IGH WNY March Issue 29 by In Good Health: WNY's Healthcare Newspaper

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SPINE SURGEON

March 2017 • Issue 29

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Buffalo & WNY’s Healthcare Newspaper

MEN’S HEALTH

Surgeon Anthony M. Leone discusses why spine surgery is so complicated and why minimally invasive robotic spine surgery is the way of the future

‘Guys, Get Tested!’

ECMC: Highest Surplus In 7 Years

Todd Baxter is a 27-year veteran of local law enforcement and director of Veterans Outreach Center, a nonproﬁt organization that works with veterans in Western New York. He was diagnosed with prostate cancer in September. He discusses his ordeal and urges other men to get tested.

Hospital reports strong results in 2016: $2.1million operating surplus

Special ‘Men’s Health’ inside

How to be a Quitter

It’s March. How’s that New Year’s resolution to quit smoking working out?

Clearing the Air Coalition in Buffalo aims to lessen damaging effects of pollution

All in the Family

Husband-wife team: 30 years working together as chiropractors in Amherst. They are now welcoming their daughter, who just got her degree in chiropractic degree. Page15

Cantaloupes

Some fruits are so fragrant and luscious and yummy that we don’t think twice about their nutritional value. For many, a cantaloupe is just that sort of fruit. Read more in SmartBites.

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Things You Need to Know to Prevent Addiction in Childrenpage 11

Supplements

Some supplements commonly advertised to treat obesity and erectile dysfunction problems can cause health problems page XX page XX

Experts Reveal Hidden Dangers Behind Supplements Some supplements commonly advertised to treat obesity and erectile dysfunction can cause health problems

meritus Professor Duncan Burns, a forensically experienced analytical chemist from the Queen’s University Belfast’s Institute for Global Food Security, has been working with a team of specialists on a peer-reviewed paper to examine the detection of illegal ingredients in supplements. The research found that overthe-counter supplements — commonly advertised to treat obesity and erectile dysfunction problems — are labelled as fully herbal but often include potentially dangerous pharmaceutical ingredients, which are not listed on the label. “Our review looked at research from right across the globe and

questioned the purity of herbal food supplements,” said Burns. “We have found that these supplements are often not what customers think they are — they are being deceived into thinking they are getting health benefits from a natural product when actually they are taking a hidden drug. “These products are unlicensed medicines and many people are consuming large quantities without knowing the interactions with other supplements or medicines they may be taking. This is very dangerous and there can be severe side effects.” The survey raises serious questions about the safety of slimming supplements containing sibutramine.

Sibutramine was licensed as the medicine Reductil until 2010, when it was withdrawn across Europe and the US due to an increased risk of heart attacks and strokes associated with the use of the drug. Tadalfil and sulfoaildenafil were among the most frequently undeclared ingredients in products for erectile dysfunction. When taken with other medicines containing ni-

trates, they can lower blood pressure drastically and cause serious health problems. “This is a real issue as people suffering from conditions like diabetes, hyperlipidemia and hypertension are frequently prescribed nitrate containing medicines. If they are also taking a herbal supplement to treat erectile dysfunction, they could become very ill,” Burns said.

Pet Meds Sending Kids to the ER

It’s not uncommon for toddlers to ingest drugs intended for dogs and cats, study finds

he flea medications and heartworm pills that millions of Americans give to their beloved pets pose poisoning risks to any children in the home, new research warns. The study authors said just one poison center in Ohio received more than 1,400 calls for poisoning from

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pet medications over the course of 15 years, with 87 percent of those calls involving children under the age of 5. “We realize that pets are common and an important part of families, especially those with young children,” said study co-author Kristi Roberts, from the Center for Injury Research and Policy at Nationwide

Children’s Hospital in Columbus, Ohio. “However, pets often require medications to keep them healthy, and these medications could be dangerous to a child if the child is exposed,” she added. Poisoning occurs in several ways, the researchers explained. Toddlers

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

can pick up pills spit out by a pet or eat food containing medications left uneaten in a food bowl. Also, kids who pet an animal being treated with a lotion or cream can get it on their hands and then put their hands into their mouths. The report was published online Feb. 6 in the journal Pediatrics.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

ECMC Corp. Chief Operating Officer Andrew Davis (at podium) addresses the audience during the news conference that announced the opening of The Center for Elder Law & Justice at Erie County Medical Center. Other speakers, from left, are physician Kathleen Grimm, ECMC; Assemblywoman Monica Wallace; attorney Lisa Yaeger, counsel to New York State Assemblywoman Crystal Peoples-Stokes; attorney Rachel S. Baldassaro, project director, MedLaw; and attorney Karen Nicolson, CEO, Center for Elder Law & Justice.

Legal Assistance Center Opens At ECMC

MedLaw Medical-Legal Partnership to provide free legal services for patients

edLaw Cancer Partnership of Western New York has recently opened an office at Erie County Medical Center, 462 Grider St. in Buffalo. The medicallegal partnership offers free legal assistance to ECMC patients who qualify. A medical-legal partnership (MLP) unites the healthcare community with a civil legal services agency under a common mission — to address and prevent health-harming social conditions for vulnerable patients and communities, according to a news release issued by ECMC. MLPs link lawyers with doctors, nurses, social workers and other clinical staff to help patients address underlying legal problems that harm their health. People, such as those who live in low-income households, the elderly or others in vulnerable situations, can be negatively impacted by their socio-economic circumstances which can become a detriment to improving their health and wellness. Social determinants of health can cause or contribute to legal problems that become a source of stress for patients and can become a barrier to receiving medical treatment, according to a new release from ECMC. The goal of MedLaw is to address a patient’s legal needs that are beyond the scope of a healthcare provider’s clinical capacity and expertise. Attorneys from CELJ are now located at ECMC as an integral part of the patient care team. Referrals to MedLaw are being made directly by healthcare providers who are trained to identify common legal

problems impacting their patients. MedLaw provides community education and offers full representation or brief advice and counsel in such matters as: access to state and federal public benefits, health insurance, housing and utilities, employment, legal status, planning for future decision-making, end of life planning, consumer issues, and other personal/family concerns. In addition to the legal assistance center, MedLaw is providing training sessions for hospital staff, and educational events on important legal topics for patients and the community. MedLaw is currently serving ECMC, Mobile Mammography Unit, and Western New York Breast Health patients being treated for breast cancer, at risk of breast cancer, or being treated by ECMC’s palliative medicine team. Preference is given to low-income individuals. MedLaw will later expand services to help other qualifying ECMC patient populations. “The launch of MedLaw is a monumental partnership for our region,” said Buffalo Mayor Byron W. Brown. “Not only will it expand eligibility and access to free legal services for Buffalo residents, it is specifically designed to help some of our most vulnerable residents — those facing cancer and other serious diagnoses. Additionally, MedLaw will offer community educational events to the general public and in its work, it will offer life-saving help and instructional opportunities for City residents to improve their knowledge and quality of life.”

March 7

March 15, 28

Hearing group to explore employment protection

Schofield to offer Zumba Gold, health screening

Hearing Loss Association of America Rochester Chapter presents two programs on an National Technical Institute for the Deaf (NTID) study of health literacy and protection under the Americans with Disabilities Act on Tuesday, March 7, at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester. Each presentation follows an hour long social and business gathering. At the noon daytime meeting, three researchers from NTID will explore the gaps in health literacy between “visual learners” and non-visual learners. Recruiting hard of hearing subjects for a study conducted through the National Institutes of Health and the University of Michigan, they will explain the study’s methods of data collection and the importance of improving access to health information for all. At the 8 p.m. presentation, Jessica Lukasiewicz, an attorney with Thomas & Solomon LLP, will comment on workplace protection for people with hearing loss under the Americans with Disabilities Act. Her firm specializes in employment law. Hearing Other People’s Experiences (HOPE), a question and answer group for people considering hearing aids and those using them, precedes the chapter meetings at 10:15 a.m. Moderated by retired audiologist and hearing aid user Joe Kozelsky, it is held in the Vestry room. Anyone interested in hearing loss is welcome to any or all of the three meetings. Hearing Loss Association of America is a nationwide organization dedicated to advocacy, education and support for people with hearing loss. For more information visit www. hlaa-rochester-ny.org or telephone 585 266 7890.

The community is invited to attend wellness programs offered in March by the Mondello Wellness & Family Center at Schofield Residence, 3333 Elmwood Ave. in the town of Tonawanda. The programs are: • Medication evaluation clinic and blood pressure screenings to be held from 1 to 4 p.m. on Wednesday, March 15. Schedule a free halfhour pharmacy consultation. Bring your medications, supplements and vitamins in their original containers. Learn what medications are affected by the food you eat, what medications shouldn’t be taken together and possible side effects. • Zumba Gold. This lower intensity workout with instructor Loretta Kaminsky is perfect for seniors who want to improve their balance and range of motion while sitting in a chair. The first class is free and will be held at 1 p.m. Tuesday, March 28. An additional four-week session is available for only $2 per class on April 4, 11, 18 and 25. Register early as seating is limited. Call 716-436-6399 or visit Schofield’s website at www. SchofieldCare.org to register, or to learn more about these and other programs Schofield Residence is part of Schofield Care, a not-for-profit long-term care and home health care organization founded in 1910. More than 700 clients, patients and residents are cared for within Schofield Residence, Schofield Adult Day Health Care Program, and Schofield’s Home Health Care programs in Erie and Niagara counties.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

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In Good Health is published 12 times a year by Local News, Inc. © 2017 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, Ernst Lamothe Jr., Michael J. Billoni, Eva Briggs (MD) Advertising: Debra Kells (716-332-0640) Layout & Design: Dylon Clew-Thomas • Office Assistant: 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.

Repeal All of Obamacare? Primary Care Physicians Not in Favor, Survey Suggests

esults of a random sample survey of 426 primary care physicians by a team of researchers found that the majority does not support repealing the Patient Protection and Affordable Care Act in its entirety, and the percentage of those who support complete repeal is lower than that of the general public. In a summary of the survey results, published in the New England Journal of Medicine on Jan. 25, the research team says 15 percent of responding physicians supported complete repeal of the act. Of those who self-reported voting for President Donald Trump, 38 percent did so. “Primary care physicians are on the front lines of health care — they are physicians that patients know best and turn to first when they are

sick. With primary care physicians often helping patients navigate challenges with their insurance, it is critical to understand their perspectives on the repeal of the act,” says physician Craig Pollack, associate professor of medicine at the Johns Hopkins University School of Medicine and the paper’s lead author. Pollack and his colleagues conducted the mail and phone survey from December 2016 to January 2017 with a random sample of internal medicine physicians, pediatricians, geriatricians and family practitioners. The participants were drawn from the American Medical Association’s Physician masterfile, a database of more than 1.4 million physicians, residents and medical students in the United States. Physicians received two mailings

and a phone call, with an option to complete the survey online. A $2 incentive was included in the first mailing. In response to the question “What would you like to see the federal policymakers do with the Affordable Care Act?” 15 percent of respondents wanted it repealed in its entirety. This is lower than the 26 percent of the general public that wanted the act repealed, according to a recent Kaiser Family Foundation poll. According to self-reported political party affiliations, no Democrats wanted complete repeal, while 32.4 percent of Republicans said they did. Of those who reported voting for President Trump, only 37.9 percent wanted complete repeal. The researchers found strong support for elements of the act that increased health insurance coverage:

95 percent indicated support for insurance-market regulations that prohibit insurance companies from denying coverage or charging higher prices on the basis of pre-existing conditions, a hallmark of the act. And 88 percent supported allowing young adults to remain on their parents’ plan until age 26. Additionally, 91 percent supported the provision of tax credits to small businesses that offered health insurance to employees, 75 percent supported tax subsidies to individuals to buy insurance, 72 percent supported Medicaid expansion and 50 percent supported tax penalties for individuals who don’t purchase health insurance. “What we heard is that the majority of primary care physicians are open to changes in the law but overwhelmingly opposed full repeal,” says Pollack.

Healthcare in a Minute By George W. Chapman

New HHS Secretary

The Senate recently confirmed physician Tom Price, a 12-year republican congressman from Georgia, as secretary of health and human services. Price is a former orthopedic surgeon. He will be the first physician to be the secretary in 20 years. He faced rigorous opposition from democrats because of his investments in medical device companies shortly before he introduced legislation that would kill “bundled payments” for certain joint replacement surgeries. To control costs, hospitals would be paid a lump or bundled payment (say $50,000) which would cover all costs associated with the joint replacement procedure including hospital, surgeon, anesthesiologist, knee or hip implant, physical therapy, etc. Being capped at $50,000, hospitals would have an incentive to lower costs by negotiating lower implant prices with the manufacturers. Price is an outspoken critic of the Affordable Care Act. The AMA was quick to endorse Price, hoping he could reduce the excessive regulatory burdens imposed on physicians.

Top 10 lobbyists

Last year, over 11,000 organizations spent over $3 billion lobbying the federal government. Although the lowest since 2007, experts expect the amount to increase as Trump looks to shake up the status quo on a lot of things, especially the Affordable Care Act. All the top lobbyists have some sort of stake in healthcare, be it: taxes, commercial insurance, Medicare, hospitals, device manufacturing,

drugs, physicians, research, IT or the self-employed. The top 10 lobbyist by total spending, healthcare or otherwise, are: 1. US Chamber of Commerce: $75 million. 2. National Association of Realtors: $53 million. 3. Institute for Legal Reform: $28 million. 4. Pharmaceutical Research and Manufacturers: $20 million. 5. American Hospital Association: $19 million. 6. American Medical Association: $19 million. 7. Boeing: $17 million. 8. Business Roundtable: $16 million. 9. Google: $15 million. 10. Dow chemical: $13 million.

Most promising healthcare jobs

Using data from the US Bureau of Labor Statistics, LinkedIn evaluated the jobs in healthcare based on salaries, demand, annual growth and advancement opportunities. The rank: 1. pharmacy manager; 2. project manager; 3. compliance officer.; 4. hospitalist (MD); 5. financial analyst; 6. sales director (insurance); 7. pharmacist; 8. product manager; 9. program manager; 10. regional director of operations.

Hospital facts

There are 5,564 hospitals across the U.S. That total includes: academic/teaching, community, VA, long-term care, psychiatric, drug abuse and rehab hospitals. The vast majority, 85 percent, are your basic general or community hospital. About a third of all hospitals serve rural communities. 20 percent are state owned; 59 percent are nonprofit and 21 percent are for profit. (NYS does not allow for-profit hospitals). Hospital mergers declined slightly last year. There were 102 in 2016 vs,

112 in 2015. The five largest forprofit hospital systems, based on the number of hospitals in the system, are: Hospital Corp. of America, 169; Community Health Systems, 158; Tenet Healthcare, 79; lIfePoint Health, 72 and Prime Healthcare, 44. Three of these top five are based in Tennessee. The five largest nonprofits are: Ascension, 141; Catholic Health Initiatives, 103; Trinity, 92; Baylor, 48; Adventist, 46. The average length of stay in 2015 was about five days, but that is misleading considering the different types of hospitals. The average profit or operating margin for most nonprofits is around 1-2 percent.

ACA future

At this time, it seems there won’t be an immediate repeal and replacement of “ObamaCare.” Congress is discovering the ACA is far more complex. While applauding the selection of Tom Price, five physician specialty organizations have asked congress to consider the following when they tinker with the ACA. 1. Do not increase the number of uninsured. 2. Protect the healthcare safety net. 3. Protect consumers from excessive insurance costs. (This should apply to ALL Americans, not just the 20 million covered by the ACA). 4. Maintain premium subsidies currently received by about 7 million people. 5. Protect small insurance markets.

Right to die

This highly charged and controversial topic has been brought to the forefront again by the nomination of Neil Gorsuch to the Supreme Court. He is on record as being deeply opposed to physician-

March 2017 •

assisted suicide or euthanasia. His belief is based upon the premise that all humans are intrinsically valuable and the intentional taking of another life by a private person is always wrong. Five states have passed “death with dignity” laws: Oregon, Washington, California, Vermont and Colorado. These laws allow physician-assisted death for terminally ill patients. This issue confronts physicians with a conundrum. On one hand they pledge to do no harm. On the other hand they may be forcing people to go through a prolonged and painful death. Participating in an assisted death is clearly up to the individual physician. In the meantime, Vice President Mike Pence is in favor of a “right to try” law that would allow terminal patients to receive experimental, not yet finally approved drugs.

Health information

To research just about any health issue, from A to Z, try www.health. ny.gov/healthaz www.health. ny.gov/healthaz. Being informed makes you a better partner with your physician. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. 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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Meet

Your Doctor

By Chris Motola

Anthony M. Leone, M.D.

U.S. High School Surgeon discusses why spine surgery is so Kids Abandoning complicated and why minimally invasive robotic spine surgery is the way of the future Sweetened Q: Give us an overview of your surgey isn’t like that. When you do Sodas specialty and the patients you see. surgery in someone’s spine, you have

CDC study finds daily intake of these and other sugary drinks fell to just 20 percent by 2015

here’s good news when it comes to American teens’ diets, with more high school kids saying no to sodas and other sweetened beverages, researchers say. A new report from the U.S. Centers for Disease Control and Prevention found that while just over a third of kids in grades nine through 12 drank a sweetened beverage each day in 2007, that number had fallen to 20.5 percent by 2015. Still, more can be done to help kids avoid the empty calories of sweetened sodas and drinks, the CDC team said. Despite declines in soda consumption, “intake of other sugar-sweetened beverages, including energy drinks and sports drinks, are increasing,” noted a group led by CDC researcher Caitlin Merlo. “And overall consumption of all sugarsweetened beverages, such as soda, fruit drinks and sweetened coffees and teas, remains high.” According to the report, children and adolescents get about 20 percent of their daily calories from beverages. Some of these drinks can contain nutrients such as calcium or vitamins D or C, but many “provide [only] calories with no beneficial nutrients.” Rising child obesity rates have given new urgency to messages about the health hazards of sugary drinks, and the new study suggests those messages may be getting through. In the study, Merlo’s team looked at 2007-2015 data from a large U.S. survey of youth health. Besides noting the big drop in daily intake of sugary drinks, they said that teens’ daily intake of milk also declined (from about 44 percent to 37 percent of those responding), as did 100 percent fruit juice intake (27 percent to 21.6 percent). It’s not clear what, if anything, teens are drinking instead of sodas, milk and juice, although the Dietary Guidelines for Americans currently recommends no-addedsugar beverages such as water. The decline in soda intake was seen across all subgroups — boys and girls, all races/ethnicities and all socioeconomic levels.

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A: I’m a board-certified spine surgeon. I’ve been doing it now for 22 years and have been in private practice for most of that time. My approach has always been very minimalistic; less is better. I prefer to use conservative treatments and, if those fail, use surgery if the patients’ symptoms warrant it.

Q: Traditional spine surgery has kind of an ominous reputation. What are some of the factors that, in the past, may have led to patients defering spine surgery? A: A lot of the patients that I see in Buffalo want to avoid surgery because they’ve heard of instances where spine surgery went poorly. Almost everyone around here seems to know someone who has had a bad experience. These are fairly large procedures. When you operate on someone’s joints, not to lessen that type of surgery, it’s unlikely that you’re going to make the situation worse. When someone breaks a bone, you put the bone back together and in position and, in all likelihood, the patient will be better off than before you intervened. Likewise, if you have arthritis in your shoulder, there are joint replacements that have a 95 percent chance of getting rid of 95 percent of your pain. Spine

something more like a 75 percent chance of getting rid of 75 percent of their symptoms.

Q: Why is that the case? A: The bigger the procedure, usually the bigger the risk. When you’re operating on someone’s knee, it’s usually only the knee that you have to worry about. When you operate on the bones of the spine, you have all of the nerves right in the vicinity of where you’re doing all your procedures. Many of the procedures, like fusion, are irreversible. Less is usually better with surgery. In situations where the discs are collapsed and there’s instability, those are larger procedures. That’s how I became interested in minimally invasive robotic spine surgery. Q: How does robotic spine surgery solve some of these issues? A: The minimally invasive robotic spine surgery lets you take a surgery that typically had a long recovery, a measurable amount of blood loss, a significant amount of post-op pain and turn it into something far more manageable and far less frightening for the patient. What was once done through a 7-inch incision or larger in the middle of the back, is done through a 2-inch incision. The standard way of doing a fusion from the back was a mid-line incision in the middle of the spine. You would then strip out all the soft tissues — muscle, ligaments — off the spine. And when you looked down, it was almost like looking at a model. Now we don’t have to strip the muscles off the spine. As you can imagine, that used to cause a significant amount of pain and blood loss. When you do that much trauma to the muscles they often wouldn’t ever function quite the same again.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

Q: What does the procedure look like now? A: Now, [it’s done] through a small incision. On Monday, a patient had pain in his right leg, so I went in through the right side, removed the bone where the joint is, which allows access to the disc space. Through that tiny incision, I was able to decompress the nerves, which was responsible for the leg pain. You can access the disc, remove it, and separate the bones. In his case, the

two bones had collapsed the disc space was about half what it should have been. We were able to open the disk space, separate the bones with a ring that’s called a cage. Inside the ring, you put a bone graft — which is the bone you removed on the way in because nothing gives you [better] fusion results than the patient’s own bone. Then you can program the robot to put the screws in through the same incision. Q: How are the outcomes? A: The day after the surgery, the patient’s leg pain was gone and he went home. He was on oral pain medicine and was able to get up and move around on this own. It’s still amazing for me, because I’m used to seeing people who have gotten fusions have a hard time even rolling over in bed the next day, let alone sit up, stand and walk across the room. But thanks to the enormous decrease in damage to soft tissues and the smaller incision — and being able to put the screws in through the same incision — recovery is so much better. We don’t have to strip the muscles, we just part the fibers. It also has the secondary benefit of allowing us to avoid prescribing powerful painkillers which, given the size of the opiate epidemic right now, is a good thing. Most patients are off painkillers within a couple weeks. Q: How difficult is it to become a board-certified spinal surgeon? A: The American Academy of Orthopedic Surgery is the board that certifies us. After you complete your M.D., complete your residency, take a written test, after you’ve been in practice for a few years, they pick 10 surgeries you’ve done. Then you defend your treatment of those patients, orally, to a board of your peers. Every 10 years, you take a recertification exam and show that you’re keeping up with current technology. It was in the process of doing that that I came across the robot in Chicago. At the time, I didn’t expect local hospitals would be willing to make such a large capital investment at the request of one doctor. But they saw the sense of it. Every other kind of surgery seems to be following that path, so why shouldn’t spinal surgery? In many cities every doctor doing spine surgery is using this technology. You don’t want to be the only surgeon in town doing it the old way. For patients, it’s a pretty obvious choice.

Lifelines

Name: Anthony M. Leone, M.D. Position: Orthopedic spine surgeon Principal at Dr. Anthony Spine & Surgery Orthopedic Surgery, Cheektowaga Hometown: Bronx, NY Education: University of Rochester; SUNY Upstate Medical University; Tufts University Affiliations: Has privileges at most Buffalo-area hospitals, but primarily does surgeries at Sisters of Charity Hospital. Organizations: American Academy of Orthopedic Surgeries; North American Spine Society; International Society for Minimally Invasive Spine Surgery Family: Married; one daughter; two dogs Hobbies: Fishing, traveling, weightlifting

How to be a Quitter

It’s March. How’s that New Year’s resolution to quit smoking working out? Area experts — including a former smoker — offer their best tips for ridding your life of cigarettes.

By Deborah Jeanne Sergeant From registered nurse Patricia Bax, department of health behavior at Roswell Park Cancer Institute: Decide what works for you For most people who are thinking about quitting, it usually is a precipitant, such as their health, money or family, which motivates them to make a change. Although evidence-based strategies are proven to be effective, developing a tailored quit plan can increase the likelihood of success in becoming and staying tobacco-free.” Commit to quit “Quitting is hard and there will be discomfort. Expect to make changes in your daily routine. Then design a plan before you actually try to quit and put together your own toolbox of coping strategies, to help you prepare to quit for good. Take time to write out your plan so you can monitor your progress.” Talk with your health care provider “Your doctor offers assistance and advice with your quit plan.” Set a quit date “The date you select needs to be a day when you would most likely be ready to quit. For example, some tobacco

users pick an anniversary or birthday. Whatever day you select, this is your new ‘birthday’ for the new tobaccofree you.” Enlist help “Make a list of family and friends who will support you and be sure to communicate your plan to them and how you will most need their help and support.” List triggers “These can be anything that reminds you of smoking. We pair smoking with the things we do, such as lighting up while driving or after meals. For each trigger, specify a solution that will work best for you. Keep this list handy and track your triggers so you can be ready for them when you quit. Improve your overall health “A positive step to include is an exercise plan, with your doctor’s approval.” From Lynn Kozlowski, professor of community health and health behavior in the School of Public Health and Health Professions at UB: Persist “Keep trying to quit smoking and do not expect that any one method will erase their smoking. If it does, be grateful and move on. The research shows that with multiple attempts,

Clearing the Air

Coalition in Buffalo aims to lessen damaging effects of pollution By Tim Fenster

hen residents of the north towns of Buffalo began to suspect industrial pollutants were causing cancer and other illnesses in their neighborhood, they didn’t wait around for answers from industries or government agencies. They took action. Now, some 10 years after Tonawanda-area residents formed the Clean Air Coalition, pollutant levels are down dramatically, and the worst polluters have been convicted of criminal charges. But their ongoing fight for cleaner air in Tonawanda, southern Grand Island and northwest Buffalo is far from over. The group is continuing to monitor the air and soil near Tonawanda Coke and other manufacturing plants to ensure the health of residents. “There were residents who were really sick and were concerned

that environmental pollution might have caused or impacted that,” said Rebecca Newberry, executive director of the CAC. The coalition was formed more than a decade ago when residents became concerned that area manufacturing plants were causing higher rates of cancer and other serious illnesses among those who lived nearby. They began pushing the New York State Department of Environmental Conservation to test the air, which the agency conducted from July 2007 to June 2008. Meanwhile, CAC volunteers formed a bucket brigade, using ordinary buckets with Teflontype bags to capture air samples and then sending them to the EPA for analysis.

they’ll be successful. They learn pitfalls.” Call for help “Get help with the NYS Quit line.” Separate yourself from smoking “Get the things you associate with smoking out of your house. Don’t keep a pack of cigarettes around. Don’t let people who smoke in your house. There’s no doubt if you try to quit when others in your house want to try to quit, that will be more promising for everyone.” Consider nicotine replacements. “The nicotine patch, gum and lozenge are safer nicotine sources than cigarettes. In some places where smoking isn’t permitted, smokeless tobacco is permitted. No one smokes in a fireworks factory or sawmill. Yet smokeless tobacco is commonly used by smokers in those places. If they stopped using cigarettes, that would be progress. None of these is harmless.” From Glenn Gordon, a computer programmer living in Amherst, who started smoking to fit in at age 17 in 1972. Eventually, he noticed that smoking made his chest hurt and he began coughing. It took him 30 attempts to finally quit in 1982.

Keep your mouth busy “I chewed a lot of gum and I would ‘smoke’ a straw. It gave me the physical sensation but not the nicotine or the smoke that comes with it.” Manage stress “I went away on a vacation by myself to quit smoking. I didn’t smoke the entire week. When I came back, I discovered my roommate had made a mess of my apartment. I got angry and yelled a bit. I went out to my car for a cigarette because I really wanted one. I ransacked my car because I figured I’d find one in there. I’d been smoking in it for five years. There wasn’t one. That was the moment that I truly stopped being a smoker. I stayed clean after that. I had a fair amount invested in something, so I didn’t want to lose the investment of my time and emotional battle of quitting.” It will take time for cravings to subside “There were times I really wanted cigarettes and it was 10 years before I stopped wanting cigarettes.” Think about how cigarettes affect your life. “Don’t focus on getting cancer. Focus on the overall impact of cigarettes on people’s lives. Bronchitis, circulatory damage. It has a major hit on the body above and beyond cancer. It impacts your lifestyle very dramatically.”

Benzene the culprit The studies confirmed residents’ fears: benzene, a chemical shown to cause leukemia and other illnesses, was found in unusually high concentrations in the areas tested near Tonawanda Coke. One air monitor recorded levels of benzene that were nearly 75 times the exposure standards set by the DEC. “That was a huge red flag,” Newberry said. The following year, the New York State Department of Health conducted a health outcomes review for Tonawanda and the surrounding areas. Their findings, too, confirmed residents’ fears — that occurrences of lung, bladder and overall cancers were higher in those who lived near the plants than in other parts of the state. The studies soon led to action. In December 2009, the EPA raided Tonawanda Coke, and the plant’s environmental control manager was arrested shortly after. The company was accused of using cooling towers that lacked necessary anti-pollution equipment

and of illegally disposing of toxic byproducts. The company was eventually convicted of more than a dozen violations under the Clean Air Act and fined more than $12 million. The court also ordered Tonawanda Coke to remediate soils near the plant, fund a 10-year health study conducted by the University at Buffalo and immediately change its pollution control systems. The result has been dramatic. The most recent DEC study, conducted from July 2015 to June 2016, found a 92 percent reduction in benzene levels. “We know with these lower benzene levels, fewer people will get cancer,” Newberry said. Looking forward, the CAC will continue to advocate for better pollution controls at Tonawanda Coke, aid in air and soil testing near the plants, and advocate for other Western New Yorkers who have been harmed by air pollutants. “Our role right now is to ensure the state agencies are doing their job to hold these companies accountable,” Newberry said.

March 2017 •

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Embrace the ‘Ides of March’

ften associated with Julius Caesar (and his untimely demise), the month of March has gotten a bad rap. Sure, it’s cold, it’s gray, it’s damp. But it need not be the death knell of your contentment. If the month of March is stretching out in front of you as a big, dreary void to fill, you are not alone. For many, our winter wonderland is not so wonderful when cabin fever sets in. That’s when anxiety can make an unwelcome visit. You might feel yourself spiraling down, questioning the past, and second-guessing your decisions. And that’s when you could be tempted to grab for the TV remote and head to the couch. I can remember many nights after my divorce, coming home after work to an empty apartment with hours on my hands and a heavy heart. The prospect of a long, lonely evening ahead was almost unbearable. I was fine during the day, but when the sun started to set or the weekend rolled around, I would start to panic. After way too many nights

watching mind-numbing reruns, I had finally had enough and started making better use of my “me time.” I am now much more comfortable spending time by myself and have come to enjoy my own company. In fact, it’s not unusual for me to pass on an invitation out, in favor of spending a nice quiet evening at home — relaxing or fully engaged in something I love to do. If you are challenged by time alone this time of year, consider the suggestions below. You might even clip this column and post it on your refrigerator as a handy reminder.

Read

In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely evening. Don’t know where to start? Ask a friend for a suggestion or select a New York Times bestseller. Snuggle up in a comfy, well-lit place, and let a good book introduce you to new

KIDS Corner 8 Ways to Boost Your Child’s Immunity

o magic elixir can prevent children from developing occasional colds and viruses, but takings steps to boost their immune system can minimize their chances of catching every bug that winds its way through the daycare center or school. “The immune system helps us fight infections,” says family medicine specialist, physician Palak Shroff, University Hospitals Family Medicine in Painesville, Ohio. “Immunity develops over time, so the more someone gets exposed, the more the immune system develops. Kids’ whole environment is new, but over time, their immunity will develop and get better.” Page 8

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According to Shroff, parents can take eight steps to boost their child’s immunity, including: Breastfeed. Boosting a child’s immunity should begin on day one with the first feeding. Breastfed babies benefit from several days of carbohydrate-, protein- and antibody-rich colostrum followed by a year or so of regular breastmilk. “During breastfeeding, the mother’s immunity transfers to the child,” Shroff says. Vaccinate. Making sure kids receive all recommended vaccines is one of the best ways to prevent them from catching potentially dangerous illnesses, such as pertussis (whooping cough),

people, new places, and new ideas. We rarely feel alone when reading. I just finished “The Boys in the Boat” by Daniel James Brown and highly recommend it.

Write

Marcel Proust wrote, “We are healed of a suffering only by expressing it to the full.” Even if you never look back at what you write, the act of committing thoughts and feelings to paper is therapeutic. Consider starting a journal, if you haven’t already done so. A few minutes in the evening or on the weekend is a perfect time to write. As you work through some of the issues associated with living alone, and you become more content, you will find that reading and rereading your journal entries will be a great way to see how much progress you are making.

Clear Out the Clutter

I know this might sound uninspiring, but clearing out the clutter can be very satisfying and a great way to spend a few hours alone. I spent one recent Tuesday night sorting out my closet and filling two bags for Volunteers of America. It felt terrific. I not only lightened my load, I did something for a good cause. As a result, I felt part of something bigger than myself and less alone.

Pursue a passion

This can be daunting, especially if you’ve yet to identify your passion, but hang in there. Many men and women in long-term relationships often lose sight of their own interests in favor of attending to the needs of others. The pursuit of your own passions or personal pursuits can be lost in the process. Now is a good time to rediscover your “loves” and to dedicate your time alone to those pursuits. Do some digging and identify the things you loved as a child or

measles, mumps, hepatitis, chicken pox and others. “All children over 6 months of age should get a flu shot,” she says. “Sometimes small kids get the flu and that develops into pneumonia, then they struggle to get better for a long time.” Nourish them well. Feed kids a balanced diet filled with fruits and vegetables. The antioxidants, vitamins and minerals abundant in produce are essential to boosting the immune system. Promote good sleep habits. When kids (and parents, too) aren’t well-rested, their bodies lose their natural defense mechanisms and don’t fight off illness effectively. Exercise. Encourage kids to run around the back yard or participate in team sports. Physical activity promotes better blood circulation and helps the lungs and heart work better, which in turn, boosts immunity. Practice good hygiene. Staying clean lessens the threat of contracting an infection. Encourage kids to wash their hands after using the bathroom or before eating, cover their mouth when they cough and never share their toothbrush. Make sure to replace their toothbrush following a bout of

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

3. 4. 5.

young adult, then make a conscious decision to revisit those things now. Evenings or weekends spent doing what you love can be very fulfilling. Loneliness can dissipate and you can feel alive again.

Reach Out

With time on your hands, you are in a great position to reach out and make connections with others, including long lost friends. This can be a very meaningful way to spend an evening. Just yesterday, I received an email from a former colleague. I was very touched, and accepted her kind invitation to get together with her and a few other retired co-workers. So, pick up the phone, send an email, or send a snail mail note to someone with whom you’ve lost touch. Chances are you’ll be rewarded with a warm reunion.

“Veg out.”

That’s right, veg out. Grab the TV remote, a pint of ice cream, and head for the couch. Do it without guilt; do it without beating yourself up. Everyone is entitled to an occasional night when they just hang out, do nothing, and eat junk food. Indulge yourself and tell yourself you deserve it. Wake up the next morning — free of remorse — and ready to take on the day: alone at home and “at home” with yourself, even in the Ides of March.

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, NY. For information about her Living Alone workshops or to invite Gwenn to speak, call 585-624-7887 or email: gvoelckers@rochester.rr.com. strep throat. Shield them from secondhand smoke. Any allergen will worsen a child’s immunity, and secondhand smoke is no exception. Kids who are exposed to cigarette smoke on a regular basis tend to develop respiratory infections. Don’t rely on antibiotics. All upper respiratory illnesses, including most coughs and colds, are viral. That means they won’t respond to antibiotics, so don’t pressure your doctor to prescribe them. When antibiotics are overused, bacteria develop resistance to them. So, if your little one catches a bacterial illness that would normally be treated with an antibiotic, the drug may not work. Your best bet is to let most viral illnesses run their course your child will get better and further develop immunity. It’s important to remember that gardenvariety colds, strep throats and occasional viruses are a normal part of childhood — and a necessary means of building your child’s immunity. But if you think your youngster is falling ill more often than other kids, it’s time to check in with the pediatrician.

7. 8.

Owner of Eat Right Foods Luke Bright (left) and Mike Delzoppo (right) donating $2,630 to Roswell Park Cancer Institute for breast cancer research.

Not Time to Cook? A Cheektowaga Meal Company Can Help Eat Rite Foods specializes in preparing fresh food. Owners claim they prepare 5,000 meals a week By Tim Fenster

et’s not mince words: eating healthy is hard work. Not only hard work in willpower and sacrifice, but also in grocery shopping, label reading, cooking, dishwashing, packaging in Tupperware, followed by more dishwashing. That is why, over the last few years, a growing market for food prep services has emerged locally. Luke Bright, co-owner of Eat Rite Foods in Cheektowaga, says his company offers food that’s fresh, not frozen, and customized both to customers’ tastes and dietary goals. “I’ve yet to see another company do what we do,” Bright said. “More times than not when you order from Nutrisystem, Weight Watchers or other regional companies, you get a box [and] have no idea what comes in this box. It’s like a surprise when you open it.” At Eat Rite Foods, customers can select whatever meals they fancy from 10 breakfast, lunch and dinner options that rotate weekly. What’s more, if one desires the spicy garlic chicken without a side of broccoli, or wants a couple extra ounces of sirloin steak; not a problem. Customers can purchase however many meals they want per week, though customers may also purchase monthly plans. Meals consist of close to 350 calories, and 4 ounces of protein (though customers can add more to their meals for an added charge). “We do some custom-tailored meals for people who want to bulk up,” Bright said. “But our everyday customer is someone who just wants to eat better, feel better and look better. I would say only 5 percent of our customers is an athlete.” Meals can be picked up every Sunday and Thursday. Bright says they always prepare the food the day before — from their location at 3525 Genesee St., Cheektowaga. Customers who live within a 30-mile radius can instead have their food delivered for an added $10 charge. “More times than not the meals come frozen from other companies,”

Eat Right Foods prepates 5,000 meal a week, according to its owner. Shown are some of the dishes they offer: Baked lemon lime haddock meals and chipotle sirloin steak.

said co-owner Mike Delzoppo. “We pride ourselves on freshness. It’s always cooked before the day you get it [and] guaranteed five days fresh in the fridge.” So far, their approach appears to be catching on. Less than a year after opening, they have grown from sales of about 200 meals per week to 5,000, the owners said. It’s a tremendous growth for two fitness buffs who, less than a year

ago, were working factory jobs at the DuPont Manufacturing Plant in North Tonawanda. They may never have entered the emerging field had it not been for an announcement they received in December 2015 that the plant would be closing within a year. So Delzoppo, a longtime personal trainer and competitive bodybuilder, and Bright, an avid-gym goer and amateur chef, decided to put their skills together. They knew meal-prep services had proven popular in cities like Los Angeles, New York and Miami for years, and felt the local demand for such services was growing. “Shortly after that, we started devising this plan. It seemed like a market that was growing and something that we could do well at,” Bright said. They quickly managed to secure a lease on a former tavern near the intersection of Genesse Street and Union Road, and began advertising through friends and family, gyms and workplace visits, and most effective of all, social media. In two months they had grown their orders 10-fold, from 200 to 2,000 meals per week. Their rapid growth has allowed them to bring on two chefs who design and prepare the meals with input from Bright. They also are moving ahead on plans to relocate to Tonawanda Road in Kenmore, noticing a higher demand and lower competition in the north towns. The new space will include twice as much floor space, about 4,500 square feet total, and will allow them to quadruple their production capacity, from 5,000 to 20,000 meals per week. “In January, we just ran with the idea, got this place, started putting out orders. Then soon after that it just kept getting bigger and bigger. It was like, holy crap, this is actually happening,” Bright said. For more information on Eat Rite Foods, visit www.eatritefoods716.com.

March 2017 •

before anything else, we’re all human rethink your bias at lovehasnolabels.com

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SmartBites

The skinny on healthy eating

Go Crazy for

Cantaloupes S

ome fruits are so fragrant and cubed cup) more than meets our daily luscious and yummy that we needs for vitamin A. don’t think twice about their Vitamin C seekers will be thrilled nutritional value. For many, including to know that a cup of cantaloupe me, a cantaloupe is just that sort of boasts nearly 100 percent of our daily fruit. Oh, to sink your teeth into that needs. Vitamin C, which contributes to sweet juiciness: Who can blame us collagen synthesis and development, for forgetting that it’s a nutritional plays an important role in wound powerhouse? healing and in maintaining healthy, Orange-fleshed cantaloupes are resilient skin. (Wrinkles, watch out!) excellent sources of beta-carotene, And although this immune-boosting which the body then converts into vitamin can’t prevent colds, vitamin A. Essential for growth and research has revealed healthy vision, vitamin A helps that loading up on maintain the immune this nutrient may system and also acts help shorten the as an antioxidant, time you’re sick and protecting our cells reduce the severity of from free radical your symptoms. damage. A study by the Potassium-rich National Eye Institute cantaloupes are great showed that certain for hearts. A must-have antioxidant mineral, v i t a m i n s Some fruits are so fragrant and luscious and yummy potassium (A,C, E) and that we don’t think twice about their nutritional helps trigger zinc helped value. For many, a cantaloupe is just that sort of your heart to slow the fruit. to squeeze progression b l o o d of advanced macular degeneration by through your body. It also helps your about 25 percent over a six-year period. muscles to move, your nerves to work, An average serving of cantaloupe (one and your kidneys to filter blood. While

Savory Cantaloupe Salad with Feta and Basil ½ cantaloupe, seeded and cut into bite-size cubes 1 cup cherry tomatoes, halved 1 garlic clove, minced ¼ cup minced shallots 1 small jalapeno or Fresno chile pepper, seeded and finely chopped (optional) ½ cup fresh basil, chopped or cut into slivers Zest from 1 lime 1/3 cup crumbled feta or goat cheese 2 tablespoons lime juice 1 tablespoon olive oil ½ teaspoon kosher salt ¼ teaspoon coarse black pepper ½ cup slivered almonds, toasted In a large bowl, combine the cantaloupe, cherry tomatoes, garlic, shallots, jalapeno or Fresno pepper (if using), basil, lime zest, and crumbled cheese. Gently mix. In a small bowl, whisk together the lime juice, olive oil, salt and pepper. Pour over the cantaloupe mixture and toss lightly. Garnish with toasted almonds and serve immediately. To toast almonds: Preheat oven to 350 degrees. Place almonds on a baking sheet and bake for 7 minutes.

Got a Cancer Diagnosis? A Good Diet is Crucial Roswell oncology dietitian: “There is strong evidence suggesting that a healthful diet, rich in a variety of vegetables, fruits, whole grains and legumes or beans, and low in red and processed meat can fight cancer” By Tim Fenster

ost everyone knows that a good diet, when part of a healthy lifestyle, can reduce your likelihood of developing some forms of cancer. But should that dreaded diagnosis come, maintaining a nutritious and healthy diet will be more important than ever. Rachel Simson, a clinical dietitian with Roswell Park Cancer Institute, says research has shown that people who eat healthy and maintain a healthy weight tend to have fewer Page 10

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complications and a better quality of life during treatment. “There is strong evidence suggesting that a healthful diet, rich in a variety of vegetables, fruits, whole grains and legumes or beans, and low in red and processed meat can fight cancer,” Simson said. “This general pattern of eating provides v i t a m i n s , minerals and phytochemicals that can help to defend the body against cancer and other diseases.” A good diet is crucial whatever the type of cancer, Simson added. However, both the type of cancer and the method of treatment can cause varying side effects, such as loss of appetite, nausea,

Simson vomiting, constipation, diarrhea, mouth sores, taste alterations, or smell sensitivities. Often patients who are undergoing chemotherapy for a neck or head cancer will have difficulties swallowing. It’s a clinical dietitian’s job to help patients maintain a full and healthy diet in spite of these challenges. “An important part of what oncology dietitians can do is suggest foods that are likely to be best tolerated for a given individual,” Simson said. “Adequate calories and protein are important to optimize nutrition during treatment, and that’s another important element we pay close attention to.”

Consider the whole picture

Of course, appetites are not the only factors to determine a diet.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

potassium doesn’t treat or prevent heart disease, it does help control blood pressure and also enables your heart to beat in a healthy way. An average serving of cantaloupe has about as much potassium as a banana. Nutritious cantaloupes are low in fat, cholesterol, sodium and calories (about 50 per cubed cup), and offer a modest amount of fiber: 6 percent of our daily needs. As for sugar, it has less than a banana, more than strawberries and about the same as a peach.

Helpful tips

Select a cantaloupe that feels full and heavy. Ripe cantaloupes sound dull (not hollow) when you tap the rind with your finger. Smell the end opposite from the stem end: it should smell fragrant, but not overpowering. Store your ripe cantaloupe in the refrigerator for three to four days; cut cantaloupe should be eaten within three days. Unripe cantaloupe can be left out at room temperature for a couple of days to soften. Cantaloupe needs to be washed before slicing because the skin can harbor harmful bacteria; but wait to wash it until just prior to cutting.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com. That is why Roswell dietitians also have to take into account a variety of lifestyle factors — a person’s tastes, living situation, and access to grocery stores. “Does the individual live alone? Do they cook for themselves? Do they have access to a grocery store? Do they need Meals on Wheels? All these factors will ultimately affect a patient’s dietary needs and nutritional status,” Simson said. Dietitians also must take into account a patient’s personal knowledge of nutrition. Many patients at Roswell are well informed and interested in nutrition, but naturally there are others who know a good deal less about healthy eating. The importance of nutrition does not end with remission, or a cancer-free declaration for that matter. The American Institute for Cancer Research recommends cancer survivors follow the same dietary recommendations it offers for reducing the risk of cancer — lots of vegetables, fruits, whole grains, legumes, and less red and processed meat. Although nutrition is crucial to fighting cancer, it is not a cure all. Some alternative cancer treatments promise that a certain diet — commonly an allraw diet — can cure a person’s cancer. Simson said patients should have a more holistic view of nutrition’s role in fighting cancer. “There is no one single food or combination of foods to prevent or cure cancer. If strawberries cured cancer, everyone would eat them and no one would have cancer,” Simson said. “It’s the variety of healthy foods — fruits, vegetables, whole grains and legumes — that evidence shows to be associated with good health and risk reduction.”

Things You Need to Know to Prevent Addiction in Children

By Ernst Lamothe Jr.

ddiction of any kind can ravage an individual and a family. It can come at any time and be triggered by anything from family history to personal demons. However, it is not insurmountable. Physician Richard D. Blondell, professor of department of family medicine in the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo and a physician with UBMD, specializes in addiction medicine. He provides care to patients as they withdraw and stabilize from drug or alcohol addiction at Erie County Medical Center and Terrace House at Horizon Health Services. Here are five things Blondell believes patients should do to prevent addiction in their children.

Learn about your family history and risk of addiction.

Whether a person decides to use alcohol or drugs is a personal choice, influenced by multiple biological, familial, psychological and sociocultural factors. Numerous scientific studies reveal that alcohol and drug dependence runs in families, according to the National Council of Alcoholism and Drug Dependence. “Alcoholism and drug addiction have a genetic component,” said Blondell. “This risk may be passed along to children. Teenagers and preteens need to know about their genetic risk that may increase the

chances of developing alcoholism or drug addiction. The children should be taught to never even begin to take that first drink or experiment with that first drug.” Blondell believes all young people should wait until the age of 21 before taking the first drink.

Limit the use of narcotic painkillers.

In an attempt to help slow the prescription drug abuse epidemic, the U.S. Food and Drug Administration this year announced that immediate-release opioid painkillers such as oxycodone and fentanyl will now have to carry a “black box” warning about the risk of abuse, addiction, overdose and death. Prescription opioid painkillers are divided into two main classes — extended release, which have more pain-killing opioid per dosage, and immediate release, which have less opioids, but need to be taken more frequently. Ninety percent of opioid prescriptions are for immediate-release painkillers, according to the FDA. “Even one time use of an opioid painkiller before the age of 17 will increase the risk of developing an addiction by 33 percent in later life,” said Blondell. “When given a prescription for an opioid pain killer, parents should ask the dentist or physician about non-addictive alternatives, especially if there’s a family history of alcoholism or drug addiction.”

Richard D. Blondell specializes in addiction medicine. He provides care to patients at Erie County Medical Center and Terrace House at Horizon Health Services.

Supervise medication use

Painkiller overdose deaths have become a national epidemic. The US Attorney General stated that the growing number of deaths from prescription painkiller overdose is an urgent and growing public health crisis. The agency said 45 people die every day from narcotic prescription painkiller overdoses — more deaths than heroin and cocaine overdoses combined. “If an opioid painkiller is truly needed for a severe painful condition, it should be given at the lowest possible dose for the shortest duration. Parents should control the bottle of medication, and it should not be given to the young person under any circumstance,” said Blondell.

Dispose of unused medication.

The following guidelines were developed to encourage the proper disposal of medicines and help reduce harm from accidental exposure or intentional misuse after they are no longer needed: • Follow any specific disposal instructions on the prescription drug

labeling or patient information that accompanies the medicine. Do not flush medicines down the sink or toilet unless this information specifically instructs you to do so. • Take advantage of programs that allow the public to take unused drugs to a central location for proper disposal. Call your local law enforcement agencies to see if they sponsor medicine take-back programs in your community. Contact your city or county government’s household trash and recycling service to learn about medication disposal options and guidelines for your area. “Unused medication is one of the biggest contributors to the initiation of an addiction. Many police stations will accept unused medications as do some pharmacies,” said Blondell.

Learn about alcoholism and drug addiction.

Blondell said government websites run by the National Institute of Health provide a wealth of information to the layperson. Also, organizations such as Alcoholics Anonymous or Narcotics Anonymous have information available online and in print form that can be helpful. For more information on addiction, here are a few video links suggested by Blondell • Understanding addiction as a disease https://vimeo.com/72731647 • Drugs destroy families (for parents) https://vimeo.com/101824215 • I am the face of addiction (for parents) https://vimeo.com/90664021 • Consumer reports video http://www.consumerreports. org/cro/video-hub/3705124027001/ • NIH video: Anyone Can Become Addicted to Drugs (general info) www.youtube.com/watch?v=SY2luGTX7Dk • NIH Video: Why are Drugs so Hard to Quit/ (general info) https://www.youtube.com/ watch?v=zV6zKmt7S5E

What readers say about In Good Health Comments from readers who recently signed up to receive In Good Health: “Great paper.” about medical treatments. This is Dr. Edwin Mirand, Buffalo a perfect paper for me.” Tim Woodman, North Tonawanda “I gain a lot of knowledge about health by reading In Good Health. Also love the recipes in “Interesting articles” the SmartBites column.” Pauline Albino, West Seneca Bridget Block, Lackawanna “Great articles on health-related “All articles are very issues. informative and well written.” Chelsea Oberkeiser, South Eleanor Kimmick, Whales Cheektowaga “I personally find the articles “I like reading about health relevant and easy to read.” issues, and being informed Mary Oksman, Hamburg

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March 2017 •

in good Physicia of the Ye n ar Mar

y Katherin e Kolbert, a Hamburg primary care physician, is Lifetime Health’s physician of the year . The Physical Therapy Solution to Back Pain

When Your Spouse Has ADHD Should Med School Go to Three Years? Yep, it’s not just your impression. Prices of generic drugs are going up

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Men’sHealth

How Common is Prostate Cancer?

Todd Baxter: ‘My Battle with Prostate Cancer’ By Lynette M. Loomis

odd Baxter is a 27-year veteran of local law enforcement and also served three years of active duty with the US Army. He is the executive director of Veterans Outreach Center, a nonprofit organization that provides services to veterans within a 14-county area that includes Erie and Monroe counties in Western New York. Baxter continued his military service with the US Army Reserves for another 19 years before retiring as a master sergeant, brigade antiterrorism NCO. He is a guy’s guy so to speak — he also is a prostate cancer survivor. “Guys talk about sports, business and our kids. But we usually don’t talk about personal health issues,” he said. “I can’t recall a single conversation I ever had with a friend about prostate cancer. “The only man who spoke to me about it? My doctor during a routine physical. Dr. Charles Courtsal [of Rochester] pointed out that while they were taking blood samples anyway, one more test wasn’t a big deal.” The extra test proved to be crucial in Baxter’s life — it was in fact a big deal. It turned out that Baxter was diagnosed with prostate

cancer last September. “I was emotionally devastated. I kept the news from my wife and two boys as long as possible as I did not believe it could be true. I work out all the time and am considered pretty fit, so my sons couldn’t really process that while I looked fine, I had cancer. It was not an easy conversation but a lot easier than the conversation my wife would have had with them if we hadn’t caught this in time. I in no way saw myself as a cancer victim.” The procedure to remove his prostate in November took about four hours. The recovery was difficult, taking about four weeks. “Once they got in there, they found that the cancer had spread. Our blessing is that the surgeon, Dr. Jean Joseph [of University of Rochester Medical Center], was able to remove all of the cancerous cells.” Baxter was able to return to work part-time and then returned to full time after another two weeks. Two months after surgery he and his son Zac completed a 5K race. “It was a personal goal, to prove to myself and my sons that obstacles can be overcome,” Baxter said. Now his goal is to have as many men as possible hear about the early warning testing and how it saved his life.

Todd Baxter is a prostate cancer survivor. “Guys, go get the test done. It’s a lifesaving test and most of us don’t realize we need to do it. Like me, most men procrastinate going to the doctor. This is a good opportunity for me to share the burden that got placed on me and make it a positive thing.” Baxter feels grateful. “Faith and family, especially my beautiful wife Mary, have carried me through.

Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society’s estimates for prostate cancer in the United States for 2017 are: • About 161,360 new cases of prostate cancer • About 26,730 deaths from prostate cancer • About one man in seven will be diagnosed with prostate cancer during his lifetime. • Prostate cancer develops mainly in older men. About six cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66. • Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. Source: American Cancer Society.

Amazing medical professionals have done their job with expertise. Now, continued prayers for clean blood tests are invited as I will be evaluated in in late winter. I will live a healthy positive life and I, now more than ever, will evaluate what is really important. “I now see myself as a cancer survivor. Guys, I can’t say it often enough. Talk to your doctor. Get the PSA test. Live.”

Identifying Aggressive Prostate Cancers Roswell researchers developing genetic testing to establish if prostate cancer is slowgrowing or fast-growing. Test to help patients, doctors to determine cancer treatment. By Deborah Jeanne Sergeant

rostate cancer is one tricky cancer. Men with prostate cancer may have a tumor that doesn’t grow or spread quickly. In this case, a waitand-see option may be favorable over prostatectomy, which can cause side effects like incontinence and impotence. But other men have aggressive tumors that spread to other areas of the body rapidly. Surgery or followup cancer treatments can give them the best chance at save their lives. Telling the difference between slow-growing and fast-growing and recurring tumors has relied mostly on prostate-specific antigen (PSA) testing. But soon, genetic testing may lend a hand. Factors other than prostate cancer can elevate the PSA level. Obesity and other factors can abnormally lower PSA levels. Various factors can skew PSA testing, resulting in false negatives or false positives. Researchers with Roswell Park Page 12

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Cancer Institute in Buffalo, led by Irwin H. Gelman, Ph.D., have identified the 11-gene signature linked to advanced, recurrent prostate cancer. Once they establish the gene signature’s predictive value, they can perform a biopsy to give men and their doctors more information to make what is often a life-altering decision. Gelman directs Research Integration and serves as a distinguished professor of oncology, along with chairing the Cell & Molecular Biology Academic Program. He also directs shRNA Core Resource at Roswell Park Cancer Institute. “The signature is based upon trying to predict early on whose cancer might recur,” Gelman said. “The research is to look at tumors, or human cell lines which recapitulate this recurrence type of disease and then trying to find out genetic gene signatures that align with a recurrence versus a primary disease.” Men with family history of prostate cancer are more likely to

have a more aggressive prostate cancer, which makes such testing even more meaningful. Gelman and his team hope to start a clinical trial to confirm that the gene signature can accurately predict which tumors will spread and recur and which ones won’t. For those with recurring tumors, treating with drugs that attack the gene signature can disrupt the cancer’s mechanism and “decrease significantly the recurrence of the disease,” Gelman said. “Hopefully, it will become a predictive marker to figure out who’s at higher risk and develop and test to decrease the incidences of occurrence.” The team has a few ideas of drugs that could be useful in preventing recurring prostate cancer, and hope to complete a trial in a few years. William Phelps, PhD, works with American Cancer Society-funded researchers as vice president of Extramural Research in Atlanta, Ga. He said that the question of whether a tumor is slow growing

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

or fast growing “is certainly one of the critical questions that physicians don’t have a tool to answer. “People’s perception of cancer can be, ‘Just get it out of me.’ But if they want to wait and see, it is absolutely a critical question if their cancer will grow quickly and the field needs this as a prognostic and diagnostic tool.” Bill Krellner leads the Buffalo chapter of Us Too, a prostate cancer support group. He said that identifying aggressive cancers is important. “A man can see if he needs treatment and how much time he has before seeking treatment if he needs it. He can delay or forgo surgery and its side effects.” Krellner added, “I’ve been a chapter leader for over 10 years and I’ve seen so many men who have been over treated and have to go through incontinence and erectile dysfunction and they may not have needed radiation. “Absolutely ask your doctor. I don’t think every doctor is on board. Seek a second opinion. These tests

Men’sHealth

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Answers for men with low testosterone By Deborah Jeanne Sergeant

vague collection of symptoms afflicting men mid-life may signal low testosterone levels. The hormone is responsible for many bodily functions and can cause a variety of unwanted symptoms. Scott Leuthe, nurse practitioner and owner of Alembic Wellness in Depew, said that treating low testosterone is based upon the individual, but replacement therapy offers one answer. First, Leuthe discusses patients’ diet and exercise. “Getting in better health won’t be a 100-percent fix, as there are other reasons for low testosterone, but men at this point in life are busy. Their diet isn’t what it used to be and they get trunk obesity, which lowers their testosterone level.” While decreased testosterone starting at age 40 to 45 is normal, carrying additional weight and forgoing exercise exacerbates the problem, since staying lean and maintaining muscle mass promote testosterone. After helping the patient improve other lifestyle factors, Leuthe looks at testosterone replacement. “Many insurance companies won’t cover this unless it’s extremely low,” Leuthe said. He completes a health history with patients, and performs a blood test to ensure that low testosterone is the culprit behind their symptoms. Other issues, such as endocrine system problems may be to blame. If it’s low testosterone, Leuthe prescribes testosterone replacement to bring it up to a normal level. “They have more energy, sexual drive, and a better mood and sense of well being,” Leuthe said. “They have more energy to exercise and have better sex. It brings youthful exuberance.” While the link between testosterone replacement and an increased risk of prostate cancer has been largely disproven, other concerns surround testosterone replacement, such as its effects on the environment. “The FDA doesn’t like testosterone replacement for a number of reasons,” said physician Matthew Davis, medical director of Rochester Clinical Research. “It gets into the waste stream. It can negatively affect women who come in contact with it. It’s a drug that has a fair amount of abuse associated with it as far as

sports. The FDA is pushing to get drug manufacturers to help men with low testosterone without giving them testosterone.” Davis said that his organization is studying the effect of blocking an enzyme in fat cells to block the conversion of testosterone to estrogen. “Especially in middle-age men who are fairly overweight, this blocks that conversion,” Davis said. “That’s fairly exciting.” The study is in a fairly early phase. So far, researchers have found that by boosting the testosterone into the normal range, it helps with the symptoms like metabolism, bone mineral, muscle mass, mood disorders, low energy and libido. Instead of introducing outside testosterone to the body, the medication would help the body generate its own. Davis said that the new therapy is four to five years away from submission to the FDA for approval. “It is an exciting area,” Davis said. “There are a lot of other things coming along with low testosterone that aren’t replacement therapies. this is the tip of the iceberg.”

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Symptoms of Low Testosterone Scott Leuthe, nurse practitioner and owner of Alembic Wellness in Depew, listed the symptoms of low testosterone as: • Irritability or unexplained negative mood • Loss of motivation • Anxiety or increased pessimism • Increased fatigue, low energy • Diminished sense of well-being • Difﬁculty concentrating and lack of focus • Forgetfulness and loss of memory • Feeling that you have passed your peak • Insomnia or poor sleep • Joint pain • Lacking desire (low libido) or pleasure in sex • Decreased ability to perform sexually • Erections that are less strong

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Men’sHealth

Colon Cancer Screening at Home

Colonoscopy remains the gold standard, but home screening is an option for low-risk people, experts say By Deborah Jeanne Sergeant

s a general rule, most people 50 and older should receive colon cancer screening. But the liquid diet and laxatives required for colonoscopy, followed by an exam that can include sedation and a rectal probe, deters some people from receiving the lifesaving screening. Colon cancer is a largely preventable cancer since colonoscopy can detect pre-cancerous polyps and include remove of them. Current compliance with colon cancer screening is about 50 percent nationwide — but home colon cancer screening kits may change that. Available since about five years ago, the fecal immunochemical test (FIT) screening involves taking small fecal samples at home. Users do not need to make dietary changes in advance or perform the test at a doctor’s office. They simple mail in the samples and await the lab results. The test looks for blood in the stool, a common sign of polyps. When stool leaves the body, it tends to bump into polyps, which resemble large grapes on a stem. When polyps move, they often bleed a little. Though the blood is often invisible in the stool, the test can detect it, along with other evidence of colon cancer. “Any test is better than no test,” said Michael Sapienza, president and CEO of Colon Cancer Alliance in Washington, DC. “The colonoscopy is the gold standard, but you have to look at the actual number of people who will do the test.”

One of the disadvantages of the FIT is that it must be repeated annually. People with average risk of colon cancer need return for a test every decade after their initial test shows no polyps. A person whose FIT comes back with questionable findings must proceed with a colonoscopy at that point. Those who receive colonoscopy can have polyps removed before they awake from sedation. “Normally, this is a disease affecting people over 50, but over the past two decades, we’re seeing a 2 to 3 percent increase every year in people who are younger and being diagnosed with colon cancer,” Sapienza said. “But screening is only covering people over 50. If you have cramping, night sweats, change in the size of stool, or blood in your stool, ask for a screening.” Most people should begin screening at age 50, unless they have a first-degree relative diagnosed with colon cancer under the age of 50. In that case, the patient should begin screening 10 years before the age of their relative at the time of diagnosis. Blacks should begin screening at 45, and people with bowel issues such as irritable bowel syndrome, colitis, or diverticulitis. “Talk with your doctor,” Sapienza said “There are a lot of things that could potentially make you a candidate to go in earlier.” If you lack sufficient insurance to cover the cost of colonoscopy or other screening method, community

organizations may help, such as Cancer Services Program of Erie County. Michelle Wysocki, program coordinator, said that the organization offers free FITs for people of average risk. “There was a home collection kit that required change in diet and a lot more effort,” Wysocki said. “It was a tough sell and hard to get the kits returned, because people found it hard to do. FIT doesn’t require a change in diet. It’s more readily accepted by people who don’t even want to hear about colonoscopy. It’s effective and readily acceptable.” Rather than offer only colonoscopy, the most costly screening, the FIT can save money on the majority of people who won’t need polyps removed. Wysocki said that only roughly 10 percent of participants using the FIT must come back for a follow-up colonoscopy, and not all of those have colon cancer. “Why put them all through the more invasive and costly test?” she said. “Colonoscopy is a medical procedure. It has its place and is the gold standard of screening but there are other tests.” In Erie County, the Cancer Services Program offers cancer screenings, including the FIT, for those who have limited or no health insurance. The organization also distributes free FITs to anyone on select days at Tops stores throughout the county.

Free Colon Cancer Home Screening If your insurance won’t sufficiently cover colon cancer home screening, visit Tops in March to pick up a free FIT from 4 to 7 p.m. on one of the dates below:

Alden

12775 Broadway March 22

Buffalo

1275 Jefferson Ave. March 7 425 Niagara St. March 8 1740 Sheridan Drive March 16 3500 University Plaza March 9

Depew

4777 Transit Road March 23

East Amherst

9660 Transit Road March 28

Hamburg

S. 6150 South Park Ave. March 21 Orchard Park 3201 Southwestern Blvd. March 14

Tonawanda

150 Niagara St. March 29 890 Young St. March 15

West Seneca

355 Orchard Park Road March 30

Obese Couples May Take Longer to Conceive His weight appears to affect pregnancy success, too, study finds

t’s not just a woman’s weight that matters when couples are trying to conceive, a new study suggests. When a woman and her partner are both obese, their chances for pregnancy during any menstrual cycle are about half that of a normalweight couple, according to the analysis from the U.S. National Institutes of Health. “It translates to maybe a longer time to get pregnant,” said lead study author Rajeshwari Sundaram. She is a senior investigator at the U.S. National Institute of Child Health and Human Development, a unit of NIH. Prior studies show an association between female obesity and reduced Page 14

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odds for pregnancy in a single menstrual cycle, as well as a link between men’s increased body weight and lower sperm count, the researchers noted. This study breaks new ground because it enrolled couples hoping to get pregnant, not couples undergoing fertility treatment. Measurements of body fat were taken before they conceived, and the researchers followed each couple for a year or until a pregnancy occurred. Lauren Wise, professor of epidemiology at Boston University School of Public Health, said, “This study represents an important contribution to the literature on couples’ body size and fertility.”

Wise, who was not involved in the study, said its strengths include use of more than one measure of body composition and fertility over multiple menstrual cycles. The researchers also controlled for physical activity, a key factor, she added. However, they did not take couples’ diets into account. The findings, Sundaram said, are representative of reproductive-age couples in the United States. A total of 501 couples from Michigan and Texas joined the study from 2005 to 2009, as they were ready to try to get pregnant. Infertile couples were excluded. The women ranged in age from 18 to 40 and the men were over 18.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

The researchers interviewed each partner to gather data on lifestyle, habits, and medical and reproductive history. Couples completed daily journals on lovemaking, and women recorded their menstrual cycles and pregnancy test results. Nurses weighed each participant and measured their height as well as their waist and hip circumference. Height and weight were used to calculate body mass index (BMI), an estimate of body fat. People with a BMI of 30 or higher are considered obese. Researchers divided the obese couples into two groups: BMIs of 30 to 34.9, and BMIs of 35 and over.

Team of chiropractors at Amherst Chiropractic: Zach Kashevaroff, from left, followed by Chelsea, Elizabeth and Tom Lyons. The Lyons have been in business for 30 years. Daughter Chelsea recently joined the business.

Husband-Wife Team: 30 Years Working Together as Chiropractors Couple excited their adopted daughter has joined the practice, also as a chiropractor By Tim Fenster

or the past 30 years, the Lyons family has worked to relieve Western New Yorkers’ chronic pain and discomfort at Amherst

Chiropractic Associates. And it’s looking as though they may continue for decades more. That’s because Tom and

Elizabeth Lyons, who started the practice at 1622 Hopkins Road in November 1986, recently brought on their adopted daughter, Chelsea Lyons, who has long dreamed of following in her parents’ footsteps. “I think I heard Chelsea say she wants to be a chiropractor when she was in second grade,” Tom said. Unlike Chelsea, neither Tom nor Elizabeth grew up with dreams of working in chiropractic, or even in medicine at all. After high school, where the then-East Side couple met, Tom found work as a draftsman, and Elizabeth worked as a pulmonary doctor at Mercy Hospital, having received a degree in medical assisting from Erie Community College. But soon Tom grew tired of his job and sought new employment. He had long been fascinated at how his own chiropractor, Dr. Grankowski, was able to relieve the headaches he suffered as a child and thought it may be a viable career path for himself. “He talked to his chiropractor that he went to as a young person, and always was amazed that he felt better and didn’t take any medications,” Elizabeth said. After researching various schools with chiropractic programs, he settled on Northwestern Health Sciences University in the suburbs of Minneapolis, Minn., in part because he felt it would be easier for Elizabeth to land a job in such a large metropolitan area. “I had no intention at first of going to chiropractic school,” Elizabeth said. “But when he started, the students and their spouses could go to the school clinic. I started to feel

March 2017 •

better; I had less headaches. And I kind of said, ‘Hey, I would like to do this, too.’” Tom urged her to attend, pointing out that it would be easier to attend school then, while they were already living near a chiropractic school. So, in 1982, right as her husband was finishing his degree in chiropractic, she enrolled. Upon Elizabeth’s graduation, the couple relocated to Amherst and opened the location where they still serve patients today. “This has been a great location. When we moved here they were building a lot of houses, and the neighborhood kind of grew up around us,” Tom said. Chelsea also grew up around chiropractic, and found that it helped tremendously with high school sports-related injuries and pain. She worked at the family practice throughout her pre-chiropractic studies at the University at Buffalo. “I like seeing people get healthy without drugs or resorting to surgery,” Chelsea said. “I saw a lot of people come in here who were not walking straight, and then they would get adjusted and they would walk straight. That was kind of the light bulb.” So, after completing her studies at UB, she, like her parents before her, enrolled at Northwestern Health Sciences University. She received her doctorate in 2015 and soon began working at her parents’ practice. Several months later in September 2016, Tom and Lyons brought on Zach Kashevaroff, another chiropractor.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Study: 10,000 U.S. Seniors Die Within a Week of ER Discharge May be due to gaps in medical knowledge about which patients need more attention, researcher says

ach year, about 10,000 generally healthy U.S. Medicare patients die within seven days of discharge from a hospital emergency department, a new study contends. “We know that hospitals vary a lot in how often they admit patients to the hospital from the ED [emergency department], but we don’t know whether this matters for patient outcomes,” said lead researcher, physician Ziad Obermeyer. He is a staff physician in the Brigham and Women’s Hospital department of emergency medicine in Boston. “The variation in outcomes that we observed may be linked to gaps in medical knowledge about which patients need more attention from physicians,” Obermeyer said in a hospital news release. Geography and socioeconomics may also play a role, he said, adding that “access to resources varies dramatically across hospitals.” The analysis of more than 16 million ER visits showed that the most common causes of death in the following week were heart disease and chronic obstructive pulmonary disease (COPD), said Obermeyer, who is also an assistant professor at Harvard Medical School. But another major cause was

overdose from opioid painkillers like Oxycontin, Percocet and Vicodin, mostly after ER visits for pain and injuries, the study found. Most of these deaths occurred among patients seen at hospitals that admitted few patients from the ER. Policymakers often regard these hospitals as models due to their low costs, the researchers noted. However, deaths occurred far less often among patients seen at large, university-affiliated ERs with higher hospital admission rates and higher costs. This was so even though patients at these ERs tended to be less healthy upon arrival at the ER, the study authors said. Patients at greatest risk for death included those with confusion, shortness of breath or generalized weakness. The researchers found that those with chest pain had a much lower risk of death. The study looked at ER visits made by seniors between 200712 across the United States. It did not include patients with known serious illnesses or diagnoses of life-threatening conditions in the ER, any one over 90, or those receiving palliative care. The results were published Feb. 1 in the journal BMJ.

For Millions of Americans, Everyday Life Takes Toll on Their Hearing Contrary to popular opinion, work-related noise not the main culprit, CDC reports

he noise of modern life causes permanent hearing damage to many U.S. adults who don’t even suspect they’ve experienced a loss, federal researchers recently reported. Up to now, it’s been suspected that work-related noise has been the culprit behind most hearing loss, the researchers said. But about 53 percent of adults with noise-induced hearing damage reported no exposure to loud sounds while on the job, according to the study from the U.S. Centers for Disease Control and Prevention. Instead, their hearing apparently has been damaged by exposure to loud noise at home (think headphones) or in their community (blame those leaf blowers). Many of these people don’t even know they’ve lost hearing. One in four adults who believes his or her hearing is good or excellent actually has hearing damage, the CDC found. Hearing damage occurs when people are exposed to sounds above 85 decibels for an extended period. Many Page 16

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common noises are that loud, the CDC said: • Traffic noise in a car is 80 decibels, brushing up against the upper limit. • A leaf blower operates at 90 decibels, and can cause hearing damage after two hours of exposure. • A live sporting event generates 100 decibels of noise, and damages hearing after 14 minutes of exposure. • A rock concert generates 110 decibels, damaging hearing within two minutes. • A siren produces 120 decibels of noise, damaging hearing within one minute. To see whether these common noises are causing unsuspected hearing damage, the CDC researchers analyzed more than 3,500 hearing tests conducted on adult participants in the 2012 National Health and Nutrition Examination Survey. They found that one in five people who reported no job-related noise exposure had hearing damage in a pattern that’s typically caused by noise. The damage, shown by a distinctive drop in the ability to hear high-pitched sounds, appeared as early as age 20.

The Social Ask Security Office

From the Social Security District Office

Your Contributions Make Our Nation Stronger

t first, seeing taxes taken out of your paycheck can be a little disappointing. However, you can take pride in knowing you’re making an important impact each week when you contribute to Social Security. Understanding how important your contribution is takes some of the sting away because your taxes are helping millions of Americans — and protecting you and your family for life — as well as wounded warriors, the chronically ill and disabled. By law, employers must withhold Social Security taxes from a worker’s paycheck. While usually referred to as “Social Security taxes” on an employee’s pay statement, sometimes the deduction is labeled as “FICA” which stands for Federal Insurance Contributions Act, a reference to the original Social Security Act. In some cases, you will see “OASDI” which stands for Old Age Survivors Disability Insurance. The taxes you pay now translate to a lifetime of protection — for retirement in old age or in the event of disability. And when you die, your family (or future family) may be able to receive survivors benefits based on your work as well. Because you may be a long way from retirement, you might have a tough time seeing the value of benefit payments that could be many decades in the future. But keep in mind that the Social Security taxes you’re paying can provide valuable disability or survivors benefits now in the event the unexpected happens.

Q&A

Q: I recently retired and am approaching the age when I can start receiving Medicare. What is the monthly premium for Medicare Part B? A: The standard Medicare Part B premium for medical insurance is currently $134 per month. Since 2007, some people with higher incomes must pay a higher monthly premium for their Medicare coverage. You can get details at www.medicare.gov or by calling 1-800-MEDICARE (1-800633-4227) (TTY 1-877-486-2048). Q: I recently applied for a replacement Social Security card, but I might be moving before it arrives in the mail. What should I do if I move before I get it? A: Once we have verified all your documents and processed your application, it takes approximately 10 to 14 days to receive your replacement Social Security card. If you move after applying for your

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

Studies show that of today’s 20-yearolds, about one in four will become disabled, and about one in eight will die before reaching retirement. Be warned: if an employer offers to pay you “under the table,” you should refuse. It’s against the law. They may try to sell it as a benefit to you since you get a few extra dollars in your pay. But you’re really only allowing the employer to cheat you out of your Social Security credits. If you’d like to learn a little more about Social Security and exactly what you’re building up for yourself by paying Social Security taxes, take a look at our online booklet, How You Earn Credits, at www. socialsecurity.gov/pubs/10072.html. If you have a friend who lost a parent when they were a child, they probably got Social Security survivors benefits. Social Security helps by providing income for the families of workers who die. In fact, 98 of every 100 children could get benefits if a working parent dies. And Social Security pays more benefits to children than any other federal program. You can learn more at www.socialsecurity.gov/ survivors. Do you prefer videos to reading? Check out webinar, “Social Security 101: What’s in it for me?” The webinar explains what you need to know about Social Security. You can find it at www.socialsecurity. gov/multimedia/webinars/ social_security_101.html as well as on YouTube at www.youtube.com/ watch?v=5hkLaBiavqQ You can also learn more at www. socialsecurity.gov.

new card, notify the post office of your change of address and the post office will forward your card to your new address. If you do not receive your card, please contact your local Social Security office. To get a replacement, you will have to resubmit your evidence of identity and United States citizenship, or your lawful immigration status and authority to work. You can learn more at www.socialsecurity.gov. Q: Why is there a five-month waiting period for Social Security disability benefits? A: The law states Social Security disability benefits can be paid only after you have been disabled continuously throughout a period of five full calendar months. Social Security disability benefits begin with the sixth full month after the date your disability began. You are not able to receive benefits for any month during the waiting period. Learn more at our website: www. socialsecurity.gov/disability.

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Do You Need to File a Tax Return in 2017? Dear Savvy Senior, What are the IRS income tax filing requirements for retirees this tax season? My income dropped way down when I retired last year in 2016, so I’m wondering if I need to even file a tax return this year. New Retiree Dear New, There are several factors that affect whether or not you need to file a federal income tax return this year, including how much you earned last year (in 2016), and the source of that income, as well as your age and filing status. Here’s a rundown of this tax season’s (2016) IRS tax filing requirement thresholds. For most people, this is pretty straightforward. If your 2016 gross income — which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately — was below the threshold for your filing status and age, you probably won’t have to file. But if it’s over, you will. • Single: $10,350 ($11,900 if you’re 65 or older by Jan. 1, 2017). • Married filing jointly: $20,700 ($21,950 if you or your spouse is 65 or older; or $23,200 if you’re both over 65). • Married filing separately: $4,050 at any age. • Head of household: $13,350 ($14,900 if age 65 or older). • Qualifying widow(er) with dependent child: $16,650 ($17,900 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see IRS. gov/pub/irs-pdf/p554.pdf.

Special Circumstances

There are, however, some other financial situations that will require

you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from selfemployment in 2016 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file. To figure this out, the IRS offers an interactive tax assistant tool on their website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. It takes about 15 minutes to complete. You can access this tool at IRS. gov/filing — click on “Do you need to file a return?” under the Get Ready tab. Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get faceto-face help at a Taxpayer Assistance Center. See IRS.gov/localcontacts or call 800-829-1040 to locate a center near you.

Check Your State

Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency before concluding that you’re entirely in the clear. For links to state tax agencies see Taxadmin.org/statetax-agencies.

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Tax Preparation Help

If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit IRS.treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 5,000 sites nationwide. To locate an AARP Tax-Aide site call 888-2277669 or visit AARP.org/findtaxhelp. You don’t have to be an AARP member to use this service. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 17

Health News Non-surgical weight-loss procedure now at Sisters Sisters of Charity Hospital announced that the ORBERA procedure, a non-surgical weight loss procedure is now being offered to adult patients suffering from obesity. The first procedure in all of Western New York was performed successfully recently at Sisters Hospital, St. Joseph Campus. This procedure and program are for those patients for whom a more permanent bariatric surgical procedure may not be appropriate and for whom diet and exercise or pharmaceutical interventions have not been successful. The outpatient procedure involves the insertion of a deflated gastric balloon (ORBERA) through the esophagus, which is then inflated with a saline solution until the ORBERA device is roughly the size of a grapefruit. The presence of the balloon enforces meal portion control. Once a target goal weight has been reached, the balloon is safely deflated and removed. Physicians Ramesh Luther and Abha Rani, both gastroenterologists at Digestive Health Associates, are certified to perform the ORBERA procedure. Both doctors perform the procedure at the St. Joseph Campus of Sisters of Charity Hospital in Cheektowaga. The procedure is one element in a three-part program that also includes involvement and consultation from the Sisters Hospital bariatric team and a customized nutrition and fitness plan. Patients that qualify as candidates will work directly with a registered nutritionist from Sisters Hospital and a certified trainer from HIVE Lifespan Center. “This managed approach to weight loss is a healthy and safe alternative for patients that have been dieting and exercising, but are not seeing results and aren’t able to lose the weight,” said Luther. “

BlueCross BlueShield improves access to care BlueCross BlueShield of Western New York has recently announced significant changes that will allow members more efficient access to care as directed by their physicians and other health care providers without having to wait for approval from the health plan, a process known as “preauthorization.” In response to significant feedback from members and physicians, effective Feb. 1, more than 200 services across 20 medical protocols no longer require preauthorization. The designated set of services will be covered in accordance with a member’s specific benefits. According to the nonprofit, this shift will most positively impact primary care physicians, home health and durable medical equipment providers and their BlueCross BlueShield patients. Preauthorization is a process Page 18

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used by health insurance companies to determine if a prescribed procedure, service, or medication is medically necessary and covered under a member’s benefits. Although the decision to significantly reduce preauthorization requirements took several months of data and trend analysis, the health plan’s efforts and announcement align and coincide with a recent call by the American Hospital Association and American Medical Association to reduce prior authorizations in the interest of efficiency and patient care. “I was a full-time practicing pediatrician before accepting a senior leadership role at BlueCross BlueShield a few years ago,” said physician Thomas Schenk, BlueCross BlueShield senior vice president and chief medical officer.” Since arriving, our team has made purposeful strides to streamline policies and procedures that get in the way of doctors caring for their patients. Today’s announcement puts our physicians more squarely in the driver’s seat regarding medical decision making and the care they provide to our members.”

ASTS elects new officers & board members

Amherst Senior Transportation Services, Inc. (ASTS), a private nonprofit organization that contracts with the town of Amherst to provide transportation to seniors, has elected new officers and board members. In 2016 ASTS vehicles traveled more than 135,000 miles, providing roughly 20,000 trips for medical appointments, nutrition lunches and shopping to nearly 600 seniors within the town of Amherst. New officers are: president: Timothy Trabold, president of Shared Mobility, Inc.; vice president: Lisa Wiedemann, president of Home Instead Senior Care; secretary: Jane Woodward, former town board member and current board member of Amherst Meals on Wheels; and treasurer Keith Bookbinder, CPA, managing partner with Lougen Valenti Bookbinder & Weintraub LLP. New board members are Steven Szubinski, president of PCA Technology Group; Karen Synor, former director of volunteer services at Roswell Park; and Warren Clark, president/ and CEO of the Better Business Bureau of Upstate New

On Feb. 14 ECMC Corporation (ECMCC) received a generous Valentine’s Day donation from Russell J. Salvatore. Pictured with the donation check are (from left): ECMCC Board of Directors Vice Chairman Kevin E. Cichocki; ECMCC President & CEO Thomas J. Quatroche Jr.; ECMCC Board of Directors Chairwoman Sharon L. Hanson; restaurateur / philanthropist Russell J. Salvatore; Danielle Fox ECMCC Board of Directors chairwoman-elect; ECMC Foundation Board Chairman Jonathon A. Dandes; and ECMCC Board of Directors Vice Chairman Michael A. Seaman.

$1 Million Donation to ECMCC Buffalo restaurateur and philanthropist Russell J. Salvatore has provided a special Valentine’s Day gift to Erie County Medical Center: he committed $1 million to the hospital’s capital campaign. With the contribution from Salvatore, ECMC has raised $2.5 million for its capital campaign, which is just beginning the process that will lead to the building of a new state-of-the-art trauma center

/ emergency department, as well as other capital improvements at the hospital, including the main entrance/lobby. In July 2014, Mr. Salvatore donated $500,000 that led to the opening of the Russell J. Salvatore Orthopaedic Unit in 2015 on the sixth floor of ECMC. He had also previously in 2012 donated $250,000 to upgrade televisions in patient rooms.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

York. Continuing board members include: Sheila Gillert, also serving on the Amherst Youth Board; Karen Lisiecki, project coordinator of Amherst Senior Outreach Services; Richard Gehring, former CEO of Meals on Wheels of WNY and now serving on the board of Amherst MOW; and Claudia M. Reeves, former risk manager and director of social work at WNY Children’s Psychiatric Center. Pamela Krawczyk, executive director of the Town of Amherst Department of Senior Services, is an ex officio member of the board; Michael Gibbons is the ASTS executive director; and Steven Sanders serves as the Amherst town board liaison.

Schofield Foundation get award from Rotary Club The Rotary Club of Kenmore has awarded $6,000 to help create a new welcome center at Schofield Residence. “The Kenmore Rotary Foundation recognized the longterm relationship our club has with Schofield and is happy to support this endeavor,” said Richard Graham, The Schofield Foundation’s president. “On a personal note my father spent several years at Schofield, my mother volunteered there and my one daughter actually worked for Schofield many years ago.” The Kenmore Rotary Foundation will be recognized with a plaque near the welcome center as well as being named as part of the Schofield Foundation’s highest donor level, the fellow level ($10,000-plus) for the club’s long partnership in supporting Schofield Residence. “We are looking forward to transforming our current reception desk into a welcome center,” notes Randy Gerlach, administrator. “With more than 200 visitors a week as well as admitting 25-30 new residents to our rehab unit each month, we applied to the Rotary Club to help us to enhance the initial experience for visiting families and neighbors.”

Campaign to promote new children’s hospital As Kaleida Health prepares for the opening of the new John R. Oishei Children’s Hospital in November 2017, the community can expect to see a robust advertising campaign highlighting the hospital’s opening in just nine months. The full multimedia campaign includes TV, radio, billboards, print, social media and Internet as well as bus wraps and indoor advertising at the airport. The goal of the campaign is to get the community excited about the new hospital, which is nearly 85 percent complete, as well as talk about the phased approach of the move and the specialty clinics now open in the Oishei Children’s Outpatient Center.

Health News

UB Study: Poor and Less Educated Suffer the Most from Chronic Pain

ECMC Has Highest Surplus In Seven Years Hospital reports strong results in 2016: $2.1million operating surplus for 2016

OPERATING REVENUE 2015

2016

$553.1 million

$593 million

OPERATING EXPENSES

Erie County Medical Center Corporation (ECMCC), Western New York’s only Level 1 adult trauma center, closed 2016 with a $2.1 million operating surplus on its total $593 million in operating revenues, reflecting the hospital’s overall strong performance in health care services for the year. The hospital days cash on hand grew from 71.8 days in 2015 (with $102.4 million in cash) to 77 days in 2016 (with $115.6 million in cash). Revenues grew from $553.1 million in 2015 to $593 million in 2016. ECMC reported that 2016 was the busiest year in the hospital’s history. From emergency room visits to outpatient visits to both inpatient and outpatient general surgeries, the key categories for measuring ECMC’s operations demonstrated strong, positive growth, especially among elective procedures in areas such as orthopedics and kidney transplants. “Operationally, we knew that 2016 was a year of growth for ECMC, which affirms ECMC has become a hospital of choice for our community,” said ECMCC President and CEO Thomas J. Quatroche Jr. “This success is directly attributable to the 3,100 members of the ECMC family who provide compassionate and lifesaving care every day to our community.”

2015

2016

$552.2 million

$590.9 million

OPERATING SURPLUS 2015

2016

$0.9 million

$2.1 million

TOTAL INPATIENT 2010

2016

Growth

15,007

18,839

22.5%

TOTAL SURGERIES 2010

2016

Growth

11,944

14,552

21.8%

TOTAL ER VISITS 2010

2016

Growth

58,090

69,290

19.3%

TOTAL OUTPATIENT VISITS 2010

2016

Growth

255,264

306,564

20.1%

AVERAGE LENGTH OF STAY 2010

2016

8.4

7.5

In Good Health

6 Free Issues Meet Meet Your Your Docto Doctorr

Physician Brian M. Murray, ECMC chief medical ofﬁcer, talks about career, the care provided at ECMC and the reasons the medical center was chosen as ‘Hospital of the Year’ by a national hospitalist organization

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“We have to remember that pain is a legitimate and widespread problem,” she says. The study also serves as an argument for investing more into research for other treatments. “We don’t have particularly good treatments for chronic pain. If opioids are to some extent being taken off the table, it becomes even more important to find other ways of addressing this big public health problem.” Hanna Grol-Prokopczyk’s groundbreaking study is among the first to look beyond either the presence or absence of chronic pain to examine instead matters of degree, asking whether the pain was mild, moderate or severe. Her research, based on the Health and Retirement Study, which asked participants if they were “often troubled with pain,” also follows the same subjects over 12 years, as opposed to most studies that illuminate a particular point in time. “I found that people with lower levels of education and wealth don’t just have more pain, they also have more severe pain,” she says. “I also looked at pain-related disability, meaning that pain is interfering with the ability to do normal work or household activities. And again, people with less wealth and education are more likely to experience this disability.”

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oorer and less-educated older Americans are more likely to suffer from chronic pain than those with greater wealth and more education, but the disparity between the two groups is much greater than previously thought, climbing as high as 370 percent in some categories, according to new research by a University at Buffalo medical sociologist. The results, based on 12 years of data from more than 19,000 subjects aged 51 and over, excluding those diagnosed or treated for cancer, provide several kinds of bad news about chronic pain in the United States, according to Hanna GrolProkopczyk, an assistant professor of sociology at UB and the paper’s author, published in the February issue of the journal Pain. Chronic pain levels are also rising by period and not just by age, meaning people who were in their 60s in 2010 reported more pain than people who were in their 60s in 1998. “There are a lot of pressures right now to reduce opioid prescription,” says Grol-Prokopczyk. “In part, this study should be a reminder that many people are legitimately suffering from pain. Health care providers shouldn’t assume that someone who shows up in their office complaining of pain is just trying to get an opioid prescription.

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ECMC-RET-14049 InGoodHealth March Kidney_9_75x13_75_M | 9.75”w x 13.75”h no bleed | CMYK

Offering the community the best kidney care.

In 2016, ECMC established the highest level of kidney transplant activity in the hospital’s history with a record of 119 kidney transplants (from both living and deceased donors) and 13 pancreas transplants at our Regional Center of Excellence for Transplantation and Kidney Care. This growth is possible thanks to our dedicated, compassionate caregivers; selfless donors through the state’s Donate Life registry; our industrious partners at Unyts; and state-of-the-art technology that positions ECMC in the forefront of major innovations in transplantation. We appreciate the trust the Western New York community has shown in giving us the opportunity to produce

The difference between healthcare and true careTM

ECMC-RET-14049 March Kidney_9_75x13_75_M.indd 1 Page 20 • INInGoodHealth GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2017

positive transplantation outcomes for patients and their families.

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