in good December 2015 • Issue 14
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Buffalo & WNY’s Healthcare Newspaper
STD
Niagara Falls physician developing reputation for successful outcome in high-risk surgeries, acid reflux disease treatment
Is This Toy Safe?
Teens are waiting longer to engage in sexual relations, yet number of sexual transmitted diseases in Western New York continues to rise
Nearly 150,000 children become injured while playing with toys every year. Be careful before you buy your next toy
Holiday Blues Yoga improves arthritis symptoms, mood. Says who? Researchers at Johns Hopkins
Gwenn Voelckers
It’s supposed to be the most wonderful time of the year, but for some people, the holiday season brings just the opposite: stress, sadness and anxiety. But why? And how to beat the blues. INSIDE
‘Thoughtful Gift Ideas for Those Who Live Alone’
SmartBites: Why Beef Deserves a Shout-Out
High Blood Pressure Nearly half of Americans don’t control it, according to a recent CDC report December 2015 •
Holiday Giving
Looking for something to give? We’ve asked local merchants about the ideal holiday gift you should buy
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Nearly Half of Americans With High Blood Pressure Not Controlling It: CDC
Big part of the problem is getting people to take medications, stick with them, experts said
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early half of Americans with high blood pressure are not properly controlling their condition, increasing their risk of heart attack, stroke and heart disease, a new government report shows. About 47 percent of people with high blood pressure have not brought their numbers to a normal range, through either lifestyle changes or medications, according to data published Nov. 12 from the U.S. Centers for Disease Control and Prevention. That’s actually a huge improvement: Back in 1999, more than 68 percent did not have their blood pressure under control, the report found. But it’s far short of the federal Healthy People 2020 goal, which calls for fewer than 40 percent of people with high blood pressure to have it uncontrolled by that date, according to the CDC researchers. Experts agreed that the problem is still significant. “I don’t think we have enough positive information to be cheering,” said physician Patrick O’Gara, executive medical director of the Carl J. and Ruth Shapiro Cardiovascular
Center at Brigham and Women’s Hospital in Boston. “Although the trend is positive, the magnitude of the problem is self-evident. We have a lot of work to do.” High blood pressure is defined as 140 or higher systolic pressure (the top number) and 90 or higher diastolic (the bottom number). Systolic is the pressure of blood in the vessels when the heart beats, and diastolic is the pressure between beats. The overall rate of high blood pressure in the United States has remained constant, hovering between 28 percent and 29 percent, the new report found. Two in three people over the age of 60 have high blood pressure, and one in three people between the ages of 40 and 59 have the condition. What improvements there have been in controlling high blood pressure have not benefited all groups in the United States. Whites are most likely to have their blood pressure under control, close to 56 percent, the CDC report showed. Blacks (48 percent under control), Asians (43 percent) and Hispanics (47 percent) are all more likely to be living with uncontrolled high blood pressure. A large part of the problem is getting people to start taking blood pressure medications, and then to stay with them, said physician
Richard Stein, director of the Urban Community Cardiology Program at the New York University School of Medicine. “Patients don’t like to take drugs,” Stein said. “I don’t like to take drugs. Drugs that don’t have an
obvious beneficial effect for me, it’s easier for me to forget to take them.” High blood pressure is called the “silent killer” because people often have no immediate symptoms. Prescribing medication to a person who feels well can be difficult, Stein said.
One in 45 US Kids Has an Autism Spectrum Disorder
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bout one in 45 children in the United States has an autism spectrum disorder, according to a new government estimate of the condition’s prevalence in 2014. This new report is based on data collected during the yearly National Health Interview Survey, from interviews of parents about their children, and is the first report of the prevalence of autism in the U.S. to include data from the years 2011 to 2014, according to the researchers from the Centers for Disease Control and Prevention (CDC). Although the new estimate looks like a significant increase from the CDC’s previous estimate — which put the autism spectrum disorder rate at one in 68 children — the previous estimate was made using data from a different CDC survey, called
the Autism and Developmental Disabilities Monitoring Network, which gathers information from children’s medical records. This one-in-68 estimate was reported in 2014, but was based on data collected during 2010. None of the interview surveys and monitoring methods that report increasing prevalence rates of autism in the U.S. looked at why these numbers seem to be rising. But one reason could be that awareness of the condition has increased among both parents and health care providers, which has likely led to more children with the condition being identified, said Robert Fitzgerald, an epidemiologist in psychiatry at the Washington University School of Medicine in St. Louis, who was not involved in the research.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2015
Teens, Sex & STDs
Finally.
Closure to my leg pain and varicose veins.
Rates of gonorrhea, Chlamydia and syphilis are all going up in WNY but figures show teens are waiting longer to engage in sexual relations
There is a solution to the discomfort, swelling and appearance of varicose veins.
By Deborah Jeanne Sergeant
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ationwide, fewer of today’s teens engage in sexually activity than those of 25 years ago. “Nationally between 2011 and 2013, 44 percent of female teenagers and 47 percent of male teenagers aged 15 to 19 had experienced sexual intercourse. The percentage has declined significantly, by 14 percent for female and 22 percent for male teenagers, over the past 25 years,� said Shari L. Curry, community educator with Kaleida Health Family Planning in Buffalo. National data also shows that 79 percent of female teens and 84 percent of males used a method of contraception the first time they had sexual intercourse. Since the condom is the most common form of contraception used by teens, those using condoms greatly reduce their risk of contracting STDs. Despite these trends, people aged 15 to 24 represent about half of the estimated 20 million new cases of STDs annually in the nation. Locally, community health educators still see far too many STDs among the area’s teens for a variety of reasons, including decreased condom use and non-traditional sexual contact. Jacquelyn Andula, a registered nurse and medical care administrator for Erie County Department of Health, said that the clinic is seeing higher rates of gonorrhea than it used to and that Chlamydia cases have increased slightly. “The biggest increase we’re seeing is a pretty significant increase in syphilis,� Andula said. The Erie County Department of Health Epidemiology/Disease Control Program states that the reported cases of early syphilis increased from 33 in 2012 to 58 in 2014. Chlamydia increased from 4,897 to 5,025 from 2013 to 2014. Andula said that increased concern over unwanted pregnancy prevention has contributed to the increase in STD cases for some teens. “Long-lasting methods [of contraception] are what teens are looking for, like implants and IUDs,� she said. “Teens especially forget to take medication, like The Pill. Long-lasting methods prevent pregnancy but it gives no protection against STDs.� Teens perceive unwanted pregnancy as a more imminent threat than STDs since they likely attend school with teen who are parents. But few discuss STDs with their peers or even know who among them has been infected. Another factor in the local increase in STDs has to do with teens’ misconception that only traditional sexual contact spreads STDs when actually, anal and oral contact can also transmit infections. Skin to skin contact without actual intercourse
can spread some STDs, irrespective of condom use because condoms do not cover all of the affected tissues. The Centers for Disease Control states on its website, “Consistent and correct use of male latex condoms can reduce (though not eliminate) the risk of STD transmission.� One reason is that people don’t always use condoms correctly. Also, sometimes condoms break. “The most reliable ways to avoid transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), are to abstain from sexual activity or to be in a long-term, mutually monogamous relationship with an uninfected partner,� The Centers further states. “However, many infected persons may be unaware of their infections because STDs are often asymptomatic or unrecognized.� Andula encourages parents of teens to try to help the young people feel comfortable about discussing sex so that they receive accurate information. Initiating the conversation themselves also empowers parents to help instill the values they want their teens to share. But many parents find the subject awkward, especially if they fear the conversation may cause greater interest in sex. “It would be great if parents talked with their kids about this,� Andula said. “There’s nothing wrong with a parent saying to his kid, ‘I really wish you would wait,’ but give them another option because the reality is many won’t. I think about HPV and herpes and the ones you can’t cure.� Though most parents probably wish their teens would wait, the experts think that it’s not likely to pan out that way. “Abstinence-only-until-marriage [programs] have been around for well over 25 years, and yet there are still no published studies in peer-reviewed journals that shows that these programs are effective,� Curry said. “In fact, there is mounting evidence that these programs simply don’t work.� A television show, movie or news story that touches on STDs may help parents raise the subject without sounding too personal, which can backfire and cause teens to clam up. By explaining the possible consequences of intercourse, parents can arm teens with the information they need to choose wisely and keep themselves safe. “Messages to teens should always include abstinence, but no studies show that abstinence-only programs work,� Andula said. “We always encourage limiting the number of partners, knowing their status and knowing your status. Abstinence is an option and we hope it’s one that they choose but we’re realistic.�
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December 2015 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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CALENDAR of
HEALTH EVENTS
Medical Milestones in 2015 By Deborah Jeanne Sergeant
The year 2015 brought many medical discoveries and trends. These represent just a few. The Pink Pill This year, the FDA approved Addyi (flibanserin), the first medication to treat generalized hypoactive sexual desire disorder (low libido) in premenopausal women. Sprout Pharmaceuticals, based in Raleigh, N.C., manufactures the prescription medication. Despite Addyi’s relatively low success rate (women reported only one additional sexual experience per month during its trials) and its contraindication for women who drink alcohol, the very development of such a drug acknowledges the importance of women’s sexual health and should help spur more research in the area.
New Antibiotic For the first time in a decade, a new antibiotic was discovered. Researchers have found that teixobactin possesses the ability to clear up life-threatening infections in laboratory animals without the disease resistance response that emerges with other antibiotics. So-called “super bugs” may not be so super anymore. Though not yet FDA approved, the discovery could prove lifesaving for the antibiotic-resistant infections that kill more than half a million people annually.
Hope for a Muscular Dystrophy Cure Researchers at the University of Missouri have developed a gene therapy that in lab animals has treated muscles affected by muscular dystrophy. The scientists use a common virus to deliver a microgene to each muscle in the body to stimulate the production of dystrophin, a protein inherent to the body that regenerates muscle tissue. The therapy evidences no side effects.
Drug Delivery Robots These aren’t drones delivering prescription bottles to patient’s homes, but miniscule robots that deliver medication inside the body. They can target specific areas — such as cancerous tumors — and deliver Page 4
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medication such as chemotherapy drugs 1,000 times more powerful than those currently used without so many side effects. By pinpointing the places in the body needing treatment, the robots can improve the patient’s chance of beating the disease. The discovery may lead to microrobots that can perform other tasks such as clotting wounds, killing bacteria and more.
Whole Body Transplantation Italian surgeon Sergio Canavero of the Turin Advanced Neuromodulation Group announced he plans to perform the first transplantation of a donor body onto the head of volunteer Valery Spiridonov. The 30-yearold scientist from Vladimir, Russia, has Werdnig-Hoffman disease. The genetic disease causes muscle wasting and patients eventually lose the ability to perform activities of daily living. Canavero believes the 36-hour surgery should require about 150 surgeons and nurses and cost about $11 million. Slated for 2017, Canavero’s groundbreaking and ethically questionable surgery involves a myriad of difficult and likely impossible procedures to connect a living head to a donated body and then revive the body. Canavero hopes to raise more discussion on transplantation ethics and possibilities while researching his project.
New Breast Cancer Drug Pfizer Pharma introduced Palbociclib (Ibrance) in February. The CDK4/6 inhibitor for breast cancer, paired with Letrozole, is meant for postmenopausal women with certain types of breast cancer. The drug works so well that the FDA gave it priority review designation in late 2014. The company predicts that sales of the drug should reach $3 billion annually within five years.
Dec. 2
Dec. 2
Club offers free crosscountry lessons
Center presents ‘The Sounds of The Season’
Interested in learning more about cross-country ski and other ways to enjoy Western New York winters? The Buffalo Nordic Ski Club will hold its annual open house from 7:30 – 9:30 p.m., Dec. 2, in the Wick Center of Daemen College, 4380 Main Street, Amherst. The event is free and open to the public. No reservation is needed. Among the many highlights of the evening will be a video covering cross-country skiing for beginning to advanced skiers, waxing clinics, displays of equipment and clothing from area ski shops, door prizes and much more. Buffalo Nordic Ski Club is Western New York’s only club that focuses on promoting cross-country skiing in the greater Buffalo area. The club is very active and provides for members many exciting trips, weekly ski tours, ski lessons and much more. For more information visit www. buffalonordic.org.
Win a Free Pair of Hearing Aids Hearing Evaluation Services of Buffalo (HES) is sponsoring the 2015 Good to Hear Giveaway. Western New Yorkers can nominate any friend or family member with hearing loss to receive a set of brand new, premium hearing aids. The hearing aids have been donated by last year’s winner, Katie Fish, in conjunction with Oticon USA. Earlier this year, as part of receiving a national award, Fish elected to donate a set of premium hearing aids from hearing aid manufacturer, Oticon USA. HES will accept nominations until Dec. 11. Nominations consists of story submission (400-word maximum) describing the nominee’s experience with hearing loss and why they
are deserving of a premium set of hearing aids. Nominations must be submitted to HES audiologist Rebecca Wantuck at RWantuck@HESofBuffalo. org. The top nominations will move forward to a voting round by the general public through HES’ Facebook page in mid-December. Stories will be published for the general public to view and vote for their top choice. Hearing Evaluation Services of Buffalo is one of the largest freestanding, nonprofit audiology practices in the country; has locations in Amherst, Williamsville, Orchard Park and Tonawanda. To learn more about HES, visit www.HESofBuffalo.org.
Serving Western New York in good A monthly newspaper published by
Health Buffalo–WNY Healthcare Newspaper
Personalized Medicine In 2105, several types of drugs and treatments became more individualized as physicians and biomendical companies perfect methods of treating depression, heart disease and cancer that meet the person’s needs as determined by genetic analysis. Genetic testing helps guide physicians in making the best choices for that patient’s health while reducing side effects.
The Amherst Center for Senior Services will host the Sounds of The Season featuring “Serendipity Swing.” This big band-style group is an eight-musician ensemble — plus a female vocalist from Buffalo — reflecting a musical style from an era of famous dance halls, glamorous ballrooms and classy supper clubs. The event will take place from 6 – 7 p.m., Dec. 2 at the Amherst Center for Senior Services, 370 John James Audubon Pky., Amherst, behind the Audubon Library. Prior to the event, a dinner will be served from 5 – 6:30 p.m. and will include roast beef on Kimmelwick, horseradish, potato salad, green beans, brownie and coffee/tea. The meal cost is $5 and a sandwich is $3. Payment is due the evening of the event and reservations are preferred by calling 636-3055, extension 3108. Walk-ins are welcome.
Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region
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, Daniel Meyer, Ernst Lamothe, Jr., Katie Coleman, Tim Fenster, Matthew Liptak • Advertising: Donna Kimbrell • 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 – Buffalo & WNY’s Healthcare Newspaper • December 2015
Still Hitting Hard
Group of 25 seniors — ages 62 to 94 — going strong in part thanks to tennis matches By Katie Coleman
A
t Miller Tennis Center on Sheridan Drive, there’s a group of about 25 tennis players ranging from 62 to 94 years old who are leading examples of staying active
John Bannen in ready position at one of his weekly tennis matches
through older age. At 88, Don Sadkowski plays tennis with his buddies twice a week. When he’s not out on the court, he’s oil painting, woodworking, golfing or gardening. “For my age I move around very well. I keep up with the younger guys, have made a lot of friends, and have had a really good experience here,” Sadkowski said. Allan Schutte, 71, ended up at Miller after becoming bored with his gym membership and constantly using a machine to stay in shape. Since he’s started playing tennis twice a week, he’s lost 15 pounds. “This is a bunch of great guys,” Schutte said. “We play year round and are always active.” Lou Pennella, 75, has been going to Miller for 14 years. He’s had a lot of injuries over the years. “Win or lose - it doesn’t matter. I’m just happy to walk on and off the court. Playing with these guys has been a wonderful experience.” At 83, Neil Struebing says that any sedentary elderly folks out there
A group of people at Miller Tennis Center getting ready to face off with their friendly competition. They meet at the center twice weekly to stay active and social. Top left to right: Tom Schlerer, Ray Zielinski, Al Schutte, Duane Hemedinger, Bob Buzby, John Bannen; bottom left to right: Joe DiFalco, Don Sadkowski, Norm Ossenberg, Roger Tunmore, Frank Silvestro, Lou Pennella should try to get out and be more active. He’s been going to Miller for 16 years, and has played tennis for 73 years, starting out at Tonawanda
High School and then playing for the University of Buffalo. “This is about friendship and also staying active and enjoying it,” Struebing said.
Healthcare in a Minute By George W. Chapman
USA is still No. 1
When it comes to the cost of healthcare we’re still No. 1 in the world. In a study by the Commonwealth Fund, comparing costs and outcomes among economically developed countries, the U.S. maintains its No. 1 ranking in cost of care per capita. In 2013, our cost per capita was $9,086. That’s 50 percent higher than the cost per capita of No. 2, Switzerland. Australia, Denmark, Germany, France and Canada were all below $5,000. Japan, the UK and New Zealand were below $4,000 per capita. Again, we are not getting our proverbial bang for the buck. The U.S. did not rank “best” in any of the healthcare outcome measurements such as life expectancy, obesity, infant mortality, etc. Most interesting was the fact we see a doctor an average of four times per year, which was the third lowest among the countries in the study. High deductible plans or lack of insurance may be the reasons why many of us put off seeking care. Sixty-four million Americans reported they have some trouble paying their medical bills, which probably keeps a lot of them from seeking care when they should.
Robot hospital
The first fully digital hospital ($1.7 billion and 656 beds) in North America opened in October in Toronto. In addition to having the most advanced/futuristic technologies and equipment, several areas are served by robots. They transport patients through imaging services, mix chemotherapy drugs in the pharma-
cy, scan drugs to be sure they go to the right patient and deliver medical supplies and food to patients. All of this will surely be coming to your hospital soon.
Women physicians increasing
Thirty-five years ago, only 12 percent of practicing physicians were women. Today, 33 percent of all practicing physicians are women. The 50 percent mark is not far off since 50 percent of medical students over the past few years have been women. Industry observers are anticipating that women physicians will have an increasing impact on healthcare policy, politics, leadership, delivery and payment.
Revolutionary innovations
According to the Cleveland Clinic, we’ve seen these innovations recently: 1. Fast-tracked vaccines. Ebola was nipped in the bud rather quickly thanks to advances in genetic engineering, which gives scientists the ability to quickly target viruses and eradicate them. This will drastically limit the spread of diseases in the future. 2. Genomics. Physicians can target treatments for specific DNA markers of a patient’s disease, getting them into clinical trials matched to their conditions much earlier. 3. Lifelike robotic limbs. You will be able to control them with your mind. However, still being tested and very expensive. 4. Stroke treatment. A tiny wire cage-like device is implanted in blood vessels to catch and remove clots, speeding recovery and increasing the chances of a full recovery from a stroke.
ACA enrollment Health and Human Services estimates about 10 million people will have purchased insurance through the marketplaces in 2015. While officials believe the vast majority will re-enroll next year, HHS isn’t counting on a lot of growth in 2016 for a variety of factors. Individuals drop out when they get employer-based insurance. Some can no longer afford the premiums, even if subsidized. Others are just confused by their plan’s requirements. The biggest factor, however, is that we are down to the “hard core” uninsured or the toughest of the remaining 8 percent to 9 percent still uninsured. The uninsured rate was 17 percent just two years ago.
Population health
As physician and hospital reimbursement transitions away from fee for service to pay for quality or outcome, the emphasis for healthcare providers and their systems will be effective population management of the people for whom they are responsible. According to the director of the Centers for Disease Control, physician Tom Frieden, there is a pyramid model to maximize outcome. The first level of the pyramid is comprised of income, employment, race and education. The second level includes public healthcare interventions like expanded coverage and benefits. The third level includes long-term preventive measures like immunizations and healthy life styles. The fourth level includes clinical interventions for chronic ailments
December 2015 •
like hypertension, depression, obesity and diabetes. Education and outreach efforts are the tip of the pyramid. Frieden maintains the third and fourth levels are the most important for population management.
Advance care planning
Remember “death panels”? This cynical and misleading euphemism was part of the uninformed and hysterical criticism of the Affordable Care Act. Fortunately, six years into the ACA, the term has been dropped because there never were “death panels.” Honest and direct discussions between a physician and patient of the realistic options remaining toward the inevitable end of life are standard of care. Too often “heroic” measures are undignified and simply delay the inevitable. Following the lead of Medicare, most insurance plans pay physicians for “advance care planning” which includes discussing advance directives (DNR, ventilators, feeding tubes, etc.), hospice care and other end-of-life issues confronting the patient and their family. Medicare is very clear that advance care planning is at the discretion of the patient. 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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Married People Fare Better Following Cardiac Surgery Patients who are divorced, separated or widowed had an approximately 40 percent greater chance of dying or developing a new functional disability in the first two years following cardiac surgery than their married peers, according to a new study from researchers at the Perelman School of Medicine at the University of Pennsylvania published at the end of October in JAMA Surgery.
‘Tummy Tuck’ Complications Bring High Risk Factors Abdominoplasty — sometimes called “tummy tuck”— has a higher risk of major complications than other cosmetic plastic surgery procedures, reports a study in the November issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.
Better Sex Lives After Weight-Loss Surgery Both men and women see lasting improvements in their sex lives after bariatric surgery, according to a new study, funded by the National Institutes of Health (NIH) and presented here at ObesityWeek 2015, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity. Findings were presented at a weeklong obesity conference hosted by the American Society for Metabolic and Bariatric.
Weight Loss Apps Alone Might Not Help Used alone, a cell phone app that tracks exercise, calories and weight loss goals is, on average, not enough to create meaningful weight loss in young adults, according to new research from Duke Medicine.
Meet
Your Doctor
By Chris Motola
Bala Thatigotla, M.D. Niagara Falls physician developing reputation for successful outcome in high-risk surgeries, acid reflux disease treatment Q: What kind of surgery do you specialize in? A: I am a general surgeon specializing in bariatric and robotic surgery. Q: You’ve garnered a bit of a reputation as a surgeon who takes on high-risk surgeries who many would shy away from. How did you fall into that role? A: It’s the nature of my training in dealing with complex patients who have obesity or need abdominal reconstruction, or have had massive hernias. There is a lot of risk of complications with those patients, so many surgeons do not want to operate on them. Many patients do not have a lot of options in the local area. So I wanted to help these patients, and I would say it’s my passion now. We’re having very good results. I’m also trying to bring new technologies to this area to help with the management of serious acid reflux disease. Q: So your typical patient is having issues with their weight or digestive system? A: Yes. Part of my practice is weight loss surgeries. I also specialize in minimally invasive approaches, so the recovery time is a lot faster. We do robotic and laparoscopic bariatric surgery. Recent research has clearly shown the efficacy of surgery in treating metabolic issues like high cholesterol, high blood pressure and sleep apnea. We’re also becoming a management center for treating
severe acid reflux disease. Right now, severe acid reflux disease is mainly treated with medications. But longterm use of these medications comes with a big gamut of side effects like kidney disease and cancers that many people aren’t aware of. Acid reflux is actually a mechanical problem, not just a chemical problem. So medication will affect the chemical aspect of it, but not the mechanical problems in the digestive tract that put a patient at risk of acid reflux disease. We’re able to treat both of those things. Surgically, there are options such as fundoplication surgery. For patients with moderate to severe acid reflux, we’re bringing in a new technology called LINX. I believe we’ll be one of the only hospitals in the state to offer it. Q: What do you say to someone who is weighing the risks and costs of surgery for one of these diseases? A: If you are doing a monetary cost-benefit analysis, these surgeries can actually save millions of dollars in follow-up visits and long-term medication costs. The surgery usually ends up paying for itself within three years. They not only improve the quality of life for the patient, but they also help reduce the risks of cancers. As for surgical risks, there is a small risk of leaking, or narrowing of the junction where we do the surgeries. So we have both pre-operative screening and education as well as follow-ups post-op to keep our complication rate low. Our rate
Self-Weighing May Be a Hazardous Behavior Among Young Women Self-weighing can be a useful tool to help adults control their weight, but for adolescents and young adults this behavior may have negative psychological outcomes. Researchers from the University of Minnesota tracked the self-weighing behaviors of more than 1,900 young adults as part of Project EAT (Eating and Activity in Teens and Young Adults) and found increases in self-weighing to be significantly related to increases in weight concern and depression and decreases in body satisfaction and self-esteem among females. Page 6
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2015
of complications is far lower than the national average Q: How much interaction with patients are you able to have? How do you introduce the idea of a new procedure or technique to them? A: We do have a patient education program at the hospital and have educational seminars at least three times a month. It’s free for the public, and there’s information on times and locations on the hospital website. We talk about surgical options. Q: What are some of the challenges associated with introducing new technology into a large institution? How do you navigate these challenges? A: Number one is educating the patients of risks involved with other treatments, such as the risks involved with long-term usage of acid reflux medication. In terms of weight loss, explaining how their weight worsens their health problems and complicates their lifestyle. We also try to educate the primary care providers about the availability of these options. So our goal is to try to meet more people and make them aware that these options exist. Q: Since a lot of this is focused on long-term management of diseases, how much better are the long-term outcomes of surgery? A: Yes. There’s an article in the New England Journal of Medicine about the positive long-term effects of bariatric surgery. And again, we are avoiding a lot of the side effects of long-term medication use. Q: What kinds of recovery times can patients expect from this kind of minimally invasive surgery? A: With minimally invasive laparoscopic and robotic technologies, the average hospital stay is about 1.7 days. Usually you’ll go home the following evening. If they’re working, most patients can get back to work within about two weeks, three weeks if they’re doing more physical work.
Lifelines Name: Bala Thatigotla, M.D. Position: Attending bariatric, minimally invasive, robotic surgeon at Niagara Falls Hospital. Performs general, laparoscopic, robotic and bariatric surgery. He also treats patients with acid reflux, hernias (including complex hernias), and gallbladder issues. Hometown: Tirupati, India Education: Sri Venkateswara Medical College; Royal College of Surgeons of Edinburgh. Fellowship: Advanced laparoscopic surgery / bariatric surgery - Vanderbilt University Medical Center, Nashville; residency: in general surgery at Bronx Lebanon Hospital Center/Albert Einstein School of Medicine, Bronx Board Certifications: Certified in General Surgery by the American Board of Surgery; Certified in General Surgery by The Royal College of Surgeons of Edinburgh, UK Affiliations: Niagara Falls Hospital Organizations: American College of Surgeons; American Society of Metabolic and Bariatric Surgeons Family: Married to an internal medicine physician, one daughter Hobbies: Tennis, biking, traveling, history
The New Drink Fad? Try Bubble Tea Despite claims of being healthy, bubble tea has huge caloric content, according to experts By Deborah Jeanne Sergeant
I
t’s creamy, bubbly and the latest drink fad: bubble tea. Tea Leaf and Kung Fu Tea, both in Amherst, offer two examples of shops in the area that sell the beverage. Originating in Taiwan, bubble tea, also known as pearl tea, seems like a health drink at first. After all, tea is well-known for its antioxidant properties. Adding wholesome, proteinand calcium-rich milk and tapioca
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pearls seems harmless enough. However, the other ingredients in bubble tea dramatically detracts from its healthfulness. Bubble tea’s 200 to 400 calories for a standard, 16-oz. serving make it a dessert. “It has way more sugar than you need,” said Francesco Giardina, registered dietitian and owner of SMART Nutrition by Frank in Williamsville. “They’re high in calories and don’t have many nutrients. If you use a sugar substitute, it puts your body into a calorie storage mode.” Bubble tea contains around 35 grams of sugar per 16-oz. serving. That equals 11 tsp., more than the American Heart Association’s recommended maximum of added sugar, six teaspoons for women and nine for men. Ask the server to reduce the amount of sweetener or request stevia as a substitute to reduce calories. “When ordering bubble tea, avoid getting it made with sugary syrups, high fat milk products and
lots of extras,” Amy Smalter, registered dietitian with Balanced Nutrition of WNY, PLLC in Amherst. “Keep your order simple.” To reduce cholesterol, fat and calories, choose the milk wisely. Skim milk, not whole milk or non-dairy creamer, is the best dairy choice, although soy milk or non-dairy creamer can offer a good option for people intolerant of lactose. One-quarter cup of boba tapioca pearls, the kind used in bubble tea, contain about 110 calories, so skip extra pearls to keep the calories lower. “The tapioca balls are a source of carbohydrates,” Smalter said, “and then fruit juices and syrups are often added, adding even more sugar to the drink.” She recommends ordering the smallest size when ordering bubble tea, or making homemade, brewed tea (not powdered tea) without added sugar. “You can make bubble tea at
home as the tapioca balls can be found at Asian grocery stores or online,” said Smalter. “At home, you have a little more control of what is being added compared to ordering at a cafe.”
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
‘Tis the Season: Thoughtful Gift Ideas for Those Who Live Alone
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his column is for all of you who have friends or family members who live alone. While the holidays can be a joyous time filled with laughter, cheer and gift giving, this time of year can also generate feelings of loneliness and anxiety. In my experience, those on their own may be especially susceptible to the “holiday blues.” What can you do to add a little “merry” to the holidays for those who live alone? You can give the gift of time together — probably the most welcome and cherished gift of all. You can also give a thoughtful gift to lift a spirit, safeguard a loved one and warm a heart. Below, I’ve compiled a list of gift ideas for you. Some are practical, others personal, all are designed to put a smile on the face of someone who lives alone:
For fun
• An invitation to join you on New Year’s Eve. This can be a challenging night for those who are newly divorced or widowed. I popped the cork with my sister and her husband after my divorce and was deeply grateful for their invitation to spend the evening together. It got my new year off to a great start. • Tickets or gift
certificates to movies, concerts, art openings or the theater. Include an invitation: “Be my guest.” And insist on doing the driving. • Dancing, cooking or art/craft classes. Do you have a single friend with two left feet? Dancing lessons might be in order. A widowed father who eats supper directly from the container? Consider a cooking class. Or a divorced sister who’s been looking for a creative outlet? A workshop in jewelry-making might delight her. There are so many possibilities!
For safety
• An AAA membership. I don’t leave home without it. A flat tire, an empty tank, a lost key — I’ve been there! This is a gift worth its weight in gold. • Handy tools for emergencies or life’s unexpected moments. Consider a compact no-battery wind-up LED flashlight with a hand crank. This is one of my prized possessions. How about a Swiss Army knife, complete with screwdrivers, scissors, toothpick, and tweezers? It even comes with a nail file and a highly coveted corkscrew. Or, consider a motion-sensor that activates a chime or alarm when a visitor (or new suitor?) arrives. Those of us who live alone need to be prepared for whatever life offers up. • A gift certificate for car washes.
Drinking tea may benefit the heart and blood vessels
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ea drinkers are less likely to develop cardiovascular disease than those who don’t drink this soothing beverage. The hefty dose of flavonoids in tea may keep the heart and blood vessels healthy, according to a recent Harvard Heart Letter, a newsletter published by Harvard Medical School. “Tea is a good source of compounds known as catechins and epicatechins, which are thought to be responsible for tea’s beneficial health effects,” says Howard Sesso, associate professor of medicine at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital. These compounds belong to the flavonoid family of plant chemicals. Flavonoids have been shown to quell inflammation. That, in turn, may reduce the buildup of cholester-
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ol-filled plaque inside arteries. Green tea has slightly higher amounts of flavonoids than black tea. Short-term studies have shown that drinking tea may improve vascular reactivity — a measure of how well blood vessels respond to physical or emotional stress. There’s also evidence that drinking black or green tea may lower harmful LDL cholesterol levels. Several large, population-based studies show that people who regularly drink black or green tea may be less likely to have heart attacks and strokes. However, people who drink tea tend to be different from people who don’t drink tea. As a result, researchers can’t be certain if it’s the tea or something else that tea drinkers do that lowers their risk of cardiovascular disease. “Drink tea if you enjoy it, in
While not necessarily a “safety gift,” I always feel better when my car is clean (and that can’t help but make me safer on the road). Who doesn’t enjoy a clean, sparkling car? Choose a car wash near your recipient’s home or work place.
For pampering
• An opportunity to be “treated like royalty.” How many of your friends who live alone indulge themselves in luxurious services? My guess is not many, if they’re like me. Who has the time or money? But that’s what makes this the perfect gift! Why not surprise her with a spa certificate for a massage, facial, manicure or pedicure? Or make his day with a certificate for a gentleman’s facial or deep tissue/sports massage. • For women in particular who live alone — fresh flowers delivered. Do you know a single woman who lives by herself? When’s the last time she got flowers? It’s probably been years . . . don’t I know it. So, delight her with a bouquet of roses or tulips — preferably yellow, a color known to evoke the feelings of warmth and happiness associated with friendship. • And speaking of deliveries, check out gift-of-the-month clubs. Coming home alone at any time of
moderation, and not because you’re taking it as a medicine,” says Sesso. Stirring in a little sugar is fine, but adding a few heaping teaspoons of sugar probably cancels out tea’s possible benefits, he notes. And beware
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2015
year can feel a little empty, but it can really feel lonely during the holidays. Discovering a package on the doorstep can change everything. Go online and check out gourmet gifts and food clubs. You won’t believe the variety of delicious items that can be delivered on a monthly basis: chocolate, hot sauce, cheese, tea, cigars, wine, beer, pastas, olive oil, cookies, popcorn, pancakes, you name it. I love this idea so much, I might treat myself.
For inspiration
• A gift of charity. Making a donation in someone’s name is a gift you can both feel good about. Think about your friend or family member who lives alone. What do they care about? Choose an organization that supports his or her values. • An invitation to join you in a volunteer activity. Helping others is a great holiday tradition. Early on in my solo journey, a dear friend invited me to join her for a holiday gift-wrapping event to support the Humane Society. It felt wonderful to be out of the house and surrounded by other volunteers and staff who embraced the spirit of giving. • A subscription to “In Good Health” and/or “55 Plus” produced by editor and publisher Wagner Dotto. Both periodicals are filled with inspirational articles and trusted health information. Consider gift subscriptions for your friends and family members who live alone. Chances are good your holidays and theirs will be healthier and happier for it. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call her at 585-624-7887, email her at gvoelckers@rochester.rr.com.
of the sugar found in many bottled teas, which can contain up to nine teaspoons of sugar per serving—almost as much as colas and other soft drinks.
Healthful Holiday Gifts Looking for something to give? We’ve asked local merchants about the ideal holiday gift you should buy By Deborah Jeanne Sergeant
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how how much you care this year by treating your friends and family to healthful gifts. “Giving something that will help someone’s health is a great way to kick off a new year,” said Stephanie Moses, store manager at Feel-Rite Fresh Market & Natural Foods’ Williamsville location. She recommends giving organic, local items. “We have lots of fair-trade and organic chocolate for stocking stuffers,” Moses said. Essential oils sell well at the store, as to essential oil burners. Some are made to plug into a computer USB or car lighter.
“We have beautiful candles with natural wicks and lovely gifts for teachers at school and small things for the mailman,” Moses said. “It’s thoughtful when you give someone something that’s clean and healthful for them. It shows you care about your health.” Gabrielle Torre, associate at Catalyst Fitness, which has locations throughout Buffalo area, likes how FitBit both functions as useful fitness equipment, but also “looks like a piece of jewelry,” she said. “It counts steps, calories and heart rate.” Kelly Cardamone, registered dieticians and diabetic educator with Kaleida Health, also likes activity trackers. “Different trackers will have different bells and whistles,” she said, “however, they all serve the same purpose which is tracking your physical activity and steps. Most people overestimate how much they move on a daily basis and these trackers give you something more concrete to work with.” Depending on the model, some track other activities and synchronize with smartphone apps. For people who enjoy technology and having information handy, an activity tracker may provide further motivation to take charge of their health. For people who enjoy working out, or simply need to stay hydrated, Cardamone recommends the Saavy
Infusion or Aquablend, infusion water bottles that allow users to create naturally flavored water. Consider the recipient’s interests and give a subscription. Cardamone mentioned Runner’s World, Yoga Journal, Nutrition Action, Vegetarian Times, Men’s Health, and Prevention. Pop a Paderno Vegetable Slicer in someone’s stocking. “This handy little gadget Available at Feel-Rite Fresh Market & Natural makes pasta from fresh raw Foods are a variety of gifts, including a USB vegetables like zucchini, Essential Oil Diffuser from GreenAir, Essential carrots and eggplant,” Cardamone said. Oils from Natures Fusions, Diffuser from NOW Replacing starchy pasta and Essential Oils Diffusing Pendant from Nature’s with veggies reduces calories Alchemy. Photo courtesy of Feel-Rite Fresh Market and ramps up the nutrients & Natural Foods. in the meal. Cardamone also likes the Oster My Blend Portable Blender specific goals such as weight loss. with Travel Cup since it can create a Think about the recipient’s personal smoothie without the hassle current activities and what accessoof hauling out the large blender. ries could make it more enjoyable. A “A great way to start the mornfriend who participates in an exercise ing is with a healthy smoothie,” she class may enjoy a new water bottle, said. mat, and socks. But giving these to Exercise care when considering giving gifts directly related to weight someone who doesn’t work out regularly may appear judgmental. loss because the recipient may think your present insinuates you disapGive gifts such as a gym memprove of their weight. Instead, focus bership only if the person has on positive aspects of wellness, such explicitly stated the desire for such, as equipment and products that especially since it may not be refundpromote health and fitness instead of able.
Is the Toy You’re Buying Safe? Nearly 150,000 children become injured while playing with toys every year, according to a report By Deborah Jeanne Sergeant
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s you consider the “naughty” and “nice” children on your list, think of safety first. The Center for Injury Research and Policy at Nationwide Children’s Hospital states that almost 150,000 children become injured while playing with toys every year. What can you do to keep children on your list safe? Rob Kornblum, consumer protection campaign organizer with New York Public Interest Research Group at NYC College of Technology, advises shoppers to follow package labels about age-appropriateness. Simply because a toy appears on the shelf in the baby aisle doesn’t mean it’s safe for small children. Toys may be mislaid or wrongly categorized by store personnel. Kornblum also warns shoppers to watch for hazards such as toys with magnets, small parts, or large toys with small, detachable or breakable parts. For example, a toy purse with rhinestones may not be safe for a toddler because the stones may pop off.
“These pose a choking risk for young children,” he said. Anything smaller than 1.75 inches may choke a small child. “Shoppers need to be aware of the chemical content of toys on shelves, as well as other tough-tospot hazards,” Kornblum said. Toys purchased without packaging, such as at a thrift store, craft fair or on eBay, lack age recommendations. In addition to small parts, look for hazards such as lead paint, toxicity (especially for craft projects), strangulation hazards (such as long strings and cords), loud noise levels (if it sounds too loud when near your ear, it’s certainly too loud for a child) and sharp edges and points. Safety hazards also depend upon the child’s maturity level. Some 5-year-olds, for example, still put small objects in their mouths, so “parents should always use their common sense and knowledge of their own child to supplement the label’s age-range guides. “Labels are necessary and helpful, but parents should stay informed
so they can take stronger safety precautions.” Look for quality toys. Cheap, thin plastic comprise many toys at dollar stores. Their brittle plastic tends to snap easily. With wooden toys, look for unfinished, splintery edges. “European toys are tested at a higher standard than U.S. toys and definitely toys from China,” said Tera McElligott, co-owner of Clayton’s Toy Store in Buffalo. “Higher-end brands tend to age things more appropriately for kids’ development.” Older isn’t necessarily better. Vintage toys may have sharp edges, worn parts, lead paint, shatter-prone materials and excessive weight. Toy safety standards have changed a lot in the past 50 years. Carefully examine vintage toys before passing them on to this generation. They’re not as accustomed to watching out for hazards—and neither are their parents. Don’t give young children display-only models. For example,
December 2015 •
a glass figurine of her favorite fairy presents an irresistible temptation. Children want toys to play with, not look at. Shopping at a dedicated toy store may help you find what’s appropriate if you’re really uncertain, because these offer wide selection and personnel experienced with toys, unlike many discount and department stores. Review toy recall lists. Every year, NYPIRG releases its Trouble in Toyland report at www.nyprig.org to help shoppers know about recalls and other issues. You can also consult The Consumer Product Safety Commission’s recall list at www.cpsc. gov/en/Recalls/Recalls-by-Product. The CPSC’s Twitter handle @OnSafety also offers real-time product recalls.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Holiday Blues Why it happens and how you can beat it
By Deborah Jeanne Sergeant
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t’s supposed to be the most wonderful time of the year, but for some people, the holiday season brings just the opposite: stress, sadness and anxiety. But why? It’s important to distinguish between “the blues” and true depression, according to experts. Depression can be clinically diagnosed by a mental health professional. Family members may notice diminished interest in activities previously enjoyed, isolation, altered sleeping or eating habits, distraction and expressions of hopelessness or suicidal thoughts. Seasonal sadness may not qualify as depression, but individuals experiencing them should work through those feelings. And people prone to depression should guard their emotional health, since a blue mood can morph into depression. Deborah Legge, a licensed mental health counselor practicing at The Counselor’s Corner in Williamsville,
said that the holidays can stir up memories that can contribute to the seasonal sadness. “If we have some troubling memories, we may bring that expectation or fear into the present,” Legge said. “Or if we are in a different place and remember happy holidays, that can be difficult. If we’re unable to provide what we had or missing a loved one, that can be difficult.” The excitement of the season can deepen grief for people mourning a loss because the ubiquitous family-centered celebrations only underscore the contrast between intact families and theirs. Instead of dwelling on the loss, beginning a new, meaningful tradition Legge to honor late loved ones or focusing on the remaining family members can help make the holidays less painful.
Even for those who have experienced closure with the past or who cherish happy memories, the stress of the season can cause emotional issues. Personal expectations generated from a wonderful childhood often form that mile-long to-do list and ratchet up anxiety. “One of the major problems is expectations versus reality of the holidays, both the media and expectations we put on ourselves,” said Wendy Baum, licensed clinical social worker practicing in Buffalo. It may seem strange that happy childhood memories could cause adults to feel blue, but, recreating the magic as an adult takes lots of rather non-magical work — and money. “Financially, it’s hard times for a lot of people,” Baum said. “So much of the focus of the season is financial. They feel like they should be able to buy or decorate or feed more than they’re actually able.” Some people re-open old wounds when they reunite with their originating family as adults, which can feel particularly disappointing when they expect that they can mend fences while visiting with family during a special time of the year. Within their own family, many feel like they must create an ideal
experience for their children. Blended families also experience the stress of meeting others’ expectations, shuttling the children around to the various relatives’ homes. Some people compare their homes and holiday experience with another’s, which can cause friction. “The most important thing I share with clients this time of year is to prepare ourselves in advance for the holidays by getting into good, healthy way of living,” Legge said. “Don’t let the holidays take us over. Respond, not react. You can only do that if you have a plan and can keep things in perspective. Expectations can be daunting.” To minimize stress and the accompanying anxiety, prioritize what’s important and let go of the rest. Getting wrapped up in minutia only cranks up stress. Simplifying traditions helps, such as giving gifts only to children, serving a potluck meal instead of relying on the host, and decorating with a few large pieces instead hanging every ornament and trimming every nook and cranny of the home and yard. Delegate tasks, don’t make everything homemade and take time to do the things you enjoy. If getting together with family has proven extremely stressful, set a time limit for a visit to give yourself breathing space. In general, maintaining the normal routine can help ward off anxiety. “Take really good care of yourself by eating right, resting and exercising,” Baum said. Maintaining your normal routine can help stabilize your mood and help you feel better emotionally.
Five Tips for a Healthy Holiday By Matthew Liptak
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he holiday season is supposed to be filled with joy, but it can take a lot out of us as we give to others. Planning the best parties, decorating to please, preparing enough and the right food, not to mention getting the right presents—it can be a lot! Take a moment to read these five tips to keep things healthy this holiday. 1) “You can do anything, you can’t do everything” This is advice some give to their children as they raise them, but these are words all of us might want to take to heart as Christmas, Hanukah, Kwanzaa and other holidays approach. Remember to pace yourself. Stress is real and many studies have shown it’s bad for your health. Instead of rushing, rushing, rushing and trying to do too much for too many, consider taking a few things off the list this year. Meaningful visits with a handful of loved ones can be
healthier than trying to make everyone happy and stressing yourself out. Special time with your loved ones might just be the best gift you get this year. 2) “A little can go a long way” Good food is one of the best parts of the holiday, but there is an obesity epidemic in the United States. Do you want to be part of it? Think smaller portions and healthier foods. And if you are going to the big dinner or party with delicious treats you can’t avoid, think about eating some healthy snacks and drinking a glass of water before you get to you destination so you aren’t as hungry. It might feel good in the moment, but overindulging on food and drink high in calories and saturated fat is something we all have to come to terms with later. A full holiday doesn’t have to mean a bulging belly. 3) “Walk it off” Most everybody knows exercise
is healthy. But with the holidays it’s easy to put exercise on the back burner when there are so many other obligations. This is a time when you need to exercise the most. And it doesn’t have to be a lot of exercise. If you can do 30 minutes a day, even if it’s broken up into 10-minute intervals, it can provide you with a gift for yourself this holiday season. The National Institutes of Health says that these short walks lower your risk of health problems like high blood pressure, heart disease and diabetes, strengthen your bones and muscles, help you burn more calories and lift your mood. If the weather’s bad outside try the treadmill at a local gym or a mall. Maybe you can buy a gift or two on your way home! 4) “Go au naturel” No, not naked — unless that’s your thing. Try taking 10 to 15 minute breaks when you need them just to be by yourself. And put down the tech. Many of us have a tendency to
fill up our moments with technology to feel busy. But according to the Mayo Clinic, these 15-minute breaks may refresh you enough to help you get everything done that needs to be done. Take a break, slow your breathing and restore your inner calm. Enjoy the moment! 5) “Remember the reason for the season” For Christians it’s the birth of Jesus, for Jews it’s the miracle of Hanukah, for others it may be heartfelt traditions and a special time with those we love. It really isn’t supposed to be about how big the pile is under the tree or how much fun we feel pressured to have. Remember to enjoy the spirit of the season if you can. And remember there are those who are struggling this holiday too. Helping them might give you a healthier perspective on what matters most.
Women’s Health • Weight Loss • Fitness These are some of the topics the January issue of In Good Health will discuss. To advertise in the issue and reach thousands of readers in the region, please call 716-332-0640. Page 10
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2015
SmartBites
The skinny on healthy eating
Why Beef Deserves a Shout-Out
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eef certainly has gotten a bad rap lately. Strike one: Many cuts contain saturated fat, the bad fat linked to heart disease. Strike two: It takes an amazing amount of water (about 600 gallons) to create a single serving, more water than any other protein source. And strike three: Its consumption has recently been linked to cancer. It’s enough to make a grown man or woman who loves beef cry! While I’m not a big beef consumer, I do enjoy a juicy burger or steak on occasion. And my holidays just wouldn’t be the same without beef Wellington. So I am not anti-beef by any means. But I do believe that, as with certain other foods that have both benefits and drawbacks — say, chocolate, wine, cheese and nuts— we should limit our consumption. Both the American Cancer Society and the Academy of Nutrition and Dietetics, the world’s largest organization of food and nutrition professionals, agree. I go for beef about once a week because, calorie for calorie, beef packs a powerful nutritional punch. First and foremost, it’s loaded with protein, an essential nutrient for building and maintaining all the tis-
sues and cells in the body. An average 3-ounce portion of lean strip steak, for example, provides about 50 percent of our daily needs. Not bad for only 155 calories! On the B vitamin front, beef rocks with healthy amounts of B6 and B12 (both aid in red blood cell production) and impressive amounts of niacin (good for nervous and digestive systems and converting food to energy). Since many older people suffer from a B12 deficiency — whether through diet or poor absorption — it’s good to know that animal-based foods such as beef are terrific sources of this all-important B vitamin. Consuming beef also boosts your intake of iron, zinc and selenium. Iron carries oxygen and is necessary for the production of energy; zinc fortifies your immune system; and selenium is an antioxidant superstar, gobbling up cell-damaging free radicals. But what about the saturated fat? Yes, beef does have saturated fat; but not all cuts are created equal: some have less saturated fat than a skin-
less chicken thigh, while others rival whale blubber. Since eating foods that contain saturated fats increases our risk for heart disease and stroke, it benefits us to eat leaner cuts (round, chuck or loin in their name) versus fattier cuts (rib-eye, skirt, porterhouse). And the link to cancer? The jury is still out on that one, although the World Health Organization recently classified the consumption of red meat as “probably” carcinogenic to humans. While some research points to the carcinogens that form when red meat is cooked at high temperatures as the culprit, other studies point to heme iron, a molecule found in red meat that may run amuck in the colon. What to do? Most organizations recommend no more than one to two servings of red meat per week.
Helpful tips
Choose lean cuts without a lot of marbled fat. If the fat is along the side of the cut, remove it before cooking. Marinate meat with rich spices and acidic ingredients, such as lemon juice. To limit exposure to the high heat of the grill, the National Cancer Institute recommends precooking meat in the microwave or oven or on the stove for a few minutes.
Pan-Seared Strip Steak with Mushrooms
Adapted from Martha Stewart; serves 2-3 1 tablespoon olive oil 1 strip steak center cut (1 lb., 1-inch thick) Coarse salt and freshly ground pepper 8 oz. package portabella mushrooms, sliced 8 oz. package white mushrooms, sliced 2 cloves garlic, minced ¼ cup (or more) low-sodium chicken stock 2 teaspoons Dijon mustard 1 teaspoon dried thyme Preheat oven to 350 degrees. Line rimmed baking sheet with parch-
ment paper. Heat oil in a 12-inch skillet over medium-high heat. Season both sides of steak with salt and pepper. Cook steak for 3-4 minutes per side. Remove from skillet, transfer to baking sheet and finish cooking in oven for 6-8 minutes (time depends on thickness of steak and how done you like it). While steak is cooking, add mushrooms and garlic to drippings in skillet, and cook over medium-high heat, stirring occasionally, until tender, about 5 minutes. Add stock to skillet and bring to a boil, scraping up brown bits. Stir in mustard and thyme, and simmer until sauce lightly coats the back of a spoon, about 3 minutes. Pour sauce over steak. 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.
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Debt Defying Programs help to ease the burden of medical student debt By Ernst Lamothe Jr.
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before anything else, we’re all human rethink your bias at lovehasnolabels.com
bfohealth.com Check In Good Health
Buffalo Niagara’s Newspaper online Page 12
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hen it comes to student loans, Charles Severin has heard a lot of interesting
stories. But as associate dean of medical education and admissions at the Jacobs School of Medicine and Biomedical Sciences in Buffalo, one story continues to speak the loudest as an example of students’ mentality toward their debt. “As a school, we send students to meet with a financial aid officer to talk about the debt they already had prior to medical school, and the adviser talks to them about what kind of lifestyle they would need to maintain so their debt doesn’t get out control,” said Severin. “In one case, the financial adviser looked at the student’s already large loans and after talking to him said, ‘You can’t spend anymore than $40. The student looks at the adviser and says, ‘I can’t live on $40 a week.’ The adviser says, ‘No, I mean you can’t spend anymore than $40 all year.’” Typically, a University at Buffalo School of Medicine and Biomedical Sciences student could walk out of college with about $150,000 in student loans — some upwards of $200,000. That figure is not only rising, but it’s an intimidating and sometimes paralyzing feeling for someone in their early 20’s even if they will make Severin six figures a decade from now. However, not only is there light at the end of the tunnel, but medical schools throughout Upstate New York are giving students the flashlights to maneuver before they hit the end. The Western New York Medical Scholarship Fund is a new, independent community organization providing four-year scholarships to Western New York students to attend the University at Buffalo School of Medicine and Biomedical Sciences. Students accepted to the UB medical school must meet highly select criteria to be eligible for these scholarships. They must have graduated from a high school within the eight counties of Western New York, excel academically and have a demonstrated financial need. In order to accept the scholarship, they also must pledge to stay in Western New York to practice. Each awardee will receive a minimum of $30,000 annually for each of the four years of medical school. “Our goal is to keep more locally trained doctors in Western
$200,000
New York,” said John J. Bodkin II, co-chair and founder of the Western New York Medical Scholarship Fund and an alumnus of the UB medical school.
Family matter
The story that Severin told about the student and the financial counselor also speaks to the greater problem — students keeping tabs on their debt. Because this isn’t always the case, the university has a program each fall called Family Day, where financial advisers talk to medical students, but more importantly, their parents in separate sessions to let them know about the various types of loans available. “Students don’t always think about their loans. They are more focused on getting into medical school, being successful students and graduating through their programs,” Severin said. “But because parents are the ones who are paying the bill, many times they are the ones who are more concerned and are trying to get as much information as possible on how to tackle the issue.” The program has been going on for years and the school receives good feedback from parents on the information. “Our school as well as other medical schools are trying to keep student debt down to a minimum,” Severin added. When it comes loan trends, B.J. Revill, University of Rochester School of Medicine and Dentistry director of financial aid, typically talks to students about two programs. While they are not necessarily the newest programs, they still garner a lot of attention from graduating medical students.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2015
The first is public service loan forgiveness. To be eligible for forgiveness, borrowers must work in a public service setting such as academic medical centers, nonprofit hospitals and clinics for 120 months. They also must make an eligible loan payment for the same 10 years. After working and paying for those 120 months, the balance will be forgiven. “This program is a very popular one among graduates. They like the idea that it is not tied to a specific specialty or the need to practice in an underserved area,” says Revill. “Most students choosing to pursue careers in medicine are doing so because of a strong passion to improve the lives of others through practice and research, rather than the earning potential they may have in the field.” There are other programs where students can earn up to $120,000 in their final year of school, but must commit to serving either three fulltime years or six part-time years at an approved site. “These are somewhat attractive to our graduates, but to a lesser degree, because the borrower must commit to serving in a primary care field in an underserved population area,” Revill added. “And failure to fulfill the commitment comes with monetary penalties.” Severin also said his financial advisers talk to students about making practical choices. “If you know that money is tight, you can’t have it all,” Severin said. “We talk to them and explain that living alone and paying all the bills by yourself might not be the best option. You can live with one or two people and split the expenses and save so much more.”
LAKE S HORE BEHAVIORAL HEALTH If you or a loved one is struggling, we can help. Mental Health & Substance Abuse Treatment for Adolescents & Adults By Jim Miller
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How to Guard Against Deadly Aortic Aneurysms Dear Savvy Senior, My father died several years ago, at the age of 76, from a stomach aneurysm, which now has me wondering. What are my risk factors of getting this, and what can I do to protect myself, as I get older? Just Turned 60 Dear 60, Stomach aneurysms, also known as “abdominal aortic aneurysms,” are very dangerous and the third leading cause of death in men over 60. They also tend to run in families, so having had a parent with this condition makes you much more vulnerable yourself. An abdominal aortic aneurysm (or AAA) is a weak area in the lower portion of the aorta, which is the major artery that carries blood from the heart to the rest of the body. As blood flows through the aorta, the weak area bulges like a balloon and can burst if it gets too big, causing life-threatening internal bleeding. In fact, nearly 80 percent of AAAs that rupture are fatal, but the good news is that more than nine out of 10 that are detected early are treatable.
Who’s At Risk?
Around 200,000 people are diagnosed with AAAs each year, but estimates suggest that another 2 million people may have it but not realize it. The factors that can put you at increased risk are: • Smoking: Ninety percent of people with an AAA smoke or have smoked. This is the number one risk factor and one you can avoid. • Age: Your risk of getting an AAA increases significantly after age 60 in men, and after age 70 in women. • Family history: Having a parent or sibling who has had an AAA can increase your risk to around one in four. • Gender: AAAs are five times more likely in men than in women. • Health factors: Atherosclero-
Individualized, client-focused care Professional, licensed counselors Walk-in and same day appointments available Psychiatrists and nurses on staff Addiction Medication Assisted Treatment (MAT) Integrated mental health and addiction treatment
sis, also known as hardening of the arteries, high blood pressure and high cholesterol levels also increase your risk.
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Detection and Treatment
Because AAAs usually start small and enlarge slowly, they rarely show any symptoms, making them difficult to detect. However, large AAAs can sometimes cause a throbbing or pulsation in the abdomen, or cause abdominal or lower back pain. The best way to detect an AAA is to get a simple, painless, 10-minute ultrasound screening test. All men over age 65 that have ever smoked, and anyone over 60 with a first-degree relative (father, mother or sibling) who has had an AAA should talk to their doctor getting screened. You should also know that most health insurance plans cover AAA screenings, as does Medicare to beneficiaries with a family history of AAAs, and to men between the ages of 65 and 75 who have smoked at least 100 cigarettes during their life. If an AAA is detected during screening, how it’s treated will depend on its size, rate of growth and your general health. If caught in the early stages when the aneurysm is small, it can be monitored and treated with medication. But if it is large or enlarging rapidly, you’ll probably need surgery.
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While some risk factors like your age, gender and family history are uncontrollable, there are a number of things you can do to protect yourself from AAA. For starters, if you smoke, you need to quit — see smokefree. gov or call 1-800-QUIT-NOW for help. You also need to keep tabs on your blood pressure and cholesterol levels, and if they are high you need to take steps to lower them through diet, exercise and if necessary, medication. 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. December 2015 •
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The Social Ask Security Office By Deborah Banikowski
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Disability: Be Prepared When Disaster Strikes
F
or many of us, preparing for winter involves pulling out heavy coats from the closet and making sure our vehicle is ready for intense weather. Whether your winter brings snow, ice or flooding, you need to be prepared. Preparing for a possible physical or mental disability is the same. Many people don’t think of disability as something that could happen to them. Statistics show the chances of becoming disabled are greater than most realize. Fifty-six million Americans — or one in five — live with a disability. Thirty-eight million Americans, or one in 10, live with a severe disability. A sobering fact for 20 year-olds is that more than a quarter of them will become disabled before reaching retirement age. Disability can happen to anyone. But who is prepared? When disability does happen, Social Security can help people meet their basic needs. Our disability programs provide financial and medical benefits for those who qualify to pay for doctors’ visits, medicines and treatments. You can learn more about how you might be covered if you are disabled at www.socialsecurity.gov/ planners/disability. Social Security pays benefits to people who worked and paid Social
Q&A
Q: If I retire and start getting Social Security retirement benefits at age 62, will my Medicare coverage begin then too? A: No. Medicare benefits based on retirement do not begin until a person is age 65. If you retire at age 62, you may be able to continue to have medical insurance coverage through your employer or purchase it from an insurance company until you reach age 65 and become eligible for Medicare. For more information about who can get Medicare, visit www.medicare.gov. Q: I prefer reading by audio book. Does Social Security have audio publications? A: Yes, we have many helpful publications you can listen to. You can find them at www.socialsecurity. gov/pubs. Some of the publications available include “What You Can Do Online,” “How Social Security Can Help You When a Family Member Dies,” “Apply Online for Social Security Benefits,” and “Your Social Security Card and Number.” You can listen now at www.socialsecurity. gov/pubs.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2015
Security taxes, but who can no longer work and whose medical condition meets the strict definition of disability under the Social Security Act. A person is considered disabled under this definition if he or she cannot work due to a severe medical condition that has lasted or is expected to last at least one year or result in death. The person’s medical condition must prevent him or her from doing work that he or she did in the past, and it must prevent the person from adjusting to other work based on their age, education, and experience. Supplemental Security Income (SSI), our other disability program, is a needs-based program for people with limited income and resources. You can find all the information you need about eligibility and benefits available to you by reading our publication, “Disability Benefits,” available at www.socialsecurity.gov/ pubs. While extreme winter weather may not affect all of us, the risk of being disabled and needing help isn’t based on geography. Chances are you know someone who is disabled or perhaps you live with a disability. If you wish to help a friend or family member — or need to plan for disability yourself — visit www. socialsecurity.gov/disability.
Q: How are my retirement benefits calculated? A: Your Social Security benefits are based on earnings averaged over your lifetime. Your actual earnings are first adjusted or “indexed” to account for changes in average wages since the year the earnings were received. Then we calculate your average monthly indexed earnings during the 35 years in which you earned the most. We apply a formula to these earnings and arrive at your basic benefit. This is the amount you would receive at your full retirement age. You may be able to estimate your benefit by using our retirement estimator, which offers estimates based on your Social Security earnings. You can find the retirement estimator at www. socialsecurity.gov/estimator. Q: I know that Social Security’s full retirement age is gradually rising to 67. But does this mean the “early” retirement age will also be going up by two years, from age 62 to 64? A: No. While it is true that under current law the full retirement age is gradually rising from 65 to 67, the “early” retirement age remains at 62. Keep in mind, however, that taking early retirement reduces your benefit amount.
Healthcare: BIG CHANGES AHEAD Things will look a lot different next year
®
By George W. Chapman
H
ealthcare will continue to go through a major transformation in how care is paid for and delivered next year. Most of the major stakeholders — physicians, hospitals, insurance companies, drug and device manufactures, employers and consumers — are being impacted by the changes. While no one can predict how things will look several years from now, it is safe to say things will look a lot different than they do than today. Here’s what to expect at least for next year. • The Patient Protection and Affordable Care Act (ACA or ObamaCare) is thelaw of the land and cannot be repealed (there have been almost 60 attempts to repeal all or parts of the ACA). The individual mandate to have health insurance will be more strictly enforced in 2016. The penalties/fines for not having insurance increase substantially. The individual penalty will be the greater of $695 or 2.5 percent of income for individuals. For families it will be the greater of $2,085 or 2.5 percent of income for families. People in lower income brackets — the majority in the uninsured population — are impacted the most by these fines, so the numbers are significant. The penalties are approaching what their out-of-pocket contribution would be if they purchased subsidized insurance on the exchange. Consequently, the number or percentage of uninsured will continue to drop. The uninsured rate was 17 percent in 2013; 12 percent in 2014 and 10 percent in 2015. The percentage of uninsured in the U.S. could drop to just 8 percent in 2016. • More and more seniors will elect commercial Advantage plans over regular government sponsored Medicare next year. In 2015, 31 percent or 17 million of eligible seniors were enrolled in a private Advantage plans. This is expected to grow to 19 million in 2016. Advantage plans cost more than regular Medicare because they have more benefits such as preventive, dental, vision and hearing care. Premiums for both regular Medicare and Advantage plans have been very stable over the past few years and should continue to be stable in 2016. • Commercial carriers will continue to merge in order to accumulate more covered lives, increase their negotiating power and lower their risk. Anthem, the second biggest carrier in the U.S., has announced its intention to purchase Cigna, the fourth biggest, for about $50 billion. If approved by the FCC and Department of Justice, it would create the largest health insurer in the country. Most markets are being dominated by two if not just one commercial carrier. Commercial insurance rates, employer and exchange based, will continue to rise at a faster rate than Medicare. Most commercial plans in NYS will increase premiums about 7-8 percent.
More ways to get your RedShirt Benefit Review.
• Not to be outdone by insurance mergers, strategic alliances, mergers and acquisitions between hospitals and doctor’s practices will continue at an accelerated rate. Hospitals will continue to form comprehensive, clinically integrated systems of care by employing or aligning with physicians. Right now, about 50 percent of all physicians are employed. This percentage is much higher for new physicians. Odds are your primary care physician will be part of a large health system is 2016. You can expect these systems to start “narrowing” or limiting your choice of physicians in order to maintain control and quality. If this sounds familiar, you’re right. Clinically Integrated Networks (C.I.N.) and Accountable Care Organizations (A.C.O.) will eventually morph into what we used to call HMOs. It has been demonstrated that the care delivered by “narrower,” clinically integrated systems with electronic records is typically better than the traditional unintegrated care delivered by an almost unlimited choice of providers. More choice is not necessarily better for the consumer. • You can expect more payments from your insurance company will be based on alternative reimbursement, quality of care or outcome, versus traditional fee for service. Next year, providers can expect at least 10 percent of their payments from insurers will be alternative in nature. In just three years, by 2018, Medicare intends to base 50 percent of their reimbursements to physicians and hospitals on quality or outcome. • In 2016 physicians without electronic health records will begin to feel the pinch from payers. The impact on their patients is that their records won’t be part of a modern, clinically integrated system where physicians and hospitals communicate among themselves in real time. Not having electronic records is a serious disservice to consumers/patients. Alternative reimbursement schemes will place more responsibility on patients for their overall health. Patient compliance will become crucial to a provider’s financial success. Non-compliant patients run the risk of being “fired” by their physician. • Next year you will see more care being delivered via telemedicine as physicians and hospitals systems avail themselves of the technology. Radiology and dermatology have been the trailblazers in telemedicine. Most insurers now pay for telemedicine, which will make it more available to everyone. Being able to “see” an urban-based specialist via telemedicine is a boon to consumers in rural areas where access to specialists has been difficult because of distance. Patients will be able to communicate with their providers and access their records via secure patient portals on the provider’s website. George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting. com.
in the mail
over the phone
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at a medicare information center
We’ll help you find the right Medicare Advantage plan with our RedShirt Benefit Review. Whether it’s through the mail, over the phone, on our website or at a Medicare Information Center,* we’ll go over your needs and help you understand your options. It’s just one of the reasons why more people choose Independent Health than any other Medicare plan in Western New York.** We offer the following benefits*** with every plan: - Affordable plan premiums - Vision, dental† and gym membership - Access to all WNY hospitals and pharmacies - Worldwide urgent care and emergency room coverage
For more information, call: (716) 635-4900 or 1-800-958-4405 (TTY users call 1-888-357-9167), Monday-Sunday, 8 a.m. to 8 p.m. www.IndependentHealth.com/Medicare
Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO, HMO-SNP, HMO-POS and PPO plans. Enrollment in Independent Health depends on contract renewal. *A sales person will be present with information and applications. For accommodations of persons with special needs at sales meetings, please call (716) 635-4900 or 1-800-958-4405 (TTY users call 1-888-357-9167). **Per CMS enrollment data 8/15. ***Benefits vary by plan. This information is not a complete description of benefits. Contact the plan for more information. Benefits, premium and/or copayments/coinsurance may change on January 1 of each year. Limitations, copayments and restrictions may apply. Members must continue to pay their Medicare Part B premium. †Excludes Independent Health’s Medicare Family Choice HMO-SNP. Y0042_C5443 Accepted 09142015 © 2015 Independent Health Association, Inc.
December 2015 •
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One Night of Poor Sleep Equals Six Months on a High-Fat Diet New research finds that one night of sleep deprivation and six months on a high-fat diet could both impair insulin sensitivity to a similar degree, demonstrating the importance of a good night’s sleep on health. This study, conducted by Josiane Broussard, PhD, and colleagues from Cedars-Sinai Medical Center in Los Angeles, used a canine model to examine whether sleep deprivation and a high-fat diet affect insulin sensitivity in similar ways. The findings was presented during a poster presentation Nov. 5 at The Obesity Society Annual Meeting in Los Angeles.
Eateries Listing Calorie Counts Offer More Lower-Calorie Items Large U.S.-based chain restaurants that voluntarily list calorie counts on their menus average nearly 140 fewer calories per item than those that do not post the information, new Johns Hopkins Bloomberg School of Public Health-led research suggests.
An Aggressive Treatment for an Aggressive Cancer Pancreatic cancer remains one of the deadliest cancers worldwide. In the United States, it accounts for only 3 percent of all diagnosed cancers but it causes almost 7 percent of all cancer deaths. A pancreas cancer diagnosis often comes after age 50 and after the cancer has spread, making it difficult to remove surgically. A new clinical trial that recently opened at the University of New Mexico Comprehensive Cancer Center may help more people to undergo surgery to remove their pancreas tumors. And that may help more of them to live longer. According to physician Itzhak Nir, surgically removing the tumors is the only way to cure pancreas cancer. “Only 20 percent of patients ever make it to surgery, which is the only way to cure someone of this cancer.” And, he said that fewer than 5 percent of people whose tumors cannot be removed surgically survive for five years or more trial requires.”
Doctors Should Cut Back on Some Medications in Seniors Anyone who takes medicine to get their blood sugar or blood pressure down — or both — knows their doctor prescribed it to help them. But what if stopping, or at least cutting back on, such drugs could help even more? Two new studies suggest doctors should be doing that more. Page 16
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H ealth News Buffalo Spine and Sports has new executive director Maria Gambino has recently taken over as the new executive director at Buffalo Spine and Sports Medicine, one of the largest physical medicine and rehabilitation practices in Western New York “Buffalo Spine and Sports has an impressive track record of success and a unique model of care,” Gambino said. “I am proud and excited to take this leadership role and look forward to helping this exceptional team improve the health of the community.” Gambino, a graduate of D’Youville Gambino College and Millard Fillmore School of Nursing, earned her executive MBA from the University of Buffalo and is an alumna of the Leadership Buffalo program. She comes to Buffalo Spine and Sports after working for both the state and county Departments of Health, Women and Children’s Hospital of Buffalo and Western New York Immediate Care. “We are very excited to bring Maria on board, because we feel her background in healthcare and her professional associations will bring a new energy to Buffalo Spine and Sports,” said physician Frederick McAdam, founder of the practice. “She shares our focus on individualized, holistic care and has proven experience in creating a positive, team-oriented approach.” Gambino’s primary goal for the practice includes exploring and expanding partnerships and collaborations with other local healthcare providers. “We have an opportunity to be an agent of change in the Western New York community, to work with other clinicians in helping people take control of their health and their lives, and I’m looking forward to being a part of it.”
Windsong Radiology recognized for its lung cancer screening Windsong Radiology has been named a screening center of excellence by the Lung Cancer Alliance (LCA) for its ongoing commitment to responsible lung cancer screening. Low-dose CT screening has shown to be the only proven method to detect lung cancer at an early and treatable stage, according to a news released issued by Windsong Radiology.
“We are thrilled to be part of this elite group as we continue our commitment to high-quality screening practices,” said physician Thomas Summers, president of Windsong. “We are proud and honored to be working with Windsong Radiology Group as a Lung Cancer Alliance Screening Center of Excellence,” said LCA President and CEO, Laurie Fenton Ambrose. “Their commitment to practice responsible lung cancer screening will lead to advancements in research and many lives saved. They are an example to follow.” Windsong is the only facility in the area to be recognized by both the American College of Radiology and the Lung Cancer Alliance as a nationally recognized lung cancer screening center of excellence. Designated screening centers of excellence are committed to providing clear information based on current evidence on who is a candidate for lung cancer screening, and to comply with comprehensive standards based on best practices developed by professional bodies.
ECMC gets award for treating patients with heart condition Erie County Medical Center (ECMC) Corporation has received the Get With The Guidelines — Heart Failure Gold-Plus Quality Achievement Award for implementing specific quality improvement measures outlined by the American Heart Association/American College of Cardiology Foundation’s secondary prevention guidelines for patients with heart failure. This marks the 10th year that ECMC has been recognized with a quality achievement award. Get With The Guidelines — Heart Failure is a quality improvement program that helps hospital teams provide the most up-to-date, research-based guidelines with the goal of speeding recovery and reducing hospital readmissions for heart failure patients. Launched in 2005, numerous published studies have demonstrated the program’s success in achieving patient outcome improvements, including reductions in 30-day readmissions. ECMC earned the award by meeting specific quality achievement measures for the diagnosis and treatment of heart failure patients at a set level for a designated period. These measures include evaluation of the patient, proper use of medications and aggressive risk-reduction therapies. These would include ACE inhibitors/ARBs, beta-blockers, diuretics, anticoagulants, and other appropriate therapies. ECMC also received the association’s Target: Heart Failure Honor
Roll. Target: Heart Failure is an initiative that provides hospitals with educational tools, prevention programs and treatment guidelines designed to reduce the risk of heart failure patients ending up back in the hospital. Hospitals are required to meet criteria that improves medication adherence, provides early follow-up care and coordination and enhances patient education. The goal is to reduce hospital readmissions and help patients improve their quality of life in managing this chronic condition.
Renowned pediatric cancer doctor moving to Buffalo Physician Kara Kelly has been appointed as the new leader of the joint program in pediatric hematology/oncology, a partnership of Women & Children’s Hospital of Buffalo (WCHOB), Roswell Park Cancer Institute (RPCI), UBMD Pediatrics and the University at Buffalo (UB). WCHOB, RPCI and UB have provided pediatric hematology and cancer care through a comprehensive and collaborative program for more than 40 years. Kelly is currently professor of pediatrics at the Columbia University College of Physicians and Surgeons. Her appointments as chairwoman of pediatric oncology, professor of oncology and the Waldemar J. Kaminski Endowed Chair of Pediatrics at RPCI and medical director of the Pediatric Hematology/Oncology Service Line at WCHOB, a Kaleida Health facility, will take effect in February. Kelly will also assume the responsibilities of division chief of hematology and oncology at both UBMD Pediatrics and the department of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, where she will be appointed research professor. Kelly is recognized nationally and internationally as an expert in the treatment of pediatric lymphoma and leukemia and serves as the chairwoman of the Hodgkin lymphoma committee of the Children’s Oncology Group. In addition to her current role as professor of pediatrics, she is associate director of the division of pediatric hematology/ oncology/stem cell transplantation at Columbia. “Dr. Kelly is a gifted physician leader who brings openness and great sensitivity to the care she provides and her interactions with families. With all she has accomplished in the clinical, academic and research arenas, she is poised to be an outstanding chair,” said Candace S. Johnson, president and CEO of Roswell Park.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2015
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Vaping: A Safe Alternative? By Tim Fenster
F
or physicians like Andrew Hyland, the increasing popularity of electronic cigarettes— more colloquially known as “vaping” — is something of a two-edged sword. The chairman of the department of health behavior at Roswell Park Cancer Institute says that the vapor inhaled from e-cigs contain far fewer cancer-causing chemicals than traditional cigarettes. But in a 2014 study, Hyland and other researchers found that concentrations of certain carcinogens, including formaldehyde and acroelin, in e-cigarette vapor were in some cases even higher than in traditional tobacco products. “It’s a twoedged sword,” Hyland said. “Most chemical compounds are Hyland significantly reduced in e-cigarettes. But the emissions say ‘safe’ is not the right word to use [in describing e-cigarettes].” E-cigarettes are battery-powered devices that apply heat to a liquid solutions containing nicotine, flavors and other chemicals. The user typically holds down a button to activate the heat, then releases the button
and inhales the vapor. Some devices allow the user to control the device’s voltage and thus the amount of heat it generates. In the study, researchers found only traces of toxic chemicals when the devices were operated at low voltage. But at high voltage, levels of formaldehyde and acrolein surpassed that of traditional cigarettes. “Toward the higher end of voltage … is where you have high levels of formaldehyde,” Hyland said. Both Hyland and Gregory Conley, president of the American Vaping Association, an industry group, said it’s the levels of cancer-causing chemicals, rather than their mere presence, that determines whether a product is unsafe. “The principle tenant of toxicology is that the dose makes the poison,” Conley said. However, Conley disagrees with the methods of many researchers in their studies, saying that many use much higher voltage than a typical e-cigarette user would. “You can generate higher levels of chemicals, but the burning acrid taste is awful,” Conley said, who began “vaping” in 2010 to quit a nearly 9-year cigarette habit. Conley also cited a report from Public Health England that estimated that e-cigarettes are “around 95 percent less harmful than smoking.” “In the real world, the actual vapor taken by the user does not contain any level of any chemical that would raise concerns,” he said.
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But Hyland is not convinced that the average user would consume only negligible amounts of carcinogens, saying lower voltage also gives the user lower levels of nicotine per puff. Although he did add: “There is not a lot of information in scientific literature on how people use these.” The Roswell Park study findings may have weighed on the minds of Erie County legislators when they voted, 9-1, in March of this year to ban use of e-cigarettes in businesses and public places. The law puts e-cigarettes under the same rules and restrictions as normal cigarettes. Hyland said the levels of carcinogens found in their emissions warrants a public debate on such a ban. Meanwhile, Conley criticized the county for not including an exemption for vaping shops (which exclusively sell e-cigarette products), and
raised concern that lawmakers would next seek to tax the products. Taxing these products, he said, would raise the cost of the devices beyond the budget threshold of many smokers, preventing access to a device that could help them finally quit. He cited a U.S. Centers for Disease Control & Prevention report which found adult smoking to be at an all time low of 15.2 percent in early 2015 (down from 19.4 percent in 2010). Other CDC reports found significant drops in tobacco use among teens since 2011. But Hyland is not convinced about the effectiveness of e-cigarettes, noting that smoking rates have long been on the decline. “I would be hard-pressed to say that there are enough controlled studies that show a link between e-cigarettes and quitting,” he said. “The evidence is pretty limited at best.”
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The 411 on Arsenic Exposure By Amanda Jowsey
T
he natural level of arsenic in the environment has increased dramatically as a result of arsenic’s industrial use and production. This harmful metallic mineral seeps into air, soil and groundwater that is used for irrigating crops, cooking and drinking. Many foods, including rice, fruit and fish, absorb the element from their surroundings. Long-term exposure to this pollutant has been linked to several health problems, especially cancer. “Drinking-water is considered to be one of the primary sources where people ingest arsenic,” said Dolores Funke, Funk director of environmental health for the Erie County Health Department. “Individuals, particularly if they cooked with water that was high in arsenic, and if they ate certain foods produced in an area where arsenic levels were high, might also get a significant part of their arsenic out of food.” Arsenic is found in two forms: inorganic and organic. “The inorganic form is more hazardous to human health… it is carcinogenic when people are exposed over a long period of
time,” Funke said. “The result tends to be skin cancer and some other internal organ cancers,” including bladder and lung cancer. Immediate symptoms of a toxic level of arsenic in the body include diarrhea, vomiting and dehydration. Funke said that organic arsenic is typically found in seafood. Inorganic is found in drinking-water. “Locally, we are not seeing any levels of arsenic even at half of the maximum contaminate level (MCL) in our public water sources,” Funke said. The MCL for arsenic in drinking-water is 10 parts per billion. To limit exposure overall, Funke recommends drinking water from approved sources. Diversifying one’s diet, and finding ways to use less water when preparing food are also common recommendations. Arsenic in water is a primary concern, but its presence in soil and air is also dangerous. In addition to its many other industrial applications, arsenic’s past and current use in pesticides and herbicides has significantly contributed to overall pollution. One local facility, FMC Corporation, caused water, soil and air contamination on and off site from the past production of arsenic-based pesticides in Middleport, NY. A cleanup and investigation with the Environmental Protection Agency, Department of Environmental Conservation and New York State Department of Health has been active since the early ‘90s.
In an email, EPA press officer and community involvement coordinator for Western New York and the Finger Lakes Region, Michael Basile, said, “Many times when we respond to an area, we determine that people are living on top of contaminated soil or adjacent to a former industrial facility that has impacted their communities,” like residents in Middleport. “It is our job to define what is going on in a community by testing soil, water and air, and quickly deciding how we can assist that community,” Basile said. The EPA tests for 126 different contaminates in these areas, including arsenic. “The NYSDOH and the Agency for Toxic Substances and Disease Registry review our testing results, and, using their protocols, recommend to us how we can protect the public both short and long term,” Basile said. Arsenic, a carcinogen, was recently added to the National Priorities List for substances known to pose the greatest threat to human health. Currently, organic arsenical pesticides are used to a limited extent. Inorganic arsenicals are banned from agriculture, but abundant levels of arsenic still exist in the environment from its long and diverse history of use. Several new studies show that as a result of this pollution, most food, to some extent, contains the contaminant. In an email, Food and Drug Administration Press Officer of Media Affairs for New York State Lauren
Sucher, cited three press releases, summarized as follows, to show the FDA’s current attempts at monitoring and controlling arsenic in food, a topic they’ve been investigating since 1991. In 2013, the FDA tested approximately 1,300 samples of rice, which is known to absorb arsenic more readily than other crops, and found that average levels of inorganic arsenic ranged from 2.6 to 7.2 micrograms per serving, which the FDA determined was not enough to cause any short-term adverse health effects. They are concerned with studying long-term exposure. A similar study of grape and apple juice revealed low levels of arsenic, averaging below the federal drinking-water standard, but a 10-parts-per-billion limit was set for arsenic in these products shortly after. The FDA is currently conducting a comprehensive risk-assessment of arsenic in food to evaluate its health effects, stakeholder and public needs, and the potential impact of regulations on the market. Any limits set on arsenic in food would only occur, if necessary, following this assessment. Several other groups are working to address the issue of arsenic pollution and human exposure, including the U.S. Department of Agriculture, National Academy of Sciences, National Research Council, National Institute of Environmental Health Sciences, World Health Organization and Centers for Disease Control and Prevention.
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A
randomized trial of people with two common forms of arthritis has found that yoga can be safe and effective for people with arthritis. Johns Hopkins researchers report that eight weeks of yoga classes improved the physical and mental wellbeing of people with two common forms of arthritis, knee osteoarthritis and rheumatoid arthritis. The study is believed to be the largest randomized trial so far to examine the effect of yoga on physical and psychological health and quality of life among people with arthritis. Results were published in the April issue of the Journal of Rheumatology. “There’s a real surge of interest in yoga as a complementary therapy, with one in 10 people in the U.S. now practicing yoga to improve their health and fitness,” said Susan J. Bartlett, an adjunct associate professor of medicine at Johns Hopkins and associate professor at McGill University “Yoga may be especially well suited to people with arthritis because it combines physical activity with potent stress management and relaxation techniques, and focuses on respecting limitations that can change from day to day.” Arthritis, the leading cause of disability, affects one in five adults, most of whom are under 65 years of age. Without proper management, arthritis affects not only mobility, but also overall health and well-being, participation in valued activities and quality of life. There is no cure for arthritis, but one important way to manage arthritis is to remain active. Yet up to 90 percent of people with arthritis are less active than public health guidelines suggest, perhaps due to arthritis symptoms such as pain and stiffness, but also because they are unsure of how best to remain active.
Eye drops could clear up cataracts using newly identified chemical
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chemical that could potentially be used in eye drops to reverse cataracts, the leading cause of blindness, has been identified by a team of scientists from UC San Francisco (UCSF), the University of Michigan (U-M), and Washington University in St. Louis (WUSTL). Identified as a “priority eye disease” by the World Health Organization, cataracts — caused when the lenses of the eyes lose their transparency — affect more than 20 million people worldwide. Although cataracts can be successfully removed with surgery, this approach is expensive, and most individuals blinded by severe cataracts in developing countries go untreated. Reported Nov. 5 in Science, the newly identified compound is the first that is soluble enough to potentially form the basis of a practical eye drop medication for cataracts.
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Never Down Down syndrome doesn’t deter goal of being physically fit By Daniel Meyer
F
ollowing his life philosophy of eating healthy, exercising and having fun, 27-year-old Craig Donatelli has overcome the obstacles of having Down syndrome to live a productive life that includes a focus on staying physically fit. The Hamburg native has a milder disability than others with Down syndrome, allowing him to enjoy himself by participating in a variety of recreational experiences. Special events coupled with regularly scheduled exercise allow Donatelli to maintain a healthy body weight and keep everyone happy, including his doctor and parents. “I am eating healthy, exercising and having fun,” Donatelli said, who thanks to assistance from Aspire of WNY resides in a shared living situation. “I want my parents to be happy and my doctor to say good things about me when I have a check-up.”
Max and Joyce Donatelli are proud parents for a number of reasons, including the fact that their son works a part-time job, attends People, Inc.’s Day Habilitation program and is a member of Self-Advocates of Western New York. But perhaps what they admire the most about their son is his attention to detail to help remain physically fit. “When Craig first moved to where he lives now, he really liked it but he put on some extra weight,” Max recalls. “It came down to portion sizes so now he and his housemates are more aware of the amount of food that Craig eats and I have to say keeping an eye on that and exercising regularly have helped to make a difference.” Craig happily lists the reasons for his success in maintaining his weight and being what in his words is “tip-top shape.”
Craig Donatelli, a 27-year-old man from Hamburg, has played a variety of sports, including time as a “Touching Bases” baseball player.
Keeping tabs on fitness
“When I go to the gym, my coach Bob has me do a lot of different activities like pushups, running and walking and it is really fun,” Craig explains. “I also do well because I have a FitBit. I’ve had it for about four years and it helps me keep track of how many steps I take every single day. When I work at Denny’s, that helps me too because I have to use my muscles when I do my maintenance work there. That is good because it gives me a different kind of workout that works different muscles.” Joyce is elated her son has embraced the importance of staying in shape. “I had noticed he had put on some weight when he first moved. It was actually about 11 pounds,” Joyce recalls. “Once he got into the routine of going to the gym and realizing the importance of eating healthy, that Donatelli knows the importance of eating healthy and enjoys preparing his own meals. weight came down and he has more Page 20
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2015
muscle mass now. It is really important to him. He takes pride in himself and just has the best self esteem that you can find in someone like him.” “Craig takes pride in his appearance and he likes to look good,” Max says, pointing out Craig is also a former taekwondo student. “We’re pleased that he is so focused and enjoys exercising. He also loves to dance. He has really good endurance and we just hope that he remains passionate about it and sticks with it.” Craig’s glimpse toward the future includes spending plenty of time with family and friends and continuing to carve out time to take care of his body. “I like to stay in shape because it makes me feel good and it makes me look really good,” Craig says. “If you feel good and look good and have fun, then you are having a great life and that makes me very happy.”