in good Niagara Falls nurse practitioner writes a book showing other nurses how to start their own medical practices
Hip Replacement
Report: number of hip replacement procedures has skyrocketed
Do You Need To File a Tax Return in 2015? Many don’t need to. See the Savvy Senior column inside Three numbers you should keep an eye on to stay healthy and live longer
March 2015 • Issue 5
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VACCINES • Understand the ‘Herd Immunity’ Notion • Mother: Why I Don’t Vaccinate My Kid • Vaccination Myths: What’s True, What’s Not
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Managing Diabetes? There’s an App for That
Getting Geared Up Page 5
Buffalo studios offer alternative fitness options
Whether its warmer temperatures, longer, sun shining days or the knowledge that your winter sweaters will soon be replaced with snugger summer clothing, there is something about spring that calls to mind the need to kick your fitness factor up a notch.
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Come March — when snow and ice still have a death grip on our climate — I pine for pineapples more than at any other time of year. See why at this month’s SmartBites column
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Meet Your Doctor Physician Armen Kirakosyan to bring back minimally invasive gynecologic surgery to Buffalo General Page 6 March 2015 •
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Energy drinks tied to inattention, hyper behavior in middle schoolers says study
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Number of Hip Replacements Has Skyrocketed, Report Shows Procedure becoming more common in younger adults, but hospital stays now a day shorter
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he number of hip replacements performed in the United States has increased substantially, and the procedure has become more common in younger people, new government statistics show. The numbers reveal the rapid evolution of the procedure, which “remains one of the most dramatic and cost-effective ways to improve the quality of life for patients,” said physician Mark Pagnano, chairman of the department of orthopedic surgery at the Mayo Clinic in Rochester, Minn. “Recovery is dramatically easier for patients, the durability of hip replacements has improved, and the baby boomer generation is less willing to accept the limitations that accompany arthritis,” added Pagnano, who was not involved in the study. For the report, researchers looked at hospital statistics on total hip replacement — replacement of the head of the femur (thigh bone) and its socket — from 2000-2010. The researchers focused on patients 45 and older, who accounted for 95 percent of the procedures.
What’s going on?
Report lead author Monica Wolford, a statistician with the U.S. National Center for Health Statistics (NCHS),
said: “The main hypothesis is that osteoarthritis is becoming more common,” but the statistics in the study don’t reveal why the procedures are taking place. Pagnano said the growing number of cases of arthritis is a major factor in the trend. Most hip replacements in middle-aged patients are due to degenerative arthritis caused by wear and tear, he said. So higher numbers of active people translate Year...........Number of procedures into more 2000..........138,700 arthritis. “Thus, the 2010..........310,800 number of patients who are appropriate candidates for hip replacement at a younger age grows,” he noted. The report also found the average What’s next? hospital stay for total hip replacement Report co-author Anita Bercovitz, a patients has shrunk from nearly five health scientist with the NCHS, said the days in 2000 to just under four days in numbers suggest a challenge down the 2010. line: Many of these hip replacements “The early recovery from hip will have to be replaced when they replacement has become dramaticalwear out. “This will have implications ly easier from a patient standpoint,” for planning for the future,” she said. Pagano said, because of improved Physicians first developed modern rehabilitation procedures, better pain “total hip replacement” surgery in the management and better control of early 1960s. But it remained a fairly rare blood loss during surgery. procedure until the late 1980s, when the
Patients....................Increase (in %) 75 and older.............92 Aged 45 – 54...........205 number of cases grew from an estimated 9,000 in 1984 to 119,000 in 1990, according to the report authors. The report was published Feb. 12 by the NCHS as a Data Brief.
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What Stresses People the Most? Money leads the list of major stress generators, followed by work, family responsibilities and health concerns
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oney continues to be the leading cause of stress for Americans, a new survey finds. Overall, stress in the United States is at a seven-year low, and average stress levels are declining, the American Psychological Association poll found. But money worries continue to nag at the American psyche, despite the ongoing economic recovery, the association says in its report released Feb. 4, titled “Stress in America: Paying With Our Health.” Financial worries served as a significant source of stress for 64 percent of adults in 2014, ranking higher than three other major sources of stress: work (60 percent), family responsibilities (47 percent), and health concerns (46 percent). Nearly three out of four adults reported feeling stressed about money at least some of the time, and about one in four adults said they experienced extreme stress over money during the past month, according to the report. “Money is a very important component of establishing a secure life,”
said Norman Anderson, CEO and executive vice president of the American Psychological Association. “When people are financially challenged, it makes sense that their stress level would go up.” The good news is that, on average, Americans’ stress levels are trending downward. The average reported stress level is 4.9 on a 10-point scale, down from 6.2 in 2007, the report found. Despite this, the association found that Americans are living with stress levels higher than what psychologists believe to be healthy, and 22 percent say that they are not doing enough to manage their stress. Financial stress particularly affects women, parents and younger adults, the survey found. For instance, three out of four parents and adults younger than 50 said money is a somewhat or very significant source of stress. Women are more likely than men to report money as a significant source of stress, 68 percent versus 61 percent.
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www.healmyknee.com March 2015 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Canisius College Prof: Use It or Lose It Research shows active learning improves cognitive function in older adults
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lder adults who learn a new, mentally demanding skill can improve their cognitive function, according to research by Jennifer Lodi-Smith, assistant professor of psychology at Canisius College. Lodi-Smith and her colleagues, including lead researcher Denise Park of the University of Texas at Dallas’ Center for Vital Longevity, randomly assigned 221 adults, aged 60-90, to engage in a particular type of activity for 15 hours a week over the course of three months. documentaries and listen to classical Some participants were assigned music. To account for the possible to learn a new skill — digital photograinfluence of social contact, some parphy, quilting, or both — which reticipants were assigned to a group that quired active engagement and tapped included field trips and entertainment. working memory, long-term memory “So when we see all these media and other high-level cognitive processreports that tell people that they should es. get involved socially, or do crossword The study took place from 2009puzzles or Sudoku, they are just not as 2011. beneficial as learning something new “At the end of three months, we where you really have to put that effort found that only the group who learned in,” says Lodi-Smith. “You have to digital photography grew in their want to change and work hard to see memory skills,” says Lodi-Smith. real benefits.” The participants were computer Next steps for further research, novices, they had to remember a series says Lodi-Smith, include potential of steps, learn to use Adobe Photomethods for improving psychological shop, and mount their photos. The key, function for older adults. “My current adds Lodi-Smith, is that the group was research examines identity in older productively engaged and consistently adults, specifically how we understand challenged during their activity. who we are, how that changes as we Other participants were asked to age, and if we can maintain that identiparticipate in more familiar activities ty long-term.” such as crossword puzzles, watch
CALENDAR of
HEALTH EVENTS
March 14
Amherst Senior Center to host house fair The Amherst Center for Senior Services will present a housing fair from 9 a.m. – 12 p.m. on Saturday, March 14, at the center. This free and informative event will explore various options on senior housing including moving and downsizing, aging in place, legal and financial issues and technology. Information sessions will include: “Reverse Mortgages” by Belmont Housing Resources for WNY; “Making Environments Safer” by UB IDeA Center; program overview of the Mental Health Association of Erie County and Compeer about the Town Square for the Aging; and “Embrace New Thresholds” by Presbyterian Senior Care of WNY. The event will also feature over 40 vendors, door prizes, refreshments and a craft sale featuring the Knitters Club and Cards by Fran. The housing fair is co-sponsored by Clover Management and Presbyterian Senior Care of WNY. The Amherst Center for Senior Services is located at 370 John James Audubon Parkway in Amherst, behind the Audubon Library. To reach the center, please call 636-3050.
April 14, 21, and 28
Naps May Improve Your Health
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rief daytime naps might protect you against the harmful health effects of a poor night’s sleep, a new study suggests. Specifically, naps appeared to restore hormones and proteins involved in stress and immune function to normal levels in the study. The small study included 11 healthy men between the ages of 25 and 32. Researchers restricted the volunteers’ sleep to only two hours for a night. The next day, they had a 2.5-fold increase in levels of norepinephrine, a stress hormone that increases heart rate, blood pressure and blood sugar. They also had lower levels of a protein called interleukin-6, which fights viruses. On another night, sleep was limited to two hours again. However, the next day they were allowed to take two 30-minute naps. After napping, the men’s norepinephrine and interleukin-6 levels were normal. The study was published in the Journal of Clinical Endocrinology & Metabolism. “Our data suggests a 30-minute nap can reverse the hormonal impact
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of a night of poor sleep,” said study author Brice Faraut, of the Universite Paris Descartes-Sorbonne Paris Cite in France. “This is the first study that found napping could restore biomarkers of neuroendocrine and immune health to normal levels,” he said in a journal news release. “Napping may offer a way to counter the damaging effects of sleep restriction by helping the immune and neuroendocrine systems to recover,” Faraut said. “The findings support the development of practical strategies for addressing chronically sleep-deprived populations, such as night and shift workers.” Lack of sleep can increase the risk of health problems such as obesity, diabetes, high blood pressure and depression, and insufficient sleep is also associated with reduced work productivity as well as traffic and industrial accidents, according to the U.S. Centers for Disease Control and Prevention. Nearly three in 10 American adults sleep an average of six hours or less a night, according to the National Health Interview Survey.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2015
Workshop for women who live alone Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own,” is a three-part workshop offered for women who want to find joy again and gain the know-how to forge a meaningful and enriching life on their own. You’ll meet others in similar situations and learn practical strategies to overcome loneliness, rediscover your true self and socialize in a couples’ world. The workshop takes place at House Content Bed & Breakfast in Mendon from 6:30 – 8:30 p.m. on three consecutive Tuesdays: April 14, 21, and 28. The
workshop fee of $145 includes a Living Alone binder, empowerment exercises, and helpful resources you can trust. To learn more, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@ rochester.rr.com
April 25
Celiac group sponsors gluten-free food fair, walk The Greater Rochester Celiac Support Group (GRCSG) is sponsoring “Making Tracks for Celiacs Walk & Gluten-Free Food Fair,” an event that will be held from 10 a.m. – 1 p.m. Saturday, April 25 at Monroe Community College. Wegmans Food Markets and 13WHAM ABC, FOX Rochester & CW Rochester are the presenters. This is a day of fun for the whole family featuring a two-mile walk, gluten-free food fair, raffles for prizes, and activities for children. The Making Tracks for Celiacs Walk is a fundraiser for the local Greater Rochester Celiac Support Group and the Massachusetts General Hospital’s Center for Celiac Research (CFCR). Locally, the Greater Rochester Celiac Support Group uses funds to help educate the Rochester celiac, gluten sensitive, and wheat allergic community. CFCR is engaged in clinical care, diagnostic support, education, and research in the field of celiac disease. Their mission is to increase awareness of celiac disease on a national level in order to provide better care, better quality of life, and more adequate support for the national celiac disease community. Gluten-free samples and hot/cold items will be available from local and national companies, and food trucks will be selling gluten free food just outside the gymnasium. The raffle drawing for exciting local and national prizes will occur at noon. Pre-registration is now available at www.celiacwalk.org. Walk-day registration and sign-in including T-shirt pick-up begins at 10 a.m. For additional information, visit www.rochesterceliacs.org.
Serving Western New York in good A monthly newspaper published by
Health Buffalo–WNY Healthcare Newspaper
Local News, Inc. Distribution: 35,000 copies. To request home delivery ($15 per year), call 716-332-0640
In Good Health is published 12 times a year by Local News, Inc. © 2015 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 – P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@buffalohealthnews.com Editor & Publisher: Wagner Dotto • Associate Publisher: Jamie Sandidge • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Catherine Miller, Jenna Schifferle • Advertising: Donna Kimbrell, Marsha Preston • Layout & Design: Chris Crocker • Officer Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
In Good Health is Printed Locally at Buffalo NewsPress
Managing Diabetes? There’s an App for That By Deborah Jeanne Sergeant
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onsidering the intense personal effort required for effective diabetes management, phone apps offer portable, easy ways to lighten the load. “I definitely like to use apps as one tool to help clients be informed and stay accountable to their goals on a daily basis,” said Beeta Fernando, registered dietitian and certified diabetes educator at Hive Lifespan Center in East Amherst. “Some of the best apps are user-friendly and have a robust database.” Since many people already Fernando carry smart phones and most health apps are free or cost very little, it’s easy to see why more and more people rely upon them. “It is more than accountability than anything,” said Nitesh Kuhadiya, assistant professor of medicine at the UB School of Medicine and Biomedical Sciences and a physician with UBMD Internal Medicine. “People become more conscientious of what they’re eating. They may not eat that meal the next time.” Since many apps offer meal ideas and recipes, they offer more healthful options for meals and snacks. “Some of the apps ask you to enter physical activity,” Kuhadiya said. “It tells you how many calories you burn.
When my patients say they want to lose weight, they enter the amount they want to lose in how much time, it shows how many calories they should eat on a daily basis. They log in their meals and their activity.” Kuhadiya likes Fooducate (iPhone, Android, free) because it helps manage one’s diet, not just by calorie counting. “Fooducate helps you identify which foods are high in sugar, fats, and unnecessary ingredients,” Kuhadiya said. “By scanning barcodes, you’ll learn more about the good and the bad in packaged foods.” An upgraded Fooducate allows you to add personal health goals, offers tips, and includes information about gluten and allergies. Glooko (iPhone, Android, free) helps with diabetes specifically by allowing you to upload glucose readings directly from a meter. You can create records viewable in graph form and online. “Track your goals and share the information with your doctor,” Kuhadiya said. Diabetic Audio Recipes Lite (Android, free) offers an ever-increasing, healthful recipe database that provides nutrition information, too. You can also add their own notes. Camaraderie and practical tips from other diabetics can help you feel less isolated. Diabetic Connect (iPhone, free) fosters interaction with other diabetics, which can help busy people whose schedules make it hard to attend support group meetings. Diabetes App (iPhone, $6.99) tracks
things that affect blood sugar and offers information on how many grams of sugar foods contain. The app also allows you to share on Twitter. Positive peer pressure can help you stay on track to better health. The American Association of Diabetes Educators (AADE) developed Goal Tracker (Android, iPhone, free) to provides diabetes education and goal-setting tips. Numerous apps can also assist with general fitness. My Fitness Pal (Android, iPhone, free) allows you to scan food package barcodes for easy food logging and tracking. By analyzing your diet, you can determine what food to cut to stay within a healthful calorie count and how many carbohydrates you eat. “An important factor to consider is that some databases like My Fitness Pal have a database of user inputted data, so many of the entry can be inaccurate,” said Fernando, the diabetes educator at Hive Lifespan Center in East Amherst. “Databases such as dotFIT (iPhone, Android, free) are based on a fixed database by CalorieKing and therefore are accurate, but can be cumbersome to access.” Calorie King Food Search (iPhone, free) stores thousands of nutrition facts labels. The format found on all store labels provides a familiar glance at nutrition information, even if it’s for a food that typically doesn’t bear a label, such as a piece of whole fruit. Visit the websites of your local grocery stores to see what apps they offer.
Wegmans.com, for example, offers an app that helps you find food in that particular location and even if it’s in stock, along with recipes and healthful eating ideas. Many free pedometer apps built right into the phone can help you track your steps or miles. Some also monitor calories eaten and burned, sleep, weight and pulse. Kuhadiya said that apps also help physicians since they don’t have as many hours with their patients as they would like. One doctor visit can only include a small amount of education and interaction needed to effectively manage diabetes. As to which app is better than another, Kuhadiya leaves it up to patients. “For people with diabetes, they really have to use it and see how it fits into their needs and their requirements,” Kuhadiya said. Diabetes and general health apps do bear a few caveats. They’re only as effective as users are honest. If you underestimate portion sizes or round up a workout’s time or intensity, your results will appear better than what they actually are. “It is important for clients to remember that apps, like all tools, can provide important information and have a place in their care plan and weight loss goals,” Fernando said. “They must remember that working with a their physician or dietitian will help them decipher what the information means and how to use it to help them reach their goals.”
Healthcare in a Minute By George W. Chapman
V.A. Reins in Hospital-Acquired Infections
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udos to Veteran Administration. After well-deserved and highly publicized criticism for lengthy appointment delays, which in some cases contributed to vets dying, credit should be given when due. In 2007, the Veterans Administration began to focus on hospital-acquired infections (MRSA) that kill 75,000 people per year. One-in-25 patients will acquire an infection while hospitalized. By 2012, five years after the V.A. began its rigorous program, hospital acquired infections had dropped an astounding 68 percent. This is even more impressive when you consider that V.A. patients are older and sicker than patients in private hospitals. V.A. is the healthcare model for the future. Ironically, the nation’s oldest healthcare system, in business since the Civil War, is basically the exact “system of care” currently being touted. There are basically six characteristics of near-future healthcare systems: 1. Multi-hospital. The V.A. operates 150 medical centers, 140 nursing homes and 1,400 community-based clinics across the country. 2. Employed providers. The V.A. employs 53,000 physicians and other licensed providers. 3. Pay for performance/value. The
V.A. operates on a fixed budget. It has never been fee for service. 4. Population management. The V.A. is responsible for the overall health status of a specific population: 8.7 million vets. 5. Incentives to control costs while improving care. As mentioned above, for example, the V.A. drastically reduced its infection rate that drastically reduced the cost of hospitalization and improved the health of vets. 6. Electronic medical records. The V.A. has had EMR system-wide for years and is credited for being a pioneer in EMR that is critical for population management.
CBO lowers cost estimate
The non-partisan Congressional Budget Office has lowered its estimate of providing health insurance to previously underserved Americans under the Affordable Care Act. The CBO originally estimated the cost would be $710 billion from 2015 through 2019. That has been lowered 20 percent to $570 billion over the next five years. The CBO estimates this year 12 million people will purchase insurance through an exchange with 75 percent being eligible for subsidy. The number of people on expanded Medic-
aid will be about 70 million this year. Minimum essential coverage. Beginning in 2014, you must have had minimum essential healthcare insurance. That can be either employer sponsored, purchased through an exchange, Medicaid or Medicare purchased directly through an insurance company. Unless exempt, the uninsured will pay a penalty (when they file their tax return) which is the greater of 1 percent of family income over $10,150 or $95 per person up to a maximum of $285 per family. The penalty increases to 2 percent and $395 per person in 2015. The penalty increases again in 2016.
Employer-sponsored insurance declining
Many advocate separating health insurance from employment. Market forces may make that happen. In the past, employees often felt “trapped” by an employer fearing if they left they could be denied coverage by their new employer. That all changed with the passing of HIPAA (Health Insurance Portability and Accountability Act) which allows individuals to carry their insurance to their new job. Every year, fewer private-sector March 2015 •
businesses offer insurance to their employees, most likely accelerated by online exchanges. In 2014, less than half of all private-sector employees were covered by employer-sponsored plans.
NYS passes telemedicine law
Commercial insurers now have to offer the same reimbursement to physicians for “seeing” patients via telemedicine versus seeing them in person. Deductibles and coinsurance must also be the same for a telemedicine “visit” as they are for an office visit. To date, very few physicians have offered telemedicine services to their patients because most carriers would not reimburse. Expect this to be commonplace within the next two years.
GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Compound Found In Grapes, Red Wine May Help Prevent Memory Loss
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compound found in common foods such as red grapes and peanuts may help prevent age-related decline in memory, according to new research published by a faculty member in the Texas A&M Health Science Center College of Medicine. Ashok K. Shetty, a professor in the department of molecular and cellular medicine and director of neurosciences at the Institute for Regenerative Medicine, has been studying the potential benefit of resveratrol, an antioxidant that is found in the skin of red grapes, as well as in red wine, peanuts and some berries. Resveratrol has been widely touted for its potential to prevent heart disease, but Shetty and a team that includes other researchers from the health science center believe it also has positive effects on the hippocampus, an area of the brain that is critical to functions such as memory, learning and mood. Because both humans and animals show a decline in cognitive capacity after middle age, the findings may have implications for treating memory loss in the elderly. Resveratrol may even be able to help people afflicted with severe neurodegenerative conditions such as Alzheimer’s disease. In a study published online Jan. 28 in Scientific Reports, Shetty and his research team members reported that treatment with resveratrol had apparent benefits in terms of learning, memory and mood function in aged rats. “The results of the study were striking,” Shetty said. “They indicated that for the control rats who did not receive resveratrol, spatial learning ability was largely maintained but ability to make new spatial memories significantly declined between 22 and 25 months. By contrast, both spatial learning and memory improved in the resveratrol-treated rats.” Shetty said neurogenesis (the growth and development of neurons) approximately doubled in the rats given resveratrol compared to the control rats. The resveratrol-treated rats also had significantly improved microvasculature, indicating improved blood flow, and had a lower level of chronic inflammation in the hippocampus. “The study provides novel evidence that resveratrol treatment in late middle age can help improve memory and mood function in old age,” Shetty said.
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Meet
Your Doctor
By Chris Motola
Armen Kirakosyan, M.D. Physician to bring back minimally invasive gynecologic surgery to Buffalo General Medical Center. Having lived in Crimea, Ukraine, and Flint, Mich., he also compares the winter between the two regions to that of Buffalo Q: You recently became the medical director at Buffalo General Medical Center’s minimally invasive gynecological surgery unit. Tell us more about that. A: The idea was to bring GYN surgery back to Buffalo General Medical Center. I’m relatively new to Buffalo; I moved here from Michigan about a year ago. They have all the necessary things to provide the full spectrum of GYN surgery. We offer everything from open surgeries all the way to robotic, minimally invasive procedures. My role is to get everything up to speed in terms of GYN procedures. Q: Are you coming from a similar position in Michigan? A: It wasn’t an official position, but my partner and I developed the first minimally invasive program at McLaren Flint hospital. We were doing mostly robotic, single-site laparoscopic surgeries. Q: What gynecological surgeries are usually good candidates for minimally invasive surgery? A: It’s very individualized. When we’re talking about minimally invasive surgery, we’re talking about the same kinds of surgeries, but they’re done in a way that minimizes the hospital stay, blood loss and incision size. Sometimes we can even do it without an incision if we can do it completely vaginally. We’re normally dealing with problems like abnormal uterine bleeding, fibroids, endometriosis, ovarian masses, things like that. Nowadays, pretty much anyone can be a candidate for a minimally invasive approach. Obviously, we try to do what’s best for the patient. We still do traditional open surgeries if they’re in the patient’s best interest. But we do like to speed up recovery and minimalize hospitalization for the majority of these surgeries. Q: In your experience, how well prepared are most hospitals to offer this technology? A: It’s hard to tell, but it’s not only a matter of equipment. You need experienced
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2015
surgeons. You need to develop pre-op program, post-op recovery. Before I even came to Buffalo, we went through the whole equipment list to look for stuff that was missing. But right now I think we’re cutting edge and in line with big hospitals in the United States. I cannot think of anything that we cannot do in this hospital that can be done in other hospitals. Q: The Consumer Research Council of America named you one of the nation’s top OB-GYNs three consecutive years in a row. How do you attain that distinction? A: I think it’s a combination of achievements in board certifications, patient satisfaction surveys and recognition from colleagues. Q: There’s been a lot done to encourage when to get screenings and stay on top of their health. Where is there still room for improvement in terms of outreach? A: Unfortunately, some of the female diseases are very hard to catch. We don’t have perfect screening tools. That’s why we really try to stress the importance of annual exams. This is when we pick up a lot of
The minimally gynecologic surgery program at Buffalo General Medical Center specializes in treating a wide variety of gynecologic issues — from hysterectomy to pelvic organ prolapse repair — through advanced, minimally invasive surgery techniques, which provide faster recovery and reduced complications. conditions that we need to treat, even if there are no symptoms. So I would see your primary of gynecologist once a year, in addition to reporting any unusual symptoms you might have right away. Q: Looking forward, how do you see this unit developing? A: I’m not currently involved in any research. I’m mostly developing a practical approach to getting all these minimally invasive programs up and running at the moment. But once we develop these programs, it’s beneficial to set up goals and conduct some research and studies. I work with a lot of residents, so I’m pretty sure we’ll be getting some research out of this program over the next several years. Q: Worst winter: Buffalo, Michigan or Ukraine? A: Of course Buffalo. I would have thought Michigan, but with this winter, Buffalo is No. 1. I’m from the Crimean area of Ukraine, which has a pretty Mediterranean climate, so winters there weren’t bad at all. Q: How was the transition from your training in Ukraine to practicing in the United States? A: I did my medical schooling in Ukraine. The medical education system there is a little different. I went to medical school right after high school, but it’s six years rather than four. I didn’t do college; that was the difference. Depending on your specialty, you do an internship-residency — it’s a little different — that lasts one to three years. I worked as an attending for about three years before moving to the United States. I had to go through certification here for foreign medical graduates. They check all your credentials and you pass a series of exams. Then you get permission for residency in the United States. I was admitted to residency in Saginaw, Michigan. I was in private practice in Flint, Michigan initially. And last year I moved to Buffalo. I was lucky in that I started learning these robotic techniques in residency back in 2007, which gave me an advantage.
Lifelines Position: Director of minimally invasive surgery at Buffalo General Medical Center Hometown: Simferopol, Ukraine Education: Crimean State Medical University; Central Regional Clinical Hospital of Simferopol; Synergy Medical Education Alliance (Michigan State University) Affiliations: Buffalo General Medical Center; Women’s and Children’s Hospital; Suburban Hospital Organizations: American College of OB/GYN; American Association of Gynecologic Laparoscopists; American Urogynecologic Society; American Medical Association; Society of Obstetricians and Gynecologists of Canada; New York State Medical Society Family: Wife, daughter Hobbies: Fitness, martial arts Language: Fluent in English, Russian, Armenian and Ukrainian.
Rise of the NP Nurse practitioner writes book showing how other NPs can open their own practice By Ernst Lamothe Jr.
V
eronica Mason never intended to be a pioneer. She simply wanted to be a nurse. She is the fourth of 10 children and it became part of her nature to help others. “Being an older sister and being part of a large family, it was just a part of life to take care of my younger siblings. I guess that is where I got the instinct and passion to care for others and it brought me into nursing,” said Mason. It did more than that. She established her own practice, Mason Nurse Practitioner In Family Medicine P.C., 2131 Sawyer Drive, Niagara Falls, in 2000. Making it even more incredible is that she was rare in her field: a nurse practitioner who owns her own practice. She wrote a book, “Nurse Practitioner Guide on How to Start an Independent Practice,” educating current and future NPs on the path to having their own business. This past year, New York began a new law that could open the door for more NPs to open their doors and start their own practice. Some call the Nurse Practitioners Modernization Act an ideal way to advance patient access to care and recognize the roles that nurse practitioners play as independent healthcare professionals. It is also being called a nice first step by others. There are 13 states that allow NPs to practice with complete independence, including Alabama, Arizona, District of Columbia, Iowa, Idaho, Maine, Montana, New Hampshire, New Mexico, Oregon, Utah, Washington and Wyoming. New York is 14th. There are more than 20,000 NPs in New York. The profession began in 1965 and it took until 1988 for the career to be fully recognized. “I really was an advocate for this law,” said Mason, an NP since 1999. “This was something that I and other nurse practitioners thought was needed for a number of years. The old law was antiquated and had been on the books forever. There were enough barriers keeping nurse practitioners from getting their own practice.”
Mason lege in Buffalo, specializing as a family NP. She completed her doctorate of nursing practice degree from Daemen College in Amherst. She has been in clinical nursing practice as an NP specializing in pain management since 2000. Mason has successfully opened her own pain management practice in Upstate New York. “I wanted a comprehensive pain management business that focused more than just on giving people medication for their pain,” said Mason, who is married with three children. “It’s difficult to have many progressive initiatives if you don’t own a practice and have full control on the philosophy. After much prayer and hard work, it became a reality owning my own practice.”
Challenging journey
Mason said it was also difficult starting a practice in her own right. In 2008, she began the journey navigating
through piles of paperwork and forms, state regulations and other roadblocks. She would often have to start over because she would either get mixed messages from officials she would call on the phone or they wouldn’t remember that she called in the first place because she dealt with a lot of different people.” “I started writing everything in a journal for myself so I would know what the exact name of the person I was dealing with each time so when I called back I had a trail,” said Mason. “It was my own personal roadmap so that I could keep track of everything. One day after I got my practice, I was talking to church members about my road and a church member told me I should consider putting it all in a book for others to learn. It never dawned on me until then.” She also wrote a second book, “Circle of Support.” The purpose of this book is to share a practice-based theoretical framework related to the use of traditional and nontraditional therapies to treat patients with chronic pain. When it comes to the new law, she scoffs at those who think this will dramatically weaken health care. She sees nothing but positives. “A lot of people think we are trying to take the place of doctors. That is not true,” added Mason. “We have always been collaborative with doctors. I have doctors calling me asking me for advice about pain treatment and I talk to doctors to get some of their views. This will be nothing but better for patients.” Michele Menkiena, who works with Mason and sees the way she handles patients, is not surprised that her pain management facility continues to thrive. She said the head of any organization sets the tone. “I just want to say that Dr. Mason is an extremely kind, compassionate and caring provider,” said Menkiena. “She goes out of her way for her patients, even making house calls for patients when they become bed bound and cannot make it to the office. This is something that you don’t see providers doing today.”
Doc no longer needed
The new law removes the requirement of a written practice agreement between an experienced NP and a doctor as a condition of practicing on their own. Any nurse practitioner with more than 3,600 hours of practice or two years will be able to continue extending their expertise and freedom beyond current limitations. Previously, they had to sign a written collaborative agreement with a physician, which was as narrow or broad as the medical doctor allowed. “In the past, many nurse practitioners who desired to start their own practices were dissuaded because of the inability to find a collaborative physician which is no longer needed in the state of New York,” said Mason. “I believe it will provide access to care where there are provider shortages.” Mason received her master’s degree in nursing from D’Youville ColMarch 2015 •
FDA Approves New Drug for Binge Eating Disorder (BED)
T
he Obesity Society says that while not all individuals with obesity have BED, about 7-10 percent of those who seek obesity treatment are affected The United States Food and Drug Administration (FDA) recently approved lisdexamfetamine dimesylate, under the brand name Vyvanse, to treat moderate to severe binge eating disorder (BED) in adults, a first of its kind prescription drug specifically indicated for BED. “The Obesity Society has long supported new tools to assist with treating obesity,” says Martin Binks, TOS secretary treasurer and associate professor of nutritional sciences at Texas Tech University. “Given that if untreated, BED has shown in some people to lead to reduced long-term success in behavioral weight-loss programs and following bariatric surgery, this new tool may prove useful in the obesity treatment setting.”
Celebrating 25 Years of Smoke-Free Skies
D
o you remember when airplanes had a row of passenger seats separating the smoking section from the non-smoking section on flights? A brightly lit sign placed between the smoking and non-smoking sections of the plane was very visible on all U.S. domestic flights and intended to protect the health of flight attendants and passengers. Perhaps you were one of those travelers hoping that your non-smoking seat wasn’t directly behind the last seat in the smoking section because you were breathing smoke-filled air. That first no smoking sign celebrated 25 years old Feb. 25 and eventually led to smoke-free policies for airlines worldwide. It was a significant public health achievement and made possible by a broad coalition of health groups, travelers and flight attendants who spoke loud and clear about the ill health effects associated with breathing in what we now refer to as second-hand smoke.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Forging a new life on your own. Need some help?
U
nmarried in midlife . . . could there be anything worse? Or maybe, just maybe, that’s an outdated myth that warrants examination. My experience leading empowerment workshops tells me that, with a little help and support, women and men are discovering that living alone can be far more complete and satisfying than most could ever have imagined. The ending of my own marriage years ago was not a welcome change for me. I never intended to be on my own in midlife. But it was a change nonetheless and one I had no choice but to accept and to ultimately embrace. It took some time and some hardknock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to organize and offer workshops to support other women in similar circumstances. “Living Alone: How to Survive and Thrive on Your Own” is a threepart workshop I developed to help women discover the know how to create a satisfying and enriching life on their own. I’ve been leading the workshop for over 10 years now, and often get questions from In Good Health readers about what the workshop covers and how it is organized. In this month’s col-
umn, I am pleased to answer the most frequently asked questions: Q. What is the purpose of the workshop and what do you cover? A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude, and my workshop will help you think differently about living alone. Specifically, I cover how to overcome loneliness and other emotional pitfalls, banish negative thinking, rediscover your true self, socialize in a couples’ world, and otherwise embrace what may be a once-in-a-lifetime opportunity to create a wonderful and rewarding life on your own. Getting good at living alone takes practice. There’s no magic pill and it doesn’t happen overnight. But it can happen, and good things can result. Feeling comfortable with your independence will improve your chances of finding happiness, and it will improve your chances of finding a new healthy relationship, if that’s what you desire. When you feel better about yourself — more confident and resourceful — life on your own or with a special someone can be richer and
KIDS Corner Energy Drinks Tied to Inattention, Hyper Behavior in Middle Schoolers: Study Kids shouldn’t drink sugary, caffeinated beverages, researchers conclude
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nergy drinks are linked to hyperactivity and inattention in middle-school students, a new study reveals. Yale University researchers looked at more than 1,600 students at middle schools in one urban school district in Connecticut. Their average age was around 12 years. Boys were more likely to consume energy drinks than girls. The research-
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ers also found that among boys, black and Hispanic students were more likely to drink the beverages than white students. Children who consumed energy drinks were 66 percent more likely to be at risk for hyperactivity and inattention symptoms, according
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2015
more satisfying. Q. Who attends the workshop? A. Most, but not all, of the women who attend the workshop are between the ages of 40 and 70, and have come out of long marriages or relationships. Some are on their own for the first time in their lives. All have one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist or their congregation. Q. I’m still grieving the loss of my marriage/spouse. Is this workshop right for me? A. Good question. My Living Alone workshop is a “nuts and bolts” practical workshop to help women become more confident and independent on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend grief counseling or the help of a professional counselor. Q. What are your credentials? A. I’m not a licensed professional. My expertise is born out of real-life experience. I’ve “been there.” I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of
to the study in the current issue of the journal Academic Pediatrics. Energy drinks have high levels of sugar and also often contain caffeine, the researchers noted. For the study, the investigators took into account the number and type of other sugar-sweetened drinks consumed by the students. “As the total number of sugar-sweetened beverages increased, so too did risk for hyperactivity and inattention symptoms among our middle-school students. Importantly, it appears that energy drinks are driving this association,” study leader Jeannette Ickovics, a professor in the School of Public Health, said in a Yale news release. “Our results support the American Academy of Pediatrics recommendation that parents should limit consumption of sweetened beverages and that children should not consume any energy drinks,” she added.
living alone. After some “hits and misses,” I found my way and now thoroughly enjoy the freedom and independence that comes with living alone. My time-tested experience, valuable resources, and tried-and-true tips and techniques have inspired and helped many workshop participants. My workshop has been the jump-start they needed to reclaim their lives. Q. How large are the workshops? A. Ideally, I like to have eight women in each workshop, although, on occasion, I have led workshops with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly gives way to a comfortable camaraderie and it’s not unusual for nice friendships to develop among participants. Q. Where are the workshops held? A. At House Content Bed & Breakfast in Mendon, south of Rochester. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the workshop. What’s my next step? A. I like to speak with potential participants by phone, as a first step. That way, I can answer your questions and you’ll know better whether this workshop is right for you. Just call me at 585-624-7887 or email me at gvoelckers@rochester.rr.com. You’ll find information about my upcoming workshop in the Calendar of Health Events included in this issue. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call 585-6247887 or email: gvoelckers@rochester.rr.com.
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SmartBites
By Anne Palumbo
The skinny on healthy eating
The Perks of Eating Pineapples
C
ome March — when snow and ice still have a death grip on our climate—I pine for pineapples more than at any other time of year. All it takes is a bite and I’m transported someplace exotic and warm. So long, winter blues: hello, spring joy! The rest of the year, I reach for pineapples because they deliver the nutritional goods in a big way. Surprised? You’re not alone. Pineapples are so yummy that we often forget about what’s behind all that sweetness. Pineapples are bursting with vitamin C — just one cup gives you more than you need for a day. A powerful antioxidant, vitamin C can help combat the formation of free radicals known to cause cancer. And though studies show that consuming vitamin C can’t actually prevent colds, loading up on this immune-boosting nutrient may help shorten the time you’re sick and reduce the severity of your symptoms. What’s more, vitamin C plays an important role in maintaining healthy, resilient skin. Concerned about your bone strength? Level of energy? Pineapples may be your ticket to standing tall
For all its sweetness, one cup of pineapple chunks contains only 82 calories and has no fat or cholesterol and scant sodium. Like all fruits, they contain sugar: 16 grams per cup. As a comparison, one cup of grapes has 23 grams; a medium apple, 19, and a medium banana, 14.
Helpful tips
and feeling peppy. This tropical fruit contains nearly 75 percent of our daily needs for the mineral manganese, which is essential for strong bones and energy production. One study suggested that manganese, along with other trace minerals, may be helpful in preventing osteoporosis in post-menopausal women. Also great: Pineapples contain significant amounts of bromelain, a digestive enzyme that has a whole slew of health benefits. Unique to pineapples, this well-researched compound aids digestion quells inflammation and may help reduce certain kinds of pain.
Eat fresh whenever possible. Choose firm, plump pineapples with a sweet smell at the stem end. Exterior colors — from green to golden brown — indicate country of origin, not ripeness. Since the pineapple you buy is as ripe as it will ever be, consume within a few days. Sections not eaten right away may be wrapped in plastic and stored in the refrigerator for one to two days. If consuming canned pineapple, select varieties canned only in pineapple juice, not heavy syrup.
Pineapple-Avocado Salsa
al) 1/4 cup chopped fresh cilantro 1 1/2 teaspoons minced jalapeño chile (include seeds for extra heat) juice from fresh lime 1 tablespoon extra-virgin olive oil salt and pepper Stir all ingredients together and season with salt and pepper. Terrific with chips or alongside any grilled meat or fish.
Adapted from Gourmet
1 cup 1/4-inch-dice fresh pineapple 2 plum tomatoes, seeded and cut into 1/4-inch dice 1 ripe avocado, cut into 1/4-inch dice 2 cloves garlic, minced 1/2 cup chopped sweet onion (option-
Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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Fitness Time to Spring Into Fitness By Catherine Miller
W
hether its warmer temperatures, longer, sun-shining days or the knowledge that your winter sweaters will soon be replaced with snugger summer clothing, there is something about spring that calls to mind the need to kick your fitness factor up a notch. When starting a new fitness plan or improving on a somewhat dormant routine, there are practices you should put into play that will help you avoid pain and injury and add enjoyment to the warmer seasons ahead.
Nutrition
While you may want to break out the bike or head to the gym at the first glimpse of a sunny day, consider your diet before bursting into action. Carol DeNysschen, a registered dietitian and associate professor of nutrition and dietetics at Buffalo State College, suggests that you review your nutritional needs while planning an exercise regimen. At each meal strive for a plate that contains one half vegetables and fruits and the other half proteins and whole grains. Beginning a new workout routine doesn’t require additional vitamin supplementation. The overall goal is to give your body the resources it needs through the use of healthy foods, rich in vitamins and nutrients. Protein supplements, for example, are not necessary when you are providing the necessary protein to your body through protein rich foods like Greek yogurt, tuna and fat-free milk. “Supplementation for the average active person is very unnecessary,” says DeNysschen, “Before beginning a new workout regimen you should, however, have approval from your physician if you have any cardiovas-
cular risk factors such as high blood pressure, excess body weight, or a family history of heart disease.” Prior to starting your workout, think hydration. Drink 16 to 24 ounces of water or sports beverage two to three hours prior to exercising. A carbohydrate-rich snack one hour before your workout will assist in keeping your energy level at its peak level. Just before your workout take a few additional small sips of water. During prolonged exercise — lasting more than an hour — additional carbohydrates and liquids are necessary to delay fatigue and improve performance. An average of 30 – 60 grams of carbs per hour is recommended for activities in excess of an hour, and an additional 16-24 ounces of water or sports drinks are required to maintain hydration levels. Once your workout is complete your body continues to require additional resources. Strive for 40 grams of carbohydrate and 15 grams of protein within 30 minutes of your workout, and increase this amount for intense activity. Fluids will also need to be replaced at a rate of 16 – 24 ounces for each pound of body weight lost during your workout to avoid the risk of dehydration.
Exercise
“Proper conditioning is absolutely essential in sport and physical activity,” says Tom McCarthy, owner of Impact Fitness Systems, “When one is not properly prepared they are more likely to suffer from event specific fatigue. This fatigue can lead to impaired performance, technique breakdown and injury. This is an area where the Boy Scouts were correct — always be
Derik Denison finishing his first full marathon last year. Page 10
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2015
Tom Burns trains for the 2014 Shamrock Run last year. He had experienced a heart attack after the 2013 Shamrock Run and was getting back in the game with fellow runner Christine O’Keeffe. prepared.” At the onset of a new activity, a gradual introduction to the exercise if often recommended, along with stretching and warmup periods before the activity. A solid 15-minute warm up period should be put in place before you start your workout. Start out slow. Once acclimated to the activity, you can increase the activity in intervals of time and intensity and watch for warning signs and limit your workout accordingly. While the most obvious sign that you are not yet ready for an activity is excessive fatigue. Another sign is an inability to maintain good technique during the activity, and a general decline in performance over the course of the workout. “Sore muscles are part of the game,” says Nathan Young, head strength and conditioning coach at Buffalo State College. “If you get extremely sore, avoid the activity until the soreness subsides. If you are experiencing minor soreness light activity and stretching should help you get back in the game.” If you experience a strain or sprain during a workout, ice the injured area. Gently exercise the sprained area without adding to the injury. The extra blood flow will help in the healing
process. With time, you will find your strength and endurance for your activities and sports improving and there are ways to bolster that development. While there are many accomplished coaches and trainers available in our area, not all activities need a fitness professional to get you out enjoying physical activity and improving your performance. “Usually a person will make natural progress for the first six to eight weeks as their body adapts to the new ‘stress’. Once you get through that initial period you can research how to improve your activity based on your goals,” said Young, the conditioning coach at Buffalo State College. “You need to make a plan that is progressive in nature. For example, running for five minutes a day one week can be increased to seven minutes the next week, and so on, until you reach your goal. There are a number of books that can help improve performance and the internet is a great search tool as well.” With a bit of planning with regard to your nutrition and an enjoyable workout routine you can spring into the new season with a rejuvenated way to lose weight, improve your health and focus, and enjoy a variety of activities with family and friends.
Buffalo studios offer alternative fitness options By Julie Halm
T
o amp up a fitness routine, the answer may not be more reps or extra trips to the gym, but rather an infusion of something fun and different. Several businesses in Buffalo offer exciting options for fitness, including Buffalo Aerial Dance and Pole Play. At Pole Play, 1444 Hertel Ave., Chelsea Kelly has created a plethora of offerings during her decade in business. After years as a gymnast and spending time as an exotic dancer as well as a teacher, Kelly decided to open up a business where people could come to work out, have fun and explore a potentially new side of themselves. “Women really wanted to get in touch with their sexiness and their femininity, and I gave them a venue to do that in,” she said. The studio offers pole dancing classes on a variety of skill levels, cardio go-go classes, and cardio boot camps among others. The variety is designed to let different students focus on their particular interests and goals. While some of the classes focus on the fun and flirty side of pole dancing, others are designed to be primarily athletic. “I drop weight like crazy when I go-go dance,” Kelly said. “It’s such good cardio.” While Kelly has been creating a fun-friendly environment in which to work out, Erica Cope has created a studio where patrons can take flight in a way while getting a workout in. Buffalo Aerial Dance opened in the fall of 2013 in the Alt Theater at 255 Great Arrow Ave. and offers classes in various proficiency levels. Aerial dance is a form in which dancers use silks or other suspended apparatus and perform mid-air. According to Cope, having awareness of one’s body in space is one of the most important factors in practicing the form. Those considering taking to the silks benefit from walking in with good core strength and flexibility, but those are points that new students can work on in initial classes as well. “The aerial dance itself is somewhat of a specialty,” says Cope. “It takes a lot of strength a lot of flexibility, there’s a lot of pieces that we work on in the classroom.” Working on silks builds strength throughout the body, according to Cope. While core strength plays a huge role in the dance form, grip strength is also built as well as muscles throughout the arms and legs. Those who have practice in yoga or other forms of dance might find themselves making a fairly smooth transition into aerial dance. Likewise, workouts at Pole Play offer different types of training. While some focus on cardio, core strength is built during pole workouts along with the exercise of other muscle groups in the arms and legs. Although some of the advanced classes require a certain
level of physical fitness, men and women of any size can begin at the studio. “You’re going to lose weight taking the class and people feel like they’re not in good enough shape to begin and I think they have this preconceived notion and it’s not like that at all,” said Kelly, adding that she has had students of every fitness level in her classes and workshops. Additionally, Kelly noted that age is also not a restricting factor for those looking to switch up their exercise routine. Her oldest new student to date was 64. In both silk and pole workouts, the instructors agree that commitment is an important factor. “You can learn it at any speed. I took a level 1 class three or four times. You can take the beginner class as many times as you need to,” said Cope. “But if you are really out of shape and you want to progress in aerial it’s highly recommended you do some sort of outside training.” Whatever your personal fitness goals may be, there are fun and creative ways around Western New York to fulfil them. For more information about Pole Play, visit www.poleplaydancestudio. com and for more information on Buffalo Aerial Dance, visit www.aerialdancebuffalo.com.
At Pole Play, 1444 Hertel Ave. in Buffalo, Chelsea Kelly has created a plethora of offerings during her decade in business. One of them is pole dancing classes. “Women really wanted to get in touch with their sexiness and their femininity, and I gave them a venue to do that in,” she says.
Buffalo Aerial Dance opened in the fall of 2013 in the Alt Theater at 255 Great Arrow Ave. in Buffalo, offers classes in aerial dance, which dancers use silks or other suspended apparatus and perform mid-air. Pictured are, from left, Andrew Kutnyak, lAnastasia Kambouris and Maura Kutnyak-Smalley. March 2015 •
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Fitness
Proper Training
Getting Ready for the Buffalo Marathon
By Jenna Schifferle
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n May 24, thousands of men and women will anxiously enter a chute at the corner of Delaware Avenue and Huron Street in the city of Buffalo. At exactly 7 a.m., the cue will be given and everyone will go barreling forward — their feet beating against the ground and hearts pounding in their chests. It will be the first step of a mileslong journey that not everyone will see through until the end. Months of sweat and dedication will have led them to that moment; a moment that will test their physical and mental resilience.
Running for a Cure
For 46-year-old Sheryl Orlowski Allen of Athol Springs, the Buffalo Marathon is more than just a race: it is a chance to run for a cause that she holds dear to her heart. When she was in her early 30s, Allen was diagnosed with rheumatoid arthritis, a chronic inflammatory disorder that affects the joints. At 40, Allen started running. “At that point, it was me saying, I have to move. I have to move so that I can keep moving. I knew I had to find something that was sustainable,” she said. With newfound resolve, Allen signed up for her first race: the Turkey Trot. After that, she ran roughly 25 more races and started raising money for various charities with each one. In 2013, she ran her first half-marathon to raise money for the Leukemia and Lymphoma Society on behalf of a friend who was diagnosed with leukemia. She raised $4,000 for the cause. For the Buffalo Marathon, she will be running with Racing for a Cure, a foundation that aids in the fight to cure arthritis. Her goal is to finish the race and earn her medal, while raising awareness and correcting misconceptions about rheumatoid arthritis. She blogs about her experiences on Facebook under “Sherylrunning.”
Chris Young: “I got out for five miles yesterday. It was 1 [degree] out with a wind chill of -25,” he said. will be 41-year-old Jim Cielencki’s first full marathon. HThe Buffalo resident has run other 5K races and half-marathons, but his passion is trail running, and he loves to take in the view of
nature as he trains. He ran a 30K in Henrietta in the Rochester are, in November, and recently ran a 7K in the middle of the polar vortex. In early January, he began his marathon training, combating negative temperatures with layers of specialized clothing, gloves, hats and goggles. Even in the dead of winter, it is a chance for him to truly take in his the world around him. “I always thought bike riding was a great way to see a place. You’re taking things slowly. In a car, you don’t really see things. But running is even better, because it’s slow enough for you to digest things and get close.” Cielencki usually runs at least four days a week with speed work, a tempo run, a long run and a recovery run. He works at Fleet Feet Sports in Buffalo and runs with the different groups that are trained out of the store. Working with a group can be an important part of any training routine, because being around other runners and working with professionals can improve performance. The hardest part is mental, Cielencki said. It’s easy to talk yourself out of going for a run or finishing the mileage, but running teaches people to overcome those obstacles. “With running…there’s something liberating. You’re just like, ‘Wow I didn’t think I could do that.’”
Back in the Saddle
For 36-year-old Chris Young of Hilton, the Buffalo Marathon will mark his return to the running world after almost 20 years out with a knee injury. He has been running again since October and recently began a marathon-training program with Fleet Feet in Buffalo. With two young kids at home and a job where he works overnights, training can be tough. That doesn’t stop him from lacing up his shoes and running five days a week. Sometimes, he brings the kids to the YMCA so that he can fit a run in on the treadmill. “I prefer outside but I will sacrifice. I got out for five miles yesterday. It was 1 [degree] out with a wind chill of -25,” he said. This will be Young’s first marathon, and shortly after, he plans on competing in the Wine Glass Marathon in Corning and the Disney Marathon.
A Mental Game
Likewise, the Buffalo Marathon Page 12
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Buffalo Marathon is scheduled to take place May 24. Shown is last year’s race. Photo submitted.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2015
Training properly is one of the most important parts of being able to run 26.2 miles, Kevin Skowronek said. In his 14 years as a chiropractor, Skowronek has seen runners in his office who try to do too much too quickly, as opposed to building up to those long distances. This can result in stress fractures, torn cartilage, lower-back trauma or sprains. To avoid this, Skowronek encourages runners to stretch before and after a run, as well as to crosstrain with activities such as swimming and yoga. Most importantly, runners should listen to their bodies. “It’s one of those types of things that patients have to be diligent and pay attention to their symptoms as they’re going,” he said. “Pace yourself. Take your time. Train. Read some articles on it. Pay attention to your body. Pay attention to your symptoms.”
15th Anniversary for Buffalo Marathon This year will mark the 15th anniversary of the marathon, which includes the full marathon, a half marathon and a 5K the day before. John Beishline founded the event in 2000 and grew the race to nearly 6,000 participants in 2013 until his passing in December of that year. Tom Donnelly took over in 2014 and improved the race and course until his death in November of 2014. Today, people come from all over the country to take part in the race that Beishline and Donnelly built. Race Director Greg Weber said that he hopes to carry on the legacy of the race, while continuing to grow the event and to partner with organizations in the community. “We’re focusing on making this the kickoff of the summer,” Weber said. “I’d like to see everyone in Erie County and Buffalo come out to see the event.” Anyone interested in signing up for the Buffalo Marathon, the Buffalo Half-Marathon or the 5k can sign up online at: www. buffalomarathon.com. Runners can get $5 off by using the promotional code: 2015-InGoodHealth.
Breast Cancer vs. Men’s Prostate Cancer Health Why is awareness of breast cancer is so much higher than that of prostate cancer? By Deborah Jeanne Sergeant
T
he pink ribbon symbolizing breast cancer appears on innumerable pieces of merchandise to raise awareness. But it seems like prostate cancer receives little press, despite its status as the most common cancer in men and the second leading cause of cancer death in men. Martha Ryan, senior director of community engagement for the American Cancer Society Central and Western New York Region, said that compared with other types of cancer, such as breast cancer and colon cancer, the guidelines for prostate screening aren’t as clear-cut. “We recommend if you’re 50-plus, you need to talk to your healthcare practitioner about getting screened,” she said. “African American men have a higher rate of prostate cancer than other races. They should talking with their practitioner at age 40.” In addition to an exam, the doctor may also order a PSA blood test. Some prostate cancers grow so slowly that doctors recommend a waitand-see approach. “When a woman has any kind of growth in her breast, they usually want to get it out of there because it grows and spreads,” Ryan said. Since some prostate cancers grow so slowly that treatment is never needed, it may seem less serious than other types of cancer and warrant less awareness. However, since prostate cancer death rates remain so high, men need to know about screening. Bob Rand, 73, facilitates Cheektowaga’s chapter of Us TOO, a national organization that raises awareness and supports families touched by prostate cancer. “Men should absolutely get screened,” he said. Rand thinks that men tend to eschew health screenings and shun awareness because “Men aren’t as proactive about their health,” he said. “It’s a private thing. Women like to get out and get things going. We want to get men more involved.” The PSA blood test reveals if a man has an elevated prostate-specific antigen (PSA), which is often high in men who have prostate cancer, but doesn’t necessarily mean a man has prostate cancer. Rand tested positive for a high PSA during an annual physical seven years ago. A second opinion and biopsy led to a diagnosis of prostate cancer. Rand opted for surgery. “You’re the boss, not the doctor,” he said. “All I could think of was, ‘Get that stuff out of me.’ I didn’t want to have cancer in me.” For some men, a wait-and-see approach offers a better option if the PSA level decreases. Many insurance companies won’t cover routine PSA testing, and many physicians don’t push PSA testing since the US Preventive Services Task Force decided in 2012 that routine PSA screening raises the risk for false posi-
Various tests other than colonoscopy can detect disease, however it still remains the golden standard for colon cancer prevention
tives, resulting in unnecessary surgery for men who aren’t aware of other options, such as active surveillance. Surgery bears the risk of urinary incontinence and erectile dysfunction. “One out of eight women will have breast cancer, but one out of six men will get prostate cancer,” Rand said. “It takes an awful lot to get people to go get a blood test for their PSA. “Once the PSA starts to indicate a problem, men have a real problem with getting a digital rectal exam. Prostate cancer is showing up in younger and younger men, 40 year olds that are diagnosed with this. “If your father has it, chances are you’ll have it. When they go to their physician, all they have to do is say, ‘Check my PSA.’ It’s so simple, but you’ll likely have to ask for it.” New, advanced tests have become available to help physicians detect if a man carries a gene indicating an aggressive type of cancer. More advanced, 3-D MRI of the prostate can also help physicians help their patients make more educated decisions. Image guided radiation can also more closely target cancer cells.
By Deborah Jeanne Sergeant
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Prostate Cancer Support Group Anyone interested in Us TOO, a national organization that raises awareness and supports families touched by prostate cancer, should call 716-834-9200, ext. 5169 or 716743-7595. The local group meets the first Thursday of each month from 7 – 9 p.m. at the community room on the first floor of the Sisters of Charity Hospital, St. Joseph Campus (formerly St. Joseph Hospital).
Colonoscopy Anyone
Bob Rand, 73, facilitates Cheektowaga’s chapter of Us TOO, a national organization that raises awareness and supports families touched by prostate cancer. “One out of eight women will have breast cancer, but one out of six men will get prostate cancer,” Rand says.
The American Cancer Society offers tips for reducing risk of cancer in general with the following tips: • Stay away from tobacco. • Get to and stay at a healthy weight. • Get moving with regular physical activity. • Eat healthy with plenty of fruits and vegetables. • Limit how much alcohol you drink (if you drink at all). • Protect your skin. • Know yourself, your family history, and your risks. • Have regular check-ups and cancer screening tests. • For information on how to reduce your cancer risk and other questions about cancer, please call anytime at 1-800-227-2345 or visit www.cancer.org. March 2015 •
ince 2000, March has been recognized as National Colon Cancer Awareness Month. Campaigns such as this have helped more people understand the importance of screening; however, colon cancer remains the second most common cancer killer and the third most common type of cancer. “The thing with colon cancer is if people would get screened, two-thirds of colon cancer could be prevented,” said Martha Ryan, senior director of community engagement with the American Cancer Society Western and Central New York Region. Since most colon cancer starts with a polyp, most screenings can identify a polyp and allow doctors to immediately remove it. But only about 69 percent of the eligible population—generally those 50 and older—receive colon screening. “People at average risk, without any family history of the disease or other risk factors, should begin screening for colorectal cancer at age 50,” said Steven Nurkin, surgical oncologist and assistant professor of oncology, Roswell Park Cancer Institute. “How often you need to be screened will depend on which screening test you have and the results of the test.” A person with an uneventful colonoscopy will probably need a follow-up in 10 years. If a polyp is found, that case may require a sooner follow-up. African American are at higher risk, and start at age 45. But anyone with a near family member diagnosed with colon cancer should begin screening 10 years prior to the age of the relative at diagnosis. For example, if a relative received a colon cancer diagnosis at 45, his relatives should begin screening at 35 Nurkin said that symptoms including a change in bowel habits, like ongoing diarrhea or constipation, blood in the stool, abdominal discomfort, pain or cramping, having the sensation of incomplete bowel movements may require a colonoscopy. Colonoscopy isn’t the only screening for colon cancer. Though many doctors feel it’s the gold standard for screening, fecal occult blood test
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Colonoscopy from previous page
(FOBT) and fecal immunochemical test (FIT) may fit a patient’s profile better instead or in addition to colonoscopy. FOBT, an annual test, uses three samples of stool from three different bowel movements. FIT also uses three different samples, but these are taken from the water in the toilet bowl with the bowel movement in it, and not the stool itself, to detect enzymes in the water released by the fecal matter. If either test is positive, a colonoscopy follows. CT colonography requires the same preparation—completely emptying the bowel first—but doesn’t require a long Nurkin scope. “If they see something, you still need a colonoscopy,” Ryan said. “But some believe the colonoscopy is too invasive.” CT colongraphy isn’t always covered by insurance but some people cannot receive standard colonoscopy. Some providers Ryan feel CT colonography does not provide the same level of screening as colonoscopy. With colonoscopy, a lighted flexible scope views the entire colon. “With CT, you’re radiating that patient,” said Raul Vazquez, family physician with Greater Buffalo Vazquez United Accountable Healthcare Network in Buffalo. “If they have other radiation-based scans for other issues, that all that adds up. CT is less invasive, but if you find something, colonoscopy is better.” Unfortunately, many people dislike and fear colonoscopy or don’t understand when they should start receiving colon screening. “The problem you have is compliance,” Vazquez said. “When you try to get them to get the test, there’s prep, you have to take someone with you, and you feel groggy after. People don’t like it.” Since most polyps may be removed during colonoscopy, many cases resolve the same day. It’s important to know whether a polyp is malignant or benign; however, doctors remove most polyps regardless. “If we find colon cancer in the screening, we can manage the condition right away,” Vazquez said. “You can do a polypectomy right there. Even if there’s a lesion that’s precancerous, you can cut it out and cauterize it. If the margins are clear, you have taken care of the issue.” To support good colon health, Vazquez said that eating right is key. “We talk about eating enough fiber,” he said. “Get yourself regular. You get a lot of medications that slow the bowel. That adds risk. I deal with prevention which is less costly and more effective than treatment.” Page 14
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Herd Immunity Protects the Community By Deborah Jeanne Sergeant
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erd immunity — the effect of reducing the spread of communicable disease through majority vaccination — only works if enough of the total population vaccinated. Steven Lana, pediatrician with Delaware Pediatric Associates in Buffalo, said that a minimum of 95 percent of the community must receive vaccination for the herd immunity effect, but not in all cases. “It depends upon what disease we’re talking about,” Lana said. “Some diseases like measles are highly contagious. You can be in the same room with someone coughing or sneezing and if you’re not immune to measles, there’s a good chance you’ll develop them.” In addition to the people vaccinated, herd immunity helps protect those who cannot receive vaccination or who are at higher risk, including young babies, chemotherapy patients, organ recipients or patients treated with immune-suppressing drugs for conditions such as lupus, fibromyalgia or rheumatoid arthritis. Although it’s extremely rare, “some individuals won’t respond as well as we would like to vaccination, but we don’t know who they are,” Lana said. Contagious “childhood” diseases aren’t limited to just children. “Although measles is usually considered a childhood disease, it can be contracted at any age,” said physician Gale R. Burstein, commissioner of
health for the Erie County Department of Health. Many people born before vaccination became widely available in the 1960s face a greater risk of infection because of their lack of vaccination, advanced age and greater likelihood of certain age-related illnesses. The effect of herd immunity is so important that recent outbreaks have prompted consideration of mandatory vaccination in infancy. Most public schools and private school require upto-date vaccination for nine communicable diseases before children may enroll. “Any legislation that makes us more successful in having everyone follow recommendation from groups like the CDC regarding vaccines is excellent,” said physician Diana Wilkins, residency program director and clinical assistant professor in the department of family medicine at University at Buffalo. RocDocs, provided by The Rochester Democrat & Chronicle newspaper, reports that “at least 25,000 elementary and secondary students in Upstate schools are not fully vaccinated against communicable diseases.” Nearly 2 million children attend school in Upstate. Religious and medical exemptions allow some students to skip some or all their vaccinations. Parents can also avoid vaccinating their children if they home school or enroll them in a privately funded school that doesn’t
Have You “Herd” of Herd Immunity (also known as community immunity)? “Vaccines can prevent outbreaks of disease and save lives. When a critical portion of a community is immunized against a contagious disease, most members of the community are protected against that disease because there is little opportunity for an outbreak. Even those who are not eligible for certain vaccines—such as infants, pregnant women, or immunocompromised individuals— get some protection because the spread of contagious disease is contained. This is known as ‘community immunity.’ “In the illustration below, the top box depicts a community in which no one is immunized and an outbreak occurs. In the middle box, some of the population is immunized but not enough to confer community immunity. In the bottom box, a critical portion of the population is immunized, protecting most community members. “The principle of community immunity applies to control of a variety of contagious diseases, including influenza, measles, mumps, rotavirus, and pneumococcal disease.” From Vacines.gov, a site operated by the U.S. Department of Health and Human Services, using information provided by the National Institute of Allergy and Infectious Diseases.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2015
Vaccination am children in the 20 ong school13-2014 school year in Erie Cou nty ranged from as low as 53.1 pe rc vaccinated to the ent completely norm for most of the schools: th e high 90s to 100 percent. In Chaut au no students in th qua County, ree of its schools were fully vaccin ated. Source: RocDocs, provided by The Rocheste r Democrat & Chronicle newsp aper
require vaccination. The ideology that causes some parents to opt out can also place their children at higher risk since the more unvaccinated that are in a group, the greater chances they can start an outbreak among the general population. RocDocs reported that in Erie County, vaccination among schoolchildren in the 2013-2014 school year ranged from as low as 53.1 percent completely vaccinated to the norm for most of the schools: the high 90s to 100 percent. RocDocs further reported that in Chautauqua County, no students in three of its schools were fully vaccinated. Three schools ranked between 20 and 50 percent fully vaccinated and four were between 60 and 80 percent. The remaining schools ranked in the 90s to 100 percent vaccinated. All but two Wyoming County schools, one at 93.3 and another at 94.1, were above 97 percent full vaccination. To look up your children’s school, visit http://rocdocs.democratandchronicle.com/database/vaccinationrates-new-york-schools.
Mother: Why I Don’t Vaccinate My Youngest Daughter Buffalo mother chose a traditional course of vaccinations for her oldest three children but has chosen to forego vaccinating her youngest daughter, Maria By Catherine Miller
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athryn Schulz of Buffalo is the mother of four daughters ranging in ages from 6 to 18. While Schulz has chosen a traditional course of vaccinations for her oldest three children, with slight variations, she has chosen to forego vaccinating her youngest daughter, Maria, who struggles with the challenges of Downs syndrome. Downs syndrome is a genetic disorder that alters the course of regular development, and in many cases, compromises the immune system. As immunizations often contain a live weakened amount of the antigen of the disease it’s meant to prevent, a compromised immune system can be adversely affected by a vaccination, which was the situation in the Schultz household. “Maria was diagnosed with Downs syndrome a few days after she was born. At the age of 6 months, she received the pertussis vaccine for whooping cough and then developed a seizure disorder,” stated Schulz. “I don’t mean to say that the immunization caused the seizure condition. She would likely have had the disorder, regardless, but I think it may have
accelerated it.” Schulz is quick to state that she is not a doctor, and that her beliefs are backed by her personal experiences, discussions with doctors and research she has done into her daughter’s condition, and immunizations in general. “At the age of 3, Maria was vaccinated for measles and immediately contracted the disease,” Schulz said. “That is when we realized that Maria’s immune system could not handle live vaccines.”
Takes her own approach
From that point on, Schulz discontinued conventional course of immunizations and viewed each vaccination on its merits, weighing the risks of contracting the condition with the risk of a reaction occurring after the inoculation. While live and inactivate vaccines vary with regard to adverse reactions that may occur, each still carries some risk, especially in the case of a person with a compromised immune system. For the most part, Schulz has discontinued all but the pneumonia vaccine for Maria, as people with Downs syndrome have a high risk of contract-
ing pneumonia and it can prove to be a serious condition in Downs syndrome individuals. As for her older daughters, while they were past the immunization stage at the time Schulz began to question vaccinations, she carefully considered future immunizations and the timing of them, delaying some when she felt the need to do so. “I believe that not every child should follow the conventional immunization schedule,” Schulz said. “I believe the schedule is built around the time periods that the child is most likely to be seen for a doctor’s visit, and not necessarily at times when it is most likely that the child would need that particular vaccine.” She said her older daughters have received all necessary immunizations for their own health and to assist in not contracting a medical condition that could be transferred to Maria.
Cause for concern
Schulz is not alone. There are many parents that have researched the need for immunizations and the risks that are involved and have made determi-
Mythsvs.Reality Myth: Immunization is dangerous. “Currently, the United States has the safest, most effective vaccine supply in its history. The United States’ long-standing vaccine safety system ensures that vaccines are as safe as possible.” Myth: Vaccines are a big money racket for pharmaceutical companies and they don’t even work all that well anyway. “Vaccines are among the most successful and cost-effective public health tools available for preventing disease and death.” Myth: I’ll take my chances with nature. “Fatalities are currently rare in the United States, but one or two of every 1,000 children who contract measles will die from the disease.” Physician Gale R. Burstein, commissioner of health, Erie County Department of Health Erie County Health Department “The Centers for Disease Control (CDC) estimated that 732,000 American children were saved from death and 322 million cases of childhood illnesses were prevented between 1994 and 2014 due to vaccination.”
Myth: Vaccines cause autism. “MMR vaccine is given around the time where you can start to pick up signs of autistic behavior. We give it around 12 to 14 months of age and around 15 months, we see some signs of autistic behavior for those who have autism. Plus, we’re identifying more cases of autism than we used to.” “The Wakefield study, credited with linking MMR vaccine and increased risk for autism, was repeatedly shown to be a fraud. Wakefield has been discredited, lost his license to practice medicine in the UK and US. Lancet [the medical journal that originally published it] withdrew the article. Wakefield had a conflict of interest and falsified data.” Physician Diana Wilkins, residency program director and clinical assistant professor in the department of family medicine at University at Buffalo Myth: No one dies from childhood diseases; they’re just inconvenient. “Vaccines have been responsible for millions of lives being saved, more than cures for cancer or any other cures we have.” Myth: I’ll build up my child’s immune system by exposing him to a child infected with the measles. “That’s madness. Why would you knowingly risk your child’s health and
life when there’s vaccine that’s perfectly safe and effective?” Myth: Vaccines weaken the immune system. “Vaccines stimulate the immune system, not weaken it.” Myth: All the terrible diseases have been eradicated. “In 2000, we declared measles eradicated in the US. But since, as a result of importing these diseases or local communities not immunizing, we have had several hundred cases per year and will likely see many this year.” Myth: Vaccines cause bad, life-long side effects. “Nothing is either 100 percent effective or safe, but when you look at benefits versus risks, it’s a slam dunk. Local pain at the injection site and fever are the most common side effects.” Myth: It isn’t safe to have my small baby injected with so many vaccines at once. I want to spread them out so they’re safer or skip some doses. “Although we’re vaccinating for more diseases than we used to, what children receive is a lower load of antigens. Compared with what our immune system deals with daily, seven antigens is a drop in the ocean.” Steven Lana, pediatrician at Delaware Pediatric Associates, Buffalo
March 2015 •
nations not to immunize their children, or to alter the course of the vaccination schedule. The toxins that are inherent to the vaccinations, the desire to have the body builds its own immunities, religious beliefs, and medical conditions that increase the risks involved with inoculations are just a few of the reasons that people choose not to immunize their children. Media attention surrounding the negative public outcry toward people that choose not to vaccinate their children makes many parents reluctant to discuss the anti-immunization topic in a public forum. Despite the unwillingness for many parents to talk openly on the subject, they continue to make decisions based on their beliefs, their research and their individualized situation. So while the inoculation controversy marches on, Schulz and parents like her continue to balance the risks of immunization with their personal health and medical challenges, realizing that the standard mindset regarding immunization is not ideal in every circumstance.
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Health Strategies for Preventing Alzheimer’s Disease By Jim Miller
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hile there’s currently no cure for Alzheimer’s disease, new research indicates that there are a number of healthy lifestyle strategies that can help most people reduce the risk of getting it. According to the Alzheimer’s Association, the key factors that increase the risk of getting Alzheimer’s are advanced age, family history and heredity, but research shows that our general health plays a factor too. While we can’t do much about our age, family or genes, we do have control over how we treat our body and brain. Some medical experts even estimate that by following these healthy tips now in middle-age, you can actually reduce your risk of developing Alzheimer’s by as much as 50 percent, or at least delay its onset by a few years. Here are the recommended strategies.
Manage health problems Studies have consistently shown that Alzheimer’s disease is closely related to conditions, like diabetes and heart disease. So, if you have high blood pressure, high cholesterol or diabetes you need to treat them with lifestyle changes and medication (if necessary) and get them under control. Left untreated, these diseases over time will cause damage to the vessels that feed blood to the brain making them more vulnerable to damage, and increasing your risk of dementia.
Exercise Aerobic exercise increases blood flow to all parts of your body, including your brain, to keep the brain cells well nourished. So choose an aerobic activity you enjoy like walking, cycling, dancing, swimming, etc., that elevates your heart rate and do it for at least 30 to 40 minutes three times a week.
Eat healthy A heart-healthy diet, like the Mediterranean diet, will also help protect the brain. A Mediterranean diet includes relatively little red meat and emphasizes whole grains, fruits and vegetables, fish and shellfish, and nuts, olive oil and other healthy fats. Also keep processed foods and sweets to a minimum.
Sleep well Quality, restful sleep contributes
to brain health too. Typically, adults should get between seven and nine hours of sleep daily. If you have persistent problems sleeping, you need to identify and address the problem. Medications, late-night exercise and alcohol can interfere with sleep quality and length, as can arthritis pain, sleep apnea and restless leg syndrome. If you need help, make an appointment with a sleep specialist (see sleepeducation.com) who will probably recommend an overnight diagnostic sleep test.
Challenge your brain Research shows that mind challenging activities can help improve memory, slow age-related mental decline and even build a stronger brain. But, be aware that mind-challenging activities consist of things you aren’t accustomed to doing. In other words, crossword puzzles aren’t enough to challenge your brain, if you’re already a regular puzzle doer. Instead, you need to pick up a new skill like learning to dance, play a musical instrument, study a new language or do math problems – something that’s challenging and a little outside your comfort zone. Brain-training websites like Lumosity.com and BrainHQ.com are excellent mind exercising tools because they continually adapt to your skill level to keep you challenged. Socializing and interacting with other people is another important way to stimulate the brain. So make a point to reach out and stay connected to friends, family and neighbors. Join a club, take a class or even volunteer – anything that enhances your social life.
Reduce stress
Some stress is good for the brain, but too much can be toxic. There’s growing evidence that things like mindfulness meditation, yoga and tai chi are all good ways to help reduce stress. For more tips, call the National Institute on Aging at 800-222-2225 and order a free copy of their booklet “Preventing Alzheimer’s Disease: What Do We Know?” 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 • March 2015
The Social Ask Security Office By Deborah Banikowski
In March Americans Recognize Middle Name Pride Day
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t the Social Security Administration, our middle name is “Security,” and every day, we do everything we can to live up to that name. As part of protecting our vital services, we safeguard against all forms of Social Security fraud. Social Security has zero-tolerance for fraud and those who try to cheat the system. While we can’t prevent all fraud schemes any more than the best police force can stop all crime, we work aggressively with our Office of the Inspector General to investigate and prosecute people who commit fraud. Acting Commissioner Carolyn Colvin’s message to those who would defraud Social Security is clear: “We will find you; we will prosecute you; we will seek the maximum punishment allowable under the law; and we will fight to restore to the American public the money you’ve stolen.” We provide benefits to one-fifth of the American population, including elderly retirees, people with severe illnesses, and widows and children after
Q&A Q: I’m gathering everything I’ll need to file my taxes this month. Do I have to pay taxes on Social Security benefits? Also, where can I get a replacement 1099? A: Some people who get Social Security must pay federal income taxes on their benefits. Still, no one pays taxes on more than 85 percent of their Social Security benefits. You must pay taxes on some portion of your benefits if you file an individual federal tax return and your combined income exceeds $25,000. If you file a joint return, you must pay taxes if you and your spouse have combined income of more than $32,000. If you are married and file a separate return, you probably will have to pay taxes on your benefits. You can read more about tax preparation in relation to Social Security at www.socialsecurity.gov/planners/taxes.htm. Social Security benefits include monthly retirement, survivor, and disability benefits. They don’t include Supplemental Security Income (SSI) payments, which are not taxable. You can also get a replacement 1099 or 1042S when you open your own personal my Social Security account at www.socialsecurity.gov/myaccount. (Editor’s Note: Read the column under Ask Your Social Security for more information on taxes). Q: I’ve been planning my retirement throughout my career, and I’m
the death of a wage earner. Our beneficiaries also include wounded warriors and the chronically ill, all of whom tend to be the most vulnerable of our population. Protecting our critically important programs from fraud can be challenging. Yet, our standard is absolute — any fraud is unacceptable. And, our focus on preventing fraud works. Our Office of the Inspector General works in concert with our frontline employees to identify fraud and bring offenders to justice. Together, we use a number of tools to help us accurately predict where fraud may occur. By monitoring cases closely, we identify fraud sooner rather than later — and often we prevent it before it happens. We also have stiff penalties that discourage people from committing fraud, including hefty fines, suspension of benefits, and even jail time for the most severe offenses. We take our middle name seriously and so should you. If you suspect someone is committing Social Security fraud, we ask that you report it online at http://oig.ssa.gov/report or call the Social Security Fraud Hotline at 1-800269-0271 immediately.
finally nearing the age when I can stop working. What is the earliest age I can start receiving Social Security retirement benefits? A: You can receive Social Security retirement benefits as early as age 62. Keep in mind that if you retire at age 62, we’ll reduce your benefits by as much as 30 percent of what you’d get if you wait until your full retirement age. If you wait until your full retirement age (66 for people born between 1943 and 1954), you’ll get your full benefit. You can also wait until age 70 to start your benefits. Then, we’ll increase your benefit because you earned delayed retirement credits. When you’re ready to apply for retirement benefits, use our online retirement application, the quickest, easiest, and most convenient way to apply. Visit www.socialsecurity.gov/ retireonline. 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 $104.90 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 (1-800-6334227) (TTY 1-877-486-2048).
mine if you’re required to file, or if you should file because you’re due a refund. You can access this page at irs.gov/ filing — click on “Do you need to file a return?” 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
By Jim Miller
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 and local tax agencies see taxadmin.org — click on “State Agencies/Links” on the menu bar.
Do You Need To File A Tax Return in 2015? Dear Savvy Senior, What are the IRS income tax filing requirements for retirees this tax season? I didn’t have to file last year, but I picked up a little income from a part-time job in 2014, and I’m wondering if I need to file this year. Part-Time Retiree Dear Retiree,
Whether or not you are required to file a federal income tax return this year will depend on how much you earned (gross income) — and the source of that income — as well as your filing status and your age. Your gross income includes all the income you receive that is not exempt from tax, not counting your Social Security benefits, unless you are married and filing separately. Here’s a rundown of the IRS filing requirements for this tax season. If your 2014 gross income was below the threshold for your age and filing status, you probably won’t have to file. But if it’s over, you will. Single: $10,150 ($11,700 if you’re 65
or older by Jan. 1, 2015). Married filing jointly: $20,300 ($21,500 if you or your spouse is 65 or older; or $22,700 if you’re both over 65). Married filing separately: $3,950 at any age. Head of household: $13,050 ($14,600 if age 65 or older). Qualifying widow(er) with dependent child: $16,350 ($17,550 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 Requirements
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 self-employment in 2014 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 a tool on their website that asks a series of questions that will help you deter-
Tax Prep Assistance
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, aged 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 888-227-7669 or visit aarp.org/findtaxhelp. You don’t have to be an AARP member to use this service. Editor’s Note: Read the column under Ask Your Social Security for more information on taxes. 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.
U.S. Smoking Deaths May Be Underestimated, Study Suggests
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moking may be killing more people than even current estimates indicate, a new study suggests. According to the U.S. Surgeon General, about 480,000 Americans die of smoking-related causes each year, but that figure may be closer to 540,000, researchers from the American Cancer Society report. While lung cancer takes the largest toll in smoking-related deaths, the additional 60,000 deaths appear to be caused by diseases not typically associated with tobacco. “The Surgeon General’s report claims 480,000 deaths directly caused by smoking, but we think that is really quite a bit off,” said lead researcher Brian Carter, an epidemiologist at the cancer society. The report was published Feb. 12 in the New England Journal of Medicine.
Top Five Reasons You Need Fat in Your Diet 1. Energy: Fat provides a highly-concentrated form of energy. One gram of fat gives you nine calories of energy, which is over twice that provided by carbohydrates or protein. 2. Organs Need a Cushion: A cushion of fat helps protect organs from injury and holds them in place. 3. Cell Structure: Whether it is hair, skin or your eyes, fats make up part of the membrane that surrounds each cell of the body and without them the rest of the cell can’t function. 4. Immune Function: Without good fats in our diet, immune function becomes partially impaired and our bodies are susceptible to foreign invaders such as bacterial and viral infections. 5. Nutrient Transport: Vitamin A, D, E and K are fat soluble vitamins and need fat to help the body transport, store, and absorb them.
Do you or does anyone you know have any of the following symptoms? n Easy bruising n Frequent or prolonged nosebleeds n Prolonged or heavy menstrual bleeding n Prolonged bleeding following surgery, dental work, childbirth, or injury If so, you should know that these symptoms occur in a common bleeding disorder called von Willebrand disease (VWD). Learn the facts about VWD. Call the Hemophilia Treatment Center of WNY at (716)896-2470 ext, 4012 to get more information. Comprehensive treatment of all bleeding and clotting disorders. In one place, at one time.
716-896-2470 • wwwhemophiliawny.com March 2015 •
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H ealth News Lifetime Health Medical names new president Andrew L. Wilson has been named president of Lifetime Health Medical Group. He began his appointment Feb. 2, and will oversee the group’s operations in Buffalo and Rochester. Most recently he served as president and senior principal for Shoreline Associates, a national consultative consortium focusing on national health care legislative initiatives, Accountable Care Organization development and physician/hospital clinical integration and bottom line improvement. Prior to that, Wilson was president and chief executive officer for St. Alexius Health System and Medical Center in Bismarck, North Dakota, and president and executive director of Wilson the Atlanta-based managed care integrated delivery network, Synergy at Saint Joseph’s, Inc. He has also held executive positions in Michigan. A native of Michigan, Wilson has a bachelor’s degree in communications/ business from Michigan State University and an MBA from Saginaw Valley State University. He has served on numerous boards, health care councils and advisory panels throughout his career, including as a member of Dow Chemical Health Care Advisory Panel, Michigan State Senate Health Policy Task Force on Managed Care, The Leapfrog Group regional hospital review committee, and United States Sen. Kent Conrad’s Health Care task force. He played a significant role and advocate in Washington for the Frontier State Amendment that was included and approved as part of the historic national Health Care Reform Bill. The amendment pays providers in rural states a 1.0 floor for Medicare reimbursement, bringing millions of additional dollars to those providers and states each year, greatly improving both the providers’ and states’ economic status. Lifetime Health Medical Group provides primary and specialty care, urgent care, pharmacy, and imaging services, serving the Buffalo and Rochester communities for more than 40 years. For more information visit www. lifetimehealth.org.
Parkinson’s Foundation names new director The National Parkinson Foundation of Western New York (NPFWNY) has announced that Christopher Jamele has been named its new executive director. Jamele served as the director of communications for the organization for nearly five years before briefly departing in September. This appointment follows a lengthy interview Page 18
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process that began in the fall. The organization serves a growing population in Western New York and is expanding its presence in the region. The groundwork for NPFWNY began almost 20 years ago, as a grassroots group of patients and Jamele caregivers gathered as the Parkinson’s Wellness Group. The organization affiliated with the National Parkinson Foundation three years ago and has continued to develop support groups, educational programs and social events that serve the nearly 9,000 Parkinson’s patients and their families in Western New York. “This region is a hotspot for Parkinson’s diagnoses,” according to Jamele. “I am anxious to face the challenges and to uncover the opportunities for bringing greater awareness of Parkinson’s disease to this area. We touch so many people every day through our programs and services, but we need to reach further. It’s a wonderful feeling when you can provide comfort and support to someone who needs it.” Jamele has experience with PD, as his father suffered with Parkinson’s for nearly 20 years. Board member and former NPFWNY President Pat Weigel stated that Jamele’s “passion and authenticity have brought great energy to the position, and he has clearly hit the ground running. I believe his leadership will inspire our local Parkinson’s patients and their families while providing the support that they deserve.” Before taking on this position, Jamele was long a familiar face in the hospitality industry in the Elmwood Village. He holds a master’s degree in English and a bachelor’s in communications, both from the SUC at Buffalo. He has been a freelance writer and is still one of the voices heard on WBFO, Buffalo’s NPR affiliate. Jamele began his job as executive director in January.
Heritage Ministries joins HEALTHeLINK Heritage Ministries in Jamestown has joined HEALTHeLINK, as a longterm care data source supplying clinical information securely and electronically to Western New York’s clinical information exchange. With authorized patient consent, treating physicians can now access admission, discharge and transfer notices from Heritage Ministries to improve transitions of care. “In a setting like Heritage Ministries and other long-term care facilities, being able to streamline communications among the various transitions of care through HEALTHeLINK is critical in ensuring that the patient receives the most effective and efficient treatment and all treating physicians have a complete picture of that patient’s medical history,” said Dan Porreca, HEALTHe-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2015
Candace S. Johnson is First Female Leader at Roswell Park Center After a national search involving the review of many applications and numerous interviews and discussions with qualified candidates, the Roswell Park Cancer Institute (RPCI) board of directors has named Candace S. Johnson as the institute’s 15th president and CEO. Johnson is the first female leader for this 117-year-old comprehensive cancer center. “Over the last few months we have met Johnson some highly qualified cancer leaders from around the country who were interested in pursuing this job. Through this process of discovery, the search committee took note of the incredible job Dr. Johnson has been doing in leading this organization since Dr. Donald Trump retired last fall,” says Michael Joseph, chairman of the RPCI board of directors. “There wasn’t a member of the board, community leader, RPCI employee or cancer center friend who hasn’t realized that our future leader was right in front of us. Dr. Johnson is a respected scientist and leader.” Johnson has led the scientific strategies and achievements of Roswell Park for 13 years. During that time, she has helped secure the National Cancer Institute’s coveted Cancer Center Support Grant for the institute LINK’s executive director. HEALTHeLINK is a collaborative effort among Western New York’s major health care organizations with the goal of providing physicians and medical staff with immediate secure access to clinical information on patients in their care, including admission, discharge and transfer messages, lab and radiology reports, radiology images, and other transcribed reports – regardless of where that information may have been recorded. This information is available to licensed health care providers such as physicians and nurses only when a patient provides authorization by signing a consent form. More than 712,000 Western New Yorkers have signed a HEALTHeLINK consent form. Heritage Ministries is the fourth long-term care organization to participate in HEALTHeLINK. “Heritage Ministries is committed to promoting, hope, dignity, and purposeful living. One of the many ways that we achieve that daily is with the use of technology and effective busi-
twice, and has built the foundation for successfully re-competing for this prestigious allocation in five years. Acting as interim president and CEO since October, Johnson immediately began meeting with RPCI corporate and Roswell Park Alliance Foundation board members, community leaders, internal leadership and healthcare decision makers throughout the Western New York region. She has also surrounded herself with a group of clinical and scientific leaders who are helping to develop strategic direction around the ever-changing dynamics facing healthcare delivery systems. Prior to becoming president and CEO of Roswell Park Cancer Institute, Johnson was the deputy director and chairwoman of the department of pharmacology and therapeutics, the Wallace family chairwoman for translational research and professor of oncology. Since November 2014, she has also served as cancer center director for the institute. Before coming to Roswell Park, she served as deputy director of basic research at the University of Pittsburgh Cancer Institute, and professor of pharmacology and medicine at the University of Pittsburgh School of Medicine. Johnson earned her doctoral degree in immunology from Ohio State University in Columbus, Ohio. She completed research and postdoctoral fellowships in immunology and cell biology at the Michigan Cancer Foundation in Detroit.
ness partners,” said Mark Wilcox, director of MIS, Heritage Ministries. “The implementation of HEALTHeLINK is a perfect example of using technology and effective business partners to further improve the care of our residents.” Heritage Ministries is a nonprofit organization that manages and operates human service ministries in Chautauqua County. Headquartered in Jamestown, Heritage Ministries directly serves more than 600 residents on a daily basis at Heritage Green Rehab & Skilled Nursing, Heritage Park Rehab & Skilled Nursing, Heritage Village Rehab & Skilled Nursing, Heritage Village Retirement Community and The Woodlands Senior Living Community.
Buffalo General recognized for quality bariatric surgery BlueCross BlueShield of Western New York has recognized Buffalo
General Medical Center as one of the first healthcare facilities in the nation to receive a Blue Distinction Center+ designation in the area of bariatric surgery by the Blue Distinction Centers for Specialty Care program. Blue Distinction Centers are nationally designated healthcare facilities shown to deliver quality specialty care based on objective measures, which were developed with input from the medical community, for patient safety and better health outcomes. “I couldn’t be prouder of our bariatric team in achieving this tremendous clinical recognition,” said Cheryl Klass, president, Buffalo General Medical Center. “This designation is the direct result of dedicated work by a multidisciplinary team whose sole goal is to provide the highest quality of care to the patients we serve.” To receive a Blue Distinction Center+ for Bariatric Surgery designation, a healthcare facility must demonstrate success in meeting patient safety as well as bariatric-specific quality measures, including complications and readmissions, for gastric stapling or gastric banding procedures. A healthcare facility must also have earned national accreditations at both the facility level and the bariatric care-specific level, as well as demonstrate better cost efficiency relative to its peers. Quality is key: only those facilities that first meet Blue Distinction’s nationally-established, objective quality measures will be considered for designation as a Blue Distinction Center+. Buffalo General Medical Center is proud to be recognized by BlueCross BlueShield of Western New York for meeting the rigorous selection criteria for bariatric surgery set by the Blue Distinction Centers for Specialty Care program. “Our weight loss patients can attest to the outstanding care and outcomes of our program for almost 10 years now,” said physician Aaron Hoffman, medical director, Center for Minimally Invasive Surgery at Buffalo General Medical Center. “This latest external honor and recognition only adds to our belief that bariatric surgery is a cornerstone of the burgeoning development of the Buffalo Niagara Medical Campus as a regional center of medical innovation and quality.”
Psychologist Lackner appointed at UB Jeffrey Lackner, PsyD, has been appointed the vice chairman for research for UB’s department of medicine (DOM). Physician Sanjay Sethi is stepping down to assume the inaugural position of assistant vice president for health sciences/ medical director, clinical research office at UB. Lackner is internationally known as a prolific and innovative researcher with over 15 years of continuous NIH Lackner funding as well as industry grants totaling $14 million. Director of UB’s behavioral medicine clinic, he established a stateof-the-science research program for understanding and treating functional GI disease. He is a member of UB’s and UBMD internal medicine’s division of gastroenterology.
Remain safely at home with help from HomeFirst.
More and more people on Medicaid who might otherwise be struggling to take care of themselves won’t have to because of HomeFirst. HomeFirst, a product of Elderplan, is one of the oldest managed long-term care (MLTC) plans in the state. Our Personal Care Workers provide assistance with bathing, dressing and meals. You can keep your own doctor, and we provide transportation to medical appointments. There is no cost to participate. HomeFirst is an affiliate of MJHS, which was founded on the core values of compassion, dignity and respect for every culture. Those core values date back to 1907, when MJHS began a tradition of caring every minute, every day.
Call 1-866-384-3509 or visit homefirst.org
Services covered by HomeFirst are paid for by New York State Medicaid. The services not part of HomeFirst benefits continue to be covered by Medicaid and/or Medicare benefits. All services are coordinated, even those not included in the MLTCP benefit package. H3347_EPHF14288
Check this issue of In Good Health — WNY’s Healthcare Newspaper online at
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Numbers You Should Watch For good health, keep track of your cholesterol, blood pressure and blood sugar numbers By Ernst Lamothe Jr.
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eople have to be responsible for their own health. While a physician can diagnose various health issues, typically you are the one who notices the first warning sign that something is happening to your body. Medical officials said because of that fact, there are certain health numbers every individual should know about themselves on a regular basis to help them live their healthiest life. George E. Matthews, director of cardiology at Millard Fillmore Suburban Hospital in Williamsville, a full-service, 265-bed acute care teaching hospital and a subsidiary of Kaleida Health, talked about the important numbers that everyone should know in their life.
Cholesterol number
Below 200 is the ideal number for cholesterol, according to the American Heart Association. When the numbers start hitting 240 and higher, that can be a dangerous limit. Total cholesterol, LDL and HDL are the measurements used in blood tests when it comes to cholesterol. “The cholesterol values represent one of the strongest measures by which we can assess an individual’s risk for the development of vascular disease, specifically coronary artery disease and stroke,” said Matthews. “Throughout the past century, it is been appreciated that cholesterol values represent strong predictors of risk for heart attacks and other vascular disease-related illnesses.” Matthews said individuals with high cholesterol have twice the risk of heart disease as individuals with optimal levels. The Centers for Disease Control report that 71 million American adults or 33.5 percent have high LDL or bad Matthews cholesterol.
Blood pressure number
The top number, or systolic, the larger of the two figures, measures pressure in the arteries when the heart beats. The lower number, or diastolic, measures the pressure of arteries between heartbeats when the heart muscle is resting and refilling with blood. High blood pressure is a condition that is often managed with medication by the time it gets to dire points. Matthews said hypertension, which sometimes is a precursor to diabetes, increases the risk of cardiovascular disease, specifically stroke, coronary artery disease, heart failure, rhythm disorders such as atrial fibrillation and peripheral vascular disease. Data from the Framingham Heart Study suggests coronary disease in men and stroke in women are the first cardiovascular events noted after hypertension onset. “The risk for both coronary artery disease and stroke increase progressively with blood pressure above 115/75,” added Matthews. About 67 million American adults have high blood pressure and seven of every 10 people having their first heart attack have high blood pressure, according to the CDC. In addition, eight of every 10 people having their first stroke have high blood pressure.
Blood sugar number
Normal blood glucose levels range from 70 to 120 milligrams per deciliter, and sometimes slightly higher after eating. If you have hypoglycemia, meaning your blood sugar levels fall too low, you can experience shaking, fast heartbeat, dizziness, headaches or weakness. If you have hyperglycemia, high blood glucose levels and a myriad of other symptoms could occur, including blurred vision and increased urination. Either condition can be life threatening, Matthews says. The doctor said he understands why many people get a queasy feeling in their stomachs just thinking about visiting a physician. He cautions people not to let fear overtake them because there is a more powerful force than fear. “Knowledge is power,” added Matthews. “The knowledge and understanding of one’s risk factors and the manner in which these risk factors predispose to the development of stroke, heart attack or heart failure allow us to modify our behaviors and lifestyle choices. Medicine and in particular science has made great strides in improving our health. It is only through the education we receive and the knowledge we gain that we can implement those lifestyle choices that will allow us to live a rewarding and fulfilling life. Page 20
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2015