in good Iron Girl Writer Melissa Stefanec talks about her training to participate in the Iron Girl triathlon on the Oneida Shores
7 in 10 Number of Americans on prescription drugs
What My Garden Has Taught Me Living Alone author shares some wisdom about life and gardening
August 2013 • Issue 164
CNY’s Healthcare Newspaper
$155,000 Fourth-year SUNY Upstate medical student Elias Awad said he will leave school with a $220,000 debt.
That’s the average loan of medical students at SUNY Upstate when they leave school. Too high? It’s actually lower than the average Page 9
Don’t Worry, Be Healthy
Researchers link positive outlook to reduction in cardiac events such as heart attacks Page 7
Is a Colonic Something You Should Consider?
To Hell and Back Page xx
Why I’m a Hospice Volunteer
free FREE
WHOLE ME Expands Horizons for the Deaf
Page 14
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Auburn resident Anthony Sorendo just released his book, “My Journey to Hell and Back with Chronic Pain,” where he discusses the chronic pain he had for 25 years and how he overcame it. The book is an inspirational healthrelated story that was written for those who deal with chronic pain Page 18
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FACT:
More hearts are cared for at St. Joseph’s than any other hospital in the region. St. Joseph’s Cardiovascular Care
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St. Joseph’s is sponsored by the Sisters of St. Francis. Franciscan Companies is a member of the St. Joseph’s Hospital Health Center system.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
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Aug. 2, Sept. 14
Trail walking taking place in Cayuga County The Cayuga County Health Department announced a trail walking series for Cayuga County trails. Through the work of the Creating Health Places to Live, Work & Play grant, which was awarded to the county’s health department in 2011, the county has worked on creating or enhancing its local parks and trails. A campaign titled “Be a Supermodel, Model Healthy Choices” is meant to encourage individuals and families to make healthier choices each day and get fit. The next trail walk will happen on: • Friday, Aug. 2. Walk in the Steps of Harriet (leaving from Auburn City Hall) at 5:30 p.m. • Saturday, Sept. 14. Fort Hill Cemetery at 10 a.m. The guided nature walk will include demonstration of the fitness equipment installed along the trail and a yoga lesson with an instructor (optional) and raffle prizes. For more information visit: www.modelhealthychoices.com
Aug. 7
Bishop’s Commons offers Alzheimer’s program Bishop’s Commons Enriched Living Residence in Oswego will host a caregiver educational program presented by the Alzheimer’s Association of CNY. The educational program titled, “Managing Challenging Behaviors”, will offer attendees a three-point approach to address challenging behaviors such as wandering, repetitive
CALENDAR of
HEALTH EVENTS
questions, agitation and other behavioral symptoms. The program will take place at 6 p.m., Wednesday, Aug. 7at Bishop’s Commons Enriched Living Residence, located at 4 Burkle Street in Oswego. It is free of charge and open to the public. Register by calling 315-5964016, ext. 125.
Aug. 7, 20
Unbiased Medicare workshops held in Auburn Learn about the basics of Medicare at two free workshops to be held from 2 – 4 p.m. on Wednesday, Aug. 7, and from 6 – 8 p.m., Tuesday, Aug. 20 at the basement training room of the Cayuga County Office Building. These sessions will be geared toward Cayuga County residents only who are approaching Medicare enrollment and for those already enrolled who are overwhelmed or confused by the information and the options available. These are not meetings during which sales efforts will be made, and no insurance vendors will be present; these presentations will contain unbiased information only. Registration is required and will be accepted until such time as the seating limit has been met. Registration is open for these classes and for several additional classes. Call the Cayuga County Office for the Aging at 315-253-1226.
Aug. 10
Scleroderma group holds meeting in Binghamton The Scleroderma Foundation / TriState Chapter will sponsor a caregiver education meeting from 8:30 a.m. – 3:30 p.m. Aug. 10 at DoubleTree by Hilton, 225 Water St., Binghamton Scleroderma [sklair-uh-DERM-uh] is a chronic, often progressive, autoimmune disease in which the immune system attacks the body’s connective tissue. Scleroderma literally means “hard skin” because it can cause a thickening and tightening of the skin. In some cases, it causes serious damage to internal organs including the lungs, heart, kidneys, esophagus and gastrointestinal tract. As scarring, or sclerosis, of these organs and organ systems progress, they work less effectively, and can lead to organ failure and death. Register at the door or online at: care.SclerodermaTriState. org
Aug. 13
Seminar to address seniors living with HIV, AIDS Are you a health or human service provider working with individuals
Upcoming Flu Season: What You Need to Know Healthcare workers in NYS who do not get the flu shot will be required to wear a face mask when interacting with patients
T
he last flu season arrived four weeks early, was more intense than expected and resulted in the deaths of more than 110 children in the United States. In an effort to get ahead of the upcoming flu season, experts at Montefiore Medical Center are raising awareness about the importance of the flu vaccine, which remains the best option to reduce a person’s risk of contracting the virus. The flu season can start as early as late September and usually runs for about 12 to 15 weeks. Infectious disease specialists already have identified the flu viruses that are the most likely to cause illness this season, and vaccines have been formulated. Experts believe about 90 percent of the viruses found during surveillance are well-matched to the current vaccines. However, there are several important factors Americans should know about the 2013-2014 vaccine: • The standard “three-strain” vaccine will be offered to healthy children and adults. This vaccine, which will be widely available, includes two strains of the more common A virus and one of Page 4
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the B virus. By comparison, last year’s “three-strain” flu vaccine reduced the risk of flu-associated medical visits from Influenza A viruses by one half and from Influenza B viruses by twothirds for most of the population. • The new “four-strain,” or quadrivalent, vaccine was designed this year to include two strains of the A and B virus in response to the fact that there have been two predominant B virus strains circulating the past two years rather than the usual single strain. Influenza B infection is usually much less severe than Influenza A, but the extra coverage will be important for immune-compromised patients who are at risk of severe infection and complications from both strains. The vaccine is intended for people with chronic medical conditions such as asthma or heart disease and those with compromised immune systems. Only five million doses of this vaccine will be developed, so it will be restricted to the high-risk patient groups, and there likely will be shortages. Also new this year is a New
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
York state regulation requiring healthcare workers who do not get the flu shot to wear a face mask when interacting with patients. Low vaccination rates among healthcare workers prompted regulators to pass the health code amendment to protect patients.
over the age of 50? To be informed on one of the challenges facing people over the age of 50, you are invited to attend “Working with Older Adults Living with HIV/AIDS.” This free one day training will provide an overview of the New York state epidemiological trends of HIV in older adults, an overview of sexual activity, social isolation, mental health and substance use issues and the impact of co-existing conditions among those aging with HIV. The HIV prevention, treatment and care needs of older adults living with and at risk for HIV will be discussed. The discussion will take place from 9 – 5 p.m., Tuesday, Aug. 13 at REACH CNY, Inc., 1010 James St., second floor, Syracuse. Register for this course at www. hivtrainingny.org. For more information contact Biallah Green, training program coordinator at 315-424-0009 ext. 101 or bgreen@reachcny.org. Seats are limited! REACH CNYs’ - HIV/STI and Viral Hepatitis Regional Training Center is funded through the NYS Department of Health AIDS Institute.
Aug. 15
Movie ‘Under Our Skin’ to show in Syracuse The CNY Chapter of the Empire State Lyme Disease Association will present the award-winning documentary “Under Our Skin” on Thursday, Aug. 15, at the Palace Theater, 2384 James St., Syracuse. Doors will open at 6 p.m. This is a free event. “A gripping tale of microbes, medicine & money, the movie exposes the hidden story of Lyme disease, one of the most serious and controversial epidemics of our time. Each year, thousands go undiagnosed or misdiagnosed, often told that their symptoms are all in their head. The evening will begin with a viewing of the film followed by a talk by physician Daniel J. Cameron, a pioneer in Lyme disease and a leader in ILADS, the International Lyme and Associated Diseases Society. Cameron will facilitate a question and answer period regarding Lyme and its co-infections. A panel consisting of Dr. Cameron, Lyme disease patients and caretakers will also be available to speak and answer questions.
Sept. 20
Hospice’s biggest fundraiser scheduled The Hospice Foundation of Central New York will hold its signature event Sep. 20. This year’s event will mark the 24th “September Song” Gala. Participants can expect great food, dancing, and an auction. Hematology-Oncology Associates of CNY is sponsoring the event. It’s the ninth year it does so. According to hospice officials, support for this year’s event is very critical for hospice as the next few years will likely bring about significant changes to health care benefits. The foundation’s goal is to ensure that everyone gets the medications, treatments, and equipment needed to make their final journey a comfortable and positive experience. September Song will be held at Traditions at the Links in East Syracuse on Friday, Sept. 20. The local band Primetime Horns will kick the festivities off starting at 6:30. Tickets are $125 per person and sponsorships start at $500. For more information call 634-1100.
Nearly 7 in 10 Americans Take Prescription Drugs Germ fighters, antidepressants, opioids top list; women, elderly likelier to have prescriptions
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early 70 percent of Americans are on at least one prescription drug, and more than half take two, Mayo Clinic and Olmsted Medical Center researchers say. Antibiotics, antidepressants and painkilling opioids are most commonly prescribed, their study found. Twenty percent of patients are on five or more prescription medications, according to the findings, published online in the journal Mayo Clinic Proceedings. The findings offer insight into prescribing practices. The statistics from the Rochester Epidemiology Project in Olmsted County, Minn., are comparable to those elsewhere in the United States, says study author Jennifer St. Sauver, a member of the Mayo Clinic Population Health Program in the Mayo Clinic Center for the Science of Health Care Delivery. “Often when people talk about health conditions they’re talking about chronic conditions such as heart disease or diabetes,” St. Sauver says. “However, the second most common prescription was for antidepressants — that suggests mental health is a
huge issue and is something we should focus on. And the third most common drugs were opioids, which is a bit concerning considering their addicting nature.” Seventeen percent of those studied were prescribed antibiotics, 13 percent were taking antidepressants and 13 percent were on opioids. Drugs to lower lipids, such as cholesterol, came in fourth (11 percent) and vaccines were fifth (11 percent). Drugs were prescribed to both men and women across all age groups, except high blood pressure drugs, which were seldom used before age 30. Overall, women and older adults receive more prescriptions. Vaccines, antibiotics and anti-asthma drugs are most commonly prescribed in people younger than 19. Antidepressants and opioids are most common among young and middle-aged adults. Cardiovascular drugs are most commonly prescribed in older adults. Women receive more prescriptions than men across several drug groups, especially antidepressants: Nearly one in four women aged 50-64 are on an antidepressant.
Yoga for Cancer Survivors Discover how yoga can further your recovery. More than a gentle or restorative yoga class. Alive! Yoga for Cancer Survivors is tailored to the physical and emotional needs as a result of cancer treatment.
Each 12-week class series combines healthful guided breathing exercises, slow arm stretches, gentle yoga sequences, and selected movement inquiries of Self-Awakening Yoga Therapeutics™ to help stimulate the immune system; move lymph; improve balance, strength and flexibility; regain mental focus; reduce fatigue, anxiety, and some of the other side effects of cancer treatment. Classes guided by Georgia Stormes, RYT 500. For more information or to register, contact Georgia at 315.696.6385 or gstormes@gmail.com
Program funded by Alive! Foundation, Inc. www.alivefound.org
HOUSEMATES Have you ever considered living with a person with a developmental disability in their home? In return for your support and companionship, you will receive free rent, utilities, and basic phone. You would be able to maintain your current life style such as work, school or volunteerism and still MAKE A DIFFERENCE in a person’s life. You must be caring, committed and responsible. If this sounds like something you may be interested in, give us a call to learn more. (315) 434-9597 ext. 210.
ONONDAGA, OSWEGO, CAYUGA AND MADISON COUNTIES in good A monthly newspaper published by
Health CNY’s Healthcare Newspaper
Local News, Inc. Distribution: 35,000 copies. To request home delivery ($15 per year), call 342-1182.
In Good Health is published 12 times a year by Local News, Inc. © 2013 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Matthew Liptak, Chris Motola, Lisa M. Mayers Advertising: Jasmine Maldonado, Marsha K. Preston • Design: Chris Crocker • Office Manager: Laura J. Beckwith 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.
August 2013 •
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Meet
Assistant Professor SUNY Upstate Medical University (multiple locations in Syracuse, NY) Offer clear and effective instruction and clinical and research training to medical, graduate, and postdoctoral students in the College of Medicine and Graduate Studies. Perform clinical care in the area of pediatric neurology, including provision of primary care and consultant responsibilities for private patients and those being followed in public clinics. Requirements: M.D. (Doctor of Medicine) or Foreign Equivalent; Eligibility for a License/Permit to practice medicine in the State of New York; Board eligible for certification in child neurology by the American Board of Psychiatry and Neurology, or equivalent international specialty board. Please send CV to: Stacy Mehlek, Faculty Affairs & Faculty Development, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210.
SUNY Upstate Medical University is an AA/EO employer engaging excellence through diversity. Women and minorities are encouraged to apply.
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Your Doctor
By Chris Motola
Dr. Mary Cunningham Gynecologic oncologist talks about gynecologic cancers, including the most common, endometrial cancer
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hysician Mary Cunningham specializes in the comprehensive care of women with gynecologic malignancies, including radical surgery and chemotherapy for patients with cancers of the uterus, ovary, cervix and vulva. She is also an expert in gynecologic surgery for benign disease. Since 2006, she has been using the da Vinci robotic system to perform complex laparoscopic procedures, including radical hysterectomy, lymph node dissection and cancer staging, as well as procedures for ovarian cysts and fibroids. Below are excerpts or our conversation with her. Q: Generally speaking, what are the risk factors for gynecologic cancers? HPV has gotten a lot of attention recently. A: HPV is a risk factor for cervical cancer, but the most common gynecologic cancer is endometrial cancer, which is cancer of the uterus. The biggest risk factor for that is being obese. So as the American population’s weight has increased, the risk of endometrial cancer has also increased. With regard to ovarian cancers, about 10 percent of those are due to genetic factors. That got a lot of attention recently with Angelina Jolie having her prophylactic surgery to prevent the development of ovarian cancer. We certainly see patients who have BRCA1 and BRCA2 mutations who need prophylactic surgery to help prevent the development of those cancers. You mentioned HPV earlier. In the United States, Pap smear screenings and HPV vaccinations work together to reduce the risk of cervical cancer. It’s much less common here now than in many parts of the world thanks to those efforts. Q: You mentioned the BRCA gene mutations. Those have an incredible correlation with the development of certain types of cancer. A: Breast cancer and ovarian cancers. If you have it, you
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
have up to an 80 percent lifetime risk of breast cancer and a 40 percent lifetime risk of ovarian cancer. Q: I’ve heard even men with the gene are at risk for developing breast cancer. A: Breast cancer in men is very uncommon, but when it does happen it’s almost always due to an abnormality in the BRCA2 gene. Q: How often is screening done for these gene mutations? A: Screening is not done for the general population, usually only for people who have a strong family history of breast or ovarian cancer. If it does run in your family, you should talk to your physician about genetic counseling. Q: As an oncologist, is most of your care intervention-based, or do you also do preventive care? A: Most of what I do is treating people who have been diagnosed with cancer or who are suspected of having cancer. So I’ll take care of patients who have an ovarian mass that may or may not be cancer. Q: What’s the prognosis like for those diagnosed with gynecologic cancers? A: Endometrial cancer, which is the most common, is usually diagnosed in the early stages when it’s highly treatable. The cure rate is in the 80-90 percent range for most people. If it’s caught early, most people are going to do fine. The difficulty is in treating them when they go undiagnosed for long periods of time. Q: What’s the typical procedure for treating endometrial cancer? A: The treat-
ment almost always starts off with doing surgery. We can treat endometrial cancers without doing a hysterectomy, but the cure rate goes way down substantially. So they usually have hysterectomies, they have the removal of the cervix, tubes and ovaries — and possibly some of the lymph nodes — to prevent the spread of cancer. And then, depending on what the pathology reports say, we may recommend some radiation treatment after the surgery. Q: How old are your patients usually? A: Endometrial cancer usually occurs in women who are past menopause, so the average age is around 60. The most common symptom is bleeding after a woman has gone through menopause. Any woman experiencing that should see a doctor right away to make sure they don’t have a cancer developing. Q: How effective has education and outreach been in making women aware of the risks? A: I think it’s gotten a lot better over the last few years due to a lot of factors. I think the awareness has really improved. That doesn’t mean there isn’t room for improvement. We always appreciate any accurate coverage we get from media people such as yourself. It’s important for people to be aware and educated. Q: What attracted you to this specialty? A: I was interested in the surgical aspects of medicine and I liked the idea that I could follow my patients after the surgery. Most surgeons don’t have the opportunity to get to know their patients. We perform the surgeries and then follow up with patients over the years to make sure there’s no recurrence. Q: Are you able to do most of those surgeries with the minimally invasive daVinci robot? A: I think the robot is an excellent laproscopic instrument. We’ve found that we’re able to treat patients who may have otherwise needed a larger incision, which usually means a shorter recovery time and sometimes a lower risk of complications. I think one of the things to remember is that the robot is an instrument under the control of the surgeon. It’s not automated in the sense that orders are plugged in and it performs them. It’s a surgical instrument like a scalpel. Robotic surgery gives surgeons a three-dimensional view, so it makes it easier to perform many operations. Q: Are these instruments changing the skill sets doctors need? A: I think medicine has become increasingly complex and technical. I think one of the important things for residents coming out of medical school is to adopt a habit of lifelong learning. Many of the tools they’ll be using haven’t been invented yet.
Lifwelines Hometown: New Hartford, NY Education: Northwestern University Medical School (medical); Hospital of the University of Pennsylvania (fellowship) Hospital Affiliations: Crouse Hospital; SUNY Upstate Medical University Organizations: American College of Obstetrics and Gynecology; the American Medical Society; Onondaga County Medical Society; Society of Gynecologic Oncology Family: Married, two children Hobbies: Skiing, traveling, cooking
Don’t Worry, Be Healthy
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Researchers link positive outlook to reduction in cardiac events such as heart attacks
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eople with cheerful temperaments are significantly less likely to suffer a coronary event such as a heart attack or sudden cardiac death, new Johns Hopkins research suggests. Previous research has shown that depressed and anxious people are more likely to have heart attacks and to die from them than those whose dispositions are sunnier. But the Johns Hopkins researchers say their study shows that a general sense of wellbeing — feeling cheerful, relaxed, energetic and satisfied with life — actually reduces the chances of a heart attack. A report on the research is published in the American Journal of Cardiology. “If you are by nature a cheerful person and look on the bright side of things, you are more likely to be protected from cardiac events,” says study leader Lisa R. Yanek, an assistant professor in the division of general internal medicine at the Johns Hopkins University School of Medicine. “A happier temperament has an actual effect on disease and you may be healthier as a result.” Yanek cautioned that cheerful personalities are likely part of the temperament we are born with, not something we can easily change. While
some have suggested it’s possible that people lucky enough to have such a trait are also more likely to take better care of themselves and have more energy to do so, Yanek says her research shows that people with higher levels of well-being still had many risk factors for coronary disease but had fewer serious heart events. She emphasized that the mechanisms behind the protective effect of positive well-being remain unclear. She also noted that her research offers insights into the interactions between mind and body, and could yield clues to those mechanisms in the future. For the study, Yanek and her colleagues first looked at data from GeneSTAR (Genetic Study of Atherosclerosis Risk), a 25-year Johns Hopkins project sponsored by the National Institutes of Health to determine the roots of heart disease in people with a family history of coronary disease. They analyzed information gathered from 1,483 healthy siblings of people who had coronary events before the age of 60 and who were followed for five to 25 years. Siblings of people with earlyonset coronary artery disease (CAD) are twice as likely of developing it themselves.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
What My Garden Has Taught Me
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ardening is ripe with life lessons for those of us who live alone. It has taught me the value of planning, preparation, patience, and pleasure — four essential “P’s” for a bountiful garden and … a bountiful life. Fertile ground exists in each of us, and a little tending can produce beautiful results. Here’s what I have learned: Plan. Realizing the garden of your dreams begins in your imagination, followed by careful planning. Diagram your garden and it will help you avoid planting bulbs on top of bulbs or mistaking a poppy for a weed. Likewise, envisioning your life goals and committing them to writing can help you flourish and grow. Cultivate. Good, cultivated soil promotes healthy, deep roots. When you add fertilizer and mix it up you are rewarded with abundance. Adding essential ingredients to the foundation of your dream garden (and your dream life) will nourish all that follows. You can’t go wrong with good, nutritious food and plenty of sunshine.
Plant. So many choices! Revisit your plan and embed your carefully selected seeds or seedlings with a tender, loving touch, being careful not to overcrowd or plant more than you can manage. And remember: We reap what we sow, so follow your dreams. Plant a rose and you get a rose; plant a dandelion and you get a dandelion. Seed your future with healthy choices that promote well-being. Weed. We all need room to breathe and positive space in which to blossom. It holds true for your garden and your life. Gardening is all about consistent caretaking. Slack off, even for a few days, and all things unwelcome show up and take root. Weed out the negativity and any dream-stealing toxins that contaminate your life, dash your hopes, or spoil
KIDS Corner 5 Tips for Toilet Training Avoiding common mistakes can help prevent potty problems
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hen it comes to toilet training, there is no shortage of advice for parents. From mothersin-law to the Internet, everyone has a favorite tip. Despite all of the information, though, it turns out that children are often trained incorrectly, leading to potty problems that range from bedwetting and daytime accidents to urinary tract infections. Physician Steve Hodges, a specialist in pediatric urology at Wake Forest Baptist Medical Center, says there are five common mistakes that parents make when toilet training their children. 1. Training too early. While early toilet training is popular, children younger than 3 don’t have the mental maturity to make good toileting decisions, says Hodges. “They don’t understand how essential it is to get themselves to a bathroom when nature calls. Instead, they hold their urine and feces, which can lead to numerous problems, Page 8
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including bedwetting.” 2. Train their child but don’t follow up with their toileting habits. Many toileting problems — from urinary tract infections to bedwetting — are often related to children holding their urine or feces. “Holding urine leads to smaller bladder capacity and sets a child up for accidents,” says Hodges. He recommends having children urinate on a schedule, about every two hours. To help make the bathroom trip “successful,” Hodges suggests having the child count to 10 while on the potty and having some favorite books and puzzles nearby. As for “pooping,” a high-fiber diet can make elimination less painful, so that children aren’t as apt to avoid it. 3. Ignore school bathrooms or bathroom policies. Unreasonable toileting requirements, restrictive bathroom policies and dirty bathrooms in schools compound children’s potty
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
your fun. When you pull out the bad, you can more easily focus on the good in your life. Prune. When weeding is not enough, a major pruning may be just what the arborist ordered. A job, relationship, or home that no longer satisfies or meets your needs may need a hard look. It may be time to pull out that pair of “life loppers.” Mulch. Mulching keeps weeds at bay and the ground moist, and returns nutrients to the soil. It also adds a finishing touch. Mulch offers a blanket of protection, in the same way that regular doctor appointments, insurances, and safety measures protect our lives. You can learn a lot from mulching. Wait. We all know that “good things come to those who wait” and it’s not just what comes out of the Heinz
problems, says Hodges. He recommends that parents be aware of day care and school bathroom policies and advocate for their children. Suggestions include touring school bathrooms to identify potential issues, making bathroom cleanliness a PTA issue, and advocating for policies that allow children to use the restroom when they need to. 4. Miss signs of constipation. Up to 30 percent of children between 2 and 10 are chronically constipated. “Many parents mistakenly believe that if their child has daily bowel movements, they are not constipated,” says Hodges. “But in kids, there’s a different definition of constipation known as ‘poop burden.’ It refers to poop backed up in their rectum that can press on the bladder and cause bedwetting and other problems.” Symptoms of constipation in children include having extra-large bowel movements or bowel movements that are very firm, rather than mushy, like pudding or a milkshake; poop accidents; poop-stained underwear, and mild belly pain with no obvious cause. 5. Ignore signs of bladder trouble. Common problems in children that shouldn’t be ignored are painful urination, frequent urination and blood in the urine. These symptoms are sometimes due to an infection or other problems and should be evaluated by a physician. Often, however, the culprit is constipation
ketchup bottle. When you exercise patience, go slowly, and enjoy the gradual unfolding of a flower, an idea, or a friendship, your life can be savored and more deeply appreciated. Each year, I look to my garden to remind me that growth takes time. Enjoy. Before you know it, your labor of love and patience will pay off. Take pleasure in the transformation as the colors, textures, and fragrances emerge. Too often, we fail to “stop and smell the roses” in our gardens and in our lives. So get busy, then step back and take a good look. There’s nothing quite as satisfying as admiring what you’ve accomplished. It’s reason to celebrate! By osmosis, gardening has taught me how to take better care of myself. I have absorbed its rich messages and learned how to nurture my inner garden and growth as a women on her own. Why not grab a spade and join me? Beauty, growth, and an energizing sense of renewal can be yours, season after season after season. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon. For information about her workshops or to invite Gwenn to speak, call 585-624-7887 or email gvoelckers@rochester.rr.com.
— one more reason to opt for a highfiber diet. In addition, accidents of urine or stool should not be seen as normal and ignored. “Often, parents have the impression that wetting, like throwing temper tantrums, is just something kids do,” said Hodges. “But accidents aren’t normal and potty-trained kids shouldn’t have accidents any more often than adults do.” Hodges is the co-author of a book for parents on toilet training and other potty issues, “It’s No Accident: Breakthrough Solutions to Your Child’s Wetting, Constipation, UTIs, and Other Potty Problems,” and blogs about the topic at www.itsnoaccident.net.
SUNY Upstate Med School
Med Students’ Average Loan Rising, Following Higher Tuition Student: ‘It’s a big burden of debt and it’s terrifying to see that number. I’ve never even come close to having any kind of money like that before where I’d be able to pay it’ By Matthew Liptak
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octors make a lot of money. That is one of the rewards of their profession. But doctors often don’t start from wealth; many of them start out as poor medical students, buried in loans. Higher school costs are making things even harder. Tuition costs for SUNY Upstate have been going up about $2,000 a year. “This year for the graduating class of 2013 we’re looking at roughly $155,000 [per student] of student debt,” said Mike Pede, director of financial aid at SUNY Upstate Medical University in Syracuse. “That’s just the principal.” Some have more. Fourth-year SUNY Upstate medical student Elias Awad has amassed over $200,000 in student loans between medical school and his undergraduate degree. “Currently between my undergraduate loans and my medical school loans by the time I’ll graduate I’ll owe approximately $220,000 of capital...I’ll have accrued about $20,000 to $25,000 in interest during school,” Awad said. Awad is not enthusiastic about his debt, but he is excited about the prospects for a good job in emergency medicine after he graduates. “It doesn’t make me feel good about myself,” he said. “It’s a big burden of debt and it’s terrifying to see that number. I’ve never even come close to having any kind of money like that before where I’d be able to pay it, but with luck, getting a good job, which I’m not guaranteed but almost guaranteed, that will be manageable, I’m hoping.” Students need a lot of money to go to SUNY Upstate: $58,000, including living expenses, for the first year, $63,000 for the fourth. And that is if you are an in-state student. It’s $57,380 for tuition alone in the year 2013-2014 if you’re an out-of-state student. But SUNY Upstate is far from the most expensive school in the nation. According to Pede, the Liaison Committee on Medical Education, an accreditation organization, reported SUNY Upstate is in the 60th percentile, meaning that 40 percent of the nation’s medical schools are more expensive Mike Pede, director of financial aid at SUNY Upstate Medical University in Syracuse, says that despite high loans, medical students are able to pay off their loans within 10 years because of the income they can make.
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when you include living expenses. When it comes to tuition alone SUNY Upstate falls to about the 40th percentile. Awad said the most expensive schools are far above his university’s costs. “The most expensive medical school in the United States is Tufts University in Boston for example,” he said. “A student who is a full-loan student there between their tuition and their living expenses can expect to take on about $95,000 a year to attend Tufts. I’m just over half of that.” Awad said he and students like him have to try to keep costs down and live on a limited income but the problem is that students sometimes are ill prepared for the realities of getting by on $20,000 or less of living expenses provided by graduate loans, he said. Budgeting can almost be part of a foreign language. “You have to educate the student to realize that if you don’t want to get yourself in a lot of debt one of the ways to do that is through budgeting,” Pede said. “We call it a financial literacy section that we talk about. We do have counselors on staff. We’re not financial planners in any way. Most of the experience we have is through our life experiences ourselves.” The financial aid office is available for students to get ideas on how to make ends meet. One of the ideas Pede promotes to students is to cut expenses. This could include such basic things as getting a roommate to share an apartment or learning to cook at home. Learning to budget right may take more than the 45-minute synopsis the financial aid office offers at orientation, but students will have four years to learn. Awad advises that new students should become familiar with their loan
Fourth-year SUNY Upstate medical student Elias Awad: “Currently between my undergraduate loans and my medical school loans by the time I’ll graduate I’ll owe approximately $220,000.” He expects to earn between $250,000 and $275 as an emergency medicine physician. debts from the start though. “Stay informed about how loans work, how interest works and how capital works and what repayment plans are because otherwise it’s going to be a really big shock on the last day of the year when you have to sit down with your financial counselor and they put that big number in front of you,” he said.
Medical School Costs Nationally ■ The median education debt for indebted medical school graduates in 2012 was $170,000. Eighty six percent of graduates report having debt. ■ Debt levels for indebted medical school graduates and medical school costs of attendance have increased faster than inflation over the last 20 years. ■ Private schools typically offer more in grants and scholarships but they rarely cover the entire cost of attending medical school. ■ Education debt or potential income may play a role when physicians choose their specialties, but they do not seem to play a determining role for most. Non-financial factors such as personal interest in a specialty’s content or level of patient care seem to have more influence in specialty choice. Source: Association of American Medical College’s 2013 report “Physician Education Debt and the Cost to Attend Medical School.” August 2013 •
Disturbing Trend — The good news in all this is that Pede said most doctors are able to pay off their loans within 10 years because of the income they can make. The bad news, though, is that the trend of rising school costs may be influencing students to turn away from becoming primary care physicians, creating a shortage. Primary care physicians had an annual mean wage of just over $180,000 in 2012, according to the Bureau of Labor Statistics. Compare that to the $330,000 median annual income of a trauma or plastic surgeon, as reported by salary.com, and you can see why moving into a specialty can be very attractive. Awad said the potential salary of a specialty was a consideration for him. He was attracted to family medicine as well as emergency medicine. He said that the higher salary of emergency medicine and the reams of red tape that primary care physicians have to go through to conduct daily business helped push him toward emergency medicine. “I plan on going into emergency medicine as my specialty which has an average salary of between $250,000 and $275,000 a year,” he said. “With that I believe that if I get a decent job in a decent place that my loan debt, even though it’s going to be around $2,500 a month on a standard repayment plan, that should still be feasible within my price range.” Pede sees the trend of losing primary care physicians and is concerned by it. He thinks more should be done. “My concern about health care in general is that as more and more students borrow to obtain their medical education...I think you’re going to see students gravitate towards the more lucrative specialties,” Pede said. “I really think as a nation we have to be concerned about that in terms of what are we going to do. Are we going to provide scholarship dollars? Are we going to apply low interest loans? Are we going to apply retainment options for our students who are going into primary care?“ Awad believes that although medical costs are exorbitant and the costs continue to rise, the ends really do justify the means. If your heart is dedicated to becoming a doctor the path through medical school, though expensive, remains worth it. “I’m not looking forward to my loans going into repayment but everything else for sure,” he said. “I’m going into one of the greatest jobs in the world. It’s incredibly rewarding every day. I get to be in people’s lives in a very unique and meaningful way. I think for me it is very much worth it in the end.”
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My Turn
By Eva Briggs
A Visit to Rosamund Gifford Zoo Humans can learn a great deal from animals
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he animal universe serves as a constant source of inspiration and fascination. Take naked mole rats, for example. Whenever I visit the Rosamund Gifford Zoo, it’s hard not to pause for a while to watch the naked mole rats with their bizarre hairless wrinkly skin as they bumble like Mr. Magoo through their tunnels. It turns out that some astute scientists noted that naked mole rats live for decades, much longer than most similarly sized rodents. That sparked an investigation into the science behind their longevity. It turns out that naked mole rat cells, when cultured, keep farther from one another than other mammalian cells. They’re separated by a gooey substance called hyaluronan, a component of the connective tissue found in all mammals. But naked mole rat hyaluronan molecules are five times as large as the molecule found in most other mammalian species. It may be that this jumbo hyaluronan facilitates the stretchy flexibility of the naked mole rat skin, allowing the creatures to
squeeze through their narrow tunnels. It also prevents the cells from clumping together, blocking tumor formation. Hence the secret to the naked mole rat’s longevity: no cancer. When naked mole rat cells are cultured in a way that replaces their large hyaluronan molecules with small (human-sized) hyaluronan, scientists can induce cancer. Perhaps this finding will be used to discover new strategies to prevent or treat cancers in humans. • Most people are aware that porcupine quills are very difficult to pull out, because of their tiny barbs. But those same barbs make the quills much easier to penetrate in to the skin in the first place. What if similar technology could be applied to medical needles? A needle that penetrates more easily would reduce the pain of injections, IVs, and blood tests. If the barbs could be modified so as be easy to remove as well as less painful to insert, the result would be a better needle. And in some circumstance — such as a patient who requires long-tern IV medications, a
barbed needle that is harder to dislodge and remove is a plus. • Bats navigate via echolocation — they send out clicking noises that enable them to perceive their surroundings and navigate. But could human beings do that? The answer is yes, Some people have learned that skill. Daniel Kish, a man blind since infancy, discovered on his own as a child how to make clicking noises and navigate by the echoes returning from objects in the environment. Even more amazingly, he has figured out how to teach others to do the same. He started an organization called World Access for the Blind (www.worldaccessfortheblind.org) whose goal is to facilitate the self-directed achievement of people with all forms of blindness. As part of that mission, he teaches people a form of echolocation, which he calls flash sonar. Echolocation seems difficult but plausible for most of us. But navigation by magnetic field? It appears that some animals do this, and people may
have a hidden ability to do the same. There are some cultures where people routinely use cardinal directions (north, south, east, west) instead of relative directions (right, left.) Instead of saying go straight down the hall and turn right, people in these cultures find it more natural to say head east down the hallway and then turn south. They learn this skill from childhood and are able to keep track of direction without orienting to external or visible landmarks. Apparently this is done by magnetoreception, sensing the earth’s magnetic field. It’s believed that all humans have this ability. It’s just not used and therefore not developed in most of us. Where do these magnetoreceptors lie? No one is certain, but certain chemicals in the retinas of our eyes respond to magnetic fields, and these may be the sensors. I’d sure love to develop this skill, rather than relying on a map, compass, or GPS receiver to tell me which way I’m headed.
Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
Parenting By Melissa Stefanec melissa@cnyhealth.com
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wo years. It doesn’t seem possible. I’ve been told hundreds of times to hold on, because Stella’s childhood will go so fast. In fact, if I had a dollar for every time I’ve heard this warning, I’d be funding a hefty 529 college savings plan. Alas, the advice doesn’t come with a monetary attachment. People offer this advice for a good reason. Stella’s childhood is whizzing by inexplicably fast. Raising my daughter is so exhausting and rewarding that I can barely find the time to recollect the moments. In honor of Stella’s second birthday, I am going to force my brain to remember some of the fast times gone past. Here are some of the most memorable moments I’ve experienced in two years of parenting. • Child birth This may seem obvious, but it’s not on the list for the reason you might imagine. What stood out most about this event is that it brought my entire extended family together. That tiny, crying face was able to bury hatchets and reassemble bridges. I didn’t know it the time, but Stella is a great unifier. Her innocence and beauty are making everyone in the family play a little nicer. When Stella brings everyone together, those are great memories. • The first changing table mishap Squeamish readers beware! Babies may seem harmless, but they are masters of expelling. One thing that will make me giggle until the day I die is the infamous snoop. That’s snoop as a noun, folks. Page 10
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
My husband learned, mid-diaper change, that sneezes add power. Besides being funny, it also taught my husband and me that love for our child would be limitless (and that snoops happen). • The first smile Corny, right? Her first smile was given to me. We have a picture of it. The thing that stands out about this moment is how nothing else in the world mattered, because my child was happy. I looked worn out and haggard, but that’s not what Stella saw. She took me as I was and shared her first physical expression of happiness with me. It was one of those times that you truly understood that your deeds define you as a person. • Her first tantrum Forget the terrible twos, Stella has been in tantrum territory since her teen months. Tantrums are the first steps toward independence. Unlike crawling and walking, there are no mixed parental emotions. Tantrums suck. During my daughter’s fits, I’ve never found myself thinking about how proud I was of her for mashing food into her hair or hitting herself in the head. When the first public tantrum happened, time that once flew came to a grinding halt. Every shriek was an eternity. These moments are tough but telling. It reminds me that life is all about give and take, especially with my favorite little person. • The first time she ran across a field For me, there are few things more enjoyable than watching a
happy, unrestricted tot run through the great outdoors. I never knew how much pleasure could be derived from running free. Seeing a look of pure bliss wash across my daughter’s face is momentous. It reminds me of what I should be focusing my energy on. • My first gift Kids are great at handing their parents things like half chewed food, bugs, pieces of garbage and the like. Kids are also great at making works of art under adult supervision and handing them out as gifts. However, the first time my daughter actually chose something for me and gave it to me with a shy, proud smile on her face, my heart came undone. Stella’s first gift to me was a small white daisy she found while hiking. I will always save it, to remember how she made me feel in that moment. • Singing her lullaby each night Every night that I’ve been with Stella, I’ve rocked her to sleep and sang her a song. It’s a Phish song I’ve loved since back in my college days. It’s silly and sweet, just like my daughter. The song unites my former and current selves and puts Stella and me at peace. If she is crying or had a tough evening, I can count on my lullaby to her lull her into comfort. My favorite moment is when I finish the song and hold her for a few extra moments before placing her in her crib. In that moment, life makes sense. Have a favorite parenting moment to share? I will be glad to run it in a future column.
Operation Medicine Spoon Poison Center launches campaign to prevent misdosed medication in children
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he Upstate New York Poison Center at Upstate Medical University has launched an awareness campaign, Operation Medicine Spoon, to encourage parents and caregivers to use a calibrated medicine spoon for giving liquid medicine to children when the medicine is not packaged with its own dosing device. People who use an ordinary “kitchen spoon” to dispense medicine may be overdosing or under-dosing their child, according to Gail Banach, director of public education and communications for the Upstate New York Poison Center. “A big issue is that spoons vary so much in size,” said Banach. “Additionally, spills can more easily occur when using a kitchen spoon. Using a calibrated medicine spoon will better ensure that the child is receiving the right amount of medicine,” she said. Operation Medicine Spoon came about through Banach’s involvement as a member of a national committee, spearheaded by the Centers for Disease
Control (CDC), looking at the problem of unintentional ingestions of medication in children. One recent study found that 40 percent of parents misdosed medication prescribed for their child that could lead to a possible overdose. The Upstate New York Poison Center adopted this cause as a poison prevention educational platform. Operation Medicine Spoon is being phased in at Upstate University Hospital outpatient locations that provide pediatric care, including the pediatric emergency room at the hospital’s downtown campus, the Upstate Golisano After Hours Care at its Community Campus and the Pediatric & Adolescent Center at UHCC (University Health Care Center) in Syracuse. Adults who bring a child to these sites for care will receive a packet of information that includes an easy-toread brochure promoting medicine safety in the home and a reusable, calibrated medicine spoon. The items are contained in a plastic medicine
Gail Banach of the Upstate New York Poison Center displays the calibrated medicine spoon, the preferred way to dispense liquid medicine to children when the medicine is not packaged with its own dosing device. bag that includes the 1-800-222-1222 telephone number of the Poison Center. Parents or caregivers will also be asked to complete a survey to help the Poison Center determine the success of the awareness campaign and that will provide data to determine future funding. Operation Medicine Spoon is funded through a Friend in Deed grant from the Foundation for Upstate Medi-
cal University and through a grant from Advocates for Upstate Medical University. Banach hopes additional funding can be secured to expand the campaign throughout the Poison Center’s 54county coverage area. For more information about Operation Medicine Spoon, contact Banach at Banachg@upstate.edu, 464-5423.
St. Joseph’s Announces Intent to Align with CHE Trinity Health
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t. Joseph’s Hospital Health Center will join CHE Trinity Health both organizations recently announced following the signing of a non-binding letter of intent by their boards. CHE Trinity Health was formed in May 2013 when Catholic Health East and Trinity Health merged to form a new Catholic health care system with operations in 21 states, becoming the second-largest Catholic health care provider in the United States The move would transition the sponsorship of St. Joseph’s from the Sisters of St. Francis of the Neumann Communities to Catholic Health Ministries, the entity that sponsors CHE Trinity Health. “When CHE and Trinity Health consolidated, we saw a new organization of which we wanted to be a part because of the promise its new ministry offers. We are very pleased to
be aligning with an organization that not only shares our mission of service but also has a national reputation for developing collaborative quality care,” said Kathryn Ruscitto, president and chief executive officer of St. Joseph’s. “This alignment will provide a strong financial foundation for the future of St. Joseph’s and help ensure our ability to meet the potential challenges of health care reform.” Ruscitto explained that the move will enable St. Joseph’s to access the resources and economies of scale provided by a large health system while continuing to provide exceptional care with the same providers patients have come to know and trust. “Most importantly, St. Joseph’s will retain its governance structure and continue to operate locally, while gaining additional support from the breadth of CHE Trinity Health’s combined
strength, educational opportunities and best practices,” Ruscitto said. “CHE Trinity Health is committed to strengthening Catholic health care in the United States and we are delighted that St. Joseph’s Hospital Health Center shares our future vision,” said Judy Persichilli, interim president and chief executive officer, CHE Trinity Health. “With our scale and scope, commitment to exceptional care, and a unified voice for serving vulnerable people, we believe that we can help St. Joseph’s Hospital Health Center meet the challenges of health care reform and continue to provide outstanding care for residents of Central New York.” “The Sisters of St. Francis fully support St. Joseph’s decision to align with CHE Trinity Health,” said Sister Roberta Smith, general minister of the Sisters of St. Francis. “We strongly believe CHE Trinity Health will provide
a strong vision, bound by faith, for the future of St. Joseph’s and the benefit of the Central New York community. We remain committed to the mission of St. Joseph’s and will continue to lend our spiritual support for the compassionate good works of the institution.” Over the coming months, St. Joseph’s will be working closely with CHE Trinity Health to perform the necessary due diligence required before finalization of an agreement, as well as educate all stakeholders on the significant benefits this relationship will bring to the Central New York community. When CHE Trinity Health joined together in May 2013, the new organization indicated it would welcome other health systems that shared its vision. The non-binding LOI is the first such agreement CHE Trinity Health has entered into since consolidating.
Excellus makes $25,000 available to nonprofit organizations Deadline to submit applications is Aug. 9
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s part of Excellus BlueCross BlueShield’s mission to improve the health and health care of the residents of the communities it serves, the company makes community health awards adding up to a total of $25,000 available to help fund health and wellness programs in Central New York. Nonprofit, 501(c)(3) organizations in Excellus BlueCross BlueShield’s eight-county CNY region are invited to apply for an award of up to $4,000 each, which can be used for a program that has clear goals to improve the
health or health care of a specific population in the community. “The company’s community health awards demonstrate a corporate commitment to support local organizations that share our mission as a nonprofit health plan,” said physician Arthur Vercillo, regional president, Excellus BlueCross BlueShield. “These awards complement our existing grants and sponsorships with agencies that work to enhance quality of life, including health status, in Central New York.” In granting the awards, Excellus
BlueCross BlueShield considers organizations which offer programs that focus on: • Activities that improve the health status of the community or that reduce the incidence of specific diseases. • Communitywide health education. • Group-specific health education. • Wellness. To be eligible, the organization must be a 501(c)(3) nonprofit and located in Cayuga, Cortland, Jefferson, Lewis, Onondaga, Oswego, St. Law-
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rence or Tompkins County. Awards will be made based on: • Scope of need. • Goals of program. • Overall number of persons to benefit from the program. • Positive impact on the community’s health status. Deadline for application is Aug. 9. Applications and additional information are available by emailing Community.Health.Awards.CNY@excellus. com.
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Iron Girl
Writer getting ready for her first triathlon By Melissa Stefanec
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t was New Year’s Eve of 2012 and I was off from work. I settled down with a mug of tea and started through my emails. There, in my inbox, was a seemingly benign email from one of my best friends. Its subject line read, “Iron Girl.” When I opened the message, my friend was asking if anyone would like to do the Iron Girl triathlon with her. I thought it was strange, since my friend wasn’t a heavy-duty athlete, but I admired her motivation. As I dunked a half-stale holiday cookie in my tea, I thought about how crazy triathletes were. Was my friend going crazy? I wasn’t feeling particularly crazy on this particular New Year’s Eve. I had a sick toddler and cancelled evening plans. I closed the email and tried to move on. Try as I might to scrap the idea of doing a triathlon, I could not. I started picturing myself doing a triathlon. Images of lost bodily functions ensued. I ran an Internet search for the Iron Girl to find out how scary it really was. My search revealed that this race featured a 600-meter swim, 30-kilometer bike ride and a 5-kilometer run. After a holiday diet of chocolate-hazelnut fudge and gravy, any one of those legs sounded daunting. Getting showered and dressed sounded daunting. I was a regular gym goer and runner, but biking and swimming weren’t my gig. I dismissed the crazy idea again. Like all crazy ideas, this one persisted. The event wasn’t until the beginning of August. I had lots of time to prepare. Then I argued that there wasn’t enough time in the world to prepare. I work full-time, have a toddler, work a side writing job and have a lot of commitments. Still I couldn’t kick the thought. My friend said I had literally hours to decide, because registration filled up within a day. Like an over-eager buyer who only realizes how badly I need the toaster-hair dryer combo when I am told there are only two left, I decided I was going to become a triathlete—even if it (literally) killed me. I went to the site to register, committed to the ridiculously high mone-
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Writer Melissa Stefanec. tary fee, and clicked submit. There was no turning back. I had clicked the crazy checkbox. I was going to do a triathlon. I thought about hyperventilating while squatting in my closet with a tin of fudge. I decided iron girls probably don’t solve meltdowns with treats, so I skipped the meltdown and just ate some fudge. I had no idea what I had signed on for. There would be lots of obstacles ahead of me, though they weren’t always the ones I anticipated. Initially I felt jubilant; I had committed myself to greatness. This single act had to count for at least six New Year’s resolutions. Jubilation quickly deteriorated into fear. What was I thinking? I didn’t know squat about triathlons. I was screwed. I wanted more fudge.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
Luckily, there are people out there who want to grow the sport of triathlon (yes, it really is a sport). I joined the CNY Triathlon Club and was promised year-round training opportunities and seminars. I started reading articles and newsletters with terms like WTF (winter training facility, but I was on board with the more street-friendly definition), body glide, nutrition and transition. I would soon get answers, but more panic ensued. I went to a couple of seminars, clinics and kick-offs and soon found myself with half of a clue. You should train year round, so an indoor training facility is important. Body glide is something you slather all over yourself so you don’t get friction-induced blisters on your tender parts. Nutrition is mostly about what you eat before and during the race. (Apparently this race would be so taxing that my body would demand food during it.) Transition is the time in-between events. You transition from swimming to biking and from biking to swimming. It was all starting to make sense, though it wasn’t getting any less scary. Then I started down the gear road. I needed a bike. Apparently my mountain bike from college wasn’t going to cut it. People have road and hybrid bikes that are designed to travel over pavement instead of tree roots. I then needed repair and replacement parts, storage for those parts, tire-pumping implements and a magic elf. Actually, I wish I could purchase a magic elf, because a lot of the bike repair stuff is still foreign to me. Then came the clothing–much to my chagrin, I couldn’t swim and bike in tank top and running shorts. I also couldn’t bike and run in a bikini. This was going to be tougher and more expensive than I thought, but I bought a tri suit, persevered, cut corners where I could, and outfitted myself. I’m still not over the stickershock of this tri, but I know I made the right choice. I just better stick with it and let my initial investments pay-off and not end up on a shelf in the shed. Then I started actually training. As the snow melted, I ran. As the weather warmed, I got on my first road bike. I couldn’t so much as check for traffic without almost falling off, but things got better. I got a friend to go for a ride with me and give me pointers. I slowly gained confidence and started standing while pedaling, shifting with ease and grabbing my water bottle while riding. I went to a winter swim clinic and got some pointers. I found my way into a pool for a few practice sessions. I started getting the hang of things. I signed up for Wednesday night trainings with the CNY Triathlon Club. These have been priceless. I went to
them and made a startling discovery: I could do this. There were lots of people at these trainings, and most of them didn’t look like triathletes to me. Some were old, some young, some overweight and some underweight. Some looked like powerhouses and others looked weak, but I learned that all these people were triathletes. Most of us worked, many of us had families, and many of us were clueless. Most importantly, most of us were at least a little fearful. We were there to conquer fear and self-doubt. We were there to prove a point to ourselves. We were our own biggest obstacles; we were determined to overcome ourselves. I will spare you the sweaty, painful, aching, tiring parts of my training. They happened. Every time I met a training goal, I set myself a new one. Finding the time in my schedule was beyond difficult, but also liberating. I couldn’t make excuses. A triathlon isn’t something you can just show-up for unprepared and finish on the fly. I made a promise to myself, and I wasn’t about to let any amount of barbeques, work demands, or family/friend obligations make me break that promise. The hardest person to schedule around was my 2-year-old daughter. It wasn’t easy. I’ve been training twice a week, and I decided I deserve that training time. I give so much time to everyone else, I shouldn’t feel guilty about getting a piece of my own precious commodity. I am only a few weeks away from the big event. I am trying to picture it my mind. I see myself getting to Oneida Shores County Park before the sun is up. I picture preparing my transition area as the sun breaks the horizon of Oneida Lake. I imagine cracking jokes about pre-race jitters with my other iron girls. I imagine going through the whole race without getting a flat tire or being clubbed by a misguided swimmer. The hardest part about training for your first triathlon is that there are so many unknowns. A few of these unknowns were out of my control, but most of them were not. I had the power to conquer my first 600-meter open water swim at a training night. I had the power to accomplish three separate legs during my training. I had the power to silence my inner critic. I was forced to realize that it isn’t about what my body looks like, it’s what I train it to do. I have trained mine to be ready. I’ve drowned my fears in accomplishment. As I wait in the early morning sun on the first Sunday in August, I hope I find a way to keep believing in myself. I plan to replace my fear with pride. I will let you know how it goes. To unknowns!
SmartBites
By Anne Palumbo
The skinny on healthy eating
Why Salmon Is Such a Nutritious Catch
S
almon is my go-to fish twice a week, and here’s why: It’s swimming with health benefits; it’s readily available in grocery stores; and it’s loaded with omega-3 fatty acid. Let’s begin with the all-mighty omega-3s. By now, most are aware that we need to include these important unsaturated fatty acids in our diet. In a word, omega-3s may help us live longer by reducing the risks of heart disease, heart attack and stroke. Fatty fish contain the most omega3s of all food, and salmon is at the top of that list. Omega-3s are believed to provide these benefits by reducing inflammation throughout the body, by slowing the growth rate of plaque, by increasing good cholesterol, and by lowering blood pressure. Something else to ponder: Omega3s are also good for brains. A large study in the journal Neurology revealed that a diet lacking in omega-3s may lead to faster memory loss and brain aging in older adults, as well as depression in all ages. Since we need
tect against heart disease and certain cancers. Lastly, salmon teems with selenium, a powerful antioxidant that supports a healthy immune system and helps to prevent cell damage.
Helpful tips When possible, consume wildcaught salmon over farmed: it contains fewer contaminants, more vitamin D, and less fat. If buying farmed, choose U.S. farmed salmon over imported. Canned salmon is a good way to get wild salmon cheaper and year-round. Plus, when it comes with bones (soft and edible), it’s a super source of calcium.
Salmon with Roasted Asparagus and LemonCaper Sauce Adapted from Bon Appetit Serves 4 this particular fatty acid to build brain neurons, it’s no wonder omega-rich fish are often called “brain food.” Salmon is also an excellent source of healthy protein, a nutrient we need to build up, keep up and replace tissues in our body. One-half a fillet (about 4–5 ounces) delivers a whopping 39 grams, nearly 75 percent of our average daily needs, for less than 300 calories. Angling to increase your vitamin D? Good news: Salmon is one of the rare foods that boasts a decent amount, with a 4-ounce fillet providing a full day’s intake for most. Vitamin D promotes healthy bones and may pro-
Elm Hill Towne Center Camillus
2 tablespoons fresh lemon juice 2 tablespoons minced shallot 1 tablespoon olive oil 1 tablespoon drained capers, chopped 1 teaspoon dried thyme ½ - 1 teaspoon finely grated lemon peel 1 1½-pound salmon fillet (about 1¼ inch thick) 1 pound asparagus, trimmed 1 tablespoon olive oil
three ½-inch-deep slits crosswise in top of salmon (as if dividing into four equal pieces, but do not cut through). Arrange asparagus in a single layer on baking sheet. Drizzle with oil and turn to coat. Sprinkle with salt and pepper. Place salmon atop asparagus; sprinkle with salt and pepper. Roast until salmon is just opaque in center, about 20 minutes (longer if you like your salmon well-done.) Transfer asparagus and salmon to platter. Spoon sauce over salmon. Cut salmon into 4 equal pieces along slits.
Whisk first six ingredients in small bowl to blend. Season to taste with salt and pepper. Preheat oven to 450 degrees. Cut
Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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ACCEPTING NEW PATIENTS • Most Insurances Accepted August 2013 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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WHOLE ME Expands Horizons for the Deaf Organization is celebrating 10 years this year By Matthew Liptak
T
o the unfamiliar, being deaf can mean living in a world of silence, but at WHOLE ME Inc. in Syracuse, being deaf or hard of hearing means being exposed to a world of communication and opportunity. WHOLE ME is an acronym for Work, Health, Organizational skills, Life experiences, Entertainment choices, Math and English. The organization serves about 50 families in the area. The nonprofit is striving to help people — from child to young adult — meet the challenges that being deaf or hard of hearing poses. Those challenges can be substantial. “Helen Keller once said that being blind cut her off from things, but being deaf cut her off from people,” said WHOLE ME’s founder Christine Kovar. “Sadly this statement still holds true to day and is underscored by the fact that 90 percent of deaf children are born into hearing families who have no knowledge of sign language or deaf culture. The inability to carry on simple conversations during a child’s formative years has far-reaching devastating effects and often leads to a lack of basic literacy and social skills.” Tamla Htoo, 26, of Liverpool is a deaf woman who has struggled to communicate with people, even in her own immediate family. She and and another WHOLE ME member, 19-yearold Christine Aiken of Camillus, sat down with American Sign Language interpreter Sue Freeman and Kovar to talk with In Good Health. “It’s very frustrating,” Htoo said. “My family being hearing we would be sitting around. They’re laughing. There’s a party going on. They’re talking, having a conversation and I would ask ‘What’s up?’ They’d keep telling me ‘Oh, I’ll tell you later. I’ll tell you later.’ I felt almost deflated, like I’m not involved with my own family. I felt
WHOLE ME Inc. in Syracuse is a nonprofit that works with the deaf and hard of hearing. Shown are Christine Kovar, the founder of the organization (center), and two clients who now work at the agency, Tamla Htoo (left) and Christine Aiken. alone. That’s the frustrating part.” Aiken finds acceptance as the most challenging thing about being deaf. “For me it’s more...the hardest challenge about being deaf is people won’t accept who you are,” she said. “Then I don’t accept who I am. That got me depressed for a long time until I came to WHOLE ME, to know there’s other people like me. That helps me a lot. It’s like my second home.” Kovar noticed these types of difficulties in her 30 years of work as interpreter, case manager, employment
specialist and teacher. She has a certificate of interpretation and certificate of transliteration from the National Registry of Interpreters for the Deaf and a master’s degree from Rochester Institute of Technology. She founded WHOLE ME in order to solve problems like the ones Htoo and Aiken have faced. This year the organization is celebrating its 10th anniversary. “If a community could look past the hearing loss and see the whole person we would be amazed at all these
children can do!” Kovar said. Htoo and Aiken are good examples of this. They both started at WHOLE ME years ago. Htoo started out as a Burmese refugee. Today both women are college veterans. Htoo has graduated from Onondaga Community College and Aiken has a 3.4 GPA at the college. She received a outstanding achievement award from the school. Among the programs WHOLE ME provides are its leadership, after-school and summer educational initiatives that improve education, life skills and
IOSWEGO AM HEALTH
After spending six weeks with his mother who was a patient at the Mayo Clinic, Clark decided to make a major career change.“I went to nursing school, and here I am.” “I had a number of offers out of college, but I chose Oswego Hospital,” said Clark. “First of all, the technology used at this hospital is more advanced and I was very impressed by everyone and their vision.” “I love to be part of change and process improvement.”
Clark Sargeant, RN Fourth Floor Oswego Hospital
www.oswegohealth.org
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
employability. “Both the after-school program and youth leadership program are very popular and essential for our children,” Kovar said. “These programs provide an opportunity for the kids to come together with peers who are the same as they are. Communication is not an issue because everyone is fluent in both American Sign Language and English. Also, all of the kids have had similar experiences of being in situations where they are the only deaf or hard of hearing person in a group of all hearing people, struggling to understand what is going on. When they are together in our program they can relax and be themselves. There is a real bond among the kids. They all look out for each another and support each other. It’s great to see!” Both Htoo and Aiken work at WHOLE ME but pursue other goals. They are inspired by and grateful for the assistance they have received through the organization. They are emphatic that there should be more organizations like it. “My other goal in life is to set up a deaf community center for the kids where if they feel like they’re not wanted at home they can come to my deaf community center where they can sign and have friends and another family to come home to,” Aiken said. “I’m very passionate for the deaf,” Htoo said. “I want them to know that they can improve. My life improved and I want to help them. The point is deaf people can be successful. Many times deaf are looked upon and they hear can’t, can’t can’t, can’t, can’t. I want to show them. I want to help them. I want to encourage them...that they can be successful. That’s what really motivates me. I cherish the deafness.” To find out more about WHOLE ME, visit www.wholemeinc.com or call 315-468-3275. WHOLE ME also provides professional sign language interpreting services for businesses, schools, health care providers, art, cultural events and other venues throughout Upstate New York. Revenue generated by this service goes back to providing programming for deaf and hard of hearing youth.
Toxicology consultation service now available Upstate to add service to aid in evaluation of patients who experience a poisoning or toxic exposure
U
pstate University Hospital has recently added a medical toxicology consultation service for patients. Upstate is the first and only healthcare facility in the region to offer this service that is available through the department of emergency medicine, in cooperation with the Upstate New York Poison Center. The service will allow physicians and pharmacists with advanced toxicology training to be available for emergent cases immediately, upon request, to help in the diagnosis and evaluation of patients who experience a poison or toxic exposure. “Our medical toxicology consultation service will improve patients’ overall care and efficiency in medical management,” said toxicologist Ross Sullivan, director of the service and assistant professor of emergency medicine at Upstate. “We are able to see these patients at their bedside immediately rather than evaluate them the next day. Studies show that this type of service results in decreased ICU stays and shorter hospital stays for the patient. It is also cost effective in that the patient needs fewer healthcare resources.” Joining Sullivan in the consultation service are medical toxicologists Michael Hodgman, and Michael Holland; clinical toxicologists Christine Stork and Jeanna Marraffa; clinical toxicology fellow Robert Seabury; and medical toxicology fellow Nicholas Nacca. To reach the medical toxicology consultation service and its outpatient clinic, call the Upstate New York Poison Center at 315-476-4766 or 315464-5369.
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Page 15
Are Colonics Something You Should Consider? Practitioners say colon irrigation can help alleviate variety of problems — from migraines to digestive problems; doctors say otherwise
Most local healthcare providers choose Laboratory Alliance. We perform more than 10 million laboratory tests each year for the healthcare providers and patients who have placed their trust in our team of 445 laboratory professionals. Every day we work hard to retain that trust. It’s the reason we have grown to become the region’s largest licensed laboratory. Laboratory tests are vital to assessing wellness and to diagnosing and treating illness and disease. We are grateful for the privileged role we play in providing Central New York with the highest quality healthcare. Working together for the health of our community.
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By Deborah Jeanne Sergeant
A
t Vitonics in Fayetteville, Lisa Jacques treats people who come to her for colonics for a variety of reasons. Some want relief for constipation. Others feel that colonics provide detoxification to their digestive systems, ridding themselves of parasites, heavy metals or yeast. Still others view colonics, also known as colon irrigation, and colon hydrotherapy, as a modality for maintaining health. Jacques is a licensed esthetician, certified at the Wood Hygienic Institute, Inc. Professional School of Massage & Colon Therapy in Kissimmee, Fla. for colon hydrotherapy. After opening the rectum with a disposable speculum inserted one and one-half inches, Jacques uses a closed, gravity-fed system of sterile, one-use tubing to direct a trickle of purified water into the colon and flush waste out.
The procedure last 45 to 60 minutes. “Colonics can be very beneficial in relieving symptoms of stress like constipation, bloating, irritable bowel syndrome, diarrhea, skin conditions, and acne,” Jacques said. “I’ve treated people [who have had] headache or backache, pain in the area of the spleen and after a colonic the pain is gone. “When your colon is full of fecal matter or toxins, it will affect all the other organs in your body. Some people when they’re done, their skin is brighter and their eyes are clearer. They say they feel less heavy and not foggy in their minds.” The frequency of colon cleanses varies among patients from weekly to annually, depending upon their goals and issues. Jacques carefully screens patients
Join Hospice of Central New York for an evening of fun and music at Traditions at the Links on September 20 from 6:30 pm to 10:00 pm. $125 per person includes dinner, drinks, dancing and more! All proceeds benefit Hospice of Central New York patients and their families. Reserve your place online at www.hospice.org or call 315.634.1100
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
with paperwork and questions to ensure they do not have any contraindicated health issues such as colon cancer, colitis, diverticulitis and women who have never had a colon cleanse and who are in the first trimester of pregnancy. “Some people I won’t try to convince because they’ve made up their mind that colonics aren’t good,” she said. “Aside from safety, some people say the body can eliminate on its own. I don’t believe that to be true. At some point in human history that was true. About 3,000 years ago, colonics started with the Egyptians. With our environmental factors and stress people are under, there are some instances where people need help eliminating.” Joanne Moore, owner of Cleanse the Internal U located in the hamlet of Memphis, near Camillus, follows a similar protocol for administering colonics to her clients. She learned the practice at the Cayce/Reilly School of Massotherapy in Virginia Beach, Va. and has been a colonics practitioner since 2004. She is also a massage therapist trained by the Onondaga School of Therapeutic Massage and offers ionic foot baths and, occasionally, ear candling. “[Colon cleansing] keeps you regular and it’s very healthy because it doesn’t give your body time to back up and store things in your system,” Moore said. “The colon is the center of your internal universe. If you keep it clean, you’re healthier. Colonics can help alleviate migraines, allergies, bursitis, colds, colitis, constipation, digestive problems, fatigue, food sensitivities, halitosis, indigestion, lack of energy, low back pain, osteoarthritis, skin disorders and parasites.” Some people who ask her about colonics express skepticism about its
benefits; however, she said, “If you believe it will help you, it will. You have to be open-minded. Some believe it will cause more hurt than good, but every amount of waste you get out, the better. The backing up of fecal matter can cause disease.” But not everyone agrees. “Independent of the theory of what they’re trying to accomplish, they’re giving an enema and it’s high up, not knowing where you’re pushing and what you’re pushing against,” said physician Jeffrey Goldstein, chief of Digestive Center of Western New York in Rochester. “Could it be a diverticulum that they’re pushing against, a weak spot in the colon? They could go through the anal canal. Suppose a person has constipation because of a tumor?” He also fears that if people receive too many colonic treatments too close in succession that they could suffer an electrolyte imbalance. Goldstein questions the premise of colonics since bacteria-laden stool passes through the colon. “Those who want to clean it and purify it are misled,” Goldstein said. “They want to take an alternative remedy that isn’t FDA approved and they could have serious, potential side effects. I think these patients are frustrated and seek it out or those who have sought medical attention and we haven’t figured out their problem so they seek out their own medical answers.” Some people hope colonics will improve their absorption of nutrients; however colonics will have no effect since absorption happens in the small intestines. As with making any other change in health habits and treatments, seek the advice of a medical professional before trying a colonic.
Lyme Disease Awareness & Prevention Event Presented by the CNY Chapter of the Empire Chapter of the Lyme Disease Association
August 15th at 6:30pm
The Palace Theatre, 2384 James St. Syracuse Program: View a showing of Under Our Skin, the award-winning documentary, that exposes the hidden story of Lyme Disease. And Syracuse welcomes Daniel J. Cameron, MD, a pioneer in Lyme disease and a leader in ILADS, the International Lyme and Associated Diseases Society, who will be presenting a discussion on Lyme Disease.
Martha Conan, MS CASAC PT-CSp
Free event • Doors open at 6 p.m.
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Page 17
To Hell and Back Auburn native releases book on his battle with chronic pain
A
udie Murphy has company. While not a decorated soldier of World War II, Auburn’s Anthony Sorendo can still relate to journeying to hell and back. He documents his own experience in a new biography, “My Journey to Hell and Back with Chronic Pain.” The book is an inspirational healthrelated story that was written primarily with those who deal with chronic pain on a daily basis in mind, or those who need a bit of inspiration to clear their own personal hurdles. Sorendo, 53, has lived with chronic pain for the past 25 years. “Other than the physical pain, there is a feeling of being alone and isolated,” he said. “Loved ones can sympathize with you, but they would have to walk in your shoes to really understand what is going on.” He said chronic pain goes beyond physical agony. It also impacted him on an emotional and psychological level as well. “It’s about depression and any kind of negative feeling you can imagine that comes along with it,” he said. “I’m trying to share my story of how I overcame that.” It is estimated that approximately 80 million Americans suffer from chronic pain. The book is a memoir of Sorendo’s life dealing with chronic pain and the complexities it presents. It starts when his lucrative baseball career prematurely ended at 19 and he was left dealing with severe pain for the first time. He was forced to find another direction in life before a workrelated accident ended his food service career and took him out of the loop for good in his mid-20s. “I lost my career and then it became a stay-at-home mom type of thing,” Sorendo said. Dealing with daily pain led to depression, and the book explores some of Sorendo’s lowest points. It also delves into the relationship he has with his family, and the guilty feelings that emanated from the limitations placed upon him. “There were a lot of times when my son Christopher was young and he wanted to do the normal things that sons and dads do,” Sorendo said. “There were many times when I had to say I wasn’t able to. He was just too young to understand.” “That guilt stayed with me for a long time and was really devastating to me,” he added.
Dreams are shattered
Sorendo was trying out for a roster spot with the Toronto Blue Jays and on the verge of signing a Major League Baseball contract when the unthinkable happened. Sliding into home plate during an exhibition game, he caught his spikes on the plate and completely severed his left Achilles tendon. His baseball career was over before it had begun. Sorendo went back to school at Morrisville Community College and earned a degree in food service administration. After rehabbing his leg for nearly a year, he jumped back into the workforce. In 1992, a work-related accident led to three back surgeries and a neck Page 18
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surgery. For the next six years, Sorendo would endure daily pain despite surgeries that did manage to correct structural problems. “There was not a day when I was not in agony,” he said. Sorendo did experience the lowest of lows. “I’m not proud of the fact that at one point, I was low enough to attempt to take my own life,” he said. “Part of me really didn’t want to die but part of me didn’t want to live that way.” Sorendo said his deep faith in a higher power and a change in his way of thinking brought him back from the edge. “Thank God I saw the light. Right at that point, I changed my mind and knew I definitely needed some help,” he said. Sorendo sought counseling and went through the long process of recovery. “That was my rock bottom point and thank God I was able to climb back up after that,” he said. Sorendo was prescribed a lot of medication, but for him, pain pills did not do the trick. “They never worked for me. The only thing they did for me was allow me to get a little sleep,” he said. “They really never did anything for the pain. Some people get highly addicted and it is a huge issue in society. Fortunately for me, that was not the case. I just stopped taking them,” he added. Sorendo said the medical profession must place an emphasis on the psychological toll of pain and not just be quick to write prescriptions for painkillers. “For me, that is putting a Band-Aid on the situation,” he said. He tried other avenues, such as nerve blocks, chiropractic and physical therapy. “It was just getting worse and worse,” he said. “There’s not a day that goes by that I don’t feel some pain, but I guess what I learned to do is channel my pain,” he said. What Sorendo discovered is that while in pain, he was “attracting negative energy.” The pain aspect became “my whole day, my whole identity,” he said. Sorendo calls it the “pain tunnel.” “Basically, I was looking through a tunnel of pain. That’s all you focus on,” he said. The more frustrated and angry he became, his body would tense up and the pain would worsen. “I was my own worst enemy trying to deal with it,” he said.
The comeback
In 2008, his life finally started to turn around. That is when Sorendo was introduced to the spinal cord stimulator. “I had tried every avenue possible that I knew of out there to manage the pain but nothing worked,” he said. The pain management unit blocks pain signals from going to the brain. Sorendo agreed to use it for nine days on a trial basis, and after invasive surgery, said it erased 75 to 80 percent of the pain, a first in 25 years. He became a candidate for a permanent implant, but had to fight his insurance company for several months
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
before being approved. After finally getting the green light, he went in for surgery but came out paralyzed from the waist down. “It was no fault of the unit or doctor. I had the trial unit and knew it worked for me. It was a fluke thing where my body rejected it. I had a blood clot that formed on my
spinal cord, and it was ready to break off and go to my heart or brain and kill me,” he said. Surgeons were forced to reverse the procedure the same day. “It took quite a while for me to get my life back,” he said. However, his slow but steady recovery from that point served as one of his biggest turning points. “I was blessed and starting thinking differently. The situation could have been so much worse. I was looking at spending the rest of my life in a wheelchair,” he said. He was also inspired on a spiritual level. “It was just something that came over me. My wife Pam really got me on board with a lot of positive energy thinking,” he said. While that may sound cliched, Sorendo said it affected his whole lifestyle. Pam said she is proud of her husband for many things. “First and foremost, I am proud of his determination and perseverance for writing and promoting this book,” she said. “Every day he continues to live with chronic pain, but he is now able to let go of the anger and frustration that used to run his daily life.” Pam said her husband has a new, positive attitude that helps him to enjoy life again, “and once again be the wonderful man that I married.” “I thank God everyday that he has allowed Tony to share his story and hopefully inspire others who are struggling with any type of pain,” she said.
Powerful positive thinking
“I believe what you put out, you get back. What you think about, you bring about,” he said. “At first, I thought, ‘How is positive thinking going to help me?’ But little by little, it just started to take on a life of its own,” he said. At that point, he decided his mission in life would be to help other people who had gone through what he
had experienced. As a result, he started a support group about three years ago. “I could see a lot of me in them at the time,” he said. Sorendo, however, wanted to share his message in a much broader way. That is when he decided to write his book. “If I could tell my story and help one person, it would have served its purpose,” he said. “You can either have it destroy you or rise above it and seek other answers and keep a positive attitude.” Not computer savvy, Sorendo wrote the entire book by hand. He would go to Owasco Lake in the summer or to the food court at Fingerlakes Mall every day to write. When writing about his lowest points, he would become overcome with emotion and “sometimes the tears would just flow and I would start crying,” he said. After returning home from writing, he would “have the worst headache because of the emotional drain. But it was worth it,” Sorendo said. Using Dragon Naturally Speaking, he dictated the book onto a computer before putting it through the editing process. Released in April by Wasteland Press in Shelbyville, Ky., the book is available in print and digital formats through 1-2-3 Books, Amazon.com, Barnes & Noble, Inc. (Kindle and Nook), Downtown Books and Coffee in Auburn, and the Auburn Community Hospital gift shop. He is on the board of directors at Options for Independence in Auburn and volunteers there on a weekly basis. He and his wife Pamela have two adult children, Jessica, 30, and Christopher, 22. The couple enjoys music and participates in area “open mic” events. Sorendo is available to speak to pain support groups and appear at book signings. To schedule an appearance, contact him at tonysorendo@gmail.com. By staff writer
Her HeartBeat Heart Health Advocate Starts Consulting Practice
What They Want You to Know:
Nurse Practitioners
By Deborah Jeanne Sergeant
T
he American Academy of Nurse Practitioners states that nurse practitioners are “clinicians that blend clinical expertise in diagnosing and treating health conditions with an added emphasis on disease prevention and health management.” Nurse practitioners are trained at the master’s degree level with an emphasis on patient-centered wellness and care. • “Legislation is pushing for nurse practitioners to be totally independent. The way we’re going with Obamacare, NPs will be relied upon more and more because there are fewer physicians coming out and the need is becoming greater. • “People ask all the time, ‘When can the doctor see me?’ and I say, ‘I’m it. I can treat you in the same way that your physician can treat you.’ • “Sometimes, NPs have a better outlook on communication with patients than doctors because we’re more on the patient’s level. • “In New York state, NPs can open up their own practices. We can write prescriptions, diagnose and treat. We can’t walk into a surgical suite and operate, but we see all types of diagnosis and conditions. If it’s above our scope, we have a way of knowing and we seek further advice from a specialist, just like a general practitioner. Terri Haskins, nurse practitioner, Finger Lakes Health Transitional Care Unit • “People get us confused with physicians assistants. The big difference is we’re nurses first and we come at healthcare from a nurses’ perspective. • “We’re experts at collaborating with other healthcare providers in the interdisciplinary team and are liaisons between the physician, patient and family. We’re often called doctors but we’re not doctors. • “I’ve been in the field 10 years. There were not a lot of NPs when I started, but the public’s perception has grown. A lot of people have told me they’d rather have a NP than an MD. There’s a growing awareness of what we have to offer.” Marcia Sanford, nurse practitioner with James Square Health & Rehabilitation, Syracuse • “NPs in palliative medicine help a lot with symptoms: pain, shortness of breath, depression, delirium and other things that affect quality of life. .
• “One of the things we do is have conversations with family and with their primary care physicians about advance directives. It’s a written medical directive and with the support of a primary care physician at his office. It doesn’t have to be made here under duress. Talk among yourselves as a family. Ask your spouse. • “Quality of life is hard to measure. It might be different for me than you. We try to learn about and encourage people to think about what brings quality to your life. Even if someone has a new diagnosis, let’s say lung cancer, but a treatable lung cancer and they’re aggressively treating it, think about the other things that can help balance out the inevitable suffering that comes with an illness like that. Peter Sinatra, nurse practitioner with Crouse Hospital Palliative Care • “What I find to be helpful is when physicians get us involved early on and get to know the family and get to honor their wishes in writing. That has been more helpful. The more you know them, the better outcomes and better support you can provide.” Wendy Campbell, nurse practitioner with Crouse Hospital Palliative Care • “Part of our focus is holistic in nature. • “We not only work with patients but their significant other. So many times a variety of family or non-family members have a close relationship with the patient. • “Our role is very supportive in nature. • “We want to keep people independent and respect their dignity. we work close with families and the supportive people in their lives. Kelly Wheeler, nurse practitioner with Crouse Hospital Palliative Care
Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.
By Lisa M. Mayers
L
eisha Tedford Doherty knows first-hand the importance of total heart health. Surviving her first cardiac event and emergency open heart surgery in 2009, she woke up on life support happy just to be alive. It was then that Doherty first conceived the idea for Her HeartBeat and became such a strong advocate for women’s total heart health. “What many women don’t realize is that heart disease is the leading cause of death — killing more women in this country every year than all cancers combined,” says Doherty. “Yet, heart disease is 80 percent preventable with lifestyle change. What other disease offers that kind of hope for prevention?” Through one-on-one counseling, coaching and consulting Doherty guides women as they navigate life transitions or find themselves at “stuck points.” Whether career, health, relationship or family related she assists her clients in getting to the “heart” of the matter and in doing so, finding their way to a healthier, happier, more passionate life. Doherty designed the Her HeartBeat “Total Heart Approach” to assess and focus in on six key areas: physical, emotional, lifestyle, career, financial and spiritual heart health. When a woman is feeling stuck, overwhelmed or unsure in any area of her life, it impacts all areas of her life. According to says Doherty, her total heart approach allows women to connect mind and heart, leading to greater clarity about their life’s mission and purpose. Hand in hand with the emotional and spiritual benefits women gain through the one-on-one support of Her Heartbeat programs, are opportunities to make improvements in their physical well-being. Doherty’s integrated approach includes everything from practical dietary advice to developing a fitness regimen, to working with your health care providers to create a complete lifestyle plan tailored to your specific needs. “I know first hand what it takes to go from surviving to thriving and I want to take other women there with me,” says Doherty. “You can’t just focus in on one area of your life to do that. It takes a holistic approach — and from my perspective and experience, that means a heart-centered approach.” As Doherty went on to explain, that was her purpose and her passion in founding Her Heartbeat. Now, clients nationwide are learning about her services and unique approach at www.HerHeartbeat.com and successfully navigating life’s challenges with Doherty via phone and Skype. Regionally, clients often connect with Doherty after a speaking engagement or through her work with corporate clients. Recently, she has also begun connecting with health care providers to accept their referrals as well. Regardless of how a client connects with her, Doherty’s approach is collaborative, practical and motivational, customized to meet their specific needs, and with the intention of leading them August 2013 •
Leisha Tedford Doherty, who had an open heart surgery in 2009, has started a consulting business — Her HeartBeat — to help women care for their heart and health in general. to their highest, heart-centered, hearthealthy life, ultimately allowing them to recognize and honor their heart’s true passions. With a graduate degree in social work and more than 25 years of counseling and wellness experience, she is able to go well beyond the scope of many coaches, creating a keenly effective blend of therapy, coaching, and consulting. In addition to her individual, private client sessions, Doherty reaches out to women through her group sessions, presentations, speaking engagements and her articles and blogs on the topic of women’s heart health. For more about Leisha Tedford Doherty’s story and Her Heartbeat, visit www.HerHeartbeat.com or connect with her on Facebook at www. facebook.com/herheartbeat.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 19
Golden Years
Making a Difference in End-of-Life Care Hospice volunteer shares experience working with the terminally ill and their families By Matthew Liptak
W
arren Baldwin of Baldwinsville doesn’t think he stands out but if you talk to one of the patients of Hospice of Central New York they may beg to differ. The 67-year-old retired SUNY counselor has been a hospice volunteer for six years and shared time with many people near the end of their life’s journey. Sometimes he offers an understanding ear, other times just a bit of welcome conversation. Baldwin said it’s not hard. You just need a caring heart. “You just have to care about people and be willing to listen and be respectful,” he said. “That’s all people really want. Sometimes there’s like this fear that I have to be able to do something or say something. All you have to do is show up, be present, be available, listen, care about people. People love to talk about themselves if you’re interested in them. They sense that. That’s all you need really.” While Baldwin plays down his contribution, Bill Pfhol, communications officer of Hospice of Central New York, makes it clear how the work of volunteers like Baldwin is critical. “From a practical point of view our volunteers save hospice over $100,000 a year,” Pfhol said. “We cannot function without our volunteers. Simply put, volunteers from the community we serve are part of our charter. We cannot be certified as the Hospice of Central New York if we didn’t have volunteers.” Baldwin’s involvement with the terminally ill started very close to home. He knew he was drawn to the
work about 40 years ago when his 17year-old sister became terminally ill. He was by her side while she was sick. The experience opened up a new facet of their relationship. The depth of the discussion that can take place with those that are in their last phase of life is one of the positives that Baldwin took away from his sister’s illness. It continues to influence his work today. “I was in graduate school at the time,” he said. “I spent a lot of time with her. I remember feeling that we had some conversations that were very profound and intimate. I don’t know if we really would have had them if it hadn’t been those circumstances, talking about life and what’s important and sharing our thoughts. I have found that when people are ill like that, if they feel safe with you, they’ll talk about some fairly important things that are on their mind. There’s a great deal of, for lack of a better work, intimacy that can sometimes take place. I guess that’s what attracted me to that.” Baldwin is also motivated by the simpler gifts one gets when giving their time. He said he is thankful for and motivated by the gratitude of both the hospice staff and the caregivers he gives respite to. “I feel like listening to people who are terminally ill or their family is something very valuable and important and special,” he said. “It means a lot to them. They’re usually very thankful that you’ve come in. That always touches me. Sometimes it’s just a matter of going in and letting them go out shopping or go to a movie or just go for a walk. It’s just time that they can have
for themselves. They know that their loved one is safe with you. They feel Baldwin good about it. That makes me feel like it’s really worthwhile. What I’m doing makes a difference. That’s what I get out of it.” The volunteer said, from his experience, there is basically no down side to working for hospice. He is not asked to tend to the patient’s physical needs or do more than he is comfortable with. Hospice calls him when a patient or caregiver near him is looking for volunteer help. If Baldwin can, he goes there and sits with them, often giving the family caregiver some badly-needed time away. Currently there are 310 volunteers with hospice, mostly caregivers like Baldwin, They give 7100 hours a year. Hospice volunteer candidates are required to take eight classes before
they can begin their work. The training takes about two months. “They’re not going to let you out there unless they know and you know that you can do the work, that you’re comfortable doing the work,” Baldwin said. While Warren Baldwin is grateful for the work he does with hospice, those who work with him are grateful he is part of the organization. “I would say working with Warren is a joy,” said volunteer director Sue Conover. “He brings a particular ‘presence’ to the patients and families he works with as he is a soft spoken, thoughtful man with a wonderful sense of humor. He is a highly skilled communicator and his wide and varied interests enable him to connect in very meaningful ways with hospice clients.”
Hospice of Central New York looking for volunteers Hospice of Central New York is searching for volunteers people who are emotionally mature, compassionate and dedicated to providing sensitive support at end of life to people and their families. Hospice of Central New York will be offering training for volunteer family caregivers starting Thursday, Sept. 19, and concluding Nov. 7. A total of eight consecutive Thursday meetings from 5 – 7:30 p.m. Those interested must register for this before Sept. 9, For more information, contact Michele Devlin at hospice at 315-634-1100. Caregivers work with a professional hospice team to help families care for their loved one at home, residential, or inpatient facilities. Hospice volunteers receive comprehensive training, education and ongoing support.
Upstate’s Community Campus opening CNY’s first ED for seniors
U
pstate University Hospital has officially opened Central New York’s first geriatric emergency department on June 26, at a ribbon-cutting ceremony. The new geriatric emergency unit, called “GEM Care, the Senior ED Unit,” is located on Upstate’s Community Campus at 4900 Broad Road. “Nationwide, the population of seniors is growing rapidly,” said physician Jamie Ciaccio, emergency medicine director at Upstate University Hospital’s Community Campus. “To meet the needs of this population, the concept of an ED for seniors emerged and is now becoming a trend across the county.” GEM Care is an eight bed unit with geriatric-specific equipment that will offer emergency care tailored to those Page 20
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65 and older. It is staffed by a speciallytrained nursing staff that has completed NICHE training (Nurses Improving Care for Healthsystem Elders). “The new GEM Care unit is the first of its kind in Central New York,” said Ciaccio. “The unit’s team of physicians and nursing staff are all specially trained in geriatrics and will be working in lockstep with pharmacists, social workers, and case managers to deliver seamless care.” The development of GEM Care was also supported by physician Sharon Brangman, division chief of geriatrics at Upstate Medical University. “She was a resource and mentor in developing concepts, processes, directing training and philosophy for the facility,” said Ciaccio. The unit’s mission is to care for
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
patients with a team approach. Physicians, pharmacists, social workers and case managers will work to coordinate care with patients’ primary caregivers, in addition to outpatient services such as visiting nurses and home health aides. This comprehensive approach to care will aid GEM Care in its goal to admit only those patients who will benefit from hospital care in an effort to keep older adults in their own homes for as long as possible. “Many older adults decline and lose function after a hospital admission,” said Ciaccio. “GEM Care’s goal of discharging patients back to their homes, vs. assisted or higher-level care, when possible, ultimately improves the patient’s quality of life and reduces heath care dollars for everyone.” The GEM Care unit also offers
patients a comfortable, calming atmosphere. The space was designed to promote safety and includes many features designed for the senior patient, including: • Patient beds with thicker mattresses for added comfort • Adjustable lighting at each bedside • Non-skid floors and handrails for safety • Large font options for medication education and discharge instructions “The space itself is very calming and will help eliminate stress and confusion for patients,” said Ciaccio. “In addition, we have a dedicated team of volunteers who will be part of the health care team who will visit with the patients, ensuring that their needs and concerns have been addressed.”
Golden Years
Chair Exercise Can Support Seniors’ Good Health By Deborah Jeanne Sergeant
M
obility or balance issues do not make it impossible to get some activity into your day. Though you may spend lots of time seated, you can still use these moves to maintain and improve your health as a senior. Since losing muscle mass can negatively affect your health, it’s important to keep yours strong. Losing range of motion can also make daily life chores more difficult. It’s important to get clearance from your doctor before starting any exercise so you don’t exacerbate or develop a health problem. Make sure you drink enough fluids and stop if anything hurts. You should start slowly with gentle movements and low repetitions for each movement. Around 10 is doable for most people. Perform two to three sets of 10 movements and rest between sets. Cara Callahan, manager of CNY Metro Fitness and certified personal trainer, recommends seated leg lifts if you have leg mobility. “Raise one leg at a time, kicking forward,” she said. “This engages the quadriceps muscle and helps to strengthen other muscles in the legs as well. To make the exercise more challenging, add an ankle weight to increase the amount of weight lifted.” Michael Knapp, certified personal trainer and owner of At Your Home
Personal Training in Syracuse, is a big believer in “functional fitness,” performing movements that help clients improve their performance of everyday activities. For example, he has clients stand up from a seated position, which uses 40 muscles. “If they have an armchair or something they can push away from to work the upper body, they should flex their arms, putting their weight on their hands and do it 10 to 20 times daily. It’s okay to do daily or every other day because these movements are low impact.” Once standing, if you have balance issues, try holding a stable object and sway or shift your weight from one foot to the other. “If you can maintain walking that helps,” Knapp said. “Our bodies are made to move, like cars. if you don’t move, things break apart a lot faster, like car.” Megan Hickey, physical therapist with St. Joseph’s Hospital, offered a few moves to keep your upper body strong. “Some examples of arm exercises are lifting your arms straight out in front of you, lifting your arms overhead, punching your arms out in front of you or curling your elbows to touch your hands to the shoulder,” she said. “If any of these feel a little too easy,
you can hold a can of soup while doing each of these exercises to add a little resistance.” Don’t forget the core muscles. Hickey recommended reaching toward the floor on each side and sitting back up straight, as well as reaching to the floor in front and then sitting back up. If you want to add an aerobic element, consider a peddler Are there any aerobic movements they can do from a chair? “You can place it at your feet and it turns your chair into a stationary bike or you can place it on a table and use it for your arms to get an aerobic workout,” Hickey said.
Misconception About Chair Exercise Megan Hickey, physical therapist with St. Joseph’s Hospital, addressed a few common misconceptions about chair-based exercise for seniors: Chair-based exercise won’t do any good. “The most important thing to remember with any exercise program is that even a little something is better than nothing. The benefits of chair-based exercise are the same as any other exercise. You maintain your joint range of motion and increase strength and endurance. Chair-based exercise is too complicated. “Some people get intimidated when they start an exercise program looking at a long list of exercises that they can do. Pick just one or two exercises and once those feel good, add in a couple more. People doing chair-based exercise can’t build endurance. “Before you know it, you’ll be doing 30-40 minutes of exercises every day. For seniors who are home alone, chair exercises allow you to remain active without risking a loss of balance that can occur with standing exercises.”
Is Calcium Bad for the Heart? Recent study shows men who took daily calcium supplements are 20 percent more likely to die of heart-related causes than those who did not take any at all By Deborah Jeanne Sergeant
A
n abundance of solid, peer reviewed, large trial group studies have proven that calcium supplementation and calcium-rich diets can help people prevent fractures in older adults. For years, geriatricians have preached calcium-rich diets and, as needed, supplementation to patients who have risk of osteoporosis. However, a few recent studies seem to indicate that for some older men, calcium could be bad for their hearts. Older adults should not take a knee-jerk reaction and arbitrarily stop taking calcium, especially if they have a high risk for osteoporosis and its complications. A recently released National Institute of Health study followed nearly 400,000 middle-aged Americans for 12 years. Researchers found that men who took 1,000 mg. of calcium supplementation daily were 20 percent more likely
to die of heart-related causes than those who did not take calcium supplements. Researchers also factored in the men’s age, race, weight and lifestyle factors. “It is not clear why calcium supplements are a risk for men but not women so I don’t think this study means that calcium supplements are necessarily a bad thing,” said physician Eugene C. Lozner with New York Heart Center in Auburn and Syracuse. “Clearly if you have osteoporosis, much more common in women, then calcium is a good thing,” Lozner added. “Certainly no one needs extra calcium before the age of 50 or 55.” Most men have higher cardiovascular disease risks than most women and most women have higher osteoporosis risks than most men. The supplements seemed to not affect women in a similar way as men perhaps because women naturally have higher calcium needs or in general have lower calcium
levels in their diet. Other studies indicate that postmenopausal women taking calcium supplements have an equally elevated risk of heart disease as men who take calcium supplements. The National Institute of Health study could have contained more women who were postmenopausal by the end of the study than women who were not, which would have skewed the results. The problem with supplemental calcium is how it’s absorbed. Laurel Sterling Prisco, registered dietitian and wellness educator at Natur-Tyme in Syracuse, said that supplementing with calcium means supplementing with vitamin D and magnesium “to help pull the calcium in the bones and not lodge in the soft tissue. If the calcium carbonates and other forms of calcium are not being pulled into the bones, it can cause kidney stones, heart irregularities, nerve problems. It can calcify in them. August 2013 •
She recommends seeking dietary means of calcium to achieve the 1,000 to 1,200 mg. of calcium daily most people need. Ingesting that amount of calcium is not as hard as you would think. One cup of skim milk contains 30 percent of the daily value of calcium most people need. One ounce of reduced fat mild cheddar cheese contains 40 percent. And two, six-ounce cups of non-fat yogurt contains 30 percent. Adding these foods to one’s diet should supply enough dietary calcium. Dairy items are not the only sources of calcium. Sardines, soybeans, almonds, broccoli, and dark, leafy greens such as spinach, kale, turnips, and collard greens also boost calcium intake. Discussing risk factors for cardiovascular disease and for osteoporosis can help you make and educated decision about your calcium supplementation needs.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2013
Column provided by the local Social Security Office
Spouses Have a Significant Benefit
S
ocial Security can be an important retirement age, can be as much as one financial asset for married couples half of your spouse’s full benefit. If you when the time comes to apply for opt for early retirement, your benretirement benefits. In many cases, one efit may be as little as a third of your spouse may have earned significantly spouse’s full benefit amount. more than the other, or have worked If your spouse has already reached full for a longer span of years. Or it could retirement age but continues to work, be that one spouse stayed home your spouse can apply for to do the work of raising the retirement benefits and request children or caring for elderly to have the payments suspendfamily members while the other ed until as late as age 70. This focused on a career. would allow the worker to Regardless of your situation, earn delayed retirement credits Social Security will look at all that will mean higher paypossibilities to make sure both ments later, but would allow spouses receive the maximum you to receive your spouse’s benefit possible. benefit. Even if you have not paid Social You can also apply for spouse Security taxes, it’s likely you’ll benefits based on the earnings be eligible to receive benefits on Banikowski record of an ex-spouse or deyour spouse’s record. If you did work ceased spouse if you were married for and pay into Social Security, we will at least 10 years. Spouses can consider check eligibility based on your work a number of options and variables. We record and your spouse’s to see which make it easier to navigate them. A good amount is higher. place to start is by visiting our benefits You can apply for spouses benefits the planner at www.socialsecurity.gov/ same way that you apply for benefits planners. Take note of the “Benefits As on your own record. You can apply A Spouse” section. for reduced benefits as early as age 62, If you are ready to apply for benefits, or for 100 percent of your full retirethe fastest, easiest, and most convement benefits at your “full retirement nient way is to apply online! You can age.” You can find your full retirement do so at www.socialsecurity.gov/apage, based on your birth year, at www. plyonline. socialsecurity.gov/pubs/ageincrease. Whether you receive benefits on a htm. spouse’s record or your own, rest asThe benefit amount you can receive as sured we will make sure you get the a spouse, if you have reached your full highest benefit we can pay you. Learn more at www.socialsecurity.gov.
Q&A
Q: How do I know if I have worked long enough — to qualify for Social Security disability benefits? A: You must have worked long enough — and recently enough — under Social Security to qualify for disability benefits. Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. The amount needed for a credit changes from year to year. In 2013, for example, you earn one credit for each $1,160 of wages or self-employment income. When you have earned $4,640, you’ve earned your four credits for the year. The number of work credits you need to qualify for disability benefits depends on your age when you become disabled. Generally, you need 40 credits, 20 of which you earned in the last 10 years, ending with the year you become disabled. However, younger workers may qualify with fewer credits. Q: My grandmother recently died and left me about $5,000 in cash. Will this affect my SSI? A: Yes, it most likely will. We count the money as income in the month you receive it, which means you will not be eligible for an SSI payment the month
that you receive the $5,000. Because there is a resource limit of $2,000 for an individual (or $3,000 for a couple), the amount you keep after the month you received it will count as a resource and may make you ineligible for a payment. As long as you have more than the resource limit, you will not be eligible for an SSI payment. It is important that you report to us the amount you receive and then let us know when your resources fall below the limit. Learn more about SSI by reading or listening to our online publication, “Supplemental Security Income” (SSI), available at www.socialsecurity. gov/pubs. Q: I’m trying to figure out the best time to retire based on my future earnings. How can I calculate my own retirement benefit estimate? A: We suggest you use our “Retirement Estimator” at www.socialsecurity. gov/estimator. It produces estimates based on your actual Social Security earnings record, so it’s a personalized, instant picture of your future estimated benefit. Also, you can use it to test different retirement scenarios based on what age you decide to start benefits. For example, you can find out your estimated monthly payments if you retire at age 62, 70, or any age in between. Try it out now at www.socialsecurity. gov/estimator.
HOME DELIVERED MEALS ARE A LIFELINE TO MANY FRAIL ELDERLY SENIORS Nutritious, hot noon meals are available throughout Cayuga County for those seniors unable to prepare a meal for themselves. Meals can be home delivered or available at one of six senior meal sites. (There is a suggested donation)
By Jim Miller
How to Choose a Home Stair Lift Dear Savvy Senior, My wife is having an increasingly difficult time going up and down the stairs in our house. We are interested in purchasing a stair lift, but aren’t sure what to get or where to look. Can you help us? Need a Lift Dear Need, A good home stair lift is a wonderful solution for seniors with mobility issues who have trouble with steps. A stair lift will carry your wife up and down the stairs in a safe seated position, giving her easy access to the second story or basement level of your home. But with so many options available how do you choose one that best meets your needs and budget. Here are a few shopping tips along with some good companies that offer them. Types of Lifts
There are two basic types of stair lifts that are sold today: straight and curved. The type you need will depend upon the design of your staircase. A straight stair lift is one that travels in a straight line up a flight of stairs uninterrupted by landings, bends or curves, and costs between $3,000 and $5,000 installed. Curved lifts, however, are much more elaborate and will go around corners, bends and changes in direction. Curved lifts are also much more expensive typically running between $10,000 and $15,000 or more depending on the complexity of the installation. Also available through certain companies are weatherproof lifts for outdoor steps, and standing stair lifts (also called perch lifts) for those who have trouble bending their knees.
If you know someone who could benefit From a hot noon meal, call the: Cayuga County Office for the Aging Senior Nutrition Program 253-1427
You also need to know that all stair lifts mount to the stair treads, not to the wall, so they are very sturdy and can be installed in almost any home. If your wife is a large person, you may need to get her a heavy-duty lift with a wider seat and bigger lifting capacity — all companies offer them. Or, if she’s tall, find out about raising the seat height during installation. Most stair lifts available today also have seats, armrests and footplates that fold up out of the way, and swivel seats that make getting into and out of the chair easier. They also come with standard safety features like seatbelts, breaking systems and footrest sensors, push-button or rocker-switch controls located on the armrest for easy operation, and “call send” controls which allow you to call or send the unit to the other end of the stairs. Make sure the lift you choose has all these features. Depending on the company, you may also have the option of choosing between an electric (AC) and a battery powered (DC) stair lift. Battery powered units charge at the base station (some recharge anywhere on the track) are quieter, smoother and better than electric lifts, and will work even if there’s a power failure in the home.
Where to Shop
While there are many companies that make, sell and install stair lifts, the most respected in the industry are Bruno (bruno.com, 866-345-7537) and Stannah (stannahstairlifts.com, 800877-8247), followed by Harmar (harmar.com, 800-833-0478) and Sterling (handicare.com, 866-276-5438). Unfortunately, Medicare does not cover stair lifts, but many states offer Medicaid waivers that will pay for lifts to those that qualify, and the VA offers cash grants to veterans with disabilities for home safety improvements. To save some money, you may want to consider purchasing a used or refurbished model. Or, if you need a stair lift for only a short period of time, consider renting one. Most companies offer these options, and many offer financing programs too. To get started, contact some stair lift companies who will put you in touch with a dealer in your area. All dealers provide free in-home assessments and estimates, and can help you choose an appropriate lift.
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. August 2013 •
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H ealth News Enable and Transitional Living Services merge The boards of directors of Enable and Transitional Living Services (TLS) have agreed to merge to form a new agency to serve individuals with developmental disabilities, behavioral health issues and other health-related concerns. The two agencies will form a nonprofit corporation under a new name as soon as practicable. The decision to merge was announced in a joint statement from TLS Board President Brian Hoke and his Enable counterpart, Marvin Reed. “By combining the resources of TLS and Enable, the new entity will be better positioned to meet the growing needs of the community in an era of serious government and tax-based funding shortfalls. The boards of both organizations have recognized a need to achieve efficient and effective use of taxpayer and donor dollars to enhance individualized, person-centered services that will create positive social change. One thing will not change: the new organization will continue to provide high quality services to those in need.” Beginning July and continuing until the merger is complete, the executive director of Enable, Prudence York, will assume executive managerial responsibilities for TLS. York will become the executive director of the new agency when it is formed in the next 12 to 18 months. The board members of both organizations will come together to form one board and be led by co-presidents Brian Hoke and Ricky Ryder. “Enable and TLS have similar missions and programs, but most importantly we share a culture of compassion for the people we serve,”
said Prudence York. “We are confident that by joining forces we will be able to offer more services to those who need them most. Combined, we will employ over 900 Central New Yorkers, operate on a budget of nearly $30 million, but most importantly will serve over 3,000 people each year. Together we bring over 100 years of service to individuals with various types of abilities in our community. This merger ensures that these vital services will continue to be available for generations to come.”
Pharmacist Zachary Merry joins Fulton Medicine Place Pharmacist Zachary Merry recently joined the staff at The Fulton Medicine Place. “Zach is a Fulton native who received his doctor of pharmacy degree in May from the Albany College of Pharmacy and Health Sciences,” Frank Badagnani, the pharmacy’s owner, said. “He had been a pharmacy intern with us since 2009 and was the perfect choice to add to our team to meet our growing business needs. We are delighted that this native Fultonian is back in his hometown serving his friends and neighbors.” The Fulton Medicine Place celebrated its 25th anniversary in 2012. Merry Badagnani said that he and his wife and co-owner, Fran, have put down roots in Fulton since they moved here and opened their original 200 E. Broadway location in 1987. As a result of sustained growth, they relocated to their present West First Street location, which is three times the size of the East Broadway spot.
Upstate’s children’s cancer center gets $5,000 donation from MDRT Foundation
Physician Richard Sills, left, accepts a $5,000 check from the MDRT (Million Dollar Roundtable) Foundation to support enhancements at the William J. Water’s Center for Children’s Cancer and Blood Disorders. With Sills from MDRT are, from left, F. P. Kessler, Lee Gatta and Milt Hill. MDRT is an international independent association representing 36,000 life insurance and financial services professionals from more than 79 countries.The Center for Children’s Cancer and Blood Disorders offers inpatient and outpatient treatment to more than 700 children, from the Canadian border to northern Pennsylvania. Page 24
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Oswego Hospital has new orthopedic surgeon Orthopedic Surgeon Ronald “Damani” Howell has joined the Oswego Health active medical staff. Howell has just completed a sixyear orthopedic surgery residency program at New York University’s (NYU) Hospital for Joint Diseases. Five years of this program are devoted to clinical rotations that are combined with a rigorous academic curriculum. He graduated from NYU’s School of Medicine with honors in cell biology. He completed a post baccalaureate pre-medicine program at City University of New York-Medgar Evers College in Brooklyn. Howell has been presented several prestigious awards and honors including the Kappa Howell Delta Young Investigator Award by the American Academy of Orthopaedic Surgery; NYU’s School of Medicine Excellence in Musculoskeletal Research Award and the Louis L. Seaman Medical Student Research Grant in Microbiology, presented by the New York Academy of Medicine. He earned his undergraduate degree at Amherst College, where he also played on the varsity basketball team as a point guard. He also was a courtside physician at NYU and a performance physician at Madison Square Garden while attending his residency training. “I am really excited about this opportunity,” Howell said. “During my visit, the close-knit atmosphere of the community left an impression on me. I am looking forward to having an impact on the community as I provide orthopedic care.”
St. Joseph’s Hospital launches health blog St. Joseph’s Hospital Health Center launched a brand-new health blog, “St. Joseph’s Health Connections,” at its website, www.sjhsyr.org. Created to provide useful health information — from prevention tips to first-hand accounts from patients — visitors to the blog can learn more about healthful lifestyles and the wide array of services St. Joseph’s offers. “It is our hope that readers find the blog educational, insightful and have as much fun reading it we do writing it,” said Nichole Wenderlich Owens, digital media specialist for St. Joseph’s. “By engaging people from throughout our healthcare system, Health Connections will not only serve as a wealth of health knowledge, but will provide a varying number of points of view.”
Red Cross honors its volunteers at annual event The Central New York Chapter of the American Red Cross recently reconozed several of its volunteers for their work. Volunteers comprise 97
percent Central New York chapter’s workforce, and the chapter’s success in delivering Red Cross services to residents in Onondaga, Oswego, Cayuga and Madison counties is dependent on the commitment, energy and enthusiasm of the chapter’s 588 volunteers. “The Red Cross mission is to alleviate human suffering in the face of emergencies by mobilizing the power of volunteers and the generosity of donors,” said Rosie Taravella, chief executive officer of American Red Cross Central New York Region. “We accomplish that mission only because of the dedication of our volunteers who make themselves available 24 hours a day, 365 days a year to prevent, prepare for and respond to emergencies and natural disasters in Central New York.” Volunteers honored in July were: • Blood Services Volunteer Award: Diane Burrell, of Cazenovia; and Jack Miller, of Auburn. • Board Chair Award: Dorothy Hall, of Fayetteville. • Board Member Award: Deana Michaels, of Fulton; and Lynn Steenberg, of Syracuse. • Clara Barton Volunteer Leadership Award: Rita Reicher, of Syracuse. • Community Service Volunteer Award: Sandi Mettler, of Auburn. • Disaster Preparedness and Response Award: May Becker, of Fayetteville. • Good Neighbor Award: Raymour & Flanigan, of Syracuse; and Tioughnioga Ruritan Club, of Deruyter. • Health and Safety Services Award: Kerland Ritchie, of Syracuse. • Service to the Armed Forces Award: Nancy Mack, of Liverpool. • Special Recognition Award (Madison County Shelter Survey Team): John Beckwith, of Oneida; Barb Kinsella, of Oneida; Fran Panek, of Canastota; and John Potter, of Canastota. • Special Recognition Award (Syracuse Office Move): Paul Francher, of Syracuse; John Hennessy, of Clay; John Rapacke, of Marcellus; and Bernie Stolusky, of Syracuse. • Volunteer Leadership Award (one for each county): Dan Harmony (Onondaga County); Deana Michaels (Oswego County); Charles Mitchell (Cayuga County); and Patrick Powers (Madison County). • Youth Award: Meagan Bridges, of Syracuse; Mallory Lang, of Saugerties; Adyna Lungu, of Millville, N.J.; and Shweta Shreyarthi, of Clifton Park.
Alzheimer’s Association names directors, officers The Alzheimer’s Association, Central New York Chapter elected five new members to its board of directors. Board members serve two-year terms that are renewable up to four times. They are: • Sandy Colabufo, Evans & Bennett Certified Public Accountants, Liverpool; • Melissa Fleischman, Rural/Metro Medical Services, Mexico; • Kathleen Hughes, The Inn at Menorah Park, Cazenovia; • Teresa Marriner, Colabufo Planned Results, Fayette-
H ealth News St. Joe’s Gala Raises Nets More Than $335,000
St. Joseph’s Hospital Foundation netted more than $325,000 at its annual gala dinner dance on May 31 at the Turning Stone Resort and Casino. Pictured from left are gala co-chairs, physician Ron and wife Joanne Caputo, and physician Matthew and with wife Colleen O’Hern, along with Kathryn Ruscitto, president and chief executive officer of St. Joseph’s.
Hughes
Marriner
ville; • Cynthia Nigolian, Accountable Care Coalition of Syracuse, Syracuse. The board of directors also elected its executive officers. These terms are one-year in length. They are: • President: Keith B. Rung, Evans & Bennett Certified Public Accountants, Syracuse; • Vice president: Robin Bennett, Loretto, Cazenovia; • Secretary: Christina Hasemann, NY-Penn Nutrition Services, Inc., Binghamton; • Treasurer: Karl Jacob, Dannible & McKee CPAs, Baldwinsville; • Member-At-Large: Thomas J. Grooms, Syracuse; • Ex-Officio: Paul C. Stepien, Camillus.
Nigolian
Community Memorial Hospital adds specialists Thanks to an affiliation with Crouse Hospital, Community Memorial Hospital announced the addition of three new medical specialties. • Physicians from Central New York Surgical Physicians have opened a part-time practice in Hamilton and will see patients on the first and third Mondays and fourth Thursday of each month. The general surgeons traveling to Hamilton are Brian Anderson and Thomas Hartzheim. • Physicians Robert Schwartz and Scott Surowiec are vascular surgeons from the Vascular Care Center in Fayetteville. They are now seeing patients in Hamilton on the third Thursday of each month. • OB/GYN services are being provided by physician Stephen Brown of Central New York Women’s Healthcare
in East Syracuse. Brown will be providing a full range of OB/GYN services including pre-birth and post-birth care with the exception of delivery. Brown will see patients on select Wednesdays of each month with the anticipation of seeing patients every Wednesday in the near future.
Tramontana appointed medical director in B’ville Baldwinsville Family Medical Care, an affiliate of St. Joseph’s Hospital Health Center, announced the appointment of physician Timothy Tramontana as medical director. In his new role, Tramontana serves as the senior medical leader responsible for provider oversight and the development of policies and procedures to ensure delivery of medical care consistent with St. Joseph’s mission. “Our patientcentered focus will Tramontana enhance our ability to meet patients’ needs through initiatives that include expanded evening and weekend hours,” Tramontana noted. “I look forward to working with our team of professionals to deliver the highest quality care to our patients.” Tramontana recently became certified in clinical lipidology, a medical specialty focusing on lipid management and preventive cardiology. He received his Doctorate of Medicine degree from Ross University School of Medicine, graduating in 2010 with high honors. He completed his residency in family medicine at St. Joseph’s Hospital Health Center in Syracuse, where he was chief resident. He is a member of the American Academy of Family Physicians, the Onondaga Medical Society, and the National Lipid Association. Prior to joining Baldwinsville Family Medical Care, Tramontana worked as a primary care physician at Glades Medical Group in Boca Raton, Fla. He was also a physician with St. Joseph’s Urgent Care located at North Medical Center in Liverpool.
St. Joseph’s opens state-ofthe-art surgical suite St. Joseph’s Hospital Health Center held a ribbon cutting and blessing for its new, state-of-the-art surgical suite June 17 at the hospital. The new surgical suite includes 15 operating rooms (ORs), which are two more than the current suite, and each OR suite is 50 percent larger to accommodate today’s state-of-the-art medical technology and larger surgical teams. Designed to enhance care for patients just before and right after surgery, the post-anesthesia care unit (PACU) has been expanded from 16 to 25 patient beds, increasing annual capacity from 10,500 to 14,000 patients. The new, co-located central sterile unit is nearly four times larger than the former, 40-year-old unit. Its position adjacent the new surgical suite increases safety and efficiency while “green” instrument washers will save water and electricity. “Today’s surgical setting has dramatically changed since 1992 when the existing 15,000 square-foot operating room suite/post anesthesia care unit was built at St. Joseph’s Hospital,” said Jodi Donahue, director of surgical services for St. Joseph’s. “Constructed to accommodate the resource needs of the surgical procedures being performed at that time, the operating rooms were once considered spacious. However, these rooms simply can no longer meet the demands of today’s advanced surgical technology and procedural complexities.” St. Joseph’s expansion not only will meet the needs of patients and community, but also will demonstrate the hospital’s environmental commitment consistent with Syracuse’s national identity as one of 10 top green communities in the nation by the U.S. Environmental Protection Agency. The project will use sustainable design principles to build a “healthy” hospital while seeking LEED certification.
Phase 2A and B together are one of the largest green health care construction projects in New York state, according to the hospital.
Crouse Hospital adds tatient tracking system Crouse Hospital has installed a new, high-tech patient tracking system in its Witting Surgical Center family waiting area. The GE Healthcare technology provides families with real-time patient status updates as their loved one moves through the surgical process, giving a virtual view on a flat-screen monitor in the family waiting area. Each surgical patient has a unique ID number assigned to him or her, which is made available only to family members or whomever else the patient authorizes. As the patient moves through the surgical process, status updates — each clearly labeled with the patient’s identifying number — appear on a waiting room flat-screen monitor in colored bubbles. “Providing the best patient care depends on effective, timely communication, not just with patients but also with their family members. By providing the ability to receive ‘real-time’ surgical status updates, we believe this will advance the overall communication and educational process for patients and their family,” said Jill Hauswirth, director of surgical services for Crouse Hospital. Patient status updates are entered into the system by operating room staff in real time and are also displayed in the OR for clinical staff to monitor. Information desk volunteers and staff of the hospital’s “We see a tremendous opportunity to improve operational performance as well as patient engagement through tools like this,” said Hauswirth, who adds that a significant benefit of the system is its ability to improve the efficiency of moving patients through the entire hospital.
Crouse Golf Classic Nets $100,000 for NICU Services
Fearless Foursome: SU Athletics team physician Brad Raphael; SU basketball coach Jim Boeheim; SU football coach Scott Shafer; and SU head team physician Irv Raphael — braved 90-plus degree temperatures recently at Bellevue Country Club in Syracuse to support the Baker Neonatal Intensive Care Unit at Crouse Hospital. 228 golfers took part in the 12th annual Crouse Golf Classic, which raised more than $100,000 for the NICU, the state-designated regional referral center for neonatal care. August 2013 •
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NEEDLE
WHAT DOES USE A BRAND NEW SYRINGE
EVERY TIME
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YOUR SKIN OR VEIN.
YOUR
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Contact the Safety First Syringe Exchange Program at 800.475.2430
Nurses at Auburn Community Hospital working with “Pat.”
Human Patient Simulator Provides Hands-On Training at Auburn Community
“P
at,” a male patient at Auburn Community Hospital (ACH), waited quietly while six nurses surrounded his bed. Pat had just had a procedure in the operating room and the nurses’ job was to monitor him through the recovery process. They began by checking his vital signs (heart rate, oxygen saturation in the blood, blood pressure, and respiratory rate) and talking to him about how he was feeling. Things looked fine until, without warning, his respiratory rate began to drop. The nurses, recognizing the danger of respiratory depression, called for a rapid response team, and administered Norcan, a drug which usually reverses respiratory depression. Despite the Norcan, however, Pat went into cardiac arrest. The nurses immediately started chest compressions and called a Code Blue. Quick response saved Pat’s life by using an AED or automatic external defibrillator. Pat, however was never actually in danger of dying because he was not alive! Pat is a SimMan Human Patient Simulator, now being used at Auburn Community Hospital to train nurses and other staff. “The nurses love Pat,” said Pamela Page 26
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Seamans, staff education coordinator at ACH. “He gives us the opportunity to train them in situations you don’t want them to learn on the floor, with an actual patient at risk. There are a variety of situations which are uncommon — high risk, low volume situations that nurses need to be prepared for. With the simulator, they can learn in a controlled environment. For example, they might not have to use an AED very often, but with the simulator they can open it, turn it on, get their hands on it – so they are ready if and when they do need to use it to save a patient’s life.” The simulator and training were provided by CHART Risk Retention Group (CHART), a medical malpractice liability insurer. ACH received the equipment from CHART without charge, with the provision that the hospital carry out eight hours of training per month. “Having this equipment will have a positive effect on patient safety at ACH,” said Seamans. “By doing this training we are being proactive, training nurses ahead of time for situations they may encounter under emergency conditions. I can honestly say this is a dream come true for the nursing education department and for the hospital.”
Contac Safety 800.47
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UPSTATE.EDU/GEMCARE 4900 Broad Rd., Syracuse (the former Community General Hospital)
800.464.8668
community August 2013 •
campus
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