Wny igh 18final by In Good Health: WNY's Healthcare Newspaper

in good WHAT’S THE SKINNY ON APPLE CIDER VINEGAR?

Going on Vacation? A week’s vacation may leave many adults with a heavier midsection — extra weight that can hang around even six weeks post-vacation.

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April 2016 • Issue 18

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Buffalo & WNY’s Healthcare Newspaper

Online Breast Milk There has been an explosion of websites that buy and sell breast milk and traffic in those sites has continued to rise. Transactions have more than doubled in the past three years. And it’s not just moms buying it. But how Page 14 safe is buying breast milk online?

One Year, No Domestic Line Infections Violence

One in four women has been the victim of severe physical violence by an intimate partner, while one in seven men have experienced the same. Why this is still a problem and how local groups are trying to tackle it

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Reasons to Do Aquatic Therapy

Autism: Are Girls Being Overlooked for Screening?

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Farrell family from Tonawanda with their newborn at the Women & Children’s Hospital of Buffalo’s NICU. The unit recently celebrated one year without any central line infections.

The Surprising Benefits of Portobellos

Tai Chi Could Be a Healthy Move for Your Heart

Tai chi and other traditional Chinese exercises might reduce depression, improve quality of life for heart patients

Q&A with Carlos A. Santos, M.D.

This mushroom possesses such a unique and vast array of nutrients, it’s hard to know where to begin.

Founder and managing partner of OB-GYN Associates of Western NY talks about growing a single-specialty group focused on women’s health April 2016 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Pedestrian Deaths Projected to Jump 10%

alking in the United States appears to be more hazardous than ever. A new report projects a 10 percent surge in pedestrian deaths between 2014 and 2015 — the largest annual rise on record. While no one cause is apparent, the rise in pedestrian deaths could reflect increased traffic volume, growing cellphone use by drivers and walkers, and more people walking for health, economic or environmental reasons, according to the report from the Governors Highway Safety Association. "We are projecting the largest year-to-year increase in pedestrian fatalities since national records have been kept, and therefore we are quite alarmed," said report co-author Richard Retting, of Sam Schwartz Consulting. Researchers made the estimate by comparing preliminary data on the number of U.S. pedestrian deaths in the first six months of 2014 (2,232) and the first six months of 2015 (2,368). Twenty-six states and Washington, D.C., reported increases in pedestrian deaths, the researchers said. Also, pedestrians now account for 15 percent of all motor vehicle crash-related deaths, compared with 11 percent a decade ago, according to the annual Spotlight on Highway Safety Report.

Vacations Not Good for Your Waistline

Study: Vacations can lead to weight gain, contribute to ‘creeping obesity’

week’s vacation may leave many adults with a heavier midsection — extra weight that can hang around even six weeks post-vacation. A faculty member in the University of Georgia’s College of Family and Consumer Sciences found that adults going on a one- to three-week vacation gained an average of nearly 1 pound during their trips. With the average American reportedly gaining 1-2 pounds a year, the study’s findings suggest an alarming trend. “If you’re only gaining a pound or two a year and you gained three-quarters of that on a one- to three-week vacation, that’s a pretty substantial weight gain during a short period of time,” said Jamie Cooper, an associate professor in the college’s department of foods and nutrition. The study supports the notion of “creeping obesity,” the common pat-

tern of adults gaining small amounts of weight over long periods of time, leading to increased health problems later in life. Cooper’s study involved 122 adults between the ages of 18 and 65 — average age of 32 — who went on vacations ranging from one to three weeks in length between the months of March and August. One of the factors that likely contributed to weight gain for study participants was increased caloric intake, especially Cooper from alcohol consumption. The average consumption prior to

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

vacation was eight drinks a week. That number went up to an average of 16 per week for study participants, which accounts for a significant increase in calories. “One of the challenges people face is unless you’re diligent about weighing yourself before and after vacation, usually you’re not going to notice a pound of weight gain,” Cooper said. “People don’t realize it’s happening, and that’s why they don’t lose weight following a vacation.” Cooper noted there were some benefits to vacations. Study participants showed significantly reduced stress levels and a slight reduction in systolic blood pressure that lasted even six weeks post-vacation. The study — “A prospective study on vacation weight gain in adults” — was published in the journal Physiology and Behavior and included Theresa Tokar of Texas Tech University as a co-author.

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Heart Surgeon Runs His Daily Commute

Michigan physician sets an example for patients by running to work every day

heart surgeon at the University of Michigan Frankel Cardiovascular Center, who like the rest of us tries to fit in some daily exercise, has been running to work every day for the past 30 years. It’s physical activity and it’s stress relief for the 60-year-old who fixes faulty heart valves. He’s one of the busiest mitral valve surgeons in the country, helping patients whose hearts are forced to work harder when their mitral valve isn’t working properly. Before hitting the road in Ann Arbor, Mich., for his six-mile run, he shared a few thoughts about his routine: • “As a kid I was a swimmer. When I pulled myself out of the pool

I figured I'd better do something to stay active so I started running. I’ve basically run every day since then: college, medical school, residency and now that I’m on the faculty [as a professor of cardiac surgery]. • “My motivation to go to work running is basically that it’s my zen moment. I really take that time out and that’s when I think about stuff. • “Some of my patients know that I run to work every day and they think it’s fascinating. They think it’s great that I’m getting in cardio every day. To practice what you preach is a good philosophy. I don’t know that running to work every day isn't practical for everyone, but doctors really should be examples for our patients.”

Tai Chi Could Be a Healthy Move for Your Heart Traditional Chinese exercises might reduce depression, improve quality of life for heart patients

ai chi and other traditional Chinese exercises may benefit people with heart disease, researchers report. The new review of 35 studies included more than 2,200 people in 10 countries. The investigators found that, among people with heart disease, these types of low-risk activities appeared to help lower blood pressure and levels of LDL ("bad") cholesterol and other unhealthy

blood fats. Tai chi, qigong and other traditional Chinese exercises were also linked to improved quality of life and reduced depression in heart disease patients, the study authors added. But the exercises did not significantly improve heart rate, aerobic fitness levels or general health scores, according to the report published March 9 in the Journal of the American Heart Association.

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In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Publisher: Jamie Sandidge • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Tim Fenster, Jana Eisenberg, Kimberly Fenter Advertising: Jamie Sandidge (585-317-1671), Donna Kimbrell (716-332-0640) • Layout & Design: Eric J. Stevens • Officer Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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Carlos A. Santos, M.D. Founder and managing partner of OB-GYN Associates of Western NY talks about growing a single-specialty group focused on women health Q: Give us an overview of your practice. A: I'm one of 11 physicians in a practice I started about 30 years ago. Back then, it was mostly solo practitioners. You'd take over for someone who was about to retire and you'd get a hand-off of patients from a physician who was on his or her way into retirement. So that's exactly what I did. There was a retiring physician, Dr. Kenneth McCarther, a pretty well-known OB-GYN. I made a commitment to him that I would take over his practice. I was in solo practice for about five years after that. I hired several physicians in succession when the practice kept growing. As of now there are 11 physicians and 10 nurse practitioners in our practice. Q: Are you all OB-GYNs and OB-GYN support staff? A: It's a single-specialty group. It's all female health-related. Out of the 11 physicians, there's one who is a maternal fetal medicine specialist. That's one of the three sub-specialists. One of the others deals with reproductive endocrinology and fertility. We have someone coming onboard in a few months who will be doing that. The third deals with gynecological cancers. We have an affiliation with CCS oncology and Roswell Park to take care of that. We have one individual who has chosen to only practice gynecology since she has young kids. Obstetrics has a more unpredictable schedule. The rest practice OB-GYN, full scale.

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Q: What kind of impact does a group practice have on the lifestyles of you and partners? A: Patients who come to our practice understand that we are practicing in a group. I mean, the reality of it is, even as a solo practitioner, you can't really promise that you'll be available 24 hours a day, 365 days a year. So that means that you need some kind of arrangement to cover for when you are taking a family vacation or need personal time. That means there's always a risk you might be delivering a baby with a physician other than your obstetrician. In a group practice, the patients can feel confident that a physician from the practice will be filling in if their physician is unavailable. So we take turns every day so that the person on call sits at the hospital all day and doesn't have any other

getting started, so their availability is limited. So being able to accommodate early, late and weekend appointments is something we can do thanks to our size. Q: A lot's been said about patient comfort issues with regard to selecting a male or female OB-GYN, but are there generational aspects to that? A: When I sit down with new patients, that's one of the things we talk about. It goes both ways, too, honestly. Nowadays with the Internet, patients will investigate their own health issues and come in with preconceived ideas about what they want done. So they're kind of diagnosing themselves. You've got to make sure you like me, and I've got to be sure I like you so we can make good decisions about how to take care of you. It's a relationship that lasts a long time, so we need that level of comfort. In other specialties, your contact with the patient is a lot more sporadic. Our number one source of referrals is other patients, which is why you don't see too much advertising. Q: Are patients well-informed? A: I think women tend to be more well-informed consumers of medical care than men. Younger patients are computer savvy, so I generally don't have a problem with them bringing that information in. I try to make sure to give them the correct medical terms so that they know what they're dealing with. If they're doing their own research, you want to help them avoid errors. They want to double-check what you're saying rather than just saying 'whatever you say, doctor!'”

commitments. So there's a bit more continuity of care by virtue for that. Q: Do you tend to lean more toward either the obstetrics or gynecology side? A: I do both. I'm 59 years old now. One of the interesting things that happens in this specialty is, as you get older, the mix changes. When you're starting out, typically the obstetrics volume is a lot higher, as your patients tend to be younger. Our patients actually grow old with us, which is kind of fascinating. Q: So you tend to lock in patients when they're younger? A: Yes. To give you a rough idea, the younger physicians in my group tend to be doing about 65, 70 percent obstetrics. Whereas around 85 percent of my practice is GYN. My patients are getting older, and people only have so many kids. Once you build up your practice, you don't really have the capacity to accept too many new, younger patients. So they navigate to the new ones, who have that spare capacity. Q: That's interesting. I assume there's not that much patient turnover in your specialty? A: Sometimes they'll move out of the area, or you might not get along with somebody. The group practice helps with that too and allows us to have greater availability. A lot more women work now than when I was

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

Q: What are some of the challenges practicing OB-GYN in Western New York? A: It’s not really unique to Western New York, but we've seen a lot of costs shifted to the patient with Obamacare. The younger generation in particular has high-deductibles, so there's a financial barrier for some of them to getting care. We don't want people avoiding care due to financial constraints. Local competition isn't a big thing; there are enough practitioners and patients. The birthrate in Erie County is pretty stagnant, so we're not seeing an increase in births, which can make for a bit of competition when it comes to obstetrics. Q: How do you distinguish or brand yourself as an obstetrician? A: You have to provide quality care. We try to make patients feel like they're a part of our family. We try to make sure we're spending enough time with patients and being available, as well as being a one-stop shop. I think that's very important for them.

Lifelines Name: Carlos A. Santos, M.D. Position: Managing Partner at OB-GYN Associates of Western NY Hometown: San Juan, Puerto Rico Education: University of Puerto Rico Affiliations: Mercy Hospital Organizations: American Board of OBGYN, Society of Gynecologic Surgeons, American Medial Association Family: Married, four children Hobbies: Boating

Hospital Occupancy in Buffalo

Focus on outpatient care has decreased the rate of hospitalizations By Deborah Jeanne Sergeant

ospital occupancy rates nationwide have declined from an average 76.7 percent in 1975 to 65.2 percent in 2012 (the most recent data available) and the trend continues to take hold, including in hospitals in Upstate New York. Melissa Mansfield, representing Healthcare Association of New York State (HANYS), said that in the Buffalo area, hospital occupancy has stabilized and a focus on outpatient care has decreased the rate of hospitalizations. Several local hospitals contacted for this story declined to share their occupancy rates. Christine Bellari, professor and clinical coordinator at Erie Community College in Williamsville, said that the trend toward the community and ambulatory care centers has reduced occupancy. "They want to get patients home," she said. "Cost is part of the reason. Years back, patients were admitted the day before surgery. Now,

it's done the day of surgery." Officials at Kaleida Health, Catholic Health System and University at Buffalo did not respond to requests for interviews for this story. With the Affordable Care Act bringing more healthcare users into the system, present resources are stretched to the limits. Physician, physician extender (physician’s assistant, nurse practitioner), and nursing shortages have made it more difficult for facilities to offer lengthy hospital stays to people who don't absolutely need them. Hospitals' lower reimbursement from insurance companies, Medicaid and Medicare also squeeze their margins tighter, along with rising overhead expenses. Keeping patients out of the hospital offers some positive aspects beyond cost. Keeping not-so-sick people out of the hospital saves space for those who truly need it; however, since hospitals experience more patient turnover, they also saddle them-

selves with "a tremendous amount of workload admitting and discharging people," Bellari said. "By not having a patient stay in the hospital as long, the patient isn't as at high of a risk of hospital acquired infection and they get moving faster," Bellari said. Antibiotic-resistant "super bugs" can cause a serious secondary illness. Although healthcare providers establish protocols to prevent the spread of infection, it still happens. Sending stable patients home can help reduce their risk, since crowded conditions exacerbate the spread of infection. John Bartimole, CEO/president of Western New York Healthcare Association in Tonawanda, said that local occupancy rates are high, but not over burdened. "No one wants to stay in a hospital," Bartimole said. "It's a healthy movement to limit hospital time without compromising patient care, quality of care and health. I think we'll continue to see a trend toward

shorter hospital stays when appropriate. A lot of hospitals are transitioning rooms to single rooms which enhances the patient experience." Occupancy importantly affects but doesn't entirely drive hospital viability. Ambulatory surgery represents a growing segment of many hospitals' income. Since patients don't stay overnight, they require less care. "It costs money to keep people in a hospital bed," Bartimole said. "The payer, whether the government or private payers, are looking for ways to diminish costs. The more quickly we can get people in and out without compromising their safety, it's better for everyone around." Bartimole said that Western New York has been "very lucky" in experiencing few hospital closings. "The smaller hospitals affiliate or associate with larger hospitals to give them a financial parachute and more resources, like specialists coming a few days a week," he said.

Healthcare in a Minute By George W. Chapman

Malpractice alternative

Patients seeking damages would present their grievance to a panel of experts and an administrative law judge. Rather than wait years for a settlement, the claimant would be quickly compensated should their case have merit. This would ameliorate if not eliminate the adversarial relationship the current malpractice system creates between physician and patient. It would also allow providers to acknowledge an error without fear of litigation. This Alternative Patient Compensation System model is being contemplated in Georgia, Florida, Tennessee, Maine and Montana.

Hundreds of US rural hospitals in jeopardy

One third of all US rural hospitals are in danger of closing. Seventy percent of them have had negative operating margins for years. The loss to a community is more economic than clinical. While clinical care is typically available at other facilities in the area, rural hospitals are often one of the largest employers where they are located. States with the most distressed rural hospitals are Texas and Mississippi. There are about two dozen small/ rural hospitals in danger of closing in New York state. Two senators have introduced legislation, “Save Rural Hospitals Act,” to provide funding to keep the doors of rural hospitals open. Without special funding, most rural hospitals will close unless they affiliate with a larger hospital or join a hospital system.

Hospital jobs on the rise

According to the Bureau of Labor Statistics, hospital employment is at just over five million people. Hospitals added a net 188,000 jobs in 2015. Most of the growth is attributed to acquisitions of medical practices, increased demand for outpatient services and gearing up for population health management. The entire healthcare sector employs almost 19 million workers. Employment was down in dental offices and laboratories.

Happy Danes

Like most Western nations, Denmark has a universal healthcare system. Danes are very happy with their lives and their healthcare because the bureaucracy that is typically associated with universal systems has been vastly reduced. The Danish system emphasizes locally focused control. A lot of value is placed on close, unfettered relationships between patients and their primary physician. Danes average seven contacts (in person, phone, electronic) per year with their primary care provider. The US average is less than four contacts. The main goal in Denmark is to catch problems early and treat. Danish per capita costs are about $5,000 compared to about $9,000 in the US.

Employer-sponsored plans cause concern

Large employers can avoid a lot of insurance regulation and requirements by forming and designing their own plans. The

hospital association is lobbying congress to close loopholes in coverage requirements. In a letter to Centers for Medicare & Medicaid Service (CMS), the American Hospital Association (AHA) expressed concern over the fact that that some employer plans are not covering outpatient surgery in order to cut costs. The AHA argues this puts employees at risk both clinically and financially, meeting neither the spirit nor mandate of the Affordable Care Act, which is to insure safe, affordable, accessible and comprehensive care to all Americans. The AHA suggests that CMS establish minimum coverage standards for all categories of care including surgery.

Healthcare advertising on the rise

The industry — providers and drug companies — spent $14 billion on ads in 2014, up 20 percent over 2011. Competition for patients and market share is fierce, causing concern among consumer groups about over utilization and higher prices to pay for the increased ads.

Moratorium on hospital mergers

While mergers can save vulnerable hospitals and/or improve services, many have resulted in nothing more than monopolies which typically lead to price hikes. Connecticut Gov. Dan Molly has placed a moratorium on hospital mergers in his state. He issued this statement, “We need balance. Fewer healthcare systems mean fewer

April 2016 •

choices for consumers, and that can dramatically affect both the quality of care and costs. It’s time we take a holistic look at the acquisition process.” In the same vein, many are questioning the impact of insurance company mergers on eventual premiums.

Medicare Advantage plans

Last year, more than 17 million seniors (about one third of Medicare eligibles) chose to enroll in an Advantage plan offered by a private commercial insurer. Advantage plans attract seniors by offering more benefits than traditional Medicare. The feds entice private insurers to offer Advantage plans with more than $3 billion in incentives and bonuses. The insurer must reinvest monies earned into additional benefits and new approaches to manage chronic conditions like hypertension, diabetes and obesity. United Health, for example, could earn over $1 billion in bonuses this year. Overall, commercial insurers have done well under the ACA.

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

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Take Good Care: You're Worth it!

his morning, I got up early, got dressed, and took a walk as the sun was peeking across the horizon. I do that every morning now. But that hasn’t always been the case. After my divorce, I adopted a “What’s the point?” approach to caring for myself and my home: What was the point of getting up early, walking, eating healthy meals or putting on lipstick when no one was watching or cared what I did? It’s not uncommon for people who live alone to fall into a “What’s the point?” frame of mind. Leaving the dirty dishes in the sink or wearing your pajamas all day may seem harmless, until you consider the impact these acts of indifference can have on your self-confidence and sense of self-worth. Taking good care — very good care — of yourself is about the value of you. It’s about your intrinsic value to yourself, to your family, and to those you encounter throughout your day. It’s an essential part of feeling good and living alone with success. Here’s why taking care of yourself is so important:

It builds self-esteem: When you take good care of yourself you send an important message to yourself that you are worth treating well, cleaning up after, fussing over and protecting. When I come home after a busy day and walk through my front door, I am reinforced when my house is tidy and the kitchen sink is empty. It means I care enough about myself to maintain an inviting home, even if it’s just for me. The appearance of my home is a visible, tangible barometer of how I value myself — and, this is just one of many examples. My self-esteem gets a boost whenever I exercise discipline and do the things I know will deliver positive and self-affirming results. It looks good on you: When you take care of yourself, it shows and people notice. It opens up your world. In my “What’s the point?” period — my blue period — I would leave the house without paying much attention to my appearance. My sorry, baggy attire was only made sorrier by the dour expression on my face.

Needless to say, I didn’t turn many heads nor invite connection with others. But, those were the old days. Today, I take more care. My experience tells me that others notice when you pay attention to your outward appearance. When you care about yourself, you radiate vitality. It’s intriguing. And it may draw people, compliments, and unexpected connections your way. It enables you to better care for others: Taking care of yourself can be essential to taking care of others. I like the “airline” example. When traveling by plane, we are all given instructions on how to use an oxygen mask, and we are cautioned to put ours on first if we’re traveling with a child or dependent person. The reason is obvious: if we don't put our mask on first, we risk passing out and putting both lives in jeopardy. One of the best things you can do for others is to take care of yourself. That way, you’ll be better able — both physically and emotionally — to help your friends and family, when they need you. It is essential to your health: Eating healthy, enjoying a good night’s sleep, getting regular health check-ups, and exercising can all contribute to feeling good and alive. But living a healthy lifestyle can be a challenge when you live alone and there’s no one there to coax, inspire or embarrass you into action. This is when becoming your own nudge (your own personal coach) can be so helpful. I was having an awful time sticking to my exercise routine, so I decided to become a group exercise instructor. I knew I needed the “obligation” of leading a class to force myself to show up. Believe me, I wouldn’t be going to the Y as often had I not become an instructor.

It was one way of taking better care of my physical health and it worked! It’s a self-care strategy you might consider for yourself. It is rewarding: And, it can lead to self-discovery. Like anything else, learning how to care for yourself can reveal opportunities for personal growth and fulfillment. It can be fun and it can take you places you wouldn’t normally go. Again, another personal example: I’ve discovered after years of living alone that my home environment is very important to me. To feel whole and complete, I need to be surrounded by inspirational images and objects, and to live in space that is at once peaceful and stimulating. Taking care of this “visual” need of mine is a way of taking care of myself, and it has motivated me to seek out artists and to pursue creative endeavors on my own. What do you need to do to take care of your needs and wants? I encourage you to give it some thought. So, what’s the point? You are the point. Your physical, mental and spiritual health are what matter. Taking good care of yourself can help you acquire the personal strength and balance you need to create or re-invent a life that you truly love and live with gusto. So . . . till next time, take care. Very good care. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call her at 585624-7887, email her at gvoelckers@ rochester.rr.com.

Lawn Mowers Can Cause Severe Injuries to Kids Study found that more than half of accidents required amputation

KIDS Corner

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espite long-standing safety guidelines, U.S. children continue to suffer severe injuries from both regular power lawn mowers and ride-on mowers, a new Pennsylvania-based study finds. In more than half of such cases, children required an amputation, the research showed. "People don't realize how dangerous lawn mowers are," warned senior study author Douglas Armstrong.

He's a physician and professor of orthopedic surgery and division head of pediatric orthopedics at Penn State Hershey Medical Center in Hershey, Pa. "All lawn mowers have a tremendous amount of kinetic energy given off at the tip of the lawn mower blade. It's higher than a bullet leaving the muzzle of a 357 Magnum, which means that the injuries we see are not just lacerations, they're the result of something more like an explosion or blast injury," he explained. The researchers looked at information from all children with lawn mower-related injuries treated at Pennsylvania trauma centers between 2002 and 2013. The investigators found an average of about 16 accidents a year. In all, the study found that nearly 200 children under the age of 18 were injured because of a lawn mower. The majority of those injured (81 percent) were boys, and the average age was 8 years. Nine in 10 accidents occurred during warm weather months (April through September), according to the study. More than half of the cases (55 percent) involved "ride-on" lawn

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

mowers, the investigators found. Ride-on lawn mowers are small vehicles outfitted with a seat, versus standard lawn mowers you need to walk behind and push. The researchers said nearly twothirds of the injuries involved the lower extremities. Slightly more than half of the kids had to have an amputation because of the injury. One child (age 1) died due to an incident involving a ride-on lawn mower, the study authors reported. "The vast majority of the injuries could have been prevented if safety guidelines had been followed," Armstrong said. Those guidelines, outlined in 2001 by the American Academy of Pediatrics (AAP), recommend that no child under the age of 16 should operate a ride-on mower, while no child under 12 should operate a powered or non-powered push mower. The advisory further cautions parents to keep all children under the age of 6 indoors when any mower is in operation. Kids shouldn't ride along as passengers on mowers operated by adults, the pediatric group said.

CALENDAR of

HEALTH EVENTS

April 6, 20

Thyroid, bone density workshops at Schofield The community is invited to attend two free wellness programs offered Schofield’s Mondello Wellness and Family Center located at 3333 Elmwood Ave, in the Town of Tonawanda. • The April 6 program — “Your Thyroid & Weight – Are They Related?” — will be presented by chiropractor Jack Saia. He will talk about the complex relationship between thyroid disease, body weight and metabolism. It starts 1 p.m. The workshop will last one hour. • The April 20 program — “Bone Density Testing and Prevention of Osteoporosis” — will be presented by a Catholic Health’s WomenCare registered nurse, Maureen McCabe. Hear an overview about your risk for this silent disease and make an appointment for a free bone density test. It will take place from 1 to 3 p.m. The Mondello Wellness & Family Center is located inside Schofield Residence. For more information, call 9953851 or visit www.SchofieldCare.org.

April 12

Breast Cancer Network holds meeting The Breast Cancer Network of WNY will hold its monthly educational meeting at 6 p.m., April 12, at Bella Moglie Building, 3297 Walden Ave, Depew. Guest speaker will be registered nurse Cheryl L. Nosek from Daemen College nursing department, who will discuss “Depression and Managing Your Emotions.” The Breast Cancer Network of WNY’s mission is to support individuals with breast cancer, survivors, their families and friends. It’s a diverse group of volunteers and survivors dedicated to providing education, advocacy, collaboration and support. Light refreshments will be served. For meeting reservations, call 716-706-0060 or visit www.bcnwny. org.

April 26

Niagara Hospice volunteer training slated Niagara Hospice will hold spring training for new volunteers who want to join the `organization. Community members interested in experiences that make a positive impact on the lives of others, as well as their own, are invited to the next hospice volunteer training to be held from 5 to 9 p.m., April 26. Volunteers provide much needed companionship and support for hospice patients by visiting them in their home or in the nursing home or assisted living facility. Volunteer

activities include conversation and reminiscing; putting together puzzles or playing games; running errands for the family; or simply just holding a hand and listening.” Volunteer positions include patient-related and non-patient related jobs. Visits take place in the patient’s or caregiver’s home, at Niagara Hospice House, and at area longterm care facilities where hospice patients reside. Non-patient related opportunities include helping with community outreach, clerical tasks and fundraising efforts of Niagara Hospice. The agency’s most immediate volunteer needs are in the areas of making visits to patients in the Niagara Falls, Gasport, and Newfane areas; visiting residents at Rebekah’s Pathway at OddFellows, at hospice at Jeanne’s House at Northgate, and at David’s Path at Schoellkopf. More information and volunteer applications call 280-0748 or visit www.NiagaraHospice.org.

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April 28

Employment conference to focus on individuals with special needs Rochester Rehabilitation is hosting the first-of-its-kind employment conference in Western New York from 8 a.m. to 4 p.m. on Thursday, April 28. Sponsored by Wegmans, Employment First is being held at the Radisson Rochester Riverside at 120 East Main St. in downtown Rochester. The conference will focus on employment outcomes for special populations, including individuals with a disadvantage, those in poverty, people with disabilities, refugees, and veterans. The conference will offer workshop sessions for both human service providers and other employers. It will feature evidenced-based, best practice models and highlight successful partnerships between nonprofit vocational employment programs and local businesses. More than 200 conference participants from Upstate New York are expected to attend this event. The keynote speaker will be Robert Egger, a nationally-known nonprofit leader, author, speaker and activist. Egger spent 24 years as the president of the DC Central Kitchen, the country’s first “community kitchen,” where food donated by hospitality businesses and farms is used to fuel a nationally recognized culinary arts job-training program. Register for Employment First by contacting Jen Bellows at jbellows@ rochesterrehab.org or via phone at 585-473-2052. Information can also be found at www.rochesterrehab.org. The conference fee is $100 per person ($80 per person for groups of three or more from the same organization).

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Page 7

Understanding Parkinson’s Disease Did you know that April is Parkinson’s Awareness Month? The almost 9,000 diagnosed patients in Western New York sure do By Jana Eisenberg

hile most of us have at least heard of Parkinson’s, and may even know someone who has it, the details may be sketchy. One of those reasons is the mystery of the disease itself. Diagnosis is not always clear-cut or definitive; there is no blood test or X-ray that confirms it absolutely. Frequently, people start out with almost undetectable symptoms. By the time they are diagnosed, their disease has progressed substantially. There is also no cure for Parkinson’s — yet. Current treatment can include physical and occupational therapy, a cocktail of medications which have varying effectiveness over time or a surgery that implants a brain stimulator to help regain or smooth out motion affected by neuron degeneration. The people interviewed for this story all said that one of the most important things to understand about PD is that it can affect people in their 40s and 50s, not just the elderly. Bob Russell, 56, was diagnosed when he was 45. In the years leading up to his eventual diagnosis, he noticed trouble controlling his hands, for example when trying to handle his keys at work, where he was an audio-visual technician. He also noticed that his foot was dragging. Russell, a resident of Youngstown, north of Niagara Falls,

Upcoming Events • April: National Parkinson’s Awareness Month • May 14: Annual information symposium • Sept. 11: Moving Day For more information, Call 716-449-3795. is now an advocate for himself and people with Parkinson’s and their loved ones and caregivers, making informative and positive videos, participating in fundraisers and awareness events, and attending support groups. For the newly diagnosed, he says, “The first thing to know is that you’re not alone — there are others to support and guide you. It’s a debilitating disease. You’re trying to move, and your body won’t. It’s scary.” He found comfort in professional support as well. “The UB neurosurgery group is extremely helpful. They sit down with you, and explain what Parkinson’s is. Getting the medications in your system is a matter of

Bob Russell, of Youngstown, north of Niagara Falls, was diagnosed when he was 45. He is next to his wife Lori at the 2015 Moving Day; Russell served as the “Face

of Parkinson’s.” Page 8

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trial and error that can take weeks or months—you have to try different combinations and see if they work for you,” he says. “Some made me freeze—you try to tell your legs and arms to move, and they won’t.” Patricia Weigel, a registered nurse who is an expert in working with and understanding Parkinson’s disease. She assists doctors at UB neurosurgery, where she’s the clinical nurse coordinator. She’s also been volunteering with the National Parkinson Foundation of WNY for over 15 years. “[The symptoms of] Parkinson’s can start out fairly obscure,” says Weigel. “No two people are the same. And it can be difficult to diagnose. Someone might notice a slight tremor, they may have it for months or years…maybe they ignore it. It can then get worse, becoming a slowness, stiffness or change in their gait. We recommend seeing a ‘movement disorder specialist’—that’s a neurologist. A primary doctor can diagnose Parkinson’s, but if the case is not clear-cut, you should see a specialist.” Weigel iterates that medications have varying degrees of effectiveness, and that surgery is an option. “The medications can suppress the symptoms; if you’re stiff, they loosen you. If you have a tremor, they can quiet it. But over time, they aren’t as effective. And they can cause negative side effects.” A huge point for most Parkinson’s advocates, she adds, is to move with purpose. “Exercise can be ‘neuro-protective,’” says Weigel. “It can slow the progression of the disease. We know it can be hard to motivate patients to exercise or get physical therapy. We tell people that they should do what they like: walking, running, yoga, boxing, dance — we have a lot of services and options.” Chris Jamele, executive director of the National Parkinson Foundation Western New York chapter, looks at the big picture: “Awareness is a big part of things. April is National Parkinson’s Awareness month,” he says. “People need to recognize the significance of the disease, and recognize that anyone can get it.”

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

National Parkinson Foundation definition of Parkinson’s disease: “[PD] is caused by the deterioration of neurons in the brain— those which produce dopamine, an essential neurotransmitter that controls smooth, coordinated muscle function. When approximately 60-80 percent of dopamine-producing cells are damaged, motor symptoms of PD appear.” He and the organization are welcoming, easy to reach and offer many options for support and education for patients, their families and caregivers. “Research points to a combination of genetics and environmental causes or triggers,” Jamele says. “We are frequently invited to speak at nursing and care facilities, which are getting more and more Parkinson’s patients. They don’t always know how to deal with it. Everyone, including the medical community, needs more awareness and education.” One of the NPF WNY’s main awareness events is “Moving Day.” This year, it takes place on Sept. 11, at Buffalo’s Coca Cola Field. Sums up patient Bob Russell, “The whole thing is that you have to keep moving, and stay active! I have a group, which includes a bunch of retired teachers — we go out for breakfast and go for three or four mile walks...If you stop moving, you stop all together.”

How to Get More Information National Parkinson’s Foundation of Western New York Chris Jamele, 716-449-3795 or cjamele@npfwny.org www.npfwny.org.

SmartBites

The skinny on healthy eating

Surprising Benefits of Earthy Portobellos

ortobellos are unlike any food you’ll encounter in the produce section. This mushroom, in fact, possesses such a unique and vast array of nutrients, it’s hard to know where to begin. But first: What exactly is a portobello? Neither a fruit nor a vegetable, this large, flavorful fungus — known for its meaty texture — is really just a mature dark-button mushroom. Indeed, portobellos are simply creminis that have been left to grow until their caps reach diameters of up to six inches. That portobellos are low in fat, calories, sodium and cholesterol may not come as a big surprise. Most produce is known for being attractively low in all of the above. What may come as a surprise, however, is that portobellos deliver a decent amount of muscle-building protein (a little over 5 grams per large cap) and a good helping of heart-healthy fiber (about 3 grams per cap). What may also raise eyebrows is that portobellos are a mineral superstar — with more potassium than a banana, nearly half of our daily copper needs, and enough selenium to make top-10 lists of foods highest in this mineral. Potassium helps to control blood pressure; copper is needed for energy; and selenium helps to protect cells from free-radical

damage. Another big eye-opener: Portobellos may help prevent cancer, especially hormone-dependent breast cancer. Due to a unique fatty acid in portobellos that helps to lessen the production of estrogen, this mushroom may actually lower the risk of this breast cancer type. And the icing on the cap: Eating mushrooms such as portobellos may be associated with reduced inflammation and a stronger immune response, according to researchers at Arizona State University and Penn State University. Translation? The humble portobello may reduce the risk of health problems associated with chronic inflammation, such as heart disease, certain cancers, and Type 2 diabetes. Lastly, while mushrooms are often touted as being a good source of vitamin D, the particular form found in mushrooms has led experts to agree that you cannot count on mushrooms to be helpful with your vitamin D requirements.

Helpful tips

When selecting mushrooms, avoid mushrooms with bruises or that feel slimy, and go for those that smell earthy. If there’s any hint of ammonia or another odd odor, then you know the mushroom has

spoiled. Store unwashed mushrooms in a brown paper bag (plastic traps moisture and encourages sliminess) and place in refrigerator for up to a week. Clean with a soft brush or a damp paper towel or by a super-quick dunk in water.

Grilled Portobello Burgers with Rosemary Mayo Adapted from Bon Appetit Serves four Rosemary Mayo ½ cup fat-reduced mayo 2 teaspoons Dijon mustard 1 teaspoon dried rosemary, crushed 1 garlic clove, minced ¼ teaspoon each: coarse black pepper, salt Balsamic marinade 1/3 cup balsamic vinegar 1/3 cup water 2 teaspoons sugar 1 garlic clove, minced 1 teaspoon dried rosemary, crushed 1/4 teaspoon cayenne pepper (optional) 2 tablespoons olive oil Portobello burgers Nonstick vegetable oil spray 4 large portobello mushrooms, stems trimmed

4 whole wheat buns lettuce, sliced onions (optional) Place cleaned and trimmed mushrooms in a glass dish, stem (gill) side up. In a small bowl, whisk together marinade ingredients. Drizzle marinade over the mushrooms; cover and place in refrigerator for about an hour, turning mushrooms once. While the mushrooms are marinating, mix mayo, mustard, rosemary, garlic and salt and pepper in a small bowl. Set aside. To cook: Spray grill rack with nonstick spray, then prepare barbecue (medium heat). Grill portobellos until tender, turning once or twice, about 8 minutes per side. Baste with marinade to keep from drying out. Place each mushroom on a bun and top with rosemary mayo, lettuce and onions (if desired). 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.

Correction: Last month’s bok choy recipe should have also included “1/4 cup sliced almonds, toasted.”

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Page 9

Reasons to Do Aquatic Therapy

Water adds gentle resistance training for people who need recovering By Deborah Jeanne Sergeant

f you’re recovering from a long-term illness, injury or surgery, consider pursuing aquatic therapy from a physical therapy office. It offers benefits you may not have previously considered. 1. You don’t need a referral from your doctor. “In New York state, patients have direct access to physical therapy,” said Marty Koslosky, physical therapist with Amherst Orthopedic Physical Therapy, P.C., in Amherst. Since you don’t need a referral from a physician for treatment at a physical therapist, you can save the co-pay for the doctor visit. Physical therapy clients may receive treatment for up to 30 days or 10 visits. Beyond that point, you will need a doctor’s prescription to receive insurance coverage. (Check your plan before seeking treatment to ensure coverage.) Medicare typically does not cover aquatic therapy. 2. Aquatic therapy can help you if you have certain painful conditions and even a combination of conditions. “We see a lot of folks in our pool that have arthritic conditions or full body pain or fibromyalgia since they can’t exercise on land against full gravity,” Koslosky said. “The hydrostatic pressure helps with swelling.” If you have fibromyalgia and are recovering from knee surgery, for example, water-based therapy can prove easier than land-based therapy. 3. Water temperature can help hasten the healing progress. “The pool is 94 to 96 degrees, and that helps improve blood flow and when you do that, you improve healing,” Koslosky said. “If we know through evaluation that someone may not tolerate land exercise, we may suggest it.” By keeping clients more comfortable, therapists and patients can accomplish more goals in each visit. Plus, they may be able to shorten the overall time for rehabilitation. 4. Buoyancy can relieve pain as you exercise. “The buoyancy and properties of the water allow them to exercise with less resistance and initiate a program earlier than you could with land-based exercise, depending upon the problem,” said Peter Young, physical therapist with OrthoSports in Amherst, Williamsville, and Buffalo Clinic. 5. Aquatic therapy can help those who are weak or de-conditioned to slowly regain strength. “It’s ideal for those recovering from a stress fracture, someone beginning to bear weight for the first time after injury, people who are weak, and those with swelling to the lower extremities,” Young said. “It’s great for those with different forms of arthritis.” Water adds gentle resistance training for people recovering, instead of pushing the body too hard too soon as with lifting weights or using other land-based forms of resistance. Those fearful of water-based exercise can relax. The water is usually kept chest-deep at its deepest and the pools’ grab bars help patients remain stable. Like a gym membership, some physical therapy offices offer memberships for former clients or openly to use their equipment for a monthly rate. If you find an office you like, you may be able to continue self-guided exercise after your 10 treatments or 30 days have expired, so ask if the office provides a membership. Marty Kolosky, physical therapist with Amherst Orthopedic Physical Therapy, P.C., in Amherst, working with two patients at his facility. Photo courtesy of Marty Kolosky.

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New Ways to Treat ADHD

UB researchers part of a study group exploring better methods for treating attention deficit hyperactivity disorder By Tim Fenster

or years, stimulants like Ritalin and Adderall were used as a first-line treatment for children and adults with attention deficit hyperactivity disorder (ADHD), but a growing body of research suggests that these medications may be far less effective than early behavioral therapy. Physician Gregory Fabiano, an associate professor in the University at Buffalo’s department of counseling, school and educational psychology, said that research has found that the most effective approaches to ADHD treatment begin with early behavioral therapy. Following this therapy with medication is found to be the most effective method for managing ADHD’s symptoms, which include poor attention, excessive activity and difficulty controlling behavior. But ADHD is rarely treated this way. According to the Center for Disease Control, only about one third of preschool children diagnosed with ADHD receive this combination of behavioral therapy and medication. “Unfortunately, the first-linetreatment is usually medication,” Fabiano said. “People should consider a different approach.” Fabiano recently took part in a study that involved more than a dozen other researchers at UB and other universities, to determine the best methods for treating ADHD. The study took 152 children aged 5-12 who had been diagnosed with ADHD, split them into two groups and attempted to treat them for one school year. The first group received early behavioral therapy, and the second received low doses of methylphenidate, a central nervous system stimulant best known by its brand name, Ritalin. After eight weeks, those whose treatment had not responded sufficiently were again split into two groups. Half of those treated with early behavioral therapy received medication, and the other half received more intensive therapy. The same went for those were started off with medication. What they found was that the students who started with behavioral therapy and ended with medication were the most successful. “Relatively speaking, the groups that got medication first did not perform as well,” Fabiano said. The group with the least success was the one that started with medication and then received behavioral therapy. “The children who received

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

medication first didn’t engage in the therapy,” Fabiano said. “It reduces the incentive for families to work with behavioral therapy approaches.” Medication is also merely a short-term fix that requires sustained use. Behavioral-based therapy has the potential to make a lasting positive change in the way individuals with ADHD cope with their symptoms, which is important, as it is a lifelong disorder. A similar study Fabiano was involved with identified that behavioral therapy is also far more cost-effective, even when complemented with medication later on. It should also be noted that these medications can cause side-effects of insomnia, poor appetite and stunted growth. “If your goal is to treat a chronic condition like ADHD, behavioral therapy is much more bang of your buck,” Fabiano said. But Fabiano stresses that it’s important for therapy to provide daily positive reinforcement. Sitting a child with ADHD down in an office and telling him or her how to behave is not very effective, Fabiano said, because they usually understand how they should behave but have difficulty doing so. “They often get into a cycle where they have a lot of discipline and punishment, and at a certain point that doesn’t work anymore,” he said. Instead, parents and educators should outline a set of goals for the children and provide him or her with a daily report card to hold them to it. For example, a parent could allow a child 10 minutes of evening television if he or she reaches one of their goals; so the kid has to hit at least three goals to enjoy a TV program. “It’s a simple program but one that our evidence shows can be highly effective with children with ADHD,” Fabiano said. Parents of children with ADHD — which affects about 14 percent of boys and about 6 percent of girls — can also enroll their child in a weekend or summer behavioral program. The Summit Center has summer programs, and the University at Buffalo has a Saturday program for children and parents. For more information on treatment programs through UB, call 645-3697. For more information on The Summit Center’s programs, call physician Burrows-MacLean at 6293445 or visit www.thesummitcenter. org.

Bootleg Bucha co-owners Todd Salansky (left) and Jeffrey Empric along with Heather Lucas. They say the growing consumption of kombucha is because of its health benefits.

Kombucha Anyone? One of the latest, and probably most unusual, health fads to rise in the last few years is kombucha, a drink that is produced by fermenting tea using a symbiotic colony of bacteria and yeast. By Tim Fenster

alk into the Horsefeathers Market on Connecticut Street on a Wednesday or Saturday afternoon, head downstairs to the basement and you will find yourself at the serving counter of Bootleg Bucha. On the far wall, behind the counter, stands a kegerator with a handful of taps, and above that, a small sign announcing the beverage flavors currently available. Along with the standards — plain, blueberry lemon, pomegranate tart cherry — are a seasonal flavor or two. To the unsuspecting eye, Bootleg Bucha might appear to be yet another of the Buffalo area’s craft breweries. But the only beverage on tap here is in fact kombucha, a fermented tea that originated in the Far East millennia ago but has seen a steady resurgence in recent years among Western consumers for its supposed health benefits. Those benefits mainly include boosting the immune and digestive systems. However, critics say evidence of its health benefits — which include more hyperbolic claims of curing

cancer and AIDS — is lacking, while kombucha consumption has been linked to cases of adverse health effects, including liver and kidney toxicity, as well as metabolic acidosis. Nicole Klem, director of the nutrition and dietetics program at Trocaire College, says kombucha’s benefits stem from the presence of probiotics (“good bacteria”) in the

drink, which is created during the fermentation process. Boosting levels of probiotics in the gastrointestinal tract, Klem says, can improve our digestive system, which in turn can improve our body’s other systems. “It really starts in the gut,” she said. Just ask Bootleg Bucha co-owners Todd Salansky and Jeffrey Empric,

Bootleg Bucha at Horsefeathers Market in Buffalo has a variety of kombucha, a fermented tea originated in the Far East. It’s believed the drink has health benefits.

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both of whom attribute kombucha to ending their frequent bouts of heartburn. “There was a point in my life when it seemed like everything I ate hated me,” Salansky said. “Ever since I’ve never had indigestion or heartburn.” Salansky was introduced to kombucha while traveling the west coast, where he says the beverage is hugely popular. Klem first tried it while attending college in Burlington, Vt. Before long, both Klem and Empric began brewing their own kombucha at home. To brew kombucha, one must brew a tea of their liking, sweeten it with sugar or honey and then add a SCOBY, which is an acronym for a symbiotic colony of bacteria and yeast. It’s a rubbery, yellowish white disc that can regenerate itself through the fermentation process. One places the SCOBY in the tea, then keeps the product sealed off for roughly a week (though it can take as much as two weeks in the winter and as little as three days in the summer). Once finished, one may ferment the tea a second time using fruits or spices for extra flavoring. “Often that second fermentation will result in another whole SCOBY,” she said. Klem recommends that those new to the drink limit their intake to about four ounces, as too much too soon might cause stomach discomfort. She also urges home-brewers to be mindful of kombucha that smells or tastes funky, or looks moldy. “It tasted and smelled just off,” Klem said, recalling the one time in six years that she brewed a bad batch. “At that point just toss it.” But if you are someone who’s prone to heartburn or indigestion, kombucha just might offer the relief you need. “In every city I travel to I search out the local kombucha market,” said Salansky, who has been drinking the beverage for three years and now swears by it. “I feel different without it.” Bootleg Bucha is open from 10 a.m. to 3 p.m. Mondays and Saturdays, and 10 a.m. to 6 p.m. Wednesdays at Market at Horsefeathers, 346 Connecticut St., Buffalo. If you would like to start brewing your own kombucha, you can find Klem at the Elmwood-Bidwell Farmers Market, or you can contact her at klemn@trocaire.edu.

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Page 11

Women’s HEALTH Breastfeeding: Is Milk Sharing Safe?

Experts say practice is OK if you know the source. For the most part, they warn moms against buying breast milk over Internet By Deborah Jeanne Sergeant

he World Health Organization, American Academy of Pediatrics, and likely any pediatrician asked would agree that "breast is best" for baby's health. When moms cannot provide their own breast milk, turning to other moms for help is becoming more accepted. But is milk sharing safe? Polly Thoman, international board certified lactation consultant and owner of Baby's Sweet Beginnings in Lancaster, urges mothers considering outside milk to "know who you're getting it from," she said. "If you're buying it Thoman from someone who's selling it online, how do you know she's healthy? "What if the mom has had an illness, thinks she's clear, and pumps milk and the virus or bacteria is in

the milk? Some medication passes through to breast milk. Some moms feel it's OK to smoke marijuana while donating breast milk. Or a [donating] mom might have gone on a bender last night." Experts say that some dishonest people may sell human milk diluted with water, formula or cow milk to make more money. Tainting human milk with other substances can cause harmful reactions to babies with allergies and diminishes the nutritional value of the milk. Experts say a number of other factors may be involved. Some honest moms may have a clean bill of health, but poor hygiene. They may not use a new pump, for example. Most providers discourage sharing pumps because even with new tubing and flanges, bacteria can build up in the machines. They may not wash their hands before pumping, clean the pump parts correctly or use sterile containers for holding the milk. Pumping moms could leave the milk out of refrigeration or delay freezing the milk. Moms could ship old milk but

'Viagra’ for Women Pill May Not Be Worth It Researchers: Addyi carries host of serious side effects without delivering much more sexual satisfaction

he much-touted "female libido" pill — also known as “Viagra for women” — seems to cause a host of serious side effects while failing to spark much additional passion in a woman's life, a new review suggests. Addyi (flibanserin) quadruples the risk of dizziness and sleepiness, more than doubles the chances of nausea, and increases the risk of fatigue by more than half, according to the analysis. For all that trouble, a woman taking Addyi can expect to gain one-half of one additional satisfying sexual event per month, on average, according to the report. It was published online Feb. 29 in the journal JAMA Internal Medicine. "We found women had, on average, 2.5 satisfying sexual events per month before entering the study, and flibanserin added one-half additional satisfying sexual events per month," said senior study author Ellen Laan, a professor of sexology and psycho-

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somatic gynecology at the University of Amsterdam, in the Netherlands. The side effects are troubling, said physician Mamta Mamik, an assistant professor of obstetrics, gynecology and reproductive science at Mount Sinai's Icahn School of Medicine in New York City. "The article is pretty comprehensive in addressing the issues. They raise valid concerns," Mamik said. "I think we have to be careful when a drug is marketed before its safety profile is approved and proper trials have been conducted." The U.S. Food and Drug Administration approved Addyi last year after a contentious review process, making it the nation's first drug designed to help women with low libido. Only 227 prescriptions for the drug were filled in its first few weeks on the market, Bloomberg reported. In the new review, Laan and her colleagues reviewed eight clinical trials conducted with Addyi, includ-

claim it's fresh. Bacteria still grows in frozen foods, just slower. Some think milk banks are too complicated and offer or sell milk through online groups or Internet sites. Thoman cautioned that's the riskiest way to obtain milk and advised against obtaining milk from an unknown source. Thoman recommends New York Milk Bank (www.nymilkbank.org) as a possible source. The organization screens donors, including blood work, and pasteurizes milk before it reaches its tiny recipients. Premature and sick babies receive priority. Thoman's Baby's Sweet Beginnings serves as a drop-off site for mothers donating milk to New York Milk Bank. She's required to check her designated, locked milk freezer temperature three times per day and has an alarm on it to signal her if the temperature were to go outside the ideal range. Thoman also must follow special shipping guidelines. Human Milk Banking Association of North America (www.hmbana.org), a Texas-based organization, and Medolac (www.medolac.com), based in Oregon, follows similar protocol as New York Milk Bank. Those who donate regularly re-test periodically. Typically, milk banks pool donations together because milk varies in its beneficial properties based upon the baby for whom it's originally intended. Milk made for a week-old baby is different from that of milk made for a threemonth-old, for example. (A woman's body can actually fine-tune milk for an individual baby's needs throughout the day.) The milk is pasteurized at low temperature to eliminate bacteria and improve its safety. Deanna Galkiewicz, a registered nurse who is internationally board certified lactation consultant and

owner of The Peaceful Baby, offers in-home lactation consultation in the Buffalo area. She said that the education about the importance of breast milk has influenced more women to seek informal milk sharing. "Informal milk sharing is risky, but it's coming from a loving place: women who have extra milk sharing it with those who need it," Galkiewsicz said. "Women aren't sharing with their lactation consultant that they're doing this. I know that they are though from what I see on Facebook." Galkiewicz advocates either going with a professional milk bank or someone you know well instead of acquiring it from unscreened strangers. Wet nursing and cross nursing used to be commonplace generations ago; however, since most families spread out, it's unlikely that you live near extended family members with babies. "It just looks different today because women are sharing their milk via pumping and freezer bags," Galkiewicz. "It comes from a loving place, and is a sisterhood of sorts. One mother Galkiewicz helping another woman in her village." She urges moms to not purchase breast milk since making milk a commodity invites fraud. Nursing mothers who struggle to produce milk for their babies should contact a lactation consultant for help in producing more milk.

ing five published and three unpublished studies involving almost 6,000 women. The combined evidence showed that Addyi provides marginal benefit for women who are suffering hypoactive sexual desire disorder, a condition involving a persistent or recurrent lack of interest in sex. For example, women taking the drug scored just 0.3 points higher on a 5-point sexual desire scale and experienced a minimal increase in satisfying sexual events each month,

the review authors found. However, Mamik noted that it's hard to judge how well Addyi performs because female desire is difficult to assess. "When you try to judge efficacy for a drug without an accurate measure of what the drug's supposed to do, it becomes fairly difficult," she explained. "It's not like blood cholesterol levels, where there's a number. How do you measure it? That's where the problem lies."

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

Women’s HEALTH

Domestic Violence Still a Scourge

Nearly a quarter of women have been the victim of severe physical violence by an intimate partner, according to CDC By Deborah Jeanne Sergeant

tion or inaction meant to cause harm. omestic violence has gained The cycle of violence usually inthe national spotlight as it was revealed that American Saeed cludes a long tension-building phase where survivors feel like they're Abedini, recently freed from Iranian walking on eggshells. After violence prison after three years of imprisonment, had abused his wife, Naghmeh breaks the tension, a short "honeymoon phase" follows, filled with perAbedini. Her plight is not rare. The CDC states "one in four women (22.3 petrators' promises of good behavior and lavish gifts. But they never admit percent) have been the victim of severe physical violence by an intimate fault for their behavior. To outsiders, perpetrators often partner, while one in seven men (14 percent) have experienced the same." appear warm and caring partners; however, they diligently hide their When including any kind of behavior, which simultaneously soabuse (emotional, sexual, financial lidifies their reputation while eroding or spiritual), the statistic for women jumps to one-third and to one-fourth that of victims. Physician Judith Feld, medical for men. director at Independent Health in Local experts believe that those who have never experienced domes- Williamsville, said that screening for domestic violence is part of a routine tic violence do not understand its health assessment at her facility. prevalence or dynamics. "It should be part of any primary "There are many people suffering behind closed doors who are too em- care visit," she said. Signs a health care provider barrassed or terrified to talk about it would notice could include unexand people don't realize what's happlained injuries, excessive control by pening," said Mary Murphy, executive director of Family Justice Center the significant other and answering for the patient. of Erie County in Buffalo. "The more For those in a dangerous rewe talk about signs and red flags, the lationship, providers can suggest more they realize it's pervasive." appropriate resources. Abuse refers to a consistent Ahlea Howard, finance chairpattern of manipulation and conwoman of the Erie County Coalition trol meant to shift the power of the relationship to one partner. It usually Against Family Violence in Buffalo, said that numerous reasons make starts subtly, increasing in intensity it difficult for so slowly that the victim doesn't survivors to realize the growing danger. leave. It may Many people think domestic actually make violence is only about black eyes and them less safe broken bones. since it breaks "Violence is just another tool of the perpetraan abuser," Murphy said. tor's control. Any infraction of ever-changing, Experts believe nitpicky rules can trigger a tirade that leaving of insults, threats, violence or punincreases the ishments such as withholding basic victim's chancrights. es of being "Many victims think that they're murdered by 70 the problem, that they're to blame," Howard percent — and Murphy said. "It's like Alice in Wonvictims realize that the danger will derland. Everything down is up and escalate. everything up is down." "Fear is a big component [ of why Physical violence can include they stay]," Howard said. "Leaving punching, pushing, slapping, hair risks the abuser's threats coming pulling, choking and any other ac-

true of harming people, animals and children." Survivors may lack resources and think that no one will believe them. Just calling the police and receiving an order of protection may worsen the danger since some perpetrators ignore orders. Howard calls survivors the experts on perpetrators, which is why working with them to form an escape plan is so helpful in reducing the risks. It takes an average of seven attempts before successfully leaving.

Why the Abuse?

Some research indicates why people abuse those they claim they love. Tina Pilkey, director of Domestic Violence Survivor's Services at the Erie County District Attorney's Office, said that although substance abuse, stress and anger problems may exacerbate domestic violence, many people with these problems never abuse their partner. "People who do have anger problems generally act out with everybody," she added. "But with domestic violence, it's just with their partner." Research also doesn't reveal what type of intervention can stop their abuse. The New York State Office for the Prevention of Domestic Violence (OPDV) states on its site — www. opdv. ny.gov — that 23 percent of perpetrators are "serial abusers: highrisk, violent offenders who have two or more orders of protection issued against them for up to eight different victims." The organization further states that most abuse perpetrators charged

April 2016 •

were arrested again for a domestic violence offense within 10 years. Most domestic violence incidences are not reported. OPDV states that counseling "has not proven to be effective in reducing violent behavior over the long term." Studies on batterer intervention programs (BIPs) vary in the success rates offered since the studies define success differently. Some measure only subsequent arrests for physical violence; others measure continued manipulative behavior as well. "Research indicates that BIPs have little effect on recidivism or attitudes of violent offenders," states the website of Stop Violence Against Women (www.stopvaw.org). If you suspect a friend or family member is a victim of domestic violence, Ahlea Howard of the Erie County Coalition Against Family Violence in Buffalo suggests offering a listening ear without judgment or negativity, even about the perpetrator. "Its' hard for the victim to deal with it," Howard said. "There are a lot of complex emotions. 'It's not that bad, but I want someone to talk to' is something I hear a lot." Calling a hotline or other domestic violence resource for information can help you support a friend, too. Engaging the perpetrator "can put that survivor at greater risk," Howard said.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 13

Annual Physical Exams: Necessity or Waste of Time? Three local physicians weigh in By Deborah Jeanne Sergeant

ow that most people have health care, it can be tougher to get seen for urgent health issues. Are routine, annual physicals really necessary or do they just sap resources further? Two area providers weighed in. "The annual physical is important and recommended to many patients," said physician Judith Feld, medical director at Independent Health in Williamsville. "That recommendation is based on the patient's age, medical history, and specific health needs. Many people will need an annual physical because it's a great opportunity to make sure medications you take or chronic illness are in good control and also an opportunity to check in with your doctor to talk about your

quality of life and all aspects of your health are being looked after." Feld said that younger, healthy people may not need a physical if they're proactive about their health screening needs. She views the annual physical as more of a health maintenance visit for people with health concerns. Feld For this reason, the physician said, young,

Chiropractic: a Growing Career Field By Deborah Jeanne Sergeant

nterested in a career as a chiropractor? If so, you can look forward to "much faster than average" job growth in the industry, according to the Bureau of Labor Statistics. The bureau outlook indicates 17 percent growth projection between 2014 and 2024, about twice as high as for all other occupations combined. That kind of demand indicates a vibrant sector of the healthcare market. "It is a career that's growing in the healthcare field," said Louis Lupinacci, president of the Albany-based New York State Chiropractic Association. "We have about 20 million Americans who seek chiropractic care annually." Chiropractors address neuromuscular problems originating from the spine. These could include issues with nerves, bone misalignment, and soft tissues. By adjusting the spine and using massage, they can address these health concerns. The Empire State is a good place to work as a chiropractor. New York ranks fifth in the nation for the highest employment level among chiropractors, behind California, Texas, Florida and Illinois. The reasons that these states have pulled ahead of the Page 14

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rest likely has to do with their large retiree population. But it's not just baby boomers who seek chiropractic care. "People across all age groups are increasingly becoming interested in alternative or complementary healthcare," the Bureau of Labor Statistics website, www.bls.gov, stated on its chiropractic page. "Chiropractic care is appealing to patients because chiropractors use nonsurgical methods of treatment and do not prescribe drugs." The influence of the Affordable Care act has stretched providers thin as thousands now have health insurance. Instead of waiting weeks to see a physician, some have turned toward complementary healthcare, including chiropractic. Chiropractic offers a prestigious career in a professional environment and with flexible hours. "A lot of the doctors have been here a long time, so there's opportunities for new practitioners to come in," Lupinacci said. "There are lots of types of offices they can get involved in." Lupinacci said that most New York-based chiropractors work in a suburban setting, with about 60

healthy people could check in less often to confirm they're on schedule for vaccinations and screenings, and plan for long-term health. The experts' advice on some screenings changes as new research sheds light on their usefulness, so if you're unsure about when to start mammograms, for example, discussing it with your physician can help because you're unique. "It's a very good idea to check with your primary to get his or her guidance as to the frequency of visits," Feld said. "They're in the best position to make those determinations. The primary care doctor is the quarterback of your health." Benchmarking your vital numbers, such as cholesterol, blood pressure and weight, can help physicians know what's normal for you when you're healthy. But doing this every year may not be necessary. Physician David Pawlowski, medical director at Highgate Medical Group, PC in Buffalo, sees value in the annual physical for young, healthy people, since new research may affect a patient's health. "How would you know about it?" he asked. "There's always something about exercise or medication or new guidelines. It's our job to give patients ideas about wellness and where evidence-based protocols are going. There's always value. With younger people, it tends to be about high-risk behavior." Pawlowski also wants patients to benchmark their vital statistics and become familiar with their physician so that when something more urgent crops up, their health history has already been established. Typically, a physical includes the physician asking about the patient's body's systems, family medical history, surgical history and any other

medical history. Lifestyle issues, such as smoking, alcohol, drug use, sleep patterns and obesity help physicians predict potential for health problems in the patient's future. A typical visit includes taking the patient's vital numbers and an examination of the eyes, ears, throat, and abdomen. Brian Herbst, a doctor of Herbst osteopathy at Buffalo Medical Group P.C. in Buffalo, looks at the annual physical as a preventive care service. "It gives us an opportunity to address different concerns or routine things that might have come up through the year if they're not here for a chronic condition," Herbst said. "The main goal with the annual physical is to help with reducing the overall burden of preventable diseases. It allows us to look at and avoid different disease states." Addressing screenings, immunizations and lifestyle issues now can help prevent more problematic health issues in the future. "I like to look at the annual from that standpoint because everyone you see doesn't have diabetes or another chronic condition," Herbst said. "If it is just once a year they come in, it gives us a chance to talk with and see that patient for that time period to address what we can and also just help counsel and promote healthy living and preventative disease counseling."

percent in private, solo practice, 30 percent share an office with other chiropractors and the remaining 10 percent work in a different environment such as in an integrative health setting. "Integrative healthcare or collaborative health care is starting to become an important factor," Lupinacci said. To become chiropractor in New York, one must be 21 years old, meet the state's educational requirements, pass the state license examination, and submit the appropriate paperwork to obtain a license. A complete list of requirements is at www.op. nysed.gov/prof/chiro/chirolic.htm. In addition to these requirements, Lupinacci said that education in business can be helpful in opening a chiropractic practice. Jeffrey Whare, director of the chiropractic program at D'Youville College in Buffalo, said that it's a popular program at the college. Currently, 85 are enrolled in it. "The career outlook for the students at D'Youville looks good because we have an integrative program," Whare said. "It includes occupational therapy, physical therapy, physician assistant and numerous other health care programs. Our students are integrated in their education, which helps them because the future model is an integrative program where chiropractors are in many settings." He said that the outlook for chiropractic employment has never

been better. "There are so many opportunities like at the VA, military installations, and at integrative programs," he said. To become chiropractor in New York, one must be 21 years old, meet the state's educational requirements, pass the state license examination, and submit the appropriate paperwork to obtain a license. A complete list of requirements is at www.op. nysed.gov/prof/chiro/chirolic.htm. In addition to these requirements, Lupinacci said that education in business can be helpful in opening a chiropractic practice. Kathy Hadley, a representative of New York Chiropractic College in Seneca Falls, said that enrollment in the chiropractic program "has been very stable over the past four to five years with an average student body of 640 to 660." Like Lupinacci, Hadley said that opportunities for new graduates are manifold. "They can specialize in areas such as sports, pediatrics, working in a hospital setting, research, teaching and consulting, to name a few," Hadley said. About 90 percent of the college's graduates still practice 10 years after graduation. "Chiropractic is a great profession for a person that desires to help individuals who are suffering from back pain, headaches, and more, get well," Hadley said. "Patient satisfaction rates for Doctors of Chiropractic are upwards of 84 to 90 percent."

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

April 30 Event Draws Attention to Colon Cancer

Now in its eighth year, Undy Run/Walk organizers encourage participants wear outlandish costumes of their own choosing, including, yes, undergarments By Tim Fenster

olon cancer tends to get less attention in our collective consciousness than other forms of cancer, such as leukemia and breast cancer, and that just may be part of the reason that it’s so deadly. Colon cancer is currently the third-deadliest form of cancer, according to www.cancer.org, and is expected to cause more than 49,000 deaths in 2016. And yet it is also one of the most treatable forms of cancer, with a five-year survival rate of about 90 percent when detected early on. Tess Fraser, a Buffalo native and board member with the Colon Cancer Alliance, said the problem is that too many people aren’t getting screened. As a result, the cancer often goes undetected until it is in a later stage, in which the chances of survival drop dramatically. Fraser said this was the situation that her mother found herself in, when she was diagnosed with stage four colon cancer and died about four years ago. “Looking back, I lost my mom to a preventable disease,” Fraser said. It’s one of the reasons why several years ago, the Colon Cancer Alliance began holding the Undy Run/ Walk in cities across the country. The run invites participants to don outlandish costumes of their own choosing, including, yes, under-

If Your Go… The Undy Run will start at 9 a.m. Saturday, April 30, at Delaware Park. Opening remarks will take place at 8:40 a.m., a 1.7 mile fun run begins at 9:10 a.m. and a survivor and patient recognition and awards ceremony will be held at 10:15 a.m. Adult registration is $35 advance and $40 on race day. Last year’s event saw about 1,000 participants — including both walkers and runners — coming together to raise some $90,000 for Colon Cancer Alliance, a nonproft. For more information, visit www.ccalliance.org/undy-runwalk.

garments, in an effort to fundraise for the group while also raising awareness of colon cancer. Fraser said the Buffalo Undy Run/Walk, set to take place Saturday, April 30 at Delaware Park, is now in its fifth year and has become increasingly popular. Last year’s event saw about 1,000 participants — including

both walkers and runners — coming together to raise some $90,000 for the alliance. Part of the draw is the wacky and sometimes revealing costumes participants wear, such as tutus, underwear (over clothes or by itself) and superhero costumes. Participants also receive a pair of boxer shorts for taking part the event. But while the garb helps attract attention and create a lighter mood, Fraser said it has another important purpose. “It’s supposed to draw attention to the area [of the body] that’s affected,” said Fraser, who is also chairwoman of the Undy Run/Walk. “The underwear thing is intended to help break the ice and get people talking.” All proceeds from the Undy Run/Walk benefit the Colon Cancer Alliance, which supports colon cancer research and is also the largest patient advocacy organization for colon cancer. Since its inception seven years ago, these Undy Run/Walks have raised some $9 million nationally for the alliance. It’s the alliance’s biggest fundraising event, both locally and nationally. “It’s grown steadily each year,” Fraser said of the local Undy Run. “It’s definitely becoming something that people are starting to recognize.”

80% by 2018

UBMD Physicians Join Fight to Reduce Colon Cancer

BMD Physicians’ Group is partnering with the American Cancer Society on its “80% by 2018” national initiative. The goal is to increase the nation’s colon cancer screening rate to 80 percent by 2018. UBMD representatives pledged the organization’s commitment March 1 at Buffalo City Hall. “This effort is doable because of the strong commitment by the primary care providers in Buffalo to make it happen,” said Anne B. Curtis, chairwoman of the department of medicine and president and CEO of UBMD Internal Medicine. “We can use the electronic health record to determine the population needing screening and also can put in reminders during pre-visit planning and during patient visits to make sure we get as many patients as possible screened for colon cancer. “By working with local partners,

we have multiple ways to identify the patient population at risk and to make sure they get screened,” Curtis continued. “Whether a patient is identified in the hospital, or through their outpatient physician, or even through their insurance companies, one way or another, we should be able to encourage them to get screening colonoscopies to reach the 80 by 18 goal. UBMD is proud to be part of this effort to improve the health of the people of Buffalo and Western New York.” Physician John R. Fudyma, chief of the division of general internal medicine and associate professor at Jacobs School of Medicine and Biomedical Sciences, University at Buffalo (and chief of the division of general internal medicine, UBMD Internal Medicine, said colorectal cancer is a leading cause of cancer

deaths in the United States. “The good news, however, is that the death rates from colon cancer have been decreasing over several decades in large part to effective screening methods for this cancer. Screening allows us to detect and remove precancerous polyps thus preventing the development of colon cancer. “There are several barriers to colorectal cancer screening including lack of understanding, patient fear and anxiety about colonoscopy, and other competing health care and prevention priorities,” Fudyma continued. “This initiative allows us to raise the community awareness of the benefits of screening while we simultaneously challenge primary care provider teams to develop new and innovative models that will reduce the barriers to screening.”

April 2016 •

Ways to Reduce Your Risk of Colon Cancer Diet, weight and physical activity play a significant role, expert says

alf of the colon cancer cases in the United States could be prevented if people followed six proven steps to reduce their risk, a cancer and nutrition expert says. Colon cancer is the second leading cause of cancer death, and the third most common type of cancer in the United States. This year, there will be over 134,000 cases of colon cancer, the U.S. National Cancer Institute estimates. “Research now suggests that 50 percent of colorectal cancers in the United States are preventable each year through diet, weight and physical activity. That’s about 67,200 cases every year,” Alice Bender, head of nutrition programs at the American Institute for Cancer Research, said in an institute news release. Bender outlined six evidence-based measures you can take to try to lower your risk of developing colon cancer: Maintain a healthy weight and control belly fat, which has been linked to increased risk of colon cancer, regardless of body weight. Get regular moderate physical activity, which can range from house cleaning to running. Eat plenty of high-fiber foods. For every 10 grams of fiber (a bit less than a cup of beans) in your daily diet, your risk of colon cancer falls by 10 percent, Bender said. Reduce red meat consumption and avoid processed meats, such as hot dogs, bacon, sausage and deli meats. Ounce for ounce, processed meats boost the risk of colon cancer twice as much as red meat. Avoid alcohol or limit your intake to no more than two standard drinks a day for men and one for women, Bender advised. Go heavy on the garlic. Evidence suggests that a diet rich in garlic reduces the risk of colon cancer, Bender said.

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Page 15

How Retirees Can Save on Prescription Eyeglasses

The Social Ask Security Office

From the Social Security District Office.

By Jim Miller

rescription eyeglasses today aren’t cheap. You can easily spend $200 for a basic pair, but if you want designer frames or need bifocal or progressive lenses the price can more than double. Here are a few different options that can help you save.

Medicare/Insurance Coverage

If you are a Medicare beneficiary, you already know that original Medicare (Part A and B) and Medigap supplemental policies do not cover routine eye exams or eyeglasses (unless you’ve just had cataract surgery), but there are some Medicare Advantage (Part C) plans that do. Many of these plans, which are sold through private insurance companies, cover vision as well as dental, hearing and prescription drugs, in addition to all of your hospital and medical insurance. To locate Advantage plans in your area that provides vision coverage, visit Medicare.gov/ find-a-plan or call 800-633-4227. But before enrolling in a plan, check the benefit details to ensure the plan’s vision coverage includes routine eye exams, eyeglass frames and lenses. You can switch from original Medicare to a Medicare Advantage plan each year during the open enrollment period, which is between Oct. 15 and Dec. 7. If, however, you don’t want a Medicare Advantage plan, you can still get coverage by purchasing an inexpensive vision insurance policy — see eHealthInsurance.com. Policy costs vary depending on where you live, but they usually start at around $6 to $9 per month for an individual. Before signing up, make sure your savings potential is worth the cost of the premiums and copays.

Discount Stores

Purchasing eyeglasses from discount retailers is another way to save. Costco is one of the best discount stores for good eyewear and low prices. Eyeglasses cost an average of around $150, but to shop there you have to pay a $55 annual

membership fee. Some other good retail options for low prices include For Eyes Optical, BJ’s Optical, Sam’s Club and Walmart. You also need to find out if you are eligible for any discounts. Many retailers provide discounts to membership groups like AARP and AAA. AARP members, for example, can get 30 percent off a pair of prescription eyeglasses as well as discounts on eye exams at any LensCrafters, most participating Pearle Vision, Sears Optical, Target Optical, JCPenney Optical and thousands of private optometrist offices.

Look Online

Buying eyeglasses online can also offer huge savings. Some online stores like ZenniOptical.com, Goggles4u.com and EyeBuyDirect.com sell prescription eyeglasses for as little as $7 plus shipping. These sites let you upload a photo of your face, so you can see what you’d look like in different frames. Or, for a fancier choice of frames see WarbyParker.com, which offers single-vision glasses for $95. They even offer a free program where you can request up to five pairs to try on at home for five days. To purchase glasses online, you’ll need your eyeglass prescription from a local eye doctor, plus your pupillary distance number, which is the distance, measured in millimeters, between the centers of your pupils in each eye.

Low-Income Assistance

If your income is low, depending on where you live, there may be some local clinics that provide free or discounted eye exams and eyeglasses. Put in a call to your local Lions Club to see what’s available in your area. See directory.lionsclubs.org for contact information. You may also be able to get free eyeglasses through New Eyes (neweyes.org, 973-376-4903), a nonprofit organization that provides free eyeglasses through a voucher program to people in financial need.

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ocial Security is committed to the principles and spirit of the Americans with Disabilities Act (ADA), which improves the lives of our beneficiaries and our employees who have disabilities. We are proud to say that we’ve been helping people with disabilities for over 25 years. We also want you to see and hear from the people who rely on Social Security disability benefits to not just survive, but thrive, as active members of our communities. Our Faces and Facts of Disability website highlights the real life stories of people who have disabilities. The address is www.socialsecurity.gov/ disabilityfacts. The newest person we are featuring on our Faces and Facts of Disability website is Lynne Parks. She is an artist from Baltimore, Md. First diagnosed with metastatic fibrosarcoma at age 14, she has lived with this illness for nearly 35 years. It started in her face and moved to different parts of her body, including her abdomen and leg. She also has various tumors on her shoulder and arm. Inflammatory responses, infections, and new tumors are complications that Lynne deals with every day. “Because of the tumors, I have limited use of my left arm,” Lynne said. “I have weakness in my legs.

There's fatigue because my immune system has taken such a big hit from the cancer and the cancer treatments. I get sick all the time. There might be a day that I can be at home and resting and I'll try to make the best of it. I'll wake up, fix breakfast and eat, and that takes a while because of my physical limitations, but also because of my first tumor that was in my face.” Having been helped by Social Security, Lynne tries to help others. “I'm also helping people who have issues learn to cope with them, because they see in me someone as a role model, essentially. Life without Social Security benefits, it's a horror story, because I imagine myself on the streets.” The disability benefits Lynne receives are a crucial resource for her quality of life. Our disability programs continue to be a mainstay in the lives of many people — people just like you. Social Security disability beneficiaries are among the most severely impaired people in the country. It’s something that can happen to anyone when least expected. We invite you to learn the facts about the disability insurance program, and see and hear these stories of hardship and perseverance at www.socialsecurity.gov/disabilityfacts.

Q: What is a Social Security Statement, and how can I get a copy? A: Your online Social Security Statement gives you secure and convenient access to your earnings records. It also shows estimates for retirement, disability, and survivors benefits you and your family may be eligible for. You can get your personal statement online by using your own My Social Security account. If you don’t yet have an account, you can easily create one. To set up or use your account to get your online statement, go to www.socialsecurity.gov/myaccount. We also mail statements to workers attaining ages 25, 30, 35, 40, 45, 50, 55, 60 and older, three months prior to their birthday, if they don’t receive Social Security benefits and don’t have a My Social Security account. If you don’t want to wait for your statement, you can access it online, whatever time of year you need it.

Q: I own a business. What should I do if an employee gives me a Social Security number but cannot produce the card, or if the employee is waiting to receive a Social Security number? A: Seeing the card is not as important as putting the correct information on the worker's Form W-2. You can verify employee Social Security numbers by using our Social Security Number Verification Service. Just go to www.socialsecurity.gov/ bso. This online service allows registered employers to verify employee Social Security numbers against Social Security records for wage reporting purposes. If the employee recently applied for a Social Security number, but does not yet have a card when you must file the paper Form W-2, enter the words “Applied for” on the Form W-2. If you are filing electronically, enter all zeros (e.g., 000-00-0000) in the Social Security number field. When the employee receives the card, file Copy A of Form W-2C, Corrected Wage and Tax Statement with Social Security to show the employee's number.

Q&A

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

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By Jim Miller

How to Avoid Medicare Mistakes When You’re Still Working Dear Savvy Senior,

Should I enroll in Medicare at age 65 if I’m still working and have coverage through my employer?

Almost 65

Dear Almost,

The rules for enrolling in Medicare can be very confusing with all the different choices available today. But when you postpone retirement past age 65, as many people are doing, it becomes even more complicated. First, let’s review the basics. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people. And Part B, which covers doctor’s bills, lab tests and outpatient care. Part B also has a monthly premium of $104.90 in 2016 (though it’s higher for individuals earning $85,000 or more a year). If you are receiving Social Security, you will be enrolled automatically in parts A and B when you turn 65. If you aren’t yet receiving Social Security, you will have to apply, which you can do online at SSA.gov/medicare, over the phone at 800-772-1213 or through your local Social Security office. If you plan to continue working past the age of 65 and have health insurance from your job, your first step is to ask your benefits manager or human resources department how your employer insurance works with Medicare. In most cases, you should at least take Medicare Part A because it’s free. But to decide whether to take Part B or not will depend on the size of your employer.

Small employer If your current employer (or spouse’s employer if it’s providing your coverage) has fewer than 20 employees, Medicare will be your primary insurer and you should enroll in Medicare Part B during your initial enrollment period. This is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. If you miss the seven-month sign-up window, you’ll have to wait until the next general enrollment period, which runs from Jan. 1 to

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March 31 with benefits beginning the following July 1. You’ll also incur a 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium.

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Large employer If your employer has 20 or more employees, your employer’s group health plan will be your primary insurer as long as you (or your spouse if the coverage is from his/ her employer) remain an active employee. If this is the case, you don’t need to enroll in Part B when you turn 65 if you’re satisfied with the coverage you are getting through your job. But if you do decide to enroll in Medicare, it will supplement your employer insurance by paying secondary on all of your claims. Once your employment (or group health coverage) ends, you will then have eight months to sign up for Part B without a penalty. This is known as the Special Enrollment Period.

Drug coverage You also need to verify your prescription drug coverage. Call your benefits manager or insurance company to find out if your employer’s prescription drug coverage is considered “creditable.” (Creditable prescription drug coverage is one that is considered to be as good as or better than the Medicare prescription drug benefit.) If it is, you don’t need to enroll in a Medicare Part D prescription drug plan. If it isn’t, you should purchase a plan (see medicare.gov/find-a-plan) during your initial enrollment period or you’ll incur a premium penalty (1 percent of the average national premium for every month you don’t have coverage) if you enroll later. For additional help, visit Medicare.gov or contact your State Health Insurance Assistance Program (SHIP) at Shiptacenter.org. The Medicare Rights Center also offers a free helpline at 800-333-4114. 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.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Health News

Deaf Access Services receives $10K grant

Deaf Access Services (DAS) recently received a $10,000 grant from The James H. Cummings Foundation, Inc. The award will assist DAS in fulfilling its mission of connecting Western New York’s communities of deaf, hard of hearing and hearing people. “This grant will enable DAS to provide the required equipment to these individuals so they can live more independently and safely in their homes,” said Sharon L. Hanson, executive director, Deaf Access Services. The DAS advocacy department provides services to deaf, hard of hearing, and late-deafened individuals who are experiencing obstacles with social services, health services and financial and legal situations. Through its advocacy department, DAS helps low-income individuals ineligible for aid from traditional sources to obtain many types of assistive and adaptive equipment including flashing doorbell systems; baby monitors; carbon monoxide detectors, fire alarms; flashers and the VP (videophone). Grant funds will be used to provide clients with assistive and adaptive equipment for approximately 30 people in need The funds will also be used to provide low-income Western New Yorkers living outside of Erie County with necessary assistive and adaptive equipment.

Gilbert named Kaleida’s director of robotic surgery

Physician Richard N. Gilbert has been named the director of robotic surgery at Kaleida Health. Gilbert is a urologist at Western New York Urology Associates with specialty training in sexual dysfunction, prostate cancer, female urology, laparoscopic surgery and robotic surgery. He is certified by the American Gilbert Board of Urology and National Board of Examiners. He is also a clinical assistant professor at the State University of New York at Buffalo. Gilbert serves on Kaleida Health’s medical executive committee board and also the New York State Urological Association as an executive committee member. He is a professional member of the American Association of Clinical Urologists, American Board of Urology, American College of Surgeons and several other professional organizations. "In his new role, Dr. Gilbert will work to enhance the efficiency and quality of the Kaleida Health robotic program. He will provide oversight and ensure that the organization continues to offer best in class robotic procedures to our community," said

David Hughes, executive vice president and chief medical officer for Kaleida Health. "Dr. Gilbert brings a wealth of experience and professionalism that will take the program to the next level,” said David Pierce, vice president, Kaleida Health, and chief medical officer for Millard Fillmore Suburban and DeGraff Memorial hospitals. "We are happy to welcome him into his new role." A resident of Williamsville, Gilbert completed a Bachelor of Arts degree at Canisius College and earned his medical degree from the University at Buffalo School of Medicine and Biomedical Sciences. He completed his residency training in both general surgery and urology at Georgetown Hospital in Washington, DC.

Frank Curci elected Kaleida’s board chairman Frank Curci has been elected chairman of the Kaleida Health board of directors. Curci, chairman and CEO of Tops Friendly Markets, has served on the Kaleida Health board since 2012. Curci succeeds former chairman John Curci

Koelmel, whose term expires in April. “On behalf of the 10,000 members of the Kaleida Health family, I would like to thank John for his tremendous leadership over the past 10 years,” said Jody Lomeo, president and CEO of Kaleida Health. “He is a tireless advocate for our community and is all about the greater good. We thank him for guiding our organization and helping us make it better for the patients we serve.” Koelmel is credited with leading the organization through its remarkable transformation including a major leadership change, plus improving market share, quality of care and the patient experience. He is most known for his support and unwavering drive in getting the new John R. Oishei Children’s Hospital of Buffalo built. William Maggio, former CEO and chairman of the board for IMMCO Diagnostics, was elected vice chairman of the Kaleida Health board. Maggio is a principal with Lorraine Capital, serves as the interim CEO of the Jacobs Institute and is the chairman of the board for 43 North. Physician David A. Milling, the senior associate dean for student and academic affairs and associate professor of clinical medicine at the Jacobs School of Medicine and Biomedical Sciences (UB), was elected secretary of the board. Milling has chaired the Kaleida Health quality committee of the board since 2009. Christopher Ross, a principal with Lawley Insurance, was elected the treasurer of the board of directors. Ross, who has spent 30 years with Lawley, is actively involved

One Year Free of Central Line Infections

eb. 26 marked one year free of central line infections in the Neonatal Intensive Care Unit (NICU) at Women & Children’s Hospital of Buffalo (WCHOB). According to the hospital, this is a significant accomplishment for staff and a major milestone in the area of quality improvement for patients. Central line-associated blood stream infection (CLABSI) happens when bacteria is introduced into the blood stream either at the time of insertion of the central line or during the maintenance of that line. “The bacteria then causes symptoms of infection in the patient which prompts the medical team to perform a blood culture,” said physician Anne Marie Reynolds, NICU’s medical director. “The CDC has very specific criteria based on how long the line has been present, the type of bacteria that is found in culture, the number of positive cultures and the symptoms experienced by the patient to determine if it meets the surveillance definition of a central line-associated blood stream infection.” CLABSI is known to increase hospital stay, increase the chances that the preterm infant will experiPage 18

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ence other long term developmental difficulties associated with prematurity, and cause anxiety for families. The NICU CLABSI rate for WCHOB in 2015 was .25/1000 line days, compared to the national average of 1.3/1000 line days. Mortality associated with CLABSI is estimated to be between 11-31 percent. “I am extremely proud to have worked with a very dedicated multidisciplinary team that led this initiative,” said Reynolds. “Without their insight, ideas, hard work, diligence, collaboration and leadership at the bedside and beyond, we would not have this level of success. Our nursing staff is truly amazing. Their excellent attention to detail and technique has made all the difference. My physician colleagues really embraced this initiative and moved out of their comfort zone to get these lines out earlier than was the previous practice. Every member of the NICU team should be proud of this achievement. We all earned it together.” As the regional perinatal center for Western New York, WCHOB cares for the most fragile newborn babies in the region.

The Farrell family from Tonawanda with their newborn at the Women & Children’s Hospital of Buffalo’s NICU. The unit recently celebrated one year without any central line infections. Photo courtesy of Kaleida Health.

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

Health News

in the community serving on the Mercy Flight and Niagara University boards. Other Kaleida Health board members include physicians Nicholas J. Aquino, Amy Clifton, Evan Evans and Kevin Gibbons. It also includes attorney Christopher T. Greene, Darren J. King, registered nurse Mary Lou Rusin and Francisco M. Vasquez. Physician Peter Winkelstein is the incoming president of Kaleida Health’s medical staff, an ex-officio position on the health system’s board.

DeGraff Memorial Nursing Facility gets top rank DeGraff Memorial Hospital Skilled Nursing Facility was one of 14 nursing homes in Western New York and one of 110 nursing homes in New York state who scored in the top quintile in the New York State Nursing Home Quality Initiative (NHQI). The NHQI is an annual quality and performance evaluation project to improve the quality of care for res-

idents in Medicaid-certified nursing facilities across New York state. The results of the NHQI are based on last year’s performance. Nursing homes are awarded points for quality and performance measures in quality, compliance and efficiency. In the report, the New York State Department of Health evaluated nearly 600 facilities based on quality indicators such as pressure ulcers, influenza vaccine rates among employees and residents, falls, infections, pain levels, and medications, among others. Facilities are ranked into quintiles based on their overall scores. Quintile one represents the top-performing facilities, while quintile five represents the lowest-performing. DeGraff Memorial Hospital Skilled Nursing Facility scored in the top quintile in the following categories: patients experiencing weight loss, complaints of pain and patients on chemical restraints.

Sharon L. Hanson Re-elected Chairwoman at ECMC Board of Directors The Erie County Medical Center Corporation (ECMCC) board of directors recently re-elected Sharon L. Hanson to serve as the board’s chairwoman. This will be the Hanson’s fourth term. Hanson has served on the ECMCC board of directors and the former board of managers since 1996 in a varied of leadership positions. “I am honored to be Hanson selected by my fellow board members to again serve as chair of the ECMCC board of directors,” Hanson said. “This is a very exciting time for ECMC as we continue to experience strong growth in our inpatient and outpatient procedures, increased emergency room visits and maintain our key collaborative role in the Millennium Collaborative Care effort that is making significant advancements in forging partnerships with over 400 healthcare providers, hospitals, skilled nursing facilities, several behavioral health and developmentally disabled clinics, and community-based organizations in our region. Most importantly, our tremendous health-

care providers help us maintain our commitment to the best possible quality services and patient experience, which is our highest priority.” Hanson is currently executive director at Deaf Access Services, Inc. (DAS), the oldest local nonprofit deaf service provider serving all eight counties of Western New York. Before joining DAS, Hanson was the director of government relations at Time Warner Cable, and area manager of public and community affairs at Adelphia Communications. She is the recipient of many honors, awards and recognitions for her untiring effort to assist local nonprofit organizations. Among other distinctions, she was the first woman and first African-American to serve as chairwoman of the board at ECMCC. Other officers elected to the ECMC Corporation board of directors include vice chairman/chairman elect Jonathan A. Dandes, president, Rich Baseball Operations/Rich Products Corp.; vice chairman Kevin E. Cichocki, co-founder, Palladian Muscular Skeletal Health; vice chairman Kevin M. Hogan, partner, Phillips Lytle, Buffalo office; vice chairman Michael A. Seaman, director of treasury and collections, City of Buffalo; secretary Douglas H. Baker, president, Mercy Flight WNY; treasurer Bishop Michael A. Badger, senior pastor, Bethesda World Harvest International Church; and president and CEO Thomas J. Quatroche Jr., ECMC Corp.

ECMC Named Among Best Hospitals For Patient Safety

Rita Hubbard-Robinson Honored as Community ‘Difference Maker’ “Black Tie for Black History,” Buffalo’s only formal affair celebrating Black History Month, honored Rita Hubbard-Robinson, project director, patient activation measure for Millennium Collaborative Care (MCC), as one of six community “Difference Makers” at a gala held Feb. 26 at The Tralf in downtown Buffalo. In addition to her MCC efforts to work with community-based organizations to connect individuals to healthcare and wellness services, Hubbard-Robinson was also recognized for her broadcasting efforts as host of “Millennium Health Matters,” a weekly radio program focused on population health and MCC project-related topics affecting

the lives of Western New Yorkers. (The show airs from 8:25 to 8:55 a.m. on WUFO 1080AM every Wednesday, and also can be heard online at www.wufoam.com). “Over 30 years of dedicated and distinguished service, Rita Hubbard-Robinson has made a significant positive difference in every role and endeavor she has undertaken,” said Alfred Hammonds, Jr., executive director, Millennium Collaborative Care. “Whether it’s her outstanding efforts to ensure under-utilizing community members are also benefitting from our projects, or her weekly radio program engagement with the community; Rita has proven time and again that she is most deserving of this outstanding recognition.”

The Erie County Medical Center has received the 2016 Women’s Choice Award as one of America’s Best Hospitals for Patient Safety. This evidence-based designation is the only patient safety award that identifies the country’s best healthcare institutions based on robust criteria that considers female patient satisfaction and clinical excellence. “Receiving this recognition from The Women’s Choice Award is another testament of ECMC’s commitment to the best possible healthcare for anyone who seeks our services,” said ECMC President and CEO Thomas J. Quatroche, Jr. “A positive patient experience and quality services are our highest priorities, which are reflected among the over 3,000 exceptional and skilled caregivers who everyday work to meet the needs of our patients.” The list of over 472 award winners, including ECMC, represents hospitals that have exceptional performance in limiting a wide range of hospital-associated infections and

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complications from surgery and medical treatment. Delia Passi, Founder and CEO of the Women’s Choice Award said, “We honor ECMC for being named and recognized as a hospital of choice among women, for it represents the strongest and most important consumer message in today’s healthcare marketplace when considering that women account for 90 percent of all healthcare decisions. Improving patient safety is not only a matter of error prevention; it’s a focused effort to create the safest patient experience.” Hospitals that have earned this award have had a low incidence of problems arising from surgical errors and infections. The hospitals that report their frequency to The Centers for Medicare and Medicaid Services (CMS) are ranked for each of the following eleven measures, among them deaths among patients with serious treatable complications after surgery, serious blood clots after surgery and others.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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What’s the Skinny on Apple Cider Vinegar? No scientific backing, but apple cider vinegar has been used repetitively — and successfully — for centuries! By Kimberly Fenter

any of my clients ask about apple cider vinegar — Is it good for me? What does it do? Should I use it? Is it harmful to use? Here are a few facts about apple cider vinegar (ACV): Apple cider vinegar is simply a product of fermented apples. This process involves a breakdown of sugars by bacteria and yeast, whereby the sugars turn into alcohol. As the alcohol ferments, the result is vinegar. The main ingredient in apple cider vinegar is acetic acid; there are also other acids, vitamins, mineral salt and amino acid. There are many beneficial uses of apple cider vinegar, externally and internally. Many of these uses are ancient remedies with no scientific backing, but have been used repetitively — and successfully — for centuries.

External uses of Apple Cider Vinegar:

Mouthwash: Mix ACV with water, swish and spit. This natural antiseptic will break down the plaque and bad breath that cause bacteria. Hair rinse: Wash away build up. Mix half teaspoon of ACV in a cup of cold water. After shampooing, pour the solution through your hair to boost your hair’s natural body and shine. Use this technique several times a week for amazing results! Toner: Soak a cotton ball with ACV and apply to T-zone or oily problem areas to minimize blemishes or breakouts. Those suffering with psoriasis can apply to affected areas to reduce inflammation. Vinegar bath: Soaking in a vinegar solution will help maintain pH levels of your skin. Add two capfuls of ACV to a warm bath to draw toxins out of the body and leave skin toned and Page 20

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moisturized. Wart removal: Soak a cotton ball with ACV and fasten to the affected area overnight. Continue this regimen for a week and see the results (do not pick at warts as they dry). Soothe sunburned skin: Apply washcloth soaked with ACV to sunburned skin to alleviate discomfort. Foot soak: Place your tired, aching, swollen feet into a tub of ACV and warm water. The anti-inflammatory elements will relieve and revive. Fleas? Saturate your pet’s fur with one part ACV/one part water, and rub into the skin. Continue every other day for up to a week. Clean and deodorize: Clean and deodorize toilets by pouring ACV into the toilet bowl and let sit overnight. Substitute ACV for dish detergent in your dishwasher. Mix ½ cup ACV with 1 cup of water to clean your microwave, kitchen counters, windows, glasses and mirrors.

Internal uses of Apple Cider Vinegar

Weight loss: Mix two teaspoons of ACV with 16 ounces of water. Sip this throughout the day. Scientific evidence shows there are benefits from the daily intake of acetic acid. Please note: studies included a change in everyday habits, in addition to the ACV consumption.

Cholesterol: Studies suggest that daily consumption of ACV (using the above weight loss combination) could induce a protective effect against erythrocyte (inflammation), kidney and liver oxidative injury and lowered serum lipid levels. In basic terms, it help to promote healthy cholesterol levels. Balance your inner body system and boost your energy: ACV helps the body achieve and maintain a healthy pH level. Research shows that higher acid levels (lower pH level) lead to a lack of energy and higher incidences of infection and illness. Heartburn: There is research suggesting that using ACV will work to alleviate heartburn by correcting low acid. Take 1 teaspoon of ACV and then drink 8 ounces of water. Relief should come quickly. Please note: ACV will not give you relief if you have an ulcer; you will activate the opposite reaction! Detox: As the ACV balances the body’s pH, this creates an environment for overall detoxification. Research shows that it can help stimulate cardiovascular circulation to help detoxify the liver. Allergies/mucous production: By breaking up mucous through the body and cleansing the lymph nodes, ACV helps to aid in relief of allergies, sinus congestion, sore throat and headaches.

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

Candida: Rich in natural enzymes, ACV will help to rid the body of this yeast. Note: Candida is, in part, to blame for low energy, fatigue, sugar cravings and memory loss. Internal use not recommended for children younger than 14 years of age.

What’s the downside

• ACV is highly acidic and could damage tooth enamel and tissues lining your throat and mouth. • Long-time use of ACV could result in low levels of potassium and low bone density. • ACV could interact with diuretics, laxatives and medicines prescribed for diabetes and heart disease. • Chromium levels in ACV help to stabilize blood sugar levels. If you are on prescribed medication for diabetes, you should check with your Health Care Provider before using.

Should I use liquid or supplement?

In my opinion, I would prefer to see liquid used versus a supplement. Bragg, Organic, Raw Apple Cider Vinegar is my choice. The choice to use apple cider vinegar is yours to make. There are many uses, external and internal, that are beneficial to your health. Be sure to consult with your health care provider if you are currently taking prescribed medication. There may be contraindications to using apple cider vinegar with your medication. Kimberly Fenter is a doctor of naturopathy (ND) and a certified health and nutrition coach. She practices in Williamsville. Contact her at Kimberly. fenter@yahoo.com.