in good Injury Free Tips for keeping your children injury-free during fall sports season
September 2015 • Issue 11
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Buffalo & WNY’s Healthcare Newspaper
Raising Kids with
AUTISM
Are our kids waking up and starting school too early? The CDC says yes
Three Buffalo-area families faced with daunting task of rearing autistic kids share their experiences Page 10
CONTROVERSY Coca-Cola Controversy: Is Exercising More or Eating Less Better for Weight Loss?
Home-Schooled To fulfill their children’s physical education requirement, home school parents use a variety of local resources
More Reasons to Gobble Up Chicken See SmartBite column on page 12
WNY Ovarian Cancer Project Kathleen Maxian and her nonprofit are on a crusade to empower, educate and energize women Page 9
The Healing Power of Horses The Buffalo area has several facilities that use horses for therapeutic purposes Page 19
Page 8
Meet Your Doctor ER physician Michael Mineo talks about his experience, what brings him satisfaction and why he would probably be more stressed working in a doctor’s office setting
GOOD NEWS New Law Allows Students to Self-Manage Diabetes at School Page 14
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September 2015 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 1
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53 million adults in the US live with a disability New CDC report provides state-by-state data on disability types
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n the United States, one out of every five adults has a disability, according to a new study published by the Centers for Disease Control and Prevention. The most common functional disability type was a mobility limitation — defined as serious difficulty walking or climbing stairs — reported by one in eight adults, followed by disability in thinking and/or memory, independent living, vision, and selfcare. The researchers found that the highest percentages of people with disabilities are generally in Southern states, for example Alabama (31.5 percent), Mississippi (31.4 percent), and Tennessee (31.4 percent). New York ranks in the middle with 22.1 percent of any disability among adults 18 years of age and older. By contrast, that percent in Vermont is 17.8. The report did not determine why differences occur by state; however, states in the South tend to have some of the higher rates of chronic diseases, such as heart disease and diabetes,
which may also be associated with disability. “We are all at risk of having a disability at some point in our lifetime,” said CDC Director Tom Frieden, “Health professionals and health care systems need to meet the needs of this growing population.” The report also revealed that non-Hispanic black (29 percent) and Hispanic (25.9 percent) adults were more likely to have a disability than were white non-Hispanic (20.6 percent) adults. Those with lower education levels, lower incomes, and those who are unemployed were also more likely to report a disability. For more information about the study, visit www.cdc.gov/disabilities.
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Daniel J. Patterson D.O., F.A.C.O.S.
Meet Your Provider
Southtowns Radiology Practice Debuts High Accuracy 3D Mammography for Breast Cancer Screening
Southtowns Radiology is pleased to introduce 3D mammography for breast cancer screening to its Orchard Park and Hamburg offices. The practice is the first in the region to offer both Genius 3D mammography and Volpara technology, a powerful computer-aided detection that measures dense breast tissue with 100 percent accuracy. In the June 25, 2014, issue of the “Journal of the American Medical Association” a groundbreaking study found that Genius 3D mammography screening technology significantly increased cancer detection, finding 41 percent more invasive cancers while simultaneously reducing the number of false positives in women of all breast tissue types. This simply means that 3D mammography is beneficial to all women, not just those with dense breast tissue. 3D mammography, also called tomosynthesis, produces a threedimensional view of the breast tissue
that helps radiologists identify and characterize individual breast structures without the confusion of overlapping tissue. All women may choose whether to have a 3D mammogram. However the radiologists at Southtowns Radiology especially recommend a woman consider a 3D mammogram if having a first or baseline mammogram, if she has dense breasts or if she has a family history of breast cancer. At Southtowns Radiology, the screening process begins with Volpara Density, to accurately screen dense breast tissue and with Genius 3D mammography the radiologist is able to see breast tissue of all types with incredible accuracy. Happily, all of this technology is incorporated into one exam, so women can know that a 3D mammogram does not involve a second test or another appointment. “We realize that women have a choice as to where they have their 3D mammography,” says Emilie Beecher,
Southtowns Radiology marketing manager. “That is why our group has always tried to focus on the patient’s experience, so that when you have your test with us you are treated with warmth and with personal attention from the moment you check in through having your exam.” To make the mammography screening process more comfortable, Southtowns Radiology has introduced sound and aromatherapy to its mammography suite for a more spa-like environment. In the past, the practice has made its mammography suites more comfortable by incorporating beautiful artwork, stained glass and softer track lighting. It also has a separate waiting room for women to receive their mammography results, eliminating the need to sit alone in a changing room. All women have the option of waiting a short time after their appointment for their results and may speak with the doctor if they ask to. At
This hologic unit is part of new equipment at Southtowns that more accurately screen women for breast cancer. Southtowns Radiology, each woman who has their mammogram receives a flower after their exam, as a way to celebrate her for taking the time to complete this important screening test. Founded in 1959, Southtowns Radiology offers 3D mammography along with a full spectrum of imaging services at its Hamburg office at 3040 Amsdell Road and in Orchard Park at 3050 Orchard Park Road by five corners. Learn more at southtownsradiology. com or by calling 649-9000.
3040 Amsdell Road, Hamburg • 3050 Orchard Park Road, Orchard Park Phone: 716-649-9000 • Website: www.southtownsradiology.com
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PSA healthcare delivers the highest quality of care in the most comfortable environment imaginable-the home. We provide pediatric and adult private duty nursing services as well as Home Health Aide and Personal Care Aide services. Call 716-276-2123 for information and services.
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From Gaunches to Givers
‘Rebels’ of yesteryear — mostly from Orchard Park High School — now join mainstream society, raising money to help those in need By Tim Fenster
T
hey were considered the bad eggs in school. The kids who liked fast cars, rock ’n’ roll and skipping class. They were the ones who were not involved in extra-curricular activities, such as sports or after-school clubs. They called themselves gaunches — a term coined by an Orchard Park High School football player in the late 1970s that was used as an insult — and carried the name with pride. In short, you could say they were the outcasts of Orchard Park High School in the 1980s. But these days, most gaunches have grown out of their troubled youth and hold down families, homes and respectable jobs. What’s more, they are paying it forward, donating their time and money to help neighbors during times of need. “Anybody who has come into any sort of life-changing experience, we try and get them back on their feet,” said Dawn Hauser, president of Gaunches Unite. A nonprofit organization, Gaunches Unite was formed in 2011 when one gaunch, Karma Wylie, was diagnosed with cancer. Dozens of Wylie’s friends came together to raise $3,000 for her family and medical expenses. Sadly, Wylie passed away later that year. But the charitable spirit her illness inspired in her former friends and classmates lives on. Gaunches Unite has helped dozens of area residents during times of need in the four years since, and was even selected by country-rocker Kid Rock to be the recipient of a $16,000 grant through the nonprofit Kid Rock Foundation. Orchard Park resident Rene Carrow said Gaunches Unite helped tremendously when her son, Devon, was battling a rare immune disorder called hyperimmunoglobulin E syndrome.
Desperate times
The Carrows had to travel to Mount Sinai Hospital in New York City to give Devon the best available treatment, a trip that the family had trouble funding on their own. “You find the hospital that can treat your son and you want to take him down there,” Rene Carrow said. “[But] it’s expensive and insurance does not cover it.” Fortunately, Gaunches Unite came through with funding for the family during this time of need. “It allowed me as a mom to not worry about having funds to eat while
Gaunchfest Slated for Sept. 26 Nonprofit Gaunches Unite is planning a major annual fundraiser, Gaunchfest, which will run from 1-8 p.m. Sept. 26 at Blasdell Fireman’s Park, off Lake Avenue in the village of Blasdell. It will feature local classic rock groups and a number of family-friendly activities. Funds will be reverted to the several families in need that the organization supports. Tickets for Gaunchfest are $20 pre-sale, $25 the day of the event, and $5 for children aged 3-13.
we’re there, pay for a hotel and have gas for the drive,” Carrow said. The group does so much good and has caught on so well in the Southtowns that it is no longer strictly composed of former misfits and rock ’n’ rollers. Today, Gaunches Unite includes former football players, cheerleaders and even star students. “We’re trying to not lose sight of our roots, but we want to promote family and how to make good choices,” Hauser said. Accordingly, the organization’s next major annual fundraiser, Gaunchfest, will be more family friendly and feature local classic rock groups as opposed to the hard-rock performers of past Gaunchfests. Gaunchfest will run from 1-8 p.m. Sept. 26 at Blasdell Fireman’s Park, off Lake Avenue in the village of Blasdell. It will feature performances by Lynz, Mid Life Crisis and The Stonebridge Band. The event will also include such family-friendly activities as Ted the Magician, a bounce house and face painting as well as a basket and 50/50 split club raffle. Tickets for Gaunchfest are $20 presale, $25 the day of the event, and $5 for children aged 3-13. Hauser said all proceeds go directly toward helping local families and individuals during times of need. “We rely on donations and volunteers, and we try not to turn away anybody who is within the guidelines and is in need,” Hauser said. “The only way we can do that is by people paying it forward.” For more information, visit www. GaunchesUnite.com.
CALENDAR of
HEALTH EVENTS
Sept. 8
Hearing loss group holds first meeting of the season Hearing Loss Association of America, Rochester chapter, welcomes community members with an interest in hearing loss to the group’s first meetings of the season on Tuesday, Sept. 8 at St. Paul’s Episcopal Church, East Avenue at Westminster Road, opposite George Eastman House. The daytime meeting will be at 11 a.m. and evening at 7 p.m. Both will review the HLAA annual national conference held in St. Louis this June. Rochester delegates will comment on their experiences and reactions to workshops and exhibits designed to help hearing-disabled individuals deal with their communication problems. Among these are the deleterious effects of untreated hearing loss, smart phones as assistive technology, and new diminutive microphones to help hear in noise. Hearing Loss Association is a nationwide organization dedicated to advocacy, education and support for people with hearing loss. For more information visit www.hlaa-rochester-ny. org or call 585-266-7890.
Sept. 19
Free wellness fair scheduled in Amherst The Amherst Center for Senior Services will host a free wellness fair from 9 a.m. – Noon, Saturday, Sept. 19, at 370 John James Audubon Parkway in Amherst, behind the Audubon Library. Various options on health and wellness will be presented, including acupuncture, yoga, hearing, healthy eating, fitness and more. Screenings will be held from 9 a.m. –Noon and will include hearing tests by Zounds Hearing and flu and pneumonia shot program by appointment only. Physician Saralyn Notaro Rietz will be the keynote speaker at 10 a.m.
“The true meaning of life and the true meaning of happiness is what you give to others, not what you take for yourself.”
Gaunches Unite
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2015
The physician will discuss “The Aging Eye: Managing Retina Conditions.” Refreshments will be served and demonstrations include Cardinale Acupuncture & Wellness, Best Fitness, Souls R Touched, Greater Buffalo Gymnastics & Fitness Center, Made 2 Move Fitness and Ivy League Psychic Academy. The event is co-sponsored by Independent Health and Tops Friendly Markets. For more information, call 636-3055, ext. 3108.
Oct. 14, 21, and 28
Workshop for women who live alone Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own,” is a three-part workshop offered for women who want to rediscover joy and contentment, and to gain the knowhow to forge a meaningful life on their own. You’ll meet others in similar situations and learn practical strategies to overcome loneliness, rediscover your true self and socialize in a couples’ world. The workshop takes place from 6:30 – 8:30 p.m. at House Content Bed & Breakfast in Mendon on three consecutive Wednesdays: Oct. 14, 21 and 28. Light refreshment is provided. The workshop fee of $145 includes a Living Alone binder, empowerment exercises and helpful resources. To learn more, contact Gwenn Voelckers at 585-6247887 or email gvoelckers@rochester. rr.com. Voelckers is the author of the column “Living Alone,” published every month in this newspaper.
Got a health event you want to share? Send it to editor@bfohealth.com. Deadline: the 10th of each month.
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In Good Health is published 12 times a year by Local News, Inc. © 2015 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, Ernst Lamothe, Nancy Cardillo, Catherine Miller • Advertising: Donna Kimbrell, Marsha Preston • Layout & Design: Chris Crocker • 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.
In Good Health is Printed Locally at Buffalo NewsPress
Coca-Cola Controversy: Is Exercising More or Eating Less Better for Weight Loss?
C
oca-Cola has given a $1 million to a new research organization that has pushed a message that lack of exercise is a bigger factor in the obesity epidemic than is calorie consumption. Science, however, still counts calories as the main driver of weight gain for most people. Although exercise makes people healthier, cutting calories usually plays a bigger role in weight loss, experts say. “There’s an overwhelming amount of research demonstrating that, from an individual perspective, the key is decreasing calories modestly to successfully lose weight over time,” said physician Pieter Cohen, an assistant professor of medicine at Harvard Medical School. “It’s certainly great to add exercise, but to suggest that it’s the solution to the obesity epidemic … is ridiculous,” Cohen said. The new nonprofit organization, called the Global Energy Balance Network (GEBN), received $1.5 million from Coca-Cola last year to help launch the organization, according to The New York Times. In a statement, Steven Blair, a professor of exercise science at the University of South Carolina Arnold School of
Public Health and a member of GEBN, said that although the media have focused on “blaming fast food” and sugary drinks for the obesity epidemic, “there’s really virtually no compelling evidence that that, in fact, is the cause.” On its website, the GEBN does not deny that good health involves both eating a healthy diet and doing exercise. But the organization’s website also says there is “strong evidence that it is easier to sustain at a moderate to high level of physical activity (maintaining an active lifestyle and eating more calories)” than it is to be sedentary and eat fewer calories. In an editorial published in 2014, several members of GEBN wrote that increasing physical activity “may be more achievable than reducing [calorie] intake” for energy balance. However, Cohen disagreed with this message. An exercise program by itself typically doesn’t lead to much, if any, weight loss, Cohen said. One reason for this is that exercise increases appetite, which can lead people to eat more, Cohen said. Exercise also causes the body to produce more muscle, which is heavier than fat tissue. In addition, it’s usually easier
to cut calories out of the diet than it is to exercise at the levels needed to burn enough calories for weight loss. For example, in general, experts say a person needs to cut 500 calories a day from his or her diet to lose 1 lb. (0.45 kilograms) a week. In theory, it would be possible to burn 500 calories through exercise instead of caloric restriction, Cohen said. But this would be
difficult, because burning this amount of calories through exercise takes time, and in order for the strategy to work, people could not consume a single calorie more than they do already, despite their increased activity. “It would be much easier to eliminate those 500 calories [from our diet] than to find the time to exercise enough to burn 500 calories a day,” Cohen said.
Healthcare in a Minute By George W. Chapman Telemedicine Mostly due to advances in technology, telemedicine is becoming more commonplace. What has been holding back the proliferation of telemedicine is reimbursement from insurance companies. While some insurance companies have been reimbursing for telemedicine, they have kept it fairly quiet. Slowly but surely, more insurers are paying physicians for telemedicine services. It has been estimated that telemedicine will save over $6 billion annually. This does not take into consideration the reduction in sick time and lost wages for patients. Telemedicine allows physicians and their support staffs to treat and monitor more patients that will alleviate the pending shortage of physicians. Many states are now pushing insurance companies to cover telemedicine. Primary care physicians Not surprisingly, those of us who see the same primary care provider fairly consistently — such as an internist, family physician or OB-GYN — have fewer hospitalizations and emergency room visits than those who do not. A study of 49,000 medical visits published in “Health Affairs” found that the more familiar a physician is with your medical history and chronic conditions, the more successful your overall care will be. As the saying goes, “Too many chefs spoil the broth.” Retail clinics According to The New York Times, CVS is now one of our largest healthcare companies. CVS operates 1,500 clinics among its 7,800 stores. Focusing
on population health, CVS no longer sells tobacco products. CVS actually resigned from the U.S. Chamber of Commerce when it learned the chamber was lobbying against anti-smoking laws. Sixty percent of Americans live near a CVS store, so the ability of CVS to have an impact on population health is tremendous. Despite criticism from traditional providers, consumer satisfaction with retail clinics is high. Healthcare strains state/local budgets An analysis by the Pew Charitable Trusts discovered that healthcare spending accounts for 31 percent of state and local government budgets. But don’t blame expanded Medicaid. The majority of healthcare spending is on public employees and retirees. It has increased 61 percent over the last six years. Medicaid spending has also increased and the federal government pays for most of it. A recent article in the Journal of Health Economics estimates the state liability for retiree health benefits is $1.1 trillion, or about one third of state annual revenues. Ninety-seven percent of this huge liability is unfunded. Premium review According to a study in “Health Affairs,” premiums are lower in states that have review authority over commercial insurers’ proposed rate increases. New York state has this regulatory authority. Big insurers get bigger The merger frenzy among commercial carriers reached a high point last month when No. 2 Anthem announced its intention to purchase No. 4 Cigna
for around $50 billion. This would create the largest health insurer in the United States with about 53 million covered lives. Also last month, Aetna bid $35 million for Humana. Both deals have to be approved by shareholders and federal regulators. If approved, the impact of these mergers on premiums would not take effect until 2017 as most carriers have rates for next year set. Federal regulators will pay particular attention as more seniors opt for rapidly growing Medicare Advantage plans that are offered through commercial carriers. While larger is essential considering the necessary huge investments in technology and health information systems, the reduction in competition could leave many communities with little to no choice when it comes to health insurance. Massachusetts General the “best” For what it’s worth, U.S. News and World Report named it the best hospital out of 5,000 nationwide. The Mayo clinic in Rochester, Minn. came in second. Johns Hopkins in Baltimore and the UCLA medical center in Los Angeles tied for third. Physician shortage The shortage is expected to be felt by 2020 although there is much debate as to degree. In the meantime, medical schools have done their part by expanding enrollment. By 2018, there will be over 21,000 medical students, which is about 4,000 more than now. Teaching hospitals have done their part by voluntarily expanding the number of residency slots. The key word is “voluntarily”
September 2015 •
because they have not been reimbursed for the costs associated with the additional slots because the federal government has not done its part to address the shortage. Since 1996, there has been a cap on the number of residency slots to be reimbursed through additional Medicare payments. With more budget cuts on the way, many teaching hospitals will be forced to discontinue the additional slots they have added. As more medical students graduate, there are not enough U.S. residency slots or jobs available to them. They will be forced to find residency jobs abroad. Hospitals must get bigger Stand-alone community hospitals are finding it harder to compete with nearby hospital systems and even harder to negotiate rates with dominant insurers. Many community hospitals will not survive unless they become part of a larger system of care. Consequently, hospital mergers and acquisitions continue on the upswing. Not to be outdone by insurance mergers, the number of hospital merger and acquisition transactions in 2014 increased by 18 percent — 637 to 752 — over 2013. GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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App Helps Patients with Depression
A
pproximately 16 million American adults are affected by depression. However, many patients see a psychiatrist only once every two to three months. Recognizing that patients often forget how their moods vary between visits, a team from the University of Missouri, Missouri University of Science and Technology and the Tiger Institute for Health Innovation has developed a smartphone application that lets users log their moods and symptoms and share that data with their psychiatrists. “Some patients keep a mood diary during their treatment, which can be helpful in assessing their well-being,” said physician Ganesh Gopalakrishna, an assistant professor of psychiatry at the MU School
of Medicine and a psychiatrist at MU Health Care. “But I thought that there must be a better way to record moods and activity. That led to the development of the MoodTrek app, which allows patients to log their moods, sleep patterns and activity levels between appointments. People tend to forget what their moods were like just a few days ago, but through this app, I can now see that data and can use it to provide the best care possible.” Gopalakrishna worked with a computer science faculty member at Missouri S&T, to create the app. The two, along with Missouri S&T’s technology transfer and economic development staff, coordinated development of the app with the Tiger Institute. The free MoodTrek app gives patients a sense of how they’re doing on a daily basis. Behavioral health has been linked to factors such as a person’s sleep and exercise levels, and the app helps users recognize what affects their mood. Users of the app are able to record their moods on a scale of one to five by selecting the appropriate “smiley face” icon that matches their current feelings. By linking the app to a Fitbit activity tracker, users can integrate their sleep and exercise activity, which is then shared with their provider. If a patient is seen by a provider who uses a Cerner-developed electronic medical record, the information is uploaded instantaneously to their medical records. Users also can download reports of their mood, sleep and exercise activities to bring to their visits. MoodTrek is available for free on Android devices, with plans to bring the app to Apple devices in the future. To download the app, visit:https://play.google.com/ store/apps/details?id=com.cerner. moodtrek. Page 6
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Meet
Your Doctor
By Chris Motola
Michael J. Mineo, MD Physician at Millard Fillmore Suburban Hospital talks about working at the ER, what brings him professional satisfaction and why he would probably be more stressed working in a doctor’s office setting Q: Has the Affordable Care Act (ACA) taken some of the stress off of emergency departments? A: I don’t know if we’ve necessarily seen a shift because of the health care law. We have seen a shift, however, due to the upswing in the number of urgent care offices. That, in combination with the number of high-deductible insurance plans, has moved some of the smaller injuries out of the ED. That’s something we’ve noticed over the last few years. Q: Overall, how does urgent care help or even complicate your specialty? A: I would say it helps the picture by encouraging non-emergent issues to be seen in that environment, leaving us to focus on the more serious injuries and illnesses. The downside to that is we’ve lost some patient variety and patient flow, where we used to have a mix of seriously and less ill patients. Q: Can you elaborate on the idea of “patient flow?” A: If you’re managing all seriously ill patients at one time, it can be a bit of a challenge to split your attention between, say, three seriously ill patients. If you have one really sick patient and two less sick patients, it can help you to divide your time more efficiently. Q: What conditions do you see most frequently? A: In Western New York, we have an elderly patient population, so we’ll see a lot of acute problems related to chronic disease: congestive heart failure, COPD. We also have the problems you see everywhere like heart attacks, strokes.
A: I’d say the biggest difference is that we’ll take care of anybody at anytime, regardless of the circumstances or condition. We don’t differentiate at the front door. We will stabilize them. On the other hand, if you’re a primary care physician, you see a patient from beginning to end. We’ll often start the care, but they’ll end up closing the care. So we don’t always get the closure we’d like. Q: How hard is it to establish the context of an acute problem you’re treating since you don’t really have a history with the patient? A: Every patient is a new encounter, so we lack what we call “collateral information.” You essentially know nothing about the patient, and sometimes the patient isn’t able to communicate. So you have to rely on the circumstances and witness reports to create a picture of how to initiate care. Q: What do you, personally, find appealing about emergency medicine? A: I would say the breadth of practice. You get to do everything. When I was coming up through medical school, I loved ophthalmology, gynecology, surgery, radiology. Emergency medicine allows you to practice all aspects of medicine. You also get to see patients from all cultural and socioeconomic backgrounds. In the course of one shift, you can see the full spectrum of your community.
Q: Like primary care physicians, emergency medicine physicians are broadly trained. What are some of the key differences between the two?
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2015
Q: What, in terms of personnel, does an ED need to function optimally? A: It’s a very involved answer, because it depends on time of day and the setting of the hospital. A suburban population with sicker patients may require more resources than a rural hospital where you may not have the same level of acuity. Generically speaking, you need a combination of nurses, advanced providers — nurse practitioners, physician assistants —and scribes, which are something we use. Scribes are typically undergraduate college students who help the physician with the electronic medical records while the physician concentrates on the interaction with the patient. Q: Do patients have a good sense of what is and isn’t an emergent illness or injury? A: I think with urgent care as an option, patients have gotten pretty good at self-triaging, which is our term for picking the appropriate level of care. The media can be pretty critical about patients going to the emergency room rather than primary care, but when you look at it, most patients who go to the emergency room do need to go there. Q: Where do you think improvements can be made to emergency medicine departments? A: The key is having good collaboration between hospital administration, physicians and support staff. Volume tends to come when you aren’t expecting it, so you need to have the communication in place to respond to those unexpected increases. The other elements are focusing on patients’ comfort and satisfaction and performing adequate follow up. Q: How do you handle the stress? A: So if you took a primary care doctor and put them in our environment, they’d probably be more stressed than we are. I think there’s kind of a self-selection process in medical school as well as training that means we won’t be as stressed out working in a more chaotic environment. I’d probably be more stressed out in a doctor’s office. At times, you’ll bring some work home with you that you wish you didn’t. You might have seen something you wish you didn’t. Had to have an uncomfortable talk with a family. So you do need to be able to decompress and debrief. Q: On that note, since you aren’t able to see outcomes down the road, what do you consider a satisfying conclusion to an emergency room visit? A: I think the moment where you sit down with a patient at the conclusion of the visit and talk. They’ll often express gratitude for what you’ve accomplished so far and you’ll be able to give them useful information about their illness or injury. We call that “the close.”
Lifelines Name: Michael J. Mineo, MD Position: Emergency physician at Millard Fillmore Suburban Hospital Hometown: Lancaster, NY Education: SUNY Buffalo School of Medicine Affiliations: Kaleida Health, United Memorial Medical Center Organizations: American College of Emergency Physicians Family: Married, three children Hobbies: Hunting, fishing
Where Are the Hot Jobs? Twelve Out of Top 20 Are in Healthcare Labor Department: Fastest Growing Occupations
The need for workers in support occupations — such as home health aides and occupational therapy assistants — drives demand in healthcare industry
The Bureau of Labor Statistics listed the following fastest growing occupations. These 20 occupations should have the highest percent of change of employment between 2012 and 2022, meaning those in school and enrolling in school soon should reap the benefit of employment availability and career stability.
By Deborah Jeanne Sergeant
H
ealthcare jobs are growing, there’s no doubt. Of the Bureau of Labor Statistics’ top 20 jobs slated for growth between 2012 and 2022, twelve are related to healthcare. The top five are, in order, personal care aides (No. 2), home health aides (No. 3), diagnostic medical sonographers (No. 6), occupational therapy assistants (No. 8) and genetic counselors (No. 9). Fortunately, the Buffalo area boasts institutions offering education for people seeking careers in these areas. Personal care aides and home health aides usually receive training from their places of employment upon hire. Allwel (www.allwelcares.com) for example, offers free training to qualified applicants. As an entry level into a possible long-term healthcare career, personal care aide and home health aide positions provide an opportunity to try out the industry. The aging baby boomer population, along with the industry-wide shift toward at-home
care, should supply plenty of work for the foreseeable future. Future diagnostic medical sonographers can receive training at Trocaire College (www.trocaire.edu) in Buffalo. The one-year certificate program in diagnostic medical sonography includes clinical and lab training. Enrollees must already have earned an associate’s degree, a bachelor’s degree or a diploma in radiologic technology with a qualifying GPA and specific course topics. As the role of ultrasound expands with both use, such as for breast ultrasound, and its scope, including 3-D and 4-D technology, it’s easy to see how sonography holds a bright future for students. Occupational therapy assistants aid occupational therapists. Erie Community College (www.ecc.edu) offers a Associate in Applied Science degree for those who successfully complete the occupational therapy assistant program. Again, the aging baby boomers
1. psychologists 2. personal care aides 3. home health aides 4. insulation workers, mechanical 5. interpreters and translators 6. diagnostic medical sonographers 7. helpers (brickmasons, blockmasons, stonemasons and tile and marble setters) 8. occupational therapy assistants 9. genetic counselors 10. physical therapy assistants
likely contribute to the demand for occupational therapy assistants. As more Americans have healthcare coverage than ever before, while reimbursements for many medical disciplines have become squeezed, the need for assistants to pick up the slack also drives demand for occupational therapy assistants. University at Buffalo (www.buffalo.edu) offers PhD and MS programs in genetics, genomics and bioinformatics. The school’s website states that the
11. physical therapy aides 12. skincare specialists 13. physician assistants 14. segmental payers 15. helpers / electricians 16. information security analysts 17. occupational therapy aides 18. health specialties teachers, postsecondary 19. medical secretaries 20. physical therapists
program’s “broad scope of inquiry encompasses human, medical and developmental genetics and genomics throughout the lifespan; microbial genetics and pathogenesis; and genetic and genomic analysis through bioinformatics.” As the field of study continues to grow in importance for predicting, preventing and treating disease, the number of genetics experts needed should continue to rise.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 7
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
The Healing Power of Forgiveness
W
ho wouldn’t be angry beyond words? After 38 years of marriage, two children and a lifetime of memories, she arrived home from work one day to find a hand-written note on her nightstand. He had left her to “find himself.” Completely blindsided, she dropped to the bed stunned in disbelief. He was gone. His clothes closet empty. His home office cleared out. With no word about his whereabouts, she racked her brain, desperate to make sense of his bizarre behavior. Had she missed something? Was he ill? And where in the world was he? Days later, her anguish was replaced by anger when she inspected his computer history and discovered that he had met someone online. He and his newfound “soul mate” had scheduled a rendezvous in Florida. It has been four years now since this nightmare, but to hear her talk about it today is to bring everything immediately to the fore — the deep emotional wound, the humiliation and the loss of life as she knew it. The retelling of her ordeal quickly ignites a seething anger just beneath the surface. How could he have done this to her and the kids? How could he have betrayed them? While my friend’s lingering bitterness is understandable, it is also unfortunate. By dwelling on this hurtful event and hanging onto her anger, she
is allowing her resentment and hostility to fester. Left unchecked, she risks bringing negativity into current relationships and experiences, or worse — letting her anger hurt the connections with the people who matter most in her life. I feel for her. Are you holding onto a grudge? Does an abiding bitterness occupy your thoughts? Nearly all of us have been hurt by the words or actions of others somewhere along the way. The wounds may be deep, but if you don’t practice forgiveness, you might be the one who pays the biggest price. While it can feel almost impossible to let go of a long-standing grudge and feelings of resentment, I can tell you from my own experience that forgiveness can bring a measure of peace that may enable you to move on with your life. It might even make room for compassion and understanding. I’ve also learned that forgiveness doesn’t just happen on its own or overnight. You must choose to forgive. It’s a process of change that requires commitment, courage, and self-reflection: Acknowledge and share your pain. Let it all out. Share your suffering with someone you trust, and don’t hold
back. When there’s someone there to really listen, your pain can become tolerable and perhaps more likely to dissipate. Empathize with the person who hurt you. I know this may not be easy. But none of us is perfect. The person who hurt you may have been acting out of self-preservation, an unspoken fear or pain of their own. Take a hard look at yourself. We all know that there are two sides to every story. What was your role in the breakdown of your relationship or in whatever has contributed to your resentment? Taking personal responsibility for our words and behavior and, importantly, their results is an essential part of forgiveness — not just of others, but of ourselves. Holding onto a victim mentality may serve to validate an unhappy situation, but it can also keep you mired in anger and thoughts of revenge. Embrace the benefits of forgiveness. Forgiveness can be empowering. It can set you free from the past and release the control the offending person has had in your life. There may be health benefits, as well, when you carry a lighter emotional load. The more I practice forgiveness, the less stress I experience and the better I
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2015
feel. Focus on the future. Rather than focus on the past and your wounded feelings, seek out positive, healthy relationships and experiences. Put your energy into finding beauty and kindness around you. When you are ready, actively choose to forgive the person who hurt you. Remember, you can forgive the person without excusing the act. Forgiveness is not about condoning. It’s a gift you give yourself — to release yourself from bitterness and vengeful thinking. Reinforce your forgiveness with a symbolic act. In my Living Alone workshops, participants take part in a “letting go” ceremony, during which they symbolically release anger, negative attitudes and unhealthy behaviors into a fire burning brightly in my fireplace. Many capture their thoughts in writing and find some relief in seeing their past hurts go up in flames. Symbolic acts such as this can help the healing process. As you let go of anger, grudges, resentments, and thoughts of revenge, you may no longer define yourself and your life by your past hurts and grievances. When you embrace forgiveness, you are embracing the promise of renewed compassion, kindness, and gratitude. Even some tenderness. Forgiveness can be healing and set you free. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, N. Y. For information about her upcoming workshop, check out the Calendar of Health Events in this issue or contact me at 585-624-7887 or through my email, gvoelckers@rochester. rr.com.
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WNY Ovarian Cancer Project Kathleen Maxian and her nonprofit are on a crusade to empower, educate and energize women By Nancy Cardillo
A
diagnosis of terminal ovarian cancer — particularly one that could have been prevented — would cause many women to simply give up. But not Kathleen Maxian, a 53-year-old who lives in Pendleton. In 2009, two years after her sister was diagnosed with breast cancer and tested negative for the BRCA gene — which can lead to breast or ovarian cancer in families — Maxian was diagnosed with ovarian cancer, which had spread to her abdomen. Her doctors were perplexed, because her sister’s genetic testing had come back negative, and that’s when it was discovered that Kathleen’s sister had not been given complete testing at the time of her diagnosis. “What we thought was a comprehensive BRCA test did not actually include the BRAC Analysis Rearrangement Test — BART — which detects familial mutations,” says Maxian. “When my sister went back and had the BART, it was positive. My dad and I had the test then, too, and discovered we both carry a genetic abnormality.” Had she had this information years earlier, Maxian’s cancer could have been prevented or caught at an early stage. Now, in her advanced stage, the prognosis is not as good. Rather than focusing on her anger, Maxian channeled her energy into
action and advocacy, forming the Western New York Ovarian Cancer Project (WNYOCP). And that’s what she does now: she is patient advocate and a speaker. The mission of her nonprofit organization — and this tireless advocate — is to educate the community on the symptoms and risks of ovarian cancer, and to provide information, support and networking for women diagnosed with ovarian cancer and their families. Q.: What motivated you to set up WNYOCP? A. Women are not educated enough about their gynecological health — and need to be. They know very little about ovarian cancer, its symptoms and risks. I had the symptoms — I just didn’t know they were the symptoms of ovarian cancer. I was also at high risk for this disease, and had no idea. I want to empower women to take control of their health so what happened to me, doesn’t happen to anyone else. Q.: Is WNYOCP just for Erie County residents? A. Not at all. We serve 12 counties, including Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Livingston, Monroe, Ontario, Orleans, Niagara, Wayne and Wyoming.
Q.: What types of services does WNYOCP offer? A. In terms of education and awareness, we offer speaking engagements to professional organizations, clubs, groups, schools — anyone who wants us. We have volunteers who distribute information at health fairs, community events and conferences. Our support and networking groups meet in various locations and are designed to help women cope with their illness and receive emotional support from others with the same diagnosis. The groups are ongoing — new members can join at any time, and at any stage of their cancer experience. Studies have shown that talking to others in a networking or support group can decrease anxiety and depression and help women feel less isolated and distressed, therefore improving quality of life. We also work with federal, state and local public policymakers to ensure funding and resources for research and services related to ovarian cancer. Q.: Is there a cost to join WNYOCP? A. All of the services of WNYOCP are free of charge. Our “Comfort & Hope” totes are given free to every woman newly diagnosed with ovarian cancer through her gynecologic oncologist’s office.
Want to Learn More?
Anyone interested in learning more about Western New York Ovarian Cancer Project may go to wnyovariancancerproject.org and get more information or call 716-946-6437. Those who want to contact Kathleen Maxian, may email her at kmaxian@wnyovariancancerproject.org. These totes are filled with items to take along to chemotherapy appointments, but — more importantly — they send a message of hope from women who have been on the journey and are extending a hand of understanding and support. We have had a wonderful response to this program, and some incredible feedback from women who have received the bags. Q.: Where does WNYOCP get its funding? A. Anywhere we can! But mostly through fundraising events, such as our popular annual spring geranium sale. September is Ovarian Cancer Awareness Month, and we have a big celebration event planned, which will include lighting up Niagara Falls. We’ll be posting more about this event on our website. Q.: What do you want women to know about ovarian cancer? A. One in 75 women in the United States is diagnosed with ovarian cancer, and nearly 80 percent do not get the right treatment within the first year — treatment that could help them survive longer. As we inform women about the symptoms and risk factors, we also talk about the importance of working closely with your doctor, particularly if you are having any of the related symptoms. Insist on being tested and, if it is ovarian cancer, make sure you are referred to a gynecological oncologist as soon as possible. We have to take our own health into our own hands.
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September 2015 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 9
Living with Autism Buffalo-area families faced with daunting task of rearing autistic kids
By Catherine Miller
“
We have a saying: If you know a child with autism, then you know one child with autism,” said Ellen Spanenthal, director of communications with The Summit Center in Getzville. Referring to the wide range of challenges that a person diagnosed with an autism spectrum disorder [ASD] may face, autism presents differently in each instance. There are characteristic tendencies to autism but each person with ASD is unique, and each family’s story distinct.
The Brown family
Matthew Brown, 5, was diagnosed with ASD just after his third birthday. With delayed speech, walking, and other such timely development markers, his parents sought help. “While we were talking to our primary doctor about our concerns with Matthew’s development, we asked if she thought it could be attributed to autism,” said Matthew’s mom, Kim, “The doctor said, ‘I can’t rule that out.’ It’s not what I was expecting to hear.” That was the beginning of the Brown family’s journey down the road into living with autism. They then sought out specialists who confirmed the diagnosis that Matthew had an ASD and began to seek the best treatment options for their son. Finding services through The Summit Center and local support groups,
the Brown family is on a path to getting their young son the services he requires. A quick glance into family life and the Brown family looks like your average American household. A typical Saturday may find Kim and her daughter Gaby at a Saturday dance competition while Matthew spends time with his father, Joe, and brother, Connor, playing on the swing set in their yard alongside Sally, their black Lab. An ordinary day such as this can be extraordinary, however, when you are living with autism. While Matthew is a happy, energetic and active 5-yearold, he is largely non-verbal and must search other avenues to communicate with family members. Short, quiet words are linked together for basic communication. A Nova Chat communication tablet allows Matthew to use photos to convey his wants and needs. When frustrated by communication issues or just simply by life in general, Matthew is prone to having fits where he may vocalize loudly or act out. “Most of the time when he has an issue in public, people are very compassionate and understanding,” said Kim of her son’s outburst. “Our issues are trying to determine what is it that he wants and needs.”
The Brown family relaxes in their back yard on a recent Saturday afternoon. Page 10
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Matthew’s siblings, Gaby and Connor, play well with Matthew despite the communication limitations. They understand that Matthew needs additional time and attention from his parents, and they assist more than most children around the home, helping to clean up, and keep the household running smoothly. “They’ve been great sports,” admits Kim. “We have our challenges, but Matthew is a very loving boy. We are very fortunate.”
The Seefeldt family
Maxwell Seefeldt loves to bowl. At age 14, he has a high score of 198 — not bad when you consider that a 150-160 range is considered average by many adult leagues. Max visits the bowling lanes weekly with his father, Chris, and they often spend just as much time watching other bowlers as they do bowling themselves. Max is autistic — and similar to Matthew — largely non-verbal. Finding enjoyment in an activity where lack of verbal skills does not hinder his abilities, Max is free to study the pins, the other bowlers and work on his game. Max was diagnosed with ASD at an early age. His mom Liz noticed that her son missed traditional speech and gross motor skill markers. When she realized that Max didn’t respond to his own name, she thought he might have a hearing problem. Auditory testing suggested it might be something more. Similar to the Brown family, a team of specialists helped to diagnose Max and get him started with the appropriate services for ASD. The lack of verbal skills is one of the most challenging issues that Max’s family faces. “You can tell what a struggle it is for him to produce what he is trying to say,” explains his father, Chris, “It’s almost as if his brain is trapped. He has well-developed cognitive skills, but he can’t express himself verbally.” Despite his communicative issues, Max has excelled on many planes and is very apt in his use of electronic devices. A natural artist, Max utilizes his iPad to write music and draw. He has uploaded some of his work to YouTube with the help of his father and sister, Alexandra. At school, he has been asked to complete sketches of the Eiffel Tower and other famous structures and does so with ease, using a Sharpie marker. He has won awards for his drawings in citywide competitions. While Max excels at many non-verbal based activities, he and his family continue to struggle with typical autistic tendencies, such as Max’s penchant for wandering from home. Many ASD children tend to bolt or wander from the safety of their home due to a desire to explore, a yearning for a favorite place, or a way to escape sensory discomfort. This can be especially worrisome for the family of a non-verbal autistic child. Parents need to be mindful of where the child is at all times when he or she is not in sight. Second-floor windows tend not
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2015
to be a prohibitive means of egress to a child that doesn’t understand the possible resultant injuries. A survey of parents has identified wandering as one of the most stressful ASD behaviors. While living with a creative and uncannily curious autistic child who enjoys wandering such as Max may sound overwhelming and a bit tiring, the Seefeldts seem to handle it with ease. “You never know what you can handle until you are in the middle of the situation,” said Liz.
The Storrs family
“If parents aren’t strong advocates for their children, who will be?” questioned Lorrie Storrs, mother of two older autistic daughters. Lorrie’s struggle was a bit different than most parents of autistic children, mainly because hers began at a time when little was known about ASD. Her daughters Taylor, 22, and Hayley, 19, have both traveled down different autistic paths, and at times when the rate of autism was not quite so alarming. “When Taylor was diagnosed nobody really knew what autism was. By the time Hayley was diagnosed, most people I mentioned her diagnosis to were familiar with autism. Speaking on the subject now, most people have at least one family member who has been diagnosed with autism,” explains Lorrie. As a result of the limited information available at the time of diagnosis, Lorrie took up the torch to advance the knowledge of ASD throughout her community and beyond. She has been interviewed numerous times regarding her experiences, and has spoken before the New York State Assembly, voicing the need for additional services and funding for ASD. She has first-hand knowledge of just how challenging living with autism is, and uses her knowledge to assist others in the understanding and awareness of the multi-leveled disability. Back at home, Lorrie admits that Taylor is the more reserved of the two girls, shy and quiet. Hayley is more outgoing. Despite Hayley’s severe hearing loss, she loves music and dancing and is a fan of rap music, which doesn’t always thrill her father, Tim. The girls love cuddling with their parents, and still need a good amount of assistance with daily life skills. After two decades of providing constant assistance to their children for their most basic of needs, the Storrs admit it can be an exhausting lifestyle. When asked what advice she would give parents that are just starting to realize that their child might have a developmental disability, Lorrie said, “Get to the doctor. Get the diagnosis. And then apply for a Medicaid waiver and find out what programs and services are available.”
The future
Presently the Browns have transitioned Matthew from Summit Pre-K to kindergarten at Maple East Elementary School and are hopeful for a smooth
conversion. Despite being non-verbal, Matthew is able to interact with other students on a level that makes it possible for him to attempt the transition. While it’s still an experiment waiting to happen, service providers at Summit and Maple East have encouraged that other non-verbal autistic students have successfully integrated into the Maple East Elementary class, and are optimistic that Matthew can do the same. As for Maxwell, he continues to work on his art, and his parents are hopeful that his artistic progression will continue. This talent is something that he can work on despite commu-
nicative challenges, and his artistic aptitude seems to evolve naturally, as does his love for bowling. He will continue through The Summit Center where he is presently flourishing. His parents admit that they are concerned what services will be available for him once he is out of school. Lastly, there’s the Storr sisters. At this time Taylor has aged out of school and is in a day habilitation without walls program that allows her to learn life skills while volunteering at Meals on Wheels and the local food pantry. Hailey is at Summit Academy but will transition soon. As the girls get older,
their parents are concerned about what the future holds. “We aren’t getting any younger,” Lorrie admits. “We want to make sure there are group homes available for them when we are older and we need to go that route.” One in 68 children are born with some developmental disability that fits the ASD definition. Each person is unique and each circumstance different. What is consistent is the fact that in about 20 years, approximately 1.5 percent of young adults in America will be attempting to fit into society with some form of autism.
The Summit Center a haven for those struggling with ASD By Catherine Miller
T
he Summit Center, regarded as Western New York’s premier facility for developmental disability services, sits as a beacon for many local families that have a member diagnosed with an autism spectrum disorder or other developmental disability. From its early intervention services to newly expanded adult programming, The Summit Center helps to coordinate the many facets of care needed by those facing the challenges of autism and its associated conditions. Long thought of as the regional center and school for children with autism spectrum disorders, The Summit Center, formerly known as Summit Educational Services, provides services for people of all ages with development disabilities. “This new name reflects our growth and expansion into areas beyond education,” said Stephen Anderson, CEO of The Summit Center, “While many people know about our school, Summit Academy, they may not be aware that we also have programs and services for adults with autism and other developmental disabilities as well as insurance-based clinics for typically developing children and young adults.” The Summit Center offers more than 30 programs in four main divisions, including early intervention, behavioral health, community support and adult services. Through early intervention and education, the center can evaluate a child for eligibility for programs and begin early autism programs as necessary. Early intervention is crucial to a child with a developmental disability. Once evaluated, specialists at The Summit Center can begin to work with the child in a classroom setting and can offer additional services including speech, occupational and physical therapy. The behavioral health division at The Summit Center includes consulting, a behavioral pediatrics clinic, a feeding clinic and other related programming including ABAworks Autism Clinic. ABAworks offers behavioral assessment, followed by an individualized program and training for the family.
Addressing vital issues
Whether a child has a developmental problem or is typically developing, the services in the behavioral health division can assist with issues such as
The annual Autism Awareness Walk features thousands of participants who raise funds to benefit The Summit Center services and increase autism awareness in the region. anxiety, depression or other behavioral problems. Ongoing data is collected with the results of the program geared toward increasing the individual’s independence and decreasing his or her challenging behavior. Self-help and leisure skills are promoted and the program assists with safety awareness. The community division provides family and community training and recreational support. Offering needed respite support designed to increase the quality of life for the entire family, the community division can assist with in-home, afterschool and evening and weekend programs. There are programs that teach strategies and practices that enable the family to better manage behavioral challenges. The adult division at Summit is growing and offering more services as needs are identified. With day programs and vocational employment services, the programs foster independence and inclusion for adults in the autistic community. The newly expanded adult division offers people with developmental disabilities increased options on how they spend their day. “This is a very exciting time at Summit as we continue to explore new opportunities to help children and adults in Western New York,” said
Anderson. “As we grow and expand, our steadfast commitment to excellence through methods based on evidence-based practice remains the same, as does our focus on making life better for the individuals in our care.” For those families that are questioning whether their child has a developmental disability, help is just a phone call away. Early intervention can make a world of difference to a person with a developmental issue. “We recommend that the first call is to your pediatrician to address your concerns about your child,” said Ellen Spangenthal, communications director at The Summit Center. “If your pediatrician agrees that there is cause for concern, then call us. We can help.” The Summit Center has its main offices situated in Getzville. It is centrally located and serves more than 2,300 children and adults throughout Western New York. It has a staff of more than 600 professionals and experts in autism and social-emotional development who work toward bettering lives in the community. For more information on the school and services available at The Summit Center, call 629-3400 or visit its website at www.thesummitcenter.org.
September 2015 •
Buffalo Ultrasound joins HEALTHeLINK First mobile imaging source to send data to Western New York’s clinical information exchange HEALTHeLINK announced Buffalo Ultrasound has joined Western New York’s clinical information exchange as its first mobile imaging data source. Diagnostic quality images for both radiology and echocardiography studies as well as reports from Buffalo Ultrasound’s testing centers, including all mobile locations can now be securely and electronically accessed through HEALTHeLINK by more than 3,400 participating physicians. “Having immediate access to current clinical information on a patient, including recent diagnostic imaging exams, provides value to health care professionals in being able to offer efficient and effective treatment at the point of care,” said Dan Porreca, executive director, HEALTHeLINK. “In the case of radiology exams, this information can also enhance patient safety by helping to reduce the number of unnecessary duplicate tests and in turn the amount of radiation exposure received.” Nearly 90 percent of the radiology reports generated in Western New York hospitals and independent radiology centers are available to participating physicians through HEALTHeLINK. “Buffalo Ultrasound is committed to any collaborative effort benefiting our community, especially those benefiting the frailest members confined to long term care facilities or their own home,” said Michael C. Straeck, president and CEO, Buffalo Ultrasound. “This partnership benefits everyone by expediting care and reducing costs.” Since 1987, Buffalo Ultrasound has provided Western New York with quality, cost effective on site diagnostic imaging services. Family-owned and operated, Buffalo Ultrasound provides imaging services and at three conveniently located testing centers in Williamsville, Kenmore and West Seneca and on site at physicians’ offices, medical centers, long term care and correctional facilities as well as for patients confined to their own home.medical information via HEALTHeLINK, resulting in more timely and effective treatment at the point of care.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 11
SmartBites
By Anne Palumbo
The skinny on healthy eating
More Reasons to Gobble Up Chicken
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et’s not beat around the chicken coop: Heart disease is the No. 1 cause of death for both men and women in the United States; and high consumption of saturated fats raises our risk for this disease. Many of us are aware of this risk and have decreased our consumption of foods high in saturated fat — such as red meats — as a result. In fact, for the first time in over a century, Americans are eating more chicken that beef. Chicken is loaded with lean protein, serving up about 30 grams per average serving of skinless breast meat and just a tad less for skinless thigh meat. Protein is a powerhouse building block for muscles, cartilage, bones, skin and blood. This essential nutrient also makes up the enzymes that power many chemical reactions in our body, from digestion to metabolism. What chicken is not loaded with is fat, especially saturated fat or calories. It’s why so many doctors and nutritionists recommend its consumption over red meat. An average serving of skinless breast meat has only 1 gram of saturated fat and 165 calories, while the same size serving of skinless thigh meat has about 3 grams and 210 calories. How much saturated fat are we
allowed in a day? The Dietary Guidelines for Americans encourage us to limit our saturated fat intake to less than 10 percent of our total calories. Chicken is super rich in niacin, an important B vitamin that helps keep our skin, hair and eyes healthy and also supports our nervous and digestive systems. In addition, niacin plays a key role in converting food to energy and influences how we process cholesterol. According to the Mayo Clinic, consuming a niacin-rich diet may raise our good cholesterol by 35 percent, while also lowering our bad cholesterol and triglycerides (another type of unhealthy fat). Lastly, chicken is a good source of selenium, a trace mineral that does wonders for our thyroid and immune system. A powerful antioxidant, selenium also helps make special proteins
KIDS Corner
Tips for Keeping Your Children Injury-Free During Fall Sports
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any children return to sports such as soccer, football, cross-country and volleyball when they return to school. Physicians in the division of sports medicine at Cincinnati Children’s Hospital Medical Center say preparation before the first day of practice is critical in helping to reduce the risk of injury. According to the American Academy of Pediatrics, approximately 3.5 million children and adolescents 14 and under get hurt annually playing sports or participating in recreational activities. More than 775,000 children and adolescents 14 and under are treated in hospital emergency rooms for sports-related injuries each year. Most of these injuries are traumatic in nature and occur as a result of falls, being struck by an object, collisions, Page 12
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and overexertion during unorganized or informal sports activities. More concerning, say Cincinnati Children’s Sports Medicine physicians, is the exponential increase in the number of overuse injuries experienced by young children today. These types of injuries are often the result of excessive training year-round or a rapid ramp up of activity after a period of inactivity. This scenario is common at the onset of any sports season. Doctors in the Division of Sports Medicine at Cincinnati Children’s suggest these tips to ensure children’s safety when they return to school sports: • Four to six weeks prior to the onset of any sports season, children should start exercising regularly to get ready for their season. • Acclimate children to hot weath-
that may prevent the kinds of cell damage that contribute to age-related diseases.
Helpful tips
Buy chicken that’s well-wrapped and then put the poultry in a produce bag to prevent cross-contamination. After prepping the chicken (the USDA advises not to rinse before cooking), wash everything that touched the meat with hot, soapy water. Whatever cooking method you use, the chicken must reach a temperature of at least 165 degrees fahrenheit to make sure all bacteria are destroyed. Buying chickens raised without antibiotics (look for the “USDA Organic” label) supports farmers who keep their chickens off these drugs and also preserves the effectiveness of antibiotics in humans. No hormones are ever used in the production of any US chicken.
Asian Chicken Salad with Cabbage Adapted from The World’s Healthiest Foods 2-3 boneless, skinless chicken breasts 5 cups Chinese cabbage, sliced thin 1 red pepper, sliced thin ½-1 cup shredded carrot ½ cup minced scallion ½ cup sliced almonds, toasted ¼ cup fresh cilantro 2 tablespoons toasted sesame seeds Dressing 2 tablespoons olive oil 2 tablespoons soy sauce ¼ cup rice vinegar 2 tablespoons honey 1-2 cloves garlic, minced
er workouts by gradually increasing time outdoors in the heat and humidity. Acclimatization should occur for about the first 10 days to two weeks of practice to help prevent heat injuries. • Make sure children drink plenty of fluids and take frequent breaks: every 10-15 minutes while participating in sports or physical activity. Also make sure they wear light clothing and limit their exposure to the sun in the hottest part of the day. Applying towels soaked in ice cubes and water to the head and neck helps to stay cool. • When heat illness is suspected, move the athlete into the shade or coolest area nearby. Try to cool them as quickly as possible by exposing the skin to ice/cold water and cool circulating air. • Young athletes with asthma should use preventative inhalers 20-30 minutes before exercise, do a gradual warm-up and should have an inhaler available to them during practices and during competition. • Make sure children wear any rec-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2015
pinch of red pepper flakes salt and pepper to taste Preheat oven to 350 degrees F. Tent chicken in foil, place on baking sheet and cook for 45 minutes (or until internal temperature reaches 165). Remove, open foil, and let cool. While chicken is cooling, thinly slice cabbage and pepper and shred carrot. Place in large bowl. Add minced scallion, chopped cilantro, and sliced almonds to this mixture. Using your hands, shred chicken into bite-size pieces and add to bowl. Whisk together olive oil, soy sauce, vinegar, honey, garlic, red pepper flakes, salt and pepper. Toss with cabbage-chicken mixture and then sprinkle with sesame seeds. (Double dressing if mixture seems too dry.) 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.
ommended protective equipment and ensure it is well-fitted. Protective equipment, such as helmets, can help prevent severe injuries such as skull fractures. Many head injuries result from helmets not being fitted or used correctly. Athletic trainers can fit helmets in the sports where they are needed. • Remind children to immediately tell the coach or trainer if they feel dizzy, “foggy,” have a lapse in memory, or have a headache after taking a blow to the head. • Parents need to be mindful that athletes who have symptoms affecting their thought process after taking a blow to the head should not return to the same practice, game or contest and should be evaluated by a physician prior to return to play.
Yawn! School Starts Too Early for Teens, CDC Says M
ost U.S. middle and high schools start the day around 8 a.m., which public health officials consider too early for teens, according to a new report from the Centers for Disease Control and Prevention. School start times that are too early can contribute to lack of sleep among teens, most of whom don’t get the recommended 8.5 to 9.5 hours of shut-eye, the report said. In 2014, the American Academy of Pediatrics (AAP) recommended that middle and high schools start no earlier than 8:30 a.m. “Getting enough sleep is important for students’ health, safety, and academic performance,” Anne Wheaton, an epidemiologist in CDC’s Division of Population Health and co-author of the agency’s new report, said in a statement. “Early school start times, however, are preventing many adolescents from getting the sleep they need.” The researchers analyzed information from a survey of nearly 40,000 public middle and high schools (and combined schools, with both middle
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and high school grades) given in 2011 and 2012. The average school start time was 8:03 a.m., the study found. Only about one in five middle school students, and one in seven high school students started the school day at the recommended time of 8:30 a.m. or later. However, school start times varied greatly by state. In Hawaii, Mississippi and Wyoming, there were no schools starting at 8:30 a.m. or later, but in Alaska and North Dakota, more than 75 percent of schools started at 8:30 a.m. or later, the report said. Schools started earliest in Louisiana, where the average start time was 7:40 a.m., and latest in Alaska, where the average start time was 8:33 a.m. In New York, the average start time was 7:59 a.m., according to the report. Too little sleep in adolescents is linked with health problems such as obesity, symptoms of depression and not getting enough exercise, as well as poor academic performance, the researchers said. “Among the possible public health
interventions for increasing sufficient sleep among adolescents, delaying school start times has the potential for the greatest population impact by changing the environmental context for students in entire school districts,” the researchers wrote in the Aug. 7 issue of the CDC journal Morbidity and Mortality Weekly Report. Educating parents as well as those who make decisions on school start times about the impact of sleep deprivation on teen health and academic performance “might lead to adoption of later start times,” the researchers said. Other steps that can improve sleep in teens include setting regular bedtimes and waking times (even on weekends), and removing technolo-
gies, such as computers, video games and mobile phones, from teens’ bedrooms. Because the study looked at school start times in 2011 and 2012, it was not able to determine whether some schools had changed their start times in response to the 2014 AAP recommendation.
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Home School Phys Ed To fulfill their children’s physical education requirement, home school parents use a variety of local resources By Deborah Jeanne Sergeant
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ore than 1.7 million kindergarten through 12th grade students received their education at home in 2012, an 18 percent spike since 2007, according to The US Department of Education. The US Department of Education further states that in the 2013-2014 school year, 87,803 of the 3,107,831 school-aged children in New York received their education at home. Home school parents rely upon curriculum workbooks, virtual classrooms or videos for the academic portion of their children’s education. To fulfill their children’s physical education requirement, home school parents use a variety of local resources. Sharon Cosimano of East Aurora home schooled Noah Cosimano-White, 17, and Michael Cosimano-White, 20, since they were in first grade. “We’re not big sports people, so the gym portion [of home schooling] was a big hurdle,” Cosimano said. The Cosimanos turned to a variety of activities to fulfill their PE requirement, including home school co-oper-
Noah Cosimano-White, left, and Michael Cosimano-White of East Aurora enjoyed a variety of activities ative activities, swimming to fulfill their physical education credits while home schooling. at the YMCA, yoga classes, walking, biking and using home gym equipment. “We don’t have a lot of fancy ence. One of the reasons many families “I would change it a lot,” Cosimthings, but some basic things people home school is to spend more time ano said. “They did a municipal class like.” together; however, driving around to during the school year. Whatever they The City of Buffalo Parks Departlessons after school time consumes were interested in and showed interest ment offers youth sports and activities, family time, as do activities that comin, we tried.” including basketball, floor hockey, mit students several days a week and The expense of lessons adds up kickball, volleyball, soccer, flag football, demand weekend participation. for parents paying for classes, such as swimming, tennis, fitness, billiards and “We’re juggling work, school and Susan Knowles, who has home educatping-pong, at locations throughout the activities and trying to have a good ed her four children at home in Wilson city. mixture of everything for school in since 2000. Still at home are children Healthy Buffalo Sports & Recrea given week,” Knowles said. “We aged 4, 11 and 16. Her oldest is away at don’t prefer activities late afternoon or ation, South Buffalo Youth Sports, JCC college. of Greater Buffalo, YMCA and churches evening.” The family has tried lessons to like St. Peter’s offer sports leagues and Knowles found Community Edfulfill PE, but found them too costly to activities as well. By joining an organiucation Classes at St. Peter Lutheran continue. zation that offers a variety of activities, Church’s Educational Resource Center “I talked with a local gymnastics home school families can streamline in Lockport in 2006. The church offers group once and tried to get a group their PE efforts, since everyone’s going classes for adults and children Monrate for home school families that join to the same facility, and likely save days and Wednesdays, which include at the same time,” she said. “Studios some money. cardio, presidential fitness challenge, can price themselves out of it if they It also provides children with the various sports and more. don’t try to make it as affordable as “We have a lot of home school fam- opportunity to try different activities they can.” and sports to discover what they like ilies participate,” Knowles said. “They In addition to the cost of lessons, and foster a healthful, life-long enjoyhave a lot of choices in the community the timing of lessons makes a differment of physical recreation. and we feel this fits their needs well.
New Law Allows Students to Self-Manage Diabetes At School
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s parents get ready to send their children back to school this fall, the parents of children with diabetes have more than backpacks and school supplies to get organized — they must also plan for how their children’s diabetes needs will be met while they are at school. This year, thanks to a new state law, children will be permitted to carry diabetes supplies and self-manage their diabetes at school and at any school function. In addition, school staff members may volunteer to be trained to adminPage 14
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ister glucagon in an emergency when a nurse is not present. “The school year is always a stressful time for families of children with diabetes,” said Renee Williams, assistant superintendent of the Honeoye Falls-Lima Central School District and advocacy chairwoman for the American Diabetes Association. “Hopefully this new legislation will reduce some of that stress for families, knowing their children will be able to self-manage their diabetes at school and have emergency back-up care in the event that a nurse is not available.”
Under the new law, students who have obtained parental consent and written permission from a physician or authorized medical provider may carry and use diabetes supplies, equipment and food to treat hypoglycemia during the school day, on school property and at any school function. The new law also allows unlicensed staff in both public and private schools to be trained to administer glucagon when a nurse is not present. Severely low blood sugar is very serious. If it happens, loss of consciousness may occur and a person may be
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2015
physically unable to eat or drink a rapid-acting source of sugar (glucose) to restore proper glucose levels. A glucagon injection would be necessary in this type of emergency. In a news release, the American Diabetes Association states that it fought hard to have these issues addressed in state law and has posted additional information on its website. For more information, visit www. diabetes.org/nyschools.
Men’sHealth Men, Too, Are Affected by Eating Disorders One-third of the approximately 30 million people struggling with eating disorders are men By Deborah Jeanne Sergeant
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ost people think only young women concerned about a slim appearance experience eating disorders. Fact is, one-third of the approximately 30 million people struggling with eating disorders are men, according to the National Eating Disorders Association. “Men can have just as much difficulty with an eating disorder as women,” said Francesco Giardina, registered dietitian with SMART Nutrition by Frank in Williamsville. “Sports play a role, if it’s a sport where weight is a factor [for success] and men have issues with body image. It’s not gender specific.” Typically, most eating disorders occur in younger people, although no age is immune. The reasons behind the eating disorders differ between the genders. Among young women, obsession with appearance and low weight drives many to eating disorders. Many men who develop eating disorders do so from involvement in certain sports. While there’s some truth to the fact that a lighter body will result in a faster run time than a heavier one, a competitive person who wants to excel can easily fall into an eating disorder if other factors come into play. “If you can control food, you can feel like you can control one area of your life,” said Nicole S. Urdang, mental health counselor practicing in Buffalo. This is especially true if other areas of life seem out of control. Ironically, the eating disorder can make a man’s life more out of control as it isolates him from family members and friends, even though he uses it as a coping mechanism. “Many people cope with mental disorders by developing eating disorders,” said physician Rich Kreipe, medical director of the WNY Comprehensive Care for Eating Disorders (www. nyeatingdisorders.org) in Rochester, which serves 30 counties in Upstate, including Erie and Niagara. “It’s not a mental illness but a developmental illness. They may feel like they can’t control anything, see ads for weight control products, and say they can do that on their own. It’s a sense of accomplishment that they cannot eat when everyone around them is eating.” Typically, overweight people trying to drop pounds or athletes who want to perform better feel content once they reach their goals. People with an eating disorder, however, never “arrive” at the ideal body, according to the experts interviewed for this story. Males often focus on bulking up, if they’re football players or bodybuilders, so it’s not always about getting
light but cutting bodily fat and building muscle in unhealthy ways. This can include excessive protein consumption or eliminating fat from the diet. Eating disorders can cause nutritional deficiencies, lifelong health issues and, left untreated, death. Addressing possible eating disorders in a confrontational manner invites resistance. But urgency may be warranted. Instead of trying to diagnose, parents should express concern about nutrition and observable health indicators, like lack of energy. Suggest arranging a physical as a subtle approach for a person not in immediate danger. Or that visiting a medical provider can help his sports performance. Remind the athlete that losing too much weight can actually detract from his performance if he loses too much muscle tissue and nutrients. Asking the coach for help may backfire, as not all coaches are up to speed on nutrition as it relates to health. Some fall into the trap of telling their athletes what to do to get the results they want instead of how to become healthy to perform their best. “Kids look at a coach like a god but[the coach] should team up with a sports-specific dietitian to help prevent eating disorders” Giardina said. “Stick to what you know best, your sport, and get the right support to see [success] happen.”
Does Your Kid Suffer from Eating Disorder? Could your son have an eating disorder? Nicole S. Urdang, mental health counselor practicing in Buffalo, offered a few signs to look for: • “The teen will be obsessed and extreme. • “He will be on a super-strict diet and shun anything he’s not supposed to eat. • “Or, he’ll eat an ice cream cone and go throw up, take a laxative or go run around the block 20 times. • “Look for changes like dropping a lot of weight at an alarming rate or gaining a lot of weight. • “He may be complaining of headaches or appear lethargic. • “You may see a change in mood. • “He may have a preoccupation with his weight for sports. • “He may use a ‘sensitivity’ to food to mask an eating disorder.”
Seek good sources of nutritional information such as from a registered dietitian or physician. Many commercial websites offer information that’s
stilted to sell a product. Instead, seek academic sites, such as the website of the Academy of Nutrition and Dietetics.
New Incisionless Surgery to Treat Enlarged Prostate 8-minute procedure relieves urinary symptoms, preserves sexual function
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y age 60, more than 50 percent of men in the United States suffer from benign prostatic hyperplasia (BPH), a condition that leads to annoying changes in urinary flow. While medical therapy is usually the first line of treatment, a new minimally invasive implant can dramatically reduce symptoms for men. “This is a safe procedure for men with BPH to improve urination while preserving sexual function,” said Mike Hsieh, urologist at UC San Diego Health System. “This endoscopic procedure is done on an outpatient basis under light sedation with virtually no side effects.” The prostate is a walnut-sized gland that sits below the bladder. When the prostate becomes enlarged, it can restrict or block urine flow caus-
ing interrupted or weak urine stream, leakage, urge incontinence and more frequent urination, especially at night. “More than half of all men in their 60s and as many as 80 percent of men in their 70s and 80s have some symptoms of BPH,” said Hsieh. “This is an excellent alternative to traditional surgeries that require removal of prostate tissue, which can cause complications such as erectile and ejaculatory dysfunction.” The implant is comprised of a series of tiny permanent sutures that lift the enlarged prostate open so that it does not interfere with the urethra or bladder anatomy. The implants are delivered through a hollow needle and into the prostate. No urinary catheter is needed post-procedure. Side effects may include burning and blood in the
September 2015 •
urine during the first 24 hours after the procedure. The device, called UroLift, was FDA approved in 2013. UC San Diego Health System showcased this new procedure in a live-surgery during the 8th annual UC San Diego School of Medicine urology postgraduate course. Hsieh specializes in male fertility and men’s health. He treats sexual dysfunction, including low testosterone, erectile dysfunction and Peyronie’s disease. He is also a recognized expert in treating male infertility, including ejaculatory disorder, hormone imbalance, sperm production impairment and genetic causes of infertility. To learn more about urological care at UC San Diego Health System, visit health.ucsd.edu/specialties/surgery/ urology
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ancer can affect any one of us, at any time. Sadly, thousands of people under the age of 20 are diagnosed with cancer every year, and it remains the leading cause of disease-related death for children. In September, we honor the strength and courage of children who are battling the many forms of cancer, as well as the young Americans who have lost their lives to these terrible diseases. Social Security provides benefits for children who suffer from many disabling diseases, including some forms of cancer. These benefits could help with the additional costs of caring for an ill child. The Supplemental Security Income (SSI) program pays benefits to disabled children who have limited income and resources. If you wish to apply for benefits for your child, you’ll need to complete both an application for SSI and a child disability report. The report collects information about your child’s disabling condition, and about how it affects his or her ability to function. Here are the steps to apply. • Review the child disability starter kit. This kit answers common questions about applying for SSI benefits for children, and includes a worksheet that will help you gather the information you need. You can view the starter kit at www.ssa.gov/disability/disability_starter_kits_child_eng.htm. • The SSI program is a “needsbased” program for people who have low family income and resources. SSI
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Q: I heard that my disability must be expected to last at least one year to qualify for Social Security disability benefits. Does this mean I have to wait until I’ve been disabled an entire year before applying for disability? A: No. If you believe your disability will last a year or longer, apply for disability benefits as soon as you become disabled. Processing your application can take an average of three to five months. If your application is approved, we’ll pay your first Social Security disability benefits for the sixth full month after the date your disability began. For example, if your state agency decides your disability began on Jan. 15, we’ll pay your first disability benefit for the month of July. We pay in the month following the month for which benefits apply, so you’ll receive your July benefit payment in August. For more information about Social
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2015
has strict limits on the amount of income and assets you can have and still be eligible for SSI. Contact Social Security right away to find out if the income and resources of the parents and the child are within the allowed limits, and to start the SSI application process. • Fill out the online child disability report. At the end of the report, we’ll ask you to sign a form that gives the child’s doctor(s) permission to give us information about his or her disability. We need this information to make a decision on your child’s claim. You can access the child disability report at secure.ssa.gov/apps6z/i3820/main.html. Social Security also has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that they obviously meet our strict disability standards. Social Security’s compassionate allowances program enables us to identify diseases and other medical conditions quickly that invariably qualify under the listing of impairments based on minimal objective medical information. The compassionate allowances list allows Social Security to identify the most seriously disabled people for allowances based on objective medical information that we can obtain quickly. Compassionate allowances is not a separate program from the Supplemental Security Income program. You can learn more about compassionate allowances at www.socialsecurity.gov/ compassionateallowances. No matter what month it is, Social Security is here to provide benefits those with severe disabilities. If you or anyone in your family needs assistance, visit www.socialsecurity.gov/disability.
Security disability benefits, refer to our publication, “Disability Benefits,” at www.socialsecurity.gov/pubs. Q: How do I apply for disability benefits? And, how long does it take to get a decision after I apply for disability benefits? A: You can apply for disability benefits online at www.ssa.gov/disabilityssi/apply.html. To get a decision on your disability application usually takes three to five months to. The time frame can vary depending on • The nature of your disability; • How quickly we can get your medical evidence from your doctor or other medical source; • Whether it’s necessary to send you for a medical examination; and • Whether we review your application for quality purposes. Learn your claim status at www. socialsecurity.gov/claimstatus.
H ealth News ECMC wins national nursing excellence award Zynx Health, part of the Hearst Health Network, recently named Erie County Medical Center the winner of one of six inaugural national awards of excellence for nurses who advance care through clinical decision support tools. Zynx recognized Erie County Medical Center for process improvement. Specifically, the first Clinical Improvement Through Evidence Award [CITE] honored registered nurses Bill Arnold, Lynn Whitehead and Nicole Knox. This nursing team created a replicable and sustainable process to consistently improve and update its evidence-based plans of care. The plans of care are closely monitored to meet the highest standards and outcomes are reported monthly for process improvement. More than 97 percent of the plans of care were initiated and updated to reflect changes in patient condition. Appropriate outcomes were identified and prioritized based on assessment data approximately 97 percent of the time. “This is a great testament to all our nurses, and specifically this team of clinicians, who strive daily to provide true care to our patients,” said ECMC CEO Richard C. Cleland. “This award is about measurable results and sus-
tained improvements in the process of caring for our patients. This reinforces the strides we’re making at ECMC.” Zynx Health is the market leader in providing evidence and experience-based clinical improvement and mobile-care coordination solutions. The annual CITE award, given for the first time in 2015, recognizes nurses for excellence in the use of clinical decision support solutions to drive improvements in patient care. “It was a difficult process choosing our CITE winners from so many impressive submissions,” said Grant Campbell, senior director for nursing strategy and informatics at Zynx Health, “Each nursing professional and team demonstrated remarkable achievements. We’re excited to recognize and congratulate them all for their excellent work using clinical decision support to deliver measurably improved care to their patients.”
WCHOB Fetal Care Center makes medical history The Fetal Care Center at Women & Children’s Hospital of Buffalo became the first facility in the world to use doxycycline, a type of antibiotic, to treat a fetus diagnosed with a rare congenital abnormality called chylothorax.
By Jim Miller
Dear Almost, The best Medicare options for retirees who travel extensively depends on your destination. Let’s start with a quick review of the different coverage choices Medicare offers beneficiaries today. One option is Original Medicare, which has been around since 1966, and covers (Part A) hospital services and
director of the Perinatal Center of Western New York and co-director of the Fetal Care Center at Women & Children’s Hospital of Buffalo. In the past, chylothorax would typically be treated by placing a shunt into the fetal chest using a metal trocar to pierce the chest and thread a plastic catheter through the center of a tube and into the chest. One end of the catheter would sit in the chest and the other end would sit in the amniotic fluid to create a permanent drain for the fluid out of the chest. “It’s a fairly morbid procedure because of the tools used and the risk of infection. It’s also common for the fetus to pull the drainage tube out prior to delivery,” explained physician Johnson. Jody Lomeo,president and CEO of Kaleida Health said, “We are so proud of Dr. Johnson and the team at the Fetal Care Center. Today’s announcement is yet another example of the tremendous work that the physicians, nurses, and staff do every day at Women & Children’s Hospital. The beneficiary of their work is our community.”
free Medicare counseling — call 800677-1116 for contact information. You can also shop and compare Medicare health and drug plans and Medigap policies at Medicare.gov/ find-a-plan, or call 800-633-4227. Also note that whatever Medicare plans you choose to enroll in, if you find that they are not meeting your needs or your needs change, you can always switch to a different plan during the open enrollment period, which is between Oct. 15 and Dec. 7.
prescription drugs purchased outside the U.S. either. But, there are some Medigap policies that do provide limited coverage abroad. Medigap C, D, F, G, M, and N plans will pay for 80 percent of medically necessary emergency care outside the U.S., but only for the first 60 days of the trip, and you have to meet an annual $250 deductible first. There’s also a lifetime maximum benefit of $50,000, so you’d need to cover any costs above that amount. If you have a Medicare Advantage plan, your coverage outside the U.S. will depend on the plan. Some plans offer emergency care coverage while others don’t. You’ll need to check your plan for details. If you want additional emergency medical coverage when traveling abroad, some good shopping sites are squaremouth.com and insuremytrip. com, which compare policies from major travel-insurance companies. Prices vary considerably, ranging from under $100 to several hundred dollars depending on your age, what they cover and how long you’ll be away.
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Medicare Options for Retirees Who Travel Dear Savvy Senior, What are the best Medicare coverage options for retirees who travel a lot? Almost 65
The procedure occurred late last month at the hospital. The patient, Jamie Reid, who is 32 weeks pregnant and was due Oct. 3 with her second son, is doing well. Reid was at a regularly scheduled sonogram when her obstetrician noticed some abnormalities on the sonogram and referred her to the Fetal Care Center. “My husband and I were both very scared. We didn’t know what was causing it or what the outcomes would be. We really didn’t know too much until we got to the Fetal Care Center,” Reid said. Initially diagnosed with excess amniotic fluid (polyhydramnios) and bilateral pleural effusions (an abnormal amount of fluid around the fetus’s lungs), maternal-fetal medicine specialists at the Fetal Care Center immediately performed a tap of the baby’s chest to remove the fluid. Biochemical testing on the fluid confirmed that the baby was suffering from chylothorax, a congenital abnormality of the thoracic duct, which causes lymphatic drainage from the gastrointestinal tract in the lower half of the body to drain into the chest, compressing the lungs and causing the heart to shift. “The diagnosis is quite rare. We only see one case every three to five years,” said physician Jeffrey Johnson, chief of maternal-fetal medicine at the University at Buffalo and medical
(Part B) doctor’s visits and other medical services. If you choose Original Medicare, you may also want to get a Medicare (Part D) prescription drug plan (if you don’t already have coverage) to cover your medication costs, and a Medicare supplemental (Medigap) policy to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles. Or, you could get Medicare Advantage (Part C) plan, which is sold through private insurance companies, that covers everything Original Medicare covers, plus many plans also offer prescription drug coverage and extra services like vision, hearing and dental care all in one plan. To help you evaluate your options, the National Council on Aging offers an online tool at MyMedicareMatters. org, and your State Heath Insurance Assistance Program (SHIP) provides
If you and your husband are planning to travel domestically, Original Medicare provides coverage everywhere in the U.S. and its territories (this includes all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa) as long as the doctor or hospital accepts Medicare. But if you have a Medicare Advantage plan, your coverage may be restricted. This is because most Medicare Advantage plans (which are usually HMOs or PPOs) require you to use doctors, hospitals and pharmacies that are in the plan’s network within a service area or geographic region. So if you’re traveling outside that area, you may need to pay a higher fee, or your services may not be covered at all. Before enrolling in a Medicare Advantage plan, check the benefit details carefully to see what costs and rules apply when traveling outside your service area.
Traveling Abroad
If you’re planning to travel abroad, Original Medicare does not provide coverage outside the U.S. including cruising, except in rare cases, and Medicare drug plans will not cover
September 2015 •
Maternal-fetal medicine specialist joins WCHOB Physician Pai-Jong Stacy Tsai has been appointed maternal-fetal medi-
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Health News cine specialist at Women & Children’s Hospital of Buffalo (WCHOB). Maternal-fetal medicine provides comprehensive care and birth planning for high risk or complicated pregnancies, including genetic counseling, prenatal screening and diagnosis. Specialists help ensure best outcomes for both the mother and fetus throughout pregnancy. Tsai received a medical degree from New York Medical College, School of Medicine and went on to complete a residency in the department of obstetrics and gynecology and a fellowship in the division of maternal-fetal medicine at the University of Hawaii, John A. Burns School of Medicine in Honolulu. She also holds master’s degrees in Tsai public health and clinical research. Tsai is a member of the American Congress of Obstetricians and Gynecologists and has authored a number of publications on obesity in pregnancy, racial/ethnic disparity in women’s health and hepatitis B in pregnancy. Tsai joins a team of board certified maternal-fetal medicine specialists at WCHOB in the Regional Perinatal Center of Western New York and the Fetal Care Center.
Eye surgeon retires after 40 years of service Faruk M Koreishi, a nationally recognized eye surgeon from North Buffalo has retired after 40 years of service. The first physician in the Western New York area who restricted his practice to diseases and surgery of vitreous and retina — repair of damaged vitreous and retina in the back of the eye —Koreishi established the Retina Consultants of Western New York in 1975. Today the practice consists of four other retina specialists, who will be taking over the care of Koreishi’s patients. Among his many accomplishments, he performed vision-saving surgery on former Buffalo Mayor Anthony Masiello in 1999. If left untreated, Mayor Masiello would have likely lost his vision. He has also treated professional boxers, artists, and coaches from Buffalo professional sports teams. Through his technical skills as a surgeon, Koreishi has helped thousands of people in Western New York maintain and improve their eyesight. Koreishi is a nationally renowned fellow of the American College of Surgeons. He is a member of the New York State Medical Society, Erie County Medical Society, the American Academy of Ophthalmology, and the Buffalo Ophthalmology Society. He has served as the president for the Asian Ameri-
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cans Physicians’ Association (AAPA), and the WNY Ophthalmology Society. He is also an active member of the Islamic Society of Niagara Frontier, the Family Justice Center, and the Coalition for the Advancement of Muslim Women. Over the years, he has been recognized on several occasions for his distinguished contributions to the Koreishi healthcare industry. He received the 2014 Ross Eye Institute Community Ophthalmologist of The Year Award, and in 2012, he was awarded Physician of the Year by the Asian American Physicians Association. He was also presented a human services award from the Muslim Public Affairs Council.
Kaleida wants your input on reuse process of Women & Children’s Hospital The reuse process for Women & Children’s Hospital of Buffalo continues to progress and Kaleida Health is now seeking community feedback as it prepares to release request for proposals for the Bryant Street campus. Nearly two dozen neighbors and community leaders have been meeting throughout the summer to formalize the campus reuse strategy. This cross-section of community members make up the Project Advisory Committee (PAC), which is designed to give Kaleida Health advice and counsel about redevelopment of the hospital. To date, the committee has developed a statement of community values as well as considerations for the request for proposal (RFP). Interested neighbors and community members are encouraged to visit Kaleida Health’s website on the reuse process to offer feedback on these documents as well as the overall reuse process: www.kaleidahealth.org/Childrens/reuse/. Kaleida Health has been working with the project advisory committee and on the reuse process for almost two years now. “We are committed to an open dialogue and transparent decision-making process regarding the reuse of Women & Children’s Hospital of Buffalo,” said Michael P. Hughes, senior vice president for Kaleida Health. “We understand the concerns of immediate neighbors, community leaders, and citizens in general, that the reuse of this property should contribute to the positive development and quality of life around the hospital.” Kaleida Health will issue the formal RFP to the local and national development community shortly after Labor Day. The Oishei Children’s Hospital, which is currently under construction on the Buffalo Niagara Medical Campus, will open in late 2017 and replace the nearly 125-year old Bryant Street facility. The Women & Children’s Hospital of Buffalo property is comprised of seven interconnected buildings constructed between 1917 and 1995, and encompassing approximately 617,000 square feet on a site between Bryant Street and Hodge Avenue. The campus also includes a second parcel of more than two acres — one block away on West Utica Street now used mostly for parking, and another parcel on Hodge Avenue.
The Healing Power of Horses Western New York offers several facilities that partner with horses to help people — and many have found relief in working with the animals By Deborah Jeanne Sergeant
M
any in Western New York enjoy horses as recreational and competitive companions but a growing number of people are using them for therapy purposes. Experts say that the bond created between client and horse achieves results not possible otherwise. Therapeutic/adaptive riding refers to using groundwork or riding to help people with social problems, developmental delays, behavioral health or physical impairment improve their lives. Hippotherapy represents a medical treatment overseen by a professional such as a physical, occupational or speech therapist who possesses further training in using horses for hippotherapy. The Western New York area offers several facilities that partner with horses to help people. One of these is Buffalo Therapeutic Riding Center, Inc., which serves children aged 6 to 18 who have different types of disabilities. Susie Schoellkopf, executive director, said that the organization’s goal is to “have the child be confident in what they’re doing and make strides and have a better way of life when they’re done with the four-week session.” Four instructors certified by Professional Association of Therapeutic Horsemanship International (PATH) lead lessons at Buffalo Therapeutic Riding Center, which features an indoor riding arena. The center uses 16 horses in its programs, which run from May to November on Monday afternoons. Schoellkopf said that equine-assisted activities are becoming more recognized on the national level. “More research is showing it helps people,” Schoellkopf said. “We want everyone to know that we are helping people and serving needs here.” Beyond experiencing the fun of riding, clients benefit in many ways from equine assisted activities. “It involves a lot of core strength, balance, hand/eye coordination and builds self esteem,” Schoellkopf said. “When they ride a horse, it works every muscle in their body that normally wouldn’t be worked.” The horse’s gait, for example, mimics a human’s and gives the feeling of ambulation to someone who has never walked. That, combined with improving balance and core and leg strength, has helped some clients improve their ability to walk. Clients also must learn to follow directions and, in time, feel pride in controlling a large animal’s movements with ease. The center also serves kids who are disadvantaged or have emotional problems. Sarah Pictor, a clinical associate professor in the physical therapy department of D’Youville College, works to promote hippotherapy because of the unique benefits it offers clients.
From the horse’s human-like gait, to the animal’s bodily warmth that relaxes riders’ muscles, to the stretching caused by riding astride, horses represent excellent partners to hippotherapists. “Our therapeutic horses are very gentle,” she said. “They know the children have special needs.” Pictor helped establish D’Youville College’s Lost Elms Therapy Services: Great Opportunities (LET’S GO!) in 2008. The program became the only college-endorsed hippotherapy program in the nation.
Four years after its founding, Lothlorien Therapeutic Riding Center in East Aurora (www.lothlorientrc. org) began administering the program, renaming it Lothlorien TRC Therapy Services. Lothlorien provides therapeutic/ adaptive riding also. Ten horses serve in the organization’s programs. Many organizations involved in equine assisted activities depend upon volunteers to keep their programs running. If you enjoy horses and helping people, consider lending your time to benefit others.
Buffalo Therapeutic Riding Center, Buffalo: “More research is showing [Hippotherapy] helps people. We want everyone to know that we are helping people and serving needs here,” said Susie Schoellkopf, the organization’s executive director.
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Optimum Physician Alliance (OPA), a wholly owned subsidiary of Kaleida HealthNow, Inc., is a physicianled network comprised of primary care and specialist physicians who are committed to providing highquality efficient health care to ensure patients receive the appropriate care, at the appropriate time, with the appropriate provider across the continuum of care. OPA’s mission is to achieve clinical collaboration among physicians and continuously improve the quality of care provided to patients, while simultaneously controlling the costs of healthcare services provided. www.opawny.com For additional information contact Meri Nataro 716-887-7015 Page 20
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2015