in good Bike to Work Stephanie Brochey of North Tonawanda writes about biking to work: “The biggest reward of bike commuting was my improved state of mind. Riding became my own form of meditation.”
April 2015 • Issue 6
bfohealth.com
priceless
Buffalo & WNY’s Healthcare Newspaper
Supplements Under Attack Major retailers, including Wegmans and Walmart, asked to halt sales of certain diet and herbal supplements Page 7
Helipad planned for new Children’s Hospital
How Medicare Covers In-Home Care
Lyme Disease
Obamacare Excludes Pregnant Women Missing Enrollment ACA coverage gap leaves women two choices: 1) pay for insurance premiums or care out of pocket —to the tune of $10,000 to $20,000 or 2) skip prenatal care Page 12
Preventing Bad Dog Behavior
As temperature goes up, so does the risk of getting Lyme disease. The bad news? Number of cases in Erie County is up
HEALTHY BUFFALO
Learn a few techniques to help train your dog
When my husband and I were first dating, he introduced me to a unique vegetable: fennel. It was love at first bite! Since then, I haven’t strayed. Find out why Page 10
Employees at BlueCross BlueShield of WNY Bike during a lunch break. More companies like BC BS are encouraging employess get fit
Page 11
Meet Your Doctor Dr. Andrew Fabiano, director at Roswell Park’s Spinal Oncology Center, discusses how patients can detect spinal cancer and how it can be treated. Page 6
April 2015 •
Red Wine One or two glass a day of wine. Remember when researchers said this was a good thing? Well, a new study says it isn’t so Page 19
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Thank You Nearly 500 people in the area have subscribed to In Good Health — Buffalo’s Healthcare Newspaper in the last few months.
They will get the paper every month at their home or office and won’t miss a single issue of In Good Health. These subscribers join thousands of other readers who pick up copies of In Good Health every month at more than 1,000 high traffic locations in the area, including all 42 Tops Friendly Markets. They also join nearly 2,000 health professionals who are on our mailing list and receive the paper on a regular basis. An estimated 100,000 people read In Good Health every month based on a distribution of 35,000 free copies. What do they have in common? They’re all interested in health issues with a local perspective.
in good February 2015
Make A Wish
Make-A-Wish Western New York makes sign ificant impact on lives. Just ask Ethan
Weight Loss 5 mistakes you should avoid
• Issue 4
Buffalo & WNY’s
SURVIVOR
ew inside
spaper
discuss ways to so: What yo ur doctor bring it down w Page an
Coconut Oil Supports Good Health
Consumers using it as moisturizers , mouth wash and acne control
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15
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Men ranging in age from 50 to nearly 90 faithfully partici pate in basketbal in Hamburg l games
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Alternative Treatments for Psoriasis Local exp
Gluten-free pizz Restaurant revi
Healthcare New
HOW HIGH RU ESROLUTIONS IS YO Why we keep ma king them BLOOD year after year? Experts explain how we to make PRESSURE? that we can achresievoluetions Local experts Al 13
Meet cancer sur vivor Amanda Velard e
priceless
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Meet Your Do ctor
A discussion abo ut bleeding, clotting disorder s with the new pediatric medical director at Hemophilia Center of Western New York, Shilpa Jain.
erts weigh in Page 10
See Smart Bite s on page 11
Move Over, Ch It’s Pork Time!icken:
page 16
Valentine’s Day
:
Love the One Who Matters Most: YOU!
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IN GOOD HEA
Weight Loss: 5 Mistakes Yo Should Avoid u
LTH – Buffalo &
WNY’s Healthcar
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What people are saying about In Good Health “In Good Health has good really great tips and information about places to help you for doctors and hospitals. Is an excellent paper.” Carol Brown, Depew “So many timely topics. Keep up your great work. Love it!” Molly Pfieffer, Tonawanda “Good Information on health care.” James Hilburger, Cheektowaga “I found the articles about nutrition and new trends very useful.” Tawana Guzman, Amherst “I like most everything about this newspaper.” Margaret Sisti, Cheektowaga “Like everything. [In Good Health] has a wide range of topics and ages.” Judith Clark, Hamburg “It brings you information you need to know. Thanks for publishing a paper like this.” Janet Weber, Alden “Enjoyed reading the entire paper, great variety.” Mary Ann Zajdowicz, Depew “I enjoy the vast variety of health topics addressed.” Rachel Costa, Lackawanna
“[The paper has] important medical articles with accurate information for the reader.”
Dr. Thomas A. Sparks, Amherst
“Very good info. Thank You!” Nancy Swain, Bemus Point
“Very informative for seniors.” Jim & Jane Sawicki, Hamburg
“Very informative!” Judith Tyler, Buffalo
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“Very informative on wide range of topics to appeal to a wide audience.” Kristen Lazzazero, Clarence “Healthy articles showing ways to stay in best shape possible.” Dan Kaminski, Hamburg “I like the entire newspaper.” Robbie Stanfiel, Buffalo “I like the different articles on health issues.” Joanne Walleshauser, E. Amherst “Very informative and interesting little magazine. Lots of info. Beth Kleinschmidt, Buffalo “Very informative.” Holly Weisenberger, Tonawanda “I like all the new information.” Chelsea Oberkrieser, South Wales
“I like all the great health articles. Very important to know. Janice Marino, Amherst I like articles on age-related health. Omprakash Sabharwal, Williamsville “I like the interviews, subjects, reviews and ads.” Pat Fowler, Amherst
“Love the columns. My favorite article is ‘Smart Bites.’” William Breslin, Hamburg “The articles on women’s health and senior articles.” Cheryl Massett, West Seneca “I love the article in Live Alone alone. I love this paper.” Juanita Richardson, Buffalo “Everything it touched base with. A lot of good information.” Karen Szymkowiak, Buffalo “Information on doctors, clinics and new programs.” Edna Kowal, Blasdell “Great articles on current health development locally.” Barbara Bosinski, Buffalo “Helpful hints.” Louise Kubiak, Tonawanda
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2015
Cancer: U.S. Spends More, Saves Fewer Lives than Western Europe
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Flu Hospitalizations Soar Among Older Adults
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his flu season has been particularly severe for older adults, with people in this age group experiencing the highest rate of hospitalizations in a decade, according to a new report from the Centers for Disease Control and Prevention. Since October, the rate of flu hospitalizations among U.S. adults ages 65 and over has been 258 hospitalizations per 100,000 people, the report found. Previously, the highest rate was during the 2012 to 2013 flu season, when there were 183 flu hospitalizations per 100,000 people ages 65 and older, the report said. Health officials started keeping track of flu hospitalizations in 2005. For the U.S. population as a whole,
the flu hospitalization rate this season was about 52 hospitalizations per 100,000 people, which is higher than the rates for the past three flu seasons, the report said. One reason the flu is more severe this year could be the types of flu strains that are circulating. The most common strain of flu this season is H3N2, and health officials know that in years when this flu strain predominates, there tend to be more hospitalizations and deaths. A study published earlier this year also found that this year’s flu vaccine is not very effective at preventing the flu, likely because the strains in the vaccine are not a good match to the strains in circulation.
Attention Medicare Part D Members
espite sharp increases in spending on cancer treatment, cancer mortality rates in the United States have decreased only modestly since 1970, Samir Soneji, PhD of Dartmouth’s Norris Cotton Cancer Center and The Dartmouth Institute for Health Policy & Clinical Practice has found. Refuting previous studies, Soneji published his paper “New Analysis Reexamines the Value of Cancer Care in the United States Compared to Western Europe,” in the March issue of Health Affairs. “Our results suggest that cancer care in the U.S. did not always avert deaths compared to Western Europe and, when it did avert deaths, it often did so at substantial cost,” explained Soneji. “The greatest number of deaths averted occurred in cancers for which decreasing mortality rates were more likely to be the result of successful prevention and screening rather than advancements in treatment.” U.S. cancer mortality rates de-
creased by 12 percent since 1970, compared to a 62 percent decrease for heart disease. Such findings have raised questions about the additional value of U.S. cancer care derived from the additional spending, in comparison to the situation in other high-income countries. This study compared U.S. and Western European spending between 1982 and 2010 for 12 of the most common cancers. Compared to Western Europe, the U.S averted 67,000 breast cancer deaths, 265,000 colorectal cancer deaths, and 60,000 prostate cancer deaths between 1982 and 2010. The U.S. experienced 1,120,000 excess lung cancer deaths in this study period compared to Western Europe. The ratio of incremental cost to quality-adjusted-life-years saved equaled $402,000 for breast cancer, $110,000 for colorectal cancer, and $1,979,000 for prostate cancer. These amounts exceed most accepted thresholds for cost-effective medical care.
Outstanding Nurses Is someone in your workplace an outstanding nurse? If so, recognize him or her with an ad in the May issue of In Good Health—Buffalo’s Healthcare Newspaper. Edition will feature several nursing-related stories to celebrate National Nurses Week (May 6-12). We design your ad at no charge. 716-332-0640
You may have been affected by recent changes in your current Medicare Part D plan. If you are self-enrolled in Univera, you recently received a notice that Walgreens and Rite Aid are no longer part of its Medicare Part D pharmacy network as of January 1, 2015. If you need to switch pharmacies, or need advice, we hope you'll consider Wegmans Pharmacy as your new partner in wellness. ¥ Wegmans accepts most Medicare Part D plans ¥ Member of the Univera pharmacy network for over 40 years ¥ Recently rated the #1 Pharmacy in America
It's easy to switch. Just provide us your prescription information and we'll do the rest. Stop in to our pharmacy today, or give us a call at 1-877-934-2479, and speak directly to our pharmacy team. Our friendly, helpful Pharmacy staff takes your health to heart. We're here to help make sense of these changes and set up worry-free wellness care for you.
Rated the #1 Pharmacy in America! April 2015 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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The Buffalo and Erie County Botanical Gardens are taking the unprecedented step of lighting their facility in recognition of an important local cause. April is Parkinson’s Awareness Month and the gardens will be lighting their central dome in blue for the month. The National Parkinson Foundation of Western New York (NPFWNY) and the Botanical Gardens are teaming up for this spectacular display. Blue is the color associated with Parkinson’s disease, and an azure glow will grace one of Buffalo’s landmark locations to heighten awareness of Parkinson’s in Western New York. Parkinson’s disease strikes Western New York particularly hard. This region ranks at the top nationally for the prevalence of diagnoses, and the reasons remain a matter of study. Add
caregivers and family members to the nearly 9,000 local patients and Parkinson’s affects tens of thousands of area residents. There are awareness events scheduled by NPFWNY throughout the month, and according to Executive Director Chris Jamele, enthusiasm is becoming contagious. “We have a number of local schools involved in our programs this year, and new businesses are coming on board as well, like the Botanical Gardens,” he said. The lighting of the dome is expected to be a great promotional vehicle for both organizations. “When Chris [Jamele] called, we were excited by the idea but had to do some leg work to pull it off. It’s great to be working with another local non profit to spread awareness,” said Erin Grajek, associate vice president of marketing and visitor experience at the Botanical Gardens. The light display will coincide with one of the most popular displays of the year at the gardens, the spring flower exhibit. “We are proud to collaborate with the Parkinson’s Foundation on lighting the dome in blue during the month of April. We are happy to celebrate our Spring Flower Exhibit and light up the Gardens in all sorts of spring colors but most of all in blue,” said Dave Swarts, Botanical Gardens president and CEO. Filters for the lights have been ordered and should be installed by the end of the first week of April. The lighting will then continue through the rest of the month. This is a landmark occasion, as the dome at the Botanical Gardens has never been lit for a specific cause before. Both the administration at the gardens and NPFWNY are anxious to see this become an annual event. The lighting is sponsored by Dual Print and Mail and Consumer’s Beverages. NPFWNY has numerous programs and events planned for April. Other lighting events include the Peace Bridge and Niagara Falls. A wine tasting will take place on the 24th, which is also Wear Blue Day, a day to wear as much blue as possible. A number of local schools and area businesses are promoting this effort.
Serving Western New York in good A monthly newspaper published by
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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@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Publisher: Jamie Sandidge • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Catherine Miller, Stephanie Brochey, Patrick Sawers • 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 Page 4
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2015
New Leader Brings Energy at Parkinson’s Foundation By Catherine Miller
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diagnosis of Parkinson’s disease is a life-altering event. While advances in medications, surgical treatment and active research into the disease have progressed rapidly in the past 10 years, newly diagnosed patients and families are challenged with navigating the physical changes that do not always follow a standard course of progression. Fortunately for these patients and their families, the National Parkinson Foundation of WNY [NPFWNY], based in Williamsville, offers a great deal of support. The NPFWNY recently named Christopher Jamele as its new executive director. A long-standing board member for the foundation, Jamele welcomes the opportunity to advance the mission of the National Parkinson Foundation in the region. “I became involved in the foundation when my father was diagnosed with Parkinson’s disease,” says Jamele, “The foundation is a great resource for information and support for people Jamele with Parkinson’s disease as well as for their family, friends and caregivers. While there is no ‘litmus test’ for the disease and no cure, becoming well
informed about the disease and its progression is one of the best things you can do as a patient or family member after a Parkinson’s diagnosis.” Parkinson’s disease is a neurodegenerative brain disorder that progresses slowly and decreases a person’s ability to regulate her movements, body and emotions. Although the disease itself is not fatal, complications related to the disease are a leading cause of death in the United States. A national study published in 2010 by Washington University School of Medicine ranked Western New York as having one of the highest rates of PD. The National Parkinson Foundation of Western New York, formerly known as the Parkinson’s Wellness Group, was established in 1997, and holds year-round events meant to educate and inform the public of the symptoms and progressions of the disease. The foundation brings local PD patients and the families together to discuss their trials and celebrate their triumphs associated with their PD challenges. “My father was an active golfer throughout his life,” recalled Jamele, “While he was struggling with the advances of his disease and his move-
ments became limited, he continued to golf with a Wii game system, and he truly enjoyed it. Even once his movements became very limited he still enjoyed being able to play Wii golf. I recommend that people with Parkinson’s continue to move whenever and however possible and as much as possible. It absolutely helps.” Early symptoms of ParkinThe annual Moving Day run/walk event unites son’s disease include obvious family and friends in the fight against Parkinson’s tremors or shaking, trouble disease. Photo taken in 2013. Courtesy of Hannah moving or walking, as well as Kathleen Photography. a softening in the tone of the voice, trouble sleeping, loss of smell or small handwriting. Parkinson’s Month Only a doctor can tell you for sure if April is National Parkinson’s the symptoms you are experiencing are Month and a great time to search out early signs of Parkinson’s disease. your local chapter, volunteer for one of While a diagnosis of Parkinson’s their many upcoming events, buy a PD disease can be alarming recent research support ribbon at a local restaurant, or into the disease, its treatment and sign up for September’s Moving Day advances, are helping to elongate the run/walk event to help the thousands quality of life for Parkinson’s patients and giving hope that greatly improved in our area that are afflicted with this disabling disease. treatments and cures are on the horiVisit the National Parkinson Founzon. Meanwhile, keeping a positive dation of Western New York website outlook, exercising, and eating a proper at npfwny.org or call them at 716-449diet can assist in slowing the pro3795 for further information on support gression of your disease. Maintaining groups and upcoming events. communication with others that are traveling a similar path can help offer See related story under our calendar support with upcoming challenges.
of events.
Healthcare in a Minute By George W. Chapman
New watch helps disclose personal health information
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pple watch. Industry experts believe Apple will sell 30 million of these within weeks of release. This “watch” is just the latest wearable device that could give insurers information about your vitals (pulse, calories used, steps taken, etc.). This creates “usage-based” insurance where healthy behavior is encouraged and rewarded. Supposedly, 90 percent of us are willing to disclose this real-time personal health information if it will lead to more treatment options. Critics are worried that insurers could use the data for discriminatory pricing. In any event, most view these wearable devices positively if they get people to be more health-conscious. Medicare fraud. While the feds have stepped up efforts to reduce fraud, the U.S. Government Accountability Office reported $60 billion, or 10 percent of all payments, were improper. The GAO issued four recommendations to reduce/eliminate Medicare fraud including, most importantly, removing social security numbers from Medicare cards. Not providing your social security number to your provider has been previously recommended here. They don’t need it.
Healthcare disparities plague U.S. system. A recent article in Forbes discusses how quality of care disparities due to race, income, gender and sexual orientation is one reason why the U.S. healthcare system ranks so poorly compared to other developed countries. Expanded insurance coverage through the Affordable Care Act, community outreach efforts and provider education are aimed at eliminating the disparities and improving access to care and outcomes. Blue Distinction Centers. Several surveys have highlighted the tremendous variances in costs among hospitals, even in the same market, for certain surgical procedures. For example, a knee replacement cost $11,317 in Montgomery, Ala. while the same costs $69,654 in New York City. In Dallas, the costs range from $16,772 to $61,585. That’s a 267 percent differential depending on your hospital. To help consumers choose safe, high outcome, cost-effective hospitals, the Blues have identified Blue Distinction Centers for certain procedures. There are 427 of these designated centers for hip and knee replacement across the U.S. with four being in Upstate New York: Arnot Ogden in Elmira, Bassett in Cooperstown, Fax-
ton-St. Luke’s in Utica and Highland in Rochester. King vs. Burwell. This is the case before the U.S. Supreme Court to decide whether or not the provision of federal tax subsidies for eligible ObamaCare recipients in those states that rely on the federal exchange are constitutional. The plaintiffs argue the federal subsidies would be legal in only the 13 states, including New York, that run their own marketplaces/exchanges. The government argues that this provision is key and the intention/ spirit of the law is to provide federal tax subsidies to eligible residents in all states. The problem is if the court decides to overturn this key provision, millions would lose their insurance and there is no backup plan. Hoping the court upholds this key provision of ObamaCare are the American Hospital Association, America’s Health Insurance Plans, the National Alliance of State Health Co-ops and the American Medical Association. Price transparency. The Healthcare Cost Institute is working on a website that lists cost information for over 70 common health conditions and elective procedures. It will be called Guroo. com. Cost information is garnered from claims data from several national April 2015 •
carriers. It is free and open to anyone regardless of insurance. Private exchanges growing. While all the media attention is on healthcare. gov and federal subsidies for care, about 2.5 million people are insured through private commercial exchanges. Industry experts predict that could grow by three times in 2015. A recent Price Waterhouse survey of employers revealed 47 percent of respondents are interested in private exchanges this year and 20 percent in 2016. Skeptics argue there is a big difference between showing interest and enrollment. ObamaCare. As of this month, 16.4 million are enrolled including 3.4 million young adults aged 19-25. The percent of uninsured Americans has decreased from 20 percent in 2013 to 13 percent in March. 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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Meet
Your Doctor
By Chris Motola
Andrew Fabiano, M.D. Director at Roswell Park’s Spinal Oncology Center discusses how patients can detect spinal cancer and how it can be treated Q. How difficult is it to detect spinal cancers? A.: Spinal cancers can be readily apparent or difficult to detect, depending on the symptoms that they cause for a patient. In instances where a spinal cancer causes weakness or trouble moving around, they may be quickly identified. In other instances where a spinal cancer causes more insidious symptoms, such as neck or back pain, they may not be immediately diagnosed, as these types of pain are common and often caused by degenerative conditions. It is important that any patient with a known primary cancer who develops new neck or back pain or new neurologic symptoms is evaluated for the presence of spinal metastatic disease. Q.: Am I correct in understanding that most spinal tumors are the result of cancer in other organs? A.: Yes, the most common spinal tumors are spinal metastases from a cancer originating in other organs, such as the lung, breast or prostate. Up to 70 percent of cancer patients will develop a spinal metastasis at some point during their disease course. Q.: What treatments are available? A.: Options available for managing spinal tumors range from observation, where you’re monitoring a patient to see if his or her tumor progresses or causes additional symptoms, to chemotherapy, radiation and surgery. A common treatment that has been demonstrated to protect a patient’s ability to walk and reduce pain involves surgery to reduce pressure on the spinal cord followed by radiation to treat any remaining cancer cells. Q.: How are the side effects from spinal cancer treatments managed? A.: A main side effect from spinal cancer can be pain. Both surgery and radiation have been demonstrated to reduce a patient’s pain over time. We treat spinal pain aggressively and involve our pain management team as soon as a spinal cancer is identified to ensure adequate control of spine-cancer-related pain, with a goal of maintaining a Page 6
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patient’s ability to continue with their normal activities of daily life. Q.: Given the proximity of the spine to major nerves, how much are neurologists involved? A.: The spinal cord and the origin of the major peripheral nerves of the body are contained within the vertebral column. A neurosurgeon is an expert on these structures and is ideally suited to treat spinal disease. When nerve damage occurs as the result of direct tumor damage or as a side effect of treatment — for example, peripheral neuropathy from chemotherapy — a neurologist often is involved. Our spinal oncology center is served by a neuro-oncologist
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2015
Roswell Park’s Spinal Oncology Center offers advanced treatment options and expert multidisciplinary care for both malignant and nonmalignant conditions of the spine. specially trained to treat these conditions. Q.: What is the prognosis typically like for spinal cancers? A.: The prognosis for spinal cancers varies depending on the pathologic diagnosis of the cancer. The most common type of spinal cancer is spinal metastatic disease. In the vast majority of cases of spinal metastatic disease, the cancer can be controlled in the spine, and the response of the cancer in the rest of the patient’s body determines the overall prognosis. It is important to appropriately recognize and treat spinal metastatic disease to prevent a neurologic deficit. In patients who have impaired walking due to spinal cancer, their overall prognosis becomes worse due to this disability. Q.: As director of Roswell Park’s Spinal Oncology Center, how is your time split between administrative and clinical duties? A.: The majority of my time is spent on direct patient care activities, including surgical procedures, outpatient clinics, and inpatient hospital rounds. I participate in multidisciplinary conferences called “Tumor Boards,” where patients with spinal tumors are presented and a group of specialists contribute to a best-practice treatment recommendation. I also have multiple administrative responsibilities. I am the principal investigator for several research studies and serve on Roswell Park Cancer Institute’s medical staff executive committee
and surgical services executive committee. I also participate in spinal surgery education at a national level as a member of the North American Spine Society’s (NASS) Committee on Robotics & Navigation. Q.: What services does a strong spinal oncology center offer? Where do you think there is room for improvement in yours? A.: Strong spinal oncology center offers multiple treatment options to patients and addresses pain management, which can often be an issue for patients with spinal disease. Representation from multiple medical specialties, including neurosurgery, radiation oncology, neuroradiology, medical oncology, and pain management, is the ideal when creating a spinal oncology center, and we’re fortunate to have all those disciplines engaged at the Roswell Park Spinal Oncology Center. Further, having a surgical team in place that routinely treats spinal tumors and has access to the latest intraoperative technology, including spinal neuronavigation, can result in increased patient safety and better surgical outcomes. We strive to continually improve our spinal oncology center and will be hosting a continuing-medical-education event in the near future to improve our community education about spinal metastatic disease. Q.: What got you interested in your specialty? A.: My grandfather suffered from a neurologic disease, so I was always interested in helping others who suffered from a neurologic problem. Q.: What personal influence do you think you’ve had on your department? A.: I have advanced training in minimally invasive surgical techniques, intraoperative spinal imaging, spinal neuronavigation, and complex spinal reconstructions. I’m glad to be able to contribute these areas of specialization to an outstanding, talented clinical team that’s committed to treating spinal cancers in a safe and effective fashion. Q.: If you hadn’t followed your career path, what do think you would have done instead? A.: My heart was set on becoming a neurosurgeon from a pretty young age. I feel fortunate to do a rewarding job that I love, and I can’t imagine doing anything else.
Lifelines Name: Andrew Fabiano, M.D. Position: Associate professor of oncology and director of the Spinal Oncology Center at Roswell Park Cancer Institute; clinical associate professor of neurosurgery at the University at Buffalo School of Medicine and Biomedical Sciences Hometown: Buffalo, NY Education: SUNY Buffalo (medical and residency), University of Illinois at Chicago (undergrad) Affiliations: Roswell Park Cancer Institute, University of Buffalo School of Medicine Organizations: American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS), Society of Neuro-Oncology (SNO) , North American Spine Society (NASS) , AANS/CNS Section on Tumors Family: Daughter, 7 Hobbies: Spending time with family and friends, boating, Buffalo Bills and Sabres fan
Supplements Under Attack State attorney general bans the sale of some diet and herbal supplements raising question about their effectiveness By Deborah Jeanne Sergeant
I
t seems that supplements are under attack lately. New York Attorney General Eric Schneiderman has set his sights on diet and herbal supplements, forcing major retailers to stop selling certain formulas, claiming several do not contain the properties advertised on their labels. Feb. 2, Schneiderman send cease and desist letters to GNC, Target, Walgreens and Walmart because most store brand supplements contained ingredients unlisted on the labels and only 21 percent of the supplement tests identified DNA from the plants the labels listed. Products included Echinacea, ginseng, St. John’s Wort and others. In addition to pulling the products from the shelves, Schneiderman requested that the businesses send documentation on how the products are made and tested for quality. Schneiderman’s report stated that Wal-Mart’s store brand represented the weakest products, containing only 4 percent of its listed plant ingredients. While consumers expect herbal blends to contain several ingredients, those not listed on the label are considered contaminants. Schneiderman’s investigation revealed unlisted ingredients such as rice, beans, pine, citrus, asparagus, primrose, wheat, houseplant and wild carrot. “This investigation makes one thing abundantly clear: the old adage ‘buyer beware’ may be especially true for consumers of herbal supplements,” Schneiderman said in a statement Feb. 3.
Currently, the FDA requires supplement manufacturers only to confirm that their products are safe and bear an accurate ingredient list, but not efficacy and side effects. Physician James A. Schulte, II of Clarkson University in Potsdam, performed the testing using barcodes to avoid brand bias. Schulte used a few samples of each supplement from each store. He tested each sample five times, equaling 390 tests from 78 samples. For details on the outcomes of each sample at each store, visit http://www. ag.ny.gov/press-release. Schneiderman’s study sourced products from stores in Binghamton, Brooklyn, Buffalo, Harlem, Nassau County, Plattsburgh, Poughkeepsie, Rochester, Suffolk County, Syracuse, Utica, Watertown, and Westchester County. Others share Schneiderman’s skepticism about supplements. “Don’t take dietary supplements,” stated phyisician Steven Nissen chairman of the cardiology department at the Cleveland Clinic and part of the AARP medical advisory board in a recent issue of AARP The Magazine. “There’s no way to know what’s in them (they are largely unregulated) and there’s little scientific evidence of any benefits.” He grudgingly acknowledged merit in taking vitamin D and calcium, but said that vitamin D supplementation is “out of control. Avoid vitamin E. Avoid coenzyme Q10. Avoid fish oil; just eat more fish.” Rosemary Russ, manager at Best
of Health in Buffalo, thinks many need supplements. “Most people really don’t eat a good diet,” Russ said. “For example, the baseline for protein is 45 grams a day. Not a lot of people do that. “Unless you’re on top of your diet 100 percent, you don’t get enough nutrients.” She cited vitamin D as another common deficiency. “You need to find out what works for you, and what you need,” Russ said. “Not everyone needs to take everything. You need a guide to help you, like a nutritional consultant.” Marcia Honsberger, who holds a bachelor’s in nursing and is a certified nutritional consultant, owns Best of Health and performs blood work and lab tests to determine if clients have a deficiency. Supplements fall into two categories: nutritional supplements and herbal supplements based on ancient traditions. Schneiderman’s investigation focused on manufactured herbals products; Nissen directed his comments more towards nutritional supplements (vitamins and minerals). “At WNY Nutrition, we believe that optimal health begins with healthy food choices,” said Sarah Thompson DiPaolo, registered dietitian nutritionist, certified dietitian nutritionist and owner of WNY Nutrition, PLLC in Holland, Depew and Williamsville. “Supplements are meant to enhance and complement a well balanced meal plan, providing nutrients in quantity above and beyond that of which we
can obtain in our food.” Bottled herbal preparations such as those in Schneiderman’s investigation may affect people with food allergies. These preparations may contain wheat, for example, that could sicken someone with celiac disease. For safety and for efficacy, finding good quality supplements is important. “Just because something’s cheap doesn’t mean it’s good for you,” Russ said. “We have brands here that all have highly tested. They’re very choosy about the ingredients.” She referenced one brand that uses 103 different third-party tests on just one of its products. “Knowing who’s producing your vitamins is important,” Russ said. “A name brand is important. You’ll pay more, but you know you’re getting the best that your body can utilize.” Thompson DiPaolo said that consideration for selecting a supplement brand should include the quality of the science behind the product, ingredients, and manufacturing process. Also important is “the synergism among product components,” Thompson DiPaolo said. “The ability for your vitamin to work properly for you can vary depending on the form used.” Pharmaceutical grade products and certificates of analysis represent good signs of quality supplements, as does a company certified by the US Food and Drug Association Good Manufacturing Practices and by the National Sanitary Foundation.
UB Research: Older, Not Grumpier Study suggests that aging tends to lead people to become more trusting, not grumpier
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ollywood has given movie-goers many classic portrayals of grumpy old men — American Movie Classics even maintains a list of the top 15 film curmudgeons. But new research suggests that getting older doesn’t imply becoming cynical and misanthropic. Instead, aging tends to lead people to become more trusting, says University at Buffalo psychologist Michael Poulin, co-author of two new studies exploring the relationship between age and trust. Though trust can have negative consequences, especially among older Poulin. adults at risk for exploitation from scams and fraud, the UB research shows that it can also be a resource for well-being. The studies find no evidence that those negative consequences erode
the benefits of trust for older adults’ well-being, said Poulin, associate professor of psychology at UB. “Both studies found a positive association between trust and well-being, which was consistent across the life span, suggesting that trust is not a liability in old age,” he said. “The kindly old man or old woman next door is really not especially likely to yell at the kids to ‘Get off the lawn,’” he added. The studies, conducted with Claudia Haase, assistant professor of human development and social policy at Northwestern University, are published in one research paper published online ahead of print in the journal Social Psychological and Personality Science. In the first study, they looked at the association between age and trust at multiple points in history in a sample of 197,888 individuals from 83 countries. “The results suggest a positive association between the two. It has been present for at least the past 30 years and the magnitude of the association
between age and trust has been about the same,” said Poulin. “This suggests that it’s not simply about people being born at certain times.” Study two was a representative study of 1,230 individuals in the U.S. that followed the same people over time. This study found they became more trusting as they aged. “The study shows that for millennials, generation X, and the baby boomers alike, levels of trust increase as people get older,” said Haase. “People really seem to be ‘growing to trust’ as they travel through their adult years.” There are two broad explanations for why trust increases across adulthood, Poulin said. “On the structural side, we know that as people age, they prune their social networks such that as we get older we interact less with people we find less emotionally rewarding,” he said. The smaller network may leave older adults with a group of people they find trustworthy. So when asked if they trust people more in old age than when they were younger, the response April 2015 •
could be due to a social circle comprised exclusively of people they trust. “The other possible explanation is that older adults are increasingly motivated to give back to others,” said Poulin. “One thing that helps motivate giving behavior is the belief that others are good and worthwhile. And so this could be a kind of motivated belief. Older adults want to contribute to people so they believe them to be good and trustworthy.” “We know that older people are more likely to look at the bright side of things,” Haase added. “As we age, we may be more likely to see the best in other people and ignore the little letdowns that got us so wary when we were younger.” Poulin said right now the researchers do not know which of those explanations is true. “Maybe the next step would be to find out.” Submitted by University at Buffalo.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
April showers can bring more than May flowers
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or me, the month of April is all about anticipation. I am eagerly awaiting the early arrival of crocus and daffodils. And I can’t wait for the butter-yellow forsythia to burst into color. The garlic in my vegetable garden is already poking through the frosty soil and I’m seeing other signs of spring all around me After this incredibly harsh winter, there’s nothing like the promise of a light at the end of the tunnel to help us endure this last rainy patch until the sunshine warms us on a more permanent basis. As spring approaches, I can feel the anticipation in the air. I don’t know about you, but I’m looking forward to the change of season. Anticipation is not the same as just waiting for something to happen. It’s not just letting time pass. I’ve discovered that intentional anticipation can be incredibly powerful and moving. It can spur us into action, awaken a longlost passion and inspire great “May flower” joy. I’m a believer that anticipation itself can transform a possibility into a reality, and so I build it into my daily
routines. In doing so, I have made living alone more of an adventure than a carefully planned existence. I encourage you to join me and incorporate a little expectancy and suspense into your world. Below are a few strategies that have worked for me. Perhaps they’ll work for you, too! Fill your future with fun. It could be concert tickets, a vacation, dinner with friends or a new class. I have tickets to see singer Michael Feinstein at the Rochester Philharmonic Orchestra in May. Whenever the doldrums set in, I put on his latest CD and imagine the good time I’m going to have with my sister Anne. She loves him, too! I enjoy being uplifted by the anticipation of Michael’s performance and a fun night out with my best friend. Plan ahead and look forward to holidays. Memorial Day is on the horizon. Consider hosting a small get-together
at your place. This “official start of summer” offers a great opportunity to bring people together for some good food and fun, in honor of veterans and soldiers both overseas and here at home. Why not embrace the holiday, make plans, and look forward to sharing this national day of remembrance with friends and family? Order something from a catalog or online store. I make good use of this simple strategy, perhaps more than I should (smile)! But, I like looking forward to a package waiting for me on my front porch. I enjoy anticipating the arrival of a good book in the mail, or a new blouse, or home accessory. It makes coming home after a long day a little more fun and interesting. Join Facebook, LinkedIn, or an online dating service. Make it possible for people to find you and for you to reach out to others. You might be surprised by
what you discover — a new friend, an old heart throb, a childhood buddy, or an unexpected opportunity to socialize. Who knows what might arrive in your inbox?! The anticipation of a “hello” or “wink” can turn a dreary day into one filled with surprises. • Schedule a “day off” a ways off just for you. I do this throughout the year. Monday is my preferred day off. I pick a Monday about four weeks out and look forward to filling it with activities I love. I choose Mondays because when the weekend is over, it’s not over for me! My special day is still out there ahead of me, yet to be experienced and enjoyed. Plant a seed for the future, literally. Just for the fun of it, I’ve purchased a container and “starter” seeds for kitchen herbs. It sits on the sunny ledge above my sink, and I just love tending it and waiting for the tiny tips to make their appearance. Consider growing a few plants from seed to harvest. It’s such a simple joy, and a reminder of the profound power of anticipating future positive events. I anticipate good things ahead for all of you who adopt some of these strategies. And I invite you to share your experience with me. email me at the address below and I’ll look forward to hearing from you! 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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Stephanie Brochey riding her bike along the Niagara River in Tonawanda. “The biggest reward of bike commuting was my improved state of mind. Riding became my own form of meditation.”
Making Bicycle Commuting a Part of Your Life
PSA healthcare delivers the highest quality of care in the most comfortable environment imaginable-the home. We provide pediatric and adult private duty nursing services as well as Home Health Aide and Personal Care Aide services. Call 716-276-2123 for information and services.
By Stephanie Brochey
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hen we think about how most people get to and from their daily activities in Western New York, cycling is not usually high on the list. However, as Buffalo and the surrounding suburbs work to become more bike friendly, the norm is shifting. More Western New Yorkers are choosing to set down their car keys to save money, get quality exercise and make their daily commute a lot more fun. The process of commuting is rarely considered a highlight of the work day. Most people start and end the day frustrated and tired from dealing with traffic and eating fast food on the run. Aside from the long list of proven physical benefits, I found out that riding a bike can drastically improve mental health as well. After this long winter, with many feeling the drain of seasonal depression, treatment could lie in a change in vehicle. This past year, I made the choice to bicycle commute to and from work at least once a week (weather permitting). My commute by car averaged around a half hour, traveling over 15
How to get started 1 — Buy a bike and learn how to maintain it If you don’t already have a bicycle, there are many options to choose from. It all depends on what type of rider you’d like to be, and how much you plan on riding. Local bike shops can provide all of the information and advice needed to get you started. GO Bike Buffalo is a local organization that promotes bike friendly initiatives throughout the region. They have a workshop and regularly hold classes to help cyclists learn the basics of bike maintenance and road safety. 2 — Gather gear No matter how
miles one way. I was already an avid recreational cyclist, but commuting this distance was a hefty goal to work toward. Between the distance and the small morning time frame I had to get there, I knew it wouldn’t be easy. I started on a mild day in early summer, mapping my route using Google Maps. I was able to take the Riverwalk path (starting in North Tonawanda) almost the entire way to downtown Buffalo, with gorgeous views of the Niagara River at my side. I was greeted by joggers on their morning runs, and parents with babies in strollers taking their walks; a much more pleasant group than the caffeinated drivers of the 290. By mid summer, I was riding in twice a week. I was averaging 800 calories burned for every day I cycled. I can’t think of any other exercise I’ve ever enjoyed that had that type of calorie burn in one day! My leg strength and endurance improved dramatically. The route did not have many inclines, but the few that existed went from being something I hated to something I looked forward to challenging. The rides were
quiet and having time to myself with no distractions was a joy. The biggest reward of bike commuting was my improved state of mind. Riding became my own form of meditation. Instead of feeling frustrated and sluggish upon arrival to work, I was alert and happy. Rides home transformed into a time to decompress and come home ready to enjoy my family. It began to feel like cycling days were not work days at all; just a few hours in between bike trips. Unlike a car, the initial investment in a bike and gear is small compared to what can be gained over time. I calculated I was saving about $5-10 a day in gas and vehicle maintenance costs, while also making huge strides in my personal health. I also was able to slightly decrease my car insurance as well. Although the financial savings were a great bonus to my decision to bike commute, the improvement in my well being was substantially more impactful. As with most health decisions, the hardest step is the first one. With a little bit of preparation, bike commuting can be a part of anyone’s normal routine.
long your commute will be, it’s smart to have basic equipment to make your trips easier and worry-free. Things like a tool kit, a helmet, and a high quality lock all make commuting safer and make you a more confident cyclist! 3 — Research and prepare Use Google Maps to calculate your route (their bike option will direct you to bike paths and bike friendly streets). Many NFTA buses have bike racks if you’d like to utilize the bus for a portion of your commute. Take a test run of your route on a weekend to determine exactly how long it will take. Spend time learning your rights and responsibilities as a cyclist sharing the road with vehicles. Bring a change of clothes and anything you’d like at your
destination ahead of time so you won’t have to worry about hauling it on your ride. Make a playlist to keep yourself motivated, or download some podcasts to listen to. Check for deductions on your car insurance for opting to bike commute! 4 — Stay flexible Choose a start day with a flexible schedule. Wake up early and give yourself time to adjust for any unexpected road blocks. Give yourself a break when weather or other conditions cancel your plans; you will find another day to make it work! 5 — Have fun There’s a saying that goes, “You can’t buy happiness, but you can buy a bike, and that’s pretty close.” Riding a bike is inherently fun. Let yourself enjoy the ride! April 2015 •
Apply on-line at jobs.psahealthcare.com or call Mary Greaves at 716-276-2123.
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SmartBites
By Anne Palumbo
The skinny on healthy eating
Why Fennel Deserves a Fan Base
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hen my husband and I were first dating, he introduced me to a unique vegetable: fennel. It was love at first bite! Since then, I haven’t strayed. I’m sweet on the taste (slightly licorice), I dig the texture (super crunchy), I’m crazy about the calorie count (only 30 per cup) and I’m smitten with its nutritious spunk. While pale green fennel may never achieve the superfood status of some 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.
of its more brightly colored comrades, it can certainly march down the “good-for-you” aisle with its feathery fronds held high. Similar to other plant-based foods, fennel is packed with antioxidants — those magical molecules that can help prevent a host of maladies, from heart disease to arthritis. In animal studies, one of fennel’s antioxidants in particular, anethole, repeatedly reduced inflammation and helped prevent the occurrence of certain cancers. Go, fennel!
Fennel deserves a shout-out for its bounty of vitamin C. In addition to its antioxidant benefits, vitamin C, which is needed to build collagen, is super good for your skin. A study published in the American Journal of Clinical Nutrition, in fact, found that higher vitamin C intakes were associated with skin that had fewer wrinkles and aged better. This bulb-shaped vegetable also boasts a decent amount of fiber — both soluble and insoluble. Insoluble fiber promotes regularity, while soluble fiber helps us stay healthy by ferrying artery-clogging cholesterol out. In addition to its fiber, fennel rocks with two nutrients that also promote heart health: folate (a B vitamin) and potassium. Folate helps to derail vessel-damaging homocysteine; and potassium can lower your risk of high blood pressure. Lastly, this aromatic vegetable warrants a round of applause for having no cholesterol, next to no fat, little sodium and a smidge of protein. The 30 calories per cup, as mentioned above, deserves a standing ovation. Helpful tips: Choose whitish to pale green bulbs that are firm and
solid, minus any splitting, bruising or spotting. Fresh fennel has a fragrant aroma, smelling slightly of licorice. Although fennel can be stored in the fridge for up to four days, it’s best to consume as soon as possible. The longer it languishes, the less flavorful it will be.
Fennel Salad
with Celery and Toasted Pine Nuts Adapted from Bon Appetit Serves 4-6
¼ cup pine nuts or chopped walnuts 2 large fennel bulbs, thinly sliced 4 celery stalks, thinly sliced 1 red pepper, thinly sliced ½ cup fresh flat-leaf parsley leaves, lightly chopped 1 to 2 teaspoons fresh lemon zest 3 tablespoons fresh lemon juice 2 to 3 tablespoons olive oil Kosher salt, coarse black pepper (to taste) ¼ cup shredded Parmesan cheese Preheat oven to 350°. Toast nuts on a rimmed baking sheet, tossing occasionally, until golden brown, 6 to 8 minutes; let cool. Toss fennel, celery, red pepper, parsley, and toasted nuts with lemon juice, zest, and oil in a large bowl; season with salt and pepper. Serve salad, topped with Parmesan.
Preventing Bad Dog Behavior By Deborah Jeanne Sergeant
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ad dog behavior like chewing furniture, barking incessantly, digging holes or jumping up on people frustrates many owners. But it doesn’t have to. You can teach old dogs new behavior and prevent pups from picking up bad habits. Many times, jumping up begins
Andrew Stain, head technician with Central Park Animal Hospital in Buffalo. He said many chew on furniture inside the home because of anxiety issues. “If [dog owners] give them something to play with it can help them relax,” he says. Page 10
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in puppyhood when the youngster receives positive attention for jumping up to greet its owner. It’s cute then. After the dog grows to 75 pounds, the animal can knock adults to the ground with the same behavior. The dog doesn’t realize why it’s now wrong to jump. Scolding an older dog for jumping only confuses the animal. “People push them away, which reinforces jumping instead of stopping it,” said Sophie Moyer Myers, owner of Happytails Dog Training in Buffalo. “Dogs think you’re playing with them.” Myers encourages owners to train with positive reinforcement by teaching the dog to sit instead of scolding the dog. Only when the dog remains calm should it receive any attention. Instead of enduring incessant barking, you can help your dog to remain quieter. Myers said that outside dogs often bark because they’re territorial over the yard. “Most owners don’t try to introduce the dog to the people who normally go by,” she said. “When the people leave, the dog thinks it’s successful.” When her dog barks inside, “I tell her thank you and to come to me,” Myers said. “Yelling at the dog is like barking back at the dog. They think you’re joining in.” Dogs who bark or chew while home alone may be bored. To make their day more interesting, hire a dog walker to drop by if you’re gone for 10 hours a day. “Oftentimes, chewing can be caused by anxiety issues,” said Andrew Stain, head technician with Central Park Animal Hospital in Buffalo.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2015
“If they give them something to play with it can help them relax.” Scatter three or four toys around the house. Rotate toys with different types to avoid boredom. Inside dogs may be distracted from outside sounds if you leave a radio on all day. Myers suggested Nylabones and Kong toys for unattended dogs because those toys are durable. She likes to put low-calorie foods such as carrots and lima beans inside hollow Kong toys to make them more interesting to pooches. Freeze the toy in advance for a greater challenge and, as with all toys, periodically examine them for wear. It’s important to replace worn toys to avoid injuries. Crate training can solve many of these problems, as it offers a cozy “den” where the dog is off-duty. Dogs in crates can’t see squirrels, stray cats and the mailman to bark at. They also have no access to furniture to chew. “The dog should be crated when you’re not there,” Myers said. “You should crate the dog for about a year.” Crating may help dogs remain calm while you’re gone at work, but don’t expect a dog to do nothing for 10 hours and remain content to curl up all evening. Sufficient exercise also helps dogs burn energy positively. “Especially with an adolescent dog, it needs lots of exercise,” Moyer Myers said. Dogs tossed in the backyard often lie around because they have nothing to do. Or, they expend their energy by destroying the fence, digging holes or barking for hours. Walking your dog daily for half an
hour or more (depending upon its size and the weather) should help him feel healthier and happier. Regular feeding times and exercise periods helps dogs understand what happens next and relieve anxiety instead of leaving the dog to tear up the household as a stress reliever. Leaving random objects lying around invites bored dogs to destroy them, so look for items on his level that he might want to chew, and then put them away. For very stressed dogs, “medication can also take the edge off,” Stain said. He added that in-home dog trainers can help owners handle dog behavioral problems, too.
Healthy Buffalo: More Companies Helping Employees Stay Fit Independent Health, BC BS are some of local companies creating wellness packages for employees By Ernst Lamothe Jr.
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t BlueCross BlueShield of Western New York, the mission is to create a variety of health programs internally that can cater to various people. The health insurance company, a division of HealthNow New York Inc., offers biometric screenings for their employees, including one-on-one health coaching. Coaches help employees with nutrition and fitness advice along with simply listening to talk about their health journey. “We have made an impact in a lot of people’s lives. We have seen people lower their blood pressure, lose weight, decrease in smoking and live better,” said Bruce A. Morlock, director of employee benefit and health. BCBS is one of several companies initiating healthy programs. “We as a company see the benefit to healthy employees. Good health can change your life,” Morlock noted. The Optum Resource Center for Health & Well-being surveyed more than 500 human resource professionals from companies of all sizes across the United States. More employers continue to show a strong commitment to employee health management programs, reporting a 21 percent increase spending on these initiatives. In addition, incentives continue to increase as does the average incentive dollar value per participant. Making contributions to a health account — such as a health savings account or health reimbursement account — is the most popular type of incentive. Over one-third (35 percent) of respondent companies offered such contributions, a slight increase from last year.
A better life
“More companies are seeing good
health as a connection to a higher quality of life for their employees,” said Philip L. Haberstro, executive director of the Wellness Institute of Greater Buffalo. “We used to ask people to identify the three most important things in your life. After we asked them, if good health wasn’t on that list, we would also say you won’t have the ability to achieve those three important goals without good health.” On average, employers offer eight programs. Not surprisingly, the larger the organization, the more such programs are offered. According to the Wellness Institute of Greater Buffalo, small companies offered 5.2 programs on average, mid-sized companies offered 7.4 programs on average and large companies offered 9.3 programs on average. The Wellness Institute of Greater Buffalo has been tracking the shifting landscape by monitoring ongoing trends in workplace health management programs for the past six years. BCBS started the “Lose to Win” program, which is a weight loss competition among employees. Each department competes against each other in a friendly, yet competitive manner to see who can lose the most pounds. “We have an industrial-sized scale where we weigh the entire team at the same time so you never know how much one person weighs,” said Morlock. “That way no one feels self conscious and they see it as you win or lose as a team, which also brings camaraderie.” The company also offers employees complimentary bikes that people can take during their lunch break to bike around Buffalo. It gives them an opportunity to sneak in a quick workout during the day. There is also a fitness center to work out before, during and
At Independence Health, officials have created a bevy of health initiatives that allow employees to choose their path to better wellness. They host 45-minute presentations on more than 30 health topics ranging from behavioral health and nutrition to exercising and offer a variety of fitness options. after work.
‘Cultural shift’ going on
“We have seen a dramatic cultural shift,” said Elizabeth Koepsell, health promotion specialist for HealthNow BCBS. “People are seeing the benefit in their lives.” Enough research shows being physically active can have a profound effect on life. Haberstro said there is a need for companies to think of something interesting and interactive to get employee’s attention. “There are even some companies that have treadmills in meeting office space with the treadmills facing each other so they can talk and walk during meetings,” said Haberstro. “That is thinking outside the box and finding simple ways to integrate exercise into the work day. Things are evolving.”
Ditching vending machines
At BlueCross BlueShield, a division of HealthNow New York, employees complimentary bikes that people can take during their lunch break to bike around Buffalo. It gives them an opportunity to sneak in a quick workout during the day. There is also a fitness center to work out before, during and after work.
At Independence Health, officials have created a bevy of health initiatives that allow employees to choose their path to better wellness. They host 45-minute presentations on more than 30 health topics ranging from behavioral health and nutrition to exercising. Headquartered in Buffalo, the nonprofit health organization continually aims to provide the community with innovative health-related products and services that enable affordable access to quality health care. “Without a doubt, there is a need for health wellness programs for both individuals and employers,” said Chadd Soto, director of wellness services at Independent Health. “From a financial standpoint, health costs are a priority for everyone involved. The best way to begin the process is for people to start prioritizing their health.” Soto said behavioral health, which includes stress management, worklife balance and smoking cessation programs, are key to anyone who is serious about their health. He said it takes more than simply implementing April 2015 •
Bruce A. Morlock, director of employee benefit and health at BlueCross BlueShield of Western New York. “We as a company see the benefit to healthy employees. Good health can change your life,” Morlock said. Next to him is Elizabeth Koepsell, health promotion specialist at BCBS Western New York. an exercise program to make a real difference. “If you fix the mind, it is much easier to fix the body. But if all you do is fix the body, then there could be some problems down the road when it comes to keeping the same mentality needed for a healthy life,” said Soto. “And we are a company that believes in wellness from the top down. Our CEO and chief medical officer are both active cyclists.” Regardless of what a company does, there are ways to force a change of culture. “One of the simplest and easiest changes is simply reaching into the vending machine and making a significant change. Too often there are few if any healthy options there,” said Haberstro. “We have found that a lot of companies are swapping out the negative things found in vending machines or at least offering some alternative choices for those who may want a snack at work.”
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Women’s issues Obamacare Excludes Pregnant Women Missing Enrollment ACA coverage gap leaves women two choices: 1) pay for insurance premiums or care out of pocket — to the tune of $10,000 to $20,000) or 2) skip prenatal care By Deborah Jeanne Sergeant
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ninsured women who missed the three-month open enrollment period have few options for pregnancy medical expenses. Though the Affordable Care Act, commonly known as Obamacare, doesn’t classify pregnancy as a pre-existing condition for women when they sign up, health benefits won’t kick in for women until after delivery if they sign up outside of the open enrollment period. This ACA coverage gaps leaves women two choices: 1) pay for insurance premiums or care out of pocket — to the tune of $10,000 to $20,000 or 2) skip prenatal care. The March of Dimes states that 50 percent of pregnancies are unplanned. Of course, some pregnant women caught in the ACA coverage gap may qualify for Medicaid. But many of those making too Johnson much money may still find paying for their pregnancy expenses daunting. Consider a family of three in which one parent stays home with the child and the breadwinner earns an income greater than $39,779. If the wife be-
comes pregnant, they won’t qualify for Medicaid, yet could find purchasing their own insurance out-of-pocket devastating to their budget. BlueCross BlueShield of Western New York’s individual plans all cover prenatal care and delivery and start at $278.95. This entry-level plan includes a $6,600 deductible that must be met out-of-pocket before the plan covers prenatal care and most other services. Paying $9,191.55 ($1,021 a month, between out-of-pocket deductible expenses and premiums) is outside of many families’ reach. Some advocacy groups such as Young Invincibles (www.younginvincibles.org) want a special enrollment period for women caught in the ACA coverage gap by classifying pregnancy as a qualifying life event (QLE). Approved QLEs permit people to sign up outside of a standard enrollment period. Medical professionals agree that prenatal care promotes healthy pregnancies. “The risks of not monitoring a pregnancy are significant and they put the baby at risk,” said physician Jeffrey Johnson, division director of maternal-fetal medicine in the department of obstetrics-gynecology at the University at Buffalo School of Medicine and Biomedical Sciences, who sees patients at UBMD, the practice plan of the medical school.
For one thing, babies born to moms who don’t receive prenatal care often require expensive treatments later. “Prenatal care is definitely the more economical way to go, allowing physicians to detect and intervene to treat chronic medical conditions,” Johnson said. “When not detected early, there is a significant cost to the patient after delivery, as well as potential lifelong implications for chronic medical conditions that have to be cared for.” He added that prenatal care can lower the risk of complication such as those caused by lifestyle habits (such as smoking, poor diet and lack of exercise), preeclampsia and gestational diabetes. One of the objectives of March of Dimes is to remove barriers to receiving prenatal care because it’s so important. Darcy Dreyer, associate director of program services for March of Dimes Central New York, Genesee Valley, Finger Lakes & Western Divisions, listed barriers such as finances, inadequate system capacity, long waits to get appointments and personal factors. “The ACA gap would certainly affect [some women’s] ability to get care,” Dreyer said. March of Dimes advises mothers
who cannot afford medical care and don’t qualify for Medicaid to seek clinics that offer sliding fees or to see what services community clinics can provide. “There are no pregnant women who will go without care,” said Gil Farkash, health chief of service for OBGYN at Women & Children’s Hospital of Buffalo. “You can come into a clinic and say, ‘I’m pregnant and have no insurance’ and you can get prenatal care, whether you have money or not.” Medical facilities’ social workers can help people get insured, work with patients to lower their costs, figure out a payment plan or direct them to a clinic that bases its fees on income. In the meantime, basic questions (Is coffee okay? Should I skip alcohol?) may be answered on pregnancy websites. Dreyer said that www.Marchofdimes.org, babycenter.com, and kellymom.com offer accurate information until the first doctor visit.
In Vitro Births Continue to Rise in U.S. Researchers also report drop in number of multiple embryo transfers, twin and triplet birth rates
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ore babies in the United States are being conceived by in vitro fertilization, a new report
shows. Nearly 2,000 more infants were born with the help of this assisted reproductive technology in 2013, compared with 2012, the researchers reported. Almost 175,000 in vitro fertilization (IVF) cycles led to the birth of slightly more than 63,000 babies, compared with just over 165,000 IVF cycles that led to the birth of slightly fewer than 62,000 babies in 2012. Babies conceived through fertility Page 12
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treatments account for more than 1.5 percent of children born in the United States, according to the report from the Society for Assisted Reproductive Technology. The society also said more women, regardless of age, chose to have a single embryo transferred. The rise in the number of women making this choice was greatest among women under 35. In that age group, 22.5 percent decided to have a single embryo transferred, compared with almost 15 percent in 2012. “We are extremely encouraged to see the number of embryos transferred
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2015
per cycle continue to go down and that more and more patients are choosing single embryo transfer,” said Dr. James Toner, president of the Society for Assisted Reproductive Technology. “The goal of reducing the incidence of multiple pregnancies is extremely important, and patients can see from the data that fewer embryos transferred do not mean a lower chance of pregnancy,” he said in a news release from the group. Trends noted in previous years continued in 2013, the report said. There were fewer embryos transferred per cycle among women of all ages, an
increase in embryo implantation rates in all age categories, and an overall decline in multiple births. The number of twins resulting from IVF fell from 12,436 in 2012 to 12,085 in 2013, and the number of triplets resulting from IVF dropped from 411 to 376.
Women’s issues
Demand for 3-D and 4-D ultrasound grows But local OB-GYN says better images don’t offer much prenatal advantages By Deborah Jeanne Sergeant
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fter the positive pregnancy test, the most exciting milestone of pregnancy is viewing the growing baby via prenatal imagery. What parent doesn’t fall in love with the first glimpse of the baby? Compared with 2-D ultrasound’s fuzzy-looking sonograms, 3-D sonograms are a photograph of babies before birth, and 4-D sonograms offer video footage of babies moving. While it’s exciting for parents to get to know their new little one, 3-D and 4-D imagery typically aren’t used medically. “3-D is a great technology, but it’s still finding a use,” said physician Jeffrey Johnson, division director of maternal-fetal medicine in the department of obstetrics-gynecology at the University at Buffalo School of Medicine and Biomedical Sciences, who sees patients at UBMD, the practice plan of the medical school. “A lot of the things we try to diagnose through prenatal ultrasound are better diagnosed through 2-D.” Doctors order 2-D ultrasound because it helps them know how the baby develops structurally since it shows the inside of the baby. 3-D ultrasound can help Johnson providers identify external issues such as a cleft lip or cleft palate, or details such as missing or short fingers or toes. “Beyond that, 3-D is just a nice thing have for souvenir pictures,” Johnson said. “It really doesn’t add a
lot to 2-D.” In some cases, providers can offer medication or surgery that can help improve the baby’s outcome. Or, at least families know what to expect for the rest of the pregnancy and after the baby’s birth. Parents’ desire to see what their baby looks like has made 3D imagery very popular. Some OBGYNs purchase the equipment to make their practices more attractive to clients, even though the imagery really isn’t necessary for diagnosing most fetal problems. “It’s a marketing tool,” Johnson said. “Our technology has gotten cheaper, so 3-D and 4-D has become more and more available to people. We still do our best to get a 3-D souvenir picture of the baby’s face because it’s almost an expectation of parents. But it doesn’t really improve outcomes.” The demand for 3-D and 4-D ultrasound has grown so much that some facilities such as Baby Bump Motherhood Center in North Tonawanda and Perfect Preview in Williamsville provide non-medical ultrasound for parents who want a glimpse of their
baby. While getting a sneak peek into baby’s appearance delights parents, Darcy Dreyer, associate director of Program Services for March of Dimes’ Central New York, Genesee Valley/ Finger Lakes and Western New York Divisions, cautions parents about 3-D and 4-D imagery taken at non-medical facilities. “Sometimes there are false-negative or false-positives, which can be emotionally and financially taxing,”
Dreyer said. View non-medical ultrasound as a pre-birth portrait, but not as medical information. Rely only on medical imagery read by OB-GYNs for diagnosing prenatal problems. “If you confirm the absence or presence of a problem, it helps families prepare,” Dreyer said. “It’s a resource and parents need to make the best decision with the information given to them based on their family health history and resources.”
Teen Pregnancies, Abortions Plunge with Free Birth Control
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eens who received free contraception and were educated about the pros and cons of various birth control methods were dramatically less likely to get pregnant, give birth or get an abortion compared with other sexually active teens, according to a new study. The research, by investigators at Washington University School of Medicine in St. Louis, appeared late last year in The New England Journal of Medicine. The study promoted the use of
long-acting forms of birth control, such as intrauterine devices (IUDs) and implants, because of their superior effectiveness in preventing unintended pregnancies. Among the 1,404 teens enrolled in the Contraceptive CHOICE Project, 72 percent opted for IUDs or implants. This compares with an estimated 5 percent of U.S. teens who choose long-acting birth control. In the United States, most teens opt for less-reliable contraceptives such as birth control pills or condoms or no method at all because of cost and other
factors. “When we removed barriers to contraception for teens such as lack of knowledge, limited access and cost in a group of teens, we were able to lower pregnancy, birth and abortion rates,” said Gina Secura, the study’s first author and director of the CHOICE Project. “This study demonstrates there is a lot more we can do to reduce the teen pregnancy rate.” From 2008-13, the annual pregnancy rate of teens aged 15-19 in the study averaged 34 per 1,000, compared with April 2015 •
158.5 per 1,000 in 2008 for sexually active U.S. teens. During the five-year span, the average annual birth rate among teens in the study was 19.4 per 1,000, compared with 94 per 1,000 in 2008 for sexually active U.S. teens. The abortion rate among teens in the study also dropped dramatically. From 2008-2013, their average annual abortion rate was 9.7 per 1,000, compared with 41.5 per 1,000 in 2008 for sexually active U.S. teens.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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A Life Without Pizza, Burgers, Pasta, Hot Dogs… How locals cope with celiac disease By Patrick Sawers
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oughly one in a hundred otherwise healthy Americans suffers from celiac disease, a genetically-acquired autoimmune and digestive disorder that causes a complete intolerance to gluten, a protein found in wheat, rye and barley, among other foods. For those living with the disease, the ingestion of any amount of gluten prompts their body to launch an immune response that attacks the small intestine, damaging its lining and preventing it from properly absorbing vital nutrients like fat, iron, calcium and folate. The only treatment is a modified diet — strict avoidance of all gluten-containing foods — and that means sufferers are barred from eating everything from pizza and pasta to hamburgers, hot dogs, subs and just about anything else served on a roll or bun. Fortunately, however, awareness of the disease is at an all-time high, with more and more area Whipple restaurants offering gluten-free menus and products, and a local support group is working overtime to help those with celiac manage their dietary affairs in a way that makes it seem less like a sentence of death-by-boredom and a lot more like a fun challenge with a healthy payoff.
“A diagnosis of celiac disease and having to eat gluten-free can be very frustrating for people, considering that gluten is found in everything that’s good, from our bread to our baked goods, and finding palatable substitutes can be quite a challenge,” said Julie Fusani, president of the Western New York Gluten Free Diet Support Group. “So we’re basically here to educate and lend support to people, especially newly-diagnosed people.” At regular group meetings, Fusani said, members and newcomers alike gather to trade stories, give advice and exchange information on the latest gluten-free products. Most meetings feature a guest speaker, such as gastroenterologists and dietitians, willing to share their expertise, and for new attendees a short counselling session is offered afterward. “It’s just a brief talk with a counselor to make sure that people are educated,” she said, “because gluten is not just found in a lot of the food that we eat. It’s also used as a binder in prescription and over-the-counter medications, it’s in toothpaste, it’s in deodorant, it’s on the glue of postage stamps, it’s even found in Play-Doh. These are things that people don’t know about, so we have a small counselling session for new members afterwards.” What’s more, every other month the group eats out, choosing a restaurant and working with its management and staff to create a fun and risk-free dining experience. Recent dinners have been held at Shogun in Williamsville and Salva-
For Celiac Sufferers, More Options to Dine Out For the last six years, Tina Weeks has been bringing her own food to restaurants. “It’s the most embarrassing thing ever,” said Weeks, 27, who lives with her mother in Blasdell. “But it’s the only way I could really even go out to eat with my family or my friends.” Diagnosed with celiac disease on her 21st birthday, Weeks was devastated to learn just how much food suddenly was no longer available to her, and the alternatives, she said, were indescribably tasteless and bland. “I’ve gone out and bought gluten-free pretzels, for instance, and I would eat like one or two and have to throw them in the trash,” she said. For the longest time, she added, restaurants with gluten-free items on their menus were few and far between, and even if she found one that did ordering from it was always risky business. “I’ve gotten really, really sick from restaurants that advertised something as gluten-free,” Weeks said, “because even if it technically is, if it’s even prepared on the same grill or in the same pan as something that’s not, my Page 14
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food can get contaminated. I’ve gotten so sick.” Recently, however, Weeks has seen a spike in awareness among area restaurants, a host of which now seem all too eager to accommodate their gluten-free customers and their dietary needs. “I would say I have maybe 10 times the options that I did, say, two years ago,” she said. “Restaurants are becoming really aware of gluten-free needs, and they’re learning how to prepare food properly. Like at the Outback, for instance, our server made a point of telling me that the chef would be sure to change gloves before he made my food.” This June, for her 28th birthday, Weeks said she plans on celebrating at P.F. Chang’s at the Walden Galleria Mall. “They’ve got an extensive gluten-free menu, and I swear some of it is better than the regular food, like some of the food I ate before my diagnosis,” she said. “And it’s so nice to know I’m not going to get deathly ill after.” By Patrick Sawers
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2015
All about gluten-free food. From left: Kyle Haak, chef instructor at the E.M. Statler Room, a restaurant run by students at ECC’s culinary arts program; Julie Fusani, president of the WNY Gluten Free Diet Support Group; and Jacquie Petty, ECC’s culinary arts program student. Photo taken at the E.M. Statler Room in September, when Fusani was invited there to discuss gluten-free dining options with the class. tore’s Italian Gardens in Depew, and according to Fusani it’s an event the group is always looking forward to. “We have someone who coordinates them,” she said. “She goes to the restaurants and she makes sure that they’re well-informed and fully aware of our needs. They come up with a menu and then they offer it to our membership. So instead of going out to dinner and having to explain to the waitress and waiter and having to rely on them to communicate our needs to the chef, we have dinner options that are already pre-planned, so all we have to do is tell them what we want to eat, write a check and show up on that date. It’s very comforting to know that everything has been taken care of.” By arranging these dinners, Fusani said, the group is also helping educate local restaurants about the dangers of exposing diners with celiac disease — even if indirectly — to gluten. “Restaurants can say that they have, for example, gluten-free pizza, and they might offer a crust that has no gluten ingredients,” she said. “But if they bake it in the same oven as they use to bake other pizza then there is cross-contamination and people can get sick. So restaurants really have to be educated, they have to be very aware because I’m told that half a fingernail of gluten is enough to do intestinal damage to someone who has celiac disease. That’s not a lot of gluten.” The group has been in operation for 25 years, and in that time Fusani said she has seen awareness and gluten-free accommodation skyrocket. Much of that improvement, she said,
has been thanks to local grocery stores such as Wegman’s, which for two decades has been leading the way in making gluten-free items available to its shoppers. “We have been working hard with our suppliers to provide great-tasting, affordable options for our customers,” said Mallary Whipple, a registered dietitian and nutritionist with Wegman’s Buffalo division. “We have over 1,700 Wegman’s brand gluten-free products, plus hundreds of national brand gluten-free products as well. We also have our gluten-free wellness key. It’s a little orange ‘G’ on Wegman’s brand recipes and products that are gluten-free. This way you don’t have to turn it over and look through the nutrition facts or ingredient label to see what’s in the product. We’ve already done that work for you.” And, Fusani said, the store’s commitment to those with gluten-free requirements does not end there. “Wegman’s also supports our group with a program for our new members,” she said. “If a new member comes to the support group and stays for the counselling session with our dietitian afterwards Wegman’s supplies us with supplying a bag of gluten-free groceries worth $25 for new members.” The road to gluten-free awareness, said Fusani, has been long, winding and oftentimes uphill, and there is still a good amount of mileage to be covered. “We live in a society where we’re diagnosed with something and then we expect to have a pill to fix it,” she said. “There’s no pill to fix this.”
Do you live alone? Living alone can be a challenge, especially for women in mid-life who are divorced or widowed. But it can also be the start of a rich and meaningful chapter in your life. Need a jump start?
Living Alone: How to Survive and Thrive on Your Own By Jim Miller
How Medicare Covers In-Home Care Dear Savvy Senior, How does Medicare cover home health care? Because of my illness, my doctor suggested I get home health care, but I want to find out how it’s covered before I proceed. Need Some Help Dear Need, Medicare covers a wide variety of intermittent inhome health care services (usually up to 28 hours per week) to beneficiaries, if you meet their specific requirements. Here’s how it works. In order for you to secure coverage for home health care, Medicare first requires that you be homebound. This means that it must be extremely difficult for you to leave your home, and you need help from a device (like a wheelchair or walker) or a person in doing so. You will then need your doctor to approve a “plan of care” confirming that you need skilled-nursing care or skilled-therapy services from a physical or speech therapist on a part-time basis. Your doctor can also request the services of an occupational therapist and a home health aide to assist with activities of daily living such as bathing, dressing and using the bathroom. Your doctor must renew the “plan of care” once every 60 days. You will also need to use a home health agency that is certified by Medicare. If you meet all of the requirements, Medicare should pay for your in-home care. But be aware that Medicare will not pay for home health aide services (such as bathing, dressing or using the bathroom) alone, if you do not need skilled-nursing or skilled-therapy services too. Homemaker services, such as shopping, meal preparation and cleaning are not covered either. You also need to know that Medicare has recently changed their home health care policy regarding degenerative diseases. They will now pay for in-home physical therapy, nursing care and other services to beneficiaries with chronic conditions like multiple sclerosis, Parkinson’s or Alzheimer’s
disease in order to maintain their condition and prevent deterioration. In the past, Medicare would only cover home health services if the patient were expected to make a full recovery. If you have original Medicare, you can locate a Medicare-certified home health agency by calling 800-633-4227 or by visiting medicare.gov/homehealthcompare. If you have a Medicare Advantage plan, you should contact your plan directly and ask which home health agencies work with the plan and are within the plan’s network of providers. For more detailed information on how Medicare covers in-home health, see the “Medicare and Home Health Care” online booklet at medicare.gov/ pubs/pdf/10969.pdf.
Other Options
If you don’t qualify for Medicare coverage, there are other coverage options depending on your situation, including: Insurance: If you happen to have long-term care insurance, check to see if it covers in-home care. Or if you have a life insurance policy, see if it can be utilized to pay for care. Medicaid: If your income is low enough, all states offer Medicaid programs that will pay for some forms of in-home care. To investigate this, contact your local Medicaid office. Veterans Assistance: If you’re a veteran, some communities have a veteran-directed home and community based service program, which give veterans a flexible budget to pay for in-home care. Also available to wartime veterans and their spouses is a benefit called “aid and attendance” that helps pay for in-home care, as well as assisted living and nursing home care. To be eligible, you must need assistance with daily living activities like bathing, dressing or going to the bathroom. And, your annual income must be under $21,466 – minus medical and long-term care expenses. If you’re a surviving spouse of a veteran, your income must be below $13,794 to be eligible. Your assets must also be less than $80,000 excluding your home and car. To learn more, see va.gov/geriatrics or call 800-827-1000. 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.
Tuesday, April 14, 21 and 28 6:30 pm - 8:30 pm House Content B&B, Mendon • 10 minutes from exit 46 on Thruway In the workshop led by Gwenn Voelckers — a women who’s “been there” — you’ll discover how to overcome loneliness and other emotional pitfalls, rediscover your true self, and socialize in a couples’ world. $145 fee includes manual, empowerment exercises and lots of helpful resources. For more information, call (585) 624-7887 or email gvoelckers@rochester.rr.com
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Prepare to Prevent Lyme Disease
The Social Ask Security Office
As temperature goes up, so does the risk of getting Lyme disease
By Deborah Banikowski
By Deborah Jeanne Sergeant
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s snow banks stubbornly cling to the landscape, it may seem much too early to think about Lyme disease, which is largely spread by ticks. But Joe Koval, owner of Mosquito Squad, which serves Buffalo, warned that ticks that find a host remain active even during cold months. Once temperatures reach the 40s and 50s in May, ticks become active and breed. Koval said that about one-fifth of his calls for insect control involve tick prevention. “It’s become a really serious problem,” Koval said. First identified in Lyme, Conn., Lyme disease can cause serious and long-lasting health problems. Although initial symptoms include a bull’s-eye rash (which may feel warm to the touch), possibly accompanied by joint pain, chills, fever and fatigue. Later symptoms that manifest a few days to a week after the bite can include severe fatigue, stiff neck, tingling or numbness in the extremities, or facial paralysis. Weeks after the bite, the Koval patient can experience headaches, arthritis, swelling, and heart and central nervous system issues. Mary C. St. Mary, public information officer with Erie County Department of Health, pointed out that since most Lyme disease cases occur along to coastal US, “the incidence of Lyme disease cases in Erie County is much lower compared to New York state counties closest to the Atlantic coast.” “In Erie County and New York state, it seems like Lyme disease issues are on the rise again” said Peter Tripi, senior public health sanitarian, Erie County Health Department. “We’ve seen a small increase year after year.” Some cases involved people who had traveled outside the area; however, Tripi said that in 2012, the first local tick was identified in Erie County. Removing a tick can be challenging. Using pointed tweezers, grasp the tick as near to its mouth as possible and lift straight up without twisting. Watching a video on YouTube or leaving it in the hands of the pros can help avoid breaking off the tick and leaving part of its head or mouth embedded in the skin. Prompt treatment with antibiotics can help reduce lasting effects of Lyme disease if an infected tick bites you. A canine vaccine for Lyme disease can help your dog; however, no human formulation exists. “Lyme disease can be chronic and debilitating,” Tripi said. “You want to protect yourself. It’s fairly easy if you use commonsense approaches when going on trails and hiking.” Preventing bites involves keeping ticks away from your property and off Page 16
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A Lyme Disease Cases in Erie County
2009 ���������� 14 2010 ���������� 15 2011 ����������� 14 2012 ���������� 11 2013 ���������� 21 2014 ���������� 30 Source: Erie County Health Department.
your clothing. Nymph ticks feed on small hosts such as field mice, which are close to the ground. Adult ticks wait on tall grass to attach themselves to a larger host, such as a deer, dog or human. Because ticks breed in decomposing leaves, woodpiles and tall grass, it’s important to keep your property clear. John Gilliland, president of Advanced ExtermiTripi nating Company in Buffalo with locations throughout Western New York, encourages homeowners to keep their laws mowed. “If the grass is short, they’re not going to be there,” Gilliland said. “Generally, they climb to the top of the grass and grab onto what’s passing by.” Heed trail signs warning of ticks. Wear light-colored clothing and tuck your pants into your socks. Spray your clothing with an insect repellent containing DEET per package directions. Change clothing and shower when you come inside. Use tick treatment on your dog and check its fur after he’s been outside. Ticks will feel like a scab under your pet’s fur. For property owners, Koval offers an organic or chemical-based tick spray which he typically applies in spring and fall to keep ticks away. It’s also important to eliminate mouse and nuisance deer problems, since these animals transport ticks.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2015
Taxes, Ex-Spouse Benefits — and You
pril 14 is both Ex-Spouse Day and the eve of tax day. These two observances are doubly important if you are an ex-spouse, because Social Security pays benefits to eligible former spouses, and you may need to claim this income on your tax forms. If you are age 62, unmarried, and divorced from someone entitled to Social Security retirement or disability benefits, you may be eligible to receive benefits based on his or her record. To be eligible, you must have been married to your ex-spouse for 10 years or more. If you have since remarried, you can’t collect benefits on your former spouse’s record unless your later marriage ended by annulment, divorce or death. Also, if you’re entitled to benefits on your own record, your benefit amount must be less than you would receive based on your ex-spouse’s work. In other words, we’ll pay the higher of the two benefits for which you’re eligible, but not both. You can apply for benefits on your former spouse’s record even if he or she hasn’t retired, as long as you divorced at least two years before applying. You can also elect to receive only the
Q&A Q: My father receives Supplemental Security Income. He recently moved, but he hasn’t reported his new address to Social Security yet. What’s the easiest way to do that? A: You can check your address online by using your personal my Social Security account at www.socialsecurity. gov/myaccount. It is very important that Social Security has your father’s most up-to-date information, including any change in income, resources, or living arrangements. This will guarantee that he is getting the benefit amount to which he is entitled. You can learn more about the rights and responsibilities of Supplemental Security Income recipients at www.socialsecurity.gov/ ssi. Q: Someone stole my Social Security number, and it’s being used repeatedly. Does Social Security issue new Social Security numbers to victims of repeated identity theft? A: Identity theft is one of the fastest growing crimes in America, so you aren’t alone. If you’ve done all you can to identify and fix the problem, including contacting the Federal Trade Commission, but someone is still using your number, Social Security may assign you a new number. If you decide to apply for a new number, you’ll need to prove your identity, age, and U.S. citizenship or immigration status. You’ll also need to provide evidence you’re having on-
divorced spouse benefits and delay benefits on your own record until your full retirement age, which may translate to a higher monthly amount for you. If, however, you decide to wait until full retirement age to apply as a divorced spouse, your benefit will be equal to half of your ex-spouse’s full retirement amount or disability benefit. The same rules apply for a deceased former spouse. The amount of benefits you get has no effect on the benefits of your exspouse’s and his or her current spouse. Visit “Retirement Planner: If You Are Divorced” at www.socialsecurity.gov/ retire2/divspouse.htm to find all the eligibility requirements you must meet to apply as a divorced spouse. Our benefits planner gives you an idea of your monthly benefit amount. If your ex-spouse died after you divorced, you can still quality for widow’s benefits. You’ll find information about that in a note at the bottom of the website. Visit www.socialsecurity.gov/ retire2/divspouse.htm today to learn if you’re eligible for benefits on your ex-spouse’s record. What you learn may bring a smile to your face … even on tax day!
going problems because of the misuse of your current Social Security number. You can read more about identity theft at www.socialsecurity.gov/pubs. Q: My father collects disability benefits, but he is interested in trying working again. Is there a program that helps disabled people find work while they’re collecting Social Security disability benefits? A: Social Security’s Ticket to Work program can help beneficiaries go to work, get a good job that may lead to a career, save more money, and become financially independent. This program doesn’t affect your disability benefits — you can keep collecting your benefits while participating. Ticket to Work is a free and voluntary program that gives beneficiaries real choices to help them create and lead better lives. You can learn more about our Ticket to Work program at www.socialsecurity. gov/work or www.socialsecurity.gov/ work/home.html. Q: I served in the military, and I’ll receive a military pension when I retire. Will that affect my Social Security benefits? A: You can get both Social Security retirement benefits and military retirement at the same time. Generally, we don’t reduce your Social Security benefits because of your military benefits. When you’re ready to apply for Social Security retirement benefits, go to www.socialsecurity.gov/applyonline.
H ealth News Hospice physician named ‘inspirational leader’ Bethany Calkins, a staff physician with The Center for Hospice and Palliative Care, was named an inspirational leader in hospice and palliative medicine under the age of 40 by the American Academy of Hospice and Palliative Medicine (AAHPM). AAHPM asked its 5,000 members to nominate individuals who are the young leaders in the field. Calkins is one of these physicians recognized by her peers for innovation and dedication to the medical specialty of Hospice and Palliative Medicine and AAHPM. “These individuals are enhancing care for seriously ill patients and their families through innovation, education, mentoring and clinical care,” said Calkins physician Jean S. Kutner, AAHPM’s president. Calkins received her doctorate in medicine from the University at Buffalo School of Medicine & Biomedical Sciences. She is a resident of Clarence and has worked with The Center for Hospice and Palliative Care for the past two and halk years. “The best advice I was given was to walk through every open door,” said Calkins. “I have never passed on an opportunity, no matter how scary or how small it may have seemed at the time. As a result, I have experienced more than I thought I could at my age and have had incredible experiences in hospice and palliative medicine.” More information on this award, including the list of the award winners is on the academy’s website www. aahpm.org.
ECMC Rehab Behavioral Health gets grant Erie County Medical Center (ECMC) Corporation announced that it has received a $13,534 grant from the Christopher & Dana Reeve Foundation. The award was one of 75 grants totaling over $600,137 awarded by the Reeve Foundation to nonprofit organizations nationwide that provide more opportunities, access, and daily quality of life for individuals living with paralysis, their families, and caregivers. Conceived by the late Dana Reeve, the program has awarded more than 2,400 grants totaling over $18 million since 1999. ECMC’s Rehab Behavioral Health Services will use the grant funds to improve quality of life through bibliotherapy, an innovative, new approach — not yet implemented in US or Canadian hospitals until now — by addressing physical and cognitive needs of patients who have survived traumatic brain and spinal cord injuries and other progressive illnesses. “We are honored to be awarded this grant from the Christopher and
Dana Reeve Foundation and grateful to receive it to assist individuals who have sustained severe, traumatic injuries,” stated Lisa Keenan, director at Rehabilitation Behavioral Health Services, ECMC. “With these funds, we intend to help these patients by utilizing bibliotherapy and providing appropriate technology equipment [Kindles] adapted to accommodate individual needs. This will facilitate reading diverse kinds of texts with the goal of enhancing the quality of their lives.”
Hammonds named Millennium executive director Millennium Collaborative Care in March named Al Hammonds, chief operating officer of the Community Health Center of Buffalo, as MCC’s executive director. He joins former Erie County Health Commissioner Anthony J. Billittier IV, MCC’s medical director, on MCC’s leadership team. Millennium is a performing provider system [PPS] involving ECMC and more than 3,800 other hospital and health-provider partners in Western New York. Millennium is the lead partner in Erie County for the state’s delivery system reform incentive payments [DSRIP] program. Each region of the state is required to create a series of projects aimed at improving patient Hammonds care and saving costs in the Medicaid population over the next five years. DSRIP’s five-year goal is to reduce avoidable admissions and emergency room visits by 25 percent statewide. The total Medicaid population for the Millennium PPS is over 230,000 Medicaid patients in Western New York. Medicaid is the federal health care system for the poor and disabled that is administered by the states and counties. “Al is the perfect person for this challenging position. He has the ideal mix of health care experience, community credibility and political experience,” said Richard C. Cleland, ECMC president, chief operating officer and interim CEO. “Medicaid reform, improved patient care, community health and overall savings are goals of this effort and Al is positioned to make it happen.” Hammonds previously served as chief operating officer at the Community Health Center of Buffalo, a federally qualified health center that provides primary care, dental and behavioral health services. “As I’ve moved through my career, I’ve been involved in helping the community and developing systems that work effectively,” Hammonds said. “I look forward to continuing these efforts with Millennium Collaborative Care, helping our partners create the best DSRIP provider in the state.”
Marketing, creative team at Roswell recognized Videos featuring cancer patients’ journeys are being recognized for excellence by the state and national communications industries. The Roswell Park Cancer Institute (RPCI) office of creative services, a team within the comprehensive cancer center’s department of marketing, has been nominated for two Emmy Awards from the New York State National Academy of Television Arts & Sciences, and is the recipient of a Telly Award and two gold awards from the Association of Marketing and Communication Professionals (AMCP). “We are proud of the recognitions received by our creative services team. The accolades from these national organizations are a tribute to the quality of the video productions that inspire and offer hope to Roswell Park patients and their families,” says Laurel DiBrog, vice president of marketing, planning, public affairs and customer relationship management at RPCI. “These awards reflect the hard work of the Roswell Park media team, which continually fosters the advancement of cancer communications.” • New York State Emmy Nominations — The creative services team received two New York Emmy nominations from the New York chapter of the National Academy of Television Arts and Sciences. Videos from the campaign “Cancer Can’t Win” were recognized in two separate categories: health/sci-
Prior to CHCB, Hammonds was the University at Buffalo’s assistant director of outreach for the Office of Economic Development. He also previously served as deputy Erie County Executive and was also a senior project director at the Center for Industrial Effectiveness at the University at Buffalo.
Kaleida Health, labor unions reach agreement Kaleida Health and the Communications Workers of America/AFL-CIO (CWA1168), 1199SEIU United Healthcare Workers East, and the International Union of Operating Engineers (IUOE 17) have reached a tentative agreement on a one-year “wage re-opener” on the health system’s master collective bargaining agreement. The wage re-opener was a key term in settling the 2013 negotiations between labor and management. At the time, the parties agreed to a three year contract, with the opportunity to renegotiate wages only in 2015. “I truly believe that our employees are deserving of this wage increase and it is a tangible sign of our support for all of our nursing staff, healthcare workers and administrative staff,” said Jody Lomeo, president and CEO of April 2015 •
ence program and human interest program or special. RPCI creative services collaborated with MediaSource, a media-relations and content-production firm located in Columbus, Ohio, to tell the story of the journeys of five cancer patients. Winners will be announced during the 2015 Emmy Awards Presentation on Saturday, May 2, in New York City. • Telly Awards — “It’s All About Tomorrow,” a original song production/music video promoting The Ride For Roswell, received a bronze award in the 36th annual Telly Awards. The Roswell Park video competed with nearly 12,000 entries from 50 states and numerous countries. The Telly Awards showcase the best work of production companies, television stations, cable operators and corporate video departments. The song is also available for download on iTunes, with proceeds benefiting cancer research at Roswell Park. • AVA Digital Awards — Additionally, the team received two gold awards in the 2015 AVA Digital Awards competition, an international contest hosted by the AMCP that recognizes excellence by creative professionals responsible for digital communications. The gold winners are: “It’s All About Tomorrow,” for creativity in video production, and “Compassionate Care,” which highlights the Roswell Park nursing team, for video production/corporate image.
Kaleida Health. “This is the very group that has helped us with the turnaround of Kaleida Health and will continue to lead us as we grow and better serve our patients.” Because the agreement must be ratified by the union membership, details of the contract were not released. Ratification voting is expected to occur at any momemnt. “The tentative agreement speaks to the value of our members and their contribution to healthcare in our community,” said Cori Gambini, president of CWA1168. “I am confident that this wage increase will be ratified.” “We feel in a time when our healthcare system is changing and our members are working harder than ever to provide the best health care for sick patients in our community, we were able to work together to reach an agreement that we feel shows they are appreciated for the work they do,” said Jim Scordato, vice president of 1199SEIU, Western New York Hospital Division. “The results of these negotiations clearly indicate that labor is recognized as an integral part and an enormous asset to the Kaleida Health organization,” said Dominic Teti, business representative for the International Union of Operating Engineers (IUOE 17). The health system’s master collective bargaining, which covers nearly
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H ealth News 8,000 employees, is effect until May 31, 2016. The Federal Mediation & Conciliation Service assisted Kaleida Health and unions with this contract negotiation.
Jefferson Family Medicine Center has new director Physician Daniel Morelli, chairman of UB’s department of family medicine and CEO of UBMD Family Medicine, has appointed physician Priyanka Patnaik as the new medical director at Jefferson Family Medicine Center, 1315 Jefferson Ave. in Buffalo. A research fellow with the department of medicine’s endocrinology, diabetes and metabolism division in 2006, Patnaik is a 2011 graduate of family medicine’s residency program. She is stepping into this role, vacated by physician Vinod Patel, who has shifted into a primarily clinical and teaching role. “Our medical directors are key to the success of our teaching and clinical missions,” Morelli said. “As they partner with our administrative staff to engineer supportive environments for patients and learners. Dr. Patnaik joins a select team of leaders within our ranks.”
News Items
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Helipad planned for new Children’s Hospital Kaleida Health and Women & Children’s Hospital of Buffalo are planning a helipad on the roof of the new John R. Oishei Children’s Hospital. The hospital filed a certificate of need (CON) with the New York State Department of Health in March for the $1.1 million project. “Having a helipad is vital to our mission of providing the best possible care for critically sick and injured patients throughout Western New York and beyond,” said Allegra Jaros, president, Women & Children’s Hospital of Buffalo. “Much like it does now for the hospital on Bryant Street, the new helipad will save lives. It allows our pediatric and neonatal transport teams to dramatically improve access and time for their patients, who need specialized pediatric and neonatal critical care.” The funds necessary to construct the helipad have been donated by Sal H. Alfiero and family. Alfiero is a long-time community leader, supporter of Women & Children’s Hospital, and successful businessman who was the founder and former chairman of Mark IV Industries. The City of Buffalo Planning Board has approved the helipad project. Kaleida Health is also in the process of seeking approvals from
the City of Buffalo Common Council, the Federal Aviation Administration, and the New York State Department of Transportation Aviation Services Bureau. The Oishei Children’s Hospital will replace the current hospital on Bryant Street in Buffalo. Ground was broken in October of 2014 to make way for the new $270 million facility, will be located on Ellicott Street, bounded by High and Goodrich Streets across from the Buffalo General Medical Center. The historic project will right-size and consolidate services in a 12-floor, 183-bed, free-standing, modern facility on the Buffalo Niagara Medical Campus. It will be an integral part of the campus, linking with Buffalo General, the Gates Vascular Institute, Roswell
Park Cancer Institute, the new University at Buffalo Medical School and more. Construction of the new hospital is expected to take approximately 34 months to complete, with doors opening in late 2017. Women & Children’s Hospital of Buffalo is the only access point for pediatric critical care, Level III neonatal intensive care, and Level 1 Pediatric Trauma Centers in and for Western New York. The sickest babies and children come to the hospital for care, either directly or through transfers from other hospitals. Without the resources available at Women & Children’s Hospital of Buffalo, these young patients would have to travel out of area for care.
ECMC Opens 22 Private Orthopedic Rooms Erie County Medical Center in March cut the ribbon on a $12.5 million expansion in the main hospital building to provide 22 state-of-the-art, in-patient, private rooms for orthopedic patient recovery. The new rooms, approved by the state Health Department, support two continuing trends at the Grider Street health campus: Dramatic growth in orthopedic surgeries — elective and especially joint replacement — and an ongoing revamping of the hospital’s physical plant to better meet patient expectations, comfort and care. “These rooms are as fine as any private hospital rooms in any hospital in the region,” said Richard C. Cleland, ECMC president, chief operating officer and interim CEO. “The demand for these rooms will be met by our growing number of orthopedic patients, especially elective surgeries.” The rooms, in two units, represent a re-distribution not affecting ECMC’s total bed count. They are dedicated to Buffalo restaurateur, philanthropist and former patient Russell J. Salvatore, who contributed $500,000 to the project. It will be called the Russell J. Salvatore Orthopaedic Unit. The contribution, to the ECMC Lifeline Foundation, is the single largest gift it ever received. “Russ has been an amazing benefactor to ECMC, adding his largesse to these rooms as he did in supplying new televisions to many of our surgical in-patient rooms a few years ago,” Cleland added. “He knows how much these new rooms mean to our staff, our patients and their families.” Page 18
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Health Benefits of Moderate Drinking Overblown
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ll that talk of red wine and other alcoholic beverages being good for your health if consumed in moderation is just plain wrong, a new analysis contends. A review of nearly 53,000 British people found little to no health benefit linked to alcohol consumption, once the results were adjusted for a range of personal, social, economic and lifestyle factors, the researchers reported. “Based on the findings from this study, alcohol consumption appears to confer little to no protection against mortality [death] in most age-sex groups,” said study author Craig Knott, a research associate in the department of epidemiology and public health at University College London. Previous research has shown that light alcohol consumption may confer some degree of protection against early death and illness, with people who have fewer than two drinks per day living longer than both those who drink more and those who don’t drink at all, the researchers said. But these earlier studies were flawed because researchers lumped former drinkers in with people who’ve never touched a drop, calling all of them non-drinkers and then comparing them to people who imbibe lightly, Knott said. “Importantly, former drinkers appear to be less healthy and at greater risk of mortality than never drinkers,” he said. “With existing research having largely grouped former and never drinkers together, there was the possibility that protective effects seen among lighter drinkers may be less a consequence of a real biological relationship and more a statistical artifact arising from their comparison against people who are simply less healthy.” In this study, published Feb. 10 in the BMJ, researchers compared interview data from the annual Health Survey for England with national death records, analyzing the drinking habits and health of almost 53,000 people aged 50 and older. Compared with people who never drank, any protective benefits from alcohol were largely limited to men aged 50 to 64 who reported having an average 15 to 20 drinks a week, and women 65 and older who had an average 10 drinks or less per week, the investigators found. And even for these groups, the benefits are so minimal that they might be explained by so-called “selection bias” -- “including but not limited to the possibility that individuals participating in a study are healthier than those who do not,” Knott said. Most of alcohol’s benefits evaporated after factoring in various definitions of occasional drinking, as well as a range of other personal and social influences, the study authors said.
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Homeopathy: natural alternative for healing pain Unique therapeutic system is an option for treating lifestyle disorders By Daniel Meyer
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medical philosophy and practice based on the idea that the body has the ability to heal itself, homeopathy — also known as homeopathic medicine — is a complete therapeutic system that is based on the idea that “like cures like.” Using the mindset that substance causes a symptom in a healthy person, giving someone a very small amount of the same substance may cure the illness. In theory, a homeopathic dose enhances the body’s normal healing and self-regulatory processes. For Marcia Sikes, a Buffalo native who has practiced homeopathy since 2000, it is her passion for helping people in need and ability to work closely with those seeking pain relief that allows her to share with others why homeopathy is safe, effective and economical. “It is truly unique because it allows me to form a direct partnership with my patients,” says Sikes, a 2000 graduate from The School of Homeopathy in England who has a practice on Main Street in the village of HamSikes burg. “For me, there is nothing more rewarding when our work, meaning the effort put forth by myself and the patient, together can help to create a return to good health and the elimination of pain.” So what is homeopathy and why do professionals like Sikes continue to see an increase in patients hoping to benefit from the often misunderstood form of therapeutic healing?
What is homeopathy?
Developed in Germany over 200 years ago, homeopathic medicine is a way to treat disease, conditions or symptoms with small doses of natural substances that help the body function better and heal itself naturally. According to the American Institute of Homeopathy, the term translates to “like disease,” meaning medicine given is like the disease the person is expressing, not a specific disease category or medical diagnosis. Plants, minerals and even poisons are used in very small doses, which are believed to have greater effectiveness. In addition, according to the National Institutes of Health, homeopathic remedies are regulated by the U.S. Food and Drug Administration, but the FDA does not evaluate them for safety or effectiveness. Homeopathic remedies are usually delivered in the form of sugar pellets to be dissolved under the tongue, but can also be made available in ointments, gels, drops and creams. While some conventional medical experts do not consider homeopathy to be a legitimate form of medicine, Sikes understands the skepticism because she herself was Page 20
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unsure of homeopathy when she was introduced to it. “When I first heard about it, I thought it sounded totally crazy,” recalls Sikes, who also has a degree from Canisius College. “I actually got involved with homeopathy by accident. But the more I learned about it and the more I studied and embraced the principle of ‘less is more’ I saw the tremendous benefits and how it can cure my patients and bring them a great sense of relief when constant pain is eliminated from their lives.”
What illnesses can homeopathy cure?
Having personally experienced the healing power of homeopathy, Sikes says her focus remains on helping patients struggling on a daily basis with chronic illnesses, including anxiety, depression, asthma, arthritis, fibromyalgia, obsessive-compulsive disorder, allergies, ADD and ADHD, hay fever, sore throats, menstrual and menopausal disorders, and severe migraine headaches. “The majority of my patients come to me because they have looked everywhere, tried everything and have exhausted all avenues of traditional medicine with very little success,” says Sikes. “We work together and identify cures that I recommend that help support what can become life changing experiences for them and their families. My greatest fulfillment from doing this is working closely with a patient and eventually recommending a remedy which helps them.” What can you expect the first time you meet a homeopath? Sikes stresses the importance of
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2015
collaboration when meeting with patients, advising anyone with an appointment with a homeopath such as herself to come into their first session with an open mind, a desire to improve their health and a willingness to work closely with the professional. “The very first visit involves a long and extensive interview where I am able to obtain details on the patient’s complete medical history and can ask detailed questions about their aches and pains,” says Sikes. “I need answers to properly evaluate them so that teamwork approach is crucial.” Sikes also stresses how important it is for any patient to have patience. “Please, please, please have patience and realize that identifying the pain, figuring out what is causing the pain and what is the proper solution to eliminating that pain takes time,” says Sikes. “It is not going to happen overnight. It is a process, but one that has great potential to finding what can get him or her well and fully heal.”
Continuing education
To further develop her understanding of homeopathy and keep up with the latest information related to the unique natural and holistic therapy, Sikes continues to study with homeopaths throughout the country as well as in Canada, England, India and the Netherlands. “There is so much that comes with education about homeopathy and it is something I have actually been studying and learning about since the 1980s,” explains Sikes. “The course work was very rigorous and represented a very challenging curriculum, really much harder than any other college
course that I took previously. On top of that, there is so much ongoing education and things to absorb. You really never stop learning no matter how long you have been practicing.” Some of the most recent research revolves around efforts to use homeopathy to help patients who suffer from severe sleep disorders, including insomnia. “Sleep is so important because it helps the body to recover from the day’s activities and enhances our memory and brain function capabilities,” says Sikes. “Without proper sleep, many health problems are likely to exist. Unfortunately, while sleep should be a natural part of time for us all, for some it doesn’t come easy for a variety of reasons. What I do with my patients is identify their symptoms and recommend homeopathic remedies to help treat their insomnia.” Homeopathy can be used in professional settings and for home care, with homeopathic self-care used for many acute and first aid purposes to address colds, the flu, bone sprains, muscle strains and other minor injuries and ailments that do not necessarily require a doctor’s care. “I have a passion for healing and continue to be amazed at how truly incredible homeopathy can change someone’s life, not only physically but also mentally and emotionally,” says Sikes. “In a sense, the remedy is the diagnosis. So in some cases, this is the last hope for some people and the pain is overwhelming and constant and they are so sick and tired of having to deal with it and live like that. When people get well, I love it. There’s nothing like it.”