WNY IGH 26 December 2016 by In Good Health: WNY's Healthcare Newspaper

in good Meet Your Doctor

Geriatrician Ken Garbarino on why he likes to work with the older population and why he needs to remind patients they don’t have the fountain of youth

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December 2016 • Issue 26

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Buffalo & WNY’s Healthcare Newspaper

Holiday Blues or Depression?

Why do many people feel sad during the ‘happiest season of all’? Is it just holiday blues or depression? Experts weigh in and suggest ways to stay positive

GMO Labeling Law to allow labeling GMO food doesn’t please critics, supporters

Sugary Drinks

Daily can of soda boosts odds for prediabetes, new study finds

Weight Gain & the Holidays Forget about losing weight this time of the year. The main challenge, experts say, is not to gain too much

More than three million patients worldwide have experienced robotic-assisted surgery since its introduction in 2000. It continues to evolve as a surgical tool, offering both surgeons and patients more advantages compared with open surgery and even standard laparoscopic surgery.

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SPANKING Fewer parents are spanking their kids. More are relying on timeouts to discipline children, study shows

Heart surgery survivor: The local VA saved my Life — twice

U.S. Heart Disease Rates Fell 20 Percent Since 1980s

Researchers chalk it up to better meds, prevention efforts a large pizza, but now it’s a medium

ER Death Rate in U.S. Drops by Nearly Half

ospital emergency room deaths in the United States plummeted by nearly half over a 15-year period, with several factors likely accounting for the drop, a new study indicates. The upshot: It’s unlikely you’ll die in the ER, say researchers who analyzed almost 368,000 emergency department visits by adults between 1997 and 2011. They found a 48

percent reduction in deaths over that period. Increasing use of home hospice care and improvements in emergency medicine and public health are among the factors that might help explain the results, study author physician Hemal Kanzaria said. “This was a descriptive study, essentially looking at trends,” said Kanzaria, an assistant professor of emergency medicine at University of

ew research shows that cases of heart disease have dropped 20 percent in the United States in the last four decades. Experts credit the trend to better detection and prevention of risk factors that endanger heart health. “That means all the efforts are paying off,” said senior researcher Michael Pencina. He is director of biostatistics for the Duke Clinical Research Institute at Duke University, in Durham, N.C. However, most major heart risk factors — bad cholesterol, high blood pressure and smoking — remain strong contributors to heart disease, showing that more can be done to protect patients, Pencina added. “Coronary disease was the size of

pizza,” Pencina said. “But in terms of slices, what portion of the pizza you can attribute to the risk factors, it’s about the same,” he explained. “There is definitely room for further improvement. We can get maybe to the smaller personal pizza size, to keep to the analogy,” he continued. “Because risk factors still matter, intervening in these risk factors should drive further reductions.” About 610,000 people die of heart disease in the United States every year — about one in every four deaths, according to the U.S. Centers for Disease Control and Prevention. The study was published Nov. 15 in the Journal of the American Medical Association.

California, San Francisco. “Finding a nearly 50 percent reduction was thought-provoking, and I think there are many possible explanations. [But] dying in an emergency department is rare, and it’s important to highlight how rare an event it is overall.” More than 136 million emergency room visits took place in the United States in 2011, the latest year for which data are available, according to the U.S. Centers for Disease Control and Prevention. About 40 million of those visits were injury-

related, and almost 12 percent resulted in hospital admission. Kanzaria and his team analyzed data from the National Hospital Ambulatory Medical Care Survey. They found that ER mortality rates fell from 1.48 per 1,000 U.S. adults in 1997 to 0.77 per 1,000 U.S. adults in 2011. Compared to ER patients who survived, those who died tended to be older, more likely to be male and white, and were more severely ill or injured when brought into the emergency room.

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

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Meet

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Your Doctor

By Chris Motola

Ken Garbarino, MD Geriatrician: ‘We have to remind patients that we don’t have the fountain of youth’

Daily Can of Soda Boosts Odds for Prediabetes, Study Finds Diet sodas do not appear to pose the same danger, researcher says

rinking a can of sugary soda every day can dramatically heighten a person’s risk of developing prediabetes, a “warning sign” condition that precedes fullblown Type 2 diabetes, a new study reports. A person who drinks a daily can of sugar-sweetened beverage has a 46 percent increased risk of developing prediabetes, said senior researcher Nicola McKeown, a scientist with the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston. However, a can of diet soda every day does not boost prediabetes risk, the researchers found. The results show how regular sugar intake can batter a person’s body on a cellular level, McKeown said. Cells require the hormone insulin to break down sugar into energy, she said. But too much sugar in the diet can overexpose the cells to insulin. “This constant spike in blood glucose over time leads to the cells not becoming able to properly respond, and that’s the beginning of insulin resistance,” McKeown said. Once insulin resistance starts, blood sugar levels rise to levels that are damaging to every major system in the body. Prediabetes is an important landmark on the way to Type 2 diabetes, McKeown said. It means a person has elevated blood sugar — a sign of increasing insulin resistance — but has not entered full-blown Type 2 diabetes. Prediabetes is reversible if a person cuts back on sugar. Sugarsweetened beverages are the leading source of added sugar in the American diet, the authors said in background notes. These results show cutting back on sugary drinks is “a modifiable dietary factor that could have an impact on that progression from prediabetes to diabetes,” McKeown said. Page 4

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Q: Give us an overview of your practice. A: The practice is the Geriatric Center of Western New York. It’s a practice geared toward taking care of people 70 years of age and older, particularly those with complex medical problems. We try to use a multi-disciplinary approach. When I finished my internal medicine residency, I discovered I enjoyed taking care of the older individuals with multiple medical problems. I, for whatever reason, enjoy working with that big picture of medical problems. I like the team approach. Q: Is it accurate to call geriatrics a kind of primary care? A: You can look at it in two ways. It can be primary care for an older individual, or you can serve as a consultant. So sometimes we’re asked to see individuals who are followed by a family practitioner or an internist who are older and have multiple complaints. Most of our consults are family driven. We’ll see a family contact us for a second opinion on medications. Sometimes other physicians will try to attribute a symptom to age, and sometimes that is the problem, but often there are underlying things we might be able to help with or at least explain to the families in a way they can understand. I would say the majority is primary care, though. So if a family brings a patient in with memory problems, we’ll try to manage other medical problems that show up during the examination just as a way to make things easier on the family. Q: How close are we to being able to treat age-related memory loss, or even just

compensate for it in a meaningful way? A: That’s the million-dollar question. With individuals living longer, we’re seeing more people with memory problems, Alzheimer’s and dementia. To date, the equation is still more about being born with the right genes and then living a healthy lifestyle, which includes exercising both your body and your mind: taking courses, playing bridge. You’ll hear a lot about different diets, but we tend to fall back on the Mediterranean diet: fish, vegetables. The medicines currently available are mostly about changing the amounts of neurotransmitters in the brain, but there aren’t really any that stop the degeneration of the nerve cells in the brain. Sometimes we see medicines that look like they’d be neuroprotective, but they don’t seem to work out. There are some new drugs that seem like they have some promise with regard to cleaning out the plaques and abnormal proteins. They’re still in the early stages. We’re just not there yet. Q: Tell us about the Spirit Award that you received. A: The Spirit Award, which I just received from Kaleida was a recognition, I guess, of my dedication to the community and staying true to my values in taking care of the elderly. Geriatrics isn’t really thought of as a sexy discipline. You’re not going to see TV dramas about geriatricians. Our success isn’t always measured in curing individuals, but in taking care of individuals. What we try to do is work with that patient and their family to give them the best quality of life we can for as long as we can. And we also focus quite a bit on what people want at the end of their lives. So it’s important, but maybe not that exciting. So maybe I touched enough lives to be recognized for what I did. Q: How are you accommodating the baby boomers and their expectations of aging? A: I think there has been a change in expectations. Twenty years ago, the whole social setting was different. Back then there was more community support for individuals as they got older

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

In the News Geriatrician Kenneth Garbarino in October received the “Spirit Award” at the 2016 Kaleida Ball, the health system’s signature fundraising event. The award is given to in appreciation for “significant and spirited support of Kaleida as it seeks to improve the health of the Western New York community. Garbarino heads the Geriatric Center of Western New York at Kaleida Health’s DeGraff Memorial Hospital. Mary Wilson, an ardent advocate of the Buffalo community for the past 25 years, was honored during the event.

and more of an acceptance of aging. I think there’s more of an expectation now of medications being able to fix problems. People want a pill to maintain the quality of their life. We’ve got so many medicines now that people may be on 10 or 12 pills at once. When you’re younger, those medicines do a wonderful job, but the older you get, the ability to tolerate those medicines and the drug interactions has to be looked at carefully. You have to weigh the benefit of being on these multiple medications and weigh the risks of taking them all. That’s why we work with a pharmacist to try to figure out the best way to maximize the effectiveness of the medications without adding to health risks. Sometimes it isn’t even the patients, it’s the family. We have to remind patients that we don’t have the fountain of youth. When you’re in your 80s and 90s, on top of that, you have to tolerate a lot of loss as well — friends, spouses, children moving away. What we try to do, instead of giving them another pill, is to try to get them to realize what they still have, especially in relation to others their own age and to accept aging as a process. Q: We’re learning about the risks of social isolation. Are the elderly especially vulnerable to that? A: Yeah, 30 or 40 years ago there was more of a sense of neighborhood and community, with children nearby and services and stores in close proximity. Now we have more land and space, but you need to drive to reach other places. So it can be a crushing blow to hear that you’re not safe driving. It can disrupt their entire social life. I think that’s very tough.

Lifelines Name: Kenneth Garbarino, M.D. Position: Medical director of the Geriatric Center of Western New York at Kaleida Health’s DeGraff Memorial Hospital Hometown: New Hyde Park, NY Education: SUNY Stony Brook; St. Georges University; Coney Island Hospital; University of Buffalo Fellowship: Veterans Administration Healthcare System Affiliations: Kaleida Health Organizations: American College of Physicians Family: Married, two children Hobbies: Gardening

Heart Surgery Survivor Says Local VA Saved His Life — Twice By Michael J. Billoni

.T. “Bill” McKibben, an 87-year-old communications practitioner and author, is a veteran of the Korean War whose life was saved twice with heart surgeries performed at the VA Western New York Healthcare System in Buffalo. He strongly supports the VA and says politics has helped create an image of the VA that doesn’t match the reality. “America was stunned by reports of vets dying while waiting to see a doctor,” he said. “But a closer look reveals that they were waiting to be accepted into the VA system. The image of sick and dying vets in the VA waiting for care is simply false.” McKibben was born with a

prolapsed mitral valve — his mitral valve did not close properly and began to leak back into the chamber it is designed to empty. In 2004, his literally began to tear itself apart and he suddenly found himself gasping for air after walking a few yards. His wife rushed him to the VA Medical Center in Buffalo where physician Carlos Li, who heads one of two cardiothoracic surgical teams, replaced the valve with a porcine valve that was expected to last about five years. It lasted 11 and the doctor replaced it in 2015 after McKibben suffered similar symptoms. “Dr. Li saved my life twice at the VA,” McKibben says, McKibben, who has authored

a business ethics book, “Play Nice, Make Money,” since his first surgery and remains involved in marketing projects, credits the VA’s heart recovery exercise and nutrition program for his ability to come back from these serious heart surgeries. “They give you a detailed road map to follow once the surgery is completed, and then it is up to you to do the work,” he says. McKibben, who honed his communication skills while serving in the U.S. Army, came to Buffalo in 1964, working at WGR Radio and TV, and a year later WBEN Radio and TV. Wanting to be his own boss, he purchased WEBR Radio in the early 1970s and after the station was sold, he created a communications/ marketing agency with his daughter, Tracy LeBlanc. “I learned a great deal about healthcare through our work for over 25 years with a private healthcare insurer and Medicare,” he says. That experience plus his life-saving experience at the VA provides the background and knowledge to respond to the criticism being directed towards the VA, he said. “The VA’s prevention-based

McKibben approach is very different from the greed-driven, treatment-based system most Americans are stuck with. Their immediate care/ emergency room facilities take care of you immediately, 24/7. “The major difference in the care vets receive and the source of its superiority is the VA’s primary focus of a prevention-based system,” he says.

Healthcare in a Minute By George W. Chapman

2015 cost of employersponsored care

The annual Milliman Medical Index is regarded as one of the most reliable sources of actuarial, analytical and financial research for employer sponsored health insurance. Here are some of their key findings for 2015. The average cost to insure a typical family of four was $24,671. This is three times the cost in 2001. The cost of care rose 6.3 percent in 2015 due largely to unrestrained/ unregulated increases in drug costs, which increased almost 14 percent from 2014. Since 2001, drug prices have increased at an average annual rate of 9.4 percent — exceeding the 7.7 percent average increase for all other services. While employers still pay the lion’s share of the premium, (58 percent) an employee’s outof-pocket cost has increased 43 percent over the last five years while employer costs increased 32 percent. Of the $24,671 cost for a family, the typical employee paid about $10,400 (42 percent). That includes about $6,400 in payroll deductions ($533 a month) and about $4,000 in out-ofpocket expenses for deductibles and copays.

2015 components of employersponsored care

Physicians and other professionals accounted for 31 percent of all costs, followed by hospitals also at 31 percent, outpatient services at 19 percent, drugs at 16 percent and “other” at 4 percent. Other includes mostly durable medical equipment, supplies, ambulance and home care. Again, drug costs increase almost 14 percent last year and almost all of this increase was due to price increases vs. increases in utilization. Physician costs increased only 3.6 percent. Hospital costs increased 5.4 percent. Most notable stat: over the

last five years, hospital utilization has increased only 0.5 percent.

ACA exchange costs

The exchanges continue to be the most misunderstood component of the Affordable Care Act, better known as “ObamaCare.” The exchanges were established to provide individuals under 65, who don’t receive insurance through an employer or Medicare, the ability to purchase an individual commercial plan. Recently, the purported average 25 percent increase in exchange premiums has brought “ObamaCare” under more scrutiny. Here are some facts and some perspective. 20plus million people are currently covered by “ObamaCare.” Of the 20-plus million, about 7 million are covered by expanded Medicaid. Consequently, they do not pay any premiums and are not impacted by the 25 percent premium increases. That leaves about 13 million people, not covered by expanded Medicaid, who do pay for their insurance and are the ones impacted by the 25 percent increase. The average insurance premium offered on the exchanges has increased 2 percent in 2015 and 7 percent in 2016. If you factor in the anticipated 25 percent increase for 2017, that is a threeyear average of 11 percent. The federal government does not set the premiums. Commercial carriers like BCBS, Aetna, Humana, United, Cigna, etc. set their own premiums. The 25 percent increase is due to two factors: the rates were way too low to begin with and the insurers grossly underestimated the health status (sicker) of their new members. Consequently, rates had to go up in 2017 if insurers were to survive. The national average premium for a standard “silver” or basic employer type plan in 2016 on the exchange was about $400 a month or $4,800

a year compared to about $6,000 a year or a typical employer-sponsored plan. A 25 percent premium increase will result in a premium of $500 a month or $6,000 a year which is just where the average employer plan is. In 2009, eight years ago, the Congressional Budget Office predicted a 2017 silver plan premium of about $5,500. Close. Why was the CBO so much better at estimating premiums than the huge commercial carriers? Most, 83 percent, of the 13 million people who are effected by the 25 percent increase qualify, based on their income, for a subsidized discount. The subsidized amount is paid to the commercial carrier. The average premium actually paid by the 13 million people this year is $113 a month or $1,356 a year. With discounts still available in 2017, and all other things being equal, the average net premium actually paid, factoring in the 25 percent increase, will be around $141 a month. That is a net increase of $28 a month.

ACA exchange carriers

Several commercial plans are pulling out or threatening to pull out of the exchanges because of losses. (Again, they miscalculated their own rates.) Many are pulling out for other reasons. First, it is far easier to sell and administer group or employer-based insurance because of clear economies of scale. Individual policies are administratively more expensive and time consuming. Second, there are no sales commissions for their agents on insurance purchased on the exchange. Third, with hundreds of carriers (local and national) fighting over 13 million people, many may not think the effort is worth it. Many insurers came into the exchanges with artificially and unsustainable low premiums in order to attract more business. Some have gone

December 2016 •

out of business as a result. Fourth, all for-profit carriers have stock holders to please. United is a perfect example. They are pulling out of the exchanges claiming losses of $720 million, which is a lot on face value but relatively insignificant when put into perspective. United reported an overall a profit of $11 billion on revenues of $157 billion, so the exchange is a small portion of their business. CEO Stephen Hemsley earned $66 million in 2014, but that is way down from $102 million in 2010. Many states claim they will be down to one or two carriers next year. The potentially bad news is less competition. But the potentially good news is one or two healthy carriers with enough members to absorb risk. The more insured lives a carrier has, the more apt it is to survive. Finally, our president-elect has promised to repeal and replace “Obamacare.” He should first get an understanding of what that is and how it works. At a pre-election rally he called the ACA a “disaster.” adding all his employees are negatively impacted, especially by the 25 percent increase. Shortly thereafter, one of the directors of all Trump properties corrected his boss and confirmed all employees are covered by normal employersponsored insurance.

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George W. Chapman is a healthcare consultant who works with hospitals and medical groups. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@ gwchapmanconsulting. com.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 5

Things That Cause Men to have Heart Disease

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hile many other health ailments receive more attention, heart disease continues to be the No. 1 killer of both men and women. Heart disease describes a range of conditions including blood vessel diseases, such as coronary artery disease; heart rhythm problems (arrhythmias); and heart defects you’re born with (congenital heart defects); among others. A heart attack occurs when the blood flow to a part of the heart is blocked by a blood clot. If this clot cuts off the blood flow completely, the part of the heart muscle supplied by that artery begins to die. About 610,000 Americans die from heart disease each year, including one in three adult men having heart issues, according to the American Heart Association. George Matthews, a 30-year cardiologist and professor at University of Buffalo School of Medicine and Biomedical Sciences, discusses five issues that cause men to have heart ailments.

Tobacco use By now, we all know the information about smoking being bad for individuals and the overall population. And while the statistics are encouraging with the number of young smokers dropping with each year, issues related to smoking still persist. “We continuously try to convey to patients that tobacco and cigarettes overall carry so many potential health risks,” said Matthews. “The problem that is still happening is while cigarette smoking is down, we see more and more people using e-cigarettes and touting them as wonderful alternatives. First off,

e-cigarettes have not been around long enough for us to know for sure there are no issues. We can’t just say there is no issue because anytime you put chemicals into your lungs, you have a potential consequence to that action.” Hypertension Also called high blood pressure, it is a condition where blood flows through the blood vessels with a force greater than normal. Hypertension can strain the heart, damage blood vessels and increase the risk of heart attacks, strokes, kidney problems and death. “This is something that is very common within our society for a variety of reasons.” said Matthews. “We often say it is the silent killer because most people don’t know they have high blood pressure until something happens that causes them to have to go to the doctor.” Matthews said as we get older and live longer, it is likely that most of us will have high blood pressure one time or another. But a lot of our outcomes depend heavily upon our diets.

Diet and Obesity “I have a friend who came to visit me from the Caribbean and he told me that he was amazed that even the poor people in the United States are overweight,” said Matthews. “Thirty years ago, I might see one patient a week who was 300 pounds. Now, I might see someone every day that weighs that much.” Matthew said poor diet leads to an increase of diabetes along with arthritis and musculoskeletal risk. When it comes to the story his friend told, many of the reasons are because poor nutrition and poor finances often go hand-in-hand. Processed and canned food are the least expensive options in the supermarket.

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

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

Cardiologist George Matthews talks about five things that cause men to have heart attacks.

Lack of exercise Many vascular issues where there are blockages leads to heart diseases. While not all of them are preventable, Matthews believes lack of a good diet mixed with little exercise leads to potential problems. Something as simple as walking regularly, let alone going to the gym, can make a world of difference. “There are plenty of studies that support exercise being a positive thing for your life. But you don’t even need studies to see the difference,” adds Matthews. “If you work out, you will see that you feel more energized. Your body feels better and so will you.”

Cholesterol elevation To understand high blood cholesterol, it helps to learn about cholesterol. Cholesterol is a waxy, fat-like substance that’s found in all cells of the body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. However, we also put foods in our bodies that elevate our cholesterol. “The ability to improve your cholesterol reduces the risk of future heart attacks and death,” said Matthews. “You have to reduce the amount of bad fats that are going into your body as well as overall caloric intake. If you want to live longer, it is very difficult to do that if you have really high cholesterol.”

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GMO Labeling Law to allow labeling GMO food doesn’t please critics-supporters By Deborah Jeanne Sergeant

n August, President Obama signed into law a requirement for labeling designating foods containing genetically engineered ingredients, often referred to as genetically modified organisms (GMOs). But it seems that the measure doesn’t please either those who support or denounce the use of GMOs. Many critics of GMOs believe the labeling is inadequate since food packers and manufacturers need only include wording about the GMO ingredients, a QR code or a toll-free phone number to access more facts. In the latter two labeling types, consumers must seek the information themselves. Isaac Marcuson, sales associate with the Feel Rite Fresh Markets location in Buffalo, said that the labels should be “more informative” for consumers. Foods that are processed from genetically modified crops and contain only traces of genetically modified material may bypass the labeling, according to the legislation. A part of the American diet since 1996, genetically modified foods are from plants that have been grown from seeds with altered DNA. The changes help plants resist pests, promote positive traits (such as non-browning apples), and resist herbicides used around crops. With only about 20 years of research on the effects of consuming these foods, Marcuson is not convinced of their safety. In fact, he stated that the “unforeseen consequences” of genetically engineered food is what worries natural health experts the most. He also believes that genetically

engineered foods aren’t as successful as they have been touted. “Some time, it could come to a point where it will increase nutrition or yield, but we’re not seeing that so far,” Marcuson said. “So far, we’re seeing detriments to people’s health.” He blames over use of Roundup, a commonly used herbicide, as one reason he believes genetically engineered crops harm people. He said that some crops genetically modified to resist herbicide are “drenched with Roundup.” Steve Ammerman, representative of New York Farm Bureau in Albany, contests this viewpoint. Roundup is “is one of the most mild herbicides. You can buy it at Wal-Mart and put it on your driveway.” But as for over-using herbicide or engaging in off-label use, Ammerman said that’s unlikely since farmers try to reduce their overhead as much as possible and herbicide

costs them money. He believes that genetically engineering is a safe way to grow food. “There have been more than 2,000 studies that have shown there’s no greater risk to human health to crops grown with genetic engineering than those traditionally bred,” he said. “The National Academies of Science has released a study. It was a very wide-reaching analysis of the information and it supported what an overwhelming number of scientists believe. It spoke a lot to the safety of GMO crops.” Available at https://nas-sites. org/ge-crops, the study stated that only about 12 percent of the world’s farmland is planted to genetically engineered crops. Few crops are predominately available and widely planted as genetically engineered. They include soybeans, cotton, corn, and canola. Sugar beets, summer squash and papaya aren’t as widespread. A few other crops, such as non-browning apples and potatoes, are still pretty rare as genetically modified types. Ammerman said that labeling foods as containing or not containing genetically engineered ingredients can lead consumer to think that “GMO” means “unsafe.” “That’s been a concern of agriculture for quite some time,” Ammerman said. “A mandatory GMO label is seen as a skull and crossbones. There has been a lot of misinformation. There has been fear bred in consumers.” He added that some foods that have never been available as genetically engineered are now being billed as “GMO-free” which he

believes is misleading. “It’s marketing and trying to take advantage of the trend of the moment and some consumer bias one way or another,” Ammerman said. “It’s like ‘fat-free’ or ‘natural’ or ‘gluten-free.’” A statement on Farm Bureau’s web page about GMOs reads: “Technology allows farmers to produce more food using less land and few chemicals, while conserving soil, water, and on-farm energy.” But farmers can choose nonGMO seeds if they wish. “Farmers have a choice,” Ammerman said. “Most corn grown is GMO, but there is non-GMO corn available that you can plant for organic or conventional use.” He views genetically engineered seeds as helping farmers cope with environmental fluctuations and challenges of areas stricken with drought or other problems. Mark R. O’Brian, PhD, professor and chairman of the department of biochemistry at University at Buffalo, stated, “Scientific evidence supports the conclusion that food derived from genetically-engineered organisms is equivalent to their traditional counterparts in terms of nutritional quality, allergenicity and toxicity. “Genetically-engineered foods have been consumed for over 20 years, and no adverse consequences have been substantiated in peerreviewed literature. The conclusion that food derived from geneticallyengineered organisms is safe is supported by the National Academy of Sciences, the American Medical Association, and the World Health Organization.”

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

A Dozen Don’ts for December and Beyond

’ve shared lots of dos in the past to help people live alone with more success. Here are a few don’ts — some lighthearted — that may also help you on your journey toward contentment as you approach the New Year: n Don’t become a hermit. Get up, get dressed, lose the PJs or sweat pants, and get out of the house (or get on the phone). We humans are social animals; we’re meant to be with others. Solitary confinement is for criminals, not for people who live alone. Stay connected! n Don’t go on a shopping spree to fill an emotional void. Your savings account will thank you. n Don’t make Fruit Loops your main course for dinner. Well ... maybe on occasion. But as a general rule? No. Create a nice

place setting, fill your plate with something healthy, light a candle, pour yourself a glass of wine or cranberry juice, and enjoy some well-deserved time to yourself. A favorite magazine, book, or crossword puzzle can make for a nice dining companion. Bon appetite! n Don’t label yourself a loser just because you are spending a Saturday night alone. It’s not the end of the world. It doesn’t define you. Stream a Netflix movie or clear some clutter and call it a night. If the prospect of a Friday or Saturday night alone is too difficult, reach out to a friend today and make plans for next weekend. n Don’t put too much stock in that Dreamcatcher. If you find yourself wide awake in the middle of night fighting demons,

KIDS Corner Fewer Parents Are Spanking Their Kids

you might try meditation, journaling or aromatherapy. I fill my diffuser with lavender oil and do some deep breathing while I repeat the phrase, “Sleep is healing.” If that doesn’t do the trick, I get up and prepare myself some warm milk or herbal tea. I return to bed with fingers crossed and eyes closed. If all else fails, consider sleep aids. n Don’t avoid dancing lessons because you don’t have a partner. Good teachers know how to incorporate singles into their classes by making introductions or by partnering with single members to demonstrate steps. Lucky you! n Don’t jump into someone’s arms out of loneliness. Feelings of desperation can make you easy prey for a “suitor” with dubious intentions. It’s a risky place to be. Getting good at living alone will build your self-esteem and improve your chances of meeting someone who appreciates your strengths, not your weaknesses. n Don’t get behind the wheel after a night of drowning your sorrows with friends. No explanation needed. Drink and drive responsibly. n Don’t be afraid to travel alone. Some of my best trips have been taken with my favorite traveling companion: myself. I create my own itinerary, go at my own pace, and meet all kinds of interesting people along the way. Even a small jaunt can boost your confidence. On your own, you’ll discover your own

resourcefulness, ability to solve problems, and capacity to spend some time alone. It can be an enlightening adventure in selfdiscovery. I highly recommend it. n Don’t decline an invitation because it means walking in (and walking out) alone. You can do it. Make a beeline for the host to say “hello” and ask for an introduction to someone, if you are surrounded by strangers. Or get in line at the refreshment station. You’ll be engaged in conversation before you know it. Be yourself, be sincere, and be curious about others. Go and have fun! n Don’t act your age. You are free, unencumbered and on your own. What better time to spread your wings, be silly and otherwise express your glorious, awesome self. Put yourself with people who make you laugh. For me, that’s my sister Anne. So keep your sense humor. After all, life can be funny. n Don’t take these don’ts too seriously. You are in the best position to decide what to do or not to do — no shoulds, musts, or other people’s agendas. That’s one of the best benefits of living alone. Don’t I know it!

of psychology at Georgetown University in Washington, D.C. “At all income and education levels, parents’ attitudes toward physical punishment have changed over the last 20 years and, very likely, their behavior with their children,” she said. For the study, Ryan and her colleagues reviewed four national studies of kindergarten-age children — about 5 years old. The studies were conducted between 1988 and 2011. Although a cultural shift away from physical discipline has occurred, some parents still believe spanking and hitting is the best way to control unwanted behavior, the findings showed.

More low-income parents than high-income parents still believe in hitting children to discipline them. Yet poorer parents, like richer parents, are increasingly using timeouts, the study authors noted. Nearly one-third of mothers with the lowest incomes still spanked or hit kindergarten-age children. Almost 25 percent reported using physical punishment in the last week, the researchers said. Parents with the highest incomes are less likely to endorse or report using physical discipline than those at the bottom of the income scale, the study found. The report was published online Nov. 14 in the journal Pediatrics.

More are relying on timeouts to discipline children, study shows

panking and hitting children to discipline them has been on the decline among U.S. parents — rich and poor alike — since 1988, a new study finds. According to the researchers, the number of mothers with an average income level who considered physical discipline acceptable decreased from 46 percent to 21 percent over two decades. Page 8

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At the same time, mothers who felt timeouts were a better type of discipline rose from 51 percent to 71 percent, the investigators found. “Parents seem to be using more reasoning and nonphysical discipline strategies with children, which is in line with what the American Academy of Pediatrics recommended in 1998,” said lead researcher Rebecca Ryan. She’s an associate professor

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

You read this

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 workshops or to invite her to speak, call 585-624-7887, or email gvoelckers@rochester.rr.com.

You read this

3,000,000+

That’s the number of robotic-assisted surgeries performed worldwide

Local providers say more progress has been made in robotic surgical equipment By Deborah Jeanne Sergeant

ore than three million patients worldwide have experienced robotic-assisted surgery since its introduction in 2000. It continues to evolve as a surgical tool, offering both surgeons and patients more advantages compared with open surgery and even to standard laparoscopic surgery. The FDA has approved only the da Vinci System as a roboticassisted surgery tool. It is used for surgery related to cardiac, colorectal, gynecologic, head & neck, thoracic and urologic issues. It may also be used for general surgery. The benefits of robotic surgery include precise control, easier access to surgical sites, faster recovery time and smaller incisions. Annie Deck-Miller, senior media relations manager for Roswell Park Cancer Institute, said that Roswell Park first used robot-assisted surgery in the Buffalo-Niagara region in 2004 for robotic prostatectomy. Today, Roswell Park performs robot-assisted surgery to treat many bladder, colorectal, gynecologic, head & neck, kidney, and thoracic cancers. “Techniques pioneered at Roswell Park support better quality of life for patients, including those who undergo robot-assisted surgery

Physician Donna Feldman, head of Niagara Falls Memorial’s Division of Robotic Surgery. cystectomy, removal of the bladder,” Deck-Miller said. “These include a robot-assisted surgery method of creating a neobladder inside the patient’s body to do the work of the missing bladder, providing a welcome alternative to an external urine-collection bag.” Studies performed by Roswell

Park indicate that robot-assisted surgery contributes to more positive patient outcomes. Physician Donna Feldman, head of Niagara Falls Memorial Medical Memorial’s Division of Robotic Surgery, said that robotic-assisted surgery originally was used for urologic disease for its improved visualization, but it’s now used for many more areas, including colon surgeries and those involving deep penetration into the pelvic areas. Feldman said that advances in robotic surgical equipment, even the past 12 months, have “improved visualization, and resulted in less pain and shorter recovery time, and a decrease in surgical complications.” Current models cost about $2 million and require hundreds of thousands of dollars in annual upkeep. Feldman anticipates that when the FDA approves other versions that the competition will help drive down costs. “The cost benefit is very significant for hospital stay time and decrease in complications,” Feldman said. “It’s a very good cost-tobenefit ratio. We’re always looking to improve our abilities to provide better patient care. We look forward to any new advances that will help

Misconceptions About Robotic-assisted Surgeries • Robotic assisted surgery involves lasers. "Roboticassisted surgery is another tool with which to perform laparoscopic surgery. It has nothing to do with lasers."

"Some people feel awkward having a machine by them and not their surgeon. That fear is relieved somewhat when we have a discussion on it. There are many fail-safes built in."

• The surgeon won't know what's going on because he won't be next to the patient.

• The robot takes over and can do what it wants. "The robot

can't do anything without being controlled by the surgeon. It's just a tool to do things we've done for decades." Source: Brian Watkins, surgeon with Genesee Surgical Associates in Rochester.

December 2016 •

patients.” Jeffrey Constantine, OB-GYN with OB/GYN Associates of Western New York in West Seneca, said that for his patients, robotic-assisted surgery has helped contribute to quicker recovery. For those who are good candidates and receive roboticassisted surgery, “It’s a superior way of performing laparoscopic surgery. You have 360 hand movements without opening the patient. It’s more agile surgery. The robot is very sensitive and responsive. You control and monitor everything.” Occasionally, patients ask if setting up the equipment around the patient makes the high-tech surgery take longer. “The more trained the surgeon and the better the setup, the faster it is to set up the patient for the surgery,” Constantine said. Some also believe that selecting robotic-assisted surgery will guarantee they will have to wait a long time; however, Constantine said that Mercy Hospital, where he operates, and at some other Western New York hospitals, the introduction of more robotic equipment has shortened that wait time. Constantine also said that patients don’t need to worry about their surgeon operating a little farther away than with traditional, open surgery. “Once the robotic arms are docked appropriately, you’re only a few feet away and the assistant is there doing the suction and also monitoring the patient,” Constantine said. “The robotic arm is so highfinesse, you perform much better surgery. It beats being near the patient and using old equipment. If it’s for the right patient, the robotic assisted surgery is the best, safest choice.”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 9

SmartBites

You read this

The skinny on healthy eating

Flour Power: What’s Good, What’s Not

s flour good for you? Now that the holidays are here — a time deliciously devoted to baking and consuming products made of flour — we wanted to shine a light on this popular grain. Let’s begin with our considerable consumption. According to some studies, the average American consumes between 400 to 500 cups of flour a year, which translates into about 1¼ cups (or 10 ounces) a day. “Six ounces of grains” is what the USDA recommends that we consume each day for all grains, not just flour, with an added recommendation that half of those 6 ounces be whole grains. So, 10 ounces from flour alone is both sobering and noteworthy. Because, like many, I get a good dose of my daily grains from flour — from bread (two slices equal 2 ounces) to pasta (one cup equals 2 ounces) — I made a conscious decision years ago to stop eating foods made with refined white flour in favor of those made with the more nutritious whole wheat flour. It’s mostly what I bake with, too. That’s not to say that white flour, which has been stripped of its bran and germ, has no merits. Much like whole wheat flour, a quarter cup of enriched white flour provides about 100 calories, 3 grams of protein and a slew of B vitamins and some minerals. Some enriched white flours, in fact,

CARPAL TUNNEL: UB PROFESSOR DISCUSSES WAYS TO AVOID IT By Tim Fenster

urely most people have experienced some pressure in their hands or wrists, be it from a long stint at a keyboard, a marathon video-gaming session or a more strenuous activity, such as practicing a sport or performing manual labor. It’s usually a fleeting discomfort — a reminder that it’s time to break and give our hands a rest. But for millions of Americans, that pressure and pain is a far worse beast. According to the Centers for Disease Control and Prevention, as of 2010, more than 3 percent of adults between 18 and 64 years old — about Page 10

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and Japan have banned the use of these chemicals, but the US has not. Food in California that contains potassium bromate, however, must bear a warning label. Although the research is still out on the potential health risks of consuming these chemicals, numerous US flour companies no longer use them. So, is wheat flour good for you? Yes; although some kinds are better than others. Whole wheat is more nutritious than white; enriched white is better than non-enriched white; and any flour that has not been bleached or bromated is better than the alternative.

Helpful tips

have more iron and certain B vitamins (such as folic acid) than their whole wheat cousins. What refined white flour doesn’t have, however, is fiber — the nutrient that keeps us regular, helps with weight control, stabilizes blood sugars and assists with the removal of bad cholesterol. Most whole wheat flours provide about 3 grams of fiber per quarter cup. Health-promoting phytochemicals and antioxidants such as vitamin E are also removed in the making of white flour. Studies have shown that both may help to protect against cancer, cardiovascular disease and Type 2 diabetes. Again, whole wheat flour boasts many of these beneficial compounds. Lastly, many flour companies add benzoyl peroxide or chlorine dioxide to chemically whiten (bleach) their flours. Some add potassium bromate to chemically strengthen their flours. Several European countries, Canada 500,000 people — had carpal tunnel syndrome within the past 12 months. In severe cases, the condition can cause permanent numbness, tingling or other discomfort in one’s wrists and hands. And the problem may be growing worse. Owen Moy, a hand surgeon at Excelsior Orthopaedics and clinical professor at the University at Buffalo, says that the increasing prevalence of smart phones, mobile games and computers could lead to higher rates of carpal tunnel syndrome. “I don’t know if they already have started to increase, but it is a legitimate concern,” Moy said. However, Moy added that there is no typical case for carpal tunnel syndrome. Anything that causes sustained pressure on one’s hands — video games, sports, texting, typing or even use of heavy equipment — can put one at risk of the condition. “I don’t think there is anything that stands out more so than the other. Any activity that requires repetitive motions will lend themselves to carpal tunnel,” Moy said. To reduce one’s risk of carpal tunnel, Moy says it is important to take breaks during long periods of repetitive activity using one’s hands. These breaks can be as short as a few minutes, but if taken as frequently as possible, can significantly reduce one’s risk of carpal tunnel. “Any break is a good break,” he

To prolong shelf life, transfer flour from its paper bag to an airtight plastic or glass container. Store refined flour in a cool, dry place. Store whole wheat flour in the fridge or freezer. Flour that has gone rancid smells sour. Bakers’ hints for baking with whole wheat flour: Make sure flour is fresh; add two teaspoons of liquid (water, milk, orange juice) per cup of whole wheat flour (to combat dryness); substitute some of the whole wheat flour in a recipe with allpurpose flour (for a lighter texture); and use “white whole wheat flour, “ which is simply whole grain flour that has been milled from white wheat (for a lighter color and milder taste).

Chocolate-Nut Thumbprints Adapted from America’s Test Kitchen; Makes two dozen cookies 8 tablespoons (1 stick) unsalted butter, softened ½ cup sugar ¼ teaspoon salt ¼ teaspoon cinnamon 1 egg yolk 1 teaspoon vanilla extract 1 tablespoon milk ½ cup pecans, toasted and ground said. If one is already experiencing discomfort and numbness, and short breaks are not sufficient, Moy recommends performing a series of stretches before, after and Moy during repetitive tasks. These can help reduce inflammation of tendons in the carpal tunnel — a narrow passageway in the wrist through which the median nerve passes — which causes the condition. “It’s a question of warming up and warming down. … I call it yoga for your hands,” Moy said. “You just stretch out before you do the activity that you know is probably going to give you some problems.” If the condition persists, one could try using a cold compress or a splint — but only if the splint keeps the hand at a “neutral” position that is in line with the wrist. Antiinflammatory medications, such as ibuprofen, can also temporarily help alleviate discomfort. Ergonomic keyboards — a split, raised keyboard that is touted as providing a more natural typing motion — can also be useful. ““Ergonomic keyboards can be very helpful, but the key is

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

fine

1 cup white whole wheat flour* ¼ cup all-purpose flour ½ cup semisweet chocolate chips ¼ cup heavy cream or milk 1 tablespoon corn syrup

Heat oven to 350 degrees. Line baking sheets with parchment paper. With electric mixer on medium speed, beat together butter, sugar, salt and cinnamon until smooth. Add yolk, vanilla, milk and nuts and beat until well blended. With mixer on low speed, beat in flour just until dough forms a cohesive mass. Roll dough into 1-inch-thick balls and place 1 inch apart on prepared sheets. Bake for 10 minutes, remove from oven, and press indent into each cookie using thumb or bottom of rounded ½-teaspoon measure. Return to oven and bake 7 minutes more. Remove to a wire rack to cool. In a small saucepan over medium-low heat, combine chocolate chips, cream or milk, and corn syrup, stirring constantly until smooth. Cool 20 minutes. Fill the thumbprints with the chocolate mixture; let sit for another 30 minutes. *New to cooking with whole wheat flour? You may want to start with a ratio of ¾ cup whole wheat flour and ½ cup all-purpose flour for this recipe. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorieconscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com. controlling the frequency and duration of the activities that’s provoking the symptoms,” Moy said. Should the symptoms become more frequent, severe or constant, it’s time to see a physician. Moy says that he takes a laddered approach with his patients, prescribing the aforementioned treatments for mild to moderate cases, and surgery for the most severe. Moy explained that the carpal tunnel is surrounded on three sides by bone, and on the fourth side by the transverse carpal ligament. Carpal tunnel release surgery involves cutting the transverse carpal ligament to relieve pressure on the median nerve. In recent years, surgeons have moved toward endoscopic surgery in which a smaller incision is made and the recovery times are shorter. Of course, surgery is something we’d all like to avoid, regardless of recovery times. To that end, Moy offers two key points to avoid severe symptoms of carpal tunnel syndrome. “The first is moderation. Try to decrease the duration and frequency of those repetitive activities as best one can,” he said. “The second part is, listen to your hands. If your hands are telling you that I’m developing some tingling here and it’s because of this one particular activity, maybe you should listen to your hands and back off a little bit and rest.”

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re you ready for flu season? February usually represents the month with more cases of influenza than any other, according to the Centers for Disease Control. You still have time to get ready. “It’s still good to get it even through January and February,” said Maryanne Closson, pharmacist at Union Medical Pharmacy in West Seneca. “A lot of people jump the gun and get it in September, but it’s still good to get it in January.” A few factors have changed since last year. Flumist inhaled flu vaccine won’t be available this winter. Though popular with children and anyone who hates needles, the inhaled vaccine won’t be offered this year. Bennett “Upon reviewing the data for the last three years for the use of Flumist, it wasn’t effective for the past three years,” said physician Nancy Bennett, chairwoman of the Centers for Disease Control’s advisory committee on immunization practices. “We’re suspending the use pending additional data. Flumist is a wonderful technology we’d like to see used.” Other major topics have been vaccines for those over the age of 65. Two new formulations may prove to offer better protection. “Both have been studied in older people to see if they’d be more effective,” said Bennett, who is also director for community health at the University of Rochester Medical Center. “The hope is that they will elicit more immunity than the standard vaccine. We’ve noted for years it’s not as effective in older people as younger. “The goal has been finding new technology that makes it more effective for older people. Older people have less strong immune response to vaccine. They’re at much higher risk for complications from influenza, so it’s especially important that they get vaccine and that it’s effective in them.” While most people recognize that influenza vaccine is important

for children and the elderly, Bennett said everyone should receive vaccine to avoid infecting these populations, who can become critically ill because of their lower immunity. “If we don’t get vaccinated, we can transmit the flu to people less able to fight it,” Bennett said. “It’s very important for everyone to get vaccinated. Flu makes you very, very sick. It’s not a cold. It’s much more severe.” Pharmacist Closson occasionally must reassure patients that flu vaccine is safe, she said. Thimerosal, an ethyl mercury-based preservative, was once erroneously linked to autism in children. The amount used was so minute that everyday foods can legally contain more mercury. Most vaccines no longer contain thimerosal. She said that the danger from contracting influenza is much greater than the extremely low danger of even a mild reaction from the vaccine. Beyond vaccination, avoiding people who have the flu is the best way to avoid the flu. But since people can spread the flu before they know they’re infected, frequent hand washing can help curtail flu. Mary Jo Parker, registered dietitian nutritionist, and owner of a private practice in Williamsville for more than 30 years, said that keeping the immune system strong helps prevent getting the flu. “If a person is well rested, that is going to help bolster their immune system, along with eating foods that are more anti-inflammatory in nature,” she added.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 11

Holidays

Holiday Blues or Depression?

Why the ’happiest season of all’ brings sadness and depression. Experts weigh in

By Deborah Jeanne Sergeant Instead of Joy to the World, some people feel sad, lonesome and overwhelmed during the holiday season. It may seem strange to those not experiencing those feelings, but for some, the season elicits symptoms that mimic depression or actually trigger depression. Maribeth H. Duncan, licensed clinical social worker practicing in Buffalo, said that a few key factors differentiate holiday blues from major depression. “Major depression is a disease and it can be triggered by a lot of different things,” Duncan said. “Holiday blues are more an environmental disorder where things trigger depression for a period of time. That will come and go, where a major depression diagnosis, it’s an ailment.” Clinical depression typically lasts longer and is typified by deeper, more profound sadness accompanied by five or more of the following symptoms: sadness, crying,

changes in sleep patterns, lack of concentration, anxiety, increased or decreased appetite, feelings of guilt and worthlessness, lower energy levels, and lower motivation. Some people experiencing depression contemplate self-harm. Feeling sad during the holidays seems incongruent with the “happiest season of all,” but for some people, it’s stressful in a negative way. “Holidays have a lot of stress because of finances, trying to meet unrealistic expectations, and trauma from the past,” said Wendy Baum, licensed clinical social worker practicing in Buffalo. If the family always gathered at Mom and Dad’s to celebrate, but Dad died and now Mom lives in a condo, it can be hard to adjust to the new normal. Or perhaps the entire family is intact but has never gotten along well. Those Hallmark-perfect memories never happen.

Instead of lamenting what cannot be, embrace what works for you and let go of the rest. For example, attending a family celebration filled with put-downs and verbal arrows can cause plenty of stress. Briefly making an appearance can help keep the tradition without enduring hours of emotional pain. It’s important to identify their source of stress and develop healthy means of addressing them. Avoidance, turning to alcohol or overspending represent unhealthy coping mechanisms. For some people, it’s hard to adjust to the post-holiday season. “The aftermath of the holidays is that you have all this craziness, then clean up and bills, and regrets,” said Brittany Bennett, licensed mental health counselor and owner of Bridge Over Troubled Water in Amherst. “The hype of Christmas is followed by a month of recuperating from five to six weeks of preparing.” Instead of feeling let down with little to look forward to for the next few months, Bennett advises clients to prepare for the new year. “Think about what you liked about last year, and things you can do without, that you can cut out,” Bennett said. “People tend to

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

home in on what they didn’t like instead of the things that made them feel good. We need more of those things. Stick with the simple goals that are reasonable, accessible and attainable. Even if that just means a cup of coffee with a friend.” It’s important to note that in the North, seasonal affective disorder (SAD) influences how some feel. Lack of sunlight can trigger the mood disorder since the body does not receive sufficient natural sunlight. “We’re going into a time of SAD,” Baum said. “That lasts beyond the holidays. It’s related to amount of light we receive.” Of course, some people may experience depression during the holidays, even if they don’t feel grief from loss or overwhelmed. Another medical condition could cause similar symptoms. “Some medical conditions could mimic a depressive disorder, like beginning phases of thyroid disorder or diabetes,” Bennett said. Although depression is a medical condition usually treated by medication and talk therapy, neither depression or holiday blues should be ignored. The Beck Depression Inventory (www.hr.ucdavis.edu/asap/pdf_ files/Beck_Depression_Inventory. pdf) may help you screen yourself for depression. Or, talking about it with a primary care provider can help.

Holidays Avoid Holiday Weight Gain — If You Can For most people, losing weight in December is next to impossible; however, maintaining the same weight is an achievable goal, experts say By Deborah Jeanne Sergeant

he Jolly Old Elf may be part of your celebration, but you don’t want to end up looking like him after New Year’s. Many people find it hard to keep weight off during the last month of the year for different reasons. Corey Ormsbee, personal training director at Catalyst Fitness in Buffalo, cited a few different reason many people gain weight from Thanksgiving through New Year’s Day: portion sizes, overeating, poor food choices and lack of activity. “Everyone’s a little more sedentary around the holidays because it’s family time, but you have to stay moving,” he said. Though it may be harder to get active outside, taking a fitness class or engaging in an active hobby or sport can help improve fitness, as can engaging in calisthenics. These include movements such as air squats, burpees, and sit-ups. Callisthenic movements like these are portable for anyone traveling during the holidays, too. To prepare for a party or holiday meal, he advises engaging in an extra workout that week and stick with healthful

choices when possible. Ormsbee also views stress and lack of sleep as contributors since these increase the body’s cortisol levels. This hormone signals the body to latch onto calories and store them as fat. Busy schedules also limit many people’s ability to exercise as they normally would. “One natural stress reliever is exercise,” Ormsbee said. “Get outside of your element at home or work. Go somewhere that’s your Zen place, like spinning, yoga or weight lifting. Or take the dog for a little longer walk. Find an escape.” For most people, losing weight in December is next to impossible; however, maintaining the same weight is certainly an achievable goal. Mary Jo Parker, registered dietitian nutritionist, and owner of a private practice in Williamsville for more than 30 years, said that poor food choices, along with overeating, contribute tremendously to holiday weight gain. “There’s a lot of things to pay attention to,” she said. “Underlying all of it is the mindful awareness. Be attentive to what’s going on.”

Portion size, poor food choices and overeating considered main causes of weight gain For example, eating a light meal that includes healthful fat, fiber and protein before leaving home can help you avoid arriving famished and making poor food choices. If it’s a casual gathering, bring your own platter of cut-up veggies or fruit, or shrimp and cocktail sauce. “A lot of people are surprised that many people go after it,” Parker said.

Go easy on alcohol, as its high caloric content and ability to impair your judgment can spell disaster for your healthful eating plan. Parker recommended using seltzer water as a mixer. At home, altering recipes can decrease their calories. Instead of pumpkin pie, Parker skips the crust and pours the filling into individual glass ramekins to bake. With parties to plan, and attend, gifts, decorations and events, it’s easy to get so busy that grabbing fast food sounds like an easy solution for meals. But Parker advises clients to carry healthful snacks with them in the car or bag to tide them over, such as a small bag of nuts, fresh fruit, yogurt and a water bottle. The snack should help you stay fueled up until you can eat a healthful meal.

Holiday Weight Gain: One Tradition to Avoid BlueCross BlueShield Health expert talks about ways to avoid weight gain

eople in general gain 1.3 pounds during the holiday season, between October and early January, according to a recent Cornell University research, published in the New England Journal of Medicine, Because of that, BlueCross BlueShield Health recently issued information on how to avoid putting on weight during the holidays. “It’s about maintaining and not gaining throughout the holiday season,” said Kelly Hahl, manager

of health and wellness programs at BlueCross BlueShield of Western New York. “By finding ways to incorporate activity and lower calories dishes into celebrations, families can build healthy traditions together.” According to Hahl, individuals can follow simple steps to stay healthy throughout the holiday season: • Plan time for exercise. Moderate exercise can help offset

increased calorie consumption. Make time for activity during your celebrations — a 30-minute game of flag football can burn upwards of 250 calories. • Eat before you celebrate. Before a party, eat a light, healthy snack such as vegetables or fruit to curb your appetite. You’ll be less tempted to over-indulge. • Bring a healthy dish to holiday gatherings. Preparing favorite dishes that are lower in calories will help

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promote healthy holiday eating, and may even become a staple at your table each year. • Take the focus off food. Conversation is calorie-free, move away from the buffet so you won't be tempted to snack while you catch up with friends and family. • Eat until you are satisfied, not stuffed. Savor your favorite holiday treats while eating small portions, smaller plates can help.

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Holidays Toy-buying Season. But How Safe Are These Toys? Experts say consumers have to be careful with what types of toys they buy for children

By Deborah Jeanne Sergeant

re children on your gift list? Keep them safe by purchasing appropriate gifts. Physician John Pastore, medical director of pediatric hospitalist service at Women & Children’s Hospital of Buffalo, advises buyers to look at gift packaging to ensure the child can safely play with it. “Parents should read all packaging labels and be sure that a toy is age appropriate and intended by the manufacture for the child’s age that it is being purchased for,” Pastore said. “Always read all safety material that is included within the packaging of a toy.” Pastore also serves as clinical assistant professor of pediatrics, University at Buffalo and pediatric hospitalist at UBMD Pediatrics. Children’s developmental stages can vary. Some children may not be mature enough to play with toys that are rated for their age. For example, a 3-year-old who still frequently places toys in his mouth may need to wait on a toy rated for his chronological age. Pastore said to especially be

careful about purchasing toys that shoot projectiles or are thrown as projectiles “as they can cause serious injury when used inappropriately,” he said. Look for sturdy construction, non-toxic materials and UL approval for electric toys. Toys that make noise can damage kids’ hearing. “Not all toys bear age safety ratings,” Pastore said. Some toys sold from a bulk bin lack packaging. You can look up used toys online for recall information (www.cspc.gov); however, vintage and handmade toys lack this information. Pastore said that as a general rule, “Large is often better when dealing with young children and infants. Make sure the toy cannot fit in the child’s mouth.” Most experts agree that any toys or parts of toys smaller than a fist presents a choking hazard. Look for removable parts or parts that may be broken off. US-made toys made more recently than the 1970s won’t contain lead; however, those made before and overseas may still

have lead which is harmful to children’s development. The Consumer Product Safety Commission has worked to tighten inspection of imported toys, but if you purchase them directly on the Internet, you can’t know if the toys contain lead or not. Pay special attention to toys purchased on Amazon. com or eBay.com, as some are used and may not include the packaging or be up-to-date with current safety standards. Some manufacturers post their safety data online, so if you want to save money buying a used toy, research the company’s available information. “Use common sense,” Pastore said. “Make sure all items are in good working order or are completely repaired before used by a child for its intended purpose.” Many people enjoy shopping at craft fairs for handmade toys. Especially with these items, look for buttons and other fasteners on teddy bears and doll clothing. Embroidered eyes are safer than button eyes, for example. “Seams of stuffed animals may split, allowing the inner stuffing to be removed,” Pastore said. Look for even stitching and quality workmanship. “Keep in mind wooden toys can sometimes produce splinters,” Pastore said. With electronic toys, note how easily batteries are to remove. The acid in them can burn the child’s esophagus or bowel, so any suspected swallowed battery should be considered an emergency. Swallowing two magnets can also cause bowel perforation.

Malachi Fisher, coalition leader for Safe Kids Western New York region, also warns that buyers should consider strangulation and circulation hazards such as pull strings that could wrap around a neck or digits. Plastic tubing used for pulling toys provide greater safety. Carefully inspect larger toys such as a playhouse for sharp edges and corners. Don’t modify the assembly information as that may compromise the toy’s safety. “If you’re buying online, took at reviews,” Fisher said. “They should have consistent reviews. Follow up on those.” Skip gifts that are too fragile for children to play with. The glass angel ornament may thrill your little girl, but will she resist playing with it? If someone gives your child a toy you don’t feel is safe, you can put the toy away until he is mature enough for it. With all the hubbub of opening gifts, he likely won’t notice one toy is “missing” anyway. If you’re in doubt, give that grandchild, niece or nephew a gift card to a toy store so the parents can help guide the gift choice.

Texting Can Be a Real Pain By Deborah Jeanne Sergeant

f your child complains of hand and neck pain, keep a closer eye on his texting and tablet habit. It might be the culprit. “I see this very, very often,” said Christopher Herrington, chiropractor and owner of Herrington Family Chiropractic in Amherst. “I see it a lot in kids through late Herrington 20s.” Called “text neck” in the industry, phone-related neck pain results because people use “the wrong muscles for the wrong things,” Herrington said. When looking down at a keyboard or phone, muscles of the chest and back of the neck, which are meant for lifting, are being used for posture. Herrington said that they weren’t meant to remain static so Page 14

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long. Sitting up straight and keeping the device at a comfortable level can help prevent injury, but he added that teens should not spend more than two to three hours daily doing things on a screen. “Change positions constantly. Set a quiet alert on your phone to remind you to get up and walk around. In general, stay more active as well,” said Herrington. In addition to neck pain issues, Herrington said that he sees many people 25 and younger who exhibit carpal tunnel-like conditions and headaches. The first step is identifying the problem. “If it’s from using a cell phone too much, stop using it so much,” Herrington said. “It’s simple, but true.” Lisa Hester, chiropractor and owner of Hester Health in Orchard Park, said that “headaches at the base of the skull are usually neck headaches. Also, those that are behind the eye. That can be another indicator of text neck, but of course

these headaches can mean other things.” In New York state, patients may self-refer to a physical therapist, chiropractor, or other specialist without seeing a primary care provider. Physical therapy, combined with home care, can offer relief for many people. Hester said that Bruegger’s Relief Position, a stretching regimen commonly available online, “is a good, general exercise to do for people using a phone or sitting at a desk all day.”

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

Herrington is a big believer in trying to help his patients become well enough so they can “treat themselves” at home with exercises to stretch and strengthen themselves.

Lancaster Commons

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Fri. Dec. 9, from 10 am to 12 pm Wed. Dec. 21, from 12 pm to 2 pm By Jim Miller

Thyroid Disorders Often Missed in Seniors Dear Savvy Senior,

Can you write a column on the overlooked problem of thyroid disease? After struggling with chronic fatigue, joint pain and memory problems, I was finally diagnosed hypothyroidism. Now, at age 70, I’m on thyroid medication and am doing great. Five years of feeling lousy. I wish I’d have known.

Frustrated Patient

Dear Frustrated,

I’m glad to hear that you’re finally feeling better. Unfortunately, thyroid problems are quite common in older adults but can be tricky to detect because the symptoms often resemble other age-related health problems. In fact, as many as 30 million Americans have some form of thyroid disorder, but more than half of them aren’t aware of it. Here’s a basic overview: The thyroid is a small butterfly-shaped gland located at the base of your neck that has a huge job. It produces hormones (called T3 and T4) that help regulate the rate of many of your body’s activities, from how quickly you burn calories to how fast your heart beats. It also influences the function of the brain, liver, kidneys and skin. If the gland is underactive and doesn’t produce enough thyroid hormones, it causes body systems to slow down. If it’s overactive, and churns out too much thyroid, it has the opposite effect, speeding up the body’s processes. The symptoms for an underactive thyroid (also known as hypothyroidism) — the most common thyroid disorder in older adults — will vary but may include fatigue, unexplained weight gain, increased sensitivity to cold, constipation, joint pain, muscle stiffness, dry skin and depression. Some patients may even develop an enlarged thyroid (goiter) at the base of the neck. However, in older adults, it can cause other symptoms like memory impairment, loss of appetite, weight loss, falls or even incontinence. And the symptoms of an overactive thyroid (or

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hyperthyroidism), which is more common in people under age 50, may include a rapid heart rate, anxiety, insomnia, increased appetite, weight loss, diarrhea, excessive perspiration, as well as an enlarged thyroid gland. Too much thyroid can also cause atrial fibrillation, affect blood pressure and decrease bone density, which increases the risk of osteoporosis. Those with the greatest risk of developing thyroid disorders are women who have a family history of the disease. Other factors that can trigger thyroid problems include: autoimmune diseases like Hashimoto’s or Graves disease; thyroid surgery; radiation treatments to the neck or upper chest; and certain medications including interferon alpha and interleukin-2 cancer medications, amiodarone heart medication and lithium for bipolar disorder.

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If you have any of the aforementioned symptoms or if you’ve had previous thyroid problems or notice a lump in the base of your neck, ask your doctor to check your thyroid levels. The TSH (thyroid-stimulating hormone) blood test is used to diagnosis thyroid disorders. Thyroid disease is easily treated once you’ve been diagnosed. Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid and others), which is an oral medication that restores adequate hormone levels. And treatments for hyperthyroidism may include an anti-thyroid medication such as methimazole (Tapazole), which blocks the production of thyroid hormones. Another option is radioactive iodine, which is taken orally and destroys the overactive thyroid cells and causes the gland to shrink. But this can leave the thyroid unable to produce any hormone and it’s likely that you’ll eventually become hypothyroid and need to start taking thyroid medication. For more information on thyroid disorders, visit the American Thyroid Association at Thyroid.org. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. December 2016 •

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The Social Ask Security Office

You read this

From the Social Security District Office

Social Security’s Gift to Children Is Security

U.S. Life Expectancy Lags Behind Other Wealthy Nations

Diabetes, drugs and guns contribute to disappointing statistics in new global report

he United States lags behind other advanced nations when it comes to infant mortality and the life expectancy of its citizens, according to a comprehensive review of global health statistics. The health of U.S. citizens is specifically challenged by smoking, diabetes, high blood pressure, drug abuse and gun violence, said study co-author, physician Mohsen Naghavi. He's a professor with the Institute for Health Metrics and Evaluation at the University of Washington in Seattle. The United States isn't meeting the high expectations set by the country's wealth and the amount it spends on health care, mainly because not all U.S. citizens benefit equally from their nation's advantages, Naghavi said. "This comes from inequality in access to health care, along with other social and economic factors," he said. Infant mortality in the United States amounted in 2015 to six deaths out of every 1,000 kids younger than 5, while the average for all highincome nations combined was about five deaths per 1,000, researchers said. U.S. men and women also had poorer life expectancy, compared with the rest of the developed world. U.S. men had an average life expectancy of 76.7 years in 2015, with

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about 66.8 of those years spent in good health. Life expectancy for U.S. women was 81.5 years on average, with 69.5 years spent in good health. By comparison, all high-income countries combined had an average 78.1 years of life expectancy for men and 83.4 years for women, the study reported. Years lived in good health averaged 68.9 for men and 72.2 for women. These findings are part of the Global Burden of Diseases, Injuries and Risk Factors Study 2015, a scientific analysis of more than 300 diseases and injuries in 195 countries and territories. The numbers show that the United States needs to rethink its approach to health care, said physician Prabhjot Singh. He is director of Mount Sinai's Arnhold Institute for Global Health in New York City. "We are investing in the wrong stuff, and we are paying for it with our lives," Singh said. Researchers found that drug abuse and diabetes are causing a disproportionate amount of ill health and early death in the United States, compared with other countries. Alcohol, smoking and access to guns also pose continuing health threats to U.S. citizens, Naghavi said. The study was published Oct. 6 in The Lancet.

This is the season of caring. No matter your religion or belief, December is also considered a time to focus on the children we love. Whether we’re wrapping Santa’s gifts, buying Hanukkah treats, decorating the house in celebration of Kwanzaa or volunteering for a toy drive, children add joy to the holiday season. And we at Social Security definitely know a thing or two about helping children. Often overlooked in the paperwork that prospective parents fill out in preparation for a child’s birth is an application for a Social Security number and card. Typically, the hospital will ask if you want to apply for a Social Security number for your newborn as part of the birth registration process. This is the easiest and fastest way to apply. The Social Security card typically arrives about a week to 10 days after that little bundle of joy! You can learn about Social Security numbers for children by reading our publication, Social Security Numbers for Children, available at www. socialsecurity.gov/pubs. A child needs a Social Security number if he or she is going to have a bank account, if a relative is buying savings bonds for the child, if the child will have medical coverage, or if the child will receive government services. You’ll also need a Social Security number for a child to claim him or her on your tax returns. If you wait to apply, you will have to visit a Social Security office and you’ll need to: • Complete an “Application For a Social Security Card” (Form SS-5); • Show us original documents proving your child’s U.S. citizenship, age and identity; and • Show us documents proving your identity.

Q&A

Q: I noticed that my date of birth in Social Security’s records is wrong. How do I get that corrected? A: To change the date of birth shown on our records, take the following steps: • Complete an “Application For A Social Security Card” (Form SS-5); • Show us documents proving: U.S. citizenship (if you have not previously established your citizenship with us); age; and identity; and • Take (or mail) your completed application and documents to your local Social Security office. Note that all documents must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies of documents. For details on the documents you’ll need, visit www.

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

Remember, a child age 12 or older requesting an original Social Security number must appear in person for the interview, even though a parent or guardian will sign the application on the child’s behalf. Children with disabilities are among our most vulnerable citizens. Social Security is dedicated to helping those with qualifying disabilities and their families through the Supplemental Security Income (SSI) program. To qualify for SSI: • The child must have a physical or mental condition, or a combination of conditions, resulting in “marked and severe functional limitations.” This means that the condition(s) must severely limit your child’s activities; • The child’s condition(s) must be severe, last for at least 12 months, or be expected to result in death; • If your child’s condition(s) does not result in “marked and severe limitations,” or does not result in those limitations lasting for at least 12 months, your child will not qualify for SSI; and • The child must not be working and earning more than $1,090 a month in 2016. (This amount usually changes every year.) If he or she is working and earning that much money, your child will not be eligible for benefits. Learn the details about benefits for children by reading our publication, Benefits for Children with Disabilities, available at www.socialsecurity.gov/pubs. Visit www.socialsecurity.gov/ people/kids to learn more about all we do to care for children. Caring for the next generation is a central part of securing today and tomorrow, during the holidays and all year long. socialsecurity.gov/ss5doc. Q: How can I get a copy of my Social Security Statement? A: You can get your personal Social Security statement online by using your my Social Security account. If you don’t yet have an account, you can easily create one. Your online statement gives you secure and convenient access to your earnings records. It also shows estimates for retirement, disability, and survivors benefits you and your family may be eligible for. To set up or use your account to get your online Social Security Statement, go to www.socialsecurity.gov/ myaccount. We also mail statements to workers attaining ages 25, 30, 35, 40, 45, 50, 55, 60 and older three months prior to their birthday if they don’t receive Social Security benefits and don’t have a my Social Security account.

n just a few short months on the job, Matthew Diegelman is making a difference in the everyday lives of student athletes at Hilbert College in the town of Hamburg. As the athletic department’s firstever strength and conditioning coach since the college began competing at the NCAA Division III level, Diegelman is laying the foundation of a comprehensive strength and conditioning program, a challenge the Hamburg native is embracing with great enthusiasm. “The best part of this job is not only did I grow up in Hamburg, I currently live here,” said Diegelman, a 1998 graduate of Hamburg High School and 2002 graduate of Buffalo State College. “To have a strength and conditioning job at a college or with a professional sports organization in the town you grew up in is not likely something that you will find very often. Hamburg is a great area for raising a family and many of my family members still live in the area. I’m very thankful to have found a career that allows us to be near everything my family enjoys.” Diegelman works closely with the coaching staffs and athletes who are involved with the 13 teams that represent Hilbert College. Much like he did when he established the strength and conditioning program at Division I Niagara University, Diegelman’s approach to his position involves plenty of one-onone training sessions and constant communication with coaches and students. “We have a great group of coaches and athletes that I am really enjoying working with each and every day I come to work,” said Diegelman, the son of Mark and Theresa Diegelman of the village of Hamburg. “I’m very excited and grateful about this opportunity to start the first-ever strength and conditioning program at Hilbert College. I feel my years of experience and knowledge of the industry will help our athletes succeed.” Hilbert College officials hired Diegelman because of his previous track record of accomplishments with the athletics department at Niagara University. “Matt brings a wealth of experience with him into the strength program,” said John Czarnecki, Hilbert College’s athletics director. “The student athletes will gain a lot from his knowledge and ultimately become healthier, grow stronger and have a more positive experience representing Hilbert College on any one of our 13 teams.” Diegelman is actually the first strength and conditioning coach in the Allegheny Mountain Collegiate Conference, with his work at Hilbert likely to eventually influence the other nine AMCC members to consider establishing strength and conditioning programs by hiring a full-time employee in a capacity similar to Diegelman’s current position. “It’s not only the AMCC but there are other Division III and there are still some Division II and Division I schools who do not have strength and conditioning coaches, but I’m sure that will be changing,” said Diegelman. “I know many of the athletes here at Hilbert are excited about this opportunity to follow a program.

Building a Strength Program One Muscle at a Time Hilbert College’s new coach helping students succeed athletically By Daniel Meyer

December 2016 •

Adding strength to program “Strength coaches are an integral part of any athletics program. Athletic performance enhancement, general health and wellbeing and having the chance to help reduce some injuries are just some of the benefits of having a strength and conditioning coach. If you have two equally talented teams but one is more physically prepared, we all know who has a better chance at winning.” Diegelman worked at Niagara University from 2006 through 2015, where he implemented specific strength, agility, speed and power programs for the 18 Division I sports programs. He also provided comprehensive plans for strength training, speed development, agility training and nutritional plans for Niagara’s student athletes during their off-seasons. Diegelman also has experience teaching at Canisius College as an adjunct professor, leading masterslevel courses for that school’s health and human performance department. In addition, he previously worked as an athletic training and health and fitness instructor. Diegelman gained valuable experience during a 2002 internship with the Buffalo Bills and a 2005 internship involving the Buffalo Sabres, both of which provided him with in-depth exposure to how strength and conditioning programs are conducted at the professional sports level. “My internships introduced me to the many concepts of sports strength and conditioning and working in athletics,” said Diegelman. “Both of these internships ultimately guided me in how I train my athletes today. While I do use many of my own ideas, those internships definitely guided me down the right path and helped me get to where I am today. I also was fortunate to meet so many different people who worked in those two organizations. I also had the chance to meet some great athletes, coaches and other staff members, all of whom are people who helped mentor me.” Diegelman also serves as the department’s athletic facility coordinator responsible for the Hawks practice and game field scheduling, safety and upkeep of the Hafner Recreation Center’s Fitness Center as well as game management supervision of any athletic competition that takes place on the Hilbert College campus. Diegelman, who also holds a Master of Science degree in health and human performance from Canisius College, is confident his long-term strategic plan will help improve the lives of Hilbert’s student athletes both on the playing field and courts as well as in the classroom. “You want well-rounded students and I think part of my job indirectly provides guidance and advice on time management and structuring your daily routine so that you schedule time to be active and attempt to stay physically fit,” said Diegelman. “The students I have worked with so far have been great in that they understand the importance of conditioning and how staying focused and dedicated are crucial to succeeding in whatever you do in life.”

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Health News Amherst Chiropractic adds two professionals Chiropractors Thomas and Elizabeth Lyons are celebrating 30 years at Amherst Chiropractic, P.C. treating patients as husband and wife. They have just welcomed two new chiropractors to their practice: Zach Kashevaroff, and their daughter Chelsea Lyons. Chelsea Lyons is focused on treating children and pregnant women who may be dealing with back and neck strain due to their changing bodies and altered centers of gravity. Zach Kashevaroff will focus on treating sports injuries. He uses Kinesio Taping, a rehabilitative taping technique for the muscles and joints that is used on Olympic athletes. Amherst Chiropractic promotes health and prevents disease by using an all-natural, conservative approach to treat patients with musculosketal conditions in their back and spine without the use of drugs or surgery. Their office also offers vitamins and nutritional consultations.

ECMCC awarded hospital accreditation Erie County Medical Center

Corporation (ECMCC) has recently earned The Joint Commission’s Gold Seal of Approval for its full hospital accreditation for a three-year period by demonstrating continuous compliance with its performance standards. The Gold Seal of Approval is a symbol of quality that reflects an organization’s commitment to providing safe and effective patient care. ECMC underwent a rigorous, unannounced onsite survey in late July. During the review, a team of Joint Commission expert surveyors evaluated compliance with hospital standards related to several areas, including emergency management, environment of care, infection prevention and control, leadership, and medication management. Surveyors also conducted onsite observations and interviews. The Joint Commission has accredited hospitals for more than 60 years. More than 4,000 general, children’s, long-term acute, psychiatric, rehabilitation and specialty hospitals currently maintain accreditation from The Joint Commission, awarded for a three-year period. In addition, approximately 360 critical access hospitals maintain accreditation through a separate program. “Joint Commission accreditation is known throughout the country

as the national standard of excellence,” said ECMCC President and CEO Thomas J. Quatroche Jr. “This accreditation affirms the quality of care at Western New York’s only adult trauma center. I commend the entire ECMC family for their incredible dedication and commitment, ensuring that our patients receive the highest quality care and their families and loved ones are treated with dignity and respect to help ensure that ECMC continues as the region's hospital of choice. The Joint Commission’s hospital standards are developed in consultation with health care experts and providers, measurement experts and patients. The standards are informed by scientific literature and expert consensus to help hospitals measure, assess and improve performance.

Compeer honored by P2 Collaborative of WNY Compeer of Greater Buffalo, the only organization in Western New York dedicated to recovery through the healing power of friendship, received a Spotlight on Population Health (SOPHi) Award from P2 Collaborative of Western New York. In the category of promoting mental

health, Compeer and its partner organizations, the Mental Health Association of Erie County, Jewish Family Service and Erie Community College, were honored for stigmareducing advocacy and education through the mental health first aid program. "The mental health first aid program is truly a collaborative effort between a dedicated team of partner organizations that collaborate each day to bring this much needed training to the community,” said Timothy Boling, executive director at Compeer Inc. “Since we began delivering the program in April 2014, we have offered 87 trainings for 1383 mental health first aiders.” Mental health first aid training teaches participants how to identify, understand and respond to signs of mental illnesses and substance use disorders. The training provides the skills needed to provide initial help and support to someone who may be developing a mental health or substance use problem or experiencing a crisis. Mental health first aid is an international evidence-based program: In the United States, more than 700,000 people have been trained in by a dedicated base of more than 10,000 instructors across the country.

Ready for delivery to the pajama program: Jennifer Lazarz, left, Amherst Senior Center program department staff, and Manjula Hathi, member and volunteer, pack donated items to help area children that are living below the poverty level.

Amherst Senior Center Collects New Pajamas, Books to Help Children In Need Rose Roussey, a certified nurses’ aide with Schofield Residence, is retiring after 42 years on the job. On her left is Lorraine, one of the residents at Schofield.

CNA Retires After 42 Years at Schofield Residence

onawanda resident Rose Roussey is beginning a new phase of her life as she retires from her work as a certified nurses’ aide, a position she has held at the Schofield Residence in Kenmore for the past 42 years. When Roussey first took the job in 1974, she thought it was just going to be a part-time, temporary job. Roussey credits the longevity of her career to her love for her job, Page 18

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Schofield as an organization, and a strong desire to care for the elderly since she was a little girl. A 13-year breast cancer survivor, Roussey’s four children and two grandchildren, one of which she raised as her own, have been trying to get her to retire for years, especially after her husband died in 2003. She said she doesn’t have plans after retirement.

enerous and caring members, staff and community members helped the Amherst Center for Senior Services collect 105 pairs of new pajamas, 160 children’s books and $154 in cash for the Buffalo chapter of the pajama program. Items were collected in September and October for area children that are living with their families below the poverty level, in desperate need of food, clothing and shelter, and for others waiting to be adopted. The Buffalo chapter of the pajama program will distribute these items through agencies in the Buffalo

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

area, including Cornerstone Manor, Baker Victory Services, Child and Family Services and the Salvation Army. “We are grateful once again to the Amherst Center for Senior Services for all the amazing donations, including so many pairs of cozy, warm pajamas and beautiful books to go along with them,” noted Jenn Bishara, president of Buffalo’s program. “You have given our kick off to the danger season a great start”. For more information about the pajama program, please visit www. pajamaprogram.org.

Health News NY Chiropractic College names new president Chiropractor Michael A. Mestan has been selected as the new president of New York Chiropractic College, based in Seneca Falls. He will succeed Frank J. Nicchi, who’s retiring Aug. 31. Mestan now serves Mestan NYCC as executive vice president and provost and holds an academic appointment in the chiropractic program. He joined the college in 2002. “Dr. Mestan is an outstanding choice,” said Thomas R. De Vita, chairman of the New York Chiropractic College board of trustees. “We are confident in his ability and excited to support him as

he leads the College to even higher levels of excellence in the future.” Mestan held positions as department head for clinical sciences, dean of the chiropractic program, and executive vice president for academic affairs before being appointed to his current position in 2010. Previously, he held academic and administrative appointments at Parker University in Dallas. He has also practiced chiropractic and served as a diagnostic imaging consultant. Having earned his Doctor of Chiropractic degree from the National University of Health Sciences in 1994, Mestan completed his residency in diagnostic imaging at Southern California University of Health Sciences. In 2011 he earned a master’s degree, and in 2013 a Doctor of Education degree, both in educational administration with a specialization in higher education, from the University of Rochester’s Margaret Warner Graduate School of Education and Human Development in Rochester. Mestan resides in Seneca Falls with his wife and three children.

Schofield Care trains, equips community to tackle opioid epidemic Organization provides free training for staff and public on the use of lifesaving emergency naloxone spray

s the opioid crisis grips communities in Western New York and throughout the nation, a local provider of home care, nursing and residential care services has taken on a major community outreach effort to educate, train and equip its direct-care staff — as well as the public — on use of lifesaving Narcan spray kits that can save lives. Narcan is an FDA-approved nasal form of naloxone for the emergency treatment of a known or suspected opioid overdose. It knocks the opiate receptors in the brain, and it can be safely administered by a layperson with minimal training: Narcan does not have an effect on a person who has not taken opioids. If a drug overdose is suspected, protocols call for administering Narcan and immediately contacting emergency medical services. “Our home care agency is proud to partner with Erie County to help deliver opioid education and Narcan training to individuals in our community,” said registered nurse Colleen Osborn, Schofield’s director of home care operations. “We offer free-of-charge programs open to the public, and people who attend leave with samples of Narcan to help our community combat the ever-growing opioid addiction crisis.”

Schofield has also trained all of its staff on Narcan, equipping them with the kits as they conduct home care visits. “The training has become part of Schofield’s home health aide courses regardless of whether the individual chooses to work for Schofield or takes their training elsewhere, and our nursing staff is similarly equipped with training and Narcan supplies,” Osborn added. “Every person we touch has the ability to positively impact this crisis.” Kenmore-based Schofield Care provides a continuum of services, from home care to rehabilitation, adult day health care, and skilled nursing. In this role, it has extensive reach into the lives of hundreds of vulnerable individuals living at home and in other settings, where they might be in the throes of an opioid overdose – or at risk of one. This makes Schofield Care an especially powerful resource for the deployment of life-saving interventions, including medical help for individuals experiencing heroin or opioid overdoses. To learn about upcoming Narcan trainings, call Osborn at Schofield Home Health Care (716-874-2600) or Erie County Health Department (716858-7695).

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Page 19

Members of the WNY Women’s Lymphedema Support Group at one of their monthly meetings

New Group in Buffalo Supports Women with Lymphedema

WNY Women’s Lymphedema Support Group wants to raise awareness for condition, increase resources available By Katie Coleman

illiamsville resident Joanne Coury had chemotherapy in 2013 and two months later was living with secondary lymphedema. “I was so frustrated there’s no real cure, and I realized there could be people in Buffalo equally as frustrated,” said Coury, who in April ounded WNY Women’s Lymphedema Support Group, which is open to women of all ages and their caregivers. People living with lymphedema tend to hide the symptoms — the constant swelling that occurs in different parts of the body with no cure to stop it. Depending on how severe and where the swelling occurs, people struggle with lymphedema in very different ways. The group meets on the first Wednesday of each month at the Sheridan Surgical, Inc. meeting room located at 4510 Bailey Ave. in Amherst. It has about 20 people and many of them participate in the regular meetings. Coury said that because there is a scarcity in treatment options and doctors specializing in lymphedema, the group is trying to advocate for more medical specialization in Buffalo. Every other month outside speakers offer educational support. The group also focuses on emotional support and raising awareness. “The group philosophy is that we are living with lymphedema, not suffering from it. We are trying to be upbeat about it and not let it get us down,” Coury said. Amherst resident and licensed social worker Sally Cisek is a member of the group. She was diagnosed with Page 20

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What is Lymphedema Lymphedema is a condition in which the lymphatic system, part of the immune system that helps rid the body of waste, toxins and other unwanted materials, gets blocked. Typically lymph fluid circulates through the body and is filtered by the lymph nodes, which house infection-fighting cells called lymphocytes that help flush the waste from your body. When lymph vessels or nodes become impaired, the fluid cannot transport back to the bloodstream, instead building up in tissues leading to swelling, infections, discomfort and even fibrosis. There are two types: primary lymphedema, which occurs on its own, and secondary lymphedema, caused by a disease, most commonly cancer, which can damage lymph nodes or require their removal during surgery. primary lymphedema at 19 years of age. “It’s a safe space for us to open up about the issues we face. In my whole life I had never met someone else with primary lymphedema until I found the WNY Women’s Lymphedema Support Group,” said Cisek. After noticing swelling in both of her ankles, she went to a vascular specialist at Buffalo General Hospital and was given a grim diagnosis. “I was told I could get surgery but the swelling would come back, and that it would get worse as I got older, during pregnancy and in hot weather. When you’re 19 years old it’s really not what you want to

Joanne Coury of Willimasville founded WNY Women’s Lymphedema Support Group to help other women cope with condition, which involved swelling of various parts of the body. The condition has no cure. hear. Back then people didn’t know much about lymphedema and they still don’t. It isn’t getting enough attention,” Cisek said. Cisek was told she was more prone to infections in her legs, and that she had to wear compression garments every day for the rest of her life to help reduce the swelling. This was really tough news at first. “Insurance coverage for garments is hard to come by. My compression stockings cost $110, and my kneehigh compression socks cost $70,” Cisek said. Group members are hoping that the federal bill — Lymphedema Treatment Act — gets approved. It

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

would improve Medicare insurance coverage for doctor-prescribed compression supplies to treat lymphedema, according to Cisez. Although specific to Medicare law, it would set a precedent for Medicaid and private insurers to follow the changes, she said. Without access to garments, lymphedema becomes progressive and increases morbidity. “It would be really helpful to have more doctors in the area who specialize in lymphedema,” Cisek said. “My biggest fear is if I got in a car accident or something and the doctor couldn’t recognize my special needs and concerns. And I would encourage any woman to come to our support group; it’s still evolving, and now is the perfect time to get support and make your needs known,” Cisek said. Roswell Park Cancer Institute’s Lymphedema Clinic is one of the places in the area where those with lymphedema can get help. It does have three lymphedema therapists who provide specialized treatment to cancer patients living with lymphedema. Treatment includes the removal of fluid through manual lymphatic drainage massage and by wrapping affected limbs with bandages. Treatment sessions also include education, and lessons on how to keep swelling down and prevent infections. “Sometimes we see patients with one lymph node removed who get lymphedema, and some who have had several nodes removed don’t get it,” said Susan Oakley, one of the lymphedema therapists at Roswell’s lymphedema clinic. “Statistics on lymphedema are hard to gauge; that’s why you won’t find many. I can tell you that we’re seeing fewer and fewer breast cancer patients [with lymphedema] because more doctors are doing sentinel node biopsy,” which prevents the problem, Oakley said. To learn more about the WNY Women’s Lymphedema Support Group email Joanne Coury at jmcouryfrake@yahoo.com.