studio for the last six years,” Klauk said. “It started as a side business and then, as it caught on, it became my career. Melanie and I became friends when she was a client. She and I opened StretchLab to allow us to hire and train more professionals to keep up with the demand and help more people.” It starts like this. You meet with a trained flexologist who will use a MAPS body scanning infrared camera to determine how well your body is presently moving as you perform three simple squats in front of the camera. With the data points from your full body scan, your flexologist has an immediate assessment of how well you are moving, what areas

Introductory cost of stretching sessions at StretchLab is $29 for 25 minutes or $49 for 50 minutes. Regular cost is $49 for 25 minuntes and $95 for 50 minutes.Discounts are available based on frequency of treatments.

need improvement and then the fun begins. You lie on a comfortable table and your flexologist moves your body with gentle stretching techniques for either a 25-minute or 50-minute period, using the data from your MAPS scan to customize your stretching session. “This is not yoga,” Klauk explained. “There is no prior knowledge needed and no strength necessary. Our flexologists do all the work.” Monthly MAPS scans will be conducted to chart your progress and continually customize your sessions for optimal results. Your flexologist will alternate you between gentle static stretches and proprioceptive neuromuscular facilitation, where you are asked to “resist” the stretch

by pushing against them, deepening the stretch for added benefit. “We are not doctors,” Klauk said. “But all of our flexologists are movement professionals. We have a chiropractor, massage therapist, physical therapy assistants, personal trainers and occupational therapists working here. They do go through an intense 65-hour StretchLab training prior to working with clients.” In addition to the one-on-one facility, the StretchLab group has gone out into the community to educate people during their “Lunch and Learn” programs. The flexologists visit business offices during a workday to show employees simple stretching techniques to alleviate pain associated with sedentary work. They demonstrate gentle stretches

and full-body movements that can be done periodically during the workday to battle desk fatigue. Aging causes the body to lose elasticity and flexibility in the ligaments and tendons. Stretching regularly with a flexologist can loosen these tight areas, bring back range of motion and improve your posture. As with any physical activity you will want to check with your physician if you have any prior health issues prior to beginning your stretching journey. Almost everyone can benefit from one-on-one stretching. Senior citizens have found the StretchLab assists them in improving their balance and range of motion. Young athletes use the StretchLab at the end or between exercise sessions to work on the muscles and ligaments that take a beating during their workouts. Anyone wanting to decrease chronic pain, increase their range of motion, flexibility and overall health would benefit from visits to this stretching facility. At the end of your session, you walk away relaxed, rejuvenated and ready to take on the world. Maybe that’s why it’s becoming so increasingly popular.

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

White House Relaunches Cancer Moonshot Initiative

resident Joe Biden announced in February that he is giving a new push to the cancer moonshot initiative that he first led during the Obama administration. In his announcement, Biden said the program would aim to boost prevention, screening and research with a target of reducing the cancer death rate by 50% over the next 25 years. Both Biden and his wife, Jill, have embraced the initiative ever since they lost their son, Beau, to brain cancer at the age of 46 in 2015. “For Joe and me, [Beau’s death] has stolen our joy,” Jill Biden said at a White House event detailing the relaunch. “It left us broken in our grief. But through that pain, we found purpose, strengthening our fortitude for this fight to end cancer as we know it.” The project will also urge Americans to resume cancer screenings, which have declined during the pandemic, and seek to create more equitable access to cancer care through

measures such as mobile screening. A “cancer cabinet” of officials from across the federal government will be created to coordinate efforts, and there will be a push to hasten emerging early detection methods such as liquid biopsies to find multiple cancers through blood tests, the White House said in a fact sheet detailing the plan. “All those we lost, all those we miss, we can end cancer as we know it,” Biden said at a White House gathering that included about 100 cancer researchers. “This is a presidential White House priority. Period.” The only thing the plan is missing is money. Biden called on Congress to fund the new program, but didn’t provide a specific proposal. In 2016, Congress provided $1.8 billion over seven years for the first cancer moonshot, and about $400 million, or two years of funding, remains, the Washington Post reported.

discharge and relieve the pressure on hospitals is severely curtailed. According to a poll of 14,000 skilled nursing facilities by the American Healthcare Association, 58% are facing severe staffing shortages. SNFs have lost 234,000 employees or 15% of their workforce since the pandemic. At the same time, hospital discharges to SNFs, primarily due to COVID-19, have increased 32%. Discharges to home health care agencies have increased 42% and discharges to hospices have increased 15%. According to the Kaiser Family Foundation, more than 200,000 SNF residents and employees died from COVID-19. Your patience, understanding and cooperation will go a long way with stressed out staff and your treatment.

mary care physicians and 43% cited need for specialists. Adding to the list of concerns were: patient safety, behavioral health and addiction, government mandates, access to services, patient satisfaction, physician and hospital relations, technology, population health management and reorganization. It will take more expertise and a lot more cash than your average hospital has to reimagine and reorganize how care is delivered. Unless there is some sort of leveling of the playing field, for profit corporations with plenty of expertise and cash (like CVS, Walmart, Amazon, etc.) will gradually dominate the industry within the next decade.

It Takes a Shark

President Biden has resurrected the Cancer Moonshot Campaign, which aims to reduce the cancer death rate by 50% in 25 years. While COVID-19 has claimed 800,000 lives the past two years, cancer continues to claim 1.2 million lives every year. Biden has directed more funding to the National Cancer Institute and the National Institutes for Health. Industry analysts estimate close to 10 million cancer screenings have been delayed during the pandemic. The Community Oncology Alliance has continually emphasized the fact that regular cancer screenings are inextricably linked to health disparities such as income, insurance, race, access to care and education. Two cancer screenings that have been proven to be both clinically and financially effective are mammography and colonoscopies.

Healthcare in a Minute By George W. Chapman

Physician Burnout at Worst Levels in Decades

t no time in the past several decades has physician burnout and stress been worse. A recent survey of 13,000 physicians, published by Medscape 2022, revealed one in four (26%) physicians describes themselves as “unhappy” versus just one in 10 (9%) prior to the pandemic. The unhappiness percentage is much higher among hospital-based physicians. The two-year-old, and counting, pandemic has taken its toll on physician relationships at work and

Telehealth Extended In January 2020, at the beginning on the pandemic, Congress declared a public health epidemic, which directed more funding to physicians and hospitals. It was scheduled to expire January 2022. Thankfully, it has been extended through April 16, 2022. What this means, primarily for consumers, is the continuing financial, operational and philosophical support for telemedicine. The pandemic has significantly accelerated the use, acceptance and effectiveness of telemedicine which, prior to the pandemic, was largely underutilized primarily because of payment issues with Medicare and commercial insurers. The PHE authorized Medicare to pay physicians the same for virtual visits as in-person visits. Commercial payers followed suit. Telemedicine has increased or improved access to care for millions of senior, infirmed, disabled, incapacitated consumers as well as those living in rural and remote areas. As an example, United Health Group saw its telemedicine visits soar from 1.2 million in 2019 to a staggering 34 million in 2020. An HHS study found that telehealth

at home. Many physicians indicated they will either retire early or reduce hours, which will only exacerbate the looming physician shortage. The burnout is attributed to staffing shortages, longer and stress-packed hours, the spike in patient deaths and non-ompliant, demanding and outright ungrateful patients. Last December, six large Ohio healthcare systems, including the Cleveland Clinic, ran ads in local papers stating, simply, “HELP.” (See Help Wanted! below)

usage ran between 21% and 28% among various demographic subgroups. Understandably, the usage rate among the uninsured was only 9%. Somewhat surprisingly, the usage rate among technology-savvy 1824 year olds was only 18%. However, when they used telehealth, 73% of them used video. Income was a major determinant as 69% of households over $100,000 income incorporated telemedicine into their care.

Healthcare System Clogged The combination of higher acuity (and length of stay) of COVID-19 patients with system-wide staffing shortages has clogged or delayed hospital discharges to nursing homes, home care agencies and even hospices. On the front end, when a hospital can’t discharge patients on a timely basis, it backs up the emergency department. Consequently, waiting times increase, ambulances are stacked up in the parking lot and ED hallways are jammed with patients on gurneys waiting for a bed. On the back end, with nursing homes, home care agencies and hospices facing their own staffing shortages, their ability to safely accept a

While the ubiquitous drug lobby has ramped up its efforts to prevent congress from fairly negotiating prices (versus “setting” prices per their misleading ads), billionaire philanthropist Mark Cuban of TV’s “Shark Tank” has started his own on-line generic drug pharmacy called “Mark Cuban Cost Plus Drug Company.” There are currently 100 generic drugs on his formulary. Several popular generic drugs are offered at around half the price of the competition. Unlike typical pharmaceutical industry practices, he has vowed to be totally transparent. In general, prices are based on the manufacturer’s price plus a flat 15% fee. He has eliminated the middle man. It will be on a cash-only basis to keep out predatory pharmacy benefit managers.

Help Wanted! For the first time, hospital CEOs cited staffing shortages as their No. 1 priority and concern. Perennial front runner finances fell to second place. Three-hundred ten hospital CEOs responded to the most recent survey conducted by the American College of Healthcare Executives. Ninety-four percent of them cited need for RNs, 85% cited need for therapists, 45% cited need for pri-

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

Cancer Prevention Campaign

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 C

Things You Should Know About Colon Cancer By Ernst Lamothe Jr.

olon cancer remains one of the most preventable cancers around. Colorectal cancer occurs when there is overgrowth of abnormal cancerous cells in the colon. Your colon is a tube-like structure in the large intestine connecting to the small intestine, which removes water, few nutrients and electrolytes from partially digested food. The American Cancer Society estimated that about one in 25 women and one in 23 men develops colorectal cancer during their lifetime. “Unfortunately, colon cancer has the third most cancer-related death and it is quite preventable when identified in pre-malignant form,” said physician Jessica Martinolich, clinical assistant professor with the Jacobs School of Medicine at the University of Buffalo and affiliated with UBMD Surgery. “With this being one of the few cancers where we have the ability to screen before it develops, that is why early detection is so essential.” Martinolich talks about five aspects of colorectal cancer and prevention that you need to know.

1.Misconceptions

There are myriad misconceptions when it comes to colorectal cancer. Anything from only people with family history get colon cancer to the idea that it is always fatal. Colorectal cancer may be curable when detected early. Over 90% of patients with localized colorectal cancer are alive five years after diagnosis. However, only around a third of all colorectal cancers are diagnosed at this early stage. Another myth is that the disease

only strikes the older population. “This is something that is not true. We are finding younger and younger patients get diagnosed with colon cancer,” said Martinolich.

2.Get a colonoscopy

In 2021, there were about 150,000 colon and rectal cancers. A colonoscopy is an exam used to detect changes or abnormalities in the large intestine colon and rectum. During a colonoscopy, a long, flexible tube is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon. “The prep for a colonoscopy can be time consuming, but it can also be life changing,” said Martinolich. “It is a fairly quick procedure that can be performed in less than an hour and then you can go home. The next day you can go back to your regular activities and it is very low risk.” There are also tests where you can send your stool to a testing site and it is screened for blood as well as chemicals that can detect abnormalities of cells within the colon.

3.Stages of cancer

Colorectal cancer grows from stage 0, which is the earliest stage to stage 4, the most advanced. At stage 0, the abnormal cells are only in the inner lining of the colon or rectum. At stage 1, the cancer grows through the inner lining and reaches the muscle layer of the colon or rectum. At stage 2, the cancer grows through the wall of the colon or rectum but won’t spread into nearby tissue or lymph nodes. At stage 3, the cancer will move to the

CSP Offers Free Colorectal Cancer Screening By Suzanne Canfield and Lisa Milewski

ing were changed from age 50 to 45 for people at average risk for colorectal cancer. If you think you may be at higher risk for colorectal cancer due to family history, symptoms, or because you have other bowel diseases, ask your health care provider if you should begin screening before age 45. The CSP is asking all adults to talk to their health care providers about their risk for colorectal cancer and when to start screening. If you do not have insurance or health care provider, call the CSP at 716-858-7376. n Suzanne Canfield and Lisa Milewski are senior outreach aides with CSP of Erie County. For more information, visit www3.erie.gov/ cancerservices.

guideline 4.Colonoscopy changes

In May 2021, the U.S. Preventive Services Task Force issued new recommendations for colorectal cancer starting at an earlier age. “Before we used to tell patients they can begin screenings at age 50. But that is one of the reasons why they have lowered the recommended age to 45 years old, especially if you are beginning to see any symptoms or have a family history,” said Martinolich. Deaths of people younger than 55 increased 1% per year from 2008 to 2017, even though overall colorectal cancer rates have dropped. In addition, she said family history could play a large role in early detection cases. “One very important thing that cannot be overlooked is patients with family history. That would include primary or secondary from mother and father to aunts, uncles and grandparents,” said Martinolich.

Physician Jessica Martinolich, affiliated with UBMD Surgery, is a clinical assistant professor with the Jacobs School of Medicine at the University of Buffalo. “You should definitely discuss this with your primary care physician.”

5.It affects women, too

Sometimes there has been confusion on whether both genders are supposed to get colonoscopies because some people mix up colon and prostates. The colon is part of your large intestine and your GI tract that turns your food into stool. The prostate is more of a male productive organ. While it lies in proximity to the colon, they should not be grouped together. “The colon is both in males and females and they are diagnosed at the same rate across the board,” she added. “People often confuse the colon and prostate. Men should worry about colon and prostate cancer and women should worry about colon or vaginal cancer.”

Registration for the 2022 Ride for Roswell now Open

45 is the new 50 for colorectal cancer screening he Cancer Services Program (CSP) of Erie County is happy to share that we now offer free colorectal cancer screening at age 45, instead of 50. Our program screens people who do not have insurance and who are at average risk for colorectal cancer. The CSP gives out screening tests that are done at home and mailed to a lab. A screening test is used to look for disease before there are symptoms. Screening tests can find cancer early when it may be easier to treat. When it comes to colorectal cancer, screening may even prevent it by finding growths that can be removed before they turn into cancer. March is Colorectal Cancer Awareness Month. Last May, the national recommendations for screen-

lymph nodes but not to other parts of the body. At stage 4 the final stage, the cancer will spread to other major organs, such as the liver or lungs. People with stage 1 and stage 2 colon cancer may experience symptoms like constipation, diarrhea, change in stool color or shape, blood in stool, bleeding from rectum, excessive gas, abdominal cramps and abdominal pain. Some people with colon cancer may not even experience any symptoms in the earlier stage which makes it even more difficult to predict the condition. But, the symptoms are noticeable in stages 3 and 4 such as excessive fatigue, weakness, weight loss, vomiting, feeling like your bowel is not completely empty. “Stage 1 and 2 means the cancer is isolated and hasn’t spread out of the colon,” she added. “If cancer spreads outside the colon wall, then it will likely spread to the lymph nodes.”

R O

ide weekend is back in June this year, being held June 25 only at the University at Buffalo. nline registration for the Ride for Roswell, presented by the West Herr Automotive Group, is now available at www.rideforroswell.org. Thousands of riders and volunteers will gather at the University at Buffalo to participate in the 27th Ride for Roswell to raise funds for cancer research and patient care programs at Roswell Park Comprehensive Cancer Center. Routes from 3 to 100 miles start between 6:30 and 10:30 a.m., providing an option for riders of all ages and skill levels. To give riders many opportunities to participate in their favorite route, organizers have added additional start times for 2022. For riders looking to create a DIY Ride Day experience, the Ride Your Own Way option is available

again for 2022. This option allows individuals, families, friends and teams to create their own ride experience by selecting a date, location and route that suits their schedule, location and experience level. “Year after year, the ride community shows up and continues to prove they are an unstoppable force in the fight against cancer,” said Candace Johnson, president and CEO of Roswell Park Comprehensive Cancer Center. “Every day, loved ones in our community are being diagnosed with cancer and the funds raised are ensuring that we can continue to discover new treatments and bring the latest care to patients, giving hope to so many families right here in WNY.” Once again, there is no registration fee and no fundraising minimum for the ride. To learn more about the locations, routes, rewards and to register, visit www. rideforroswell.org.

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

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

‘Beware the Ides of March’ ... or Not!

n William Shakespeare’s “Julius Caesar,” a soothsayer warns Caesar to “Beware the Ides of March.” That immortal phrase portends gloom and doom. It has also given the month of March, a rather wearisome month to begin with, a bad rap. Will this cold, rainy weather ever end? Will tender tree buds ever appear? Will we ever grill out again? If March is stretching out in front of you as a big, dreary void to fill, you are not alone. For many, a prolonged winter wonderland is not so wonderful when cabin fever sets in. Anxiety and restlessness can make unwelcome visits. You might feel yourself spiraling down, questioning the past and second-guessing your future dreams. And that’s when you could be tempted to grab for the TV remote, a pint of Ben and Jerry’s, and head for the couch — or worse — for bed. Sounds familiar? I can remember many nights after my divorce, coming home after work to an empty apartment with hours on my hands and a heavy heart. The prospect of a long, lonely evening or weekend ahead was almost unbearable. After far too many nights on the couch, way too much TV, I had finally had enough. Both wanting and needing to make better use of my “me time,” I made some intentional changes to reduce my stress and restore my energy. Today, I am thoroughly com-

fortable spending time by myself and have come to enjoy my own company. In fact, it’s not unusual for me to pass on an invitation to go out in favor of spending a nice quiet evening at home — relaxing or fully engaged in something I love to do. If you are challenged by time alone this time of year, consider getting back to basics this March by following the “Three Rs” below: Reading, ‘Riting, and ‘Rithmatic.

Reading When is the last time you read a good book? In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely evening for those who live alone. While I’m reluctant to credit the pandemic with anything positive, I did discover a silver lining: Sheltering in place kick-started a reading binge for me that has yet to subside. Reading “by ear” has become my preferred medium. I listen to audiobooks in my car, on my walks, while exercising, and when doing mundane tasks. Folding laundry comes to mind. Beyond the convenience of audiobooks, a good narrator can bring the text to life. When I listen to my books, I experience a more intimate and emotional connection to the

U.S. Kids Still Dying From Toppling TVs, Furniture

ake sure your TV and furniture are anchored to the wall to protect little ones from potentially deadly tip-overs. Between 2018 and 2020, an average of 22,500 Americans a year required emergency department treatment for tip-over injuries, and nearly 44% were under 18, according to the U.S. Consumer Product Safety Commission (CPSC). Since 2000, there have been nearly 600 tip-over deaths involving furniture, TVs or appliances, and 81% of those victims were children 17 and

younger. “People either don’t know about the risks, or they think it can’t happen when an adult is nearby,” said CPSC Chair Alex Hoehn-Saric. According to the new CPSC report, 71% of all child deaths involved a TV; 62% of deaths in all age groups involved a TV; 55% of deaths involved people being crushed; and 66% of deaths resulted from head injuries. In 2015, CPSC launched a campaign called AnchorIt! to educate Americans about the dangers of tip-

characters and a deeper understanding of the story. Audiobooks have reinvigorated my love for reading. Whether you enjoy reading a book in your hands, on your laptop, or through your earbuds, I’m confident you will feel less alone. Don’t know where to start? Ask a friend for a book suggestion or make a selection from The New York Time’s best-seller list. My most recent favorite is “The Midnight Library” by Matt Haig. Snuggle up in a comfy, well-lit place and let a good book introduce you to new people, new places, and new ideas as we transition from winter to spring.

‘Riting I have found that putting pen to paper often lends clarity to the issues I face as a single woman. When I put things down in words, I can better organize my thoughts and embrace life’s challenges with less apprehension and more objectivity. While I don’t keep a diary or journal, I am a tried-and-true list maker. Almost nothing gives me more satisfaction than checking things off my list — from paying bills to practicing meditation to returning emails. I’m also a believer in capturing on paper the pros and cons of bigger life decisions, such as ending a longterm relationship, moving across the country to be closer to loved ones or to buying a new versus a used car. These bigger, more profound decisions often trigger emotions and fears that can intrude on clear thinking. One helpful resource I have discovered is the “3-minute Positivity Journal” by bestselling author Kristen Butler. In her book, Kristen maintains that a daily habit of physically writing out our thoughts, feelings, intentions, reflections, goals and wins can change your life. Excepted from the book jacket: “Each entry is quick, yet powerful — overs. Between 2011 and 2020, there was a 55% decrease in tip-over injuries treated in U.S. emergency rooms, largely due to fewer TV tip-overs. “We’re pleased to see the decrease in tip-over injuries over time,” Hoehn-Saric said in a commission news release. Protection is inexpensive and easy to install, he said. “Most anti-tip-over kits cost less than $20 and can be installed in fewer than 20 minutes,” Hoehn-Saric said. “We urge parents and caregivers to protect their children and families and make the time to secure heavy items in their homes.” The CPSC offers these suggestions: • Anchor TVs and furniture such as bookcases and dressers securely to the wall. • TVs should be on a sturdy, low base and placed back as far as possible, particularly if they can’t be anchored. • Don’t display

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

only three minutes in the morning and three minutes in the evening — to keep you on track with your mindset, health and goals.” I encourage you to check it out. March won’t be so bad after all!

‘Rithmatic Yes, arithmetic. Math is all about patterns and relationships. And relationships are key to our happiness as we get older. But don’t take my word for it. In the Harvard “Study of Adult Development,” one of the world’s longest studies of adult life and health, researchers uncovered a surprising finding: That our relationships and how happy we are in our relationships have a powerful influence on our health. This is according to Robert Waldinger, director of the study and professor of psychiatry at Harvard Medical School. The study revealed that close relationships, more than money or fame, are what keep people happy throughout their lives. My readers have heard me say this many times: Mastering the art of living alone is not about mastering the art of isolation. It is about mastering the art of engagement and connection with yourself and with others. Our journey to contentment is one we make with companions. Relationships are what bring purpose and meaning to our lives. So, hug those dear to you and embrace the month of March — doldrums, slush, Ides and all! 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 or store items such as toys and remotes where kids may be tempted to climb to reach for them. • Store heavier items on lower shelves or in lower drawers. • When you buy a new TV, consider recycling your old one. If you move the older TV to another room, be sure it is anchored to the wall properly. • Keep TV and cable cords out of children’s reach. • Even when TVs and furniture are anchored, children should still be supervised by an adult.

‘The largest population group affected by suicide is men in the middle years of their lives.’ the people have mental health issues, including depression. That is sad to me because depression is very treatable. Because there is still a stigma about mental health, many people who have anxiety, depression, suicidal thoughts are afraid to say it out loud to family, friends or to health professionals. Q. It’s shocking when high-profile people die by suicide. Names like Anthony Bourdain, Robin Williams, Kate Spade, Chris Cornell, Chester Bennington come to mind. What group is most affected by suicide? A. The largest population group affected by suicide is men in the middle years of their lives. Much of that is related to expectations about what it means to be a man, what we expect men to be, perhaps their fear of showing weakness, or the stress and burden a man carries from a stressful work environment, family responsibilities. There is an informative public service announcement on our website called “Be A Man,” which addresses this issue. Women tend to seek more mental health services than men, and make more attempts. Men tend to use more lethal methods like firearms.

Q A &

with Celia Spacone

Mental health issues, including depression, are behind a great number of suicides, says coordinator of the Suicide Prevention Coalition of Erie County

Q. When a well-known person takes his or her life, is there a copycat effect? A. There can be — which is why the way these situations are reported is so important. By its nature, the story is dramatic and it’s blasted all over. Health professionals have urged the media not to describe the method of suicide. Some of the language can be triggering and offensive. Some impressionable youth could think that suicide is what everyone is doing. Because youngsters often learn by modeling behavior, this can be potentially dangerous for them. Media reports can be irresponsible — an outlet printed Kate Spade’s suicide note before her daughter saw it.

By Brenda Alesii

he difficult topic of suicide has been prominent in the news over the past few weeks. On Jan. 30, former Miss USA 2019 Cheslie Kryst took her own life in dramatic fashion in New York City. Kryst was an accomplished woman, earning a law degree and an MBA, and also worked as a social activist and an entertainment correspondent. Kryst’s mother said, after the devastating loss of her 30-year-old daughter, that Kryst was dealing with high-functioning depression, which she hid until shortly before her tragic death. In Good Health recently spoke with Celia Spacone, Ph.D., the coordinator of the Suicide Prevention

Coalition of Erie County, which is administered by Crisis Services; it includes numerous agencies, school districts, hospitals and community stakeholders. A Grand Island resident and former director of the Buffalo Psychiatric Center, Spacone currently works out of Crisis Services offices and is passionate about helping people who may be contemplating suicide. ——— Q. Why do people take their own lives? A. The reasons are typically multifaceted. It’s often several things coming together, a good portion of

Q. Are there systems in place to temporarily hold firearms? A. Yes, during a time of crisis — a divorce, economic hardship, poor

health leading to a feeling of hopelessness — gun shops, gun clubs and many law enforcement agencies will temporarily hold the individual’s firearms. No reason has to be given to authorities and it is voluntary. A map showing locations in Erie and Niagara Counties is on our website. It’s important to have some time and distance during that crisis and not have lethal methods readily available. Q. Some of the suicide-related statistics are staggering. A. Yes, more police officers, for example, die by suicide than in the line of duty. Both male and female veterans have a higher than average rate of suicide. For young people between the ages of 10 and 24, suicide in the United States is the second highest cause of death. Q. Why is listening to someone feeling vulnerable a good practice? A. It’s important to let the person talk, not to judge or problem solve. If he or she were having a heart attack, for instance, it wouldn’t be appropriate to say “you should change your diet, exercise, reduce stress.” It’s not the time for giving advice. Q. What resources are available if a friend or family member is struggling? A. Our coalition does education programs for churches, clubs, organizations, senior centers and the like. We discuss risk factors and warning signs and explain why a struggling loved one should not be ignored. Crisis Services can offer support, guidance, and referrals. Even during the pandemic, Crisis Services did not close for even one minute. The agency is available 24/7 by calling 716-834-3131. Q. Is there help available for survivors? A. Support groups and therapists can be found at www.AFSP.org. Crisis Services will do outreach at homes of survivors and link them to agencies. It takes a long time to heal. Don’t ignore survivors because it is an already isolating situation. If you don’t know what to say, simply say that you’re there to listen and you’re sorry the survivor is going through this tough experience. Editor’s Note: To learn more about suicide and Suicide Prevention Coalition of Erie County, visit www.suicidepreventionECNY.org. To find a support group or therapists, visit www.AFSP.org

COVID Helps Drive Nearly Two-Year Decline in U.S. Life Expectancy

OVID-19 is now the third leading cause of death for Americans and has shortened life expectancy by nearly two years, a drop not seen since World War II, a new government report shows. Life expectancy dropped from 78.8 in 2010 to 77 in 2020 as the age-adjusted death rate increased 17%, going from 715 deaths per 100,000 people in 2019 to 835 deaths per 100,000 in 2020, researchers from the U.S Centers for Disease Control and Prevention found. “We haven’t seen a decline like

this since 1943,” said Robert Anderson, chief of mortality statistics at CDC’s National Center for Health Statistics (NCHS). “Normally, we don’t see fluctuations of more than two or three tenths in a year. So, any sort of change of this magnitude is really quite unusual. And we can attribute the bulk of this decrease in life expectancy to COVID-19,” he said. Death rates increased for all age groups aged 15 and older. The leading causes of death were heart disease and cancer, followed by COVID-19. Other causes of death

were drug overdoses and other unintentional injuries, followed by stroke, chronic lower respiratory diseases, Alzheimer’s disease, diabetes, influenza, pneumonia and kidney disease. “There was a large increase in unintentional injury, mortality, and most of those are drug overdose deaths,” Anderson said. Overdose deaths dipped in 2017 and that was “encouraging,” he added. But they have risen again: “The bulk of the increases are due to the synthetic opioid category, most of which is illicit fentanyl,” he noted.

There were also increases in cardiovascular deaths, heart disease and stroke and, in particular, Alzheimer’s disease. Also, increases in deaths were seen in diabetes and pneumonia. “Those are the causes really driving this and, of course, the largest driver is COVID-19, which we didn’t have before,” Anderson said. He also said that COVID-19 may be playing a role in these other deaths, as some causes of death may have been misreported.

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

Spectrum Health, Evergreen Health Awarded $2.65 Million to Reduce Overdose Deaths in WNY’s Rural Communities

pectrum Health and Human Services and Evergreen Health recently announced receipt of a joint $2.65 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to expand and enhance medication assisted treatment (MAT) services in rural communities across Western New York. The grant will cover a period of five years and will benefit 10 counties in Western New York. The initiative will allow the two organizations to work together to reduce overdose deaths and respond to the overall overdose crisis across Western New York. Spectrum Health and Evergreen Health together expanding their MAT programs is a direct response to the unprecedented overdose deaths in the region and immediate need for drug user health services. “Spectrum Health was thrilled to be chosen for this SAMHSA grant with Evergreen. There is a secondary tragedy during the COVID-19 pandemic — and it’s the increase in deaths due to drug overdose,” said Cindy Voelker, associate CEO Jenna Schifferle is a writer from Tonawanda. She runs to stay healthy, challenge herself, and collect new stories to write about.

of Spectrum Health. According to the Erie County Opioid Task Force and the Centers for Disease Control, there was a 29.4% increase in opioid-related deaths since 2019. “We had been making progress in decreasing overdose deaths prior to the pandemic, and now our services are even more important,” added Voelker. The federal SAMHSA grant will fund MAT programs for adolescents and adults with substance abuse disorder and opioid use disorder, as well as those at risk of HIV and hepatitis C due to injection drug use, in rural and underserved communities. MAT is the use of medications, including buprenorphine (also referred to as Suboxone), to help an individual stop or reduce their use of drugs and/or alcohol. The collaborative program will unite two already strong MAT programs and increase the scope of Spectrum Health and Evergreen Health’s services in rural areas. For Spectrum Health, the organization will be able to more fully utilize its mobile therapy units,

put on the road in 2021, in Springville and Warsaw. For Evergreen Health, availability of its services will now extend beyond Buffalo to its Jamestown location. Ultimately, the intent of the program is to expand to ten Western New York counties. “The impact of extending our MAT programs is not only to reduce overdose deaths, but also to provide wraparound and lifesaving services. By linking at-risk individuals to vital drug user health services like MAT, we also open the door to providing medical, supportive and behavioral services, which can have true impact on a community’s health and the health of its residents. This grant will mean helping more communities and the people and families who have been historically underserved by the healthcare system,” said Khristopher Decker, vice president of behavioral health at Evergreen Health. Ann Bowback was named director of the initiative. Bowback was formerly the Clinical Director of Spectrum Health’s South Buffalo Counseling Center.

Writer on the Run By Jenna Schifferle

jenna.schifferle@gmail.com

Runner Spotlight: Thomas Alguire Runner constantly seeks out ways to challenge himself: ‘I want to see how far I can push my body’

homas Alguire, 40, of Angola, has been running for seven years. His job installing heating systems for restaurants means he’s always on his feet and occasionally has to work obscure hours. But that doesn’t dissuade him from running. He fits runs in wherever he can, even when that means hitting the pavement at midnight or 1 a.m. His girlfriend and 13-year-old daughter sometimes join him for races. Most times, he runs alone. And when the crowd roars at a race, it reminds him of all the reasons he loves to compete. Alguire’s running journey started seven years ago with a 5K race for which he didn’t train. The sun beat down hot that day. Being new to the sport, he didn’t carry hydration with him. By the end of the race, he was depleted. “I didn’t consider myself a runner back then,” he said. “I was like a fish out of water.” Despite being unprepared, he pushed forward and reached the end. His body was exhausted, but his mind was buzzing. “It was the finish line. The crowds of people. Everyone cheering you on. Everyone’s so nice out there,” he said. That day set into motion Alguire’s lifelong passion for competing. He soon did additional 5K races, including the Texas Roadhouse 5K. The sole competitor in his age group, he took first place. Following a taekwondo injury, Alguire decided to mix up his fitness routine and take his running to the next level. He registered for a half marathon (13.1 miles) in Ellicottville and soon began to wonder what he

had gotten himself into. On race day, the miles became a struggle, and his body felt under-prepared. He finished, but the soreness stayed with him for well over a week. So did the feeling of accomplishment. “As much as I hurt afterward, I had this feeling like, ‘I just ran a half. What else am I capable of?’” he said. This feeling catalyzed his fitness journey, leading him to sign up for the Spartan Sprint in Pittsburgh. Unlike a standard 5K, Spartan races

are held on off-road terrain and incorporate obstacles for competitors to work through over the length of the journey. The Spartan Sprint is often considered the “gateway” to longer Spartan races and includes 20 obstacles in mud and water that athletes climb, crawl and cross. Obstacles range from monkey bars and walls to sandbags, dunk tanks and more. For Alguire, that first sprint turned into a years-long obsession with competing in Spartan races. His goal is always to see how far he can push himself physically and mentally. He has competed in 18 Spartan races up and down the East Coast and in Chicago, completing the coveted Spartan Trifecta six times. A Spartan Trifecta consists of three parts completed over a single racing season: 1) Spartan Sprint or Spartan Stadion: a 5K (~3.1 miles) with 20 obstacles 2) Spartan Super: a 10K (~6.2 miles) race with 25 obstacles 3) Spartan Beast: 21K (~13 miles) with 30 obstacles / or Spartan Ultra: 50k (~31.1 miles) with 60 obstacles “I want to see how far I can push my body,” Alguire said. “How far can I go? What else can I do? What am I capable of?” Alguire constantly seeks out ways to challenge himself, whether that’s with a new course and different obstacles or by adding more mileage to his docket. He completed a 30-mile obstacle course in Scotland in 30-degree,

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

foggy weather. Among the obstacles for that event was a swim across the pond that was enough to give some competitors hypothermia. Alguire finished in 13 hours. He has also completed several 100-mile races, including the Beast of Burden, Florida Keys 100, and a virtual 100-mile run around his hometown. For these events, he runs for 26 or more hours at a time. “You get to a spot during 100mile races, where you just want to stop and lay down,” he said. It’s during those moments when mental preparation comes into play. Alguire typically runs every day, sometimes twice a day, as part of his training. But it’s self-reflection and mental resilience that make the difference when he needs to push through. Though it’s rare, there have been a couple occasions when he’s had to throw in the towel. “You tell yourself all these reasons you should quit and sometimes your mind just wins,” he said. “It is one of the most defeating things to know your mind quit before your body did.” At the same time, he lives for the moments when he finishes a race. It is those successes that propel him forward. In 2022, he’ll continue that forward momentum, despite injuries and life’s obstacles. His advice to others? “Be open-minded and listen to your body. Know when to push through and when to quit,” he said.

SmartBites

The skinny on healthy eating Prune’s Other Benefits May Surprise You By Anne Palumbo

hould we pity the poor prune? It’s shriveled, wrinkled and puckered. It’s best known for relieving constipation. It’s granny’s favorite fruit. It’s never in restaurants but always in nursing homes. And its sexy makeover — from dowdy prune to provocative dried plum — never gained enough traction to stick. But, no, we should not pity the humble prune. We should take a cue from granny and get to know this delicious dried fruit even better! Boasting an impressive array of nutrients — over 15 different vitamins and minerals — a prune’s health benefits go way beyond the bathroom. Ready for some surprises? Prunes are great for bones. Yes, bones! Current studies suggest that simply eating a serving of five prunes a day may help slow and prevent bone loss. While it’s not entirely clear why prunes promote bone health, this mighty dried fruit has many properties to consider: good amounts of vitamin K and potassium (both vital for strong bones), a wealth of antioxidants that may protect bones from cell damage, and the potential to increase certain hormones that are involved in bone formation. No wonder Granny’s doing the Rumba with Gramps into the wee hours!

Another startling perk from this toothsome dried plum? Prunes benefit heart health. Their fiber helps lower cholesterol; their powerful antioxidants keep inflammation at bay; and their potassium helps lower blood pressure and ease tension in the walls of blood vessels. Indeed, a trifecta of nutrients to help keep our tickers tocking longer. Lastly, prunes are good for guts in more ways than one. While the insoluble fiber in prunes promotes regular bowel movements, the soluble fiber helps to moderate digestion and absorb nutrients from our food. What’s more, prunes contain sorbitol — an ingredient known to have a laxative effect — which can increase stool frequency. Feeling blocked-up and sluggish? Passing stools as hard as golf balls? You know what to reach for! An average serving of four prunes has 90 calories, 3 grams of fiber, and no fat, cholesterol or sodium. Final surprise? A recent study found that people who snacked on prunes felt less hungry and ate fewer calories overall than people who ate other foods.

Helpful tips Look for prunes that have no added sugars and are preservative-free. Tightly reseal opened packages and store in a cool, dry place. Prunes do not need to be refrigerated. If you’re not used to eating prunes or other fiber-rich foods, you may want to start slow with one to two prunes a day and slowly work your way up.

How Calling a Food ‘Light’ in Calories Can Backfire

f the label says your food is “light,” will you eat more to fill up? Quite possibly, a new study suggests.

Make the salad Rinse the quinoa (to remove bitterness) and drain well. Combine the rinsed quinoa and water in a saucepan. Bring the mixture to a boil over medium-high heat, then decrease the heat to low to maintain a gentle simmer. Cook until the quinoa has absorbed all the water, about 15 to 20 minutes. Remove the pot from heat, cover, and let quinoa steam for 5 minutes. Transfer the quinoa to a medium bowl and fluff with a fork. Cut the peppers into small chunks, finely chop the parsley, and cut the prunes into quarters. Drizzle vinaigrette over fluffed quinoa and mix well. Add the peppers, parsley, prunes, lemon zest, lemon juice and slivered almonds and gently mix again. Adjust seasonings and serve. Make the vinaigrette

Quinoa Salad with Chopped Prunes and Prune Vinaigrette

Adapted from californiaprunes.org Serves 4-6 For the salad: ¾ cup quinoa 1½ cups water ½ cup chopped red pepper ½ cup chopped yellow pepper ¼ cup parsley, finely chopped 5 prunes, zest from 1 lemon 1-2 tablespoons lemon juice ½ cup slivered almonds, toasted For the vinaigrette: 4 prunes ½ cup water 2 tablespoons olive oil 1 tablespoon balsamic vinegar

Researchers invited 37 men and women to a simple lunch of penne pasta, snack tomatoes, pesto, oregano and basil. One time, the meal was de-

½ teaspoon Dijon mustard ½ teaspoon salt ¼ teaspoon coarse black pepper 1-2 tablespoons water to thin, as needed

scribed as “light” and not designed to fill them up. Another time, they were told the same meal was created to be “filling.” Overall, diners ate more when the meal was labeled “light.” They also said they felt less full. “It suggests that if you have this preconception the meal you’re about to eat is going to be really filling, then maybe you’ll eat less of it,” said study co-author Paige Cunningham, a doctoral student in nutrition sciences at Penn State University. “And if the opposite is true, if you perceive the meal to be light and not quite as filling, then maybe you’ll eat slightly more of that.” For the study, the researchers recruited 18 women and 19 men through ads and posters, excluding those whose sense of fullness or taste might be affected by particular dietary habits or health issues. Participants ranged in age from 18 to 65. After eating, participants were asked a number of questions. Among them: “How filling did you find this pasta salad?” and “How many calories do you think you consumed?” They were also asked “How important is your health to you?”

While quinoa is cooking, make the vinaigrette. Cut prunes in half and put in a small pan with ½ cup water. Bring to a boil and then decrease the heat to low to maintain a gentle simmer. Simmer, uncovered, for around 10 minutes until the water is almost gone. Stir occasionally while prunes are cooking. Remove from heat and transfer to a small food processor. Add oil, balsamic vinegar, Dijon mustard, salt and pepper and blend until fairly smooth. Add 1 to 2 tablespoons water to get a pourable thickness.

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.

Researchers from Maastricht University in the Netherlands repeated the same experiment. Though it’s not clear whether the findings can be generalized to other locations, Cunningham said they are exciting. “This effect could be leveraged to promote intake in vulnerable populations, [such as] older persons who perhaps aren’t quite meeting their energy needs,” she said. “The flip side is perhaps it warrants caution [in] the use of labels that denote the satiating power of food,” Cunningham added. “Weight loss products or products labeled as light, maybe those could backfire and actually result in more intake.” The findings were published online Jan. 15 in the journal Appetite. Cunningham suggested that people avoid using descriptions on labels to determine whether a food will fill them up. “Standard advice is, no matter what the label says, just be aware of the portions that you are eating and the energy content, and the actual nutrition of the dish that you are consuming,” Cunningham said. “Just make sure that you are aware of that.”

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

KIDS & TEENS

Poor Body Image Affects Teens’ Mental Health

Body image in particular for females has always been an ongoing problem By Deborah Jeanne Sergeant

eens who view their body image negatively experience an increased risk of low self-esteem, depression, nutrition and growth issues, eating disorders and having a higher body mass index of 30 or higher, according to the Mayo Clinic. Some may try to control their weight by smoking diet pills, taking supplements to increase muscle mass or change their appearance through cosmetic procedures. Oftentimes, teens base their ideal body image on what they see in the

media—only now instead of just movies, magazines and television, teens can access media anytime, anywhere. “Social media, for better or worse, contains so much information, some of which is accurate and positive and some of it is inaccurate and negative,” said Joshua Russell, child and adolescent psychiatrist with UB. “It projects unrealistic expectations.” Via social media, anyone has the ability to post and see unrealistic images and videos that portray perfect lives. The software used to improve posts is ubiquitous. Unfortunately, young people tend to view these posts as reality and the ideal to which they should aspire, whether that’s a svelte figure, chiseled abs or high cheekbones. “It gets harder as kids get older and they have more autonomy,” Russell said. “One of parents’ roles is to have a sense of what social media platforms kids are using, what kind of content is on there, for younger kids, it’s reasonable for parents to have access to passwords to sites to make sure kids are safe and looking at appropriate things. Day to day take a more nonchalant focus on how kids dress and things like that.” Russell likes the positive messages offered by the new Disney movie, “Encanto,” which parents can use

to draw attention to different body types. The movie features Mirabel, a teen with a typical body type, and Luisa, a supporting character whose physical strength is her special magical power. Luisa’s body composition befits her power, as she is tall and muscular. Neither is like the clichéd Disney female with a slim, willowy body type. “It’s useful for parents to not necessarily point out the bodies of those characters, but the positives you see from the characters,” Russell said. “A lot of it is about taking a general approach and expectation that all body types are acceptable. Look at the achievement and hard work that people have done and it has nothing to do with body size and type.” Children should take breaks from social media and to spend more of their down time engaging in activities that build their confidence. Accomplishing goals allows teens to develop a sense of worth outside of their physical appearance. Building meaningful relationships, both familial and among friends, can help teens’ self-image, too. Leading by example is how Rodrick Davis, pediatrician at Portland Pediatric Group in Rochester, wants more parents to help their children develop a healthy body image. “If parents are careful to not

Advances in Pediatric Cancer Treatment One of the latest ways to treat childhood cancer includes immunotherapy By Deborah Jeanne Sergeant

n 1970, fewer than 5% of pediatric cancer patients would be cancer-free five years later. Today, 81% of childhood cancer cases are. “In general, it’s a very exciting time in cancer therapy, and that extends to the care of children with cancer,” said physician Kara Kelly, chairwoman of the Roswell Park Oishei Children’s Cancer and Blood Disorders Program and a professor of pediatrics at UB/Jacobs School. “We’re very fortunate to offer many of these innovative therapies in Buffalo with our collaborations with Kaleida, Roswell and UB Pediatrics.” One of the latest ways to treat childhood cancer includes immunotherapy. While chemotherapy and radiation are often very effective in treating many kinds of childhood cancer, the side effects, both shortterm and long-term, can devastate children’s health: raised risk of second cancers, life-threatening cardiovascular disease, lung complications, and kidney and liver damage. Immunotherapy is like a sharpshooter, targeting the cancer while sparing the healthy cells. One kind of immunotherapy is chimeric antigen receptor T-cell or CAR T-cell therapy. This treatment is now FDA approved for children whose B-cell acute lymphoblastic leukemia has not responded to conventional therapy. Medical providers collect T cells

from the patient, filter their blood and modify those T cells so that home in on receptors on the surface of the cancer cells. The cells are reinfused back into the patient to clear out the cancerous cells. Fewer than 10% of the patients receiving CAR T-cell therapy would have survived without it. But receiving the therapy spares 65% to 70% of patients. “Immune therapy requires specialized care,” Kelly said. “In a way, the analogy is like what’s happening with COVID-19. Some get sicker form the immune response than the virus. T-cell therapy can cause children to get very sick until that passes.” While children receive CAR T-cell therapy, they can mount a serious immune response, like they have a very serious infection. Some require a ventilator or experience neurologic toxicity with seizures. The therapy increases the risk of certain types of infection, but these are typically manageable. Because these are still recent therapies, researchers have only eight or so years of follow-up to tell them about patient longevity. More time is needed to track and monitor patients so researchers can better understand the long-term effects. “Building on this success in leukemia, we and others are now using this T-cell approach in other

types of diseases and using them at an earlier time point,” Kelly said. “Perhaps someday we can use these therapies instead of long courses of chemotherapy. We won’t know until we complete all the clinical trials. We offer some of these clinical trials to help us get the information we need to make a standard of care recommendations.” Other kinds of immunotherapies use medication to stimulate the body’s own T-cells to work better against illnesses such as Hodgkins lymphoma, melanoma and lung cancer, for example. The therapies are being used earlier and earlier in treatment as they have lower risks than radiation and chemotherapy. “We’re still testing these medications in clinical trials,” Kelly said. “We’re accumulating the knowledge, so hopefully it will change what our current practice is. They are not without side effects.” Hypothyroidism is one example. However, medication can replace the hormone that the thyroid would naturally generate. Kelly said that rarely, inflammation or the lungs or heart can also occur. Further research on side effects is ongoing. “As we learn more about it, we’ll be better able to use which medications in which patients at which doses,” she said. Other trials are looking at novel vaccine treatments that target cancer cells to treat brain tumors. Sharing information through enrollment in the National Cancer Institute’s cooperative group has helped doctors succeed in treating childhood cancers.

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

judge by body size and to recognize that people have different looks and are built differently, that helps,” he said. “Start early on to help them recognize that not everything is within the normal range. If she’s 15, it may be too late. When they’re younger is the ideal time to start.” Parents should praise their children for their character and other traits beyond appearance. Modeling healthy behavior can also help children develop a better body image. For example, complaining about one’s weight, going on extreme diets, calling food “bad” or “good” or making derogatory comments about appearance can contribute to body image issues. Instead, parents should emphasize improving health, such as exercising regularly and eating a healthful, balanced diet. Regular exercise does not have to be a gymbased regimen but can include enjoyable physical activities and sports. No foods are “bad” or “good,” but a healthful diet focuses on plenty of fruits and vegetables, whole grains, lean sources of protein, dairy and a few healthful fats, but with minimal processed foods. In addition, a pediatrician can discuss healthy body weight during a well child visit. “What we found is by having enough patients on the same protocol, we can find out what works and what doesn’t,” said Steven Lipshultz, MD, who leads research and treatment on cardiac oncology and is president of UBMD Pediatrics at Jacobs School of Medicine. “We were able to take these rare diseases we were able to get rapid advances and modifications and learn about side effects and toxicity.” Progress in treating adult cancer has not progressed nearly as much as with pediatric cancer, partly because of age-related comorbidities. Another difference is the quality of life for the expected lifespan. A 75-year-old patient would have another five or so years expected lifespan, unlike a child. The long-term side effects weigh more heavily with younger patients. That is why developing effective treatments that preserve healthy cells is so important. For example, chemotherapy often damages the heart as a side effect. “What we don’t want to do is create a generation of cardiac cripples or people with so much disability that they cannot get on with their life,” Lipshultz said. Lipshultz was involved with developing dexrazoxane hydrochloride, a drug that allows chemotherapy to kill cancer cells while protecting the heart from the chemotherapy. This is part of the strategy of balancing oncologic success while preserving quality of life. “Even 18 years later, we’ve pulled back these patients who had chemotherapy as children and their hearts are significantly stronger because of this medication,” Lipshultz said.

KIDS & TEENS

Top 10 Issues Teens Face Today The pandemic has added a great deal of pressure on teen, young kids By Deborah Jeanne Sergeant

n addition to the normal issues teenagers face, the pandemic has added an additional layer of stressors and pressure. Area experts weighed in on what they believe are the top issues of young people. 1. Substance use.

“Especially with the media we have now with movies, music, social media, use is glorified,” said Felicia Diaz, addiction counselor for Kids Escaping Drugs Renaissance Campus in West Seneca. “Kids are not always growing up thinking this is wrong, especially when their role models sing about it. It’s important for schools and parents to have honest conversations about drugs and alcohol and how it can impact them, especially when they are young and not fully developed. 2. Peer pressure. “Kids like to experiment, but it’s scary how easily accessible things are,” Diaz said.

3. Vaping. “Kids are being conditioned to see that their friends do it and they think, ‘If it’s OK for them, it’s OK for me,’” Diaz said. “Have honest conversations about how these can harm them. Don’t shame them or tell them they will be punished if they have an issue.” 4. Loneliness. “This triggers a lot of issues like suicide ideation,” said Edward Cichon, director of marketing and communications at Cazenovia Recovery in Buffalo. “The more parents can help kids feel open to healthy relationships, the better.”

sations, ask about peer pressure and ask other questions,” said Angela Angora, director of reintegration at Cazenovia Recovery. 6. Alcohol consumption. “Clear, healthy boundaries are very important,” Angora said. “Individuals in recovery say they don’t want to tell their child to not have a can of beer because at that age they did. It’s important to have clear, healthy boundaries with their children. If the legal age to drink is 21, following that and having the child not drink is a reasonable rule.”

need to mature as your child goes from being a child to an adolescent.” 8. Eating disorders. “There’s an increase among teen girls for eating disorders,” Condino said. “I see kids who are very much struggling with binge eating behavior. The way I look at obesity is at the other end of the spectrum are patients with anorexia. Kids are struggling with access to healthy foods and balance.”

10. Sexually transmitted infections.

7. Mental health.

5. Bullying. “Don’t be afraid to have conver-

“One overriding theme that’s going on that the pandemic has highlighted is the mental health of our teenagers,” said physician Dalinda Condino, division chief of Adolescent Medicine at UBMD Pediatrics and associate professor at Jacobs School of Medicine. “We have had more than 100% increase of new referrals for our eating disorder program. National data shows that just with eating disorders, there are more requests for hospital admission and residential treatment. Family connection is factor for resilience. As a parent, your communication skills

patient needs.”

9. Marijuana use. “It is a common drug kids are using and teens don’t look at it as a problem,” Condino said. “I constantly have discussions. Medical marijuana is medical and not recreational. It is dispensed by someone who knows what they’re getting and what the

“Throughout the pandemic, the prevalence of sexually transmissible infections has increased like chlamydia, gonorrhea and in males who have sex with other males, increase of syphilis. We remind parents that teenagers want limit-setting. When we have parents who are absent or overly permissive, the teens struggle. If they’re too authoritarian, the teens struggle. If you’re authoritative in a positive way, kids know what the expectations are. They want some level of expectation. Communication is important. Know your kids’ friends, what goes on in their school.”

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

KIDS & TEENS

For kids and teens, it’s been hard to go back to the conventional way of doing things By Deborah Jeanne Sergeant

hildren have been through an awful lot in the past two years: online classes; social isolation; few in-person social outlets and interactions; constant stress from family finances, work and school changes; plenty of negative news media coverage; ever-shifting COVID-19 protocols; and fear of the virus itself. These factors can all contribute to a host of issues for children, including stunted social skills, developmental delays, learning issues, anxiety and depression. “General behavioral health needs with teens and substance use have been a huge, huge concern,” said Edward Cichon, director of marketing and communications for Cazenovia Recovery in Buffalo. “There’s clear data that this population has been hard hit by the pandemic. It’s led to substance abuse issues.” Especially for younger children who do not remember life before COVID-19, it can be difficult to tell what the long-term effects could be. “There’s certainly been a loss,” said physician Michael DiGiacomo with UBMD Psychiatry. “Kids are not getting a full academic experience,

especially the end of the 2019-20 school year and the 2020-21 school year. Kids are learning what they can, but certainly not to the same extent as if they were in person. It’s stressful to show up at school. There’s all the stress on six feet apart, masks and Plexiglas.” Children have missed life lessons such as how to make friends with someone new, settle small squabbles with children they do not know or develop understanding with someone from a different background. Oftentimes, these situations occur on the playground, while waiting in line or during other incidental, unplanned times during a school day. Children may struggle to understand sharing, taking turns and resolving minor conflict because those serendipitous interactions they would experience at school do not happen during Zoom and Facetime “playdates” arranged with their preCOVID-19 friends. DiGiacomo said that adolescents are becoming more involved with their online activities, gravitating towards internet friends instead of in-person friends, which has led to

an uptick in cyberbullying and online drama. While the isolation may have felt like a godsend to more introverted children, isolation prevents them from becoming as social as they could be. For older children who are home by themselves more, the lack of structure in their school day followed by the shock of returning to in-person classes has been challenging. “The routine of getting ready is lost and the structure and support,” DiGiacomo said. “It has been very difficult and puts them at risk for depression, anxiety and sometimes suicidal ideation and attempts.” Online schooling is less than ideal for most children. As children exhibit different learning style—some are more hands-on, others prefer the explanation inherent to a lecture, still more like reading over doing or hearing—virtual learning has hamstrung teachers to instruct in fewer styles than they could in the classroom. While the struggles of the past two years have certainly made typical development more difficult, DiGiacomo does see a few positives,

such as the display of resilience from so many children as they figure out how to make life work, as well as a sense of gratitude for health and relationships. Joshua Russell, child and adolescent psychiatrist with UBMD Psychiatry and assistant professor at Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, encourages parents to get creative with social interactions while staying safe according to current guidelines. “Create opportunities where there’s mask breaks,” Russell said. “Or, do playdates that are shorter. Or have everyone get some space to take the masks off. It’s still important to get kids the social experiences that are harder to come by now.” Gently reintroducing social activities to anxious children will better prepare children for long-term social success. The academic gaps concern many parents. However, they should keep in mind that this factor is universal. Nearly all children are expected to have some degree of lag in their schooling, so an amount of remedial work is normal. Russell said that parents should try to introduce hands-on educational experiences at home, as younger children absorb information better that way, although “screens can still be useful if there are ways to make it interactive, like sing-along programs. Also, parents can look up printouts for kids to fill out or turning math concepts into a game. Or take time to just read with kids. They can supplement some of the learning.” Parents can use the summer to help make up for lost time. Bringing home more library books, engaging in educational outings such as to places like museums, open houses and cultural points of interest and using educational media such as games, documentaries and puzzles can help children feel better prepared for the next school year.

From first check ups to annual physicials to chronic condition management, our primary care providers and specialists are with you for all your child’s needs. With UBMD, you can expect comprehensive care in the office, in the hospital and at home with UBMD CareConnect.

By providing primary, specialty & surgical care for all ages, UBMD is your one source for the health of you & your family.

Accepting new patients at UBMD Family Medicine and UBMD Pediatrics Page 14 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2022

UBMD.COM

Additional Information

KIDS & TEENS

Is Cocomelon Damaging Our Kids’ Brains? Some say the show is too hyper-stimulating for children By Amanda Jowsey

arents of preschoolers have come to know and love JJ, TomTom, and his sister, YoYo, the beloved characters of “Cocomelon,” a children’s show with more than 120 million subscribers on YouTube, generating 3 billion views per month. Their bright faces are now etched into our minds and hearts. And, naturally, we’re sick of hearing the same songs repeated. New claims about the show’s psychological impact on children provoke doubt about the show’s quality. Jerrica Sannes, child development specialist and online mom group celebrity, claimed that “Cocomelon” is so hyper-stimulating, it acts as a drug and mimics the effects of addiction in children. “The brain gets a hit of dopamine from screen time and it seems the stronger the ‘drug’ (level of stimulation a show delivers), the stronger the ‘hit.’ This leads to young children experiencing symptoms of addiction and withdrawal, leaving them completely dysregulated,” Sannes said on her Instagram page. She believes that the show’s hyper-stimulatory traits come from the fast-paced scenes per second and the way the camera moves frequently, if not constantly, during these scenes. She said that shows like this lead to “a general discomfort in the speed of everyday life. The more they watch the show, the more their brain begins to expect this intense level of stimulation which makes it impossible for them to play creatively and without entertainment.” Claire E. Cameron, Ph.D., associate professor of learning and instruction at the University at Buffalo Graduate School of Education, confirmed that “Rapid pacing and production features draw young

Unless you have young children at home, you probably never heard of the show ‘Cocomelon.’ But make no mistake, this is one of the hottest shows for young kids and it’s only available online — it has 120 million subscribers on YouTube and generates 3 billion views per month. children’s attention through sensory systems, not higher order brain functions like comprehension.” For young children, their priority is on orienting. “It’s a way of processing information through the sensory systems of the brain. It’s a way of making sure we are safe… paying attention to important things in our environment,” Cameron said. “This fast-paced hyper-stimulation prevents children from having time to process and comprehend what is happening. The pacing is too fast for them to comprehend so their higher order thinking and understanding is not able to develop.” Cameron developed the HeadToes-Knees-Shoulders task, a gamelike assessment of executive function and behavioral self-regulation for children. Angeline Lillard, professor of psychology at the University of Virginia, did a study on “SpongeBob SquarePants” using Cameron’s measure. Lillard proposed that those fast-paced shows, like “Cocomelon,” “are really draining to a child’s at-

tention and executive systems. After watching something like that, when asked to use those cognitive skills, they’re sort of depleted,” Cameron summarized. Many of the “Cocomelon” songs are classic children’s nursery rhymes that teach valuable lessons. It focuses on the love of family, good manners, caring for animals and other people and the importance of trying new things. So, while “Cocomelon” is full of incredibly wholesome values and seems to be very educational, the larger lessons may be lost on a child who is too overwhelmed with sensory input to grasp these larger concepts. “There are basically three conversations here,” Cameron said. “The first one is the quality of the show in comparison to other media available to young children. The second huge conversation is let’s not get too picky about an individual show. Let’s step back and think about what media use and screen time does for young children’s development and maybe what it prevents from happening. The third one that’s really important not to overlook is for parents and especially in pandemic times and what has led to increased screen times and the pressures on parents.” “You can’t tell parents what they’re doing is wrong when they’re surviving or doing what’s needed to get by. We need a structural shift so that parents can be more present when children are young. More family leave, sick leave, more vacation, we need a different social contract,” Cameron added. Can infants become addicted to shows like “Cocomelon”? Cameron believes that when asking this question, we need to talk more about the young needs of children than the show itself. We need to make sure that we are not relying on this media

Top: “Cocomelon,” a children’s show with more than 120 million subscribers on YouTube, generates 3 billion views per month. Critics say the show is so hyper-stimulating that it acts as a drug and mimics the effects of addiction in children. Below: Claire E. Cameron, Ph.D., associate professor of learning and instruction at the University at Buffalo Graduate School of Education.

to replace vital things in the home such as secure attachment, stable and warm caregivers, language input and interaction. “Which of their needs is media filling in the house?” Cameron asked. This will allow us to make more informed decisions and choose quality shows for our children. Cameron’s final takeaway about “Cocomelon” is that she would look for alternate slow-paced realistic shows and talk about them with kids while it’s on. Turning down the volume reduces stimulation. Allowing repeated views to increase the child’s understanding of what they’re watching may also help with that higher thinking. She also recommends getting an ad blocker if it’s being watched on YouTube because the ads that pop up suddenly during an episode also make it difficult for a child to follow the larger narrative, which prevents that higher thinking and comprehension. Replace screen time with rich interaction as much as possible and help children set boundaries when you turn it off.

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

Joe DiNardo with his late wife, Marcia, and daughter Julianna during a New Year’s party in 2010. He became a cancer advocate after his wife died of pancreatic cancer in 2015. He has written books and taught mindfulness at Roswell Park. Photo provided.

Cancer Experience Inspires Books, Inspirational Speaking

Author shares means of dealing with the loss of a loved one By Deborah Jeanne Sergeant

n 2013, Joe DiNardo, an attorney and founder of Counsel Financial in Buffalo, could scarcely imagine that his wife, Marcia’s “stomachache” was really a symptom of pancreatic cancer. Within days, Marcia appeared jaundiced, prompting the couple to seek medical attention. The problem seemed to be gallstones. However, none proved present. The eventual cancer diagnosis stunned the DiNardos. Within days, providers at Roswell Park Cancer Comprehensive Cancer Center spotted a shadow on Marcia’s liver that would indicate stage 4 pancreatic cancer. The second opinion at Mount Sinai in New York City confirmed the diagnosis changed from stage 1 to 4, meaning that chemotherapy but not surgery was in order. The couple returned to Roswell so that Marcia could receive treatment near their Williamsville home. All of this transpired within just one week, turning upside down the lives of Joe, Marcia and their then 13-year-old, Julianna. “You never could have imagined it,” Joe DiNardo said. “Marcia was healthy, beautiful, energetic. She never got sick. Suddenly, this happened.” As her chemotherapy treatments progressed, the chemicals built up in Marcia’s system. Joe could do little as

he watched his wife suffer while she had likely only six months or less to live. DiNardo felt that he should not share that fact with Marcia so she would not lose hope. But they both “had this intuitive sense,” DiNardo said, that their life together would not be long. Marcia endured eight weeks of weekly treatments for her first round of chemotherapy. By the end of the fifth week, she could barely walk. Beating all the odds, Marcia lived for two years after her diagnosis. Her health would stabilize periodically, but each time the cancer returned, it meant a different cocktail of chemotherapy drugs until her providers ran out of options. Near the end of her life, Marcia received an experimental but ineffective therapy. “Toward the last few months, she had no options; she wasn’t well,” DiNardo said. “She went from 115 pounds to 87. She was just skin on a skeleton but still tried to get up every day and hug our daughter.” She wanted to take one last vacation with the extended family, so the DiNardos rented a house in Fort Myers. Marcia spent the first few days recuperating from the flight. Then she decided to go shopping, ostensibly so she would have smaller clothing that fit her after losing so much weight, but also to have one last outing with Julianna; their nanny, Erin Doepp-Shapiro; the nanny’s daughter, Hayley Rinaldo; and nieces

who also came on the vacation. When Marcia later began to vomit blood, it became clear that she needed more medical care than of the nurse tending her. Marcia asked her husband pointblank if she would recover. The couple had always said they would tell each other the truth no matter what. DiNardo told her, “I don’t think you’re getting better.” She turned to the window and said, “Oh,” accepting that the end was close. The next day, the family arranged an emergency flight home so she could rest comfortably with hospice care. Within days, Marcia’s blood pressure lowered and her pulse sped up: signs she would not live long. Her family said their goodbyes. She surprised everyone by sitting up to hug Julianna. “Everyone was around her and I held her hand,” DiNardo said. “I whispered things to her, telling her it was OK. And we were OK. She was free to go whenever she wanted to. I heard the rattle of her final breath, a deep long breath, and in a few seconds, she transitioned out.” On March 3, 2015, Marcia died holding her husband’s hand. “It was heartbreaking to see someone you love suddenly not be there,” DiNardo said. To cope with the grief, DiNardo turned to vipassana (insight) meditation, which he had begun practicing

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

in 1971. He had studied under meditation teachers from the West and from India and Thailand. Mindfulness helped him feel close to Marcia. “The practice of being silent and focused and allowing emotions and thoughts to arise and pass away in formal practice, gives you an openness to whatever happens in your life that people don’t normally have,” DiNardo said. “I felt this experience was the most powerful single experience that I’d ever had. I felt like right there that the person I loved most in the world transitioned out of her body. It’s awe-inspiring, as sad as it is.” He also credits his circle of family and friends with working through his grief. To help him process Marcia’s coming death, he began writing a letter to her. The letter formed the eulogy that he read at her funeral. Afterwards, many people began asking for a copy. Eventually, DiNardo wrote a small memoir, “The Letter to My Wife,” which is now available on Amazon. He has also written “Mindfulness Matters for Everyone” (also on Amazon) to share the benefits of the practice. “Both books give you a clearer picture of my thinking and my practice and our relationship,” he said. He has taught mindfulness at Roswell Park for the past three and a half years and aided in forming their mindfulness program. “Mindfulness is a simple thing, but it’s not easy,” DiNardo said. “It involves looking at fears, pain and suffering and many people are not so sure they want to do it.” Working through emotions with mindfulness has helped him face the biggest challenge of his life with fortitude as well as thankfulness for the time he shared with Marcia.

By Jim Miller

Approaching 65? Here’s What to Know About Enrolling in Medicare Dear Savvy Senior, Can you give me a brief rundown of Medicare’s enrollment choices along with when and how to sign-up? — Approaching 65

Dear Approaching, The rules and timetables for Medicare enrollment can be confusing to many new retirees, so it’s smart to plan ahead. Here’s a simplified rundown of what to know. First, a quick review. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people, and Part B which covers doctor’s visits and other medical services, and costs $170.10 per month for most enrollees in 2021. When to Enroll: Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later. You can enroll any time during the “initial enrollment period,” which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. It’s best to enroll three months before your birth month to ensure your coverage starts when you turn 65. If you happen to miss the seven-month sign-up window for Medicare Part B, you’ll have to wait until the next “general enrollment period” which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You’ll also incur a 10% penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium. You can sign up for premium-free Part A, at any time with no penalty. Working Exceptions: Special rules apply if you’re eligible for Medicare and still on the job. If you have health insurance coverage through your employer or your spouse’s employer, and the company has 20 or more employees, you have a “special enrollment period” in which you can sign up. This means that you can delay enrolling in Medicare Part B and are not subject to the 10% late-enrollment penalty as long as you sign up within eight months of losing that coverage. Drug Coverage: Be aware that original Medicare does not cover prescription medications, so if you

don’t have credible drug coverage from an employer or union, you’ll need to buy a Part D drug plan from a private insurance company (see Medicare.gov/plan-compare) during your initial enrollment if you want coverage. If you don’t, you’ll incur a premium penalty — 1% of the average national premium ($33 in 2022) for every month you don’t have coverage — if you enroll later. Supplemental Coverage: If you choose original Medicare, it’s also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles. See Medicare.gov/medigap-supplemental-insurance-plans to shop and compare policies. All-In-One Plans: Instead of getting original Medicare, plus a Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan instead (see Medicare.gov/ plan-compare) that covers everything in one plan. Nearly half of all new Medicare enrollees are signing up for Advantage plans. These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper premiums, but their deductibles and co-pays are usually higher. Many of these plans also provide coverage for extra services not offered by original Medicare like dental, hearing and vision coverage along with gym fitness memberships, and most plans include prescription drug coverage too. How to Enroll: If you’re already receiving your Social Security benefits before 65, you will automatically be enrolled in Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have work coverage that qualifies you for late enrollment. If you’re not receiving Social Security, you’ll need to enroll either online at SSA.gov/medicare or over the phone at 800-772-1213. 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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March 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 17

More than 15,000 BuffaloNiagara Residents Eligible For Team-Guided Palliative Care

Ask The Social

OP-ED

By Richard Castaldo, MD

n 1974, a pioneering surgical oncologist in Montreal named Dr. Balfour Mount coined the term “palliative care” to create a different connotation than “hospice care.” Over the last four decades, the growth of this type of comfort care in the United States has paralleled that of hospice, which began in the same year in Connecticut. While most people are familiar with what hospice means, many others are not aware of what palliative care entails in delivering relief to patients on the late-stage illness spectrum. The two types of care share a similar focus. However, admission to a palliative program is initiated earlier in the illness process, rather than just at end of life and patients can still receive chemotherapy or dialysis. According to the Center to Advance Palliative Care, there are six million people in the United States with a serious illness who could benefit from palliative care. Based on that ratio, that translates to more than 15,000 people in the Buffalo Niagara Region who might be eligible. For Western New Yorkers with serious, progressive illnesses, it can be challenging to navigate the health care system. The extensive paperwork and variety of medical decisions can make finding and securing the needed services a difficult time. When a chronic condition impacts quality of life for patients and families, contacting a palliative care provider enables them to receive the comprehensive care and support that fits their needs. Chronic illnesses often lead to patients cycling in and out of the emergency room or hospital. Some examples of diseases for which palliative care proves especially effective include cancer, chronic obstructive pulmonary disease, congestive heart failure, dementia and neurological disorders, including ALS & MS. Anyone can make a referral; it does not have to be a health care professional. When doctors refer patients to palliative care, they are not relinquishing their primary care of that patient; rather, they are receiving a supplemental team of experts that implements additional services and resources. They collaborate with primary care physicians and specialists to create a care plan to keep patients independent at home. They serve as an extra set of eyes and hands to lighten a practice’s workload and can give doctors alerts for any condition changes. When patients enroll in palliative care, which is often covered by health insurance, they receive case management to reduce discomfort and hospitalizations. The primary goal is to alleviate distress associated with advanced illnesses. A cross-functional team develops a care plan for the patient’s home or long-term care facilities to prevent trips to the emergency room or hospital admissions and mitigate symptoms such as: pain, shortness of breath, loss of appetite, constipation and emotional needs and spiritual concerns. The services address mental,

emotional, social and spiritual issues. A medical director performs consultations to review a patient’s stage in the disease process and medical needs. Registered nurses make monthly visits in the home or assisted living facility to assess what is troubling the patient while anticipating needs and ensuring appropriate medications are available. Patients also have access to a social worker who will assist them with accessing necessary resources, applying for Medicaid and obtaining personal care aide services and social or medical transportation. Social workers also help prepare advance directives while guiding families and connecting them to community resources, personal care aides and medical or social transportation. Spiritual counselors can discuss one’s values and beliefs, the search for purpose and meaning, and how serious illness can make it difficult to find acceptance and peace. The ultimate goal is to adopt coping strategies to ease stress from the illness and its related symptoms. Sorting through the landscape of health care organizations can be overwhelming for individuals to find the proper assistance they need. Chronic illness educators spend extensive time counseling patients, answering questions and responding to concerns regarding the illness and its prognosis. They take pride in teaching patients and families about the disease process and treatment options. Another benefit is that staff can visit patients after they are discharged from the hospital to help avoid additional hospitalizations. Nurses help patients avoid exacerbating conditions related to the illness as part of a post-acute care model. Many programs now offer remote patient monitoring through telehealth kits that equip clinical staff with real-time monitoring and evaluation, enabling a rapid response whenever the situation demands it. There are many organizations that oversee palliative and hospice care, enabling a streamlined approach for clinical staff to be crosstrained in patient evaluation and admissions for both programs. Many patients eventually are referred from palliative care to hospice in a continuum of care that emphasizes comfort and quality of life for everyone involved for as long as possible. Whether a patient is discharged from a palliative program or continues to hospice care, the clinical team aims to meet the patient’s goals for comfort and dignity. The medical directors, nurses and social workers always strive to alleviate any burden in the family through dedicated, specialized care and thorough guidance at every step of the illness.

Security Office

From the Social Security District Office

Submit Your Social Security Disability Update Report Online

e are required to periodically conduct continuing disability reviews for beneficiaries with disabilities. This process requires that beneficiaries complete a continuing disability review packet, that we mail to beneficiaries, to help us update information about their medical conditions and recent treatments. Additionally, we offer an online option for beneficiaries to complete the disability update report form and provide any supporting documents about their medical treatment or work activities. We designed this form with convenience in mind — and to save you time. You can access the online form at www.ssa.gov/ssa455-online-

Physician Richard Castaldo is the medical director of Niagara Hospice and Pathways Palliative Care in Niagara County.

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

form. (Use either Microsoft Edge or Google Chrome for the best online experience.) When you complete your continuing disability review, you will need your Social Security number, current address and phone number, and a valid email address to complete the form. Also, you must have received a request for an updated disability report in the mail. Once you “Click to Sign,” you will receive an email from echosign. com asking you to confirm your digital signature. Check your junk folder if you don’t receive it within a few minutes. If your signature isn’t complete your form won’t be processed. Please be sure to let your friends and loved ones know about this new online option.

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Health News years after their diagnosis — would be incredible.” “Glioblastoma is a notoriously aggressive and hard-to-treat cancer. We are encouraged by the results from our earlier studies and excited to bring this treatment option to more brain cancer patients at more centers,” says Fenstermaker.

$90K Raised for Evergreen Health’s HIV services Dining Out For Life, the national food and drink fundraising event and the region’s largest annual HIV fundraiser, raised more than $90,000 during its October fundraiser in Western New York, according to a January news release. During the event, more than 50 restaurants donated a percentage of their sales to Evergreen Health, a local healthcare organization that specializes in HIV and hepatitis C testing, treatment and care, as well as drug user health services. “HIV is a treatable chronic health condition, and with treatment, people living with HIV can lead healthy lives. We thank the Western New York community and our restaurants for their generous donations – $90,000 that is going directly to our HIV testing, care and treatment,” said Rob Baird, director of advancement at Evergreen Health. Dining Out For Life WNY has taken place for 19 consecutive years and raised more than $1,340,000 to provide services for those in Western New York living with HIV. Dining Out For Life is a food and drink event through which, by dining out at local restaurants, patrons donate to community-based organizations serving people living with or impacted by HIV. In Western New York, 25% or more of food and drink purchases are given to beneficiary Evergreen Health. According to 2019 data, 3,400 people are living with HIV/AIDS within the eight counties of Western New York. Of those individuals, 2,929 know their diagnosis. Evergreen Health cares for more than 1500 patients living with HIV/ AIDS.

Roswell Park opens clinical trial of promising brain cancer immunotherapy Roswell Park Comprehensive Cancer Center is the first center to treat patients in a newly opened advanced-stage clinical trial utilizing the brain cancer vaccine SurVaxM, offering a new treatment option for patients who are dealing with a rare but deadly form of the disease. The multicenter randomized clinical trial is sponsored by MimiVax LLC, a company spun off from Roswell Park in 2012. Currently recruiting, the phase 2B randomized SURVIVE trial is

Independent Health recognized for mental health efforts

Candace Johnson named to ‘Health Care 100 Power’ list

oswell Park Comprehensive Cancer Center President and CEO Candace S. Johnson, Ph.D., has recently been named to City & State’s 2022 Health Care Power 100 list. The weekly news magazine counts Johnson as one of the “New York leaders who are saving lives.” Amid an ongoing pandemic, the publication notes, the individuals included in the list have led their respective organization’s response to COVID-19 as well as other pressing health care matters. Roswell Park has helped both its patients and the general public to access information and resources about the coronavirus and COVID-19 vaccines, while also forging new partnerships and published new research to further its mission as a cancer hospital.

open to newly diagnosed adult glioblastoma patients. At Roswell Park, the trial will be under the direction of principal investigator, physician Ajay Abad, a neurologic oncologist and faculty member in the department of neuro-oncology. Altogether, the trial is expected to be open across 15 sites in the United States and China. Glioblastoma, though rare, is the most common primary brain cancer. Fast-growing and aggressive, the cancer is typically treated with surgery, chemotherapy and radiation, but frequently recurs within a year of initial treatment. Median survival for patient with standard therapy is 16 months. SurVaxM, an immunotherapy developed at Roswell Park by physician Robert Fenstermaker and Michael Ciesielski, Ph.D, assistant

“Roswell Park Comprehensive Cancer Center has delivered expert cancer care and research for 124 years, serving as the only such facility in upstate New York designated by the National Cancer Institute,” City & State writes. “The center’s president and chief executive officer, Candace Johnson, has been at the helm since 2015. Over the past year, the center has come out with research on the effect chronic stress has on tumor growth and has affiliated with Samaritan Medical Center to expand oncology services in the North Country.” The partnership with the Watertown-based hospital marks the most recent expansion of the Roswell Park Care Network. Johnson leads a team of more than 3,700 as president and CEO and M&T Bank Presidential Chair in Leadership at Roswell Park. She joined Roswell Park in February 2002 from the University of Pittsburgh Cancer Institute/University of Pittsburgh School of Medicine. professor of oncology, is now being developed by MimiVax. It is a unique treatment vaccine that targets survivin, a protein that helps cancer cells stay alive. A recent single-arm phase II study in 63 patients with newly diagnosed glioblastoma demonstrated significantly longer survival time for patients treated with SurVaxM, with 93.7% alive a year after diagnosis, compared to expected 65% survival based on historical studies. “For years, we’ve struggled to move the needle as far as good treatment options for glioblastoma. Our hope is that SurVaxM will offer patients both longer survival and better quality of life,” says Abad. “To hopefully be on the precipice of meaningful progress against glioblastoma and to be able to possibly see my patients outside of the hospital —

Independent Health has been awarded the 2022 platinum Bell Seal for Workplace Mental Health by Mental Health America (MHA). The Bell Seal is a first-of-its-kind workplace mental health certification that recognizes employers who strive to create mentally healthy workplaces for their employees. Founded in 1909, MHA is the nation’s leading community-based nonprofit dedicated to addressing the overall mental health of all. MHA has spent decades researching mental health in the workplace, and in 2019, MHA introduced the Bell Seal for Workplace Mental Health to recognize companies and organizations that understand the value of addressing mental health at work and implement policies and practices that support employee well-being. “Independent Health understands mental health, just like physical health, is a critical part of an individual’s overall health and wellbeing. As such, we are deeply committed to treating the whole person. We take pride in helping our associates, members and employers recognize the signs, understand what people are dealing with, and respond appropriately to support their mental health,” said physician Michael W. Cropp, president and CEO, Independent Health. Independent Health is the only organization in Western New York to be certified by MHA. Independent Health’s status as a platinum-level Bell Seal-certified organization demonstrates the company’s ongoing commitment to employee mental health and well-being, which in turn is instilled in the company’s wellness and mental health programming for its employer groups and members. Independent Health employs a comprehensive team of mental health professionals – including psychiatrists, mental health nurses, social workers, pharmacists, licensed counselors and behavioral health case managers — dedicated to helping members obtain timely, individualized and effective evidence-based care and treatment for mental health issues and substance use disorders.

Reach thousands of health-conscious readers who enjoy reading “In Good Health” on a monthly basis. Low cost advertising, free design work. Huge exposure. 716-332-0640 editor@bfohealth.com. March 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 19

Put Down Your Phones and Throw Some Stones Buffalo Curling Club offers unique recreational fun for the whole family By Daniel Meyer

t happens every four years and board members of the Buffalo Curling Club couldn’t be happier. Whenever the Winter Olympics take center stage, a corresponding increased interest in the sport of curling results. Those curious about playing the game reach out to the folks who oversee four gleaming sheets of meticulously manicured ice inside an industrial park just off the I-190 in South Buffalo. While the Olympics have concluded, league members and pick-up players continue to enjoy Western New York’s only dedicated curling facility. Offered as an opportunity to help conquer the inevitable seasonal slump most everyone in the region faces as we trudge into spring, indoor curling provides recreational fun for the whole family.

Olympic hopefuls come forward The typical curling season runs from October through March. Buffalo Curling Club’s ability to provide consistent ice surfaces because of its indoor facility allows people to play well into May. With an increased interest in curling because of the Olympics, board members are welcoming people new to the sport with open arms. “One of the best things about curling is that it really is an activity people of all ages, all skill levels and different athletic abilities can enjoy,” said Daniel Buchbinder, the club’s membership chairperson and a past president. “Everyone can fit in and find a role no matter how old they are, if they played before and if they are any type of athlete.” With nearly 300 members who actively play, the club has grown over the years from less than 10 people regularly playing to their current crop of competitors of various skill levels. “You have some people who

come in and think after playing a few times that they can soon represent our country in the Olympics. Then they come to understand all that comes with being highly competitive and consistent,” said Tim Lowden, one of the organization’s board members. “The good thing is it is a fun sport to play so each time you get out there hopefully you are improving and getting better than from that very first time you threw a stone.” The worldwide audience last month in China helped identify new players in Western New York just as it did in 2018 and in 2014. “The Olympics is huge for us,” said Buchbinder. “Every four years we see just an incredible push from people discovering what a super sport this is and we love that. From people who want to become highly skilled and compete in tournaments to the more casual player, we welcome everyone.”

Learn to curl Curious curlers can learn the sport without fully committing to club membership. There are weekend novice and beginner sessions during which experienced players teach the basics, allowing everyone to attempt to master each lesson and correctly comprehend the scoring system. Ice rentals are offered for pick-up games and various full-fledged leagues provide top-notch competitive action. “We want people who are new to the sport to give it a try,” said Marie Nowak, club treasurer. “If it turns out you really like curling and want to become a member, we are able to make that happen. We just want to see people get on the ice and enjoy themselves.” “We have children, younger people and middle-aged to older adults coming out to play,” said David Stachura, club president. “It’s always great to see a few dozen people throwing stones, playing games and having a fun time.” “We have many former ice hockey players who have become

members. What we’ve found is most everyone can learn to curl,” said Buchbinder. “It gives people something to look forward to doing, especially during some of the darker and drab days of winter. Not everyone goes downhill skiing or sledding or plays hockey. The people we see come out and try curling tend to like it and really enjoy themselves right away.”

Physical and mental health benefits The misconception that competitive curlers don’t have to be in shape couldn’t be more wrong. The best players have tremendously welltoned arm and leg muscles and the requirement of balance as a necessary skill leads to increased core strength, flexibility and coordination. The aerobic exercise experience of moving around in colder temperatures allows for more calories to be burned and each player walks approximately two miles up and down the ice during a typical game. In addition, the sweeping motion involved in directing the 44-pound stone (also known as a rock) increases the heart rate, improves the cardiovascular system and can even reduce blood pressure. The sliding of the rock and vigorous sweeping motions also help strengthen various muscles in the upper body and below the belt. “Curling is great for your mind because of the strategy involved as you use your mind to try and figure out how to score points and defeat your opponent,” said Buchbinder. “I also love that it stimulates your brain and gives you something to look forward to and helps provide social interaction, which is also a mental health benefit. The mental stimulation from a highly strategic sport that requires planning and strategizing and teamwork probably doesn’t get as much attention as it should.”

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The future is bright The skyrocketing popularity

every four years from the Olympic attention helps fuel two other target audiences for the club. “We have a youth program that is inspiring when you see children embracing the game and really getting excited about curling,” said Buchbinder. “The future of curling in this area will be up to these young people so to see more boys and girls out there is just awesome.” A concentrated effort to be more inclusive for people with a disability began last month with the introduction of adaptive equipment. “We want to allow disabled people to play and that includes people who have suffered some type of permanent paralysis or have muscular dystrophy or some type of coordination issue,” said Buchbinder. “What we began in February is only going to improve over time as we understand the needs of specific players.” For more information, visit www. buffalocurlingclub.org or call 716464-2875.

Curling 101: The Basic Rules • Two teams of four people each throw a stone down a sheet of ice towards a painted target, a 12-foot circle also known as “the house” painted like a bulls-eye. • Teams take turns throwing stones, with each team member throwing two in a row. • The team with the stone closest to the center of the house scores one point. • Similar to bocce ball, you can keep scoring points if more than one of your stones is closer than any opponent’s stones. • The team with the most points after 10 rounds is declared the winner.