In Good Health: WNY #91 - May 2022 by In Good Health: WNY's Healthcare Newspaper

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MAY 2022 • ISSUE 91

CELEBRATING NURSES National Nurses Week is in May; a great time to thank nurses for their incredible, dedicated and continued work.

ALSO INSIDE WHAT IT MEANS TO BE A NURSE, LONG-TERM NURSES LEAD WITH EMPATHY, A NURSE AND HIS HOBBIES,

MULTIDISCIPLINARY APPROACH TO CANCER Anthony Dakwar, a surgical oncologist who specializes in colon and rectal cancers, touts the multidisciplinary approach patients receive at Roswell Park

STAY BUSY, STAY HEALTHY:

WHY I KICKED THE FACEBOOK HABIT Find out why writer Amanda Jowsey kicked the habit. P. 20

WHY A BUSY RETIREMENT IS GOOD FOR YOU

Mary Sikorski, 91, a widow and Buffalo native: “Staying active keeps me young and healthy. My attitude toward life is always ‘stay open to new ideas and things,’” she says. P. 15.

P. 13 P. 14 P. 12

Half of World’s People Suffer From Headaches

f you suffer from headaches, you have plenty of company. Headaches afflict half of the world’s population, and women are more likely to get them than men, a new paper says. “We found that the prevalence of headache disorders remains high worldwide and the burden of different types may impact many. We should endeavor to reduce this burden through prevention and better treatment,” said study lead author Lars Jacob Stovner, of the Norwegian University of Science and Technology. The researchers reviewed 357 studies published between 1961 and the end of 2020. They found that 52% of people have a headache within a given year, including 14% with migraine, 26% with a tension-type headache and about 5% with a headache for 15 or more days a month. On any given day, almost 16% of people worldwide have a headache and nearly half (7%) have a migraine, according to the findings. The results were published April 12 in the Journal of Headache and Pain. All types of headache are more common in women than men, especially migraines (17% in females vs. about 9% in males) and headaches on 15 or more days a month (6% in females vs. less than 3% in males). “Compared to our previous report and global estimates, the data does suggest that headaches and migraines rates may be increasing. However, given that we could explain only 30% or less of the varia-

tion in headache estimates with the measures we looked at, it would be premature to conclude headaches are definitively increasing,” Stovner said in a journal news release. “What is clear is that over-

all, headache disorders are highly prevalent worldwide and can be a high burden. It may also be of interest in future to analyze the different causes of headaches that varied across groups to target preven-

tion and treatment more effectively,” he added. Most of the studies in the analysis included adults aged 20-65, but some also included adults older than 65 and children as young as age 5.

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

Meet

Your Doctor

By Chris Motola

Anthony Dakwar, M.D. U.S. Life Expectancy Drops for 2nd Year in a Row

esearchers report that life expectancy in the United States dropped in 2021, continuing a troubling trend that began in the first year of the pandemic. Specifically, average U.S. life expectancy tumbled from 78.86 years in 2019 to 76.99 in 2020. It then fell by a smaller amount in 2021, to 76.60 years, the new report found. One thing was different about the latest longevity numbers: Losses in life expectancy among white Americans were largely responsible for that continuing trajectory, the new study found. In 2020, Black and Hispanic Americans were disproportionately impacted by the pandemic amid chronic health disparities. The research team speculated that the reason for the changing dynamics in 2021 could be vaccine hesitancy among some white Americans and a resistance to pandemic restrictions, including in states with disproportionately white populations. “We already knew that the U.S. experienced historic losses in life expectancy in 2020 due to the COVID-19 pandemic. What wasn’t clear is what happened in 2021. To our knowledge this is the first study to report data for 2021, and the news isn’t good,” corresponding study author, physician Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, said in a university news release. “Early in 2021, knowing an excellent vaccine was being distributed, I was hopeful that the U.S. could recover some of its historic losses,” said Woolf. “But I began to worry more when I saw what happened as the year unfolded. Even so, as a scientist, until I saw the data it remained an open question how U.S. life expectancy for that year would be affected. It was shocking to see that U.S. life expectancy, rather than having rebounded, had dropped even further.” The emergence of the faster-spreading delta and omicron COVID-19 variants played a big role, the experts said.

Surgical oncologist who specializes in colon and rectal cancers touts the multidisciplinary approach patients receive at Roswell Park Q: I understand you bring a multidisciplinary approach to cancer care at Roswell Park Comprehensive Cancer Center. Can you elaborate on that? A: I’m a fellowship-trained, board-certified colorectal surgeon. My specialty really deals with complex rectal cancers, along with inflammatory bowel disease-related malignancies, such as Crohn’s disease and ulcerative colitis, along with hereditary polyposis syndromes. Roswell Park is mostly surgical oncologists who are trained to deal with some of these problems, but both of our skill sets together really get to provide a multidisciplinary approach for these complex patients to make sure they get the best care. We really pride ourselves here on the multidisciplinary approach. All of our patients get presented at our MDC. Q: What’s an MDC? A: That’s our multidisciplinary conference where we have myself, colorectal surgeons, surgical oncologists, medical oncologists, pathologists and radiation oncologists specialized in dealing with complex pathologies. That allows us to provide very individualized, customized care plans for each patient. And that’s something we really pride ourselves on. Another aspect that we bring here is that, as a colorectal surgeon, I’m very fluent and experienced in robotic surgeries and minimally invasive surgeries in general, so we can make sure that patients receive that and help expedite their care. They have a shorter length of stay, they recover faster, have less pain. It’s really phenomenal. Q: What relationship do inﬂammatory diseases like Crohn’s and ulcerative colitis have to colorectal cancer? A: Patients with inflammatory bowel disease such as Crohn’s and ulcerative colitis have an elevated risk of developing colorectal cancers. They present a lot of times in an unusual fashion. These patients have chronic colitis and chronic abdominal pain and GI symptoms in general. So we really need a multidisciplinary approach to these patients. A lot of them are on different medications to control their ulcerative colitis or

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

Crohn’s disease, but we haven’t found the magic bullet just yet. So a lot of these patients require surgeries at times. And these surgeries can become even more complex when there are associated malignancies. And that’s some of the expertise and specialization that I bring here. Q: What kind of contact do you have with patients through this process? A: We have a very robust and organized model for the patient. We have a motto: “Spend Just One Day With Us and See the Difference.” We really try to coordinate the patients plan in a way that we can have it done in one day. So a lot of times they will meet the oncologist, the radiation oncologist, the gastroenterologist, the surgeon, social work, physical therapists, dietitians, whatever needs they may have, we try to get it done the same day. That includes imaging, MRIs, CAT scans. We really try to make it convenient for the patient to come in, get everything done so that they can have a true comprehensive plan at the end of the day. And we really pride ourselves on that. That’s a major difference between being a center versus being a community practice. Q: Does that include screening? A: Screening is a different part. Screening usually requires a colonoscopy, which is the standard screening for colorectal cancers. But we do set that up here, whether that be locally or in injunction with their community GI doctor, whatever’s more convenient for the patient. Q: How replicable do you think Roswell Park’s model is in other institutions? A: It’s difficult to answer that. I can tell you that we’re able to do it here because we’re all located in one center and frequently communicate with each other. In the community, certain physicians when they work with other oncologists, have to bounce the patient back

and forth from office to office. And that can sometimes delay care and create confusing circumstances. Here we kind of have everything at one site where we can really focus in on taking care of the patient. So it’s probably difficult to replicate unless you have everyone in the same center. Q: What kind of effect does this approach have on outcomes? A: Our outcomes here at Roswell are among the best in the country. We are a national cancer institute, a recognized center by the Commission on Cancer. Next step will be getting our accreditation to be a national credited program for rectal cancer. These are all things made possible by our multidisciplinary approaches. Q: Correct me if I’m wrong, but it seems like colorectal cancer surgery has very good results compared to a lot of other kinds of cancer surgery. Why is that? A: The screening process has increased significantly over the last 15, 20 years. So we’re finding a lot of cancers earlier on. For that reason, a lot more of them are able to be cured. Colorectal cancers are one of the types of cancers that are curable with surgery, which is one of the reasons we have such a robust team dedicated to that goal. Secondarily, the age requirement for screenings in the community has decreased. Historically, screenings were at 50 years of age. We’re finding over the last 15 to 20 years that there’s an increased trend of colorectal cancers in younger adults, from ages 35 to 45. For that reason, the American Cancer Institute reduced the screening age down to 45. So we’re seeing the secondary effects of all that. Q: You’re originally from Buffalo, right? A: Yeah, I’m from the Buffalo area. I went away for training in general surgery in New York City and then went on to do my fellowship in Tampa. After that I worked for a few years for the University of Florida until an opportunity came up to come back to my community. And what better place to work than Roswell? So everything kind of worked out. Q: Was the plan always to return to Buffalo? A: I still have a lot of family here. So there’s a lot of benefit to raising my family here. I get to see my family and friends still, so that’s definitely a positive.

Lifelines

Name: Anthony Dakwar, M.D. Position: Surgical oncologist at Roswell Park Cancer Center Hometown: Buffalo Education: Medical degree: Techinion — Israel Institute of Technology, Haifa, Israel (2008-2012); residency: general surgery, NewYork-Presbyterian Hospital, New York (2012-2018); fellowship: colon and rectal surgery, University of South Florida Morsani College of Medicine, Tampa Afﬁliations: Roswell Park Cancer Center (2018-2019) Organizations: American College of Surgeons; American Society of Colorectal Surgery; Society of Surgical Oncology Family: Married, three sons Hobbies: Travel, cooking, music

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Walking: Your Best Step to a Healthier Heart

hen the world gets you down, go for a walk and make your heart happy. Physical activity is one of the best ways to manage stress and boost your mood, while reducing your risk for heart disease and stroke, according to the American Heart Association (AHA). The AHA recommends at least 150 minutes of moderate-intensity aerobic activity each week — or about 30 minutes a day, five days a week. And the minutes don’t have to be consecutive to bring benefits. “Walking is a great way to improve your health and your mental

outlook, and it doesn’t take a lot of expensive sporting equipment to do it. Put on a good pair of shoes and grab a water bottle and you’re ready to go,” said Donna Arnett, a past president of the AHA and a dean at the University of Kentucky College of Public Health, in Lexington. “It doesn’t matter how fast or how far you walk, the important thing is to get moving,” Arnett said in an AHA news release. “Counting steps doesn’t have to be part of a structured exercise program. Increasing your everyday activity, like parking slightly further from your destination, doing some extra housework

or yardwork and even walking your dog can all add up to more steps and better health.” The association pointed to research presented at a 2021 AHA conference and published online in JAMA Network Open. The researchers found that people who took more steps in short spurts lived longer — even if they weren’t doing long, uninterrupted workouts. Benefits leveled off at about 4,500 steps a day in short spurts. Compared to no daily steps, each day that someone increased steps by 1,000 was associated with a 28% decrease in death during the study period. Those who took more than 2,000 uninterrupted steps a day had a 32% decrease in death during that time. Compared to people with the fewest steps, middle-aged people who got in the most each day had a 43% lower risk of diabetes and a 31% lower risk of high blood pressure, the researchers reported. For women in the study, those who had the highest step count also were 61% less likely to be obese compared to women who walked the least. For each 1,000-step interval

increase, women had a 13% lower risk of obesity. Individuals who walked at least 7,000 steps per day had a 50% to 70% lower risk dying during the study period compared to those who didn’t. Walking more than 10,000 steps was even better, lowering the risk of premature death from any cause among Black and white middle-aged men and women. While being outdoors in areas that have a lot of green may also have health benefits, walking anywhere, including indoors at home, in a gym or at the mall can all offer benefits, Arnett said. “Unfortunately, many people do not have access to safe walking trails or adequate green space,” she said, adding that AHA advocates for policy changes that make it easier for people to have access to safe places to walk, exercise and play, as well as transportation options that integrate walking, bicycling and wheelchair use. “The easier it is for people to engage in physical activity in all aspects of their daily life, the more likely we are to achieve healthier, longer lives for everyone,” Arnett said.

carrier upcoding in Advantage plans. Upcoding, which is technically fraud, occurs when a commercial carrier claims that their members are sicker than the average Medicare member, so the carrier requires higher payments from Medicare to operate. About 50% of seniors are enrolled in an Advantage plan versus traditional Medicare. To be fair, Advantage plans do offer more services than traditional Medicare.

Again, our representatives continue to kowtow to the drug industry with this rather harmless bill. As of this writing, it is remains uncertain if Congress will finally pass a bill that minimally allows Medicare to negotiate prices (versus set prices) with drug manufacturers. Without any compunction, Congress has no problem setting prices for physicians and hospitals.

Healthcare in a Minute

By George W. Chapman

Health: American Women Rank Last Among Women in Developed Countries

he US belongs to the Organization for Economic Cooperation and Development (OECD). Most of the economically advanced countries in the world are members. The OECD tracks costs, morbidity, access and outcomes among member nations. (Spoiler alert: The US has historically underperformed in most categories.) In a recent study of women’s health, in age group 19-49, involving the top 11 countries by income, the US placed last in most metrics covered. (Notably, the US is the only country in the top 11 without universal healthcare.) The US ranked last in the death rate from avoidable causes like pregnancy-re-

lated complications. The US maternal mortality rate was three times the 11-country average. US women have the highest out-of-pocket costs of all 11 countries in the study which can account for delayed, postponed or put off care. Fifty percent of US women said they had trouble paying a bill versus an average 10% in the other countries surveyed. The US ranked last in meeting mental health needs. US women have the highest rate of multiple chronic conditions. Finally, US women are least likely to have a regular provider. The US did manage to retain its No. 1 ranking in per capita cost of care.

Affordable Care Act: Fixing the Glitches

online. Individuals who must spend more than 9.5% of their income on employer provided insurance may opt to purchase more affordable commercial insurance (discount based on income) through an exchange. The problem has been that while it helped the individual, it didn’t help their dependents. Five million families were negatively impacted. A proposed rule that will fix the “family glitch” has recently been introduced. The entire household will be eligible for discounted insurance if employer family coverage exceeds 9.5% of family or household income.

Also referred to as Obamacare, the ACA became law 12 years ago after intense negotiations with stakeholder trade associations representing commercial insurers, physicians, hospitals and the 50 states. All stakeholders agreed to participate in the ACA with the notable exception of drug manufacturers. At the time, more than 50 million people lacked health insurance. They typically earned too much to qualify for Medicaid and not enough to afford expensive commercial insurance. The ACA has survived more than 60 politically motivated attempts to repeal it. The unanswered question was always “so what is the problem?” Promises to replace the ACA with something better were just talk. The goal of critics was simply to repeal it. Today, a record 31 million people are covered by the ACA through either expanded Medicaid eligibility or by purchasing discounted commercial insurance

Medicare Premium Increase After several years of nominal increases, CMS is proposing an 8.5% premium increase for Advantage plans (Part C) and drug plans (Part D) for 2023. The rate increase reflects more claims than normal during the pandemic and overall inflation. Skeptics believe the higher rates may have been influenced by commercial

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

All-purpose Clinics: Walmart At It Again Is this the future of healthcare? Like it not, Walmart will open five new clinics in Florida later this year. The retail giant already operates 20 full service clinics in Georgia, Arkansas and Illinois. Walmart is capitalizing on its high foot traffic to offer health services under one roof including: in-person primary care, telemedicine, dentistry, pharmacy, durable medical equipment and basic medical supplies. Walmart claims its all-purpose clinics are typically located in underserved areas. Allowing Walmart to solve healthcare inequities in cost, access and quality, is either laudable or scary.

Insulin Costs There are more than 30 million diabetics in the US and about 7.5 million rely on insulin. By a vote of 232-193, Congress recently passed the Affordable Insulin Now Act. Unbelievably, 193 of our representatives voted no! Why? The bill caps outof-pocket costs for Part D Medicare members at $35 per month or 25% of the negotiated price. Since drug manufacturers consistently refuse to negotiate prices, it looks like the $35 cap will apply. This is hardly a victory for taxpayers. While welcome relief for seniors by capping out of pocket costs, the bill does absolutely nothing to reduce the actual cost of insulin to the Medicare program.

Birth rate down again It’s not just the US. It’s worldwide. Our birthrate has been declining since 2008. In 2020 there were 3,376,000 deaths and 3,605,000 births for a net gain of just 229,000 people, which is just a fraction of 1% of our 332 million people. The net is being impacted from both ends. There has been an increase in preventable deaths among younger people (drug overdoses, suicides, gun violence) combined with increasing reluctance among younger people to procreate because of climate change, the economy, cost and availability of childcare, the pandemic, a rapidly morphing job market and general anxiety. This trend worries health planners because as our average age increases, so do the costs of healthcare. There are fewer healthy, younger people not only to offset or subsidize the cost of caring for the elderly but to literally provide care to the elderly.

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.

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U.S. STD Cases Spiked During Pandemic

ven as the COVID-19 pandemic kept people isolated at home, sexually transmitted disease (STDs) cases increased across the United States. Although cases fell in the pandemic’s early months, infections rose again by the end of 2020, with gonorrhea, syphilis and congenital syphilis surpassing 2019 levels, according to a new U.S. Centers for Disease Control and Prevention report. “STDs have been increasing now for maybe seven years in a row,” said physician Leandro Mena, director of the CDC’s Division of STD Prevention. “These increases have roots in a decrease in funding public health, which has affected health departments’ ability to provide screening, treatment, prevention and partner services,” he added. Increased substance use, which is linked to social practices and socioeconomic conditions making it difficult to access services, also plays a role, Mena said. The new 2020 STD Surveillance Report, released April 12, found that at the end of 2020: • Cases of gonorrhea and primary and secondary syphilis rose 10% and 7%, respectively, compared with 2019. • Syphilis among newborns, called congenital syphilis, also rose

by nearly 15% from 2019, and 235% from 2016. Primary and secondary syphilis and congenital syphilis cases continued to rise in 2021. • Cases of chlamydia dropped by 13% from 2019. • Chlamydia accounts for the largest proportion of reported STDs. Researchers suspect the reported drop in cases owes to reduced STD screening and underdiagnosis during the pandemic, and not a true reduction in new infections. The decline in reported chlamydia cases contributed to a drop in the number of reported STDs in 2020 —from 2.5 million cases in 2019 to 2.4 million in 2020. The researchers cited several factors contributing to the decline in STD cases in the first part of 2020, including: • Less screening. • Public health workers sidelined to work on COVID-19. • Shortages of STD tests and lab supplies. • Lapses in health insurance caused by unemployment. • A surge in telemedicine that resulted in less frequent screening and left some infections unreported. •The highest rates of new STIs were seen among gay and bisexual men and teens, the CDC reported. “Over 50% of all STDs are reported among people who are younger than 24 years old,” Mena said.

SERVING WESTERN NEW YORK A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-trafﬁc locations. In Good Health is published 12 times a year by Local News, Inc. © 2022 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., #251 • P.O. Box 550, Amherst, NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto

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Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Brenda Alesii, Daniel Meyer, Jenna Schifferle, Ernst Lamothe Jr., Jana Eisenberg, Amanda Jowsey Advertising: Anne Westcott, Amy Gagliano Layout & Design: Joey Sweener • Office Manager: Kate Honebein No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

Where excellence is. DeGraffEmergency.org May 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 7

Lessons Learned from Surviving COVID-19 COMMENTARY

By Daniel Meyer

’m a survivor. I don’t write that in jest or say it without recognizing there are countless people reading this who have survived far more serious personal health challenges. But I do proudly state that after contracting COVID-19 last month and coping with nearly two weeks of discomfort and frustration I was able to overcome a vicious virus that has claimed well more than one million U.S. lives. Faithful readers of this publication will recall that the April 2022 edition included a commentary by yours truly reflecting on the lessons we all learned over the past two years of living through the coronavirus global pandemic. Little did I know then that just a few weeks after writing that piece I would become infected and soon undergo my first battle with something that over the past 24 months claimed the lives of some of my family members, friends and colleagues. I’m proud of my body’s ability to overcome the virus and gladly share with you this month some specific details about my experience contracting, battling and overcoming coronavirus. The following are some reflections, recollections and recommendations of what I dealt with and what I advise others to do should you unfortunately become infected sometime in the future: • Sickness, symptoms and sympathy I was sick for 12 days and ended up quarantining and having to miss eight days of work. While I didn’t need to be prescribed specific medications, be placed on oxygen or have to spend any time inside of a hospital, it was a serious personal health battle that includes stretches of uncertainty and concern. My symptoms varied throughout the nearly two weeks I was ill. They included but were not limited

‘I’m proud of my body’s ability to overcome the virus and gladly share with you this month some specific details about my experience contracting, battling and overcoming coronavirus.’ to head and chest congestion, body chills, severe exhaustion, general soreness, extremely achy joints and muscles, a sore throat and a persistent nagging cough. Family members, friends, neighbors and co-workers showed plenty of sympathy and true compassion in the form of supportive telephone conversations, text messages and emails. The special (and socially distanced) deliveries of chicken noodle soup, bottled water, Gatorade and other items were tremendous gestures — all the items were immediately consumed. The constant communication helped keep me motivated to get healthy and specific

Keeping Your Mental Health Top of Mind

Catholic Charities’ mental health counselors share tips for Mental Health Awareness Month

hile one’s mental health is something to keep top of mind every day, there is an increased focus during Mental Health Awareness Month each May. With many still experiencing major impacts on their mental health due to the pandemic, the mental health counselors at Catholic Charities of Buffalo are sharing some tips to help ease anxiety and put you at the center of your own mental health and wellness. “Whether dealing with the aftermath of a major life event such as the loss of a loved one or a job or experiencing an increased level of anxiety for a sustained period of time, the pandemic has taken some sort of toll on the mental health of all of us over the last two years,” said

Michelle Abraham, assistant director of clinical services at Catholic Charities. “It’s important to focus on your own mental health. Taking regular time to de-stress or speak with a professional counselor are among some ways to help boost your mental health wellness.” Consider incorporating some of these tips from Catholic Charities’ mental health counselors into your daily routine: • Spending as little as 10 minutes a day in nature can improve your mood. Those benefits double if you spend that time barefoot in the grass. • Practicing a random act of kindness regularly will give you a free serotonin boost. Try something small like holding the door for or smiling at a stranger.

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advice from some acquaintances who had previously dealt with the same unfortunate COVID-19 diagnosis and quarantine period was greatly appreciated.

mental health status surely helped push myself past a few really frustrating and at times depressing days knowing that soon I’d be on the other side of the battle.

• Prior protection provided hope and promise for a full recovery I am vaccinated and boosted (three shots total) and was told by three different doctors and medical professionals that certainly made a difference in helping to limit the severity of my symptoms. I firmly believe that level of protection helped keep me from having to be hospitalized and avoid serious health complications. I learned that everyone reacts differently to the virus. From what I have been able to gather and have now personally experienced there are no proven reasons or explanations as to why one person has more of a negative reaction than someone else after contracting COVID-19. I believe I was fortunate to have been able to recover and have a deeper appreciation for anyone who has tested positive for the virus. If my symptoms were more severe, I’m not sure what condition I would have been in given there have been so many victims I know personally who lost their battle with coronavirus, including three people I knew since childhood who all died and were younger than 50 at the time of their death.

• Avoiding illness is always the goal, but sometimes it happens I don’t want to lecture anyone on vaccinations and boosters. Receiving the shots may not be for everyone and I am aware there are some people with legit health reasons that prevent them from getting vaccinated and/or boosted. But I will say that I am glad I was able to limit my coronavirus battle and not have to be hospitalized. I have no doubt that vaccines work in preventing serious illness and helping to avoid hospitalization. Regardless of efficacy against infection, vaccination in most instances with most people does limit severe illness and hospitalizations. Keeping sick people from clogging our hospitals is a valid reason for promoting COVID-19 vaccines since vaccination is as much as preventing harm to others as it is about protecting yourself from the virus. Vaccines work. Public health data shows us that unvaccinated individuals had the highest rates of hospitalizations during the Omicron wave of the global pandemic. I urge everyone reading this if you are eligible to get your first, second, third and fourth vaccine dose as soon as you can. COVID-19 has had a major impact on our entire society, especially for anyone who became ill from the virus. I am just one person who survived. I hope to be a better person because of that and vow to help spread compassion and empathy for anyone who has to experience the same thing in the future.

• Recovery involved rest and refusing to give up The key to my recovery was maintaining a regular routine of taking specific over-the-counter medications, participating in daily exercise activities outdoors, continued consumption of fluids, and a basic focus on my mental health. I did plenty of resting, but I was also cautious to not get too comfortable not moving. I was advised to get outside, move and breathe in fresh air whenever possible. So that’s what I did. After the initial first few days of feeling extremely exhausted, I make a commitment to taking walks at least twice if not three times a day. I also refused to give up. The motivating factor of remaining optimistic and being constantly aware of my • Positive self-talk is a technique where you speak out loud to yourself acting as your own best friend and biggest fan. Hearing your own voice saying kind words about yourself makes them stick better than just thinking them. • Just like cars need routine oil changes to run well, humans need routine time away from work and other stressful activities to recharge and run well. Be sure to make use of vacation or personal time. • Consider keeping a gratitude jar. As often as possible, write down positive events that occur in your life. They can be small like winning a free cup of coffee or big like a new relationship. See how full the jar gets and how long it takes. Once full, read those things you wrote down.

Daniel Meyer is a lifelong resident of Western New York. He is the former editor of the Hamburg Sun newspaper and is currently the deputy press secretary for numerous departments that comprise the government of Erie County. • Know your vulnerability factors. Some people are more susceptible to negative moods if they don’t get enough sleep, food, or don’t feel well. While good sleeping, eating habits and health are all important, knowing which one impacts you the most might help you prioritize. Catholic Charities’ team of professional and highly trained counseling experts are available to assist families, children, adults, and seniors with day-to-day troubles and serious concerns throughout Western New York. For more information on these or any of Catholic Charities’ programs visit, ccwny.org. Submitted by Catholic Charities of Buffalo.

20% range. For those populations, it can be even harder to quit. The Quitline offers a variety of services to help people quit, like coaching and nicotine replacement therapy, with enhanced services for those who have a harder time quitting.

Q A &

with Paula Celestino

She was a member of the team that established the Quitline in Western New York 22 years ago. As we celebrate World No Tobacco Day on May 30, she discusses what her group is doing to help people quit smoking By Brenda Alesii

ver hear the adage “If at first you don’t succeed, try, try, and try again”? That timeless phrase could be the motto for people who want to quit smoking and who have failed to kick this extremely addicting habit. Every year, on May 31, the World Health Organization and global partners celebrate World No Tobacco Day. The campaign is an opportunity to raise awareness on the harmful and deadly effects of tobacco use and second-hand smoke exposure, and to discourage the use of tobacco in any form. In Good Health recently spoke to Paula Celestino, client relations and outreach director for Roswell Park

Cessation Services’ New York State Smokers’ Quitline. The Buffalo resident, who holds a master’s degree in public health from UB, was a member of the team that established the Quitline some 22 years ago. Q: You said that tobacco control work has been a journey. With all of the health warnings, no smoking areas, and the expense of tobacco products, is smoking among adults in New York state still prevalent? A: Currently, about 12.84 % of New York state adults are smokers. But for specific populations — persons with disabilities, veterans, and individuals with mental health challenges — the rate is above the

Q: What are some common nicotine replacements? A: There are a number of nicotine replacement therapies: the over-the-counter products include nicotine patches, lozenges and gum. Other nicotine replacement and other non-nicotine cessation medications can be prescribed by a physician. Q: Do you consider tobacco usage a chronic condition? A: Yes. Tobacco usage is a physical and psychological addiction; it is a condition. I can safely say that the majority of smokers make multiple attempts before quitting the habit. The addiction to nicotine has such a strong hold on people. The habit may have started when the smoker was a teenager and not making rational decisions. While it is an addiction, it can be reframed as a treatable condition. It’s important to recognize that if a tobacco user relapses, the best thing they can do is to not beat themselves up about it, but to dust themselves off and get right back on track. The name of the game is to try multiple times to quit, ultimately giving it up for good. The willpower to stop tobacco use comes from the decision to quit and then there are resources available, like the Quitline. I want to emphasize that although it is an addiction and hard to quit, it is possible and many, many people do. Q: What are some common triggers? A: Nicotine dependence is associated with many triggers and is frequently connected to emotions. Perhaps an individual reaches for a cigarette when faced with a stressful situation. Other common triggers include having an alcoholic drink or being around other smokers. There is a need to identify those barriers and plan for them. In the end, the smoker wants to see him or herself as a nonsmoker, focusing on the benefits of being smoke-free and not on the losses. Our Quitline coaches can provide tools and advice to help

avoid and prepare for those dangerous triggering situations. Q: You’ve been with the Quitline since it launched, and served as the director for 17 years. What is the number and what happens when someone calls? A: The Quitline is a confidential and free service that offers telephone coaching as well as a starter kit of nicotine replacement medications, along with “click to quit” that offers online smoking cessation services. Our funding comes from the New York State Department of Health, and allows us to have a wide variety of evidence-based programs that can help people. Our coaches are specially trained and our counseling programs are robust, quite sophisticated, and effective. To access the NYS Quitline, call 1-866-NY-QUITS (1-866-697-8487) or visit online at www.NYSmokeFree. com. Help is on hand seven days a week, while digital and messaging services are available 24/7. After hours, messages can be left, which will prompt our coaches to phone the client the following day. Q: Technology has changed considerably in the last several years. How has your agency adapted? A: We’re at a crossroads now because talking on the telephone is not as popular as it once was. We’ve developed other modes of communication to help people, offering better instructions through text and chat messaging, and the ability to access extensive information and tools online. In addition, we recently launched “Learn2QuitNY”, a stepby-step text message smoking cessation program. Q: How has the emergence of vaping, or what you refer to as electronic nicotine devices, impacted your work? A: Electronic nicotine devices have been a game changer, but there is much more to learn about them. New York state has added to the Quitline services, “This is Quitting,” a text program for teens and young adults. Those interested can text “Drop the Vape” to 88709. More information to help parents talk to their kids about vaping can be found on the Quitline’s website.

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

Things You Should Know About IBS About 15% of the adult population suffers from symptoms of irritable bowel syndrome

By Ernst Lamothe Jr.

t’s a condition that often is difficult to talk about and experience. However, both aspects are the reasons why it is too often in the shadows and why people need to understand its impact. Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain and bloating along with diarrhea or constipation. While the cause of IBS is not clear, symptoms arise from a variety of factors, including a sensitive digestive tract and changes in muscle contractions in the gut. IBS may also be known by other names such as irritable bowel, irritable colon or also a nervous stomach, because strong emotions can aggravate its symptoms although they do not cause them. In the United States, approximately 10% to 15% of the adult population suffers from IBS symptoms, according to the American College of Gastroenterology. “This is an important health problem because IBS is the most common gastrointestinal issue and has no simple cure,” said Jeffrey Lackner, professor and chief of the division of behavioral medicine in the department of medicine at the University at Buffalo Jacobs School of Medicine. “For patients, it is a significant source of abdominal pain, distress and a significant quality of life issue penetrates different aspects of their everyday life from work productivity to relationships and intimacy.” Lackner, who holds a Doctor of Psychology degree, discusses five aspects of IBS that people should understand.

1.Difﬁcult to talk about

Irritable bowel syndrome can have many symptoms; the cardinal symptom is abdominal pain felt in the lower abdomen. Pain and bowel problems vary in severity from person to person. Like other chronic pain disorders, IBS is very burden-

some when symptoms are more severe. Yet the mental strain of having a disorder no one fully understands and wants to talk about can be just as difficult as the physical effect. “People don’t like to talk about their bowels,” said Lackner. “It is easier to talk about chronic pain problems like headaches or back pain.”

2.Stigma

Those who battle the condition also must overcome stigma and stereotypes along the way of getting the help they need. Everything from people saying it is 100% mental and “all you need to do is deal with it” to making light of the condition in real life or movies and television. “There have been times when disorders like IBS are seen as a person being weak or it being just a physical manifestation of psychological problems,” said Lackner. “This is especially the cause when it becomes difficult to find an exact diagnosis and then the pain is considered all in a person’s head. There are still some well-intentioned physicians who carry old-fashioned views of IBS. Luckily, we have come a long way in understanding IBS as a problem in how the brain and gut communicate with one another.”

3.IBS is complicated

The exact cause of IBS is unknown. Possible causes include problems with bowel muscles contraction and movement of food through the digestive tract, overly sensitive colon or issues with the immune system of the nerves in the digestive tract which dysregulates communications between nerves in the brain and gut. Several studies have assessed the prevalence of mental health problems among treatment seeking IBS patients. About 40% to 60% of people with IBS had met formal diagnosis for mental problems particularly anxiety and depression. But that also means a large percentage do not have a mental health problem, meaning it cannot be dismissed as a psychiatric problem.

Jeffrey Lackner, professor and chief of the division of behavioral medicine in the department of medicine at the University at Buffalo Jacobs School of Medicine: “Luckily, we have come a long way in understanding IBS as a problem in how the brain and gut communicate with one another.” “We know that IBS is a complex issue that is influenced by a variety of environmental, biological and behavioral factors that can aggravate the symptoms,” said Lackner. “Stress is definitely something that patients can identify as a common trigger.” He cautions anyone against making a blanket statement about the condition. “We need to get out of the habit of just seeing IBS as a psychiatric problem. It’s not helpful and gets away from the critical question which is what factors flare symptoms for which patients in what situations,” he added.

4.Hope without a cure

Despite all the scientific developments, there is still no cure for the disease. Doctors recommend a change in the lifestyle and eating habits. Home remedies or lifestyle changes include dietary changes such as avoiding food triggers like spicy or fatty foods, and a specific psychological treatment called cognitive behavior therapy. Doctors may suggest gut-directed medications if the symptoms do not improve through simple lifestyle change and cognitive behavior therapy treatment if symptoms remain refractory to first-line medications. “If someone has IBS, there is no

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

single treatment, food or medication that works across the board for everyone’s gastrointestinal system,” said Lackner. “There are foods that could trigger it, but people have a full range of symptoms that they develop with IBS. There are several nutrition and behavioral self-management processes that can help people lessen their IBS.”

5.Family history

Often occurrence of this condition is seen in people in their late teens to early 40s. It is also said that it may affect multiple people in a family. Women can be twice as likely than men to suffer IBS. “It is difficult to know what a positive family history means. It is not clear whether symptoms are due to a genetic predisposition that renders patients vulnerable to symptoms. It is also possible that what is passed on is not biological vulnerability but a psychological one that influences how they interpret and cope with symptoms. The research is compelling that family history has some influence,” said Lackner. “The good news is that just as people can learn bad habits for managing symptoms they can learn good ones and when this happens symptoms can often improve as well if not better than with medications.”

In Good Health reaches more than 60,000 health-conscious readers in WNY.

SmartBites By Anne Palumbo

Helpful tips

The skinny on healthy eating

Cream Cheese: the Good, the Bad, and the Lovely

very May, in honor of my mother, I make her favorite dessert: cheesecake with sliced strawberries. I typically don’t feature desserts, because they’re often full of empty calories. But, today, I’m making an exception. On occasion and in moderation, it’s OK to indulge. And, the good news is, most nutritionists agree! (FYI: the recipe that follows is lighter and healthier than most cheesecakes.) The star of cheesecake — and today’s column — is cream cheese.

Produced from unskimmed cow’s milk, cream cheese is a soft cheese (yes! a true cheese) that gets its firm but creamy texture from lactic acid. Let’s begin with the good. Although cream cheese doesn’t provide as much calcium or protein as many hard cheeses, it still has some nutritional merit. Cream cheese is a good source of vitamin A, with an average serving (two tablespoons) providing about 10% of our daily needs. Vitamin A promotes healthy eyesight and helps reduce the risk of vision-related problems, such as night blindness and macular degeneration. Gut health may improve with the consumption of cream cheese. Some of the bacteria used to make cream cheese are probiotics, which are friendly bacteria that keep us healthy by restoring the balance between good and bad bacteria, supporting immune function, and controlling inflammation. Lactose intolerant? You’ll be delighted to know that cream cheese is low in lactose (less than 2 grams per ounce) and so may not cause the GI discomfort associated with some dairy products. Experts recommend tasting a small amount at first to see how your body reacts. Now for the bad. Hold onto your hats, bagel-lovers, a two-tablespoon

serving of regular cream cheese is pretty high in fat and calories: 100 calories, 9 grams of fat. Unfortunately, 6 of the 9 grams of fat is saturated fat, the kind that drives up cholesterol and raises the risk of heart disease and stroke. Of course, we must end with the lovely. Oh, where to begin with luscious cream cheese? Let’s see, its creamy texture, its sweet and tangy taste, its versatility, and its important role in a classic dessert that so many mothers love.

Lighter Cheesecake with Fresh Fruit For the crust: 2 cups crushed graham crackers 6 tablespoons butter, melted ¼ cup sugar ½ teaspoon cinnamon For the filling: 2 (8-ounce) packages of reduced-fat cream cheese, softened ¾ cup sugar 2 eggs, room temperature 2 tablespoons flour 1 teaspoon vanilla extract 2 teaspoons fresh lemon juice Fresh fruit for topping Preheat oven to 375 F. Lightly oil a 9-inch springform pan (or spray with nonstick cooking spray). Set aside.

Drink Up! Daily Coffee Tied to Longer, Healthier Life

n yet another finding that highlights the health perks coffee can brew, new studies show that having two to three cups a day not only wakes you up, it’s also good for your heart and may help you live longer. In this largest ever analysis of nearly 383,000 men and women who were part of the UK Biobank, researchers discovered that, over 10 years, drinking two to three cups of coffee a day lowered the risk for heart disease, stroke, dangerous heart arrhythmias, dying from heart disease and dying from any cause by 10% to 15%. “Observational analyses have shown that coffee drinking is associated with lower rates of cardiovascular events and lower all-cause mortality compared to individuals not drinking coffee,” said physician Gregg Fonarow, director of the Ahmanson-University of California, Los Angeles, Cardiomyopathy Center. An earlier analysis of the UK Biobank found that coffee drinking was associated with lower mortality, even among those drinking up to eight cups per day. This finding was seen in people who were fast and slow metabolizers of caffeine. These associations were consistent for ground,

instant and decaffeinated coffee, said Fonarow, who had no part in the latest study. “This new study reinforces these findings associated with two to three cups per day in terms of arrhythmias, cardiovascular disease mortality and all-cause mortality,” he said. Still, Fonarow said that because this is an observational study, it can’t prove that coffee was responsible for these protective effects, only that there appears to be a connection. “Overall, however, these results provide further evidence that coffee

drinking appears safe and may be part of a healthy nutritional approach,” Fonarow added. Decaffeinated coffee didn’t guard against arrhythmia but was linked to lower cardiovascular disease, with the exception of heart failure. That suggests caffeinated coffee is a bit better, the researchers noted. Lead researcher, physician Peter Kistler, is head of arrhythmia research at the Alfred Hospital and Baker Heart Institute in Melbourne, Australia. He said, “Because coffee can quicken heart rate, some people

Choose reduced-fat or nofat cream cheese to cut calories and fat. Many stores also have vegan options. An unopened package of cream cheese is good one month past the “Best When Purchased By” date on the carton. Once opened, cream cheese should be used within 10 days. In a medium mixing bowl, combine graham cracker crumbs, sugar, and cinnamon. Pour melted butter over crumbs and mix well. Pour crumb mixture into center of prepared pan and using your hands or a spoon, press the crumbles down and around the pan in an even layer. Bake your crust for 10 minutes. Remove from the oven and let it cool while you prep your filling. Lower the oven temperature to 325 F. With an electric mixer on medium speed, beat the cream cheese and sugar until smooth, about 4 minutes. Add eggs, one at a time, beating until just incorporated, about 1 minute. Beat in flour, vanilla, and lemon juice just until combined, about 1 minute. Pour the mixture into the cooled crust and bake the cheesecake for 4555 minutes or until the middle is set. Let the cheesecake cool for 1 hour, and then transfer it to the fridge. Serve with fresh fruit of choice.

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.

worry that drinking it could trigger or worsen certain heart issues. This is where general medical advice to stop drinking coffee may come from.” But, Kistler added in a news release from the American College of Cardiology, the new data suggests that “daily coffee intake shouldn’t be discouraged, but rather included as a part of a healthy diet for people with and without heart disease. We found coffee drinking had either a neutral effect — meaning that it did no harm — or was associated with benefits to heart health.” Coffee has over 100 biologically active compounds, Kistler noted. These chemicals can help reduce oxidative stress and inflammation, improve insulin sensitivity, boost metabolism, inhibit the gut’s absorption of fat and block receptors known to be involved with abnormal heart rhythms, he explained. “There is a whole range of mechanisms through which coffee may reduce mortality and have these favorable effects on cardiovascular disease,” Kistler said. “Coffee drinkers should feel reassured that they can continue to enjoy coffee even if they have heart disease. Coffee is the most common cognitive enhancer — it wakes you up, makes you mentally sharper and it’s a very important component of many people’s daily lives.”

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

Nursing

Nurse’s Way to Relax: Hunting, Performing Taxidermy Jason Paulisczak works as a travel RN at Mercy Hospital. He says that hobbies that energize and renew him help him provide better care to patients By Deborah Jeanne Sergeant

urprise! Nurses are real people behind their masks and scrubs. Carving out time to pursue a hobby can help them beat burnout and promote self-care. Some nurses enjoy hobbies that are a bit more unusual than others. Performing taxidermy is the way Jason Paulisczak relaxes from his work as a travel RN for Medical Solutions, fulfilling a contract at Mercy Hospital. He is a bachelor’s degreed, board-certified nurse. Paulisczak grew up in suburban Buffalo and moved to Odessa, near Watkins Glen, 22 years ago as a new RN. He decided he needed a hobby that would help him stay refreshed as a nurse and that would fit in with his rural environment. Many neighbors hunted, so he decided to follow suit. “I’d always been interested in hunting but I grew up in a non-hunting family,” he said. Typically, hunters learn from relatives about outdoor life and hunting. Paulisczak had to learn on his own from books, videos and trial-and-error until a few local mentors taught him about wildlife and how to be an outdoorsman. “I studied deer and did a lot of research on their habits,” Paulisczak said. “It was good way to occupy myself. I put my effort into hunting and becoming an outdoorsman.” He hunts on his own 10 acres and neighbors’ land. As he learned more about hunting, he approached the hobby with a conservation angle. He let younger bucks go so they could mature more and strove to promote deer healthy by planting chicory and clover as healthful fodder throughout the year. Once he began harvesting surplus wildlife—an important part of environmental conservation, he said—he had a few animals professionally mounted. That can cost more than $2,500 for an entire deer or $525 for a “shoulder mount” style. This includes the deer’s head down to its shoulders. In 2008, Paulisczak asked taxidermist Howard Leiphen in New Field if he could learn from him. “He’d said he’d love to,” Paulisczak said. “He passed on his knowledge of taxidermy. We’d help each other out through the years. If he needed a cape, I’d get it for him.” A deer cape is a deer hide from the animal’s nose to the area just behind its shoulders. The pair worked together for several years until Leiphen retired. Paulisczak began performing taxidermy work for other hunters. The process involves cleaning and tanning the hide as part of preserving it—an all-day process from start to finish. When he began working as a traveling nurse, he cut back his taxidermy side gig because oftentimes he was not home long enough to complete the process. He still mounts specimens for friends and for himself. His trophy room boasts 18 deer heads, three full body deer, several

Jason Paulisczak works at Mercy Hospital as a travel nurse. In his spare time, he likes deer hunting. He learned from a professional taxidermist how to mount animals, which he often does for friends.

Jason Paulisczak’s living room in Odessa, near Watkins Glen. Jason Paulisczak enjoys hunting and completing taxidermy projects as a means of stress relief. He works at Mercy Hospital, on contract with Medical Solutions. “European mounts” (just the deer’s skull and antlers), four coyotes, a porcupine, a snapping turtle, a fisher, squirrels, rabbits, foxes, two bobcats, various birds and—believe it or not—two skunks. “I was quilled multiple times doing the porcupine,” Paulisczak said. “I kept the pliers handy to pull them out. The underbelly has no quills so you skin from underneath. Doing skunks is not good. No more skunks—ever. The last time I bought one home, I wrapped it in five garbage bags and put in the freezer. The smell permeated the house by 5 a.m.” Once mounted, the animal is de-scented. Various professional products helped him get rid of the

odor of the specimens. While a taxidermy hobby may seem strange or even macabre to some, it represents the results of some of his most enjoyable leisure time: hours sitting quietly in nature. “Being outside is really therapeutic,” Paulisczak said. “Spending time in the woods is therapeutic for me. I ride my horse in the woods, which I enjoy. Seeing the animals and when you do taxidermy, you’re bringing that animal back to life in a sense. The biggest compliment is that the animal looks alive.” He believes that hobbies that energize and renew him help him provide better care to patients. In addition to the horses, he has a

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

Dalmatian and keeps a few farm animals as pets, including a turkey and six goats. His menagerie and taxidermy hobby often provides a means of connecting with patients. “You build a rapport,” he said. “Some talk about hunting and we have conversations about deer hunting as that’s most common. You have to know your audience; some don’t appreciate it. As a nurse, it’s very important to build rapport and trust and get to know them on a personal level as they can feel they trust you. It’s a better patient-nurse relationship if they know a little bit about you.”

Nursing

What It Means to Be a Nurse It’s not ‘a job. It is a vocation, a calling’ By Deborah Jeanne Sergeant

ursing is more than a job. It is a vocation, a calling. Many nurses strongly associate their personal identity with their vocation and felt a long-term desire to enter the field before doing so. For registered nurse Martha Metz, nursing means caring for people. “It sounds generic, but that interaction with multiple patients throughout various stages of their life is so important,” she said. Metz, who has nursed for nearly 15 years, is a clinical nurse specialist

in critical care at Erie County Medical Center and the president of the Professional Nurses Association WNY. As she completed her clinical training, she knew for certain that nursing was where she was meant to be. The hands-on care in a nursing home taught her that caring for patients is more than meeting their physical needs. “The interaction was special as they were so happy there was someone to talk with them or hold their hand,” Metz said. “In acute care, that has followed me all the way. When I’m having a tough day, I put an ‘Out of Office’ on the door and spend time with patients. I clean them up, change their bedding, and help staff with patient care and it can center me. Then I can deal with whatever had been causing me stress. Being with people centers my heart.” She earned her master’s degree from University at Buffalo in 2016. Metz feels that completing each level of her degree has helped improve her clinical skills and professionalism.

For example, all the “basic” nursing protocols have been established for reasons that are important to the patient’s outcome. Even something as simple as the hourly round to check on patients is an Martha Metz important interaction to ensure the patient is doing well. Although she enjoys caring for patients at the bedside, Metz said that it can be difficult and draining at times. “There has to be a balance,” she said. She tries to take time to recharge and destress to take good care of herself and provide better care to her patients. Metz also focuses on caring for the whole person, not just the diagnosis. “I like helping others feel good,” she said. “Some of the most rewarding visits have been when someone doesn’t know how close they came from not leaving the hospital and they get to leave. I say, ‘I hope I run into you again, just not here.’” She likes that she can help patients and their families through a difficult time. That is what nursing means to her. A focus on patient needs is essential to Diane Morrison, who serves as president of the Genesee Valley Nurses Association. She began

her healthcare career as a 14-year-old volunteer at Memorial Hospital in Niagara Falls. “We had cute little blue and white uniforms,” she said. “We delivered mail and flowers. We’d speak with people.” From those early, enjoyable experiences interacting with patients, Morrison realized that nursing was the career for her. She eventually earned her bachelor’s degree at the University of Maryland in the early 1990s and worked in Maryland in a medical and surgical unit and in the intensive care unit. Eventually, she started working in hospice care. “It was a privilege to travel with their loved one at their end-of-life journey,” Morrison said. “It’s the most important part of their life journey.” After earning her M.S. in nursing education, she taught for five years at Keuka College and earned her nurse practitioner degree at Keuka College in 2017 and began working at MM Ewing Continuing Care in Canandaigua three years ago. “The wonderful thing about being here is we have our long-term care population you get close to,” Morrison said. “This is their home. We can be here to help those who pass away under hospice or palliative care. My patients become part of my heart.” She encourages self-care to prevent burnout, including seeing a mental healthcare provider as needed. “I approach things in life with humor,” she said. “You have to have humor in the healthcare field.”

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

Nursing

board-certified nurse working on contract for Medical Solutions at Mercy Hospital. Working at Mercy for about a year brings him back to his hometown of Buffalo, a homecoming he has enjoyed. Paulisczak earned his associate degree at Alfred State 22 years ago. He completed his bachelor’s at Keuka College and became board certified in 2010. In his more than two decades of nursing, Paulisczak has learned to provide patient-centered care while not trying to “pour from an empty cup,” meaning that he must recharge emotionally in order to meet patients’ emotional needs. “We want to do all we can in helping our patients and getting them better,” he said. “That’s why we got into this: to help people. I want to be the best nurse I can be.” While burnout has resulted in excessive turnover in recent times, Paulisczak has emphasized to other nurses that self-care is necessary to provide the best care possible. “You need an outlet that helps you and you need to be mentally healthy to be there for your patients,” he added. For Robert J. Dorman, who earned a doctorate in nursing practice and works as a part-time flight nurse for Mercy Flight Central, the biggest change in nursing over the course of his career is advances in technology. “I think that nursing needs to do a good job in keeping up with that,” Dorman said. A Brighton resident, Dorman is an associate professor and director of the traditional undergraduate nursing program at Roberts Wesley-

an College. Dorman believes that the pandemic highlighted and accelerated a few changes in nursing, such as the shift towards sooner hospital discharges. “Patients that used to be on a regular floor are now being cared for at home,” he said “Those that were in ICU were on a stepdown unit. Those in ICU, we’re doing so much more for them. The acuity in the hospital has increased. That’s overall, since 1993. In the last two years, the patients on the floor are so much sicker than when we first started.” Dorman completed his bachelor’s in nursing in 1993 at the University of Rochester. He liked emergency medicine and critical care. But once he started nursing that shifted to pediatrics. He continued earning credits and eventually completed the doctor’s degree in nursing practice in 2017. Though he has been an instructor for decades, “I’ve always done something clinical because I never wanted to lose my skills.” Working as a nurse certainly bears a high risk of burnout. Remembering the times when his patients experience a good outcome helps Dorman keep nursing. As for his teaching responsibilities, he focuses on the “enthusiasm of the students as they’re sometimes trudging through their degree program and then the triumph when they finish.” He encourages nurses to avoid burnout by “taking a breath and reaching out to talk with someone. If you need a break, do something for yourself. You’ve got to be good to yourself before you can be good to others.”

Nurses’ Long Shifts May Have Downside: Study

nurses a three-day work week, potentially providing better work-life balance and flexibility.” However, when “long shifts are combined with overtime, shifts that rotate between day and night duty, and consecutive shifts, nurses are at risk for fatigue and burnout, which may compromise patient care,” she added. The researchers recommended that the number of consecutive hours worked by nurses should be restricted, nurse management should monitor nurses’ hours worked (including second jobs) and state boards of nursing should consider possible restrictions on nurse shift length and voluntary overtime.

Long-term Nurses Lead with Empathy and Passion Nurses play a vital role in patient care By Deborah Jeanne Sergeant

s nurses progress in their careers, they learn a lot about the healthcare industry and the skills that are hard to teach in a classroom. In a field fraught with burnout—particularly in the past two years—enduring in healthcare for

urses who work long shifts are more likely to experience job dissatisfaction and burnout, and their patients’ care may suffer, according to a new study. The research included nearly 23,000 registered nurses in California, New Jersey, Pennsylvania and Florida. Sixty-five percent of the nurses worked shifts of 12 to 13 hours. The three-year study found that nurses who worked shifts of 10 hours or longer were up to 2.5 times more likely than nurses who worked short-

decades represents an important accomplishment worthy of recognition. “It’s definitely becoming more challenging, especially in the last several years between the extreme changes in healthcare, the pandemic, and everything going on with nurses being short-staffed,” said Jason Paulisczak, a bachelor’s trained,

er shifts to report job dissatisfaction and burnout. In addition, seven of 10 patient outcomes assessed in the study were significantly worse when nurses worked the longest shifts, the University of Pennsylvania School of Nursing researchers found. In hospitals with more nurses working longer shifts, a greater percentage of patients reported that nurses sometimes or never communicated well, pain was sometimes or never well controlled, and they

sometimes or never received help as soon as they wanted. The study was published in the November 2021 issue of the journal Health Affairs. “Traditional eight-hour shifts for hospital nurses are becoming a thing of the past,” Amy Witkoski Stimpfel, a registered nurse and postdoctoral fellow at Penn Nursing’s Center for Health Outcomes and Policy Research, said in a school news release. “Bedside nurses increasingly work 12-hour shifts. This schedule gives

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Mary Sikorski, 91, a widow, likes keeping busy. Born in Buffalo, she drove a school bus for 35 years and retired in 1995. “Staying active keeps me young and healthy,” she says.

Stay Busy, Stay Healthy: Why a Busy Retirement is Good for You By Deborah Jeanne Sergeant

etirement is time to sit back, put up your feet and relax. Or is it? Watching TV all day or napping on a whim may seem like an ideal retirement. However, it can quickly slide into a loss of connection and even feelings of meaninglessness. These factors can harm health. That is one reason that Mary Sikorski, 91, a widow, likes keeping busy. Born in Buffalo, she drove a school bus for 35 years and retired in 1995. “Staying active keeps me young and healthy,” she said. “My attitude toward life is always ‘stay open to new ideas and things.’” One example is using her iPad and staying in contact with her daughter, son and five grandchildren. Sikorski also has five great-grandchildren. As a young person, she never dreamed of such convenient means of communication. She also likes to participate in activities and meet friends at the Cheektowaga Senior Center. “I’m not feeling sorry for myself

now that I am a widow,” she said. “Coming to the Senior Center does that.” She enjoys jigsaw puzzles and is working on “the challenges of 1,000 pieces in a box” with puzzles in progress both at the center and at home. “When I finish, I’m feeling great and looking at the beautiful pictures,” she said. Every day, she completes the newspaper crossword puzzle and works on Wordle puzzles, activities which she feels help keep her mind sharp. Her diminished hearing makes speaking on the phone challenging, so visiting with others at the center helps keep her connected. Sikorski encourages other retirees to join a senior center. “You meet so many new friends and that is so important,” she said. “They have so much to offer. Plus, you yourself have so much to offer to others.” She likes completing craft projects such as with ceramics. “When you retire, it is a special time to reinvent yourself,” she said. “You find you have time for your-

Out-of-State Residents Can Now Seek Medical Aid to Die in Oregon

regon will no longer require terminally ill patients to be residents of that state to use its law allowing physician aid in dying. A lawsuit that challenged the residency requirement as unconstitutional was settled in March, with the Oregon Health Authority and the Oregon Medical Board agreeing to stop enforcing the requirement and to ask the Legislature to remove it from the law that was first enacted in 1997, the Associated Press reported. “This requirement was both discriminatory and profoundly unfair to dying patients at the most critical

time of their life,” Kevin Diaz, an attorney with Compassion & Choices, the national advocacy group that sued over Oregon’s requirement, told the AP. Compassion & Choices sued on behalf of Nicholas Gideonse, a Portland family practice physician and associate professor of family medicine at Oregon Health and Science University who couldn’t write terminal prescriptions for patients who lived just across the Columbia River in Washington state. While Washington has a similar law, it can be hard to find providers who will do it in the southwestern

self.” She likes reading, walking in nature and meeting friends for breakfast. “Life is great; live it to the full extent,” she said. “You only have one chance. We can’t come a second time and change things. If you are fortunate to have grandkids, be with them. They keep you young. You are never too old to act like a kid.” Sikorski’s advice rings true with Kerry Peek, director of senior services at Cheektowaga Senior Center. “It’s about the socialization and connection that older adults find,” Peek said. “They now have ways to use their talents, explore new opportunities for hobbies, education, awareness and enrichment.” She said that some older participants at the center have lost many of their friends and that making new ones at the center has provided a second chance at friendship. As these relationships form, participants have more places to go and things to do. “In many cases, they’re making new connections with people they wouldn’t have met otherwise,” Peek said. In addition to socialization and connecting with other adults, Peek said that the center provides older adults with connections to services and resources about which they may not be aware. Staying physically active is important to avoid becoming sedentary. Even retirees who had desk jobs will have much less movement after retirement since they no longer need

Golden Years

to get up and go somewhere else for the day. Regular exercise can reduce the risk of disabling falls, weight gain and physical decline. This may not mean spending hours at a gym but could include a fun activity, like dance class, tai chi group, geocaching, or tennis. Many people find that attending a class builds in accountability because other group members expect their attendance. Classes can also help foster new friendships to replace some of the social interaction lost upon retirement. “I like to counsel patients who are nearing retirement to have a good plan in place,” said Daniel King, a geriatrician with Highland Hospital. “Most people have worked their whole life perhaps in one job. There’s going to be a large hole and a lot of free time when they retire.” Making specific goals to learn a new skill, travel to certain venues and volunteer or teach certain skills or populations can offer concrete ways to remain active. Otherwise, King warns patients that they can become complacent and lose function over time. He also encourages patients to keep a schedule to maintain structure in their day, such as rising, dining and going to bed at the same time most days. Planning times to volunteer, exercise and cook healthful meals is also important. Of course, the flexibility in retirement is part of the fun. Having no plan can cause problems since people crave routine. “Retirement is a challenging time for a lot of people and they underestimate how challenging it will be,” King said. “It takes careful planning and thought. You plan your savings. You have to plan for your time in a way that’s rewarding for you.”

Active seniors enjoying one another at Cheektowaga Senior Center. Kerry Peek, the center’s director, said getting together is an opportunity for people to establish new connections and socialize. part of the state, where many hospital beds are in religiously affiliated health care systems that prohibit it, according to the AP. “Any restriction on medical aid in dying that doesn’t serve a specific medical purpose is difficult,” Gideonse told the AP. “In no other way is my practice restricted to Oregon residents, whether that’s delivering babies in the past or other care that I provide.” A group called National Right to Life opposes physician-assisted death, and spokeswoman Laura Echevarria said that without a residency requirement, Oregon risked becoming the nation’s “assisted suicide tourism capital,” the AP reported. But that’s unlikely, according to Diaz. He pointed out that Oregon’s law has a number of safeguards, includ-

ing a requirement that physicians determine whether patients are mentally capable, and that it’s extremely difficult for terminally ill patients to make long trips to another state, and that many people want to die near home with their loved ones by their side, the AP reported. “There’s no tourism going on,” Diaz said. Over 2,100 people have died after ingesting terminal drugs under the law since it took effect, according to data published in February by the Oregon Health Authority. California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Vermont, Washington state and Washington, D.C., have approved similar laws, all with residency requirements. Montana’s Supreme Court has ruled that state law does not prohibit medical aid in dying.

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

Golden Years

Ask The Social

Security Ofﬁce

From the Social Security District Office

AFib: A Common Heart Problem That’s Often Ignored

eart palpitations can be harmless if they are brief and infrequent. But if you’re experiencing an erratic heart rhythm, you need to get checked out by a doctor for atrial fibrillation, or AFib. AFib — which is marked by rapid, fluttering beats — can lead to serious complications such as stroke and heart failure, when the weakened heart can’t pump enough blood to the rest of the body. Normally, your heartbeat follows a steady rhythm as your heart contracts and relaxes. But when you have AFib, the upper chambers of your heart (atria) beat rapidly and irregularly, sending blood to the lower chambers (ventricles) less efficiently. These episodes can last for minutes to hours or longer, and can cause palpitations, lightheadedness, fatigue or shortness of breath. Over time, AFib tends to become chronic. Age is a common risk factor for AFib, which affects roughly 10% of people older than 75. Other factors include genetics, obesity, diabetes, high blood pressure and alcohol and tobacco use. The condition has also been linked to viral infections, including COVID-19.

Diagnosing AFib If you’re experiencing AFib-like symptoms you need to see your doctor who will listen to your heart and likely recommend an electrocardiogram (EKG) or a treadmill heart test, or you may wear a portable monitor for several weeks to look for abnormal heart rhythms to confirm a diagnosis of AFib. Such tests can help distinguish AFib from less serious conditions that may cause the heart to flutter, like anxiety and stress. AFib affects some three million adults in the United States, a number that is expected to quadruple in the coming decade as the population ages and risk factors like obesity, diabetes and high blood pressure become even more common. The lifetime risk of developing AFib is greater than 20%, yet many people don’t even know they have it.

Treatment Options A growing body of research underscores the importance of lifestyle

‘AFib affects some three million adults in the United States, a number that is expected to quadruple in the coming decade as the population ages and risk factors become even more common’ steps such as exercise, a healthy diet and limiting alcohol for treating AFib. Depending on your age and symptoms, your doctor may prescribe drugs to help control your heart rate, like beta blockers such as metoprolol (Toprol XL); or rhythm, such as antiarrhythmics like flecainide (Tambocor). You may also need an electrical cardioversion, an outpatient procedure that delivers an electrical shock to the heart to restore a normal rhythm. You will be sedated for this brief procedure and not feel the shocks. Catheter ablation is another outpatient treatment for AFib that scars a small area of heart tissue that causes irregular heartbeats. This procedure is becoming more common based on evidence of its safety and ability to normalize the heart rhythm and ease symptoms. Ablations can be effective in people 75 and older, but medication may still be required afterward. If you’re at higher risk for stroke, you may be prescribed a blood thinner, too. In the past, Coumadin (warfarin) was the only such drug widely available, but it requires monitoring with regular blood tests. Newer anticoagulants, like apixaban (Eliquis) and rivaroxaban (Xarelto), don’t have that requirement and have been shown to be just as effective at preventing strokes.

Celebrating a Decade of ‘My Social Security’

an you believe it’s been 10 years since we launched My Social Security? Since then, 67 million people have signed up and benefited firsthand from the many secure and convenient self-service options. And we’ve added and upgraded features that make your life easier when doing business with us online. We take great pride in providing this and all of our services. It’s part of how we help you secure today and tomorrow. If you still don’t have a personal My Social Security account, you’re missing out. A secure account provides personalized tools for everyone, whether you receive benefits or not. If you don’t currently receive benefits, you can: • Estimate your future benefits and compare different dates or ages to begin receiving benefits. • Get instant status of your Social Security application. • Review your work history.

Q&A

• Request a replacement Social Security card (in most states). If you receive benefits, you can use your personal My Social Security account to: • Get your instant benefit verification or proof of income letter for Social Security, Medicare, and Supplemental Security Income (SSI). • Check your information and benefit amount. • Start or change your direct deposit. • Change your address and telephone number. • Request a replacement Medicare card. • Get an instant Social Security 1099 form (SSA-1099) or SSA-1042S. • Report your wages if you work and receive disability benefits and SSI. Visit www.ssa.gov/myaccount today and join the millions to take advantage of your own personal my Social Security account. Please also encourage your friends and family to sign up for their personal my Social Security account today.

ministered by the Centers for Medicare & Medicaid Services (CMS). You Q: I just started my first job and my pay- can visit CMS’ Medicare website at check is less than I expected. Why am I www.medicare.gov or call them at paying for retirement benefits when 1-800-MEDICARE (1-800-633-4227). I have a lifetime to live before retire- Online or by phone, you can find anment? swers to your Medicare questions at A: Besides being required by law, CMS. you are securing your own financial future through the payment of Social Q: I understand you must have limited Security and Medicare taxes. The tax- resources to be eligible for Extra Help es you pay now translate to a lifetime with Medicare prescription drug costs. of protection, whether you retire or What does this mean? become disabled. And when you die, A: Resources include the value of your family (or future family) may the things you own. Some examples be able to receive survivors benefits are real estate (other than your primabased on your work as well. Aside ry residence), bank accounts, includfrom all the benefits in your own fu- ing checking, savings, and certificates ture, your Social Security and Medi- of deposit, stocks, bonds, including U. care payments also help today’s retir- S. Savings Bonds, mutual funds, indiees. To learn more, visit www.ssa.gov. vidual retirement accounts (IRA) and cash you have at home or anywhere Q: I have been getting Social Security else. To learn more about Extra Help, disability benefits for many years. I’m and to apply online, visit www.ssa. about to hit my full retirement age. gov/prescriptionhelp. What will happen to my disability benefits? Q: I applied for my child’s Social SecuA: When you reach full retirement rity card in the hospital, but have not age, we will switch you from disabil- received it. How long does it take? ity to retirement benefits. But you A: In most states, it takes an avwon’t even notice the change because erage of three weeks to get the card, your benefit amount will stay the but in some states it can take longer. same. It’s just that when you reach re- If you have not received your child’s tirement age, we consider you to be a card in a timely manner, please vis“retiree” and not a disability beneficia- it your local Social Security office or ry. To learn more, visit www.ssa.gov. Card Center. Be sure to take proof of your child’s citizenship, age, and Q: Where can I find general informa- identity as well as proof of your own tion about Medicare benefits? identity. And remember, we cannot A: Social Security determines divulge your child’s Social Security whether people are entitled to Medi- number over the phone. Learn more care benefits, but the program is ad- at www.ssa.gov.

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

Pelvic Floor Therapy Can Alleviate Urinary Incontinence

There are several options to deal with the condition By Deborah Jeanne Sergeant

By Jim Miller

When to Expect Your Social Security Checks Dear Savvy Senior,

I am planning to retire and apply for my Social Security benefits in July. When can I expect my first check, and is direct deposit my only option for receiving my monthly payment? — Almost 62

Dear Almost, Generally, Social Security retirement benefits, as well as disability and survivor benefits, are paid in the month after the month they are due. So, if you want to start receiving your Social Security benefits in July, your July benefits will be distributed in August. The day of the month you receive your benefit payment, however, will depend on your birthdate. Here’s the schedule of when you can expect to receive your monthly check. If you were born on the: • 1st through the 10th: Expect your check to be deposited on the second Wednesday of each month. • 11th through the 20th: Expect your check to be deposited on the third Wednesday of each month. • 21st through the 31st: Expect your check to be deposited on the fourth Wednesday of each month. There are, however, a few exceptions to this schedule. For example, if the day your Social Security check is supposed to be deposited happens to be a holiday, your check will be deposited the previous day. And, if you are receiving both Social Security benefits and SSI payments, your Social Security check will be deposited on the third day of the month. You should also know that for Social Security beneficiaries who started receiving benefits before 1997, their Social Security checks are paid on the third day of the month. To get a complete schedule of 2022 payment dates, visit SSA.gov/ pubs/EN-05-10031-2022.pdf.

Receiving Options There are two ways you can receive your Social Security benefits. Most beneficiaries choose direct de-

posit into their bank or credit union account because it’s simple, safe and secure. But if you don’t want this option, or you don’t have a bank account that your payments can be deposited into, you can get a Direct Express Debit MasterCard and have your benefits deposited into your card’s account. This card can then be used to get cash from ATMs, banks or credit union tellers, pay bills online and over the phone, make purchases at stores or locations that accept Debit MasterCard and get cash back when you make those purchases, and purchase money orders at the U.S. Post Office. The money you spend or withdraw is automatically deducted from your account. And you can check your balance any time by phone, online or at ATMs. There’s also no cost to sign up for the card, no monthly fees and no overdraft charges. There are, however, some small fees for optional services you need to be aware of, like multiple ATM withdrawals. Currently, cardholders get one free ATM withdrawal per month, but additional monthly withdrawals cost 85 cents each not including a surcharge if you use a non-network ATM. To learn more, visit USDirectExpress.com or call 800-333-1795.

When and How to Apply The Social Security Administration recommends that you apply for benefits three months before you want to start receiving checks. This will give you enough time to make sure you have all the needed information to complete the application. See SSA.gov/hlp/isba/10/ isba-checklist.pdf for a checklist of what you’ll need. You can apply for your Social Security benefits online at SSA.gov, by phone at 800-772-1213, or in person at your local Social Security office – call first to make an appointment. 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.

f you leak urine, pelvic floor physical therapy can help you ditch pads and rushing to the bathroom throughout the day. While it would seem like medication or surgery are the only ways to solve urinary incontinence, physical therapy provides a different approach that solves the common yet not normal issue. Sarah Capodagli, doctor of physical therapy with CorrEra Physical Therapy in Williamsville, said that urinary incontinence affects men and women of all ages—not just post-partum and post-menopausal women. “I would say overall, women might know more about physical therapy for urinary incontinence but sometimes the extent they know about treating it is Kegel exercises,” she said. Kegel exercises—consciously working the muscles that control urine flow to strengthen them—are not always the answer. Many do not know how to perform them correctly and engage the wrong muscles. For people with tight bladder control muscles, these exercises worsen the problem. Some people hold stress in their shoulders. Others hold stress in their pelvic floor, which can interfere with continence. That is why it is important to learn the patient’s health history. Professionals typically look at the body mechanics, posture, and breathing patterns. All of this affects continence. The physical therapist also discusses behaviors such as avoiding constipation, lifting mechanics and movements in daily living such as getting in and out of a car. Ironically, many people reduce drinking fluids to help control their incontinence. That tends to worsen the problem. Most providers recommend drinking throughout the day and to reduce accidents, stopping three hours before bedtime. Since constipation is sometimes related to urinary incontinence, Capodagli encourages patients to have easy, consistent bowel movements by eating enough fiber and drinking enough water. Providers also discuss when the person experiences leaks. Stress incontinence is caused by sneezing, laughing, lifting objects and other types of movement. Urge incontinence occurs frequently throughout the day when the patient feels an intense need to urinate. Physical therapy can help with both types of incontinence. “They learn how to relax them and learn how to mechanically relax them. That can help,” said physician Jacquelyn Gonka-Griffo, who completed a fellowship in Female Pelvic Medicine and Reconstructive Surgery. She practices at Western New York Urology Associates in Cheektowaga. She added that for many people with incontinence, their bladder control muscles are either too lax or too tight. They may be out of synch with when they want to hold their bladder and when they want to release urine. Learning stretching exercises in the office that they can perform at

home may be the key to conquering incontinence. “A lot of these patients are in significant discomfort and this is the only thing that can help,” Gonka-Griffo said. “A lot of patients have urinary incontinence with interstitial cystitis, a term that’s been brought into the urology world for those with unexplained bladder pain or discomfort. Some are put on diets where they can’t eat anything acidic and they’re told there’s nothing else they can do. Pelvic floor physical therapy can treat general pelvic pain, overactive bladder, fecal incontinence and organ prolapse.” By the second visit for pelvic floor physical therapy, some patients may need an internal exam, performed through the vagina for women and through the rectum for men. This can help the physical therapist know how the muscles are engaging. Rehabilitative ultrasound is another tool therapists use. Similar to pregnancy ultrasound, it gives physical therapists a better idea of how the pelvic floor muscle is working. When someone learns how to perform a bicep curl, she can watch her reflection in the mirror to monitor her movement. Since pelvic floor muscles are inside, the ultrasound gives a peak at what they’re doing. Within a few weeks, most patients see improvement in continence and those effects last. “They may still have exercises they need to do when done with therapy, but my goal is to teach them how to correctly use their body, so they don’t need to see me again,” said Mary Roberts, doctor of physical therapy with Buffalo Rehab Group in Williamsville. Of course, those who seek treatment sooner tend to see quicker results. Roberts wants anyone struggling with urinary incontinence to know that it’s never too late to see improvement. “The big thing is that you don’t have to live with it, even if it’s only happening occasionally,” she said. “It’s easier to treat it if it’s going on a couple months than people who let it go on years and years. It’s usually a longer road to get there. Don’t be afraid to talk about it; people don’t talk about it. And ask your doctor and advocate for yourself.” Roberts added that few physicians refer people to pelvic floor physical therapy. As with any type of physical therapy, patients can go directly to a physical therapist without a referral and most forms of health insurance will cover it.

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

Health News Grant to Help UBMD Pediatrics Treat Children with Type 1 Diabetes The majority of children living with Type 1 diabetes in the United States are not meeting their hemoglobin A1c (HbA1c) goals, a measure of how much sugar is in the blood, and a leading indicator of both short- and long-term disease state complications. Current research indicates that this trend is particularly prevalent in underserved communities lacking access to appropriate health resources. Now, pediatric endocrinologists at UBMD Pediatrics and the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo have launched a collaboration to provide remote care management and physiological monitoring for children living with Type 1 diabetes. The team will be evaluating the financial viability of providing these services as well as their impact on diabetes-related outcomes. A $1.43 million grant awarded to UBMD Pediatrics from The Leona M. and Harry B. Helmsley Charitable Trust is making this program possible. Despite recognition of the benefits of remote care programs that deliver support in-between physician visits, most primary care and specialty providers lack the financial resources to deploy them effectively. Moreover, the COVID-19 pandemic has exacerbated outcome gaps among underserved communities primarily due to limited access to remote care services and community-based resources. By working with Cecelia Health, a “virtual-first health care provider,”

UBMD Pediatrics will be supplementing the in-person patient care it provides with care from an experienced remote diabetes and chronic care management team. Cecelia Health provides patients with a spectrum of support in managing their diabetes to ease the daily burden, help improve health outcomes, and free up care resources for providers. A key goal of the program is to explore how improving access to remote support and the internet to better manage chronic conditions will improve outcomes. In particular, the program will examine whether access to fully supported cellular-enabled tablets and remote support enables patients to take full advantage of their existing diabetes technologies, such as continuous glucose monitors and insulin pumps. In return, this should improve HbA1c levels and reduce hospital admissions for diabetic ketoacidosis, a life-threatening condition which develops when the body doesn’t have enough insulin to allow blood sugar into cells for use as energy. “Using telehealth to improve care of youth with Type 1 diabetes is at the forefront of clinical care,” said physician Lucy Mastrandrea, associate professor and chief of the division of pediatric endocrinology/ diabetes at the Jacobs School and UBMD Pediatrics. “We expect to show that utilizing certified diabetes care and education specialists to deliver virtual support and education to our patients and families is financially sustainable. We are also taking this further by studying the clinical outcomes of patients with limited internet access who are provided tablets with cellular service and full technical support.”

“Our division of pediatric endocrinology/diabetes cares for about 1,000 patients with diabetes,” said physician Kathleen Bethin, principal investigator of the study and clinical professor of pediatrics at the Jacobs School. “We have many years of experience with both basic and clinical research to improve the lives of our patients.”

ECMC Achieves National LGBTQ “Leader Status” Erie County Medical Center (ECMC) Corporation has achieved leader status in the Human Rights Campaign’s LGBTQ healthcare equality index (HEI). ECMC scored 100 points in the HEI to earn the LGBTQ+ Healthcare Equality Leader designation. The Human Rights Campaign Foundation released its 15th anniversary edition of the HEI March 27; it is the country’s foremost benchmarking survey of healthcare facilities on policies and practices dedicated to the equitable treatment and inclusion of their LGBTQ+ patients, visitors and

CALENDAR of HEALTH EVENTS

Free Rabies Vaccination Clinics For Dogs, Cats, Ferrets The Erie County Department of Health (ECDOH) has opened registration for two rabies vaccine clinic sites clinics in May. • Saturday, May 7, 9 a.m. – 1 p.m. Town of Tonawanda Highway Garage, 450 Woodward Ave., Kenmore Between Sheridan Drive and Kenmore Avenue. Register: www.erie.gov/health/rabies • Saturday, May 21, 9 a.m. – 1 p.m. Buffalo Public School #84 (parking lot), 462 Grider St., Buffalo Behind ECMC Hospital Register: www.erie.gov/health/rabies Appointments are required and a limited number of appointments are available. Individuals who are unable to access online registration may

call 716-961-6800 or 716-858-2929 during business hours to schedule an appointment. Pet owners must make an appointment in order to attend these clinics. Up to three pets will be accepted per appointment. No walk-ins will be accepted. Dogs, cats and ferrets 3 months of age and older are eligible for a vaccination. Pet owners are asked to bring proof of vaccination with them to the event in order to receive a three-year vaccination certificate; otherwise, a one-year certificate will be given. Pets must be secured with a collar and leash or restrained in a carrier. Pet owners should limit the number of people in the vehicle. Masks are encouraged but not required. ECDOH thanks the Niagara Frontier Veterinary Society, the Medaille College Veterinary Technology Program, the SPCA Serving Erie County and Erie County SMART for providing volunteers and support in coordinating these free rabies vaccination clinics.

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

employees. A record 906 healthcare facilities actively participated in the 2022 HEI survey and 496 of those earned an LGBTQ+ Healthcare Equality Leader designation, while 251 earned the LGBTQ+ Healthcare Top Performer designation. “ECMC is committed to the principles and objectives of Human Rights Campaign and we are honored to receive this designation, which reinforces our dedication to ensuring these important standards are maintained throughout our institution,” said Thomas J. Quatroche Jr., PhD, ECMC president and chief executive officer. Cynthia R. Bass, ECMC’s chief diversity officer, said, “After much time and effort put forth to achieve this goal, we are honored and thankful to the Human Rights Campaign for recognizing ECMC’s commitment to achieving this level of recognition. As a result, ECMC is now nationally a recognized LGBTQ+ healthcare leader; we are pleased and proud of this very gratifying accomplishment.”

Evergreen Health recently opened its new facility at 7 Community Drive in Cheektowaga. The facilty was previously occupied by Aspire of WNY, now part of Evergreen Health.

Evergreen Health Opens New Primary & Specialty Care Practice In Cheektowaga

vergreen Health recently announced that its newest practice, located at 7 Community Drive in Cheektowaga, is now open. The opening of Evergreen’s first Cheektowaga location is the result of its acquisition of Aspire of WNY’s primary care practice and includes a new group of employees and the addition of 1,400 patients to its patient population. “The availability of Evergreen primary and specialty care services in Cheektowaga is the result of two like-minded organizations coming together, to improve health outcomes and build healthier communities,” said Raymond Ganoe, CEO of Evergreen Health. “We thank our partners at Aspire of WNY for their shared vision and support through the transition process. We welcome our new employees and patients to the Evergreen family and I’m confident that patients old and new will receive the same high-quality

and compassionate care they have come to trust and rely on.” The 7 Community Drive location in Cheektowaga is now open Monday through Friday, from 8 a.m. to 4 p.m., and will offer primary care and podiatry services to patients living with developmental or similar disabilities and the general community. Evergreen opening its practice in Cheektowaga expands the organization’s geographic footprint, which spans more than 10 total locations throughout Buffalo and the Southern Tier and now includes five primary and specialty care locations. Evergreen now offers primary and specialty care in Buffalo, Jamestown and Cheektowaga. In August 2021, leadership from Evergreen and Aspire of WNY announced a mutually beneficial partnership, particularly Evergreen’s acquisition of Aspire of WNY’s Article 28 primary care practice. Under the agreement, Aspire would cease operations of its primary care practice at 7 Community Drive in Cheektowaga, due to unsustainable reimbursement rates. That same location is now Evergreen’s newest practice.

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May 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 19

SOCIAL MEDIA DETOX:

WHY I KICKED THE FACEBOOK HABIT By Amanda Jowsey

ick up the phone. Click. Scroll. Close. Open. Click. Scroll. Close. Repeat. What was I even looking for? Why did I crave that little red notification and feel empty when I didn’t see it? In no way did it cure my boredom, it even exacerbated it. My creativity felt nonexistent, pushed aside for something easier to distract myself with. This was me one month and 14 days ago when I recognized the mindless habitual bond I’d developed with my Facebook. I knew it was time for a digital detox — at least a modified version of it. Let’s face it. I depend on it. I can’t quit all my social media at once. I started my cleanse with Facebook. Just deleting the app helped me rewire that habit of clicking for no reason. Its absence gave my mind pause long enough to make a different choice. The average adult checks their phone 80 times a day. A recent study published by the World Psychiatric Association found that the impact of social media on our brains most closely resembles “age-related cognitive decline.” It causes problems with memory, language, thinking and judgment. The result, over time, “is neurological damage.” It’s imperative that we participate in a digital detox every now and then. Digital detox is when a person refrains from using electronic devices such as smartphones or computers, in order to reduce stress or improve focus and social interaction in the physical world. Adam Kowalyk of Buffalo puts himself through a digital cleanse every four months. Each break usually lasts at least one month. Kowalyk studied smartphone addiction as part of a research project for SUNY Empire State College. After completing that study, he is especially in tune with consciously using his device. He participates in these online cleanses “for grounding and self-reflection.” “We’re constantly looking at other things, other people, and other situations other than our own lives, and for a lot of people that can

Adam Kowalyk of Buffalo studied smartphone addiction as part of a research project for SUNY Empire State College. He puts himself through a digital cleanse every four months. “I needed to take my life back…,” he says.

Alex Reid, Ph.D., director of the University at Buffalo’s department of media studies: “Phones are designed to structure our attention in particular ways that claim to be of interest to us but are surely of interest to the designers and sellers of phones and apps.”

become an escape from their own reality,” he said. He makes sure to evaluate himself and choose more productive things to replace his social media time. This mindfulness allowed him to make healthy lifestyle changes overall. It started with a weight loss journey about seven years ago. “I needed to take my life back… I tried to find everything I could do to create daily habits. I noticed that first thing in the morning, I would just sit there on social media. So instead of that, I got my dogs, and we would go start taking a walk in the morning,” Kowalyk said. With these digital cleanses, his mental, emotional and physical health greatly improved, he said. “I realized how much time I spent on social media instead of doing something else,” he said. “Removing myself from that situation gave me time to cook my own meals, to meal-prep for the week. I was amazed how much time I had…” He found that rewiring the brain

this way has a profound and unexpected impact in daily life. We are losing human connection, but we’ve never been more connected. It’s changing how we relate to one another as a society. Kowalyk also decided to practice mindful social media use, or detox altogether, because he was worried about the consumption of media in general, and the loss of human connection it creates. “It’s so awesome to just sit and hold my girlfriend’s hand while we’re just talking, instead of her or me being on our phones and not having any conversation… People aren’t talking. People aren’t enjoying life… They’re not learning how to have good conversations properly,” he said. Social media connections dehumanize us in many ways. We don’t have that face-to-face time as much as we used to. Kowalyk also worries that we forget to take time to do proper research and form our own opinions about the things we read online.

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Alex Reid, Ph.D., director of the University at Buffalo’s department of media studies, said “We now get information through our phones in a way we didn’t before. We’re processing information differently, at a different speed, through different media, coming from different places.” Reid studies the way emerging technologies change the way that we communicate with each other. “Phones are designed to structure our attention in particular ways that claim to be of interest to us but are surely of interest to the designers and sellers of phones and apps. So, we’re always having to balance competing interests in our own hands, in our lives, in a way that we didn’t have to before,” Reid added. “There are so many things that are within reach for us because they’re right there on our phones. That’s almost overwhelming. It can be anxiety inducing… We don’t know how to live with these devices. We’re learning how to live in this new world that we don’t quite know how to do yet,” Reid said. One study published by the National Library of Medicine indicated that even just occasional users of social media are almost three times less likely to be depressed than heavy users. Another study published in the Journal of Social and Clinical Psychology found that people who limited social media use to half an hour a day have lower depression and anxiety symptoms and significant improvement in overall well-being. Those who limited their use also showed reductions in loneliness and depression over a three-week period compared to a control group. Like Kowalyk, I too plan on staying off my Facebook. My mind feels clearer. I’m less agitated. I still can’t shake the occasional urge to post a status update when I’m bored or looking for some external validation about something. The research is ongoing. Digital detox is a relatively new trend. Clearly, though, it has its benefits. It can reduce anxiety and depression and improve focus and mood. Delete the apps. Reconnect with your surroundings. This is a trend worth trying.