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Meet Your Doctor UBMD orthopedic surgeon Tom Duquin: People don’t need to live with bad shoulders. Field has come a long way in the last few years
July 2016 • Issue 21
A unique center in Upstate New York, The Gender Wellness Center has seen number of transgender patients skyrocket in one year
Benefiting from equine therapy at Buffalo Therapeutic Riding Center
Experts suggest ways to cope with the problem
Buffalo & WNY’s Healthcare Newspaper
Mistaken Identity
EQUINE THERAPY
Chill Out Hot Flashes
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Mental Health & Kids What parents need to do to provide a mentally healthy summer for their kids
The New MIND Diet May Help Prevent Alzheimer’s
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Hot Dogs
SmartBite columnist: The good, the bad and the healthy about hot dogs
Live Alone & Thrive Author of ‘Live Alone & Thrive’ column gets a new puppy and writes about the importance of touching. ‘Touch: An Essential Ingredient for Those Who Live Alone’
Americans Living Longer and Better
Improvements in heart and vision care likely behind the progress, study finds
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mericans aren’t just living longer, they’re living more years without disabilities, too, a new study shows. Harvard University researchers reviewed federal government data. They found that in 1992, life expectancy for the average 65-year-old was 17.5 additional years, 8.9 of which were disability-free. By 2008, life expectancy for someone age 65 was an additional 18.8 years, 10.7 of which were disability-free. “This suggests, for the typical person, there really is an act beyond work — that once you reach age 65, you can likely look forward to years of healthy activity,” said study co-author David Cutler, a professor of applied economics at Harvard. “So this is good news for the vast bulk of people who can now look forward to healthier, disability-free life, but it’s also good news for medical care because it demonstrates the value of medical spending,” he said in a university news release. The researchers said improvements in vision care and in heart disease prevention and treatment are major factors behind the trend
toward healthier, longer lives. “There has been an incredibly dramatic decline in deaths and disabilities from heart disease and heart failure. Some of it is the result of people smoking less, and better diet, but we estimate that as much as half of the improvement is because of medical care, especially statin drug treatment, which is both preventing heart attacks and improving people’s recovery,” Cutler said. Cataract treatment is responsible for much of the improvement in vision health. “In the past, cataract surgery was very lengthy and technically difficult. That same surgery today can be done in an outpatient setting, so that complications and disability are significantly ameliorated,” Cutler said. “It used to be that when you turn 70, your occupation became managing your health. Now you can increasingly just live your life,” he concluded. The study is described in a working paper released recently by the National Bureau of Economic Research.
Last year’s Fitness in the Parks at Ralph Wilson Stadium in Orchard Park, which is one of the most popular sites for this free fitness program.
Free ‘Fitness in the Parks’ Program Gets People Moving Free, weekly exercise classes will be held throughout WNY including two new locations – Buffalo Medical Campus and Buffalo RiverWorks
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ndependent Health and YMCA Buffalo Niagara are teaming up for the fifth consecutive year to offer Fitness in the Parks, free outdoor community exercise classes throughout Western New York. The outdoor Page 2
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classes began in June and will run until Saturday, Aug. 27. “Independent Health is excited to partner with YMCA Buffalo Niagara again this summer to offer Fitness in the Parks. It’s a great way to get
outside and get in a workout,” said Nora McGuire, senior vice president and chief marketing officer, Independent Health. “Independent Health is committed to the health and wellness of Western New Yorkers. By offering
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
New Psoriasis Drug Works Longer Term, Too Moderate-to-severe skin disease improved with Taltz over 60 weeks, study finds
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new drug that has shown “unprecedented” effects on the skin condition psoriasis seems to work well in the longer term, too, researchers report. The drug, called ixekizumab (Taltz), was approved in March by the U.S. Food and Drug Administration. That came after initial trials showed that over 12 weeks, the drug soundly beat standard medication for moderate-to-severe psoriasis. The new findings show the benefits are still there after 60 weeks. At that point, about 80 percent of patients were seeing at least a 75 percent improvement in their skin symptoms, the researchers said. So far, ixekizumab has shown “unprecedented efficacy” against more severe cases of psoriasis, said Joel Gelfand, a dermatologist who wasn’t involved in the research. The drug, given by injection, targets an inflammatory protein called IL-17, said Gelfand, who directs the Psoriasis and Phototherapy Treatment Center at the University of Pennsylvania. The FDA approved another IL-17 inhibitor, called Cosentyx, last year.
Fitness in the Parks, we’re aiming to make a healthy lifestyle more accessible to folks by bringing exercise classes to the communities in which our members live and work.” The free outdoor fitness classes include boot camp, cardio dance, cardio kickboxing, Pilates, yoga and Zumba. Each class is 60 minutes and is taught by YMCA-certified instructors. Classes will take place at 18 parks and locations throughout Western New York. “Due to the popularity of Fitness in the Parks, we’ve added two additional locations for 2016, the Buffalo Medical Campus and Buffalo RiverWorks. These additional spots in the City of Buffalo will help us to meet the demands of the city’s population and workforce,” said McGuire. “Having more locations to work out outdoors this summer makes accessing classes more convenient and even makes for a healthy social event for friends and colleagues to encourage and support one another.” Classes will be held in Amherst, Buffalo, Cheektowaga, Clarence, Jamestown, Lancaster, Lewiston, Lockport, Orchard Park and Tonawanda. A boot camp class will be held at Ralph Wilson Stadium every Monday at 6 p.m. from July 11 through Aug. 22. There is no advanced sign up required to participate in any of the classes. People can simply show up to the location of their choice at the day and time listed on the class schedule. For a complete list of Fitness in the Parks locations, times and dates for giveaways visit www.independenthealth.com/fitpark.
15.5 Million Americans Now Surviving Cancer But better tools needed to support their long-term recovery, experts say
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ancer survivors in the United States reached record numbers this year — 15.5 million — and the American Cancer Society predicts they’ll total more than 20 million in another decade. But along with these success stories comes a growing demand for medical, emotional and psychological support to aid survivors’ longterm recovery, according to a new cancer society report. “Many cancer survivors have to cope with long-term physical and psychological effects of their cancer treatment,” said lead researcher Kimberly Miller, an American Cancer Society epidemiologist. “It’s important for the public health community to have a better understanding of the current and future needs of these survivors.” Although cancer rates are declining for men and stable for women, survival numbers are up because of improved detection and treatment, as well as a growing and aging population, the study authors explained. According to the report, nearly half of survivors are 70 and older, and 56 percent were diagnosed within the past 10 years. One-third were diagnosed less than five years ago. Among men, survivors were most likely to have had prostate cancer (3.3 million), colon or rectal cancer (725,000), or melanoma (614,000). Women survivors most often had breast cancer (3.5 million), uterine (757,000), and colon or rectal cancer (727,000), the researchers found. These aren’t necessarily the most frequently diagnosed cancers. For example, lung cancer is the second most commonly diagnosed cancer in men, but because of its poor survival rate, it ranks eighth among survivors, Miller said. While older age is common, survivors’ age varies significantly by the kind of cancer, the findings showed. For example, 64 percent of prostate cancer survivors are 70 or older, compared with just 37 percent of melanoma survivors. And more than 65,000 cancer survivors are 14 and under, while 47,000 are 15 to 19,
according to the report. Because of the toll cancer takes on patients and their families, it is important to offer emotional, financial and physical support, said physician Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. “Cancer not only affects a specific organ but has effects on the mind and spirit as well,” said Bernik. Many groups, such as the American Cancer Society and the U.S. National Cancer Institute, have made progress in providing services for patients outside of just the standard medical treatments, Bernik said. Miller added that local groups of cancer survivors can help provide information and emotional support. However, much more is needed as the number of cancer survivors increases, Bernik said. “Complicating the matter is the fact that every patient is an individual and often has unique needs. With time, the hope is that more programs will emerge to help with all aspects of cancer care,” she said. Miller added that primary care doctors and survivors must work together to help deal with the lasting effects of the disease. “A lot of people go to their primary care physician after completing treatment for information, and that’s an area where physicians may need more education and support,” Miller said. Primary doctors can help survivors with cancer screening and encourage good habits, such as quitting smoking, eating a healthy diet and exercising. In addition, they can make referrals to mental health experts if a patient is psychologically distressed. “They just need the tools to manage care efficiently,” Miller said. While most patients fare well emotionally, fears of cancer returning or a new cancer developing are common. Family and friends may find that many cancer survivors have “unmet psychosocial and medical needs,” the study authors explained.
Serving Western New York in good A monthly newspaper published by
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Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region
In Good Health is published 12 times a year by Local News, Inc. © 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, Tanya Peterson, Aaron Gifford 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.
July 2016 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Nancy Bowen, founder of Sisterhood Wellness Center, and his daughter Corrina (Corey) Schultz. They run the nonprofit organization, which organizes retreats to help cancer survivors and patients.
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Reach thousands of healthcare professionals every month. Advertise with In Good Health Call 716-332-0640 for more info or email: editor@bfohealth.com
Cancer Nonprofit in Search of Sponsors
Sisterhood Wellness Center, an organization that works with breast cancer survivors, looking for sponsors By Tim Fenster
is accepting applications for the following position for the 2016-2017 school year:
• Speech Therapist • BCBA (Board Certified Behavior Analyst) • School Psychologist Please visit the St. Lawrence-Lewis BOCES website at www.sllboces.org for the application and more information. Applications will be accepted until the positions are filled.
Drivers Needed Only one or two days a month In Good Health, WNY’s Healthcare Newspaper is expading its distribution and needs additional drivers to help place copies of the paper at various businesses in the area. One or days a month. $9 an hour plus 30 cents per mile. No heavy lifting. Must have dependable vehicle. Please call Michelle at 332-0640.
RN Assessment Coordinator
Current NYS RN license and 3 years of RN exp. and at least 1 year exp. with MDS that includes knowledge and application of the 3.0 process. A working knowledge of the MDS/PRI process required, including a track record of maximizing reimbursement and regulatory compliance. Full-time, days.
RN Supervisor
Accountable for the supervision of patient care within LTC/brain injury/subacute units. CPR/AED certified. Full-time 11:00 p.m. – 7:00 a.m. NYS RN licensure required. We are always on the lookout for talented individuals to join our team. We currently are hiring for LPN, CNA, Food Service and Housekeeping. We offer competitive wages and benefits, free parking, and a convenient suburban location on the bus line located close to major shopping centers, schools, and downtown Syracuse.
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EOE / Affirmative Action Employer
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ack in December of 1996, Derby resident and insurance agent Nancy Bowen underwent a lumpectomy to remove cancerous lymph nodes under her left arm, and came out of surgery to bad news. Her breast cancer had spread, meaning that it was a stage II cancer and she would need to undergo radiation and chemotherapy. While her treatment was obviously crucial to her surviving another two decades and counting, Bowen equally credits two fellow breast cancer survivors with getting her through this terrifying time. She says Mary Jane Charles, a then seven-year survivor and registered nurse, and Marjorie Brown, her husband’s cousin’s wife and two-year survivor, offered important advice and helped her keep her “sanity” through chemo. “It’s a proven scientific fact that if women have support from other survivors, their chances of survival are better,” Bowen said. A few years later, as Charles and Bowen began to realize how crucial support from other survivors can be, they came across an ad for a breast cancer retreat in western North Carolina, and decided to go with two other local survivors. They enjoyed the five-day retreat, but found it lacking. It was not run by breast cancer survivors, attendees were expected to follow strict rules and very little of the time was spent on recreation. On the long drive home, they made notes on what they did and did not like about the retreat. Just months later, in February of 1999, Charles and Bowen formed the nonprofit Sisterhood Well Center to offer their own retreats in Western New York. They hit roadblocks pretty much right off the bat. Every facility they looked at was too expensive, and Charles had to quit due to personal reasons, which led to another survivor, Florence Fox, taking the reins. Together they set up and held the first retreat at Cradle Beach Camp in Angola in September of 2000. From then on, each spring and autumn they would rent a U-Haul and fill the camp’s Jim Kelly House with bedding and furniture for their weekend-long retreats. After two good years at Cradle
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
Beach, they had to relocate, and spent the next decade moving around hotels and facilities in Western New York. Most recently, they landed on Holiday Valley’s Tamarack Club in Ellicottville. “They’ve made us feel very welcome, and have gone out of their way to make us feel comfortable,” Bowen said.
Keep going strong
They are still there today, holding two weekend retreats a year with 22 survivors at each. However, every retreat is different, with different activities — such as horseback riding, scuba diving, kite-flying, ballroom and belly dancing — being offered and a mostly new crop of survivors at each. “We keep it smaller to reach out to them on a personal level,” Bowen said. Attendance is based partially on a first-come, first-served basis, though they always accept the recently diagnosed repeat first-timers and those with stage IV cancer, who are typically on chemotherapy for the rest of their lives, Bowen said. The cost for each attendee is $400, but most, faced with medical bills and unable to work, cannot pay the full amount. “Most women cannot afford to pay it. We don’t question them,” she said. Instead, the center solicits donations and holds an annual fundraiser in November to cover the retreat costs that attendees can’t afford to pay. “It’s difficult because it costs a lot of money and sometimes the money just doesn’t come,” Bowen said. She says the center’s board of directors is looking for sponsors, and hopes that someday it can bring in enough cash to put on more retreats. It’s especially important, Bowen says, because theirs is the only retreat program of its kind in New York state. “I know we’re doing the right thing, I know we’re helping a lot of people,” she said. “I just wish we could do more.” For more information on the Sisterhood Wellness Center, visit www. sisterhoodwellnesscenter.org. Donations can be sent to P.O. Box 433, Derby, N.Y. 14047.
Among U.S. Military, Army Members Face Highest Suicide Risk Firearms implicated in about two-thirds of cases, study finds
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uicide rates have been increasing among all active U.S. Navy, Air Force and Army personnel, but those in the Army appear to be most at risk, new research indicates. An analysis of all U.S. military suicides between 2005 and 2011 revealed that the suicide rate among Army members was roughly double that seen among the second highest risk group, the Marines. The investigation further revealed that guns are the principal cause of most military suicides. Firearms were implicated in more than 62 percent of all suicide cases that have a definitive cause of death, the study found. "The trends in suicide are similar to what others have found," said study lead author Andrew Anglemyer, from California State University, Monterey Bay. "The differences in those rates between services are striking, though. Not only are most suicides in the active duty military among the Army personnel, but the
suicide rate among Army personnel is the highest and has been every year since 2006." Suicide was the 10th leading cause of death in the United States as of 2010. And the current investigation comes amid a rising suicide rate among military personnel throughout the last 15 years of continual war. In fact, the U.S. military has seen its overall suicide rate nearly double between 2001 and 2011, the researchers said. The latest study looked at suicides among all active-duty enlisted U.S. military personnel as recorded by the suicide data repository. This listing combines information from the U.S. Centers for Disease Control and Prevention, the National Death Index, and the Military Mortality Database. The research team identified 1,455 U.S. military suicides between 2005 and 2011. The Army had the highest rates between 2006 and 2011.
There were between roughly 19 and 30 cases of suicide for every 100,000 soldiers. The most commonly held positions were in infantry or special operations, the study found. The lowest suicide rate — nearly 10 suicides for every 100,000 — was seen among both Air Force and Navy personnel in the year 2005, the study showed. Of all the military cases, men accounted for the lion's share of suicides at 95 percent. More than three-quarters of the suicides involved white service members. Marital status didn't appear to exert any influence on suicide risk. The vast majority of suicides (87 percent) involved service members who had no more than a high school education, the research revealed. Across all military branches, the
average age at suicide was 25. The median length of time served by a military member who took his life was four years, the study said.
Healthcare in a Minute By George W. Chapman
Medicare fraud
We are losing more than $60 billion annually to Medicare fraud. While the Affordable Care Act has greatly expanded resources to prevent and detect fraud among providers, it is still difficult to completely stop it. First, Medicare is huge. It is by far the largest healthcare insurer/payer in the country. It receives more than 4.5 million claims daily and pays out over $1 billion to providers daily. Second, Medicare is more “open” (trusting) than commercial insurers. Once an applicant provider meets all the basic requirements, Medicare is obligated to begin processing the claims and paying. Medicare does not physically confirm the existence of all new providers be they a home health agency, medical group, pharmacy or durable medical equipment supplier. In addition to the cost, fraud makes it more difficult for Medicare to make policy or health decisions because a lot of the claims upon which decisions are made are fake/tainted, distorting claims data. How much damage can just one doctor do? In 2012, Dallas physician Jacques Roy bilked Medicare for $375 million through a phony home care company. It is still the largest home care fraud case in the history of Medicare. Most get caught because they get greedy. Roy “enlisted” more than 11,000 beneficiaries to receive home care through his phony company. This number of enrollees was, by far, the most by a single physician in the country. Fraud auditors were immediately suspicious as this came up on their radar. Roy is serving a life term in prison, but most of the $375 million he stole is gone.
Fee for service: phased out
It has long been argued that fee for service or volume payments to physicians and hospitals has produced the wrong incentives and the highest costs in the world. In a FFS environment, there is no incentive to not provide unnecessary care or to focus on long-term outcomes or to coordinate care with other providers. Experts believe the sooner FFS is gone, the better for all. Recently, 52 percent of the members of the New England Journal of Medicine Catalyst’s Insights Council agreed that FFS reimbursements must go and it stands in the way of providing value-based and outcomeoriented care. The switch to value based reimbursement will not only change how physicians practice. Consumers will be increasingly expected to hold up their end of the bargain by eating healthy, exercising and following physician orders.
Primary care doctor salaries up
Although most specialists still earn more, compensation for primary care physicians is improving. According to a reliable and respected national survey of medical practices, primary care compensation has increased 18 percent over the past five years. Specialist compensation rose 11 percent over the same period. This is good news because it should encourage more medical students to pick primary care and alleviate the predicted shortage of primary care providers. The transition from feefor-service to value-based care shifts more responsibility, and therefore more money, toward primary care.
Family health premium
According to the Milliman Medical Index, health insurance for an average household of four, with an employer-sponsored plan, costs $25,826. This is more than three time the cost of $8,414 in 2001. Employers still pay most of the premium (57 percent) but cost shifting to the employee is increasing. The average household is paying about $11,000 or about 43 percent of the total premium. The “good” news is annual rates of cost increases have dropped from 10 percent years ago to 5 percent in recent years.
Exchange rates up 8 percent
According to the Robert Wood Johnson Foundation, the average premium on the exchanges rose 8.3 percent, but there was tremendous disparity across the country. Rates went up almost 42 percent in Oklahoma, but fell 12 percent in Indiana. So, the RJW researchers concluded the national average is a fairly meaningless statistic and more attention should be paid to comparing the characteristics of markets with high rates of increases to those with lower rates of increases. Despite the disparities among markets, many predicted the average rate of increase would be in the double digits. Insurers like United are pulling out of the exchanges as the enrollment of sicker and more expensive consumers creates “unsustainable” losses. Some states (Alaska, Alabama, Wyoming so far) will have only one insurer on their exchanges next year. Insurer losses would be mitigated or offset by the enrollment of younger and healthier consumers. But the current penalty for not buying insurance is still far
July 2016 •
cheaper than buying premiums; so, younger and healthier people take their chances by foregoing insurance and paying the penalty.
Big Pharma “charity”
You have heard on the ubiquitous drug ads that, “if you are having trouble paying for….. (the particular drug), financial assistance is available.” This seemingly charitable / humanitarian act is done to deflect much deserved criticism for profit mongering and bankrupting the entire healthcare system and to boost sales. To offset the “charity” or discount, drug manufacturers merely increase the prices of their drugs.
Protect your identity
Hackers want to steal your personal information and your identity. Your mobile phone, laptop and router are all access points for thieves. The best way to reduce your risk of being hacked is to frequently change your passwords. The main reason why we don’t do this nearly enough is that we all have several (too many) passwords. Experts remind us that the hassle of changing our passwords pales in comparison to the disruption of life and financial loss if we are hacked.
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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Your Doctor
By Chris Motola
Thomas R. Duquin, M.D. Summer Months: Watch Out for Snakes
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t has been estimated that 7,000 to 8,000 people per year are bitten by venomous snakes in the United States, and for around half a dozen people, these bites are fatal, according to the American Association of Poison Control Centers (AAPCC). In 2015, poison centers managed over 3,000 cases of snake and other reptile bites during the summer months alone. Approximately 80 percent of these poison center calls originated from hospitals and other health care facilities. Venomous snakes found in the U.S. include rattlesnakes, copperheads, cottonmouths/water moccasins, and coral snakes. They can be especially dangerous to outdoor workers or people spending more time outside during the warmer months of the year. Most snakebites occur when people accidentally step on or come across a snake, frightening it and causing it to bite defensively. However, by taking extra precaution in snake-prone environments, many of these bites are preventable by using the following snakebite prevention tips: • Avoid surprise encounters with snakes: Snakes tend to be active at night and in warm weather. They also tend to hide in places where they are not readily visible, so stay away from tall grass, piles of leaves, rocks and brush, and avoid climbing on rocks or piles of wood where a snake may be hiding. When moving through tall grass or weeds, poke at the ground in front of you with a long stick to scare away snakes. Watch where you step and where you sit when outdoors. Shine a flashlight on your path when walking outside at night. • Wear protective clothing: Wear loose, long pants and high, thick leather or rubber boots when spending time in places where snakes may be hiding. Wear leather gloves when handling brush and debris. • Never touch or handle a snake: Never handle a snake, even if you think it is dead or nonvenomous. Recently killed snakes may still bite by reflex. There have even been cases of detached snake heads being able to bite, reflexively. • Bring a partner: If you are planning to spend time in a snakeprone area, it is best not to go alone in case you are bitten by a snake or have another emergency. If you must go alone, make sure you bring a fully charged mobile telephone, and stay wherever your phone gets a signal.
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UBMD orthopedic surgeon specializes in shoulder replacement: people don’t need to live with bad shoulders, he says Q: You perform a lot of shoulder replacements. What’s involved with working with such a complicated joint, and who is a good candidate for a shoulder replacement? A: Shoulder replacements are for people who have shoulder arthritis, which can come in several forms. There’s osteoarthritis, which is similar to wear-and-tear issues you see in other joints, where the cartilage is worn away until you have bone-onbone articulation, which then results in pain. There’s also inflammatory arthritis like rheumatoid. And some people have arthritis related to a longstanding rotator cuff tear where the joint will still become degenerative, but you have the added complication of a rotator cuff tear. They’re also candidates for shoulder replacement, but we do what’s called a reverse shoulder replacement where we actually change the polarity of the joint, meaning we put the ball on the socket side of the joint and the socket on the ball side of the joint. The reason we do that is that it allows the shoulder to function without having the rotator cuff tendon. Other people who may or may not be candidates are people with complex fractures. I think in general shoulder replacements aren’t as commonly done, so people don’t know that much about them compared to knee and hip replacements. So a lot of patients and even primary care professionals don’t know they’re an option. It’s unfortunate because those people don’t need to suffer.
ferent. Just historically the results weren’t that good years ago. Since you don’t really weight-bear on your arms, a lot of people were just told to live with it. The reality is that people with bad shoulder arthritis have a very low quality of life and have a hard time taking care of themselves, bathing, washing their hair. A lot of people have a very difficult time sleeping at night. The reality, though, is that you don’t have to live with it. The surgery is very similar to hip replacement. Generally speaking, we can make a very big difference in their quality of life. Q: How much strength are you able to restore? A: Most people, activity wise, I tend to have a very frank conversation about not necessarily what they can and can’t do but what they should and shouldn’t do. It’s a small difference, but the reality is you can get back to doing pretty much anything depending on your goals and the amount of rehabbing you want to do. So you can get back to sports and even manual labor. The difficulty is that, in the younger patients, we worry about the longevity of the joint. We are talking about metal-on-plastic articulation. Eventually that does wear out. So the more wear-and-tear you’re putting on it, the faster it will wear out. I try to advise people not to overdue it, not to beat up on the shoulder. Avoid doing things you don’t have to do. But you can do pretty much whatever you want and are capable of.
Q: Is that due to the difficulty of replacing the shoulder? A: It is dif-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
Q: How old is your typical shoulder replacement patient? A: The majority of people we see are in their 60s and 70s, though I’ve done them in much younger patients in certain scenarios. We’re seeing more people in their 50s that have early arthritis due to old injuries. We also see heavy laborers who can wear out their joints at a young age. Certainly, because of the longevity issues, we like doing it for the 60s and 70s group because we can say with some confi-
dence that it will last for the rest of their lives. For someone in their 50s, I tell them that there’s a good chance we might have to do a revision as they might outlive the prosthesis. Q: With lesser shoulder dysfunctions like rotator cuff tears, at what point is surgery a good option? A: The majority of people with rotator cuff pathology we treat non-operatively: physical therapy, cortisone injections. Those modalities tend to work pretty well. People with full-thickness tears, especially younger, active patients, we’ll want to repair the joint, which we can usually do arthroscopically. We evaluate the joint with cameras, anchor the tendon back down to the bone so it can heal. Usually we prefer non-operative therapies in younger patients unless they’ve suffered a truly traumatic shoulder injury. So if they’ve fallen off a ladder or something and lost the ability to raise their arm immediately following that, there’s a good chance that it’s an acute tear that should be treated surgically right away. But most rotator cuff injuries are attritional and happen over time. Q: Do partial tears indicate that patient is likely to need shoulder replacement down the road? A: It’s pretty unlikely if it’s managed effectively. It’s mostly patients who have large, longstanding full-thickness tears, which keeps the ball from being fully centered in the socket. When it doesn’t fit, it results in secondary wearing out of the joint. People that could be at risk are those with instability. Q: How do you sell the medical students you work with on your specialty? A: I try not to sell to people. I do enjoy working with the students and residents; it helps keep us on our toes. In terms of guiding students, it’s a challenging thing to decide what the best specialty for you is. So I work with a mentoring program through the University of Buffalo and we have discussions about different specialties, lifestyle, work hours. It really depends what brings them satisfaction. Usually the people interested in orthopedics are those who like the technical aspects of medicine, like working with their hands and be relatively active throughout the day. That’s opposed to the more social aspects you see in primary care and chronic illness management. It’s a tough decision though, because once you make it, you’re kind of locked in.
Lifelines Name: Thomas R. Duquin, M.D. Position: Physician at UBMD Orthopaedics & Sports Medicine; assistant professor at the Department of Orthopaedic Surgery at UB Specialty: Elbow and shoulder surgery, general orthopedics Hometown: Williamsville, NY Education: SUNY Buffalo; Mayo Clinic School of Graduate Medical Education Affiliations: University of Buffalo; Erie County Medical Center; Kaleida Organizations: American Academy of Orthopaedic Surgeons; American Board of Orthopaedic Surgeons; Orthopaedic Research Society. Family: Married, one child, another on the way Hobbies: Golf, running Office location: ECMC 462 Grider St., Buffalo
Stable Condition
Horse riding center offers equine therapy where it’s most needed By Tim Fenster
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ocal mother Lisa Valle has been taking her 8-year-old daughter Maya riding for years now, and plans to continue to for the foreseeable future. She does this not because she envisions Maya as a future champion rider, or simply because her daughter enjoys it, although Maya does look forward to her horse-riding sessions. Rather, Maya, who suffers from a rare epileptic disorder, and as a result is non-verbal and non-ambulatory, is a patient of the Buffalo Therapeutic Riding Center, which offers affordable equine-assisted therapy to hundreds of local children with disabilities. “She’s 8 and a half years old and learning how to walk. It’s given her a lot of strength to walk herself,” Valle said. Equine-assisted therapy, in its current form, was developed in central Europe in the 1960s, and was popularized in North America in the late ‘80s and early ‘90s. It can be used to help treat a wide range of physical and mental disorders, including attention-deficit/hyperactivity disorder, anxiety, autism, cerebral palsy, post-traumatic stress disorder and more. While the therapy is helpful to people of all ages, the Buffalo Therapeutic Riding Center focuses its efforts on children aged 6-16. Susan Schoellkopf, executive director, founded the center in 1992. Its facility at 950 Amherst St. was constructed in 1922 on the site of the Pan American Exposition — a 1901 World’s Fair that is best known for being the location of the assassination of President William McKinley. It is one of the largest and oldest continuously operating riding facilities in the United States. Schoellkopf said shortly after taking over the facility in 1990, she decided to establish the therapeutic riding center to benefit local children with special needs. “The board and I felt it was better to go with something that we could give back to the community,” Schoellkopf said. “There seem to be a lot of kids in trouble and needing this program.” Today, the center offers its ther-
Kacey Bechtel, a 12-year-old boy enjoying a ride at Buffalo Therapeutic Riding Center.
Maya, 8, with volunteers and instructor during a riding session at Buffalo Therapeutic Riding Center. apeutic riding program on Mondays from early May to late November over the course of six four-week sessions. The rest of the time the center serves as a show barn and basic equestrian center.
Widespread impact Each year, the therapeutic riding center helps some 150 children who receive a range of physical benefits from the sessions: better balance, strengthened muscles, improved coordination and the stretching of tight or spastic muscles. Valle said riding a horse for 30 minutes is equivalent to taking 3,000 steps, making it highly effective for her daughter Maya. “Riding a horse strengthens your core and hip muscles. So from a therapeutic standpoint, it’s extremely beneficial,” Valle said. But the benefits of equine-assisted therapy go beyond strengthening muscles and improving balance. It also helps children with behavioral problems, as the act of riding forces riders to consider how their behavior affects the horse, and thus, their experience. “They see how their behavior impacts the animal, how it upsets the animal and makes their riding experience not as pleasurable,” said Donna Steinwachs, a nurse practitioner who serves as the vice president of the center’s board of directors. “They learn that by them keeping control, the animal stays in control. If they lose control, chances are they may
lose control of the animal.” The children are well protected should they or the animal lose control, or anything else go wrong. Each child is accompanied — and, if necessary, held upright — by several instructors, each of whom are certified with the Professional Association of Therapeutic Horsemanship International. During therapy sessions, the horses are kept to a gentle trot, as the children steer the animal around posts and markers. “It’s not that we’re teaching them to ride a horse. We’re using the horse as a form of therapy,” Steinwachs said. Still, the act of riding and steer-
ing such a large, powerful animal can be a tremendous boost to the child’s self-esteem, which is yet another important benefit of the therapy. “As they go through the therapeutic lessons and they’re here week after week, they see that ‘I can control this very large animal,’” Steinwachs said. “So it gives them a sense of encouragement. It empowers them that they are able to do that.” The Buffalo Therapeutic Riding Center costs $400 per four-week session. However, with help from outside donations, the center offers scholarships for families who cannot afford to pay the full amount. For more information, visit www. thebtrc.org.
Jacob Campbell, 13, with his instructor Maddie Callanan (left) and a volunteer.
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Live Alone & Thrive
It felt awkward for me to hug relatives, much less friends. I was forever bumping cheeks and leaning right, when I should have been leaning left in an embrace. But years ago, I made a deliberate decision to become a hugger. I intuitively knew I was missing out on this natural form of human expression. The good news? I got better at it over time, and life is sweeter, as a result. It gave me an opportunity to convey love and friendship, and accept it in return. ■ Volunteer to touch. The benefits of “loving touch” are not just for the ones receiving it. Those who deliver it also reap great personal rewards and satisfaction. If you look around, there are plenty of opportunities to administer positive, healthy touch to someone in need. Many hospitals have volunteer “rockers” for newborns, and nursing homes are often looking for volunteers to make personal connections with residents who may not have family nearby. Just an hour talking to a nursing home resident, while applying hand cream, could change his or her day. To volunteer in this way can be a healing act of kindness, one that says that we are in this life together. What soothes one soothes us all. ■ Own a pet. A number of wellknown studies have shown that petting a dog or gently stroking a cat has a calming effect on people, reducing blood pressure and heart rate. Again, I don’t need a study to validate my own experience. Petting Scout or snuggling with her on the couch has an almost immediate and relaxing effect on me. After a long day, almost nothing is as grounding as a few minutes with
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Touch: An Essential Ingredient for Those Who Live Alone
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s I sit here at my computer writing this column, I can hear my new puppy Scout trotting toward me. She nuzzles my leg and looks up at me with her big, brown eyes, begging for attention and a little touch. My heart swells and I scratch the back of her neck. She bows her head, asking for more, and I happily oblige. I’m such a pushover! Scout asks for what she needs without reservation, without any shame or self-consciousness. She knows what we all know in the deepest parts of ourselves: we need touch to survive. I’m no expert on these matters, but others are, and research has shown that touch is absolutely essential for healthy emotional and physical development. In fact, studies have shown that premature infants who are tenderly touched on a daily basis gain weight more rapidly than those who are not touched. It’s because touch releases certain chemicals in the brain that, in turn, promote the baby’s development. But I don’t need a study to con-
vince me of the value of touch and affection. I have my own “proof,” and it’s revealed to me whenever I am touched or touch another. A friend’s warm hug can lift my spirits, a reassuring hand on my shoulder can hold the demons at bay, even a handshake can be affirming. Those who live alone can often unwittingly, almost unconsciously, neglect this vital component of a happy, healthy life. It’s easy to do, especially if you have a tendency toward isolation or are without a significant other in your life. If that’s the case, I encourage you to take notice. Is touch absent in your life? Has it been weeks or months since you have felt the warmth of an embrace? When was the last time you felt the comfort of a soothing caress? Below are a few tips to “keep in touch.” They have worked for me, and it’s my hope that you, too, will benefit from incorporating positive, loving touch into your life. ■ Become a hugger. If you’re not a hugger, I might suggest you become one, even if it’s outside your comfort zone. A little practice is all it takes. Hugging wasn’t natural for me.
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t may seem like eye-rolling teens never listen, but a new U.S. government report finds many kids are getting some health messages loud and clear. Smoking among high school students is at an all-time low. Slightly more than one in 10 high schoolers used cigarettes in 2015. That's down from more than one in four in 1991, the U.S. Centers for Disease Control and Prevention reported in June. However, use of e-cigarettes is up. The survey — called the National Youth Risk and Behavior Survey — included more than 15,000 high school students. A number of factors have conPage 8
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tributed to the decline in smoking, according to Patricia Folan, director of the Center for Tobacco Control at Northwell Health, in Great Neck, N.Y. They include "environmental tobacco bans, increased taxes on cigarettes, anti-tobacco media campaigns, as well as the removal of point-ofsale tobacco advertising from stores," she said. But some teens are replacing traditional cigarettes with electronic ones. Almost one-quarter of high school students said they'd used e-cigarettes in the past 30 days. And 45 percent said they'd tried an e-cigarette at least once in their life, the report found.
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.
Sun Safety Tips for Babies
KIDS Corner Teen Smoking Down, E-Cigarette Use Up
my affectionate pooch. Feeling bereft of touch? Owning a pet can help you feel connected and comforted. ■ Become in touch with yourself. “Self-touch,” with the goal to sooth, heal or relieve tension is natural, and can be a healthy expression of self-care and an act of self-affirmation. When self-love and pleasure are the intent, something profound and restorative can be the result. ■ Splurge for a massage. I read recently that, “Massage is to the human body what a tune-up is for a car.” Among its many benefits, therapeutic massage can bring relief from anxiety, reduce stress, fight fatigue, and increase your capacity for tranquil thinking and creativity. If you are touch-deprived, this form of safe, non-intimate touch can refocus the body’s natural ability to heal and regenerate itself. Hugging, caressing and soothing touch are natural expressions of friendship and affection, compassion and comfort. We all can benefit — both physically and emotionally — from good, loving touch on a regular basis. It enhances bonding and gives us a sense of belonging and well-being — important essentials for everyone, but especially for those who live alone.
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dults know they should cover up with hats, sunglasses and sunscreen when they’re in the sun. But babies’ skin is thinner and more delicate. What are the guidelines for them? UCLA Health pediatrician Jay Joo says the best protection is to avoid direct sun exposure, especially during the hours of 10 a.m. to 2 p.m. If that’s not possible, follow these tips: • Cover up the baby’s skin with a wide-brimmed hat and long sleeves and pants. Make sure the clothing is made of lightweight materials. • If the baby will tolerate wearing sunglasses, you can try that too. • For babies up to 6 months, it
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
is OK to apply a small amount of sunscreen to exposed parts of the skin such as the hands. Do a testpatch first to make sure the sunscreen doesn’t irritate their skin. • For babies age 6 to 12 months — and for older children as well — apply a liberal amount sunscreen on all exposed skin. Be sure to apply at least 15 minutes before heading outside. Reapply every two hours and after they swim or sweat. • Use a broad-spectrum sunscreen with an SPF of 30. • If the baby does get too much sun, soothe their inflammation by applying a cool compress or a calamine or aloe-based lotion.
Finally.
Closure to my leg pain and varicose veins.
FDA: Think Twice Before You Get That Tattoo Though popular, they carry infection risks and are hard to remove
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attoos are increasingly popular in the United States, but getting one carries risks, the U.S. Food and Drug Administration says. There are increasing reports of people developing infections from contaminated tattoo inks and having bad reactions to the inks, according to physician Linda Katz, director of the FDA’s Office of Cosmetics and Colors. She offered some advice for people trying to decide whether to get a tattoo. Think carefully before you make a decision. Removing a tattoo is a painstaking — and potentially painful — process and complete removal without scarring may not be possible, Katz said. If you do decide to get a tattoo, confirm the tattoo parlor and artist are in compliance with all state and local laws. The National Conference
of State Legislatures has a Web page on state laws, statutes and regulations governing tattooing and body piercing. To find out about local regulations, contact your county or city health department. You need to be concerned about unhygienic practices, non-sterile needles and contaminated ink, Katz warned. You can get infections from ink contaminated with microorganisms such as bacteria and mold. Contamination could occur either in the manufacturing process or at the tattoo parlor. A common culprit is non-sterile water used to dilute the pigments, the agency said. Signs of a tattoo-related infection include a rash at the site of the tattoo, or a fever. More serious infections could cause high fever, shaking, chills and sweats. Serious infections could require months of antibiotic treatment.
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Immunotherapy developed at Roswell Park being tested as treatment for multiple myeloma
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n immune-based therapy developed at Roswell Park Cancer Institute (RPCI) is moving forward with its third clinical trial. The early-stage clinical trial will assess whether SurVaxM — a cancer vaccine developed at Roswell Park — is a safe and effective treatment option for patients with multiple myeloma, a rare type of blood cancer. The vaccine will be tested in combination with REVLIMID (also known as lenalidomide) as maintenance therapy for adults with multiple myeloma. “Almost all patients with multiple myeloma who go into remission will still have microscopic amounts of disease left following treatment, and this residual cancer eventually can grow back and cause a relapse. It’s a problem compounded by the fact that these patients eventually become resistant to current therapies,” says physician Kelvin Lee, Jacobs Family chairman of immunology,
who is leading the phase I clinical trial. “But in combination with oral lenalidomide, which exhibits both immune-modifying and tumoricidal effects, we believe that this vaccine may trigger antimyeloma immune responses, which may prevent recurrences and eradicate the disease.” Created by Roswell Park faculty members Robert Fenstermaker and Michael Ciesielski, the SurVaxM vaccine stimulates the immune system to target the surviving protein, which helps cancer cells survive under stressful conditions. SurVaxM was first tested in brain cancer patients, and it may prove effective against other types of cancer as well. A phase I study of SurVaxM in some brain cancers concluded last year, and a phase II study of the vaccine as part of combination treatment for patients with newly diagnosed glioblastoma is ongoing at Roswell Park, the Cleveland Clinic and Dana-Farber Cancer Institute. July 2016 •
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Teen Drivers Take Deadly Toll AAA: Distractions played role in 60 percent of crashes involving teenagers,
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here’s an epidemic of distracted driving that’s maiming — and in too many cases — killing people in crashes involving teen drivers, a new report shows. A full 60 percent of car crashes involving teenagers occur while these young and inexperienced drivers are talking, texting or are otherwise distracted. And this happens far more often during the summer, according to the American Automobile Association (AAA). “I think everyone gets that distracted driving is bad and you shouldn’t do it, but until now parents didn’t have data in front of them to suggest that it was a much bigger problem that they should be concerned about for their teens,” said Jake Nelson, director of traffic safety advocacy and research at the AAA. For the study, researchers at the University of Iowa and the AAA Foundation for Traffic Safety analyzed the moments leading up to a crash in more than 2,200 videos from in-car dashboard cameras. The researchers found these top three distractions for teens: • Talking to passengers accounted for 15 percent of crashes. • Talking, texting or operating a cellphone accounted for 12 percent of crashes. • Looking at something inside the car accounted for 11 percent of crashes. According to the AAA report, released June 1, more than 1,000 people die in crashes involving teen drivers every year. And summer is the most dangerous season, when the average number of deaths involving teen drivers aged 16 to 19 increases 16 percent per day compared with other times of the year. In the report, the researchers also found teens were more likely to be texting or looking at the phone than talking on it. AAA’s Nelson said distracted driving makes crashes more likely because it “makes you less likely to react quickly to a dangerous situation.” Also, a phenomenon called “attention blindness” — when you don’t see something right in front of you because you’re focused on something else — can be deadly, he said. The association urges parents to teach their teens about the dangers of distracted driving with these tips: • Talk early and often about the dangers of distraction. • Have a parent-teen agreement that sets rules against distracted driving. • Teach by example — keep your eyes on the road while driving.
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What Kids Need for a Mentally Healthy Summer S
ummer is about to begin in earnest. Those adults who have children in their lives likely have a checklist of summer necessities to keep kids healthy. Sunscreen, bug spray, water bottles, Band-aids and other such necessities will help kids stay physically healthy and well through the summer. But what about a checklist for kids’ mental health this summer? What’s necessary to help kids be mentally healthy during the summer months? When we care for our children (whether they’re our own offspring or someone else’s), it’s natural to want them to thrive. “Have a great summer” can take on a new level of meaning, and there can be a great deal of pressure behind that command-style wish. There are certain things all children need in order to experience mental health and well-being and thus have a great summer. Think of the following list as a checklist for a mentally healthy summer.
■ 1 — Kids Need a Sense of Belonging in the Summer to Enhance Mental Health
Prominent psychologists such as Abraham Maslow, William Glasser and others have demonstrated through copious amounts of research that a basic human need is love and belonging. It’s essential for mental health and well-being. For most of the year, school is a major source of belonging for kids of all ages. While kids don’t feel close to everyone at school (and there are some people they’d love to get far away from), school in general provides an important sense of belonging and human connection. When the doors close for the summer, some kids can have a hard time adjusting to a sudden void in their network of connections. Tips to help children adjust and maintain a sense of belonging: • Help them know that if they’re feeling lonely or down, they’re not alone. It’s normal to need some time to adjust to a change, even a good change. • Plan some special activities together. A picnic in a park, a game of catch in the backyard, a night of stargazing — anything that allows
By Tanya Peterson your child to connect with you is excellent. • Allow your child to have friends over, go to friends’ houses, and otherwise connect with kids of the same age. For optimum mental health, kids need connections with peers. It fulfills the need for belonging, and it creates a support network that contributes to the development of resilience.
■ 2 — A Sense of Purpose Gives Kids a Mental Health Boost Throughout the Summer
As much as kids grumble about homework or their classes in school, these things are actually very good for them in a number of ways. Academics aside, school helps kids develop a sense of purpose. A universal question, worded differently across the life span, is “why am I here?” We answer that question by discovering a sense of purpose. School-age kids need to feel a drive, a motivation, a sense of purpose in order to be mentally healthy. Sometimes, the summer months can contribute to feelings of depression or anxiety because of their lackadaisical days. To help kids maintain a sense of purpose, and thus mental wellness, consider these ideas: • Let them help decide and plan activities (with age-appropriate limitations, of course). Allow them to brainstorm things to do, and have them make the plans for it. This can apply to the lunch menu or to a weekend outing. Kids thrive when they are allowed to have some responsibility for what the family does. • Give them age-appropriate chores. Sure, they’ll likely grumble, but behind the rolled eyes is a kid who is developing a sense of purpose, a sense that there are things to do during the summer and that they can contribute to getting them done. That develops self-confidence, an important component of mental health.
■ 3 — Summer Fun is Essential to Kids’ Mental Health
Like belonging and a sense of purpose, fun is actually essential to mental health and well-being. Experiencing fun reduces stress, anxiety and depression, and it increases our connection to others. For kids who are out of school, away from their normal routine, network of sup-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
portive adults, and peers, summer vacation can become a drag. Kids can become listless and apathetic or irritable and prone to getting into trouble. Introduce fun for a mentally healthy summer. Fun is a balancing act. Kids need structured fun, such as involvement in sports, clubs, classes and camps. Structure provides routine and a sense of safety. Too much structure, though, can be stifling and stressful, even contributing to anxiety. Kids also need unscheduled time for free play to enhance their mental health. To find this balance: • Decide how much you can spend on structured activities, and research what is available in your area. The older your child is, the more input she can have in this process (other than the budget, of course). Let her help you choose one or a few structured activities • Put together a kit or box for free time. Again, let your child contribute. Being set loose for free time can be overwhelming for kids, resulting in the complaint that there’s nothing to do. Having things on hand for your child to do is helpful in getting them into the fun. You might have noticed that belonging, purpose and fun are interconnected. They exist together, contributing to each other positively. Together, belonging, purpose, and fun help your child have a mentally healthy summer. Children, like adults, are complete and complex creatures. Their skin must be protected from the sun’s rays. Their bodies must be properly nourished and hydrated. And their mental health needs to be cared for as well to help them thrive through the summer and well into next school year. Tanya J. Peterson is a nationally certified counselor, novelist and columnist who uses writing to increase understanding of and compassion for people living with mental illness. Her last book, “My Life in a Nutshell: A Novel” (Inkwater Press, 2014) was awarded a Kirkus Star, an honor given by Kirkus Reviews “to books of remarkable merit.”
SmartBites
The skinny on healthy eating
Hot Dogs: The Good, The Bad and The Healthy
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et’s be frank: When it comes to healthy foods, hot dogs rarely top anyone’s list. They’re processed; they can be high in fat, calories and salt; they’re sometimes made from ingredients we don’t even want to think about; and they’ve recently been linked to cancer. Nonetheless, we Americans love our hot dogs. According to the National Hot Dog and Sausage Council, more than 7 billion will be eaten between Memorial Day and Labor Day, with 155 million downed during the biggest hot-dog holiday of the year: July 4th weekend. Whoa, doggies. No wonder July is National Hot Dog Month. Taste aside — and, oh, they can be so delicious! — there must be something else good about them, right? Indeed, hot dogs are a convenient, economical source of protein, supplying on average about 7 grams per link. What’s more, the hot dog itself is not all that caloric, averaging around 150 calories per link, with lower-fat versions boasting a mere 50. (As a comparison, a typical hamburger patty has about 230 calories.) On the other hand, hot dogs are dogged — and rightly so — by several things that do not make them
man’s best friend. To begin, they’re processed; and diets high in processed meats have been linked with cancer, especially colorectal cancer. Also, they’re no slouch in the salt department, with some dogs running over 700 mg per link. Consuming high amounts of sodium contributes to high blood pressure, which can then lead to stroke, heart disease and heart failure. Lastly, many hot dogs teem with fat, including the dreaded saturated fat. Too much fat never does a body good. So, what’s a hot-dog lover to do? Can we teach an old hot dog new tricks? Yes! Thanks to the responsiveness of hot-dog makers to our demands for healthier products, we now have all kinds of healthier hot dogs — from lower-fat turkey and chicken hot dogs to lower-sodium beef hot dogs to uncured hot dogs preserved with celery salt (versus artificial sodium nitrite). The selection at major grocery stores is doggone good.
Healthy tips
Read labels carefully. Opt for healthier “uncured” hot dogs over conventional, highly processed ones, which typically contain low-quality meats, oodles of preservatives and
more fat, calories and salt. Choose varieties that say 100 percent beef, 100 percent chicken, etc. to avoid byproducts. Consider vegetarian versions. Pair with a whole grain bun or pita and add fresh toppings. Most importantly: Eat hot dogs in moderation, as they are processed, and, according to the American Institute for Cancer Research, “eating hot dogs every single day is an unhealthy choice.”
Mediterranean Hot Dogs with Pesto and Chopped Tomatoes 4 grilled hot dogs ½ cup prepared pesto 1 – 2 teaspoons reduced-fat mayo 1 large tomato, chopped ½ cup sliced Kalamata olives
1 small onion, chopped (optional) crumbled feta cheese 4 whole-wheat buns In small bowl, blend pesto with mayo. Arrange buns on plates. Spread each with pesto mixture, then top with grilled hot dog. Sprinkle dogs with chopped tomatoes, olives, onions (if using) and cheese. 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.
Calorie Burners: Break Through the Plateau By Deborah Jeanne Sergeant
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f you’re starting to get fit and eat right but have hit a weight loss plateau, burning more calories can help you break through. If you want to really torch calories during your workout, some activities will prove more helpful than others. Though any exercise is better than none, engaging in certain activities can give you more benefit for the time you spend doing them. And how you engage in any activity makes a difference, too. “It matters about how fast the tempo of the reps, how many reps, and how many sets,” said Greg Bulter, certified personal trainer with Achieve Personal Fitness, Inc. in Snyder. “Your body gets used to things in four to six weeks and that’s when you plateau.” Using proper form and control when weightlifting, instead of letting weights flop around, uses more calories. Shuffling through a Zumba class, instead of high-stepping with the rest of them, won’t burn as many calories, either. The activity should engage more areas of the body. Walking, for example, offers a good entry level activity and helps many people get fitter. But many other activities burn more calories per hour. “A vast majority of people, when they want to lose fat, the two biggest things they start doing is walking
and running,” said Joe Fox, personal trainer, certified functional strength training coach and owner of Train Smart, Buffalo. “It’s an indisputable, inarguable fact that in the hierarchy of exercise, walking and running are the least productive.” Instead, he advises lifting as heavy weights as possible, use “explosive action” for movements, take short rest periods between reps, and perform as many movements as you can for as long as you can. To do all of those safely, he advises seeking a personal trainer who can help you learn proper form and develop an effective routine. If you have only a limited time in which to exercise, you could benefit more from other activities. A 150-lb. person burns about 600 calories practicing martial arts, compared with 225 calories walking at a moderate pace. “Cardio kick boxing is great for burning calories because it’s an entire body workout,” said Cory Webster, gym manager at WNY Mixed Marital Arts & Fitness in Buffalo. “It’s not like running. You use legs, core, arms, shoulders. It’s more like a sprint, opposed to long distance running. You get your body going, cool down, and get it going again,
for a certain amount of time at the same rate.” It’s a highly individualized subject. You have to find that avenue for yourself.” Choosing an activity that includes lots of variety, or selecting a few activities that includes the entire body, can help you break through a weight loss plateau.
as opposed to a long-term, slower movement. Your muscles are more engaged. You’re using a lot more muscle groups in a more explosive manner.” Eric Madia, personal trainer at Fierce Fitness in Buffalo, recommended swimming laps for similar reasons, because the entire body participates in movement. “If you use intensity as the main driver of your workout, you’ll have more success,” Madia said. “High-intensity interval training is where you go 30 seconds as fast as you can go, then have 30 seconds of rest. You burn more calories that way instead of steady state cardio, like running
July 2016 •
Tracking Calories You Burn
So how many calories do burn performing your activity? Your smartphone may already have an app that can give you an idea. Numerous websites may also help you estimate, such as • www.myfitnesspal.com and •www.healthstatus.com/calculate/cbc.
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Women’s HEALTH How Not to Gain Weight Back After Weight Loss Surgery Studies show many patients gaining weight back after bariatric surgery — experts advise how to keep the weight off By Deborah Jeanne Sergeant For people who are overly obese, bariatric surgery may provide a means to quickly shed weight that threatens their health and hampers their quality of life. However, nearly half the laparoscopic sleeve gastrectomy patients in a study published in the Journal of the American Medical Association in November 2015 reports regaining the weight that they have lost shortly after surgery. Additional studies have made similar findings for other types of weight loss surgery. The key to success lies in viewing the surgery as a tool, not panacea, for weight loss, several local experts said. “[Weight loss surgery] should help them at the start, but they will have to be working at it,” said Dangtuan Pham, bariatric surgeon with Buffalo Minimally Invasive Weight Loss Surgical Solutions in Buffalo. “It’s not a miracle solution.” Pham carefully screens potential patients. Those who are good candidates and who wish to proceed usually lose most of their excess weight in the six months following surgery, and then more gradually lose weight for months after. To keep the weight off for life, “you will have to change and work for the rest of your life to make sure it works,” Pham said. Buffalo Minimally Invasive Weight Loss Surgical Solutions offers regular follow-up, support groups, and counseling as needed. The staff also works with patients to prevent nutrient deficiency. “We work with their primary care provider to make sure we’re both following the patient so they don’t fall through the cracks,” Pham said. Jennifer Turesky, registered dietitian nutritionist at Synergy Bariatrics a department of ECMC in Williams-
A B C of Weight Loss Surgery Here’s a rundown of the kinds of surgery available: • Roux-en-Y is not reversible. It involves reducing the size of the stomach and attaching the small intestine to it. Patients cannot eat as much food as they used to and their ability to absorb nutrients is limited as well. • Biliopancreatic diversion with duodenal switch removes most of the stomach and bypasses most of the small intestine. Patients cannot eat as much as they could before, and increases the risk for absorption issues.
ville, said that follow-up is “what we know works” for keeping weight off. “We have at least annual visits here at the office,” Turesky said. “You can use food journaling to ensure you’re getting adequate nutrition, specifically protein and fluids. You also need regular physical activity.” She encourages patients to follow up with her individualize a game plan to get back on track–and stay accountable. “The more you come in here, the more you know someone is holding you to it,” Turesky said. “Some people do better weighing themselves weekly or monthly, but that is individualized per patient.” Since patients are asked to shun the very foods and lifestyle habits that contributed to their obesity, going alone is rough. That’s why Synergy hosts a support group twice a month. Whether participants journal or not, they’re welcomed to attend to get the support they need. Working with a personal trainer or fitness class can provide more motivation, according to Joe Fox, certified personal trainer and owner
of Train Smart in Buffalo. He also encourages people to gradually change life habits that affect weight control. “It’s one habit at a time, like putting 10 percent of income away for retirement,” Fox said. “It doesn’t do much for you right away, but in time, it makes a difference. Steadily make progress.”
Obesity at Glance
Obesity represents a serious health threat in the United States. According to the Centers for Disease Control: • “More than one-third (34.9 percent or 78.6 million) of U.S. adults are obese. • “Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death. • “The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight.”
• In laparoscopic adjustable gastric banding, the surgeon places a band around the top part of the stomach to separate it into two areas. The tiny pouch in the uppermost part cannot hold much food, so patients eat less. The tightness of the band may be adjusted. Patients may not lose as much weight with this method. • Vertical banded gastroplasty, commonly called “stomach stapling,” surgically divides the stomach to control food intake. The top portion of the stomach empties food into the rest of the stomach. While this slows eating, many patients find they don’t achieve lasting weight loss. • Sleeve gastrectomy, or vertical sleeve gastrectomy, is like biliopancreatic diversion with duodenal switch, but without changing the placement of the small intestine. By changing the shape of the stomach, patients eat less but may not lose as much weight as with other methods.
U.S. Teen Birth Rate Continues to Fall, Hits New Record Low CDC statistics for 2015 show another 8 percent drop
T
he number of babies born to American teenaged girls fell another 8 percent in 2015, reaching a new record low. According to the report from the U.S. Centers for Disease Control and Prevention, moms aged 15 to 19 accounted for about 22 of every 1,000 live births in 2015 — down from about 24 per 1,000 the year before. Page 12
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Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York City, applauded the news. “Most teenagers are not financially or emotionally equipped to be mothers at this point in their lives,” said Wu. “Teenage pregnancies present a myriad of social, medical and economic problems,” she added,
and “most of these pregnancies are unplanned and these mothers miss out on important aspects of prenatal care.” Overall, the report from the CDC’s National Center for Health Statistics saw a continuance of a trend in which American women are having children later in life. Birth rates were also down for women in
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
their early and late 20s, the report found — but were rising for women in their 30s and 40s. About 40 percent of births in 2015 occurred among unmarried women, a number unchanged from the previous year.
Women’s HEALTH
Chill Out Hot Flashes By Deborah Jeanne Sergeant
I
f you’re a woman experiencing menopause, hot flashes can become a real nuisance. For years, doctors prescribed hormone therapy as the best choice for 40-plus menopausal women who wanted relief. However, since a World Health Organization study linked hormone therapy with an increased risk of heart disease, stroke, blood clots, and breast cancer, physicians prescribe hormone therapy more selectively. They also suggest other ways to tame hot flashes. David Kurss, OB-GYN with Invision Health in Buffalo, is a nationally certified menopause specialist. “Hormone therapy is safe, effective, and has inappropriately impugned,” Kurss said. “It’s a legitimate option. Patients shouldn’t shy away from it if they want it or if other options aren’t helpful.” Carmen Todoro, OB-GYN with OB-GYN Associates of WNY in Depew and West Seneca, said that hormone replacement therapy benefits some women, but he advises women interested in it to go with the smallest effective dose for the shortest period of time. “There still are many benefits for hormone replacement therapy,” Todoro said. “If the benefits outweigh the risks and you feel so much better with it, after five years, I tell them we should think of a different alternative. We give them a list of alternatives.” If hormone replacement therapy isn’t for you, other, nonpharmaceutical choices may help. Environmental measures can help you stay cool, such as keeping the room temperature cool with open windows and fans or air conditioning; cooling your skin with a wet cloth, and dressing in layers
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so you can lighten your clothing as needed. Drinking cool beverages may also help lessen a hot flash. Triggers can include stress, anxiety and cigarette smoke. Some women find that losing weight helps reduce hot flashes. Supplementing with vitamin B6, black cohash, progesterone cream, evening primrose oil, aloe vera gel in water, pomegranate juice and shatavari and wild yam, also called vidari, with a few sips of water twice a day after lunch and dinner. A small study published in 2011 indicated that women treated with acupuncture showed markedly fewer menopausal symptoms than women treated with psudo-acupuncture, where the practitioner did not insert the needles with sufficient depth to stimulate the nerves. As to what to avoid, Todoro suggested shunning coffee, caffeine, hot showers, heavy clothing and excessive cardiovascular exercise. Swimming may provide a good form of exercise, since the water may help prevent the increase in body temperature associated with exercise. Jeffrey Constantine, also an OB-GYN with OB-GYN Associates of WNY in Depew and West Seneca, said that women should consider options other than hormone replacement therapy if smoke heavily, or have a history of liver disease, breast cancer, or blood clots, among other factors that can contraindicate the treatment. Women should also weigh the risk compared with how hot flashes and other menopausal symptoms affect them. “If hormone replacement is necessary to achieve good quality of life, and you’ve tried other methods, hormone replacement can be helpful,” Constantine. “It’s
important to assess the contraindications. That’s why it’s important to talk with your doctor.” With some
women, other medication has anecdotally shown to reduce hot flashes, although they’re not approved for treating hot flashes. These include gabapentin and pregabalin, normally prescribed for nerve pain, gabapentin, a seizure medication, and antidepressants venlafaxine, fluoxetine, and paroxetine. Constantine added that regular check-ups are important for every woman, even for those who have had a hysterectomy. “The best screening method for gynecological cancers is a pelvic exam, even though they don’t need a Pap smear anymore,” Constantine said. Before making any changes in diet, exercise or supplementation, it’s important to consult your physician.
Ways Women Can Take Care of Their Tickers Currently, 1 in 4 American women dies from heart disease, CDC says
eart disease is the leading cause of death among American women, but there are a number of preventive measures women can take, the U.S. Food and Drug Administration says. “The risk of heart disease increases for everyone as they age. For women, the risk goes up after menopause, but younger women can also develop heart disease,” FDA cardiologist Shari Targum said in an agency news release. One in four American women dies from heart disease, according to the U.S. Centers for Disease Control
and Prevention. Here, the FDA offers six ways you can reduce your risk: — Control your risk factors. Diabetes, high blood pressure and high cholesterol increase the risk of heart disease, so it’s important to manage these health conditions if you have them. Talk to your health care provider about an effective treatment plan. — Don’t smoke. If you smoke, try to quit.
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— Maintain a healthy weight and get regular physical activity. “Walking may be one easy way to start. Talk to your health care provider about how much activity is right for you,” Targum said. — Eat a heart-healthy diet. A diet that’s full of vegetables and fruits and whole grains is good for your heart. Limit the amount of saturated fat and sugary beverages in your diet. — Talk with your doctor about aspirin. Daily use of low-dose aspirin is not right for everyone. Aspirin
July 2016 •
can have side effects, so talk with your health care provider first.
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— Know the symptoms of a heart attack. Symp-
toms of heart attack in women can be different from those in men. For women they may include shortness of breath; nausea; and an ache or feeling of tightness in the chest, arm, neck, jaw or abdomen. “If you have these symptoms and suspect you’re having a heart attack, call 911,” Targum said. It’s also important for women to work with their health care team to make a plan for their heart health, the FDA recommended.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Women’s HEALTH
10
Mistakes Women Make in Their Health
By Deborah Jeanne Sergeant
W
omen tend to make a few mistakes in their health that can cause bigger problems in the future. We recently interviewed five local experts (listed at the bottom of the story). Here’s what they said:
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Skipping routine exams. “It’s very, very important that women have annual visits to their general doctor and gynecologist. They tend to work in concert to give you complete reassurance that you’re in good health and nothing needs to be imminently addressed. Proper preventive methods such as Pap smears and mammography and occasional sonograms and also screening for genetic cancer risk is paramount today. Don’t miss your annual visit.”
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Trying to get fit alone. “Some people need motivation in doing something. A class creates accountability. If you’re doing something on your own, there’s no accountability. We have semi-private coaching where we have friends or couples training together. It motivates you to get back in the gym.”
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Staying in an exercise rut. “A huge pitfall is people get into a rhythm of doing the same thing for the same amount of time for the same distance every day. The body adapts to that. Change up the intensity or mileage. Some people increase too quickly, so you have to do it gradually.”
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Focusing too much on cardiovascular exercise. “For weight loss and overall fitness, the more muscle you have, the more calories you burn when just sitting.”
Choosing the wrong activity. “A lot of times, they’re doing the wrong types of workouts for their goals, like working out only on the treadmill. That’s great if you’re overweight and need a place to start.”
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Using exercise to tone muscle. “You want to mix in a weight routine and routines that activate muscles to get toned. Every day on the treadmill isn’t going to do it.”
Sources for the story: • David Kurss, OB-GYN at Invision Health, Buffalo (tip 1) • Eric Madia, personal trainer at Fierce Fitness, Buffalo (tips 2 and • Greg Bulger, personal trainer at Achieve Personal Fitness, Inc., Snyder (tip 4) • Cory Webster, gym manager at WNY Mixed Martial Arts & Fitness, Buffalo (tips 5 and 6) • Joe Fox, personal trainer, certified functional strength training coach and owner of Train Smart, Buffalo (tips 7 through 10)
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
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Obsessing about exercise for weight loss. “Research argues that 69 percent of fat loss comes thru nutrition. If someone wants to lose fat, you can’t out-train a bad diet. If someone’s not happy with their weight loss or fat loss, they need to look at nutrition. It’s the way the body works.”
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Looking for quick fixes to weight loss. “Our society has become obsessed with challenges like losing 20 lbs. in 6 weeks, kick starts, and all kinds of fitness events where you get big results in a short period of time. The fact of the matter is, those challenges are completely are completely flawed.”
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Fixating on the scale. “Weight loss is a terrible way to measure progress. If someone’s lost weight, the question is, have they lost muscle or fat? They should look at body fat percentage. Losing fat is really easy, if someone’s really committed to doing it.”
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Trying to get healthy all at once. “Change one habit at a time. I would say that life is a marathon, not a sprint. It’s a proven fact that if someone tries to make one change, there’s an 85 percent chance they’ll succeed. It’s 35 percent if they change two habits at once. If it’s three or more, the chances of success go down to seven. If the only change that person makes is to eliminate soda, they could lose 10 lbs. a year from that.”
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Obesity Rates Rising Among Women: CDC
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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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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
Beloved Buffalo Sabres broadcaster and throat cancer survivor Rick Jeanneret helping promote Relay to Life. See inside
The Revenge of Bedbugs They’ve grown thicker skin, which helps protect against pesticides and may explain why population is growing worldwide, scientists suggest
search Center, in Derby, Conn., and president of the American College of Lifestyle Medicine. “Given all the high-profile attention to the obesity epidemic in America, even by those in the White House, we might be surprised and appalled that, overall, obesity rates are rising, not falling, and that the best news in the mix is stabilization of alarmingly high rates in a few select groups,” he said. But even as health experts fret about obesity and its consequences, American culture “ignores it, denies it or simply profits from it,” said Katz. The reports were published June 7 in the Journal of the American Medical Association. Katz sees the obesity epidemic as a cultural problem. “We continue to aggressively market [the] food and drink most implicated in obesity and chronic disease,” he said. “We live in a culture where we know food is willfully engineered to be all but addictive, but express no outrage and take no action,” Katz said. “We lament epidemic obesity even as we propagate it. We could fix this any time we decide we care enough about it to bother trying.”
A Former Ballet Dancer Making a Difference Dancer Cynthia Pegado has performed in Belgium, Switzerland and Portugal. Now she is devoted to helping patients with Parkinson’s disease in Buffalo
Living Alone: Create Your Own Perfect Day!
If 1 in 10 U.S. Smokers Quits, $63 Billion Saved icking the smoking habit boosts more than just your health — it also saves money. That’s because health care costs plummet just one year after stopping, new research shows. A 10 percent decline in smoking would reduce U.S. health care costs by $63 billion the following year, a study from University of California, San Francisco (UCSF) estimated. “Our study shows that significant changes in health care expenditures begin to appear quickly after changes in smoking behavior,” study first author James Lightwood, an associate professor in the UCSF School of Pharmacy, said in a university news release. The researchers reviewed health care costs linked with smoking in all 50 states and the District of Columbia. They looked at the time period between 1992 and 2009. In addition to the direct effects that cigarettes have on smokers, the study also included the indirect effects of passive smoking on non-
bfohealth.com
STROKE Things You
Teenage girls now try alcohol before boys do, says study
Though a major health concern, little has changed, expert says
ore American women than ever are obese, while the number of men carrying around far too many pounds has held steady, new research shows. And a second study finds U.S. teens are another group that continues to struggle with obesity. “Obesity remains a public health concern,” said Cynthia Ogden, an epidemiologist at the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics. She worked on both reports. “Our study didn’t look at why, we just looked at the trends to see what was happening,” she explained. More research is needed to determine the reasons for the continuing obesity epidemic, she added. The statistics are sobering. Forty percent of American women and 35 percent of men were obese in 2013-2014, reflecting an increase among women but not among men, the report found. Among children, 17 percent were obese in 2011-2014, while nearly 6 percent were extremely obese. The prevalence of obesity seesawed among young children, but increased slightly among teens, researchers found. Physician David Katz is director of the Yale-Griffin Prevention Re-
May 2016 • Issue 19
With 4.5 million dog bites occuring annually in the US, parents with young kids are advised to be careful before bringing a dog in their home
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Why You Should Fall for Mangoes
NYS Hospital Mergers Driving Up Prices A study by the conservative think tank, the Manhattan Institute, concludes that the 100-plus hospital mergers in NYS have served to only increase costs and decrease competition with no perceptible increase in quality. See “Health in a Minute” on page 5
Q&A with Christopher Kerr, M.D.
Mangoes, the world’s most popular fruit (who knew?), bring a wealth of powerful nutrients.
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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Autism: Are Girls Being Overlooked for Screening?
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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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 and other traditional Chinese exercises might reduce depression, improve quality of life for heart patients
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 •
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Tai Chi Could Be a Healthy Move for Your Heart
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.
Hospice Buffalo chief medical director talks about the end-of-life experience and why we have the thoughts we do when we’re in final hours May 2016 •
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Reasons to Do Aquatic Therapy
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THE COMMISH March 2016 • Issue 17
No Reading Glasses Ephraim Atwal is one of the first eye doctors in NYS to use camera inlay to eliminate need for reading glasses. He shares his technique
MEN’S SPECIAL ISSUE
• More options to fight prostate cancer • Fat Dads = Fat Children
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Buffalo & WNY’s Healthcare Newspaper
The Long Road to Get a New Kidney Paul Bloser is one of 100,791 people waiting for a lifesaving kidney transplant in the U.S. The median wait time to get the organ is 3.6 years. The 58-yearold shares his story
At 91, former President Jimmy Carter is the most famous cancer patient to benefit from a groundbreaking new treatment — immunotherapy
See story inside Page 9
Roswell doc: Therapy a ‘game-changer’
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Winter Gardening
First-Time Moms Are Getting Older in US
Frozen spheres developed by Connie Oswald Stofko, a local gardening expert. She talks about making your garden prettier — in the winter
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Women’s pay lacks parity with men’s, according to experts
Twenty-eight percent of consumers in the U.S. are preparing ethnic foods more frequently than five years ago. Bowl of Thai is just an example. See story inside
Tax Filing for Retirees
Fat Dads = Fat Children
Living Alone: Making Choosing a Hospice the Best of 2016 Care Program
Buffalo & WNY’s Healthcare Newspaper
New Hope for Cancer Patients
Erie County Health Commissioner Gale Burstein: Happy to have opted for career in public health. Her major challenge: decrease opioidrelated deaths locally
11 Food Trends Yes, Women Make Less in Healthcare Industry, Too
bfohealth.com
February 2016 • Issue 16
The Commish
A recent study indicates that maternal health isn’t the only influence on childhood obesity. Having a father who is obese may increase the child’s chances of becoming obese as well Page 14
Oh Boy, Is Bok Choy Nutritious!
Water Quality: Buffalo is No Flint
But officials say lead in paint still poses a problem, especially in older houses
March 2016 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Telehealth Expected to Living Making Grow Alone: Exponentially
the Best 2016 “Healthcare in a of Minute” on p. 5
Beyond Genes–Keys to Healthful Aging URMC prof says in many ways we’re not growing older healthfully
Oysters
Pet Therapy For the past year, care providers at Sisters of Charity Hospitals have been treating patients in a new way — with smiling, tail wagging, certified therapy dogs. They count on 12 dogs that are ready to help
And it is loaded with an impressive array of nutrients, so loaded that the wellregarded World Health Organization considers bok choy to be one of their highest nutritionally ranked vegetables.
Maple Syrup Season Coming
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Is there any truth to their libidoboosting power? Read “SmartBites” column inside
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Half of Those with Glaucoma Don’t Know They Have it — Are You at Risk? February 2016 •
Special Olympics Project Unify has athletes who have disabilities competing alongside high school students who have no disabilities
New Guidelines New U.S. Dietary Guidelines: Boost Fruit and Veggie Intake, Limit Sugar and Salt
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smokers. Smoking causes a wide range of serious health issues. These include heart and lung disease, as well as pregnancy complications, the researchers explained. The researchers found clear evidence that reducing the number of people who smoke, and getting smokers to have fewer cigarettes, was quickly followed by a rapid decline in health care costs. A major reason is that the risks for smoke-related diseases also change quickly once smokers quit, the study reported. The study was published May 10 in PLOS Medicine.
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Part of the team at The Gender Wellness Center in Oneonta are, from left, physicians Diane Georgeson and Carolyn Wolf-Gould (the practice’s founder) and Tania Villa, a registered physician assistant. The one-of-a-kind center opened last year and has seen a surge in number of patients, some coming from Massachusetts and Pennsylvania.
Mistaken Identity
A unique center in Upstate New York, The Gender Wellness Center has seen number of transgender patients skyrocket in one year By Aaron Gifford
C
arolyn Wolf-Gould found a way to combine her two passions — medicine and social justice. So when the physician expanded her family practice in Oneonta to include a special emphasis on treating transgender patients, she immediately realized that the need for these services was both overwhelming and long overdue. Within a few months, she was seeing dozens of patients of all ages who traveled to the rural college town located in the foothills of the Catskill Mountains from all parts of Upstate New York and even neighboring states. “Our practice is completely thriving,” she said. The Gender Wellness Center inside the Susquehanna Family Practice officially opened last year, though Wolf-Gould has been treating transgender patients for nearly nine years now. Since June of 2015, the center’s patient load increased from 180 patients to 350 patients, and some travel from Pennsylvania, Massachusetts and the New York City area. Transgender is defined as the mismatch between a person’s assigned sex at birth and their gender identity. Someone who is transgender is not necessarily homosexual, and the classification of transgender is not restricted only to those who are taking steps toward a sex change. Wolf-Gould had been in practice as a family physician for decades before she carved out her niche. The genesis came in 2007 after a patient — formerly female — had just moved to the area to work at one of the colleges and requested a prescription
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for testosterone. Wolf-Gould had little knowledge of transgender care, but was persuaded to help. “He was so persistent,” she said. “He otherwise had to go to Philadelphia for testosterone. He asked me, ‘Would you be willing to learn?’” Wolf-Gould, who had worked in the Congo as a Peace Corp volunteer, sponsored a school in Mali and set up a free clinic in Oneonta, was more than willing to learn. She soon learned that many providers across the state declined to provide transgender care to patients because it was out of their comfort zone. “People have been turned away from doctors, even for treatment for a broken leg,” Wolf-Gould said. “They were treated like curiosities or mocked. That’s what happened with African-Americans a number of years ago.” “I think patients, in general, are lovely people,” she added. “People come to me because they feel they aren’t living authentically.” The National Center for Transgender Equality conducted a national study that found nearly 20 percent of those surveyed were refused medical care because of their transgender status, and 50 percent indicated that they had to teach their physicians about transgender care. Twenty-eight percent responded that they had postponed medical care due to discrimination issues. The study, which consisted of interviews from 6,450 transgender or gender non-conforming participants across the country, reported that 41 percent of the respondents had previously attempted suicide, and a significant number of them were
fired from a job, bullied in school, had low household incomes, or were the victims of assault. In addition, 53 percent of the respondents reported being verbally harassed or disrespected in public places like retail stores, hotels, restaurants, bus terminals, public offices, courtrooms, hospital emergency rooms and medical offices. Wolf-Gould said medical providers who care for transgender patients often face distrust and suspicion from their peers. “Many doctors think that gender dysphoria is a mental illness or a perversion, and treat these patients with hostility or contempt,” she said. “Transgender patients face terrible discrimination in health care settings because of this. The doctors who treat these patients are often treated in similar ways by their peers — considered quacks, or to be practicing on the fringes. This is mostly because of lack of education about this gender variance.”
Unusual center in Upstate
The Susquehanna Family Practice and the Gender Wellness Center, which is affiliated with Bassett Healthcare Network, is also staffed by Wolf-Gould’s husband, physician Chris Wolf-Gould; physician Diane Georgeson, Michelle Kutalek (nurse practitioner), Justine Wollner Wise (licensed master social worker), and Susan C. Turell (psychologist). According to its website, the Gender Wellness Center offers primary care and gynecologic care for nonconforming youth
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
and adults; cross-sex hormone therapy; evaluation of gender nonconforming youth and treatment with pubertal blockers and crosssex hormones when indicated; referrals for gender confirmation surgeries locally, nationally and internationally; referrals to voice therapists and support groups; preoperative and postoperative care for gender confirming surgeries; and training and mentoring for health care providers with an interest in transgender health. Wolf-Gould said this is the only multi-disciplinary group in Upstate New York that also offers onsite mental health services to transgender patients, and the network has surgeons who have been trained in transgender care. “I think it’s unusual in New York state,” she said. “We offer a good mix.” An Internet search for transgender medical services in Upstate New York indicates there are many physicians who are identified as transgender friendly and offer services such as hormone prescriptions and therapy, but there were no other listings of entire practices specifically for transgender patients. Patient Rebecca Drebert, of Binghamton, made her first trip to the center last year after learning about the practice at a transgender conference in Boston. An Episcopal priest, Drebert was always transgender and legally changed her identity from David Drebert to Rebecca Drebert several months ago. She is undergoing hormone therapy but is undecided if she will eventually get a sex change operation. When Drebert was forced to leave her former position at an Episcopal Church, Wolf-Gould immediately made the trip from Oneonta to Binghamton to support Drebert in her time of need and offered to discuss the matter with congregation members who forced Drebert out of the church. “That’s the kind of person she is,” Drebert said. “She is so very caring about everyone and wants to get the message out that transgender is not all we are. I know physicians, lawyers, mechanics and priests who are transgender. This is an important part of our lives and it’s who we are, but it’s not all we are.” There is no board standard for transgender care specialists, but a new certification program was established last year for medical professionals with no previous experience in this field. Transgender care in not usually a required part of medical school curriculum, WolfGould says, but gay, lesbian and transgender advocacy groups are pressuring for change. “Medical school doesn’t touch on this right now, but I think that’s going to change,” she said. “I think transgender [care] has become a visible issue in the last couple years.” Wolf-Gould added there is a strong demand to extend her practice well beyond the Oneonta area. She envisions an “Upstate Center for Transgender Excellence” someday, and believes that in the short-term, she and her staff can offer services to patients who live far away via telemedicine technology. “I love the mix of medicine and social justice,” she said. “It’s a beautiful process to watch them be able to live more authentically.”
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By Jim Miller
The New MIND Diet May Help Prevent Alzheimer’s I’ve heard that there’s a new diet that can help prevent Alzheimer’s disease. What can you tell me about this? My 80-year-old mother has Alzheimer’s and I want to do everything I can to protect myself.
Concerned Daughter
Dear Concerned,
The MIND Menu
The MIND diet has 15 dietary components. The emphasis is on eating from 10 brain-healthy food groups, and limiting foods from five unhealthy groups. Here’s a rundown of the healthy foods you should work into your diet:
• Green leafy vegetables (like spinach and salad greens): Eat at least one serving per day. • Other vegetables: At least one other vegetable a day. • Whole grains: Three or more servings a day. • Nuts: Five one-ounce servings a week. • Beans: At least three servings a week. • Berries: Two or more servings a week. • Fish: Once a week. • Poultry (not fried): Two times a week. • Olive oil: Use it as your primary cooking oil. • Wine: One glass a day.
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And the five unhealthy food groups you should limit include: • Red meat: Eat fewer than four servings a week. • Butter and margarine: Less than a tablespoon daily. • Cheese: Less than one serving a week. • Pastries and sweets: Less than five servings a week. • Fried or fast food: Less than one serving a week.
T:5.6875”
Other Benefits
One of the best things about the MIND diet is that it’s easer to follow than most other diets and you don’t have to stick to it perfectly to gain the benefits, which makes it more likely you’ll follow it for a long time. And the longer you eat the MIND way, the lower the risk of getting Alzheimer’s disease. Another advantage is that the MIND diet can help you lose some weight too, if you keep your portions in check and are careful about how the food is prepared. It’s also important to understand that even though diet plays a big role, it’s only one aspect of Alzheimer’s disease. So get regular exercise, if you smoke, quit, and learn how manage your stress to lower your risk even more. 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.
T:21”
It’s true! Research has found that a new diet plan — called the MIND diet — can have a profound impact on your brain health as you age, and can even lower your odds of getting Alzheimer’s disease. The MIND diet takes two proven diets — the heart-healthy Mediterranean diet and the blood-pressure lowering DASH diet — and zeroes in on the foods in each that specifically affect brain health. The MIND diet, which stands for “Mediterranean-DASH Intervention for Neurodegenerative Delay,” was developed by Martha Clare Morris, a nutritional epidemiologist at Rush University Medical Center, through a study funded by the National Institute on Aging. The study followed the diets of nearly 1,000 elderly adults, who filled out food questionnaires and underwent repeated neurological testing for an average of 4.5 years. It found participants whose diets most closely followed the MIND recommendations had brains that functioned as if they were 7.5 years younger, and it lowered their risk of developing Alzheimer’s disease by as much as 53 percent. And even those who didn’t stick to the diet perfectly but followed it moderately well reduced their risk of Alzheimer’s by 35 percent.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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The Social Ask Security Office
From the Social Security District Office
Social Security’s Programs Are As Diverse As Those Served
F
rom women and children, to the elderly and disabled, Social Security has you covered. Because we value and appreciate the differences that make up our nation, our programs are as diverse as those we serve. We’re with you throughout every stage of your life, and we’re always working to provide services that meet your changing needs. Our programs serve as vital financial protection for millions of people. When you work and pay Social Security taxes, you earn credits. These credits count toward retirement, disability and survivors benefits. A program everyone should be familiar with is Social Security’s retirement program. Whether you’re a young adult paying Social Security taxes for the first time or a retiree receiving benefits, this is a program that will affect you during and after your working years. You can learn more about your earnings and potential benefits by visiting www. ssa.gov/retire/. Social Security administers the largest disability program in the
Q&A
Q: I am receiving Social Security retirement benefits and I recently went back to work. Do I have to pay Social Security (FICA) taxes on my income? A: Yes. By law, your employer must withhold FICA taxes from your paycheck. Although you are retired, you do receive credit for those new earnings. Each year Social Security automatically credits the new earnings and, if your new earnings are higher than in any earlier year used to calculate your current benefit, your monthly benefit could increase. For more information, visit www. socialsecurity.gov or call us at 1-800772-1213 (TTY 1-800-325-0778). Q: I want to estimate my retirement benefit at several different ages. Is there a way to do that? A: Use our Retirement Estimator at www.socialsecurity.gov/estimator to get an instant, personalized retirement benefit estimate based on current law and your earnings record. The Retirement Estimator, which also is available in Spanish, lets you create additional “what if” retirement scenarios based on different income levels and “stop work” ages. Q: I am expecting a child and will be out of work for six months. Page 18
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nation. A severe illness or injury robs a person of the ability to work and earn a living. Thankfully, Social Security disability benefits can provide a critical source of financial support during a time of need. For more on disability benefits, visit www.socialsecurity.gov/disability. When a family loses a wage earner, it can be both emotionally and financially devastating. However, Social Security can help secure a family’s financial future if a loved one dies with survivor benefits. The best thing you can do for your family is prepare as much as possible: get started at www.socialsecurity.gov/ survivors. Social Security’s programs are neutral regarding gender, age, race, and orientation — individuals with identical earnings histories and needs are treated the same in terms of benefits. We’re proud the diverse public we serve reflects the programs we offer. Visit www.socialsecurity. gov today to see how we can serve you and secure your today and tomorrow.
Can I qualify for short-term disability? A: No. Social Security pays only for total disability — conditions that render you unable to work and are expected to last for at least a year or end in death. No benefits are payable for partial disability or short-term disability, including benefits while on maternity leave. Q: I get Social Security because of a disability. How often will my case be reviewed to determine if I’m still eligible? A: How often we review your medical condition depends on how severe it is and the likelihood it will improve. Your award notice tells you when you can expect your first review using the following terminology: • Medical improvement expected — If your condition is expected to improve within a specific time, your first review will be six to 18 months after you started getting disability benefits. • Medical improvement possible — If improvement in your medical condition is possible, your case will be reviewed about every three years. • Medical improvement not expected — If your medical condition is unlikely to improve, your case will be reviewed about once every five to seven years. For more information, visit www. socialsecurity.gov.
Health News Buffalo General / Gates Vascular recognized Buffalo General Medical Center /Gates Vascular Institute (BGMC/ GVI) has received the American Heart Association/American Stroke Association’s Get With The Guidelines-Stroke Gold Plus Achievement Award with Target: Stroke Honor Roll Elite Plus. The award recognizes the hospital’s commitment to providing the most appropriate stroke treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Hospitals must achieve 85 percent or higher adherence to all Get With The Guidelines-Stroke achievement indicators for two or more consecutive 12-month periods and achieve 75 percent or higher compliance with five of eight Get With The Guidelines-Stroke Quality measures to receive the Gold Plus Quality Achievement Award. To qualify for the Target: Stroke Honor Roll Elite Plus, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. If given intravenously in the first three hours after the start of stroke symptoms, tPA has been shown to significantly reduce the effects of stroke and lessen the chance of permanent disability. BGMC/GVI earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These quality measures are designed to help hospital teams follow the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. “This recognition further demonstrates our commitment to delivering advanced stroke treatments to patients —morequickly and safely,” said physician Elad Levy, director of stroke services at Kaleida Health and chairman and professor of neurosurgery at State University of New York at Buffalo.
Schofield earns Bronze National Quality Award Schofield Residence is a winner of the Bronze National Quality Award for 2016 from the American Health Care Association/National Center for Assisted Living (AHCA/ NCAL). The award is the first of three distinctions possible through the AHCA/NCAL National Quality Award Program, which honors long term and post-acute care centers that have demonstrated their commitment to improving quality care for seniors and individuals with disabilities.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016
“We live our mission every day,” said Randy Gerlach, administrator of Schofield Residence. “Our quality improvements are focused on the highest level of professional care for the physical, psychological and spiritual needs of each person; in other words, a ministry of care to the whole individual. Our entire organization is committed to translating this belief into action in all of our programs and services.” Schofield Residence uses a Quality Assurance Performance Improvement program (QAPI) containing steps to achieve systematic performance through evaluation, review, problem analysis, and implementation of corrective measures. The Bronze Quality Award will be presented during AHCA/NCAL’s 67th Annual Convention and Exposition in Nashville, Tenn., in October.
Kaleida Health, unions agree to new contract After three months of cordial, good-faith negotiations, Kaleida Health has reached a tentative agreement with the Communications Workers of America/AFL-CIO (CWA1168), International Union of Operating Engineers (IUOE 17) and 1199SEIU United Healthcare Workers East on a new three-year master bargaining agreement, which covers 7,500 unionized employees. The groups began bargaining in early March and through nearly two dozen negotiating sessions, reached tentative agreement on over 100 articles, MOUs, and letters including all economic and non-economic issues in the contract. The contract calls for wage increases and hiring additional frontline staff while making changes to work rules to better serve the patients across the hospitals and services at Kaleida Health. “Our workforce has played a significant and tangible role in the transformation of Kaleida Health over the past two years,” said Jody Lomeo, president and CEO of Kaleida Health. “This new contract recognizes their hard work and commitment. I am confident that our nursing staff, healthcare workers and administrative staff will continue to help us grow while serving our community in the years ahead.” Because the agreement must be ratified by the union membership in the coming weeks, full details of the contract were not released. Ratification voting is expected to occur in the next few weeks. “We are pleased to announce that we have reached a new tentative agreement with Kaleida Health, Jim Scordato, vice president of 1199SEIU, Western New York Hospital Division. “The parties worked long and hard for many months to craft an agreement that will continue to provide the best wages and benefits of any health contract in Western New York.”
Health News Eye surgeon Dan Schaefer Doctors join Windsong joins Atwal Eye Care Health Medical Alliance Daniel P. Schaefer, an eye physician and surgeon with training in eye plastic and reconstructive surgery, has recently joined Atwal Eye Care. Schaefer’s practice is located at 4590 Main St. in Snyder. Schaefer is the recipient of the Outstanding Contribution Award from the American Society of Ophthalmic Plastic and Reconstructive Society. He is a clinical professor at the SUNY at Buffalo since 2001. Schaefer was appointed director of the department of oculoplastic, orbital and reconstructive surgery since 1997. He has also served as the chief of ophthalmology at the St. Joseph’s Intercommunity Hospital since 1991 and served as the president of the medical staff at the hospital from 2001 to 2003. Schaefer has also served as visiting professor and has lectured throughout the United States, Central America and India. He has written numerous articles in the fields of oculoplastic, orbital and reconstructive surgery. Schaefer
Physicians Katherine O’Donnell and Michael Peyser have recently joined Windsong Health Medical Alliance, PLLC, an affiliate of Windsong Radiology Group. This transition strengthens the nationally accredited Windsong Breast Care program. The focus of this first-of-its-kind collaborative program in WNY is to assist newly diagnosed breast cancer patients through coordinated care and ultimately improved outcomes. O’Donnell is a board certified surgeon specializing in breast surgery. She serves as medical director of O’Donnell Windsong Breast Care (WBC) program. She has been the designated lead for its weekly multidisciplinary conference, which focuses on individualized care planning. She is joined by a team of radiologists, medical and radiation oncologists, pathologists, local referring physicians and survivorship support services. O’Donnell has directed these conferences since the program’s inception in November 2011.
Peyser is a board-certified surgeon with an extensive medical background in surgical oncology and breast care. After medical school, Peyser completed a fellowship in surgical oncology at Roswell Park Cancer Institute and was a clinical instructor through the University at Buffalo School of Medicine. He has been the recipient of several outstanding achievement awards from the Commission on Cancer, American College of Surgeons. “Dr. O’Donnell and Dr. Peyser Peyser are important partners in the breast care team, and we are happy to make them part of the Windsong family” said physician Thomas Summers, president of the group. “We have worked on this transition for several months, and believe it will reinforce our team approach focused on improved access with quality outcomes.” Windsong Breast Care is WNY’s first breast care facility accredited by the National Accreditation Program for Breast Centers (NAPBC). The NAPBC designation is only given to those centers that have demonstrated and are committed to providing the highest level of quality breast care.
ECVA has new office in Williamsville Eye Care & Vision Associates (ECVA) has recently moved to a new office in Williamsvile, localted at 811 Maple Road — next to Maple West Elementary School. The new office is less than two miles from ECVA’s former Hopkins Road office in a building the practice has purchased and renovated. New and long-term ECVA patients will notice many new amenities, including a larger, more elegant optical store stocked with a variety of frames and lenses; free WiFi in the spacious waiting area; a redesigned floor plan that allows for a smoother patient flow and plenty of free parking. “Our new office is about 1,200 square feet larger than our Hopkins Road office,” said Daniel M. Cotter, managing partner. “It is much more patient-friendly and spacious, allowing us to provide our patients with the most advanced methods of diagnosis and treatment for eye conditions and disorders in a more efficient and pleasant environment.” In addition to its Williamsville office, ECVA also has offices in the Elmwood Village, Niagara Falls and Orchard Park. Each office also features a full-service optical shop.
ECMC Physical Therapy Department at School 84 Earns Clinical Education Award
Displaying their “Outstanding Center for Physical Therapy 2015 Clinical Education Award” from the New York / New Jersey Physical Therapy Clinical Education Consortium are Public School #84 ECMC physical therapy staff and associated physical and occupational therapy (APOT) staff. From left are APOT staff members Katie Fetter; Kaitlyn Russo; Emily Coutts; Ben Chen; and Lauren Patterson; ECMC senior physical therapist Lori Miller, Sr.; APOT staff members Michelle Zyhowski and Lindsay Colbert; and ECMC physical therapist Courtney Cholis. July 2016 •
The physical therapy department at Public School #84 Health Care Center for Children at ECMC was recently awarded the “Outstanding Center for Physical Therapy 2015 Clinical Education Award” by the New York / New Jersey Physical Therapy Clinical Education Consortium. School #84 Health Care Center for Children, located on the ECMC health campus, is the designated school in the district for students with severe disabilities and illnesses and has 165 students in grades K-12. ECMC provides one senior physical therapist and one staff physical therapist at the school. The winner of this award demonstrates the following criteria: promotes best practice, offers a diverse or advanced clinical experience to physical therapy students, has well designed clinical teaching methods and/or materials and demonstrates outstanding communication skills with students and academic programs. “This recognition is a testament to the expertise, dedication and quality care delivered each day by ECMC physical therapists and all the caregivers throughout our organization,” said ECMC Corporation President and CEO Thomas J. Quatroche Jr. “We are proud to partner with School #84 in providing such critically important services to the students, helping to improve their educational experience and their overall quality of life,” The nomination was made by the clinical education staff from D’Youville College. A ceremony to present this award took place recently at School #84. Representatives from D’Youville College, Daemen College, the University at Buffalo, ECMC, Associated Physical and Occupational Therapists and former physical therapy students of School #84 were present during the award presentation.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Summer Outings
The two-and-a-half hour tours begin at Mutual Riverfront Park, off Hamburg Street in the city’s First Ward neighborhood, and proceed up the Buffalo River past industrial sites like Silo City and the General Mills manufacturing plant, ending at Canalside — where the Buffalo River empties into Lake Erie.
Buffalo River Kayak
Once a symbol of economic decline, the area known as ‘Silo City’ is becoming increasingly popular for its history and sights, thanks to By Tim Fenster
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ong a symbol of Buffalo’s economic decline, the rusting grain silos and manufacturing plants that tower south of downtown are now aiding the city’s resurgence in new and unique ways. Bolstered by the boon in restaurants, popular events and recreation options near Buffalo’s waterfront, the industrial area commonly known as “Silo City” is becoming increasingly popular for its history and sights. Noticing this increased interest in Buffalo’s decaying industrial sector, Explore Buffalo began offering kayak tours on the Buffalo River last year in partnership with Elevator Alley Kayak. And it’s already become Explore Buffalo’s most popular tour, with many dates selling out a full month before the tours began in May. “It’s really one of our most popular tours,” said Brad Hahn, of Explore Buffalo. “People are really fascinated by the grain elevators.” The tours begin at Mutual Riverfront Park, off Hamburg Street in the city’s First Ward neighborhood, and proceed up the Buffalo River past industrial sites like Silo City and the General Mills manufacturing plant. The two-and-a-half hour tours typically run for about four miles, ending at Canalside — where the Buffalo River empties into Lake Erie — before heading back to Mutual Riverfront Park. If the conditions are favorable, the tour will include a Page 20
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stop at another local icon, the Buffalo Main Light lighthouse. “If the weather’s good and everybody’s moving at a good pace, we will stop at the lighthouse,” Hahn said. In addition to good exercise and recreation, the tour gives participants an opportunity to learn more about the grain silos and how they helped put Buffalo on the national map. Hahn explained that the completion of the Erie Canal in 1825 turned Buffalo into a hub of transportation of grain and other raw materials that were being shipped from the Midwest to the East Coast. “With the construction of the Erie Canal, Buffalo went from a small backwater village to a major American city overnight,” he said. In an effort to improve efficiency, the steam-powered grain elevator was invented in 1843 in Buffalo by Engineer Robert Dunbar. The invention allowed grain to be moved more quickly from large merchants ships to smaller canal barges. As a result, Buffalo was able to keep pace with increased American agricultural production in the Midwest during the 1840s and 50s, eventually making the city the grain capital of the world. “The grain elevator really transformed that process [of shipping grain] and allowed Buffalo to become the grain capital of the world,” Hahn said.
The grain elevators remained in service even after railroad improvements rendered the Erie Canal obsolete by the end of the 19th century. The influx of grain also led to the creation of flour mills and cereal factories, some of which still call Buffalo home. The jobs created by the grain industry brought Buffalo its peak population of some 580,000 residents in the 1950s, making it the 15th largest city in America at the time. But the prosperity didn’t last. In
1959, the St. Lawrence Seaway was completed, and suddenly Buffalo was no longer the end of the Great Lakes shipping route. Industry left, thousands of jobs were lost and the city entered a decades-long economic downturn from which it is still recovering. But the grain elevators remain a unique and, in the right light, beautiful part of Buffalo’s history and skyline. For more information on Buffalo River kayak tours, visit www. explorebuffalo.org.
Photos taken in the summer of 2015 on the Buffalo River. Courtesy of Elevator Alley Kayak.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2016