In Good Health: WNY #95 - September 2022

ALSO INSIDE Alzheimer’s U.S. Hospitals Are Getting Safer for Patients P. 5 Finally, Lower Drug Prices. But Wait… P. 6 Just 8% Lack Health Insurance, a Record Low P. 5 BFOHEALTH.COM SEPTEMBER 2022 • ISSUE 95 Aside from higher risk of lung cancer, men who smoke are more prone to develop early impotence, lower sperm count and greater risk of prostate cancer and cardiovascular diseases, say experts. P. 16 P. 8 TOO LITTLE SLEEP MAY HARM YOUNG KIDS’ BRAINS FREE Daughter Myzette Howell, 53, of Buffalo (left), is in charge of the care of her parents, Percy, 90, and Loretta, 88. They were both recently diagnosed with Alzheimer’s disease. P. 14 THE CAREGIVER MEN & SMOKING Better treatments for those diagnosed with Alzheimer’s are on the horizon, say local experts. Q&A with Amanda Nobrega, interim director at Alzheimer’s Association WNY Chapter Citicoline: A possible Alzheimer’s treatment See Alzheimers: Pages 6, 10-12

The International Space Station has a running machine, exercise bike and weight training program, but adapting the training programs during spaceflight to better meet the

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

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Travel Speeds Up Aging, Weakening

“For those affected, this means they will have to expect a much earlier onset of osteoporosis and sus ceptibility for fractures,” she said in a hospital news release. The way the bones aged in space appeared different from bones ing on Earth. In space the inner structure of astronauts’ bones was affected more than the periosteum, the exterior sheath that supplies bones with blood, nerves and cells that help them grow and heal. Some astronauts had irreparable damage, the study found. “We were able to demonstrate that regeneration is more difficult the longer the astronauts were in space,” Liphardt“Bonesaid.turnover is the process by which cells are broken down and new ones form,” Liphardt said. “People with higher activity levels have a higher bone turnover and the challenge is to keep up these activity levels during missions in space.”

The solution could be adapting training and adding medication for those who journey to space.

Astronauts may go to space for weeks or months, and their bones can lose years in that environment.Longperiods in space can irrep arably damage bone structure and cause parts of the human skeleton to age as much as 10 years, new re searchResearchreveals.teams from Germany, the United States and Canada stud ied 14 men and three women before their spaceflights and at six and 12 months after their return. They measured the density and strength of their shin and lower arm bones, the tibia and radius. They also measured the trabecular microstructure inside the bones.Boneturnover — the assimilation of old bone and replacement by new — was also measured using biomark ers in astronauts’ blood and urine. The results, researchers said, are worrisome.Nineof the 17 astronauts had not completely recovered a full year after returning from space. They had a re duction in bone strength and mineral density of up to 2%.

“This may not sound like much, but it corresponds to age-related bone loss of at least a decade,” said study author Anna-Maria Liphardt, a sports scientist at University Hospital Erlangen in Germany.

This finding could have bearing on the future of spaceflight to Mars. “If human beings are in space for three years at a time, we need to keep an eye on the health risks involved as well,” Liphardt said. “This already applies today for missions where astronauts are subject to zero-gravity conditions for usually no longer than six months.”

Space of Bones individual needs of the astronauts is crucial, according to the study. “Developing new sports equip ment that works in zero-gravity conditions and that does not take up much space is particularly challeng ing,” Liphardt Medicationsaid.such as bisphospho nates, which prevent bone degrada tion and are used as an osteoporo sis treatment, may also help. “Bisphosphonates are already used by NASA, but we do not yet know enough about exactly how they work in microgravity,” Liphardt said. “We recommend conducting further systematic research into the combination of medical therapy and physicalTheseexercise.”findings may also be able to help people with chronic diseases on Earth. Some lead to muscle and bone loss due to a lack of activity. The findings were recently published in the journal Scientific Reports.

September 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 3 Add your cancer screenings to your summer calendar. Too many cancers are being found late — when they are harder to treat and more deadly — because of missed cancer screenings. The best cancer screening is the one you get. It could save your life. IT’S TIME TO GET BACK TO YOUR HEALTH If you’ve delayed your cancer screening or doctor’s visits or are ignoring that lingering symptom that is just not right — now is the time to act. Colonoscopies, mammograms, pr ostate cancer PSA, Pap test… Not sure where to start? Let us help. RoswellPark.org/BackToHealth Scan the QR code or visit RoswellPark.org/BackToHealth 51462 Back to Your Health Ad-In Good Health_vf.indd 1 7/12/22 6:47 PM

A: One class of these medicines is helping the nerve cells communi cate with each other. So nerve cells are dependent upon communication with each other. With Alzheimer’s some of the nerve cells get sick and die while other lose part of their com munication. This class of medication, what they do, is increase the survival of these little envelopes of commu nication. So even though there are fewer cells, there are more commu nicating envelopes. It does not stop the disease, it does not reverse the condition, but it helps the viable nerve cells to survive. The other class of medication has been shown in moderate-to-severe stage dementia to help maintain basic functions like feeding yourself, clothing yourself, being able to use the toilet. These are the issues that tend to lead to caregiver burnout. So if you can delay these problems in the course of the disease, the less time the caregiver has to deal with theseThereissues.is still a lot of progress in

A: I’m a professor of neurology at the Jacobs School of Medicine and a biomedical scientist. I’m the founding director of the Alzheimer’s Disease and Memory Disorders Center. We just received a Center of Excellence nomination from the New York State Department of Health to promote the public health mission of early diagnosis and evidence-based treatment of patients with Alzhei mer’s.

Q: Can you describe your role at the University at Buffalo’s Alzhei mer’s Disease and Memory Disorders Center?

Q: Alzheimer’s disease seems to be very stubborn when it comes to finding effective treatments. Have we made any recent progressive toward stop ping or curing it?

Name: Kinga Szigeti, M.D. Position: Associate professor and director of University at Buffalo’s Alzheimer’s Disease and Memory Disorders Center Hometown: Pecs, Hungary Education: Medical degree from University of Pecs, Hungary, Summa Cum Laude (1994); fellowship, postdoctoral fellowship, Harvard Medical School (1998); neurology residency at University at Buffalo (2002); fellowship, molecular and human genetics at Baylor College of Medicine (2004); sabbatical, medical officer, Richter Gedeon Pharmaceutical PLC (2006). Ph.D., clinical neuroscience, University of Szeged, Hungary, Summa Cum Laude (2006). Affiliations: Kaleida Health System Organizations: American Academy of Neurology; Society for Neuroscience Family: Husband, three children Hobbies: Hiking, reading the field, in the basic science. Differ ent mechanisms are being explored. There are a lot of drugs that are good candidates for Alzheimer’s. The bottleneck is drug development, because what works in mice may or may not work in men. And then we are trying to take the medicines that worked in mice in a human model. We have probably hundreds of drugs that could work, but they have to go through rigorous testing, which is in progress. There are a lot of ongoing trials that can be found on clinicaltri als.gov. It tells people where people can volunteer for the trial if they’re a good fit. People ask how the trials are going, and we won’t know — it’s randomized, it’s double-blind — until they’re finished, the data is logged, and they un-blind. There will be some interesting read-outs toward the end of the year. There’s a lot of excitement, but hopefully we’ll find something is just working out of the blue one day soon.

Page 4 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2022 Meet Your Doctor

Q: For early intervention, what age range are we generally talking about?

A: What we know from twin studies — if it’s genetic, it will show up in both twins, if it’s environ mental it may only show up in one — overall, it’s about 70% from the genes and about 30% from the envi ronment. There are some people for whom it’s 100% genetic; this is usual ly the early-onset Alzheimer’s due to a mutation in the gene. And there are people who get it mainly due to envi

Q: What distinguishes Alzheimer’s from dementia generally? A: Dementia is an umbrella term. All it means is that someone can’t perform at the level they used to. A loss of function, essentially. So you’re not as sharp and independent as you used to be. What’s causing that dementia are different specific diseas es, one of which is Alzheimer’s. Now that we know all of these pathologies we can detect them, because many times they start years and years earli er before the symptoms. And there’s also an early stage where symptoms are detectable but they’re not clearly demented. But Alzheimer’s presents along a spectrum, from pre-symp tomatic through Alzheimer’s demen tia.

Kinga Szigeti, M.D.

By Chris Motola

Better treatments for those diagnosed with Alzheimer’s are on the horizon, says founding director of the UB Alzheimer’s Disease and Memory Disorders Center because there was a lot of hype about it, and then it just fell through the cracks. We do have medications that are shown to slow disease progres sion that have been available for the last 10 to 15 years.

A: Research drove me toward an interest in Alzheimer’s. I was very interested in neural degeneration and genetics. Alzheimer’s is at the intersection of these two things, so this got me interested in the disease itself. And of course it grows on you. The patients are wonderful. The caregivers are wonderful. It’s a chronic condition. There’s so much you do to support the families. It has its challenges and sad moments, but it’s a very rewarding field.

Q: So on some level it’s a matter of the brain lacking stimulation?

Q: How did you become interested in this field?

ronmental factors because they have a lot of vascular risk factors, they may have untreated sleep apnea. But it’s a different risk assessment for each patient. The environmental risk factors are modifiable, so when people come into the office with hearing loss, which is a risk factor for dementia, we recommend they get a hearing aid, which makes the risk go away. Hearing stimulates the brain cells and makes them communicate better.

Lifelines

Q: What’s an example of a drug we use to slow the progression of Alzhei mer’s?

A: It’s preventive medicine, so it should start when you’re born. We know that brain resilience is related to education. The more you use your brain, the more reserve you have. We know that, by the time you start to have memory problems, you already had the problem going on in your brain for probably about 20 years. Risk factors between ages 30 to 50 are mainly vascular, so you have to treat your high blood pressure, your diabetes. You shouldn’t smoke, you should exercise, you should eat well. You should use your brain, use your muscles. Controlling these risk factors usually means if you’re going to get Alzheimer’s, you’re going to get it later.

Q: What are the risk factors?

A: You might have heard about a new drug that was approved last spring that got a lot of publicity, Aduhelm. That was thought to be a very big breakthrough in Alzhei mer’s, but unfortunately it didn’t pan out and the approval was a bit premature. Because the clinical trials were really not completed, the data was not interpretable. There just was not enough evidence of efficacy and there were significant side effects. So it was too risky for the unproven benefit. If there’s no clear benefit, it’s really hard to interpret the risk-bene fit ratio. This was a very sad moment

A: It’s not that lack of stimulation causes Alzheimer’s, it’s that it makes the person deteriorate faster. So the cause itself is biochemical, but lack of stimulation accelerates it. It’s a mat ter of resilience, which we can build up. We can also treat the vascular risk factors. So even if you get it, it won’t progress as fast.

The number of Americans without health insurance continues to drop, reaching 8% in 2022 — a record low. That leaves about 26 million people living in America without health insurance.Theannouncement was made early in August by the U.S. Department of Health and Human Services.

sheer vinyl cape which you will wear out to your car and discard at your convenience. Temperature will be taken

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Just 8% of Americans Lack Health Insurance, a Record Low

Those numbers may improve again after Congress passed the Democrats’ latest proposal, which would provide money for climate and health care, including extending federal subsidies for health insurance.As part of their 725-page package, Democrats proposed spending $64 billion to extend those price breaks for three more years, the APBeforereported.lastyear’s decline, the rate of uninsured Americans was in double digits for decades, though it began dropping after the ACA was enacted in 2010. The ACA expanded Medicaid and offered health insurance to people who didn’t have health plans through their jobs. About 2% of children in the United States are among those who remain“Weuninsured.knowthat access to quality, affordable health care is key to healthier lives, economic security and peace of mind,” HHS Secretary Xavier Becerra said in a statement.

“Every American has the right to the peace of mind that comes with access to affordable, quality health care,” President Joe Biden said in a HHS statement, according to the Associated Press. The significant decline began last year, helped by the $1.9 trillion coronavirus relief package approved by Biden and Congress. Federal subsidies for people buying private insurance through the Affordable Care Act (ACA) helped more people afford coverage, driving the percentage of uninsured folks down to just under 9% in 2021. Also, premiums and out-of-pocket expenses were set at lower rates for new and returning customers.

Due to Covid-19, strict safety policies are in effect and to also wear protective There is no way an operator could be three feet apart from a while working, that’s why client and a at door. touched

by bare hands. ONLY THE CLIENT IS PERMITTED INSIDE! We also have Hats & Scarves! NO EMAIL OR TEXTING ★ ★ ★ ★ ★ RATING If you or someone you know is struggling, Crisis Services is here. Suicide Prevention Emergency Mental Health Response Domestic Violence & Sexual Assault 24-Hour Crisis Hotline 716-834-3131 Crisis Services Textline 716-300-2338 (Mon-Fri 6-11PM) Crisis Services Chatline www.crisisservices.org (Mon-Fri 6PM-11PM) National Suicide & Crisis Lifeline Call or Text “988” Whichever path you choose to reach us, our counselors are ready to help you.

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September 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 5 Editor & Publisher: Wagner Dotto Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Brenda Alesii, Amanda Jowsey, Ernst Lamothe Jr., Jenna Schifferle, Jana Eisenberg • Advertising: Anne Westcott, Amy Gagliano • Layout & Design: Staff designers Office Manager: Bernadette Driscoll A monthly newspaper published by Local News, Inc. Distribution: 25,500 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. P.O. Box 550, Amherst, NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com SERVING WESTERN NEW YORK 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.

Page 6 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2022 U.S. Hospitals Are Getting Safer for Patients, Study Finds

HealthcareinaMinute

Price Transparency As of July 1, 2022, all insurance companies and self-insured businesses are required to post online what they paid for just about everything including physician services, hospitals, surgery centers and skilled nursing facilities. This includes previously secretive negotiated rates. This is different from the law that requires hospitals to post their most common charges.

“There has been a precipitous, very important drop in the number of these events, which to me validates the idea that these were preventable,” said senior researcher Harlan Krumholz, a physician who serves as director of the Yale New Haven Hospital Center for Outcomes Research and Education in New Haven, Connecticut. “The status quo wasn’t written in stone. We have been able to actually make hospitals safer for those conditions.”

• Adverse drug events, hospital-acquired infections, and general adverse events declined significantly across all patient groups, the findings showed. Events following a major surgery also declined.

Primary Care Upheaval Healthcare is a $4 trillion market. Primary care is a $260 billion sub-market. Industry analysts predict giant retailers and new startups could grab 30% of the primary care market by 2030. There are a lot of negatives facing traditional primary providers including a shortage of physicians, increasing demand for digital and virtual medicine and the transition from volume-based fee for service to value-based care or even capitation.Onone side of the coin, deep pocket nontraditional upstarts like Amazon, CVS and Walmart are licking their collective chops. Amazon just bought fledgling One Medical for almost $4 billion. Although not profitable, One Medical operates around 200 offices in 30 markets. It has approximately 800,000 members. Amazon will grow its online pharmacy and diagnostic services via this purchase. On the other side of the coin, cash-strapped traditional providers like hospital systems continue to merge hiring more and more primary care physicians who are abandoning private practice. It remains to be seen which side of the coin will prevail in the delivery of primary care over the next several years.

• Heart attacks (17% of hospitalizations) had a reduction in adverse events from 218 to 139 per 1,000 discharges.

By George W. Chapman

“There was a recognition that patients are being harmed in hospitals, and we can’t determine if things are getting better without tracking them in a reliable, consistent way,” said co-researcher, physician Mark Metersky, a professor of medicine at the University of Connecticut School of Medicine, in Farmington. The researchers analyzed the de-identified medical records of nearly 245,000 patients treated at more than 3,100 U.S. hospitals during the past decade, looking at a list of 21 potential harms that can befall a hospitalized person during their stay.

The investigators found that for the four most common reasons a person winds up in the hospital, safety has indeed improved:

Finally, Lower Drug Prices.

• Pneumonia (21%) had adverse events fall from 195 to 119 per 1,000 discharges.

Nursing Homes Struggle It seems like everyone has a horrific story about their or someone else’s experience in or with a skilled nursing facility (SNF). We all know bad news travels faster and further than good news. Some perspective is needed. There are currently about 15,000 SNFs in the U.S. More than 1,000 SNFs closed between 2015 and 2021 and another 400 will close this year. Most closed for financial reasons. There are 60 million people older than 65 (Medicare-eligible). This number is growing exponentially as baby boomers age. At any given time, there are about 1.3 million to 1.5 million SNF residents. The average resident is 83 years old. About half of SNF residents die in six months with the average passing being in 14 months. Nursing homes are facing unprecedented and dangerous staffing shortages, certainly exacerbated by the seemingly interminable pandemic. SNFs, like hospitals, are paid prospectively by CMS (Medicare and Medicaid.) In other words, payment rates are predetermined based on a patient’s acuity and need for therapy services. Higher acuity results in higherButreimbursement.prospectivepayment is based on budget neutrality. CMS budgets a fixed amount for SNFs every year. The theory (hope) is higher-than-average claims will be offset by lower-than-average claims which results in budget neutrality or breakeven. Of course, this never works as planned. The system basically encourages what critics call acuity creep. SNF costs and patient acuity

.S. hospitals became much safer places for patients over the past decade, with medical errors and adverse events declining significantly across the nation, federal government data show. Between 2010 and 2019, patient safety dramatically improved among the four types of conditions for which people are most often hospitalized: heart attacks, heart failure, pneumonia and major surgical procedures.Peoplehospitalized for those problems became less likely to suffer from medication errors, hospital-acquired infections, procedure-related adverse events, pressure ulcers from being bedridden or serious falls that cause injury, researchers found.

He’s fortunate to be negotiating ANY prices. Just ask a physician or hospital.

• Heart failure (17%) had an adverse event reduction from 168 to 116 per 1,000 discharges.

“In the last 10 years, the rates of those events overall have declined, so hospitals are becoming safer, at least as measured by this metric,” Metersky said.Theresearchers credit the improvement in part to programs undertaken by hospitals to reduce harmful events like medication errors and infections.

George W. Chapman is a wchapmanconsulting.organizations.andphysicians,exclusivelywhobusinesshealthcareconsultantworkswithhospitalshealthcareEmail

are rising much faster than what CMSItbudgets.seemslike SNFs just can’t get ahead financially.

The current reimbursement system is gimmicky, confusing, divisive and, worst of all, consumes way too much of management’s valuable time, resources and attention.

While there will always be legitimate cases of resident abuse, considering the overwhelming negative circumstances ranging from severe staffing shortages to totally inadequate reimbursement, most SNFs do a commendable job.

Just about every healthcare organization and association, including the AMA and AHA, has petitioned Congress to allow foreign medical students in the US to forego the visa requirement that they return home for two years before returning to the US to practice. Experts are predicting a shortage of 45,000 physicians in just a few years.The Conrad 30 Waiver Program and Physician Access Reauthorization Act would eliminate the twoyear visa wait if the student agrees to work in a designated physician manpower shortage area. This would be an immediate boon to rural and underserved communities.

Uninsured Hits Low Record Thanks primarily to expanded Medicaid and the Affordable Care Act, the US has achieved a record low of 8% uninsured or about 26.5 million people without insurance. The continuation of ACA premium subsidies for people making from 100% to 400% of poverty guidelines has been particularly instrumental in lowering the uninsured rate to 8%. Now, if we only had universal healthcare.

PhysicianAddressedShortage

But Wait… I t’s a victory, but don’t get too excited. After years of frustration, Congress has passed a bill allowing Medicare to use its massive purchasing power to negotiate drug prices with manufacturers. The drug lobby has managed to keep this bill from passing for decades, even though 85% of us support negotiating. And why does it take an official bill to “allow” Medicare to simply negotiate drug prices? Shouldn’t the government be negotiating the price of just about everything it buys with our tax dollars? Fearing the passing of the bill, the huge drug lobby ran totally misleading and threatening ads claiming government “price fixing” will lead to less drug development. First, negotiating prices is not “fixing” prices. Second, most manufacturers invest just 20% of income on research and development. The top 14 largest manufacturers spent $57 billion of income more on stock buy backs and dividends than R&D. The bill also includes a 1% excise tax on stock buybacks.Industry watchdogs will let us know if we will finally get the discounts that other countries have been getting for years. So, all is good, right? Well, not exactly. The bill allows Medicare to negotiate the price of just 10 drugs. Yep. Ten. The drugs selected must be on the market for several years and with no competition.Negotiations don’t start until 2026! That gives drug companies four years to jack up their prices ahead of negotiations.In2027Medicare gets to negotiate a whopping 15 prices and then gets to negotiate 20 prices a year after that. Sounds to me like the drug lobby did its job and still controls Congress.ACEO of one of the largest and most profitable manufacturers was whining to congress about having to negotiate 10 prices.

• Major surgical procedures (22%) experienced a decline from 204 to 130 adverse events per 1,000 discharges.

The new study relied on data gathered by the Medicare Patient Safety Monitoring Program, an effort created in the wake of a landmark 1999 Institute of Medicine report that drew national attention to patient safety in hospitals, the study authors said in background notes.

U

The Erie County Department of Health (ECDOH) has opened registration for three free rabies vaccine clinic sites clinics this fall.

Two locations...

“Our staff will be reaching out directly to communities highlighted in the local law that established our office. We are especially interested in people who are most affected by poor health outcomes and health inequities.”Thesurvey can take about 10 minutes to complete at https://bit. ly/eriecountysurvey.Usingawebbrowser, the survey is available in about 100 languages. Scroll down to the bottom of the page to select a language. The survey is also available on paper and in large print. To request copies, please call 716-858-2152 and leave a message with your name, address and phone number; or email healthequity@erie.gov.

Planned for September Cats, dogs and ferrets welcome at Orchard Park, Cheektowaga and Buffalo sites up to three pets will be accepted per appointment. Individuals who are unable to access online registration may call 716-961-6800 during business hours to schedule an appointment.Dogs,cats and ferrets 3 months of age and older are eligible for a vaccination. Pet owners are asked to bring proof of their pet’s 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; do not use retractable or extended leashes. Pet owners should limit the number of people in the vehicle for drive-thru sites. Wear a mask. ECDOH officials say they are thankful to 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. are committed topeopleempoweringofall abilities to lead the independentmostlivespossible.

Free Rabies Vaccine Clinics

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

Erie County Residents Invited to Participate in Survey, Earn $100 Responses will inform department’s work to address health disparities; respondents eligible for $100 gift card drawing of Health Equity Director Kelly Wofford. “This survey is one method to gather more current information from Erie County residents on their lives and health behaviors.

• Saturday, Sept. 24, 9 a.m. – 1 p.m. Erie County Emergency and Training Operations Center 3359 Broadway St. (Near Union Road), Cheektowaga. Drive-thru site.

• Saturday, Oct. 8, 9 a.m. – 1 p.m. Broadway Market 999 Broadway (parking rampground floor), Buffalo. Walk-through site. Registration links to all dates are posted at www.erie.gov/health/ rabies.Appointments are required, and The Erie County Department of Health (ECDOH) Office of Health Equity has developed a Health and Wellness Survey for Erie County residents. Responses will inform the work of the office as it compiles a needs assessment report and develops pilot models and programs to improve health disparities.Thesurvey is intended to collect responses from all Erie County residents, especially those represented in the local law that established the Office of Health Equity in 2021. This includes residents who identify as racial or ethnic minorities or persons of color; residents who identify as LGTBQ; residents whose members have been subjected to prejudice based on race, ethnicity, gender, socio-economic status, sexual orientation, or gender expression and identity. This further includes residents of rural areas who experience health inequities based on health care access and the effects of poverty.“Inpublic health, we generally have access to data that are already several years old,” said Office

The first two dates at Orchard Park and Cheektowaga will follow the drive-thru model used by ECDOH for the past two years. For the Broadway Market location on Saturday, Oct. 8, pet owners will walk or carry their animals

• Saturday, Sept. 10, 9 a.m. – 1 p.m. Erie Community College, south campus, 4041 Southwestern Blvd., building 7, Orchard Park. Drive-thru site.

One group of expert emergency physicians. It takes a lot to provide excellence in emergency care. It takes quick and easy access to care, state-of-the-art technology, and most importantly, it takes physicians who have dedicated themselves to achieving excellence every single day. Physicians who have seen it all and know how to handle essentially anything. That excellence can be found at the Emergency Center at DeGraff Medical Park (formerly DeGraff Memorial Hospital). Our physicians are second to none and combined with our highly-trained nurses and staff, they all share one goal– to provide patients with outstanding medical care. In fact, they’re the same physicians who provide emergency care at Millard Fillmore Suburban Hospital. Where excellence is. DeGraffEmergency.org

Here’sthrough.theschedule:

Participants who complete the survey will be eligible for a drawing of a $100 Target gift card. Recipients will be chosen after the survey closes on Dec. 31.

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Practical tips, advice and hope for those who live alone Alone & Thrive

• Stop mail and newspaper delivery. Better yet, have a neighbor or friend sign on for pick-up duty. Having someone you trust making daily visits to your home when you’re not there offers added protection.

• Consult a good locksmith to have high-quality deadbolts and other locking systems installed on your doors and windows.

•

By Gwenn Voelckers

“We found that children who had insufficient sleep, less than nine hours per night, at the beginning of the study had less gray matter or smaller volume in certain areas of the brain responsible for attention, memory and inhibition control compared to those with healthy sleep habits,” said study co-author Ze Wang. He is a professor of diagnostic radiology and nuclear medicine at the University of Maryland School of Medicine, in Baltimore.“Thesedifferences persisted after two years, a concerning finding that suggests long-term harm for those who do not get enough sleep,” Wang said in a university news release. These differences were associated with more severe mental health issues, such as depression, anxiety and impulsive behavior, in those who got too little sleep. Inadequate sleep was also linked to difficulties with memory, problem solving and decision making.

As summer transitions to fall, I welcome a respite from gardening. I’m ready to embrace the change of season, the crisp air and the savory scents of Septemberautumn.ismy favorite month of the year, and not just because it’s my birthday month (smile)! I love making my home warm and cozy in anticipation of chillier weather. And I’m already looking forward to cozy nights by my fireplace with my rescue cat Little Merry and an historical novel on my lap. But each September also brings with it a cautionary memory. It was years ago on a Friday night around 10:15 pm. I returned home from a night out with friends and all was good — that was, until I walked through my front door. I could tell something was amiss the moment I stepped inside. Things were slightly out of place. The lid on one of my little decorative boxes was askew. A door was ajar. My dog was jumpy.Feeling uneasy, I poked my head into the living room and saw nothing unusual there. Whew! Then, I made my way upstairs and found something that took my breath away. My bedroom and spare room were completely torn apart: clothes and personal effects strewn everywhere, drawers yanked open and emptied in the middle of the rooms, closets ransacked. Even the lampshades outlikecrooked.wereItlookedasceneofascary movie! Trembling, I called 911. A thatcautioningimmediately,thegettolddispatchermetooutofhousethe burglar might still be present. Holy (expletive)! I hadn’t thought of that. I grabbed my cell phone, left the house, and waited in my locked car for the police to arrive. While waiting, I called a friend and asked him to come over. Needless to say, that experience was a wake-up call for me. Realizing I needed to pay closer attention to my safety and security at home, I talked with police, insurance consultants, and other reliable safety advisers to put into practice multiple precautions to protect myself and my property.Ishare them with you here: If you are going out for the evening, do the following

The study findings were published online July 29 in The Lancet Child & Adolescent Health. To promote optimal health, the Kids’ Brains

Too Little Sleep May Harm Young

• Make arrangements to have your grass mowed or snow shoveled depending on the time of year. To be extra cautious, ask your local police to keep an eye on your home. Make long-term investments in home security

• In addition to your front and back porch lights, consider motion-detector lights outside your home or install a Ring-type system of video surveillance.

•

F or peak performance, schoolage children need more than a healthy diet and exercise. They also need plenty of sleep.

By Gwenn Voelckers

American Academy of Sleep Medicine recommends children aged 6 to 12 sleep for nine to 12 hours every night.The American Academy of Pediatrics advises parents to instill in their children healthy sleep habits. Its advice includes prioritizing adequate sleep as a family, maintaining a regular sleep schedule, promoting physical activity during the day, limiting screen time and avoiding screens an hour before bed.

• Make it look (and sound) as if you are still at home. Leave the TV on and use automatic timers on lights and radios.

• Eliminate hiding places outside your home. Cut back bushes and shrubs, especially those that hide windows.

Creating a Safe Haven

• Lock all doors and windows. You’d be amazed how many people don’t do this!

Keep your purse, wallet, money, jewelry and other valuables out of sight — at least out of view from a window. If you are going away for an extended period of time, do the following

• Consider installing a security system, especially one with a loud alarm and flashing lights that will attract immediate attention. The door or lawn sign provided by your alarm company may help deter a break-in all byWhileitself.there are never any guarantees, using common sense and some simple precautions can reduce your risks of a break-in that could result in theft, property damage, or worse.Let’s face it, crime is a reality. Women and men who live alone need to take extra measures to protect themselves.Besafe, not sorry. Instead, be happy and content, knowing you have secured your home and well-being.

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

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

• Again, make it look and sound as if you are still home with the help of automatic timers on lights and radios.

Live

• Give a spare key to a neighbor you trust, rather than hiding one outside your home or apartment. Let this same trusted neighbor know of your travel plans, itinerary and how to reach you.

A new study finds that elementary school kids who get less than nine hours of sleep each night show significant differences in some brain regions responsible for memory, intelligence and well-being compared to those who get the advised nine to 12 hours’ sleep.

Turn on interior and exterior lights. Light is your friend, and the enemy of those with misguided intensions.

Optometrist Avani Dave at Ross Eye Institute: “We advise people to walk away from their computer screen every 20 minutes.”

3.PEDIATRIC PATIENTS

Programs are funded in

Specialists

2.EYE EXAM Regular eye exams are also an important part of finding eye diseases early and preserving your vision. Eye diseases are common and can go unnoticed for a long time; some have no symptoms at first. A comprehensive dilated eye exam by an optometrist or ophthalmologist is necessary to find eye diseases in the early stages when treatment to pre-

“What drives a lot of people when they come to see their eye doctor is that they feel like something is going wrong with their vision,” said Dave. “Oftentimes our exams are the first time when they really attempt to close one eye and see how successful their vision is with the other eye and vice versa. That is when they find out that one eye might be stronger or weaker and that corrective lenses may be necessary.”

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Parents can schedule a comprehensive eye exam for children as young as 6 months old. A parent should have his or her child’s eyes examined at least once before they start kindergarten. Though people tend to have more vision problems as they get older, children need eye exams to ensure healthy vision too. But only 39% of preschool children have had their vision tested, which is needed to diagnose eye diseases. Amblyopia, which is reduced vision because the eye and brain aren’t working together properly, is the most common cause of vision loss

“What we are seeing now is that nearsighted conditions that normally would develop later in life, we are having children develop those issues very early,” said Dave. “Many of the issues are because of children and teens on their cell phones for hours.”

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“A big misconception is that people think your eyes are solely about vision,” said Dave. “They think if your eyes are working fine then your overall eye health must be good, but that is not “Peopletrue.don’t realize that we can check early signs of diabetes through the back of the eye vessels. Your eyes can be the first indication that you are having symptoms of multiple sclerosis as well.”

us.

Presbyopia is a refractive error that makes it hard for middle-aged and older adults to see things up close. It happens because the lens, which is an inner part of the eye that helps the eye focus, stops focusing light correctly on the retina, a light-sensitive layer of tissue at the back of the Presbyopiaeye. is a normal part of aging. Everyone gets presbyopia as they get older — usually after age 45.

About 12 million people in the United States — mostly 40 years of age or older — have some type of vision impairment, according to the Centers for Disease Control and Prevention.

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5

1.EYE HEALTH

Things You Need to Know About Your Vision

When it comes to treatment for eye exams, it depends on your condition. Cataracts or clouding of the lens is the leading cause of vision loss in the United States. Diabetic retinopathy causes damage to blood vessels in the back of the eye and is the leading cause of blindness in American adults. Glaucoma is a group of diseases that damages the optic nerve along with age-related macular degeneration. Some can be fixed with drops such as dry eyes, other ailments require glasses or contact“Welenses.alsoadvise people to walk away from their computer screen every 20 minutes. It’s not ideal to be doing work and staring into a screen for hours,” added Dave.

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

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“When you have this condition, you have difficulty focusing up close,” said Dave. “You get the feeling like your arms are not long enough because you are often holding things out away from your eyes as far as possible to see or read the object in your hand. This was previously something that we saw beginning with people in their 40s. But, like many conditions, we are seeing them earlier now.”

5.TREATMENTS

you

in children—two to three out of 100 children, according to the American Academy of Ophthalmology. Amblyopia needs to be treated promptly to help avoid vision loss. Problems treated early almost always have good outcomes so a child can have a healthy start to their education.

4.PRESBYOPIA

“One of the many reasons why people should think about their ocular health is that the eye is one of the most utilized organs,” said Avani Dave, optometrist and director of the specialty contact lens service at the Ross Eye Institute. Dave offers five tips for quality eye health.

“People don’t realize that we can check early signs of diabetes through the back of the eye vessels. Your eyes can be the first indication that you are having symptoms of multiple sclerosis as well.”

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UB assistant professor Jim Lenker points out that occupational therapy offers great opportunities for variety, working with different age groups and settings, like schools, hospitals, community-based program, or in mental health. And, he adds, there are plenty of good-paying jobs available—something for anyone, and especially middle-, highschool and undergraduate college students to consider. “Like other areas of health care, including nursing, PT, and speech, there’s a wide range of geographic areas with acute needs; rural, suburban and urban,” he said. “The national median salary is around $75,000–78,000.”

The commitment to become a licensed OT requires a master’s degree, and the field offers options, also similar to a nursing career. “Earning a master’s, especially at a state college, is less expensive than medical school,” said Lenker. “There are also many programs that offer an OT assistant program, which can be a great career in itself, or a stepping-stone to becoming a licensed OT.” He adds that while the profession has traditionally been made up of white female practitioners, greater diversity benefits all. “Patients, consumers, people in the public want to see a workforce that looks like them. Occupational therapists work on things that are generally private, like doing makeup, hair, dressing, bathing, on up to being able to get around in public with transportation, working and succeeding in school,” he said. “People usually feel comfortable working with those who can appreciate their lives and where they are.”

“One of OT’s premises is to help people of any age to gain a stronger sense of identity and agency, after some disruption or erosion. OTs have a broad background; we also are trained to consider the patient’s goals,” said Lenker. “For family and caregivers, like people who have a child with a disability, or a relative who’s had an injury or illness, OT treatment sessions focus on purposeful activities, and also can help the caregivers to support their loved one.”Erin McBundy is an occupational therapist in the Erie County Medical Center (ECMC) Outpatient Rehabilitation Department. She provides rehabilitation therapy for people who have neurological or physical impairments such as stroke or traumatic brain injury (TBI).

Jim Lenker, an occupational therapist and an associate professor in the University at Buffalo Department of Rehabilitation Science, and program director for the Advanced Graduate Certificate Program in Assistive & Rehabilitation Technology, says that the basic goals of OT are to help people engage in life’s meaningful activities.Inaddition to anatomy, neurobiology and kinesiology, OT training includes things like communication, psychology and human behavior.

Erin McBundy, an occupational therapist a ECMC, instructs a patient using an advanced hand therapy device. become a grandmother, but worried that she would not be able to hold the baby or take care of him. We used constraint-induced therapy which constrained her stronger arm, forcing use of her weaker arm. Weights were used that approximated the baby’s weight, and created adaptive strategies to independently dress him.”

“We work with patients to find compensatory strategies to help them live at home, either independently or with caregivers — as safely as possible,” she said. “For example, I had a patient whose arm was affected by a stroke. She was excited to

Page 10 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2022 Medical Career

“In many contexts, we’re trying to anticipate what needs and goals people will have,” said Lenker. “We work where we are recognized as having a legitimate contribution, helping to reduce risk and increase efficiency—whether it’s parents and babies learning to play, or assisting someone to be able to live independently for longer.”

Jim Lenker, an occupational therapist and an associate professor in the University at Buffalo Department of Rehabilitation Science.

A Career in OT Is Rewarding in Many Ways

T

“This is roughly only 16 extra calories, which is not significant,” said DiMarino, who wasn’t involved with the study. “In contrast, most specialty coffees run hundreds of calories from sugars and fats.”

he field of occupational therapy (OT) is one of the helping professions — the populations of people it has the potential to positively affect spans the life cycle, from newborns, to children, adolescent and young adults, to people who are sick or aging. It’s a still-evolving field, yet one that, unless you or a loved one has experienced it, might not be familiar.

Participants were tracked for an average seven years to see whether coffee drinking affected their overall risk of death, as well as their risk of death from cancer or heartResearchersdisease. found that unsweetened coffee reduced participants’ risk of death regardless how much they drank, with a “sweet spot” of maximum benefit around 2.5 to 3.5 cups a day. Sweetened coffee also had health benefits, as long as the person drank fewer than 4 cups a day. Sweetened or unsweetened, coffee also appeared to consistently reduce the risk of death from specific causes such as cancer or heart disease, the researchers found.

“On average, even when your coffee is a little bit sweetened, it still seems to be potentially beneficial and at least not harmful,” said physician Christina Wee, the journal’s deputy editor, who wrote an editorial that accompanied the study. Don’t rush out to order that caramel macchiato just yet, though — people in the study tended to add modest amounts of sugar to their brew, experts noted.On average, people put about 1 teaspoon of sugar in each cup of coffee, said Wee and Anthony DiMarino, a registered dietitian at the Cleveland Clinic’s Center for Human Nutrition.

And unlike physical therapy (PT), which mostly focuses on movement and strengthening, OT focuses on the intersection of movement and cognitive skills, addressing problem-solving, sensory capability and environment in the context of a person’s life. OTs can work in hospitals, clinics, schools, rehab facilities, private practice, nursing homes, and home health care agencies; the therapy is often provided in conjunction with other treatments, like physical, speech or audiology therapies.

To clarify a common assumption, the “occupation” in “occupational therapy” doesn’t necessarily mean “work-related” — it includes anything that occupies a person in the course of daily life. That could mean relatively simple things like brushing your teeth and bathing or more complex activities like getting in and out of a car, going to the dentist or, yes, being able to sit at a desk and work.

By Jana Eisenberg

Occupational Therapy: Helping Many with Common Sense and Creative Thinking

That Morning Cup of Coffee May Extend Your Life Folks who take their coffee with a little cream and sugar have reason to rejoice, health-wise.Anewstudy shows that coffee’s potential health benefits persist, even if you add a bit of sugar to your java. People who drink any amount of unsweetened coffee are 16% to 21% less likely to die early than those who don’t imbibe, based on data drawn from more than 171,000 British participants without known heart disease or cancer. And even folks who take their coffee with sugar saw some health benefits, researchers found.Sweetened coffee drinkers who downed an average 1.5 to 3.5 cups a day were 29% to 31% less likely to die during an average seven-year follow-up than non-coffee drinkers, according to findings published May 31 in the Annals of Internal Medicine.

1 cup crumbled cheese, cotija or goat ½ cup fresh cilantro lime wedges

1½ cups toasted chopped walnuts* 3 cups roughly chopped white mushrooms

½ cup low-fat sour cream

The skinny on healthy eatingBy Anne Palumbo Why You Should Go Nuts for Walnuts

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

1½ teaspoons chili powder

Eat more walnuts and you just may live That’slonger.themessage from a recent study at Harvard that explored the link between walnut consumption and longevity. According to Yanping Li, senior research scientist at Harvard, “What we’ve learned from this study is that even a few handfuls of walnuts per week may help promote longevity, especially among those whose diet quality isn’t great to begin with.”

To arrive at those recommendations, researchers from the Mayo Clinic used data from questionnaires completed by kidney stone patients between 2009 and 2018. The team compared the diets of 411 people who had already had their first kidney stone and a control group of 384 individuals.“Wehad this information and then we, number one, could look at things that … differed between controls and kidney stone formers, but then we’ve also been following these people forward in time,” said study author physician John Lieske, director of the O’Brien Urology Research Center at the Mayo Clinic in Rochester,DuringMinn.amedian of just over four years of follow-up, 73 patients in the study had recurrent kidney stones. Lower levels of calcium and potassium predicted that recurrence. After adjustments for non-dietary factors, lower calcium continued to be a predictor. So did lower potassium, but only among those who weren’t already taking certain types of diuretics and calcium supplements.The good news? While patients may not be willing to adjust their diet before a first kidney stone, they are far more likely to do so to prevent a recurrence, the authors noted.Akey piece of advice on avoiding recurrent kidney stones includes drinking water, lots of it — about nine 12-ounce glasses of water per day.Though this new study didn’t note the benefit from water, that may be because it was following people who already were drinking high quantities of water after their first kidney stone, Lieske noted.

So, how much calcium and potassium should be consumed each day to keep kidney stones at bay? Two to three servings of low-fat dairy daily would be the ideal way to consume the needed calcium, Lieske said, or an amount equal to 1,200 milligrams. That number matches the U.S. Department of Agriculture’s (USDA) daily recommended amount for most adults. The findings were published online Aug. 1 in Mayo Clinic Proceedings.

Walnut Mexican Tacos with Corn Adapted from walnuts.org Hot Sauce

2-3 cloves garlic

1½ tablespoons olive oil, for cooking Tacos

1 teaspoon Kosher salt

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing avpalumbo@aol.com.touchSmartBites,andfordishes.calorie-consciousnutritious,SheishungryyourquestionscommentsaboutsobeinwithAnneat

There are several reasons why walnuts promote longer lives. First of all, walnuts do a heart good — in more ways than one. Along with “good” fats that may lower your LDL or “bad” cholesterol and triglyceride levels, walnuts contain more heart-healthy omega-3 fatty acids than any other nut. These fatty acids, together with a walnut’s special form of vitamin E, may help prevent the buildup of plague in arteries, as well as lower blood pressure.Despite being high in calories, walnuts actually support weight iesNumerousacontributemaylaterpeciallyweight,aMaintainingcontrol.healthyes-inyears,alsotolongerlife.stud-showthatnuts are not associated with weight gain and, in fact, may contribute to weight loss because they are so satiating. “When people eat nuts, they tend to compensate by eating less during others times of the day and offsetting a good portion of the energy,” says Richard D. Mattes, professor of nutrition science at Purdue University.

Helpful tips Since walnuts go rancid when exposed to warm temperatures for long periods of time, it’s best to keep them cold. Store walnuts in their original packaging (or airtight container) in the fridge or freezer. If your walnuts smell like paint thinner, they’re rancid and should be tossed. For best flavor, wait to shell, chop or grind walnuts until ready for use.

SmartBites

1 cup corn, drained or fresh cooked

*Note: Toast raw walnuts in a 350 F oven for 8 minutes; let cool.

Stir together hot sauce ingredients. Refrigerate until serving. Mince garlic in large food processor, then add the roughly chopped mushrooms and gently pulse a few times until mushrooms are evenly chopped to the size of a popcorn kernel. Scrape contents into medium bowl.Place walnuts in processor and pulse in a similar fashion to mushrooms. Add walnuts to mushroom mixture, along with spices, soy sauce and lime juice, and gently combine. Heat olive oil over medium-low heat in a non-stick skillet. Add walnut mixture and cook for 8-10 minutes, stirring until it releases some liquid and begins to turn dry and browned. Stop whenever the crumble texture suits you. Adjust seasonings. Spoon walnut taco meat over tortillas; top with corn, cheese, hot sauce, cilantro and lime wedges.

Had a Kidney Stone?

This Diet May Help Prevent Another Anyone who has ever had a kidney stone never wants a repeat of the blinding pain that comes when it passes. Now, a new study maps out a diet that can help guard against that. The cornerstones of that diet include eating plenty of foods that contain potassium, as well as a few servings of low-fat dairy daily, to get enough calcium. High-potassium fruits and veggies that could help include bananas, oranges, grapefruits, apricots, mushrooms, peas, cucumbers, zucchini and melons such as cantaloupe and honeydew.

1½ tablespoons fresh lime juice

12 mini or 6 (6”) flour or corn tortillas

1½ tablespoons low-sodium soy sauce

1 teaspoon ground cumin

Another way walnuts champion longevity? They’re loaded with polyphenols, plant-based compounds that may reduce the risk of certain cancers (breast, prostate and colorectal) by quelling inflammation and by blocking hormone receptors in the body. Results of a recent study, conducted at Marshall University, showed that eating two ounces of walnuts a day for about two weeks slowed breast cancer growth or reduced the risk of developing the disease. While more studies are needed to confirm walnuts’ affect on cancer, the data so far is promising.Ahandful of walnuts (about ¼ cup) has 190 calories, 2 grams of fiber, 4.5 grams of protein and 18 grams of (mostly) good fats. Low in cholesterol and sodium, walnuts are rich in a variety of vitamins and minerals, especially copper and manganese.

“I would still say that’s always one of the mainstays when we see people, that they should definitely drink more fluid if they’ve had a kidney stone. That just will always be helpful,” Lieske Unfortunately,said.people who’ve had one kidney stone have a good chance of a repeat one, about 30% within five years. Having a kidney stone isn’t only an excruciating experience, but it’s also associated with other health issues, including chronic kidney disease, osteoporosis and heart disease.

2 teaspoons fresh lime juice salt & pepper to taste Walnut Taco Meat

1½ tablespoons hot sauce of choice (I used Sriracha)

A film about identity, postpartum depression —and the first year of motherhood By Amanda Jowsey

The auditorium grew quiet. The lightsOpeningdimmed.scenes of a mother and her baby in the first few days of new life appeared on the screen. Nostalgic, bittersweet music set the tone.I immediately started to cry. My tears didn’t stop rolling until a few minutes after the final credits did. Erin Bagwell (mom, artist and filmmaker) gifts the audience a raw look at her postpartum journey. I call it a gift, because the courage it took for her not only to document this experience, but to strip down her soul and share it with perfect strangers in the name of clarity, selfforgiveness and healing—that is a gift which she chose to give to the community of mothers (and a few fathers) present that night. It was a night of “connection, cocktails and conversation about maternal mental health” at the Buffalo premiere of Bagwell’s award-winning film “Year One,” a 30-minute documentary about identity, postpartum depression and the first year of motherhood. The event was held at the Seneca One Screening Room and was sponsored by Revolution, a femalefounded and -owned boutique fitness center “with a wide range of fitness offerings and amenities, strengthening each other through mind, body and community one workout at a time.” After the film, Amanda Myers, cofounder of Revolution, led a panel discussion exploring the themes that tied the film together: grieving the loss of old identities, mom guilt and shame, isolation and a lack of community and stigma around maternal mental health.

Bagwell and Myers joined WKBW news anchor Ashley Rowe and Davina Moss (founder of Positive Direction and Associates, Inc.) to discuss their journeys through that fourth trimester and their experiences with balancing identity and career with their role as moms. The film and these panelists were not afraid to ask the hard questions, the ones we don’t talk about for fear of being judged or misunderstood, or even worse, labeled as “ungrateful,” as Bagwell described in the film.

“Asking for help was the first step toward choosing myself. And in doing so, it gave me permission to redefine my relationship to motherhood. I’m not a bad mom because I have depression. I’m a great mom and I have depression.”

• WNY Postpartum Connection, Inc: A directory of mental health and support services for pregnant and postpartum families wnypostpartum.com

• Postpartum Support International postpartum.net

Bags available during the premiere event in Buffalo featuring “Year One: Surviving the First Year of Motherhood.”

Buffalo Premieres Erin Bagwell’s ‘Year One’

The night of the screening of “Year One,” one resounding theme came through for me. Why are we all trying to live our truths in secret when there is a community of people to share with? Why are we ashamed by our fear, by our weakness, by our vulnerability? The same things that eventually lead us to find our greatest strengths and the greatest truths about ourselves.

• Maternal Mental Health Now: supporting the well-being of growing families maternalmentalhealthnow.org

during and after pregnancy.” Their mission is “to provide hope, healing and empowerment to pregnant women affected by substance use disorders, giving them comprehensive knowledge, treatment and support to ensure a healthy and successful pregnancy.” The room buzzed all night with hope, relief, tears and laughter. Bagwell’s film gave voice to things I rarely receive the openness to express out loud. It gave voices to all mothers. I felt seen, heard and loved. This feeling of shared experience and unconditional support empowered me. One day early in my own postpartum recovery, my aunt asked what I sometimes dreaded hearing: “Don’t you just love being a mom?” What a loaded question. I sleep in two-hour shifts. I feel like I’m living in some alien skin that doesn’t belong to me. All I think of is another human’s digestive cycles, endless bottle washing and laundry. I have no idea what happened to my past as I grapple with this incredible and overwhelming future. Am I supposed to love this at first? Bagwell’s film hit all these points. “Every day it felt like I was starting over, being met with a million new questions: is it time to feed her? Where are her socks? What are my priorities now and who do I want to be?”— “Year One.” So, after thinking with what little brain power I had left, I said… “I love her like crazy, but I don’t love being a mom.” My aunt looked refreshed and impressed by my honesty. She understood.Weallneed more moments like that: when we are in the trenches of those first few days, weeks, months, even year of vulnerable.wepretendMomentsmotherhood.wherewedon’tlikeit’sallOK,wherearen’tafraidtobeweakandBagwellcutherselfopenand let it bleed on the screen so that the rest of us could find some healing. Her courage and self-compassion inspired discussions that lead to change and facilitate growth for everyone in a similar position.

Helpful resources

— “Year“YearOne.”One: Surviving the First Year of Motherhood” is available on YouTube. You can also check out more of Bagwell’s work at erin-bagwell.com and subscribe to her monthly blog and newsletter where she “share[s] musings about motherhood, identity, art and spirituality.”

The Centers of Disease Control and Prevention says that about one in eight women (with a recent live birth) experience symptoms of postpartum depression. There are incredible resources out there for help and support. Reach out. GO Buffalo Mom, an event sponsor for the premiere, is one such resource.Onein 10 children are born prematurely in the U.S. The Erie County rate of premature birth is similar to the national rate, but higher than that of New York. Since 2007, Erie County has had higher premature birth rates, on average, than New York. The city of Buffalo has rates of premature birth that are higher than the county, state and national average. GO Buffalo Mom “provides local mothers with a variety of resources to help them build healthier futures for their children.” The program ensures low-income pregnant women regularly attend prenatal appointments [thereby reducing the rate of premature births] and save for economical transportation options for future doctor appointments. Moss, one of the panelists that night, said she had never heard of postpartum depression until she experienced it firsthand. She later created Positive Direction & Associates, Inc. “with the goal to shorten hospital stays for infants exposed to medication-assisted treatment, while addressing the emotional, physical and mental health of a pregnant woman before,

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

Talking with someone about suicide will not cause that person to attempt it, say experts. “That’s a myth,” said Anna Shurmatz, licensed clinical social worker in private practice in Buffalo. “Most people who struggle with suicide ideation want someone to ask about it. Part of them doesn’t want to do it. Say, ‘I’m concerned about you. You sound very sad lately. I want you to know how important you are to me and there’s nothing you could say that will make me not care about you.’ Many people don’t know what to say when someone says, ‘I’m struggling with thoughts about

LEFT OUT for some, feeling lasts more than a moment. We can change that.

• Withdrawing from social contact and wanting to be left alone.

We’ve all had moments where we’ve felt we didn’t belong. But for people who moved to this country, that feeling lasts more than a moment. Together, we can build a better community. Learn how at BelongingBeginsWithUs.org

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

• Saying goodbye to people as if they won’t be seen again.

• Developing personality changes or being severely anxious or experiencingparticularlyagitated,whensomeof the warning signs listed above. ending my Shurmatzlife.’”encourages people to check on family or friends who appear to be struggling. A call, text or visit can provide invaluable encouragement.Otherwise,people feeling low may not naturally feel valued enough to seek mental healthcare. Offering to make an appointment with a healthcare provider and provide transportation may be enough support to get professional help.

“It’s important for people to give themselves permission to talk about uncomfortable things,” Shurmatz said. “If someone in your life or if you are struggling with thoughts that are scaring you, it’s OK to say that out loud to people or a professional. You’re not going to scare a therapist by saying you’re having these thoughts. No one wants to feel judged.”Oftentimes, the person suffering has an underlying mental health condition, according to physician Steven Dubovsky, president of UBMD Psychiatry and professor and chairman of the department of psychiatry at Jacobs School of Medicine and Biomedical Sciences.

• Getting the means to take your own life, such as buying a gun or stockpiling pills.

THE MAYO CLINIC LISTS AS SUICIDAL WARNING SIGNS:

Sept. 10 is World Suicide Prevention Day. Nearly 46,000 Americans died by suicide in 2020— about one death every 11 minutes, according to the Centers for Disease Control and Prevention. Although rates declined in 2019 and 2020, it is still a leading cause of death in the United States.

• Having mood swings, such as being emotionally high one day and deeply discouraged the next.

Begins with Connections CDC: 46,000 Americans died by suicide in 2020 SUICIDAL WARNING SIGNS

Suicide Prevention

• Being preoccupied with death, dying or violence.

• Changing normal routine, including eating or sleeping patterns.

By Deborah Jeanne Sergeant

Physician Steven Dubovsky, president of UBMD Psychiatry and professor and chairman of the department of psychiatry at Jacobs School of Medicine and Biomedical Sciences: “Most commonly, it’s depression, bipolar, schizophrenia and certain personality disorders and substance use disorders. Those are conditions with the highest risk of suicide.” We can change that. We’ve all had moments where we’ve felt we didn’t belong. But for people who moved to this country, that feeling lasts more than a moment. Together, we can build a better community. Learn how at BelongingBeginsWithUs.org

“Most commonly, it’s depression, bipolar, schizophrenia and certain personality disorders and substance use disorders,” he said. “Those are conditions with the highest risk of suicide.Receiving treatment for any underlying conditions can help reduce risk of suicide. People who feel hopeless because of recent grief or loss may lose progress they have made in treating mental health Conversely,issues.”someone who has struggled with depression for a long time and abruptly states they are fine may have developed a plan for suicide, he added. “They may think the solution to their problems is suicide,” Dubovsky said.Talking about suicide frankly and without minimizing their concerns can represent the first step toward seeking professional help. Asking direct questions can help determine the level of risk and then the next step, whether making an appointment with a mental healthcare professional or seeking emergency care. “If it’s a loved one who says ‘I don’t think life is worth living’ take it seriously,” Dubovsky said. “If you don’t feel comfortable about it, ask who they’ve talked with. Suggest they see a doctor or go to the ER. If they say no and say they’re going to drive into the Niagara River, don’t jump into the car and try to stop them. Call 911.” He added that talking about suicide will not “make” someone attemptAnyoneit. struggling with thoughts of suicide or who knows someone who is struggling should call 988 or if an emergency 911.

• Feeling trapped or hopeless about a situation.

• Doing risky or selfdestructive things, such as using drugs or driving recklessly.

• Giving away belongings or getting affairs in order when there’s no other logical explanation for doing this.

• Talking about suicide — for example, making statements such as “I’m going to kill myself,” “I wish I were dead” or “I wish I hadn’t been born.”

LEFT OUT for some, feeling lasts more than a moment.

• Increasing use of alcohol or drugs.

The CDC states that about 12.2 million adults considered suicide, 3.2 million planned an attempt and 1.2 million attempted. In 2020, it was one of the top nine leading causes of death for those aged 10 to 64 and the second leading cause of death for those 10-14 and 25-34. Anyone who feels a friend or loved one is in imminent danger should call 911 or transport the person to a hospital’s emergency department. For others, it may be only a consideration at this point, but nonetheless it needs to be addressed.

“You have more time to grasp what’s going on,” she said. “A lot of patients come in without a healthcare proxy and power of attorney. To be given a life-changing diagnosis, it’s good to have all those things in place before they’re not able to make those decisions.”Thedepartment of neurology can help plan how to get supports and resources they will likely need, such as in-home aides, respite caregivers, safety equipment and personal emergency response systems and door“Allalarms.these things help people age at home longer,” said Rachel Eisenberg, licensed clinical social workerCarethere.athome can help preserve finances. The average life expectancy after an Alzheimer’s diagnosis is five to 10 years. The cost of living in a nursing home in New York averages $11,370 per month, or $1.3 million in 10 years without inflation adjustment.Themental health of Alzheimer’s caregivers may be overlooked.

People with Alzheimer’s or another dementia will eventually require support to live at home safely. Oftentimes, that begins with family caregivers such as Myzette Howell, 53, of Buffalo. Her family suffered some tough blows in early 2019: the death of two of her siblings and her parents’ dementia diagnoses from Dent Neurological Institute. Then COVID-19 hit and Howell was laid off. In hindsight, Howell views the timing of her layoff as helpful since it allowed her to become her parents’ full-time caregiver. Her mother, now 88, had worked as an assistant principal at West Hertel Academy in Buffalo. Her father, 90, retired from General Motors. The couple has been married 68 years. Though Howell provides most of their care, her parents participate in an eight-hour adult day program at Lord of Life Lutheran Church Monday, Wednesday and Friday. “It’s invaluable. The people there are amazing,” said Howell. A family friend helps her father with a weekly shower and spends a couple hours with him so Howell can mow the lawn, her “therapy.”

The association can help identify resources that can ensure the patient’s wishes are carried out and that the caregivers have the support they“Havingneed. a strong support network leads to better outcomes later in the disease,” Koch said. “If you have someone you know is in your corner and is prepared to help, it’s easier to pick up the phone and ask for Earlyhelp.”diagnosis offers many benefits, according to Allison Case, registered nurse and program director of the Center of Excellence for Alzheimer’s Disease, UBMD Neurology and department of neurology at University at Buffalo.

“The overall benefit of citicoline in humans is not entirely definitive. It seems to be protective in slowly advancing neurogenic disorders such as glaucoma and mild vascular impairment, although the mechanism of action is still not clearly understood. Two recent largescale clinical trials revealed no benefits with ischemic stroke and traumatic brain injury.” Although since it is both well-tolerated and nontoxic, it may be worth incorporating more citicoline-rich foods into the diet. Those foods include organ meats, wheat germ, eggs, chicken, salmon, shrimp, oysters and roasted soybeans. Parker said that brain-boosting foods include those rich in omega-3 fatty acids such as fatty fish, walnuts, flaxseeds, chia seeds, algae and seaweed. “Other healthy fats contribute to brain health as well, including those from nuts, seeds and avocado,” Parker added. “They provide antioxidants, vitamin E and minerals important for brain health like zinc, magnesium, copper and iron. Many fruits and vegetables are protective in the brain due to their flavonoid and other phytonutrient composition, as well as antioxidant vitamins like vitamin C, as well as vitamin K.” She advises shoppers to look for produce with deep colors and varied textures and scents for the most protection, such as blueberries, purple grapes, dark green leafy vegetables, broccoli, purple cabbage and spices like turmeric and Payingsaffron.attention to overall health is also vital for protecting cognitive function.

Citicoline: A Possible TreatmentAlzheimer’s

“Get exercise and good quality sleep at night,” she said. “A lot of people have untreated sleep apnea is a risk factor for dementia.”

“It’s a very difficult form of caregiving because the person is declining,” said Andrea Koch, director of education for the Alzheimer’s Association, WNY Chapter. “It’s an extended grief process as you lose this person over time in a gradual, relentless way.”

While challenging, caregiving brings often unexpected rewards, including knowing that the patient’s wishes have been honored. Caregivers “feel great about the care that they provided,” Spina said. “They feel that this person had increased quality of life. They know them and their needs better than anyone else and they understand their loved one better than anyone else. I consider it unconditional love.”

“Caregivers seldom call until they reach that crisis or point that they can’t do it any longer or their health is suffering,” said Andrea MacDonald, registered nurse, clinical operations manager for Nascentia Health, which operates in Buffalo. She encourages caregivers to seek respite programs, whether a few scheduled in-home hours per week or as temporary stays at a long-term careFamiliesfacility. can also schedule care with a home health aide through Nascentia Health or other organizations. MacDonald also mentioned day programs, which gives patients a regular place to go for supervised care, activities and socialization.“Ifyoucan take care of yourself, you’ll be better and stronger to take care of your loved one,” said Susan Spina, licensed clinical social worker who consults for Nascentia. “Selfcare is very important. I can’t tell you how many folks do it on their own. They may have an elderly spouse. They never want to put them in a nursing home and they themselves are getting worn down,” she said. “Sometimes, they really just don’t know where to turn and on occasion, the caregiver breaks down.”

Howell has developed helpful strategies, like household cameras, accessibility remodeling and streaming favorite programs to minimize her father’s nocturnal

By Deborah Jeanne Sergeant Afew small studies have found that supplementation with citicoline, a choline derivative, may be useful to limit neurologic damage in stroke

Citicolinepatients.occurs naturally in the body as part of cell membranes.Because no randomized control trials have been conducted, it remains unclear whether citicoline could be used in the treatment of “Cholinedementias.isaprecursor to neurotransmitters in the brain which affect mood and memory,” said Mary Jo Parker, registered dietitian in private practice in Williamsville.

■ More about Alzheimer’s: Reed the interview with the founder of UB Alzheimer’s Disease and Memory Disorders Center on page 6.

Allison Case, registered nurse, program director at the Center of Excellence for Alzheimer’s Disease at UBMD Neurology and Department of Neurology at University at Buffalo, encourages people to monitor their overall health and in particular, risk factors such as blood pressure and cholesterol.

Providing Memory Care at Home: Always an Overwhelming Job

Daughter Myzette Howell, 53, of Buffalo, is in charge of the care to her parents, Percy, 90, and Loretta, 88. They were both recently diagnosed with Alzheimer’s disease. “I know there will come a time where I may have to consider a nursing home—but I’m pleased that by the grace of God, I’ve been able to do it,” she says.

By Deborah Jeanne Sergeant

wandering.Howell orders fully cooked, microwavable meals delivered from Factor 75, whose keto diet plan appears to reduce her parents’ sundowning.Sherealizes that when her parents’ behavior is difficult, it is not because they want to make things challenging.“Thistime I can never get back again,” she said. “I’m so happy and thankful. They’re still amazing, wonderful, beautiful people. “I know there will come a time where I may have to consider a nursing home—but I’m pleased that by the grace of God, I’ve been able to do it.”For those struggling with caregiving, the Alzheimer’s Association operates a 24/7 helpline, 800-272-3900, online information, support groups and educational programming.

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

A. We cover all eight counties of Western New York. Our 24/7 helpline never closes: 1-800-2723900. It is staffed by master’s-level clinicians who are there to answer questions, offer guidance on what to say to a person’s physician and link people to other resources. Help is available to both people living with dementia and their caregivers. We offer Zoom sessions and can meet inperson at a neutral site — a library, coffee shop, but not in people’s homes. Our social workers and care consultants can help develop an action plan for the person living with dementia, family members, and friends.

A. As we age, typical changes will happen; one of the hallmarks of dementia is short-term memory loss. That is a red flag. Others include difficulty performing tasks that were once routine. For example, if a person has made the same Thanksgiving recipe for years but suddenly cannot remember how to make it, that could be a Othersymptom.concerns involve problems with language. For instance, if a person is trying to refer to a watch, he or she may describe it as the clock on their arm. We have 10 warning signs listed on our website, www.alz.org. If these signs are occurring, a thorough medical check-up should be completed. Jot down and keep track of what’s happening and tell your doctor. It’s important to understand that several other medical problems can mimic symptoms of dementia: thyroid disease, anxiety, depression, vitamin deficiencies.

Q. So many people comment on walking into a room and pausing to recall what they were looking for. It’s also not unusual to misplace keys or other everyday items. How can we tell if those situations are normal sign of aging or if it could be dementia-related?

A. Yes. Alzheimer’s disease is a cause of dementia, which is a cluster of symptoms. More than 50 diseases cause dementia; Alzheimer’s is the leading cause of dementia.

Q. For that reason, is the disease becoming de-stigmatized?

Q. Are men or women more affected by the disease?

Adiagnosis of dementia or Alzheimer’s disease can stop anyone in their tracks, but help is available not only from the national organization but also locally at the WNY Chapter of the Alzheimer’s Association.Tonawanda resident Amanda Nobrega, who earned a master’s degree in social work from the University at Buffalo, serves as the chapter’s interim executive director and senior director of programs. Nobrega manages a staff of 18 employees and more than 400 volunteers. She recently spoke with In Good Health — WNY’s Healthcare Newspaper

Interim director at Alzheimer’s Association WNY Chapter: ‘It is harder and harder to find anyone who has not been impacted in some shape or form by the disease.’

By Brenda Alesii

Q. How prevalent are Alzheimer’s and other memory-related diseases here and in the U.S.?

Q & AAmandawithNobrega

Q. Is there a difference between Alzheimer’s disease and dementia?

A. The disease affects women more than men, but we don’t know why. Scientists are studying the reasons for that difference. Early onset of the disease results in a more aggressive form. Frontal temporal dementia is the type that generally affects younger people.

Q. What about education resources and support groups?

A. We offer more than 30 support groups and several education programs. Topics include how Alzheimer’s impacts our loved ones and ways to deal with challenging behavior. A grant from the New York State Department of Health provides free safety services and will even pay for free driver evaluations. The Erie County Department of Senior Services provides respite relief, a much-needed break for caregivers. Their loved ones can attend activities at an adult day care center, giving the caretaker some personal time and relief. In addition, the Center for Elder Law and Justice offers free legal service, covering topics like power of attorney documents, estate planning, etc.

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

REACH 70,000 HEALTHCONSCIOUS READERS IN WNY

Q. How can the WNY chapter of the Alzheimer’s Association help people in this region and how far does your agency extend?

A. Yes, but we ask that the person calls ahead – 716-626-0600. We are located at 6400 Sheridan Drive in Williamsville.

For information about advertising, please call: 716-332-0640 or send an email to editor@bfohealth.com

A. Data varies, but it’s estimated that more than 6.5 million Americans have dementia caused by Alzheimer’s. In New York state, 410,000 people have that diagnosis, in both cases affecting people over age 65. It is harder and harder to find anyone who has not been impacted in some shape or form by the disease.

A. Always. We are constantly looking for ways to educate and spread the word.

Advertising with In Good Health is a powerful way to reach an audience of educated, health-minded consumers and healthcare professionals who are interested in healthcare news and information to help them make healthy buying decisions.

IN GOOD HEALTH — WNY HEALTHCARE NEWSPAPER

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Q. You said the Helpline is the best way to reach the WNY Chapter. Can an individual in need of information visit the office?

A. Since Alzheimer’s disease is a huge public health crisis, people are talking more openly about it and are less hesitant to speak to their doctor about the challenges they’re facing. Also, I attribute part of the de-stigmatization to the dedicated advocates, who share stories, shine a light on the disease and make those human connections.

Q. Can you use more help from volunteers?

In addition, smoking “is a caus ative factor in not only lung diseases but cardiovascular diseases. It affects the circulatory system and contrib utes to heart attacks,” said Albert Rizzo, chief medical officer of the American Lung Association. Heart disease remains the leading cause of death in the US, followed by cancer and in fourth place, stroke. Of American men aged 18 and older, 14.1% smoke cigarettes, according to the Centers for Disease Control and Prevention. Rizzo said that 80% of lung cancers are related to smoking. In addition to allow ing carcinogens into the lungs and subsequently other tissues, smoking compromises blood flow, which adds greater risk for bad outcomes to people with many health conditions, including cardiovascular disease, diabetes, high blood pressure and more.“Some studies I’ve run across show there may be differences relat ing to sex,” Rizzo said. Some theorize that overall, men may be affected by cigarette smok ing worse than women because they smoke more often, inhale deeper or smoke longer in duration than

“The main factor is smoking,” Dryjski said. “When they quit smok ing, we may salvage their limbs. Young men keep smoking and they are losing lower extremities and even arms.”

Quit

Men’s Health

Ready to Help Help from coaches and proper medication use can help tobacco users overcome nicotine addiction, say experts By Deborah Jeanne Sergeant

Aside from higher risk of lung cancer, men who smoke are more prone to develop early impotence, lower sperm count and greater risk of prostate cancer and cardiovascular diseases, say experts

according to its website. “Because no single quit method is effective for all tobacco users, the program includes a comprehensive variety of evi dence-based, proven-effective cessa tion techniques. The curriculum also includes information about nicotine replacement therapy (gum, inhalers, patches, lozenges and nasal spray) and other FDA-approved smoking cessation medications such as Zyban and Chantix.” Maciej Dryjski would like to see more men quit smoking. “It raises the risk of heart disease and arterial disease,” he said. “It’s clear that cigarette smoking cor relates significant with cardiovascu lar disease.”Dryjskiis a vascular surgeon at UBMD Surgery, director of Vascular & Endovascular Surgery at Kaleida Health and professor at Jacobs School of Medicine and Biomedical Sciences at University at Buffalo. Dryjski said that not receiving regular check-ups can mean that health issues worsen far more than they would have, such as for the stereotypical men who won’t see a doctor until something hurts or won’t work anymore. Receiving a lecture from their doctor on smoking raising heart attack risk typically does not convince many men to quit. He also shares with patients that smoking is related to chronic obstruc tive pulmonary disease and cancers of the larynx, pancreas, bladder and lung. For some, learning they can lose limbs provides motivation. While developing arterial plaque has genetic factors, smoking can ac celerate its development by 10 years.

The psychology behind smoking matters when it comes to cessation. Although many women began smoking to stay slim—smoking can depress appetite—or deal with stress, men tend to smoke for different, more complex reasons that are harder to shake. Embracing a healthful diet and exercise regimen can help con trol weight and engaging in self-care can help manage stress. Advertising campaigns for cigarette companies have made smoking appear rugged, manly and appealing to men, such as the long run of the Marlboro Man. The self-image of rebellion and inde pendence hooked many men decades ago and made quitting more difficult. Smoking became part of their person ality.“It’s an addiction, one of the strongest known of, and rather than giving lip service to the fact that it’s a bad habit that will kill you, what will we offer can help you quit,” Rizzo said.He recommends checking into the seven FDA-approved cessation medications to support an effort to quit, along with counseling to address the psychological reasons people smoke. A supportive envi ronment at home and work can also promote“Mostsuccess.haveto try 10 to11 times before they’re successful,” Rizzo said. “They need a strong support group of family friends and counseling. They need support from those they live with. If your wife or husband smokes, it’s a great time for both of you to Thequit.”American Lung Associ ation’s Freedom from Smoking program has proven helpful for many people who want to quit. It “uses techniques based on pharma cological and psychological princi ples and methods designed to help tobacco users gain control over their behavior and break their addiction,”

Smoke Cessation: Coaches Are

Overcoming nicotine addiction, despite its challenges, is one of the best things one can do to live a hap pier, healthier and longer life. The Quitline provides coaching support seven days a week via phone at 1-866-NY-QUITS (1-866-697-8487), through text messaging and online at nysmokefree.com. Submitted by the New York State Smokers’ Quitline.

Twomen.heNew

York State Smokers’ Quitline (Quitline) reminds New York state residents that cigarettes and vape products are highly addictive. To overcome this addiction, the use of FDA-approved medications known as nicotine replacement ther apy (NRT) can help alleviate physical cravings as part of a tobacco-free journey. As is the case with all med ications, NRT is most effective when used as ”Thedirected.FDAincludes seven types of NRT medications, each with its own unique method of delivery,” said physician Martin Mahoney, the Quitline’s medical director and professor of oncology at Roswell Park Comprehensive Cancer Center in Buffalo.“Sometimes, tobacco and vape product users need to try different NRT medications to determine what works best for them. Combining medications can be quite effective to tackle both short-term and longterm urges. NRT is very safe to use, but I recommend tobacco users first consult their healthcare professionals and the Quitline’s knowledgeable quit coaches when beginning a quit journey.”Most participants are eligible to receive a free starter kit of NRT med ications shipped to their home ad dress, usually consisting of nicotine patches or nicotine gum or lozenges.

The Quitline’s quit coaches found sometimes people use NRT too sparingly or, conversely, as a permanent substitute for cigarettes or vape products. When used as directed, NRT medications should be eventually weaned once the person transitions to a tobacco-free lifestyle. Continued use of cigarette or vape products while using NRT will essentially render the medication treatment ineffective. Some of the quit coaches also offer the following considerations for effective NRT use: “Rotate where you place the nicotine patch each day to avoid skin irritation — place it below your neck, above your waist and away from your heart. Or make a plan to decrease your nicotine gum usage each week, and use the gum to con trol urges rather than to replace past smoking-vaping routines.”

NRT is an important part of a quit journey; additional resources for behavior modifications will increase the odds for prolonged success in becoming tobacco-free.

The Quitline encourages all par ticipants to develop a comprehensive quit plan in consultation with their healthcare professionals and to par ticipate in a local cessation program if available.Whileno one approach works best to become tobacco-free, proven FDA-approved NRT medications can make the quit-process easier.

“As the disease progresses, peo ple lose limbs because of the obstruc tion of the arteries,” Dryjski said. Interventions such as stents and bypasses can spare life and limb. Continuing to smoke often causes the interventions to fail.

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

Smoking Cessation Matters Even More for Men

In addition to the increased risks for health issues that both genders experience, smoking also raises risks exclusive to men — including erectile dysfunction, impotence, lower sperm count and greater risk of recurrence and dying for those diagnosed with prostate cancer.

HELPdistribution.WANTED

One or two days a month. Great for active retirees or athome moms in need of some extra cash. Not a regular job. Call 716-332-0640, ask for the office manager

— Penny Pincher Dear Penny, For many seniors, like yourself, who only want a simple basic cell phone for emergency purposes and occasional calls, there are a number of super cheap plans available from small wireless providers you may have never heard of. Here are some of the best deals available right now.

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Cheap Basic Cell PinchingPlansPhoneforPennySeniors

By Jim Miller 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 and author of “The Savvy Senior”

Senior-Targeted Providers: In addition to these super cheap plans, there are several other wireless companies that cater to older customers and offer low-cost basic plans and simple flip phones. One of the least expensive is through TracFone (Tracfone.com), which offers a 60-minute talk, text and web plan for $20 that lasts for 90 days. That averages out to $6.66 per month. Three other providers that are popular among seniors are Snapfon (Snapfon.com), which offers a 100 minutes and unlimited texting plan for $10. Consumer Cellular (ConsumerCellular.com), which provides an unlimited talk plan for $15 per month. They also give 5% discounts to AARP members. And Lively (Lively.com), maker of the popular Jitterbug Flip2 senior-friendly flip phone. Their cheapest monthly plan is 300 minutes of talk and text for $15.

Dear Savvy Senior, A few months ago, I read a column you wrote on extremely cheap smartphone plans for budget-conscious seniors. Can you do a similar column for those of us who still use basic flip phones? My old 3G flip phone is about to become obsolete, so I’m looking for the cheapest possible replacement. I only need a simple cell phone (no data) for emergency calls when I’m away from home.

Cheapest Basic Plans: For extremely light cell phone users, the cheapest wireless plan available is through US Mobile (USMobile.com), which has a “build your own plan” that starts at only $2 per month for 75 minutes of talk time. If you want text messaging capabilities, an extra $1.50/month will buy you 50 texts per month.USMobile runs on Verizon’s and T-Mobile’s networks and gives you the option to bring your existing phone (if compatible or unlocked) or purchase a new device, while keeping your same phone number if you wish. If your flip phone is becoming obsolete, as you mentioned in your question, you’ll need to buy a new device, which you can do through US Mobile if you choose their plan. They offer the NUU F4L flip phone for $39 for new customers. Or you can purchase an unlocked phone through retail stores like Walmart or Best Buy or online. One of the best value flip phones right now is the (unlocked) Alcatel GO FLIP 4044 4G LTE, available at Amazon.com for $80.

Help Us Distribute Copies of In Good Health newspaper to businesses and organizations in Western New York. The paper is usually distributed at the beginning of the month on Mondays between 9 and 5. Drivers pick up the papers at our storage area in Buffalo and leave copies at various locations. No heavy lifting. Drivers are required to have a dependable vehicle, be courteous and reliable. We audit all areas of

Subsidized Plans: You also need to know that if you’re on a government program such as Medicaid, Supplemental Security Income or food stamps/SNAP, or, if your annual household income is at or below 135 percent of the federal poverty guidelines – $18,347 for one person, or $24,719 for two – you might also qualify for free or subsidized wireless plans from various carriers via the federal Lifeline program. To find out if you’re eligibility or to apply, visit LifelineSupport.org.

September 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 17 SEND US YOUR FEEDBACK AND GET A FREE SUBSCRIPTION! In Good Health: WNY’s Healthcare Newspaper provides health and wellness news that is trusted by experts from across the region. Send us your feedback and receive 6 free issues of In Good Health mailed right to your home or business! ADDRESSNAMEWHATDO YOU LIKE ABOUT IN GOOD HEALTH NEWSPAPER? CITY/TOWN STATE ZIP Yes! Send me six free issues of In Good Health to the above address, beginning with the upcoming issue.P.O. Box 550, Amherst, NY 14226 Disclaimer: your comments may be used for marketing purposes. WHERE DID YOU PICK UP THE PAPER?

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Some other super cheap wireless plans worth a look are Ultra Mobile’s “PayGo” plan (UltraMobile. com/PayGo), which provides 100 talk minutes, 100 texts for only $3 per month. And Tello’s (Tello.com) “build your own plan” that starts at $5 per month for 100 talk minutes and unlimited texting. Both Ultra Mobile PayGo and Tello also run on T-Mobile’s network and will let you use your existing phone (if compatible or unlocked) or buy a new one.

Q. My spouse died recently and my neighbor said my children and I might be eligible for survivors benefits. Don’t I have to be retirement-age to receive benefits?

Schoolchildren Face More Anxiety This Year

• Publications of interest, depending on the claim and current step in the process. Use your personal “my Social Security” account to instantly check the status of your application or appeal at retirement,www.ssa.gov/myaccount.Ifyouhavequestionsaboutdisability,Medicare, or survivor’s benefits, as well as Supplemental Security Income, visit our webpage at www.ssa.gov/benefits.

By Sergeant

• Create Your Personal my Social Security Account. Did you know you already have access to much of your Social Security information? All you need to do is create or sign in to your personal my Social Security account. You can verify your earnings, get future benefit estimates, instantly get a benefit verification letter, and more, with your own personal my Social Security account, at www.ssa.gov/ myaccount.

Q. I prefer reading by audio book. Does Social Security have audio publications?

Q. I suspect that someone I know is collecting Social Security disability benefits when they shouldn’t be. What is the best way for me to report fraud? A. You can report fraud online at www.oig.ssa.gov/report or call the Social Security Fraud Hotline at 1-800-269-0271. Social Security has zero tolerance for fraud and uses many proven tactics to prevent fraud, waste, and abuse. Our Office of the Inspector General is relentless in its pursuit of people who conceal work activity while receiving disability benefits. We investigate and seek prosecution for people who receive benefits for a child or children who aren’t under their care, or who fail to notify Social Security of the death of a beneficiary and continue to receive and cash checks of the deceased. We also depend on you to help stop fraud.

Page 18 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2022 Ask From the Social Security District O ce The Social Security Office Q&A Three Social Security Online Musts

• Scheduled hearing date and time, if applicable.

It’s never been easier to do business with us online. Often there is no need to call or visit an office. Here are three webpages that can make your life easier:

A. No. As a survivor, you can receive benefits at any age if you are caring for a child who is receiving Social Security benefits and who is under age 16. Your children are eligible for survivors benefits through Social Security up to age 19 if they are unmarried and attending elementary or secondary school full time. Keep in mind that you are still subject to the annual earnings limit if you are working. If you are not caring for minor children, you would need to wait until age 60 (age 50 if disabled) to collect survivors benefits. For more information about survivors benefits, read our publication Survivors Benefits at www.ssa.gov/pubs.

A. Yes, we do. You can find them at www.ssa.gov/pubs. Some of the publications available include “What You Can Do Online,” “Working While Disabled — How We Can Help,” “Apply Online for Social Security Benefits” and “Your Social Security Card and Number.” You can listen now at www.ssa.gov/pubs.

Q. Do Members of Congress have to pay into Social Security?

• File for Your Retirement Online. Planning for retirement? Or looking to retire now? You can complete and submit your online application for retirement benefits in as little as 15 minutes at www.ssa.gov/retirement.

Jasmine Thorpe, mental health counselor in private practice in Buffalo, said that anxiety and depression top the list of mental health issues children are facing because of current events.“The more adults listen to kids’ feelings and experiences and engage with them on how they’re feeling, the better they’ll feel,” Thorpe said. “They’re more grounded.” Validating their feelings also matters.“Kids are trying to make sense of themselves, their bodies and the world,” Thorpe added. “Adults can shoo their emotions to the side, which can make them feel unseen and unheard. It helps, having adults and parents remember what it feels like to be 10 or 13 and add to that what it feels like to go through a pandemic.”Elizabeth Woike-Ganga, licensed clinical social worker and president and CEO of BestSelf Behavioral Health in Buffalo said that a perception of lack of control often contributes to poor mental health, anxiety and “Wedepression.wantto encourage them to focus on what they have control of like physical activity, healthy friendships and self-care,” she said. “It is important that we as parents limit things that are outside of their control.”Although your children can do little to affect global issues, they can improve their health by doing what they can to sleep well, eat a healthful diet, manage stress and connect with others.Talking about what disturbs them may help, but “if it’s beyond something the parent can handle, reach out to the primary care provider or school counselor. If there are thoughts of hurting others or selfharm, get a crises provider involved right away.”

Deborah Jeanne

A. Yes, they do. Members of Congress, the president and vice president, federal judges and most political appointees have paid taxes into the Social Security program since January 1984. They pay into the system just like everyone else, no matter how long they have been in office.

Andrea Lighthouse represents the New York Association of School Psychologists. She believes that the pandemic has affected children’s ability to self-regulate their behavior. “During the shutdown and subsequent year to year and a half, they didn’t have those typical social interactions with their peers,” she said. “Kids missed out on some important opportunities to navigate disagreements, experience reciprocation in play and navigate those social situations.”Thesesocial “lessons” are not necessarily taught in the classroom but are taught on the playground, in the lunchroom and in the hallway. Younger children missed absorbing these behavioral and social “rules.” As a result, they may act inappropriately to social situations they encounter at“Aschool.huge piece I’m seeing is the emotional impact too. Kids are struggling with managing frustration, persisting when things get tricky with academic tasks,” she said. “With school being interrupted, they missed those opportunities when things get hard. They missed some emotional regulation.”Asaresult, Lighthouse said that teachers are more explicitly teaching these principles to their classes. Current events can cause anxiety about returning to school. Fearing violence, bullying, or becoming ill from COVID-19 can cause some children to not want to attend school. “School avoidance—if you catch it early—we can fix it quite quickly and easily,” Lighthouse said. “The longer it goes on, the harder it can be to turn around.” It may seem like knowing all about a topic would help children feel safer. However, the opposite can happen. While sensible caution is warranted, children should not have so much information that they obsess over what could happen. “As a parent, you have to figure out the most amount of information to give them they can manage,” Lighthouse said. “Always be honest and clear but not give them more information than what they can handle.”Italso helps for children to feel a sense of predictability with a printed schedule. Consistent bedtimes, mealtimes and other home routines help children know at least in part what to expect. Lighthouse also recommends children have sufficient “down time” for craft, free play, creativity, going outdoors and pleasure reading to “work through stressors they have,” she said.“When school starts up, there’s a change in routine,” Lighthouse said. “It’s normal for kids to regress those first few weeks of school, as they might be more emotional. Recognize that can be normal. Schedule in time with your child to do something together, maybe 10 minutes playing a game or reading a book. Do something you enjoy together.” She tells parents to let their children’s school know about any updates of stressors at home or other concerns a child may have and seek help from the school’s mental health professionals as needed.

Pandemic adjustments, economic difficulties, school violence, racial tension: a lot of big issues have caused some major upheavals in the lives of American families. The stress from these challenges affects children’s mental health. As they return to school, that additional stressor may cause some to manifest mental health issues.

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By day, Kinsey works as a cus toms and border protection officer — a job that keeps her on her feet. It’s the same job that simultaneous ly launched her foray into running. When she decided to switch careers following changes at her previous company, she set her sights on law enforcement. With that came the need to pass a physical fitness exam and run a mile and a half within a specified timeframe. She’d run cross-country track in high school for one year and admits that she wasn’t the most talented runner on the team. To prepare for her career shift later in life, she got to work, started running and hasn’t stopped since. For the test, she also needed to do pushups, a practice she hasn’t stuck with through the years. It’s all about finding and sticking with the types of fitness that work best for her. “I have no need to do pushups,” she said. “I recognize how good they are for me, but I feel no need to do them.”These days, Kinsey’s usually training during her down time for an upcoming race or ride. She’s part of multiple run groups and frequently attends bike clubs — not to mention all the hours she logs training on her own time. Whether she’s running, biking or roller skating, her days are filled with everything Buffalo’s fitness community has to offer. Once upon a time, she even played roller derby on a league, stepping into the role of blocker. If she’s learned anything from all the activities she does, it’s that you have to find exercise that you like doing. From there, start to network, because you’re less likely to quit if you have a system of accountability in place.“Find something you like to do, then find people who like to do it, too.”Beyond the friendships and sense of achievement she’s gotten from staying active, Kinsey also tries to use fitness to give back to the com munity of which she’s part. This July, she was planning to take part in Empire State Ride, a weeklong cycling event from Staten Island to Niagara Falls that cov ers more than 500 miles for cancer research at Roswell Park. After that, she was planning to tackle Bike MS, a ride to benefit the Multiple Sclerosis Society, and Lindsay’s Legacy 5K to benefit the Courage of Carly Fund. In June, Kinsey also completed the Ride for Roswell, as well. All of these philanthropic endeavors are her way of enjoying the sports she loves while making an impact.

“My joke is that I’m a freakedout human trying to do some good in the world,” she said with a smirk. She added, “I’m going to do the fitness stuff anyway. I might as well make it about something bigger than myself.”

Barbara Kinsey lives for for ward motion. At age 53, the Tonawanda resident says she has always been active with a bit of a competitive streak. As a kid, she rode her bike every where and kept the habit well into adulthood. Thinking back, though, she attributes a cardio kickboxing class at her martial arts studio to the start of her fitness journey. At the time, she’d been training in aikido, and the class shifted her curiosity to a different form of exercise.

EXERCISE Barbara Kinsey of Tonawanda: ““Find something you like to do, then find people who like to do it, too.”

By Jenna Schifferle

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

What it is: “It’s like a request, asking the universal chi — the energy available to all of us — to examine and find and address what might be causing problems,” McCoon said. How it’s used: “Let’s say a child has a recurring strep throat,” she said. “With the EM request, the strep bacteria are eliminated from the body.” Why it’s used: “It can be used to address almost anything,” McCoon said. “It supports a person’s health for many different diseases.” Caveats: “Similar to tuning, there are people who should not have it, like those who are pregnant or un dergoing chemotherapy or radiation. It’s used in conjunction with and not instead of Western medicine.”

By Deborah Jeanne Sergeant

You may be familiar with many of the more common place complementary health modalities. However, some are less well-known than others. The modalities listed here are all available in Western New York.

3. MOXIBUSTION What it is: “It is the burning of mugwort,” said Stephen Sedita, licensed acupuncturist with Neu roloQi Acupuncture in Rochester. “In Chinese medicine, there are different ‘flavors’ of medicine. The moxa or mugwort puts ‘hot’ energy back in the body. Moxa is one of the few ways to add energy.”

Page 20 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2022

4. BIOFIELD TUNING

1. CUPPING

They are all available in Western New York and practitioners say they may help you, depending on the condition you have

COMPLEMENTARY MEDICINE 5 HEALTH MODALITIES YOU PROBABLY DON’T KNOW ABOUT

2. GUA SHA

What it is: “It’s taking a tool, a gua sha, a Chinese soup spoon and scraping it against an oiled area of skin,” Wachowiak said. It is thought that the tool scrapes away dead skin cells and stimulates blood flow to promote recovery from injuries to deeper tissue. How it’s used: “It is good for someone in good health, like an athlete, who has pain. The direction varies on the person. We think about energy flow. If we’re going to work on someone’s shoulder and neck area, we might go towards the head to bring energy up or towards the feet, if we’re bringing energy down. It could be both types of energy, emo tional or physical.” Why it’s used: “Similar to cup ping and Chinese medical massage, it is going to create a healing response by bringing blood flow to the area.” Caveats: “The person has to have robust health or this will overwhelm their system. It’s a delicate balance between addressing a problem and supporting their overall health and constitution. We don’t want to drain them away; that will negative impact on them.”

5. EMINUS MIRUS (EM) MEDICINEENERGY

Caveats: “If someone has a loss of their ability to feel temperature, you wouldn’t want to use it because you wouldn’t want to burn some one.”

How it’s used: “It’s only mug wort and only the heat is released,” Sedita said. “It’s not aromatherapy. We have smokeless moxa. It’s char coal version of it. It comes in a stick like a cigar and you hold it over the point you’re working on. It doesn’t touch the skin. Why it’s used: It is used to ad dress “pain, digestive issues and in some cases, to calm emotions. From the Chinese medicine side of things, it is used for heat deficiency, which can manifest in many different ways, like infertility and chronic pain.”

What it is: A heated glass cup is applied to the skin. The heat allows the cup to form a vacuum on the skin. How it’s used: “I use it most for people who are healthy but have an acute injury, like athletes,” said Ariel Wachowiak, licensed acupunctur ist, diplomate of oriental medicine, Chinese medicine practitioner and owner of Northeast Integrative Medi cine in SomeBuffalo.athletes use cupping to shorten recovery time between work outs. Why it’s used: “The suction cre ates a healing response, like acupunc ture,” she added. It is thought that the suction stimulates blood flow to help heal the minor trauma caused by the cup. This hastens the recovery of the inju ry in question. Caveats: “Downsides of cupping is people are depleted and that’s where their health issues are stem ming from. Cupping can be a little too powerful and draining for a lot of constitutions.”Cuppingalso leaves circular bruise marks on the skin.

What it is: The practitioner uses tuning forks of specific frequencies near a client lying on a table, fully clothed. How it’s used: “As you go through life and have difficult or traumatic events—everything from you’re 5 and moving and won’t see your best friend again to really major accidents and injuries—some of the energy in the event is held in the energy field around the body and it ties up your lifeforce,” said Carol McCoon, licensed massage therapist at Wheeler Healthy U in East Roch ester. “If you’re 40, 50, 60 years old, all these events are tying up your lifeforce.” Why it’s used: People who seek it often feel they have little energy or motivation or are recovering from a major health issue. “After multiple sessions, more and more of their lifeforce is returned to their body and is available for the body’s natural healing ability,” McCoon said. Caveats: It is contraindicated for people who are pregnant, in the middle of cancer treatments or are severely obese.