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March 2016 • Issue 17

No Reading Glasses Ephraim Atwal is one of the first eye doctors in NYS to use camera inlay to eliminate need for reading glasses. He shares his technique

MEN’S SPECIAL ISSUE

• More options to fight prostate cancer • Fat Dads = Fat Children

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Buffalo & WNY’s Healthcare Newspaper

The Long Road to Get a New Kidney Paul Bloser is one of 100,791 people waiting for a lifesaving kidney transplant in the U.S. The median wait time to get the organ is 3.6 years. The 58-yearold shares his story

See story inside Page 9

11 Food Trends Yes, Women Make Less in Healthcare Industry, Too

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Women’s pay lacks parity with men’s, according to experts

Twenty-eight percent of consumers in the U.S. are preparing ethnic foods more frequently than five years ago. Bowl of Thai is just an example. See story inside

Tax Filing for Retirees

Fat Dads = Fat Children

Living Alone: Making Choosing a Hospice the Best of 2016 Care Program

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A recent study indicates that maternal health isn’t the only influence on childhood obesity. Having a father who is obese may increase the child’s chances of becoming obese as well Page 14

Oh Boy, Is Bok Choy Nutritious!

Water Quality: Buffalo is No Flint

But officials say lead in paint still poses a problem, especially in older houses

Pet Therapy For the past year, care providers at Sisters of Charity Hospitals have been treating patients in a new way — with smiling, tail wagging, certified therapy dogs. They count on 12 dogs that are ready to help

And it is loaded with an impressive array of nutrients, so loaded that the wellregarded World Health Organization considers bok choy to be one of their highest nutritionally ranked vegetables. March 2016 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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High Deductibles = Fewer Imaging Tests

Insurance costs keep patients from seeking X-ray, CT or MRI scans, researchers report

.S. patients whose health insurance plans have high deductibles undergo fewer diagnostic imaging tests, a nationwide study finds. Researchers analyzed 2010 insurance data from more than 21 million adults nationwide and considered plans with high deductibles to be those with an annual deductible of at least $1,200 for one person and $2,400 for a family. They found that patients in plans with high deductibles underwent 7.5 percent fewer diagnostic imaging tests, such as X-rays and CT or MRI scans, than those with other plans. This resulted in 10.2 percent less in imaging payments, according to the study in the journal Medical Care. "I think what we found most surprising is the large reductions in imaging use among people with high deductibles. We had hoped to find that patients were reducing use of low-value imaging, but we found they reduced all use similarly," study senior author Kimberley Geissler,

from the University of Massachusetts at Amherst, said in a university news release. Geissler, an assistant professor of health policy and management, noted that a growing number of people are enrolling in high-deductible plans because of the lower premiums. But, she added, "It seems patients are not informed enough to discern which tests are more optional and which are medically necessary." Low-value imaging tests are those that are less critical, such as MRIs for low back pain. The study findings raise concerns that high-deductible health plans "may be a blunt instrument reducing all diagnostic imaging, rather than helping physicians and patients choose high-value imaging," the researchers wrote. Efforts to reduce diagnostic imaging tests should be combined with improved patient awareness and education about the appropriate use of such tests, the researchers said.

Fight back against gout with medication and lifestyle changes

out is like no other joint pain. It strikes suddenly, like flicking on a light switch, and brings pain that is often severe, with intense swelling and redness. It is triggered by the crystallization of uric acid within the joints. It affects more than eight million people, but older adults are the most susceptible, according to the February 2016 issue of Harvard Men’s Health Watch. The large joint of the big toe is the most commonly affected area, followed by the side of the foot and ankle, along with the knees, hands, and wrists. In general, if a person has one gout attack, there is a good chance he will have another within the next year. “The first line of treatment is medication,” says Robert Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center. This includes

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

common over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve). Pain relievers and prescription anti-inflammatories like colchicine (Colcrys) and corticosteroids also can help. But medication is only one way to fight gout attacks. “Altering lifestyle habits can add further protection,” says Shmerling. Some lifestyle changes that can help with gout include: • Reduce intake of meat and shellfish, which can raise uric acid levels. • Limit intake of alcohol and drinks with high-fructose corn syrup, such as soft drinks. • Increase intake of coffee, cherry juice, and vitamin C–rich foods like bell peppers, broccoli, strawberries, and oranges, all of which have been shown to lower uric acid levels.

Many U.S. Women Still Smoke Before, During Pregnancy: Report Smoking puts about 300,000 infants at risk each year, experts say

espite the potential risks to their baby's health, roughly one in 10 women smoke in the three months before getting pregnant, U.S. health officials recently reported. And only one-quarter of those women quit before they become pregnant, the researchers said. "Smoking during pregnancy is double trouble," said lead researcher Sally Curtin, a statistician at the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics. "There is a mountain of research that shows it does affect the unborn child." Edward McCabe, senior vice president and chief medical officer at the March of Dimes, said, "We know that smoking is a problem for pregnancy, and we continue to see many women smoking." Smoking leads to premature birth and low birth weight infants, which increases the odds for mental and developmental problems that can affect someone for their whole life, McCabe said. Premature birth is also a risk factor for cerebral palsy, lung. According to the report, smoking was most prevalent among women aged 20 to 24 (13 percent). In addition, American Indian and Alaska Native women were most likely to be smokers (18 percent). Smoking during pregnancy in most states averaged about 10 percent, ranging from almost 2 percent in California to about 27 percent in West Virginia, Curtin said.

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In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Publisher: Jamie Sandidge • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Tim Fenster, Catherine Miller, Katie Coleman, Jessica Brant Advertising: Jamie Sandidge (585-317-1671), Donna Kimbrell (716-332-0640) • Layout & Design: Eric J. Stevens • Officer Manager: Alice Davis 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.

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March 2016 •

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CALENDAR of

HEALTH EVENTS March 8

Breast cancer support meeting in Depew The Breast Cancer Network of WNY, a grassroots, community-based breast cancer organization, will hold its monthly educational meeting at 6 p.m., Tuesday, March 8, at Bella Moglie building, 3297 Walden Ave., Depew. Guest speakers Terry South and Carol Stein, Himalayan Institute, will present the topic “Stress Reduction Through Tai Chi, Yoga and Exercise.” All interested individuals are welcome to attend. Light refreshments are served. A peer-led support group for cancer survivors begins at 8 p.m. For meeting reservations, contact Breast Cancer Network of WNY at 716-706-0060 or visit our website at www.bcnwny.org.

March 10

Seminar on ‘Take Charge of Your Health’ Sharon Lawrence, a recognized leader in science-based nutrition education and health promotion with more than 35 years of experience as an integrative clinic nutritionist, health coach, educator and motivational speaker, is the guest speaker during a wellness seminar taking place from 7 to 8:30 p.m., Thursday, March 10, at Buffalo Spine and Sports Medicine, 100 College Parkway, suite 100 Williamsville. Lawrence is considered to be one of the 10 most influential women in Western New York healthcare industry. She will address a number of health issues, including cardiovascular health, digestive health, bone and joint and mind and energy support. The seminar — “Take Charge of Your Health” — is free and open to the public. Advanced registration is required. Register online at www. buffspine.com/sharon, call 716-6503101 or send an email to dmanquen@ buffspine.com.

March 19

Center for Senior Services holds housing fair The Amherst Center for Senior Services will present its second annual Housing Fair from 9 a.m. to noon, Saturday, March 19, at the center, 370 John James Audubon Pkwy in Amherst. This free event will explore various options on senior housing, including moving and downsizing, aging in place, legal and financial issues and technology. The event will feature representatives from senior outreach services who will be available to go over housing options and from D’Youville school of pharmacy, who will be available to do blood pressure screenings, counseling on medications, BMI readings and answer health questions. Page 4

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Meet

Your Doctor

By Chris Motola

Ephraim Atwal, M.D. Eye doctor one of the first in NYS to use camera inlay to eliminate need for reading glasses Q: What types of corrective surgery do you do? A: We do everything from cataract surgery, we do glaucoma surgery, we do plastic surgery. With regard to LASIK, we do both nearand far-sighted surgeries. Most recently we've begun doing camera inlay, which allows our patients to live their lives with less dependency on glasses.

Q: Is it a more difficult procedure than LASIK? A: It's more difficult than traditional LASIK in the sense that it is very sensitive to small changes in positioning. LASIK is basically a twostep procedure: we create the flap first and then our second laser tracks the eye and makes the correction automatically based on mathematical algorithms. With camera-inlay, it's very much surgeon-dependent. The company was very selective about who they allowed to do it. Q: I frequently hear that it's best to get LASIK before you reach a certain age. Is that true of camera inlay? A: There is some truth to that, but it's not the case with camera-inlay. The patients tend to be 40 years or older. They come in because they want to be free of their reading glasses. There is a limit with regard to whom we can place the device in. We can't place it in anyone who has a cataract or anyone who has dry eyes or ocular surface issues. It tends to be a very selective process, but we haven't had to turn away too many people so far. Typically the patients who come in have never had to wear glasses in the past and aren't too happy to have to start wearing them to read. Q: So can this procedure only correct far-sightedness? A: It corrects a condition called presbyopia. What that is the eye's inability to change the shape of the lens to allow you to read something.

Q: You also perform plastic surgeries. What does that mean with regard to ophthalmology? A: We do a lot of eye lifts and eyebrow lifts. Traditionally we call them blepharoplasties. It tends to be a condition that affects the aging population. Most of our cataract patients are older. It's something that we do quite a bit of. Q: What does it have to do with cataracts? A: It doesn't necessarily have anything to do with cataracts. But if you have a 75-year-old patient coming in with cataracts, if they have so much excess skin covering their eyes, they may still have an obstruction to their peripheral vision. Some of our patients have so much extra skin that they might not be able to see anything other than what's right in front of them. Q: And finally, because it tends to be a point of confusion, what should patients know about the difference between optometry and ophthalmology? A: Optometrists are very skilled at what they do, but ophthalmologists go through the full rigors or medical school. So optometrists aren't allowed to operate. They handle some minor conditions and get a lot of training at prescribing corrective lens. In fact, they're probably better at it than most ophthalmologists.

Q: What is camera inlay with regard to eye surgery? A: It's a small device we actually implant in the layers of the cornea. It's a small ring that streamlines the light onto the retina and allows the patient to read without the aid of glasses. Q: How new is it? A: It's been around in Europe and internationally for the past three years. It's only been FDA-approved in the US since 2015. I'm one of the first people in New York state to be allowed to implant it.

put in the wrong position would probably be one of the more common causes of complications.

When it hits around the age of 40, it feels like your arms are getting shorter because you can't hold the paper out any further in order to focus on it. Those are the patients we're seeing. Patients who have worn glasses their whole lives don't usually mind adding a bifocal element to their glasses. People who aren't used to that have to accommodate a major lifestyle change. Q: Do you see other potential uses for this kind of technology? A: With the camera, it's pretty much limited to the presbyopia condition. There are other inlay devices being developed with various pluses and minuses. Camera-inlay is the first one to be approved because it allows for the greatest benefit to the patients. It looks simple, like a smaller version of the reinforcements you used to put on papers in your looseleaf binder, but it has thousands of little holes that allow nutrients to pass through to the cornea. Past devices haven't allowed nutrients to pass through, so you'd end up seeing a thinning of the cornea. Q: Does the device wear out? A: That's a good question. No, it doesn't wear out, but it is removable if, for some reason, you're unhappy with the results of it. Q: Are there any complications with the device? A: In terms of complications, we haven't seen any, but the literature suggests that patient satisfaction is the main one. You'll also want to go to the right surgeon. If it's done correctly, you shouldn't see complications. Because the device is surgeon-dependent, the device being

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

Q: Eye care is often considered in its own category, apart from health care, when it comes to insurance and access. Does that complicate your practice? A: It's less so these days. There are some separate insurance plans for glasses and things like that, but for the most part surgery is covered under your regular insurance.

Lifelines

Name: Ephraim Singh Atwal, M.D. Hometown: Buffalo Position: Medical Director of Atwal Eye Care Education: Jagiellonian University (Krakow, Poland) Affiliations: Catholic Health System Organizations: American Academy of Ophthalmology; American Society of Cataract and Refractive Surgeons; Association for Research in Vision and Ophthalmology Family: Married, two daughters Hobbies: Dining out Ephraim Atwal specializes in laser vision correction including LASIK and PRK, "laser assisted" small incision cataract surgery with premium multi-focal intraocular lenses; functional and cosmetic lid surgery; glaucoma treatment and surgery; corneal transplants; medical retina and other laser procedures. He is the director of the Atwal Laser Vision Correction and Aesthetic facility at the 3095 Harlem Road office in Cheektowaga, N.Y. At Jagiellonian University he completed a fellowship with world renowned researcher, Dr. Herbert Kaufman at L.S.U. He completed his internship in internal medicine at the Ochsner Clinic Foundation in New Orleans, and his ophthalmology residency at the Ochsner, Louisiana State University School of Medicine in New Orleans.

Water Quality: Buffalo is No Flint

Region has good quality water but officials say lead in old homes’ paint poses a big threat

By Tim Fenster

f there is any silver lining to be found in the horrific water crisis in Flint, Mich., it’s that the often-overlooked threat of lead poisoning is getting some much-needed public attention. While the poisoning of as many as 12,000 children via the city’s water supply is certainly unprecedented, the problem is by no means limited to that impoverished Michigan city. Lead poisoning affects children in communities throughout America, and the Western New York region is certainly no exception. According to the New York State Department of Health, 279 children in Erie County tested positive for unsafe levels of lead in 2012. That translates to an average of 15 to 20 of every 1,000 children tested each year will be found to have unsafe levels of lead in his or her blood. “People don’t realize how common lead poisoning is,” said Cara Matteliano, vice president of Community Foundation for a Greater Buffalo, which launched the Wipe Out Lead program in 2009. “The Flint issue has brought it back to life but in a different way —

though water, not paint.” Matteliano said the combination of high rates of poverty and old housing stock — the oldest in the nation, according to the U.S. Census Bureau — contribute to the city’s high lead poisoning rates. The Wipe Out Lead page states that one-third of all lead poisoning cases in Upstate New York are located in nine zip code regions in Buffalo, most concentrated in the city’s poorer east and west sides. “There’s a risk because of our population and our housing stock,” Matteliano said. Children under the age of 6 who are exposed to even small amounts of lead can suffer from a range of health problems, including lower IQ, impaired neurobehavioral development and decreased growth and hearing acuity. Children exposed to levels of lead higher than 15 milligrams per deciliter require hospitalization, and can suffer from severe neurologic problems, such as coma, convulsion or even death. “It just rips the carpet right out from under them,” said Matteliano of children exposed to lead.

The CDC report also states the vast majority of lead poisoning cases go undiagnosed and untreated. That is why the Wipe Out Lead initiative is trying to raise awareness of the problem, and encourage Buffalonians to have their homes and children tested for lead. Parents can have their homes tested through the Erie County Department of Health, or can buy lowcost lead testing kits from hardware stores. Matteliano says the highest concentrations of lead are often found near windowsills, because exposure to the elements chips away new and

old layers of paint, creating a leadpaint dust that can easily be blown through windows. If residents are unable to paint over problem areas, Wipe Out Lead helps connect residents to youth groups and church organizations that help with the work. Matteliano says they are all trained in containing lead-based paint. She also advised not to try to scrape or remove any lead-based paint, as that will only spread more lead throughout the home. She notes that because lead-based paints were only banned in 1978, most Western New Yorkers are living with lead paint; the key is to keep it covered and contained. Matteliano hopes the situation in Flint will encourage more Buffalonians, especially those with young children who are most susceptible to lead poisoning, to have their homes tested immediately. “We still have a lot of children here who are poisoned not through water but through our housing stock,” she said. “Investing in our housing and the families who live in them is very important. As we think about Flint, it’s incumbent on us to think about how our housing is hurting our children.” For more information on lead, contact the Community Foundation for a Greater Buffalo at 852-2857. Qualifying families can also receive low-cost testing through the ECDOH’s Lead Hazard Control A bus shelter ad encourages residents who Program, which can be reached at 961-6800. live in homes built before 1978 to have homes tested for lead.

Healthcare in a Minute By George W. Chapman

Best jobs

Healthcare jobs fared well in the US News & World Report’s 100 Best Jobs ranking. Five healthcare jobs were in the top 10. Rankings are based on salary, work-life balance, stress levels and opportunities for advancement. The rankings are: No. 4: nurse anesthetist; No. 5: physician assistant; No. 6: nurse practitioner; No. 8: pediatrician and No. 9: anesthesiologist.

Hospital cost cutting

The American Hospital Association is recommending that members cut down on paperwork by reducing and converting as many administrative processes to electronic as they can. In its report, the AHA estimates that overall, the healthcare delivery system in the United States spends 15 percent to 32 percent on administrative costs.

‘Narrow’ provider networks

Organized healthcare systems are moving toward narrower provider networks in order to control costs and improve outcomes. The upside for consumers is the providers in the system are much more familiar with each other and work more as a cohesive unit. The downside for consumers is less choice. The Affordable Care Act is encouraging the development of these more defined delivery systems, or accountable-care organizations. How the physicians in a network interact and communicate with each

other is far more important than the pure number of physicians in a network. To protect consumers, both federal and state regulators have issued proposals to better regulate narrow insurance and provider networks. Number of physicians, how well care is coordinated, communications and the average turnover rate are all useful information for consumers.

Satisfied consumers

The results of a poll taken by the Kaiser Family Foundation show many insured Americans are satisfied with their health plan. Seventy-four percent of those under 65 (non- Medicare) said their coverage was worth what it costs. Sixty-one percent rated their plan as a good or excellent value. Eighty-seven percent said they were satisfied with the choice of physicians. Only 12 percent said they had to change physicians because of their plan.

Hospital star ratings

Medicare bases its hospital rating system on 113 measures of inpatient and outpatient quality. A survey, called the Hospital Consumer Assessment of Healthcare Providers and Systems, is sent to patients recently discharged from a hospital. Quality measures are lumped into seven weighted categories: mortality, safety, readmissions, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging. Only 7 percent of 3,500 ranked

hospitals achieved five stars. Forty percent received three stars. The survey intentionally avoids asking patients about amenities that don’t impact quality and outcome like food, telephone and television services, parking, visiting hours, etc.

ACA enrollment

The Congressional Budget Office has lowered considerably its estimates for the number of people insured under the ACA in any month this year from 21 million to 13 million. For the first time, spending on federal healthcare programs — ACA, Medicare and Medicaid — exceeded spending on Social Security. The $936 billion spent in 2015 was 13 percent more than what was spent on healthcare in 2014. The CBO did predict spending would increase due to the increased life expectancy of baby boomers. The CBO report will surely add fuel to the debate in Congress over federal healthcare spending.

Geriatrician shortage

Related to increased life expectancy is the predicted shortage of geriatricians. The current supply of 7,000 geriatricians needs to grow to 30,000 by 2030, a recent New York Times’ article pointed out. Geriatricians focus on the chronic conditions brought about by normal aging such as hypertension, peripheral vascular disorders, dementia, mobility, medication management, depression, nutrition, hydration and social support.

March 2016 •

Current compensation issues prevent many medical students from specializing in geriatrics. However, compensation may increase as market forces drive up demand for geriatric services.

Malpractice alternative

Hospitals and physicians spend almost $10 billion a year on payouts and associated administrative costs linked to malpractice. That is literally a drop in the bucket compared to total spending on health care that is more than $3 trillion. The problem isn’t the expense of malpractice; it’s the perpetuation of the blame shifting and adversarial relationship between patient and provider. Denmark and New Zealand compensate patients for harm due to medical errors, but then share the data with physicians, hospitals and researchers. It keeps all parties on the same side so to speak with the main interest being how to prevent the errors from reoccurring rather than simply pointing a finger at someone.

George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.

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Live Alone & Thrive

first things I did after my divorce. I picked up the phone and made an appointment with a financial adviser. I now enjoy peace of mind."

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Making the Best of Living Alone: Are You a Pessimist or an Optimist? "Optimism is essential to achievement and it is also the foundation of courage and true progress." – Nicholas Murray Butler

Is your glass half empty or half full? Take a look at the list below, which contains actual quotes from divorced or widowed women and men I've encountered along my journey and in my Living Alone workshops. Do you find yourself identifying with one perspective over another?

NOT BEING MARRIED

icholas Murray Butler knows a thing or two about the power of optimism. He is an American philosopher, educator and diplomat. He was president of Columbia University and a recipient of the Nobel Peace Prize. Seeing the glass as half full rather than half empty is all about focusing on what's positive in our lives, regardless of what life offers up. It's about being thankful, appreciative and even grateful for the challenges we face. I’m convinced that our thoughts and attitudes determine the life we have. And experience has taught me that seeing the glass half full can make all the difference for those who live alone. We have a choice. We can choose to see the positive or we can choose to wallow in the negative — to close our eyes to possibilities and to begrudge the cards we have been dealt. So, how do you view your life?

• HALF EMPTY "Something must be wrong with me. All my friends are married, and here I am alone and miserable." • HALF FULL "Not in a million years did I expect to be divorced at my age, but I am resourceful and persistent. I've always wanted to travel and try new things, and now I have that opportunity — to create a life that's full of new people and experiences."

DECISION MAKING

• HALF EMPTY "Are you kidding? I don't know enough to buy a house or a car. Those are the big decisions my husband used to make. I wouldn't know where to begin." • HALF FULL "Finally, I get to make all my own decisions! No one's around to second-guess my choices. I just purchased my first car all on my own: a new Nissan Sentra. I did the research and was completely prepared when I went to the dealership. My color choice? Fresh Powder!"

IN A CRISIS

• HALF EMPTY "I'm no good in a crisis. I go to pieces. When I hear bad news, I long to be taken care of and protected, as if I'm a child. But, on my own, there's no one to turn to." • HALF FULL "Being alone in a crisis isn't the end of the earth. In fact, some of my most significant growth has been during tough times. When I got the call that my father had had a heart attack, I took charge, made calls, and brought the family together. I learned I could take care of myself and others, too."

DATING

• HALF EMPTY "I can't imagine dating at my age. What could anyone possibly see in a middle-aged, gray-haired retiree with grandchildren?" • HALF FULL "Warm friendships, even romance, can happen at any age. I met my second husband when I was 72. We met in a grief support group and the rest is history. Next year, we are celebrating our fourth anniversary."

FINANCES

• HALF EMPTY "He took care of all the finances, the bills, the taxes, everything. I feel helpless and, honestly, I fear dying alone and penniless." • HALF FULL "I knew it wouldn't be easy, but I figured I could do it. Getting help with my finances was one of the

COOKING FOR ONE

• HALF EMPTY "Why would I invest any time in creating a special meal for just myself? It hardly seems worth it. I often indulge in Ben and Jerry's and call it a night." • HALF FULL "Creating a pleasant 'table for one' makes me feel good about myself. It means I'm nourishing my body as well as my spirit. When I prepare a nice table setting and sit down to a healthy, home-cooked meal, a sense of serenity comes over me. I feel at home with my own good company."

TIME ALONE

• HALF EMPTY "Living alone is for the birds! I just want to stay in bed and pull the covers up over my head." • HALF FULL "Living alone need not be a time of diminished opportunities. It can be a time of expanding possibilities. Used wisely, time alone can be an adventure in self-discovery and reveal opportunities for personal growth and fulfillment." That last quote is one of mine. I discuss this at length in my workshops. If you don’t like the results you are getting in your life, consider changing the attitudes that are producing those results. Who knows what great adventures and joy await those who adopt an optimistic outlook and embrace the wisdom of seeing the glass half full. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call her at 585624-7887, email her at gvoelckers@ rochester.rr.com.

Gains in Kids' Health Coverage Continue, But Many Still Uninsured

KIDS Corner

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NYS still has one of the highest percentages of kids with no insurance

espite a significant increase in the number of American children with health insurance, many still lack coverage, a new study reveals. From 2013 to 2014, the number of uninsured children fell from 5.9 million to 4.9 million. In 2013, 7.5 percent of youngsters were uninsured, compared to 6.3 percent in 2014 — a 16 percent decrease. While the findings show progress, nearly 5 million Americans under age 19 still lack health insurance, according to the Robert Wood Johnson Foundation report

prepared by University of Minnesota researchers. "Despite the politicking around health policy lately, I think we can all agree that coverage for kids is essential for their healthy development," Kathy Hempstead, the foundation's director of coverage issues, said in a news release from the organization. "The last year has shown continued progress in expanding coverage to children and the reduction of differences by race, ethnicity and income, but there is more work to be done," she added. The percentage of uninsured children fell sharply in 23 states and no states had significant increases, the investigators found. The states with the largest declines in uninsured children were Ar-

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

izona, Colorado, Minnesota, Nevada and Rhode Island. Nearly half of the 4.9 million uninsured children are in six states: Texas (880,000), California (550,000), Florida (410,000), Georgia (210,000), Arizona (180,000), and New York (160,000). Of these six states, four had the largest decrease in the number of children without coverage from 2013 to 2014: California (down 210,000), Texas (down 95,000), Florida (down 87,000), and Georgia (down 53,000). Two states — Massachusetts and Vermont — had fewer than 2 percent of children who were uninsured. In three states, more than 10 percent of children lacked coverage: Alaska (12.3 percent), Texas (11.8 percent), and Arizona (10.5 percent).

Tim Richter, a site manager at Sisters of Charity Hospitals’ St. Joseph campus on Harlem Road, Cheektowaga, with his 7-year-old Labrador Retriever Hayley. The dog is one of 12 active therapy dogs helping patients at Sisters of Charity Hospitals

Finally.

Closure to my leg pain and varicose veins. There is a solution to the discomfort, swelling and appearance of varicose veins. The Venefit procedure is a clinically proven, minimally

invasive way to treat venous reflux, the underlying cause of varicose veins, with little or no pain. Venefit patients can return to everyday activities within a day, and the Venefit procedure is covered by most insurance providers. Find out if the Venefit procedure is right for you.

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Pet Therapy Aids Patients in Pain

Venefit htpps://venefitprocedures.com

Daniel J. Patterson D.O., F.A.C.O.S.

Program has been in place at Sisters of Charity Hospitals for over a year

By Katie Coleman, Special for In Good Health Western New York Healthcare Newspaper

or the past year, care providers at Sisters of Charity Hospitals have been treating patients in a new way — with smiling, tail wagging, certified therapy dogs. There are now 12 active therapy dogs at the hospital’s two campuses — Main Street Campus and St. Joseph Campus) — according to Heide Cornell, director of volunteer services who spearheaded the pet therapy program to help patients address pain and reduce anxiety in a new way. “I proposed the idea and was ready for rotten tomatoes,” Cornell said. “Instead, people were immediately excited and it’s been a wonderful program for everyone.” All of the therapy dogs have been certified through Therapy Dogs International (TDI), a volunteer organization that regulates, tests and registers therapy dogs and their volunteers to visit nursing homes, hospitals, and other institutions. Tim Richter’s 7-year-old Labrador Retriever, Hayley, is one of the TDI-certified dogs at Sisters. Richter works as a site manager at the hospital, and as soon as he heard about the program, he thought to himself, “I’ve got the perfect dog at home!” and he jumped right on board. “There’s so much stress and anxiety in a day,” Richter said. “People don’t expect to see a dog in the hospital, and it’s a real nice break for

them.” Richter and Hayley visit all the nurses’ stations at Sisters, and then walk down the halls for one-onone visits with patients. A patient was navigating the hallway with a stretcher as Richter and Haley strolled down the hallway. When he saw Hayley he lit right up. “I’m trying to get better so I can get home to my dog,” he said, as his nurse encouraged and congratulated him with each recovery step he took. Richter said it’s important that dogs and their handlers be comfortable with large crowds, lots of activity, and be prepared for the different emotions and temperaments that come with patients in pain, and the chance of loss in hospice care. They will see many patients attached to IVs, tubes, and other hospital equipment. Richter shared a story about taking Hayley to see a hospice patient who was on his deathbed. The patient was surrounded by family, and kept insisting that he see his dog, who wasn’t allowed in the facility. Richter was called up to the fifth floor and headed up with Hayley to pay a visit. The patient gave Hayley a great, big hug. After about 10 minutes, Richter led Hayley out, and as they ducked through the doorway, the patient was finally ready, and died. “It excites the patients, and you watch them do a complete 180 when they see your dog,” Richter said. March 2016 •

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Roswell Park Endorses Increased HPV Vaccination for Cancer Prevention

oswell Park Cancer Institute has joined with all the top cancer centers across the nation in issuing a statement urging for increased HPV vaccination for the prevention of cancer. Recognizing that insufficient vaccination is a public health threat, these leading institutions have called upon the nation’s physicians, parents and young adults to take advantage of this rare opportunity to prevent many types of cancer. In a consensus statement, the nation’s cancer centers say, HPV vaccination is our best defense in stopping HPV infection in our youth. “Most HPV-related cancers are preventable through the administration of safe and effective vaccines. This joint statement sends a strong message to the medical community encouraging health care providers to recommend this cancer-preventing vaccine to their patients and their families,” said Candace Johnson, president and CEO of Roswell Park With 100 percent participation, all 69 National Cancer Institute-designated cancer centers joined this effort, which appropriately coincides with the launch of a national “moonshot” to cure cancer, a collaborative effort announced in President Barack Obama’s State of the Union address and led by Vice President Joe Biden.

UB to launch Center of Excellence for Alzheimer’s

Award from NYS to improve Alzheimer’s disease diagnosis and treatment in Western New York

estern New Yorkers with Alzheimer’s disease and other dementias will soon have access to improved care, thanks to a five-year, $2.35 million New York state grant to researchers in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. UB was awarded the grant to launch the Center of Excellence for Alzheimer’s disease in Western New York because of the strong partnership between its Alzheimer’s Disease and Memory Disorders Center and its Division of Geriatrics and Palliative Medicine. The purpose of the grant is to significantly improve the screening, diagnosis and treatment of Alzheimer’s disease and other dementias by providing state-of-theart care and educating primary care providers, patients and their caregivers in Western New York. The grant also will help educate future medical professionals at the Jacobs School of Medicine and Biomedical Sciences about dementia and geriatrics, which are becoming increasingly important as the patient

population ages. One of 10 grants designed to improve Alzheimer’s disease care throughout the state, the grant is especially important given the region’s proportion of older adults, which at 16.7 per cent is higher than the 14.4 per cent statewide, or 13 per cent national, average. The grant draws on the Troen strength of multidisciplinary collaborations at UB, particularly between neurologists and geriatricians in the Jacobs School of Medicine and Biomedical Sciences, according to physician Bruce R. Troen, professor of medicine, chief of the division of geriatrics and palliative medicine and director of UB’s Institute for Person-Centered Care.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

Troen is co-principal investigator on the grant with physician Kinga Szigeti, associate professor of neurology and director of UB’s Alzheimer’s Disease and Memory Disorders Center at Buffalo General Medical Center. Both see patients through UBMD Physicians Group. Szigeti The Center of Excellence will work with multiple primary care clinics and providers throughout the region, including the Great Lakes Health System and the Veterans Affairs Western New York Healthcare System, including its Geriatric Evaluation Management (GEM) Clinic, the Geriatric Center of Western New York at DeGraff Hospital, Dent Institute and others.

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A Long Battle Against Chronic Kidney Disease A Buffalo resident has been on dialysis for the past year. He shares his experience By Katie Coleman

arch is National Kidney Month, and a great time to make sure yours are functioning properly. Our kidneys are bean-shaped organs that keep our blood healthy by filtering out waste and excess fluid through our urine. When they start malfunctioning, excess fluid and waste build up in our bodies and can lead to chronic kidney disease, kidney failure and other problems. Joseph Pietrzak, a 74-year-old Buffalo resident, was diagnosed with chronic kidney disease 10 years ago. Because he had no symptoms, he didn’t want to go on dialysis, which acts in place of your faulty kidney and filters your blood for you. What made him start a year ago? “I decided not to die,” Pietrzak said. He added that his lungs had filled with so much fluid he couldn’t breathe. Now Pietrzak and his wife Christine dedicate three days a week to his dialysis treatments at Pure Life Renal in Williamsville. “Dialysis changes your whole quality of life,” Christine said. “Joe’s very tired all of the time and it can be very hard on us. I spend

a lot of my day helping him.” Pietrzak said his dialysis treatments last over four hours and he spends them immobilized with a catheter inserted into his neck. "My Kindle, my wife and son have been lifesavers to me. All that helps me pass the long hours during dialysis," he said. His biggest piece of advice is that although it’s a big decision and can cause unhappiness, start treatment as soon as you get diagnosed with kidney disease. "Dialysis is a big decision. This is for the rest of my life. I'm not real happy about that. But you should start it as soon as you get diagnosed," he said. His wife Christine said he is not eligible for a kidney transplant because his overall health is not good.

Numbers spiraling upward

Kidney failure has more than tripled in the United States since 1990, according to the Centers for Disease Control, and the CDC expects that number to keep climbing. Chronic kidney disease is di-

agnosed through a simple urine or blood test. Because there may be no symptoms present, it’s very important to get tested to slow or even prevent kidney disease and failure. Once your kidneys fail, you have to have regular dialysis or you need a kidney transplant. The National Kidney Foundation is a free resource dedicated to the awareness, prevention and treatment of kidney disease for healthcare professionals, patients and their families, and those at risk. “Twenty-six million people have kidney disease. Seventy-three million people in the U.S. are at risk for it,” said Elissa Rowley, program manager for the NKF. “Our goal is to spread the word.” On April 2 at Linwood Church of Christ, 2523 Main St., Buffalo is “KEEP Healthy,” a free kidney health check made possible by the NKF. The church consists of mostly African-American members who are at higher risk for kidney disease, according to Rowley. “The main causes of kidney failure are diabetes, high blood pressure, and a family history of kidney fail-

ure,” Rowley said. At KEEP Healthy screenings, a urinalysis station tests patients’ urine for protein. If present, it’s a warning sign because protein should not be leaving our bodies. However, it doesn’t necessarily signify kidney disease, just that something’s not functioning right. Based on those results, patients then speak with a clinician and are given a lot of education and resource literature to take home with them. To learn more about chronic kidney disease, kidney failure, or resources available to you, go to www.kidney.org, call (800) 622-9010 or email info@kidney.org. 100,791 People Await Kidney Transplantation • There are currently 121,678 people waiting for lifesaving organ transplants in the U.S. Of these, 100,791 await kidney transplants. (as of 1/11/16) • The median wait time for an individual’s first kidney transplant is 3.6 years and can vary depending on health, compatibility and availability of organs. • In 2014, 17,107 kidney transplants took place in the US. Of these, 11,570 came from deceased donors and 5,537 came from living donors.

On average: • Over 3,000 new patients are added to the kidney waiting list each month. • 13 people die each day while waiting for a life-saving kidney transplant. • Every 14 minutes someone is added to the kidney transplant list. In 2014, 4,761 patients died while waiting for a kidney transplant. Another, 3,668 people became too sick to receive a kidney transplant. Source: National Kidney Foundation.

The Long Road to Receiving a New Kidney A local resident’s life with kidney failure

By Katie Coleman

aul Bloser has been on dialysis and waiting to receive a kidney transplant for the past two years. The 58-year-old Rochester resident is potentially going to receive a kidney donation from his sister Susan in the near future. “I’m anxious to get on with my life. It feels like the past two years of my life have been put on hold,” Bloser said. He had to leave his job a year ago due to the impact of his dialysis treatments. Bloser decided to travel to Charlotte, N.C., to get tested and make sure Susan is a successful match. When he initially went to doctors, they diagnosed his kidney disease as hypertension. He was taking up to 18 of the wrong pills for a long time until he said he started becoming his own advocate, eating healthy and taking vitamins.

Chilling reality

Bloser is now on one prescription pill per day, but living on dialysis is

still certainly a struggle. “I’m a really active guy but now I sit for four hours a day. I can’t move my arms. All I can do is watch TV and I’m not a TV watcher. I’m kind of a hostage, and the treatment is very physically draining,” Bloser said. He wakes up at 4 a.m. every morning to put numbing cream on his dialysis site before heading to Unity Hospital in Spencerport to start his treatment at 6 a.m. He doesn’t leave until lunchtime. Bloser said this experience has been absolutely life-changing for him. He joined the board of the WNY Kidney Foundation, and donates a lot of his time to helping people, something he’s always been passionate about. Bloser recommends every patient out there to become his or her own advocate. “I absolutely rely on my doctors, but they don’t have all the answers. The National Kidney Foundation has helped and taught me so much.” Kidney failure has more than tripled in the United States since 1990,

according to the Centers for Disease Control, and the CDC expects that number to keep climbing. Chronic kidney disease is diagnosed through a simple urine or blood test. Because there may be no symptoms present, it’s very important to get tested to slow or even prevent kidney disease and failure. Once your kidneys fail, you have to have regular dialysis or you need a kidney transplant. The National Kidney Foundation is a free resource dedicated to the awareness, prevention and treatment of kidney disease for healthcare professionals, patients and their families, and those at risk. “Twenty-six million people have kidney disease. Seventy-three million people in the U.S. are at risk for it,” said Elissa Rowley, program manager for the NKF. “Our goal is to spread the word.” To learn more about chronic kidney disease, kidney failure or resources available to you, go to www. kidney.org, call 800-622-9010 or email info@kidney.org.

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SmartBites

The skinny on healthy eating

Oh Boy, Is Bok Choy Nutritious!

ooks can be deceiving, even with food. Consider bok choy. On the outside, bok choy — also known as Chinese cabbage — doesn’t look like a nutritional powerhouse. Its soft green leaves appear wan next to kale’s; and its rather pale stalks seem devoid of all value. Ho hum? Hardly. Bok choy is loaded with an impressive array of nutrients, so loaded that the well-regarded World Health Organization considers bok choy to be one of their highest nutritionally ranked vegetables. A member of the cruciferous vegetable family, bok choy has unique sulfur-containing compounds that help the body fight cancer. These magic bullets launch their attack in one of three ways: by helping the body eliminate carcinogens, by preventing cells from turning into cancer or by altering metabolism to stop the development of hormone-sensitive cancers. Several population studies, in fact, have shown that people who eat more cruciferous vegetables (cauliflower, cabbage, garden cress, broccoli, brussels sprouts) have a lower

11 M

ore than ever consumers are identifying themselves as foodies with an on-the-go lifestyle that translates to food choices that are more experiential, convenient and impulse-driven. In the January issue of Food Technology magazine published by the Institute of Food Technologists (IFT), contributing editor A. Elizabeth Sloan writes about consumers’ mealtime choices and behaviors in 2015.

Forty-seven million adults define themselves as foodies, and 29 million are categorized as being part of a highly involved, serious culinary core group. Millenials account for 36 percent and baby boomers for 32 percent. In addition, those consumers who enjoy food as an “art form” climbed by 20 percent.

Yogurt tops the list of foods/ beverages that are consumed more today than 10 years

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risk of developing lung, prostrate, colorectal and breast cancer. Bok choy’s remarkable arsenal of antioxidants — from vitamins to minerals to phytonutrients — further boost its cancer-fighting properties. Antioxidants gobble up damaging free radicals, which have been implicated in many cancers, along with a host of chronic, age-related diseases. Bursting with vitamins A, C, and K, bok choy plays an important role in maintaining good eyesight and a healthy immune system, keeping our bones strong and our skin elastic, and helping our blood clot properly. Hearts benefit from bok choy, too, as this tasty vegetable teems with nutrients that keep our tickers tocking longer: potassium, folate, calcium and vitamin B6. Lastly — and more good reasons to reach for China’s most popular vegetable — bok choy is super low in calories (only 10 per shredded, raw cup), has no fat or cholesterol, and offers up some fiber and a bit of protein.

Helpful tips

Look for firm stalks and crisp,

green leaves. Avoid those that appear wilted, discolored, or distressed. With proper storage, bok choy can last up to a week in your refrigerator. To store, place bok choy in a plastic bag, removing as much air from the bag as possible, and put in the crisper section.

Healthy Bok Choy Salad with Sesame Dressing Dressing ingredients: ¼ cup red wine vinegar 2-3 tablespoons olive oil 2 garlic cloves, minced ¼ cup sesame seeds, toasted 2 tablespoons soy sauce ¼ teaspoon red pepper flakes (optional) salt and pepper, to taste Salad ingredients 1 head bok choy, rinsed and sliced (trim off tough base) 1 red pepper, chopped 4 scallions, sliced 2 carrots, shredded

Facts About 6. America’s Eating Habits 7.

Desserts account for half of in-store bakery sales and specialty desserts and brownies/dessert bars show the highest sales growth.

When it comes to fast casual restaurants the Asian/noodle sectors is projected to lead growth followed by Mexican, coffee/ café, chicken and bakery café. The pizza, sandwich and burger segments are expected to underperform.

ago, followed by bottled water, pizza, poultry sandwiches, Mexican foods, fresh fruit, bars, frozen sandwiches, chips and pancakes.

An increase in the number of meals prepared and eaten at home and a corresponding decline in restaurant usage is one the single biggest changes in eating patterns in the United States in the past five years.

Twenty-eight percent of consumers are preparing ethnic foods more frequently than five years ago.

More than half of grocery shoppers buy fresh readyto-eat items like rotisserie chicken, sandwiches and sushi often or sometimes.

¼ cup sliced almonds, toasted In small bowl, whisk together dressing ingredients. Prepare salad ingredients and place in large bowl. Toss dressing with salad and top with sliced almonds. (Toast sesame seeds in a dry skillet over medium heat for three to five minutes or until lightly browned, stirring occasionally. Toast sliced almonds—spread out on a cookie sheet—in a 350-degree oven for five to eight minutes; they easily burn, so closely monitor.)

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

9. 10.

For the first time in more than five years, indulgent snack sales outpaced healthy in the $38 billion snack product category. Vegetarian tops the list of hot appetizer trends, followed by charcuterie/ house-cured meats; ethnic street food inspired appetizers; seafood charcuterie; and high-end chef-inspired appetizers and ethnic dips.

11.

Nine out of 10 adults say that information about fruit and vegetable content is important to them in determining if a food is healthy. That is followed by preservative-free, added nutrients or no artificial sweeteners, no antibiotics, unprocessed, natural or hormone free, organic or non-genetically modified, clean and “real.”

One-quarter of consumers ate soup at home at least once a week in 2014. While broth, stew, chowders and chili are Americans’ favorite forms of soup, one-third of consumers would eat more soup if it contained a serving of vegetables, was heart healthy, or high in protein.

Best sellers in the fresh bakery category are breads, cakes, cookies and rolls.

Bowl of Thai food. Twenty-eight percent of consumers are preparing ethnic foods more frequently than five years ago, according to an article in Food Technology magazine.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

Medical Debt Collectors

What You Need To Know By Alexander J. Douglas, Esq.

Patti Smith (left), chairwoman of the Pride Center board, and Siobhan FitzgeraldMatson, Trans Wellness coordinator, at a rally in support of the governor's executive order on trans nondiscrimination. Photo courtesy of John Carocci.

Many Local Doctors Not Friendly Toward LGBT Members

It creates this fear among the transgender population, and it keeps them from seeing a doctor,’ leader says

What should I do?

By Tim Fenster

mericans’ attitudes toward LGBT issues may be heading on a general trajectory toward tolerance and acceptance, but for members of WNY’s transgender community, change isn’t coming fast enough. Siobhan Fitzgerald-Matson, coordinator of the WNY Pride Center’s Trans Health Initiative, says transgender individuals still face significant discrimination and transphobia in their daily lives. This in turn can cause myriad issues from lack of proper medical care to loss of employment and poverty to isolation, loneliness and depression. “We know transgender people have all kinds of needs,” said Fitzgerald-Matson. “There’s a whole slew of issues they face.” That’s why the WNY Pride Center launched the Trans Health Initiative in 2011, funded by a five-year, $2 million grant from the AIDS Institute of the New York State Department of Health. It is the only program of its kind in Upstate New York. Modeled after New York City’s LGBT-focused Callen-Lorde Community Health Center, the Trans Health Initiative aims to provide comprehensive care and support for all transgender individuals living in the eight-county Western New York region. (Fitzgerald-Matson notes that transgender is an umbrella term that applies to anyone who does not identify with the gender they were born with — not only those who transition to the opposite gender.) While the program itself doesn’t offer medical procedures — with the exception of HIV testing — it does connect transgender individuals to health providers who are trained and educated in trans issues. Fitzgerald-Matson says many doctors either aren’t trained in LGBT issues or are discriminatory against this community. Some ask inappropriate questions, call the person by the wrong name or forbid them from using the bathroom in which they

npaid medical debt is the leading cause of personal bankruptcy in the country, according to CNBC. The Consumer Financial Protection Bureau reports that 43 million people — or nearly 20 percent of adults in America — have unpaid medical debt. If you find yourself unable to pay medical debt, you will probably receive phone calls and letters from debt collectors, and that can be unsettling or even intimidating. But you shouldn’t let the debt collectors scare you. Here are answers to some questions that you might have when dealing with debt collectors.

feel most comfortable. “It creates this fear among the transgender population, and it keeps them from seeing a doctor,” she said. “People say they are LGBT-friendly but they’re really only LGB-friendly.” Trans Health Initiative also offers services geared toward outreach — including group meetings, activities and social events — in an effort to help reach a group that has long been pushed to the fringes of society. “A lot of people lose their support network when they come out,” Fitzgerald-Matson said. “When you have no savings or support, things can get kind of out of control.” The Initiative also promotes safer sex and lifestyles, offering free HIV & STI testing, a free onsite syringe exchange program, drug and alcohol abuse counseling and a discussion group to connect HIV/AIDS positive individuals. Fitzgerald-Matson said HIV rates are four times higher among transgender than cisgender individuals, which is something that the Initiative is also researching. Fitzgerald-Matson is hopeful that the Initiative will receive another funding grant to continue their efforts, and urged state lawmakers to adopt the Gender Expression Non-Discrimination Act, to better protect the trans community. Until lawmakers pass better protections, and society in general becomes more educated and tolerant, she said, transgender individuals will continue to face discrimination and transphobia. “We take for granted the privilege to be ourselves all the time,” she said. “I hope one day transgender people can be themselves too.” For more information on the Trans Health Initiative, visit www. pridecenterwny.org/transhealthinitiative.

If you don’t recognize the debt, your first step is to send a letter to the debt collector informing them that you (1) dispute the debt, (2) request verification of the debt, and (3) request the name of the original creditor. You must send this letter within 30 days after you receive their first collection letter. After they receive this letter, the debt collector is required by law to stop collecting until it sends you verification of the debt. If debt collectors are calling you too much, you can also send a letter requesting that they cease communications. You must also make this request in writing. The law then requires the debt collector to obey this request.

imate and you recognize the debt, you should ask the debt collector if they can settle the debt for a lower amount. You can also try to negotiate a payment plan.

Are they breaking the law?

Debt collectors have to follow the Fair Debt Collection Practices Act (FDCPA). According to that law, debt collectors are not allowed to harass or abuse you when collecting. That means they cannot curse, yell at you or otherwise try to intimidate you to pay the debt. They also are prohibited from misrepresenting any information about the debt or using deceptive practices when collecting. If you think that they might be violating the FDCPA, you may wish to contact an attorney.

What if they sue me?

If a law firm sues you for the debt, you should contact an attorney as soon as possible. If you don’t answer the lawsuit in time, the debt collector can obtain a judgment against you. After that, the debt collector can garnish your paychecks and freeze your bank accounts. Dealing with a debt collector can be difficult and scary. However, if you follow the above suggestions, you can navigate this process in the least stressful way possible.

Should I pay?

You should only pay if the debt collector seems legitimate and if you recognize the debt. Remember that legitimate debt collectors will not ask for your social security number — they can only ask for the last four digits in order to confirm your identity. If the debt collector seems legit-

Alexander J. Douglas is a Rochester attorney with Gesund & Pailet, LLC, a consumer protection firm. He focuses on filing lawsuits against debt collectors for deceptive and unfair practices. Email: alex@ gp-nola.com; phone: 585-703-9783.

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Vinegar may be effective in treating colitis

inegar is the perfect ingredient for making tangy sauces and dressings. Now, researchers report in ACS' Journal of Agricultural and Food Chemistry that the popular liquid could also help fight ulcerative colitis, an inflammatory bowel disease that research suggests is related to the gut microbiome. They found that vinegar suppressed inflammation-inducing proteins while improving the gut's bacterial makeup in mice. Ulcerative colitis is a chronic condition that affects millions of people around the world. Although its cause isn't completely understood, research suggests that bacteria in the gastrointestinal tract play an important part. People with the condition experience repeated inflammation of the large intestine's lining, which can cause ulcers, abdominal pain, diarrhea and other symptoms. At least one recent study suggested that vinegar, which has been used in traditional medicine for centuries, might be effective against ulcerative colitis.

Hiccups: seek medical advice if they last

ost of us can remember the Grey's Anatomy episode where Meredith's step mom checks into the hospital for a case of hiccups that won't go away. The diagnosis wasn't pretty and it may have caused viewers to panic about their health every time they hiccupped. Everyone gets hiccups in their life. The majority of the time they are completely harmless and are more of an irritant than a symptom of an underlying condition. However, if you experience hiccups that last more than 48 hours this could potentially signal serious health complications. "You should seek advice from your health care provider if your hiccups progress from happening every once in a while to becoming persistent or intractable," said physician Timothy Pfanner at the Texas A&M Health Science Center College of Medicine. Hiccups happen when the diaphragm and respiratory organs experience a sudden, involuntary spasm. This spasm is usually followed by the closure of the glottis (the slit-like opening between the vocal cords and larynx) and a characteristic sound like that of a cough. Persistent hiccups are hiccups that last more than 48 hours but less than 30 days while intractable hiccups are classified as hiccups that last more than 30 days.

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Heroin-related Deaths Increasing

Excessive opioid painkiller prescriptions fuel heroin addiction, experts say By Deborah Jeanne Sergeant

he Erie County Department of Health reports that 127 people died from heroin-related overdose in 2014. That number soared to 203 for just the period of January through October 2015 (complete year figures are not yet available). "It's a growing issue," said physician Gale R. Burstein, commissioner of health with the Erie County Department of Health. "The rate of heroin use and deaths is rising exponentially. It's a huge problem." Burstein said that part of the reason some people become addicted in the first place is that they were prescribed opioid painkillers after surgery. By the time their prescription ends, some have become dependent upon the opioid because of a genetic tendency toward addiction and a desire to escape struggles they face. This class of painkiller works by affecting the area of the brain that controls emotions and pain sensitivity. The patient may no longer need pain control, but crave the effect the drug has on blunting their emotions. Purchasing prescription opioids on the street is expensive; heroin is much less expensive. Prescription drugs of this class have become much harder to obtain. By turning to street drugs, addicts don't know the potency of the drugs they're taking, or even if it is the drug they think. "Many times when they buy a bag of white powder, they don't realize its contents," Burstein said. Heroin is often laced with fentanyl, a opioid up to 100 times stronger than morphine. Or, a bag that should contain heroin mixed with fentanyl could be straight fentanyl. Burstein believes that exploring additional means of pain management can help prevent addiction. "We're looking at changing prescribing practices for pain management," she said. "We need to

also talk about medication to help them avoid street drugs and craving." Physician Richard Blondell serves as vice chairman of addiction medicine and professor of family medicine at the Jacobs School of Medicine and Biomedical Sciences, as well as director of the National Center for Physician Training in Addiction Medicine. He views the heroin epidemic as "starting with doctor's prescription pads," he said. "We need to have better educated workforce of physicians so they don't prescribe people into addiction in the first place. Prevention is the way to deal with this epidemic." He also wants physicians trained to more readily recognize addiction in its earliest stages. Blondell views two schools of thought for breaking heroin addiction: abstinence with talk therapy and replacement therapy. Abstinence works to detoxify people and use therapy to address the underlying issues that contributed to the addiction. Replacement therapy involves prescribing drugs to prevent people from turning to illicit drugs. Some clients eventually don't need replacement drugs. Some need them for life. While Blondell admits that replacement therapy trades one drug for another, "it's a good trade," he said, considering the riskiness of taking street drugs, including issues contamination, dosing and shared needles. "Addiction has to do with the abnormal social situations that revolve around the drug," Blondell said. "It changes behavior so you become enslaved to it. Replacement drugs don't work that way. People can take them for a long time period and they don't affect their ability to function." He compared lifelong replacement drugs to other maintenance drugs, such as insulin for diabetics. Because addiction changes how the brain functions,

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

Blondell said that damage likely cannot be undone; however, "moving forward, we have to know what will give the patient the best quality of life. Ideally, they should never need drugs again but we don't live in an ideal world." The success rate after a year with replacement drugs is about 50 percent. The success rate of abstinence treatment ranges from 10 to 20 percent. "Of the remaining 80 percent, about 50 percent respond to replacement therapy," Blondell said. "We try abstinence first." Burstein said that the health department is working to train medical personnel and the families of addicts to know signs of overdose and how to administer naloxone, sold under the brand name Narcan, a heroin overdose antidote. Naloxone may now be purchased without a prescription. Some overdose incidences, especially those involving fentanyl, happen quickly because it enters the bloodstream rapidly. "Victims are found with the needles still in their arms," Burstein said. "Or may have naloxone near them but they didn't have time to get it." Since beginning the training program, Erie County Health Department has trained more than 1,000 responders to recognize overdose victims and administer naloxone. People taking opioid medication or any medication should make sure it's taken as directed by the instructions on the bottle and to monitor the prescription. Signs of drug dependence could include abrupt changes in behavior, socializing, eating and sleeping. When you no longer need any prescription, especially a pain medication, get rid of it. Check with your local pharmacy or police department for drop-off events and locations.

Meet Your Provider Cazenovia Recovery Systems Local agency offers individuals in recovery four levels of residential care

azenovia Recovery Systems has more than 30 years of experience serving individuals in recovery throughout Western New York. Our agency is dedicated to supporting those who are often underserved and unjustly stigmatized.

This population is gaining nationwide attention lately due to the opioid epidemic occurring throughout the country. New York state is not immune. While announcing the “Combat Heroin” campaign last year, Gov. Cuomo said, “Heroin and opioid addiction has impacted families in every corner of our state.” Lawmakers across the state agree that the services we provide are direly needed and, in fact, need even greater support.

manent supported subsidized apartments throughout the area. This year, we expanded our reach into Niagara County by assuming operations of four programs that were similar to programs we already operate in Erie County. By the end of 2016, we expect to serve more than 900 individuals annually.

People often turn to substance use to cope with past histories of trauma. Our agency is in the process of becoming truly trauma-informed to better help our residents. Many of the people we serve have had multiple experiences with trauma. Cazenovia Recovery’s residents build inspiring Over half of our residents have a prior history of futures. homelessness. More than half have a mental health Individuals in recovery face daunting chalCazenovia Recovery offers four different levels diagnosis. Approximately 20 percent of the women of residential care throughout 10 programs in Erie, we serve have past histories of domestic violence. lenges. From health concerns related to long-term substance use to the continuing stigma associatNiagara and Genesee counties. Individuals who Needless to say, without our help, the crisis ed with recovery, the road to a better life is not are new to recovery or who have had multiple surrounding substance use would continue ununsuccessful recovery attempts benefit most from abated throughout Western New York. We provide a simple one. Cazenovia Recovery provides our Intensive Residential Rehabilitation. Our commu- life-saving services to a wide-ranging public health residents with hope, stable housing, and a positive way to live. Having progressed through much of nity residences are suitable for individuals in need crisis that is in desperate need of more support. of continued structured assistance with additional While we strive to have the widest positive impact our continuum of care, one of our current Supportive Living residents recently said, “I have responsibilities and independence. Meanwhile, possible, there’s even more to do. According to the nothing but good days.” Supportive Living is appropriate for those who New York State Office of Alcoholism and Subhave a solid foundation in recovery but still need If you or someone you know is in need of stance Abuse Services, our state responds to only some continued support. Lastly, we also offer per- 25 percent – 30 percent of the need. recovery services, please contact us.

Cazenovia Recovery Systems • www.cazenoviarecovery.org • 716-852-4331

Yes, Women Make Less in Healthcare Industry

Their pay lacks parity with men's, according to experts By Deborah Jeanne Sergeant

emales working full time in Rochester made 84 percent of what men did in 2014, according to the American Association of University Women in Washington, D.C. The median earnings for women was $40,773 compared with men's $48,555. That's still better than the national figure of women earning only 79 percent of what men earn. But what about women in the healthcare industry? The American College of Healthcare Education has found that in the industry, more women work in entry level, administrative and care giving roles than men and that more men work in higher management positions, 57 percent compared with 44 percent of women. In those higher positions, women receive 18 percent less salary than men in the same position, even with the same levels of education and experience. The organization has observed this trend since it began studying the issue in 1990. Julie Anderson, a research associate for The Institute for Women’s Policy Research in Washington, D.C., hopes to improve these figures. "More and more women are

getting education and moving up the ranks in medicine, but change is very slow," she said. "We know the value of mentoring and networking. It takes a critical mass of women at the top to pave the way. Women tend to want female mentors to help them. It's a gradual process." Ironically, the higher positions that women occupy, the greater the wage gap grows, according to experts.

Though women usually care for children or elderly family members, that's not a main factor in the wage gap. The American College of Healthcare Education states that "career interruptions of three

or more months did not markedly diminish women’s salaries when compared to women with uninterrupted careers." Anderson said that women who leave work for caregiving tend to do so because they have no other choice. Options such as flextime, paid leave and working remotely can help manage family obligations; however, women must work out the arrangement with employers, which isn't always possible. Some women choose starting their own practice as a means of balancing family and work life; however, the costs of setting up a business takes years to recoup. Anderson points more blame at lack of knowledge than care giving. Most employers frown upon employees sharing salary information with each other, or talking openly about the promotion process. She also believes that career counselors and other mentors should talk with girls more about their potential earning level. "We talk a lot of talking with girls about going into STEM [science, technology, engineering and math]," Anderson said. "But we need to talk with girls about income. It's not a correct assumption to assume people know how much different job titles earn. "We need more transparency. They don't know about how much income they'd make for a job that would give them equal satisfaction but more income." She also encourages women to negotiate a better salary from the get-go, as that

March 2016 •

benchmark helps decide their salary for years to come. Anderson said that many women balk at discussing salary with their employer, but doing so can help them earn what they're worth. "Do research to know if you deserve more," she said. Kevin Miller, senior researcher with The American Association of University Women, says that his organization has been developing workshops to teach women about negotiating for more money. "Women can certainly look into learning about what they're worth and how to talk about the value they bring to their employer," Miller said. "It can be risky, but women who feel they're being discriminated against, they can get information on if they're getting paid less than their male coworkers." Officials from Finger Lakes Health, Rochester Regional Health and University of Rochester declined to comment for this story.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Men’sHealth

Fat Dads = Fat Children

Paternal health affects child's obesity, say experts By Deborah Jeanne Sergeant

recently released Danish study indicates that maternal health isn't the only influence on childhood obesity. Paternal obesity may affect the father's sperm so that his offspring's satiety cues mimic those of obese people. In essence, having a father who is obese may increase the child's chances of becoming obese. "Obesity in either the mother or father can lead to a child being overweight or obese not only as a child, but the risk of the child being obese in adulthood is also inYoder creased," said Melinda Yoder, registered dietitian and owner of Balanced Nutrition of Western New York, PLLC. Obesity elevates the risk of disease later in life, such as diabetes, cardiovascular disease, and certain

types of cancer. But Yoder said that these diseases are now more frequently seen among children because of the rise of childhood obesity. "Being diagnosed with something like diabetes as a child not only hampers quality of life, but increases risks for other complications throughout life," Yoder said. Organizations such as the American Medical Association and the American College of Endocrinology have categorized obesity as a disease. "As parents, both the mother and father can set a positive example by following a healthy nutrition plan," Yoder said. "Genes may play a role in the weight status of parents and children, so creating a positive environment at home to develop healthy behaviors can help control weight status." Though lab tests can't determine if someone has a higher genetic risk of obesity, a blood test can indicate insulin resistance. Along with a family health history, physicians can help their patients determine if they should change their lifestyle. People with elevated risk for obesity may be able to avoid the stimuli that stifles their metabolism

ED: Over-the-Counter Sexual Treatments Unproven Some products could be harmful

rom horny goat weed to ginseng and maca, over-the-counter dietary supplements sold to improve male sexual health contain a wide variety of “natural” ingredients. Researchers from Wake Forest Baptist Medical Center reviewed the scientific evidence for the most common ingredients to determine if they are effective — and most importantly — safe. The results are published online in the Journal of Sexual Medicine. “While certain natural supplements we reviewed show promise for improving mild sexual dysfunction, they lack robust human evidence,” said physician Ryan Terlecki, associate professor of urology and senior author. “In addition, because of concerns that some products are impure or weak, we do not routinely recommend these products to our patients.” For some products, there is no scientific evidence to support claims that can positively impact erectile function, libido and sexual performance. And perhaps most troubling, some products that are advertised

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as being “natural,” contain traces of phosphodiesterase-5-inhibitors (PDE5Is), the same class of medication that includes prescription drugs such as Viagra, used to treat erectile dysfunction. One study revealed that 81 percent of tested samples of overthe-counter products purchased in the U.S. and Asia contained PDE5Is. “PDE5Is cannot yet be legally sold over the counter in this country,” said Terlecki. “Men who use these medications without a physician’s supervision run the risk of taking them inappropriately. Patients with advanced heart disease, for example, or who take nitrates, such as nitroglycerin, should not use PDE5Is as it may cause an unsafe drop in blood pressure. Likewise, men with severe liver impairment or end-stage kidney disease requiring dialysis should avoid these products.” In addition, Terlecki said, men with enlarged prostates who take medications such as Flomax (tamsulosin), terazosin or doxazosin need to know how to time the dosing of the two medications to avoid causing

by limiting high glycemic foods. "It is imperative that both parents manage their weight and food choices to help prevent these conditions in their children," Yoder said. "Genetics cannot be changed unfortunately, but your environment can." J. Elizabeth Smythe, registered dietitian in private practice and director of the American Diabetes Association for Smythe Upstate New York, isn't as convinced by the Danish study, but said that the home environment and eating habits of the family can "directly affect a child's weight and that fathers absolutely can positively be role models in establishing a healthy relationship with food and good eating habits."

Paying attention to a baby's satiety cues, such as turning away from the offered spoon, can start children on the path of a healthy perception of food. "Parents buy into the concept of cleaning the plate," Smythe said. "Children mirror parents. If you eat sugar-sweetened beverages and no vegetables, that's what they'll eat." Most children don't initially like many foods. It may take as many as a dozen times for them to eat a new item. Modeling healthy activity behaviors also help. Encourage physical hobbies and helping out with chores. "Especially if there's a propensity for being overweight, don't mention dieting, but model and encourage healthy behaviors," Smythe said. "Many school systems don't have the same PE that we had 20 to 30 years ago. It depends on the parents to encourage that, like going for a walk after dinner or having a dance party in the living room." Consulting the child's pediatrician can provide more detailed and specific information.

dizziness and potential falls, which may result in fractures. An estimated 40 to 70 percent of men experience some form of sexual dysfunction during their lives. Due to concern regarding costs of prescription drugs, or embarrassment over discussing sexual concerns with their physicians, some men turn to over-the-counter products. According to a recent nationwide survey, 50 percent of respondents reported using dietary supplements for a variety of conditions. “There is a dizzying array of

formulations available and the health effects of nutraceuticals are often confusing to patients and medical practitioners alike,” Terlecki said. “We reviewed the current evidence available for each of the ingredients in top-selling men’s health products to provide urologists with a guide they could use to counsel their patients. “Patients are paying more than $5 per day to take products with no proven effectiveness,” he said. Products included in the survey ranged in cost from 83 cents to $5.77 per day.

PSA Testing Differs Among Primary Care Doctors, Urologists

rologists are far more likely than primary care doctors to do prostate cancer screenings known as prostate-specific antigen (PSA) testing, a new study reports. For the test, a blood sample is taken and sent to a laboratory to check for levels of a protein produced by cells of the prostate gland. PSA testing declined overall after the U.S. Preventive Services Task Force in 2011 recommended against routinely screening all men. But the new research finds the falloff was sharper among primary care doctors than urologists. Between 2010 and 2012, PSA

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

testing decreased from about 36 percent to 16 percent at primary care physician visits but only from about 39 percent to 34 percent at urologist visits, the researchers found. This discrepancy may reflect different perceptions of the benefits of the test among doctors, the authors said in the study published online Feb. 8 in JAMA Internal Medicine. The greater decline in PSA testing among primary care doctors could also stem from conflicting prostate cancer screening guidelines and differences in patients' demographics or expectations, the study authors suggested.

Men’sHealth Options for Prostate Cancer Continue to Grow By Deborah Jeanne Sergeant

en have more options than ever for treating prostate cancer. As with other kinds of cancer, treatment continues to become more and more specialized, both to the cancer type and the individual. As recently as 2007, the only options were chemotherapy or surgery. In the past several years, however, more drugs have approved such as Enzalutamide (xtandi) and Zytiga (abiraterone acetate), which have proven effective for men with metastatic prostate cancer. Immunotherapy, another type of treatment for metastatic prostate cancer, uses the patient's own blood to expose the immune system to a protein in the prostate cancer and make a vaccine. For certain mutations, Krellner physicians can use lab tests to determine the most effective therapy, including clinical trials available nationwide. "Medical science is coming up with lots more options for men," said Bill Krellner, chapter leader of Us TOO Buffalo Metro Chapter, a local prostate cancer support group. Many other new drugs awaiting approval by the FDA show improvement in men's survival rates. Krellner also said that MRIguided biopsies can help physicians take more accurate samples of suspicious tissues. "Needles can miss cancers," Krellner said. "MRIs can zero in and see things better and with the biopsy they can hit the right spot." Darryl Mitteldorf is a licensed clinical oncology social worker and founder and executive director of Malecare (www.malecare.org), a nationwide 501(c)(3) men’s cancer survivor support and advocacy organization. He encourages men to take charge of their own health. Prostatectomy bears the risk of urinary incontinence and impotency, he said. "All men 35 and older should talk with their doctors about screening for prostate cancer," Mitteldorf said. "It has to be tailored to individual men and his desires. Some men will do anything to see the sunrise. Others are willing to trade some years in their 70s for quality of life in their 50s and 60s." Unlike many types of cancer, when it comes to prostate cancer, early detection and treatment only

saves the lives of very few patients, according to Mitteldorf. Elevated prostate specific antigen (PSA) levels can indicate prostate cancer or health conditions unrelated to prostate cancer. That's why some men opt for scheduled surveillance. For some men, prostate cancer doesn't grow rapidly. "You have to treat 24 men to extend the life of one man," Mitteldorf said. "Another study says you have to treat 47 men to extend the life of one man. "Prostate cancer isn't just about cancer but overtreatment, surveillance and what a man wants out of life. Most people just look at it as how to stop the progression of disease. From our support groups, it's not just about cell division but about life." Unlike other cancer-related surgeries, prostatectomy can significantly and negatively affect the patient's life even though he doesn't have "a visibly appreciated body part removed or have [his] hair fall out," Mitteldorf said. "But if you have to sit around your house because you have urinary incontinence or you're a single man, it's hard to seek out intimate partners if you're incapable of engaging in intimate acts. Prostate cancer treatment can do that to men." Despite the swelling number of support group members, Mitteldorf believes men undergoing prostate surgery do not have all the information they need to make a decision with which they Mitteldorf will be happy. "It's a difficult thing to be told you might have cancer and that's followed up with, 'We don't know what to do about it,'" Mitteldorf said. "It's not as easy a thing as people make it out to be to the point where if you have doctors you feel confident in, go for it. All the support groups say talk with someone who's already gone through it. "With prostate cancer, you may talk with someone who only wants to advocate for his approach. It's not even safe to say to talk with one other man. Or go to any support group organization. Many are mouthpieces for the pharmaceutical industry." He recommends his group as a source of information. Us TOO Buffalo (racer3232@verizon.net) represents a support group closer to home.

Local Dancer Wines it Up, Grooves it Out with New Workshop Series By Jessica Brant

natural curiosity landed Rishone Todd, then a 12-year-old kid living in Montego Bay, Jamaica, at sound battles, street parties where music and dancing brought communities together in cultural celebration. “In Jamaica they have sound battles, where deejays put a bunch of speakers together and they name their sounds. They have artists remix their songs to represent their sound and they battle against each other,” Todd said. From this instantaneous attraction Todd learned the basic steps of dancehall, the country’s only true dance style existing at the time. Today, Todd, now a local chef and accredited dance instructor in Buffalo, is on a mission to revive the culture of his native dance style through a new workshop series at Verve Dance Studio. “I would go to those [sound battles] and I would watch the women dance, because the men wouldn’t dance. I used to look at the men and think, ‘Why aren’t they dancing? The women obviously want someone to dance with.’ So as a little kid I used to go out [on the dance floor] just to learn from the women,” Todd said. The workshops, which will be held at the beginning of March and run through mid-April, are tailored to dancers of all levels and will teach the history of reggae and dancehall through two fundamental movements, the wine and the groove. “Wining is about isolation, and connecting the isolations of the hips and chest and using your foundation to make it through and connect to the beat, rather than trying to hit the music,” Todd said. The groove, which is dominant in dances like the Willy Bounce, is the more masculine style of movement in dancehall, Todd said. “When I got older, the creation of dances through reggae and dancehall music incorporated movement that was groovey, like “The Bogle” by Buju Banton and “World Dance” by Beenie Man,” Todd said. “Those were the two dances that existed when I was growing up.” Todd intertwines the feminine and masculine elements of dancehall, providing the dancer with a well-rounded exercise. A dancehall class varies slightly

from a traditional hip hop class, even though, Todd said, the genres borrow steps from one another. “Hip hop has so many different styles. You have girly, you having popping, you have locking, you have krumping, which is a combination of all the funk styles. Of course in hip hop there are grooves. Some of those moves actually derive from Jamaican moves,” Todd said. In dancehall, the emphasis is placed on the entire line of the body and the full flow of bodily movement. Once the dancer learns how to move “within the lines,” they are free to take the basics and create their own style. This is the essence of dancehall. When Todd was a college student attending Niagara University in 2005, he recalls dancehall stealing a permanent place in the hearts of locals, who would go out to Chippewa and hear the sounds of reggae, the more socially conscious part of dancehall, playing at clubs. “That’s when the explosion happened, in the 90s, early 2000s. In the 90s, there were artists like Buju Banton, Capleton, Mad Cobra and Super Cat. There were so many artists. In the 1990s it was more open. Those songs were playing on a regular basis,” Todd said. Music could be heard in small Jamaican eateries and dance parties seemed to pop up everywhere. Its disappearance from the local scene left a void in fans that was never fully filled, until now. “I have noticed more and more people wanting to learn how to whine. With this workshop in particular I noticed a large interest unlike what I’ve seen for other workshops,” said local dancer Ebony Cymonne of the overwhelming turn-out for Todd’s past workshop in January. The dream is not far from sight. “I’m definitely trying to start the movement back in Buffalo because… it’s not here. I think it’s a beautiful dance,” Todd said. “I definitely want to bring a dance style that is close to my heart and my culture and share it with the dancers here.” The dancehall workshops will begin March 4 and run through April 14. The drop-in price is $15 or $48 for four classes. Visit vervedancestudio. com for more information.

A group of dancers learn a dancehall-styled routine at Rishone Todd’s dancehall workshop at Free Soul Dance in Blasdell. The series will continue this March at Verve Dance Studio in Buffalo.

March 2016 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Choosing a Hospice Care Program

The Social Ask Security Office

By Jim Miller

ospice can be a wonderful option in the last months of life because it offers a variety of services, not only to those who are dying, but also to those left behind. Here’s what you should know.

What Hospice Offers

Hospice care is a unique service that provides medical care, pain management and emotional and spiritual support to people who are in the last stages of a terminal illness — it does not speed up or slow down the process of dying. Hospice’s goal is to simply keep the patient as comfortable and pain-free as possible, with loved ones nearby until death. The various services provided by a hospice program comes from a team of professionals that works together to accommodate all the patients’ end-of-life needs. The team typically includes hospice doctors that will work with the primary physician and family members to draft up a care plan; nurses who dispense medication for pain control; home care aides who attend to personal needs like eating and bathing; social workers who help the patient and the family prepare for end of life; clergy members who provide spiritual counseling, if desired; and volunteers that fill a variety of niches, from sitting with the patient to helping clean and maintain their property. Some hospices even offer massage or music therapy, and nearly all provide bereavement services for relatives and short-term inpatient respite care to give family caregivers a break. Most hospice patients receive care in their own home. However, hospice will go wherever the patient is — hospital, nursing home or assisted living residence. Some even have their own facility to use as an option. To receive hospice, your grandmother must get a referral from her physician stating that her life expectancy is six months or less. It’s also important to know that home-based hospice care does not mean that a hospice nurse or volunteer is in the home 24 hours a

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day. Services are based on need or what you request. Hospice care can also be stopped at anytime if your grandmother’s health improves or if she decides to re-enter cure-oriented treatments.

How to Choose

The best time to prepare for hospice and consider your options is before it’s necessary, so you’re not making decisions during a stressful time. There are more than 5,500 hospice programs in the U.S., so depending on where you live, you may have several options from which to choose. To locate a good hospice in your area, ask your grandmother’s doctor or the discharge planner at your local hospital for a referral, call your state hospice organization (see hospicefoundation.org/hospice-directory for contact information), or search online at sites like the National Hospice and Palliative Care Organization at nhpco.org. When choosing, look for an established hospice that has been operating for a few years and one that is certified by Medicare. To help you select one, the American Hospice Foundation provides a list of questions to ask at 16HospiceQuestions. us.

Who Pays

Medicare covers all aspects of hospice care and services for its beneficiaries. There is no deductible for hospice services although there may be a very small co-payment — such as $5 for each prescription drug for pain and symptom control, or a 5 percent share for inpatient respite care. Medicaid also covers hospice in most states, as do most private health insurance plans. For more information, see the “Medicare Hospice Benefits” online booklet at medicare.gov/pubs/ pdf/02154.pdf. And if you have financial questions or concerns, talk to your hospice provider. Most hospices offer financial assistance to help families in need. Jim Miller writes the Savvy Senior column published monthly in this newspaper.

By Deborah Banikowski

Filing Taxes Just Got (a Little Bit) Easier

ow that it’s March, your annual tax filing deadline is fast approaching. If you receive Social Security benefits, one of the documents you need to file your federal income tax return is your Social Security Benefit Statement (Form SSA-1099/1042S). Your Social Security benefits may be taxable. This includes monthly retirement, survivor and disability benefits. About one third of people receiving Social Security benefits must pay taxes on some of these benefits, depending on the amount of their taxable income. This usually happens if you have other substantial income — such as wages, self-employment, interest, dividends and other taxable income that must be reported on your tax return — in addition to your Social Security benefits. You will never have to pay taxes on more than 85 percent of your Social Security benefits, based on Internal Revenue Service (IRS) rules. To find out if you must pay taxes on your benefits, you will need your Social Security Benefit Statement (Form SSA-1099/1042S). You should automatically receive it in the mail each January. It shows the total amount of benefits you received from Social Security in the previous year so you know how much Social Security income to report to the IRS on your tax return. The benefit statement is not available for people who receive Supplemental Security Income (SSI), as SSI payments are

not taxable. Whether you file your taxes early or wait until the deadline, Social Security makes it easy to obtain a replacement benefit statement if you didn’t receive one or misplaced it. You can get an instant replacement easily by using your secure online My Social Security account. If you don’t already have an account, you can create one in minutes. Follow the link below to the my Social Security page, and select “Sign In or Create an Account.” Once you are logged in, select the “Replacement Documents” tab to obtain your replacement 1099 or 1042S benefit statement. You can also use your personal My Social Security account to keep track of your earnings each year, manage your benefits, and more. You can also obtain a replacement benefit statement by calling us at 1-800-772-1213 (TTY 1-800-3250778), Monday through Friday from 7 a.m. to 7 p.m., or by contacting your local Social Security Office. If you live outside of the United States, please contact your nearest U.S. embassy or consulate. But by going online you can print your replacement benefit statement immediately and not have to wait to receive it in the mail. With a My Social Security account, gathering your Social Security information for tax season has never been easier. Open your own personal My Social Security account today at www.socialsecurity.gov/myaccount.

Q&A Q: Do I need a Social Security card? I want to get a summer job and my dad can’t find my card. A: If you know your number, you probably don’t need to get another card. If you find out that you do need a replacement card, the best place to go to find out how to get a replacement is www.socialsecurity. gov/ssnumber. In some states and the District of Columbia, you might even be able to request a replacement Social Security card online. In other areas, you can download the application to print out, complete and submit by mail or in person. If you do get a replacement card or find the original, you shouldn’t carry it with you. Keep it in a safe place with your other important papers. Learn more at www.socialsecurity.gov/ssnumber.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

Q: Can I get a new Social Security number if someone has stolen my identity? A: We don’t routinely assign a new number to someone whose identity has been stolen. Only as a last resort should you consider requesting a new Social Security number. Changing your number may adversely affect your ability to interact with federal and state agencies, employers, and others. This is because your financial, medical, employment and other records will be under your former Social Security number. We cannot guarantee that a new number will solve your problem. To learn more about your Social Security card and number, read our online publication “Your Social Security Number and Card” at www.socialsecurity. gov/pubs/.

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By Jim Miller

2016 Tax Filing Requirements for Retirees Dear Savvy Senior, What are the IRS income tax filing requirements going to be for this tax season? Due to health problems I stopped working early last year, so I’m wondering if I need to file. Unintended Retiree Dear Unintended,

There are a number of factors that affect whether or not you need to file a federal income tax return this year including how much you earned last year (in 2015), and the source of that income, as well as your age and filing status. Here’s a rundown of this tax season’s IRS filing requirements. For most people, this is pretty straightforward. If your 2015 gross income — which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately — was below the threshold for your age and filing status, you probably won’t have to file. But if it’s over, you will. • Single: $10,300 ($11,850 if you’re 65 or older by Jan. 1, 2016). • Married filing jointly: $20,600 ($21,850 if you or your spouse is 65 or older; or $23,100 if you’re both over 65). • Married filing separately: $4,000 at any age. • Head of household: $13,250 ($14,800 if age 65 or older). • Qualifying widow(er) with dependent child: $16,600 ($17,850 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see irs. gov/pub/irs-pdf/p554.pdf.

Special Requirements

There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment

in 2015 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file. To figure this out, the IRS offers an interactive tax assistant tool on its website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. You can access this tool at irs. gov/filing — click on “Do you need to file a return?” Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See irs.gov/localcontacts or call 800-829-1040 to locate a center near you.

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Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency — https://www. tax.ny.gov/ — before concluding that you’re entirely in the clear.

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Tax Prep Assistance

If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit irs.treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 5,000 sites nationwide. To locate an AARP Tax-Aide site call 888-2277669 or visit aarp.org/findtaxhelp. You don’t have to be an AARP member to use this service.

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Health News Renowned oncologist moving to Buffalo Physician Marc S. Ernstoff has been appointed professor and chief of the division of hematology/oncology in the department of medicine in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo (UB), and chairman of the department of medicine and senior vice president of clinical investigation at Roswell Park Cancer Institute (RPCI). Ernstoff Ernstoff also will serve as chief of the division of hematology/oncology at UBMD Internal Medicine, the clinical practice plan of the UB department of medicine. The appointments take effect on April 1. “His joint appointment as chief of the division of hematology/ oncology at the Jacobs School of Medicine and Biomedical Sciences at UB and chair of medicine at Roswell Park is a clear indication of the close collaboration we have between the two institutions. We look forward to working with Dr. Ernstoff to build clinical, educational, and research programs at Roswell Park, as well as with UB and UBMD Internal Medicine,” physician Anne B. Curtis,

chairwoman of the UB department of medicine. In 2014, Ernstoff became the director of the melanoma program at Cleveland Clinic’s Taussig Cancer Institute. From 1991 to 2014, he served as associate professor of medicine and professor of medicine at Dartmouth College’s Geisel School of Medicine and Dartmouth-Hitchcock Medical Center. During much of his tenure, Ernstoff was the director of the melanoma program at the Norris Cotton Cancer Center and the section chief of hematology/oncology. Ernstoff was previously a faculty member at the University of Pittsburgh’s School of Medicine, where he directed the hematology/oncology fellowship training program; he also was an assistant professor of medicine at Yale University and director of its clinical research office.

Local eye doctor, surgeon receives national award Daniel P. Schaefer, eye physician and surgeon, and plastic and reconstructive surgeon, is the recipient of the Outstanding Contribution Award from the American Society of Ophthalmic Plastic and Reconstructive Society. Schaefer has been a clinical professor at the SUNY at Buffalo since 2001. Schaefer was appointed director of the department of oculoplastic, orbital and reconstructive surgery in 1997. He has also served as the chief of ophthalmology at the St. Joseph's Intercommunity Hospital since 1991 and served as its president of the

BlueCross BlueShield Recognizes Hospitals for Delivering Quality, Affordable Maternity Care

lueCross BlueShield of Western New York recently recognized local hospitals that deliver quality, affordable maternity care. They all received the organization’s “Blue Distinction” and “Blue Distinction+ Centers for Maternity Care” designation. Mercy Hospital of Buffalo, Millard Fillmore Suburban Hospital, and Sisters of Charity Hospital were all designated as Blue Distinction Centers+. Mount St. Mary's Hospital and Women & Children's Hospital of Buffalo received the Blue Distinction Center designation. These designations, an expansion of the national Blue Distinction Specialty Care program, recognize hospitals for delivering quality specialty care safely and effectively, based on objective measures developed with input from the medical community. To receive a Blue Distinction Centers+ for Maternity Care designation, a hospital must meet the same

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quality criteria as Blue Distinction Centers while also meeting requirements for cost efficiency. Childbirth is the most common cause of hospitalization with nearly four million babies born in the U.S. annually. In Western New York, in 2014, Catholic Health hospitals delivered 5,953 babies and Kaleida Health delivered 5,462. Mount St. Mary's Hospital, which officially joined Catholic Health July 1, 2015, delivered 311 babies in 2014. “We are pleased that Catholic Health and Kaleida Health have been recognized for their maternity care,” said physician Thomas Schenk, senior vice president and chief medical officer at BlueCross BlueShield of Western New York. “These nationally recognized hospitals deliver quality care for our members and the community.” For more information about the program, please visit www.bcbs. com/bluedistinction.

medical staff from 2001 to 2003. Schaefer has served as visiting professor and has lectured throughout the United States, Central America and India and has written numerous articles in the fields of oculoplastic, orbital and reconstructive surgery. Schaefer

ECMC trauma nurse gets recognition ECMC Trauma Program Manager Linda Schwab recently avhieved the trauma certified registered nurse designation from the Board of Certification for Emergency Nursing (BCEN). Schwab becomes one of the first trauma nurses in the country to take and pass the new exam to earn this credential through the BCEN. The TCRN is the first trauma-specific, national credential that designates expertise in trauma. Schwab Schwab has served in various clinical positions during her 35 years at ECMC. As trauma program manager since 2004, she works regionally and in collaboration with statewide committees to establish trends in the incidence of traumatic accidents and to implement research-based practice changes in trauma care and public health policy. She is extensively involved in outreach education for injury prevention. In 2007, Schwab was honored by the New York State Chapter of the American Trauma Society as the Trauma Coordinator of Distinction for New York State. Schwab earned her Master of Science in nursing (2004) and her Bachelor of Science in nursing (1981) degrees from D'Youville College.

A first for Gates Vascular Institute The Gates Vascular Institute has recently implanted the WATCHMAN, a recently FDA-approved cardiac device that helps prevent strokes in patients with non-valvular atrial fibrillation. According to a news release from the organization, Gates Vascular is the only facility in Western New York to perform implantation of the WATCHMAN, a catheter-delivered

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

heart insert designed to close the left atrial appendage. Buffalo General Medical Center and the Gates Vascular Institute received top 2 percent ranking in the nation for cardiac surgery from the Society for Thoracic Surgery and, according to officials, this new procedure is another example of their commitment to cardiac services. “We are proud that the Gates Vascular Institute is the only facility in the area to utilize the WATCHMAN device. We have a dedicated team of skilled physicians, led by Drs. Iyer and Fernandez and myself, who work collaboratively to ensure the best possible outcomes for our patients,” said electrophysiologist Chee Kim. “It is a tremendous alternative to a lifetime spent taking blood thinning medications.” Traditionally, patients with atrial fibrillation (A. Fib or AF) are prescribed blood thinners to prevent the formation of blood clots and remain on them for the rest of their life. The WATCHMAN is a permanent alternative to blood thinners with minimal side effects. The minimally invasive procedure takes approximately 60 minutes, and once in place the risk of stroke is reduced to that of a person with a normally functioning heart. It allows for successful discontinuation of blood thinning medication, which is associated with lifelong risk of bleeding complications. Patients are also able to return home the following day.

Buffalo Sabres and Roswell Park team up United behind the shared vision of reducing cancer’s impact in Western New York, the Buffalo Sabres and Roswell Park Cancer Institute (RPCI) have launched a collaboration that will see the National Hockey League franchise and the National Cancer Institute-designated comprehensive cancer center teaming up to arm fans and supporters with important guidance on cancer risk, prevention and research. Over the next five seasons, the two organizations will initiate a broad-based educational campaign with the tagline “One Goal: Inspire Cancer Cures.” Roswell Park, the official and exclusive comprehensive cancer center of the Buffalo Sabres, will provide evidence-based tips on cancer prevention, early detection and risk reduction to hockey fans and audiences through a variety of platforms, inside and outside First Niagara Center, the home of the Buffalo Sabres. Fans will also have the opportunity to support the most promising research at Roswell Park through donations and will be able to take advantage of free cancer screening programs, as medically appropriate. The “One Goal” campaign will inform audiences, for example, about which cancers are associated with behavioral choices such as smoking and tobacco use, obesity and certain diets.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Essential Oils Can Help Overall Health According to the owner of 716Health, essential oils can treat and help fight a number of ailments, ranging from sore throat and cough to chronic stress to yeast infection By Tim Fenster

o-called essential oils have been used by numerous cultures over periods of thousands of years, yet they remain a mystery to much, if not most, of the health-conscious public. Kristen Cooper, president of the Buffalo Wellness Center and owner of 716Health, explains that essentials oils come from raw plant material — such as flowers, leaves, wood, bark, roots, seed or peel — that has been distilled to a liquid. Unlike fatty oils from vegetables or nuts, essential oils are composed of very small molecules that can penetrate the membranes of cells. “It’s usually the whole plant — even the seed or root of the plant,” said Cooper, who has been studying essential oils for years. “Essential oils can actually penetrate the cell membrane and do healing on the inside.” Through this process, essential oils can treat and help fight a number of ailments, ranging from sore throat and cough to chronic stress to yeast infection. The benefits vary depending on the type of oil and the method of use, which includes topically, aromatically or by ingestion. Some of the most popular and inexpensive brands include: peppermint, which can clear your sinuses

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and help numb aches and pains; thieves oil, a combination of rosemary, eucalyptus and other plants that helps boost the immune system; and lemon oil, which can boost your digestion system and metabolism, and also helps with a cough. “There’s a lot you can do with lemon oil and it’s very inexpensive,” Cooper said. If you’re willing to spend a little more, Cooper said, you can find a number of other oils that provide a range of holistic benefits. For example, frankincense oil, Cooper says, has been known to help shrink cancers and also support the nervous system, which makes it beneficial to patients with muscular sclerosis. “Frankincense is one of the few oils that can actually penetrate the blood-brain barrier,” Cooper said. But those interested in getting on an essential oil regimen should proceed carefully, and knowledgeably. Cooper warns that using too much of an essential oil, via any method, can lead to adverse effects, including severe irritation, allergic reaction and hepatotoxicity (chemical-driven liver damage). And certain oils, such as grapefruit oil, can negate cholesterol medication as well as birth control. Cooper recommends no more

than one or two drops of any oil per day. “You want to use it in small amounts,” she said. In addition, you should be sure to purchase your oils from a trusted manufacturer. Warning signs include an expiration date (essential oils don’t expire), a light or clear container (it should be in a dark container, as natural sunlight tampers with the oil) and a warning label to not apply topically (all oils can be applied topically). Cooper says she has been studying essential oil brands for years. She eventually settled on Young Living, after researching it extensively, because of their farm-to-bottle approach. “That’s when I realized there are so many brands out there that aren’t doing this properly,” she said.

More About Essential Oils? For more information on essential oils, you can also attend one of 716 Health’s Introduction to Essential Oils. Cooper and other members of the 716 Health team provide samples, lessons and informational guides on the science of essential oils. And while some oils can be pricey, Cooper says they will often

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2016

donate oils to clients suffering from cancer or MS. Though many of her attendees come in skeptics, she says, they all leave believing. “It’s very rare that someone doesn’t leave a believer,” she said. For more information on 716 Health, or to look up a class near you, visit www.716health.com.