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Dr. Hanan Goldberg Dr. Hanan Goldberg recently joined Upstate Urology at Mohawk Valley Health System in Utica. Page 4
JUNE 2020 • ISSUE 172
Welcome to ‘new normal’ Special Edition
Ticked Off! Tired of COVID-19? Here’s one more thing to worry about this summer: disease-carrying ticks
Health Careers
True Heroes: Riding out the storm
Page 9
Stressed? The good, the bad and the ugly Page 20
Fearless frontliners fuel recovery A health care worker gives the thumbs up sign recently at Oneida Health. Check out our feature on area nurses who are making a difference against COVID-19. Page 5
Brianna Schneider LPN serves as office nurse at the Falcon Clinic in New Hartford. Page13 4 Page
Baby boom after pandemic?
Succulent Snapper For starters, snapper is an excellent source of lean, high-quality protein.
Experts say despite stay-at-home orders, baby boom doubtful. Page 3
See SmartBites, Page 14 June 2020 •
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper
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Between You & Me
By Barbara Pierce
Coping with COVID-19 Lockdown languidness? Turn obstacles into opportunities
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n May, top professional basketball player LeBron James put together an all-star event to honor and celebrate the high school class of 2020, which has had its graduation season upended by the novel coronavirus pandemic. The special aired on all major networks. “I wanted to create a show that looked and felt different from traditional specials. These kids worked so hard to graduate and what is happening to them Pierce is truly unfair,” James said in a statement to The Associated Press. James is all too aware of painful disappointments and tough losses. He knows that in order to win at the highest level, you need to overcome serious failures and adopt worldclass mental frameworks to succeed after difficult losses. What can we learn from LeBron’s journey to becoming the most powerful athlete in the world? Ten years ago, he made the decision to leave his Cleveland team and move to Miami. With that decision, he became the most hated athlete in America. Fans were outraged and even burned his jersey on national television. This decision could have been a huge obstacle for him. So how does he feel about that decision now? According to his recent interview in GQ magazine, “It was the best thing that ever happened to me. I needed it. It helped me grow … “I spent my whole life in Ohio … Everything was comfortable. I knew everything, everybody knew me —everything was comfortable. I needed to become uncomfortable. Now I’ve seen everything on and off
the floor this league has to offer.” When he was so disliked after leaving Cleveland, he transformed this obstacle into a challenge. As a result, he stopped caring about what people thought of him, and just carried on being himself. People admired him more. He turned a huge obstacle into a complete success. What we can learn from this? Where there is an obstacle, there is a solution. Obstacles, negative things — like being forced to work from home during the novel COVID-19 crisis, getting laid off, not getting the raise we expected, or being locked down at home can be used to create new opportunities. We can use them to our benefit. We just need to create the right mental framework to take advantage of the opportunities. Like Olympic gold medal swimmer Sharon van Rouwendaal. With gyms and pools closed to curb the spread of COVID-19, she came up with a creative way to work out. Instead of admitting defeat and
giving up on her training regime in lockdown, she set up a small pool in her back yard. So that she could get in her laps, she used a bungee cord to add resistance and lock her in place in the middle of the water while she swims. “Whenever there’s an obstacle, there’s always a solution. You just have to be creative!” the Olympian wrote on Instagram.
Let creativity loose
She’s right: You do have to be creative. Think outside the box, as they say. Spend some time thinking about it: How can you get to your goal another way? You can’t get there the way you want to get there, so what might be another thing to try? Consider your options as experiments. Try one experiment; experiments sometimes fail, so try another. The way you perceive the obstacle makes a difference. If you see it as permanent barrier, a wall that you can never get over, it will be just that. If you see it as a challenge, a
puzzle to solve, an experiment, you will come up with a way to solve it. Your view of the obstacle affects how you react. If you have faith in yourself and your ability to find a way, you will find a way. Consider this: If a friend was having the same problem you have and asked you for your advice, what would you tell that person? Also, do ask for input from others. Sometimes all it takes is another pair of eyes looking at the problem to come up with a solution. Global catastrophes change the world, and this pandemic is a global catastrophe. Our lives are changing. There will be a day when this is over. We will hug our friends and family members we haven’t seen for a while. We will get back to work. We will return to our classrooms and coffee shops. We will get our haircut by a professional and mingle with others freely in large gatherings. Our economy will recover. You are doing your part by staying home, and you may be facing some huge obstacles because of what’s going on. What obstacles have you overcome as we’ve gone through this lockdown? I’d love to hear how you solved the obstacles that you have faced. Send me an email at barbarapierce06@yahoo.com and tell me about it. You can, and you will, come out on the other side — growing, learning and becoming a better person because of this experience and the obstacles you have conquered. • Barbara Pierce is a retired licensed clinical social worker with many years of experience helping people. If you would like to purchase a copy of her book, “When You Come to the Edge: Aging” or if you have questions for her, contact her at barbarapierce06@yahoo.com.
Baby boom on heels of pandemic?
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t’s happened before: Couples stuck at home during blizzards, hurricanes or other natural disasters enjoy some “alone time” — and a baby boom follows. But a new survey from researchers at the University of Florence in Italy suggests the same probably won’t unfold during the COVID-19 pandemic. “What we found the main reasons that led people to not wanting to conceive included worries related to future economic difficulties and consequences on pregnancy,” said study author Elisabetta Micelli, from the university’s Assisted Reproduc-
tion Technologies Center. The researchers conducted nearly 1,500 online interviews and found that nearly 82% of those surveyed said they didn’t plan to conceive during the coronavirus pandemic. The survey was conducted in the third week of the lockdown in Italy and included men and women in a stable heterosexual relationship for at least one year. The findings were published May 7 in the Journal of Psychosomatic Obstetrics and Gynecology. Of the 268 participants who said that, prior to the pandemic, they had plans to have a child, more than
one-third abandoned their intentions when the pandemic struck. The main reasons were worries about future economic struggles (58%) and any potential consequences on pregnancy (58%) from the new coronavirus. Even though almost half of those who responded to the survey had not lost their jobs or income, “the fear of imminent and future economic instabilities led those who were searching for a pregnancy to stop their intention in 58% of cases,” Micelli said in a journal news release. Interestingly, 140 (11.5%) of the participants — mostly women — expressed a new desire for parenthood
June 2020 •
during quarantine, with the main reasons being “the will for change” (50%) and “the need for positivity” (40%). But only six of the 140 (4.3%) actually tried to get pregnant during the lockdown. “Again, fear of consequences on pregnancy in addition to the economic impact on families are probably the reasons why almost the whole group of couples who unexpectedly started to express a desire for parenthood during quarantine did not translate this dream into a concrete attempt,” said study co-author Gianmartin Cito, a specialist training in urology.
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Meet
Your Doctor
By Barbara Pierce
Dr. Hanan Goldberg
Dr. Hanan Goldberg recently joined Upstate Urology at Mohawk Valley Health System in Utica. MVHS and SUNY Upstate Medical University have joined forces to provide enhanced diagnostic and management strategies for all urologic diseases. Q.: As a professor at SUNY Upstate Medical University, what is most important for medical students to learn today? A.: The art of listening to the patients — understanding their needs and making sure they understand their physician. It is the most critical skill medical students need to acquire. Technical skills can be learnt with time and practice, but the art of listening and understanding the patient and his or her needs is an ability that is difficult to master. Perfecting this ability is an important goal that students should focus on, and provides the greatest satisfaction for anyone involved in patient care.
Q.: How did you come to choose urology as a specialty? A.: I chose urology and urologic oncology because it’s a profession where I can help people in different stages of disease. I can see them suffering with the disease, and then, with the care and help that my team provides, they actually get cured and that brings me great satisfaction. Urology is a versatile profession in which I can help patients in various ways — both in the clinic and by performing surgery. I see men and women of all ages. We are able to help people with both oncological and non-oncological issues with high rates of success. That is why this is a wonderful specialty. Q.: We are fortunate to have you here in the Mohawk Valley. How did you decide to move here? A.: This is a growing area with a tremendous amount of potential. There is a big need for urologic care, especially in urologic oncology, in which I have more expertise. Urologic oncology is devoted to the diagnosis and treatment of tumors of the urinary systems. Together with our excellent team, we can do a lot of good here. Q.: What services do you offer at Upstate Urology? A.: We diagnose and manage almost all urologic problems, including screening for prostate cancer in particular. We also screen for bladder, kidney and testicular cancers as well. We treat prostate cancer using a wide array of treatment options. We are able to provide robotic surgery here as well as many other technological treatment modalities. These include performing accurate biopsies, using advanced MRI imaging, robotically operating, and using a multidisciplinary approach with excellent cooperation with the radiation and medical oncology teams. We rely on the most updated guidelines and minimally invasive techniques. Patients are diagnosed, treated and followed over a longterm period, all locally in our clinic. We also treat more common non-oncological urological issues, including benign prostate enlargement, incontinence, urinary stones, erectile dysfunction, urinary tract infections, vasectomy, renal cysts, overactive bladder, and many more. Q.: What are the prostate cancer screening guidelines? A.: This is an important topic. We practice according to the currently accepted guidelines of the American Urological Association and National Comprehensive Cancer Network. Page 4
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We believe in a shared decision approach with the patient, particularly in men over 45. This depends on family history, risk and whether he has genetic mutations that predispose him to develop prostate cancer. The screening process is quite simple and involves a complete urological physical examination and a simple blood test.
Q.: You have received many awards, given many presentations, and written many articles for the worldwide medical community. What are you most passionate about? A.: My colleagues at Upstate Urology and myself are very involved in research, and I strongly believe that research is extremely im-
Q.: Are there symptoms of prostate cancer? How do you discover the disease? A.: Most commonly, when prostate cancer has not spread, there are no symptoms. Only at an advanced stage do patients experience symptoms. Ideally, we want to diagnose the disease at an early stage. This is why screening is so important. Q.: What is the treatment for prostate cancer? A.: The treatment for prostate cancer varies based on the stage of the disease. Options include surgery that is performed with the da Vinci robotic-assisted system, or radiotherapy with or without hormonal treatment. For low-grade disease, active surveillance of the disease is a good option.
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020
portant. It allows us to develop new diagnostic and treatment options and improve patient care. I am very passionate about my research, especially dealing with prostate cancer prevention and improved diagnostic markers. Being involved in research, conferences and professional meetings enable me to be updated in all the newest medical developments in my field and become a better physician and urologist. Q.: What are some of the more common symptoms patients come to you with? A.: Patients can see us with any urinary concern, including incontinence, pain, cancer screening, prostatic enlargement, stones, sexual concerns, and any other relevant issue. Most patients usually see their primary care physician first and are referred to us. However, patients are also welcome to see us directly. Q.: What else would you like people to know about Upstate Urology? A.: Our team is comprised of excellent physicians, nurses, clinical and non-clinical staff. We have come together to form one group with one single goal, which is to upgrade, enhance and improve the urological care of men and women of this beautiful area. Editor’s note: Dr. Hanan Goldberg and Upstate Urology are located at 1676 Sunset Ave., Utica, and can be reached at 315-624-5252 or see https://mvhealthsystem.org.
Lifelines Birth year: 1979 Birthplace: Israel Current residence: New Hartford Education: Master of Science degree from the Institute of Medical Science at the University of Toronto in Toronto, Ontario, Canada; medical degree from Hebrew University Hadassah Medical School in Jerusalem, Israel; urology residency in Rabin Medical Center, Tel-Aviv University affiliated hospital, Israel; fellowship in Urologic-Oncology at the Princess Margaret Hospital, University Health Network, University of Toronto Hospital affiliations: St. Luke’s and St. Elizabeth, MVHS, Utica; Upstate University Hospital, Syracuse Personal: Married; one daughter Hobbies: Spending time with my wife and daughter; sports; skiing, running, spinning, hiking, reading books, and watching movies
Fearless Front-liners
MVHS nurses stand tall in face of COVID-19 epidemic By Daniel Baldwin
T
hree registered nurses at Mohawk Valley Health System took time out of their busy schedules recently to discuss how their work and personal lives have changed since the outbreak of COVID-19. They also touch on what attracted them to the medical field and how they became who they are today. Alexis Charbonneau Boonville
Q.: Just how hectic has your work schedule been during the novel coronavirus outbreak? A.: Fortunately, my schedule has not required me to work more days than normal. My shifts, however, are very hectic and exhausting. Q,: What sort of help and assistance do you provide to patients infected with COVID-19? A.: Each patient requires a different plan of care depending on why they are hospitalized. We as nurses must help individualize care, treat accordingly and work in collaboration with the providers. Those infected with the virus are receiving individualized care just as those who are not infected with the virus are. This is a really tough time to be a nurse or provider as well as a patient, whether you are fighting COVID-19 or not. Q.: What is the experience like working at the hospital during this outbreak? Is it nerve wracking or are you managing to remain calm? A.: I have surprised myself in my ability to remain calm and focus of patient care during this time. We are so lucky to have a strong, dedicated, and brilliant group of hospitalists, intensivists, and pulmonologists that have been working so hard to treat these patients and get them home to their families. Q.: How far are you willing to go to help the patient fight through the symptoms of the virus? A.: I think that as a nurse I agreed to put myself second and the patient first the minute I received my degree. Time and time again, I have left work feeling as though I could not give an ounce more of my time, effort, and understanding to my job. It’s an exhausting feeling for sure. But when a patient you’ve helped through a devastating cancer diagnosis, or open heart surgery, or even now through the coronavirus, thanks you for being there for them, it is undeniably worth the exhaustion. Q.: What sort of challenges and tasks do you and your staff face while helping a coronavirus patient? A.: It is very challenging to
Charbonneau
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connect with our patients during this time. Walking into a patient room and having them only being able to see your eyes can warrant some nervousness. Prioritizing is something we are all getting better at. Q.: What do you feel are the keys to being a nurse on a highly successful level? A.: You must possess good listening skills to be a successful nurse. I have learned so much from listening to providers discuss patient care as well as asking questions in order to understand why we are treating a patient a certain way. Listening to your patients is another very important skill to have as a nurse. Honing in on your assessment skills and anticipating course of care is another good way to become a successful nurse. Communication is another very important key to being a great nurse and also a great coworker.
Karina Gomolka New Hartford Q.: What is the situation at your hospital and work environment like right now? How has COVID-19 impacted your hospital? What’s it like for you? A.: The situation is very stressful given the circumstances. The virus has caused all non-essential work to stop, but in terms of dealing with the virus, we are handling it well. The guidelines on how to provide adequate and correct care to patients constantly changes, which leaves me feeling unsure at times. However, I have been trying to keep hopes high for coworkers and myself by doing little things each day such as bringing in chocolates, soaps, and pins.
Q.: Is burnout a threat for nurses? If so, what types of remedies are available to address burnout? A.: I think burnout is always a threat for nurses, especially on floors like mine. The wonderful thing about nursing is that there are so many opportunities to change your path and hopefully avoid burnout.
Q.: How would you describe what you’ve been going through recently? A.: At first when the virus came about, I was uneasy — just not knowing what was expected of me and my fellow health care workers. However, as we learned more about the virus and ways to combat it, I feel more confident. Overall it has not been easy, but we pull through and will continue to do so until the very end.
Q.: What kind of advice would you give a nursing student who is embarking on a career as a health care professional? A.: I would say, even though currently these are trying times for health care workers, keep pursuing what you love and are passionate about. If you love helping people and are empathetic, this is where you are supposed to be.
Q.: What is your specific job now, with this crisis? How has it changed because of the virus? A.: I am a registered nurse and on the front lines delivering the best care possible to each of my patients. My work ethic has not changed — I provide the same care to my patients that I did before the virus outbreak, so nothing has changed there. However, since the outbreak, things have
June 2020 •
become more demanding. Q.: How has it impacted your personal life? A.: I have become more worried about bringing it home to my family or perhaps getting it myself, leaving me unable to do my job. I am not able to see my grandson really at all since the outbreak — just FaceTime. I don’t go around my mother either, because she has a compromised immune system, but we chat daily on the phone. Q.: At what point in your life did you decide on a career in the health care industry? What were your primary motivating factors and influences? A.: When I turned 23, I decided I wanted to give back somehow to society. I felt like taking care of the sick was a good way to achieve that. It was easy to get into the nursing field, since my biggest influence was my mother who was also a very strong and devoted nurse. Q.: What do you feel are the keys to being a nurse on a highly successful level? A.: To be a successful nurse, you need to treat every patient as if he or she is part of your own family and treat them how you would like to be treated. You do this by talking to them, listening to them, and being an advocate for them on every level. I believe being compassionate is key to being a nurse on a highly successful level. Q.: What are the most gratifying or “feel good” aspects of being a nurse? A.: The rewarding aspect of nursContinued on Page 19
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By the numbers, COVID-19 was never ‘like the flu’ I
n the early days of the coronavirus pandemic, President Donald Trump announced that Americans need not worry because the new coronavirus was “like a flu.” Now, 1.4 million cases and more than 84,000 COVID-19 deaths later (as of May 17), a new report finds the comparison was never valid. “Public officials continue to draw comparisons between seasonal influenza and SARS-CoV-2 mortality, often in an attempt to minimize the effects of the unfolding pandemic,” wrote physicians Jeremy Faust, of Harvard Medical School, and Carlos del Rio, of Emory University School of Medicine in Atlanta. But those comparisons are “apples and oranges,” the physicians reported in an article published May 14 in the journal JAMA Internal Medicine. That’s because the numbers comparing COVID-19 and flu just don’t match up. For example, the U.S. Centers for Disease Control and Prevention pro-
duces an annual tally of deaths caused by flu. During the 2018-2019 flu season — by all accounts a moderate one — 34,200 Americans are thought to have died from complications linked to the flu. In more severe flu seasons, that number can go higher — the 2017-2018 season was linked to more than 61,000 deaths, for example. However, Faust and del Rio noted that confirming that flu caused a patient’s death (and not some other underlying condition) is often tough, so the CDC long ago issued their numbers as “calculated estimates” — not actual death counts as verified by death certificates. An annual number for verified flu deaths also exists, however, and it’s much smaller than the calculated estimates. Between 2013 and 2019, “the number of counted influenza deaths was between 3,448 and 15,620 yearly,” the report authors noted. Conversely, COVID-19 deaths occurring in 2020 have all been count-
ed, not estimated. That means that by May 14, the more than 84,000 deaths from coronavirus are already about 5.5 times higher than the highest annual death count for the flu over the past seven years. Those ratios widen even further when deaths are looked at on a weekly basis. “Statistics on counted deaths suggest that the number of COVID-19 deaths from the week ending April 21 was 9.5-fold to 44.1fold greater than the peak week of counted influenza deaths during the past seven influenza seasons in the U.S.,” Faust and del Rio said. Finally, there’s simply no comparison between flu and COVID-19 when it comes to
what medical staff are experiencing on the frontlines. “In some hot zones of the pandemic … ventilators have been in short supply and many hospitals have been stretched beyond their limits,” the two experts noted. This overwhelming demand on hospitals, “has not happened before in the U.S. even in the worst of influenza seasons.” Finally, they said, the actual death count of COVID-19 may be even higher than current estimates, because “indirect” deaths linked to the pandemic aren’t factored in. Those include deaths that occurred because people with other, often fatal conditions couldn’t get the help they needed as health care systems became overwhelmed by COVID-19.
Healthcare in a Minute By George W. Chapman
CARES Act expands beneficiary coverage for COVID-19
I
n late April, the Centers for Medicare & Medicaid Services (CMS) issued radical changes to combat the COVID-19 pandemic. The Coronavirus Aid, Relief, and Economic Security Act expands beneficiary coverage for the virus and gives providers greater flexibility in delivering care. Some of the important provisions are summarized below. It should be noted that CMS rules pertain to Medicare and Medicaid beneficiaries. However, most commercial carriers tend to mimic CMS especially during this pandemic. If you are covered by a commercial plan, to be sure about coverage, contact them first.
Testing
You do not need a written order from your treating physician to get tested for the virus. An order (it does not have to be written) from any qualified healthcare practitioner authorized to do so under state law will be accepted. Pharmacies can do testing if enrolled with CMS as a lab. Beneficiaries can now be tested in so called “parking lot” sites operated by qualified entities such as hospitals, community health centers, pharmacies, etc. CMS will pay for the services related to the virus in full. The beneficiary will not be responsible for any deductible or co-pay. Page 6
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Practitioners Advanced practitioners (nurse practitioners, physician assistants, clinical nurse specialists) can provide home health care without physician certification. APs can order the services, establish care plans and certify that the patient is eligible for home care. Teaching hospitals are allowed to send available residents to other affiliated or non-affiliated hospitals to help out. Physical and occupational therapists can delegate routine maintenance services to their qualified assistants. During the COVID-19 emergency, hospitals and ambulatory surgery centers will not have to pe-
riodically reappraise staff privileges. This allows them to keep providers whose privileges would normally be expiring. It also allows them to temporarily bring retired physicians back.
Telehealth
These temporary changes will most likely have the most profound and enduring impact on the delivery of care far beyond the pandemic. Up until the pandemic, telehealth was used sporadically and traditional face to face encounters were preferred. Red tape and low payment discouraged both physicians and patients from using telehealth. CMS and commercial carriers have long feared the easy use of telehealth would merely increase utilization without any real impact on outcome. As the pandemic lingers, both consumers and providers are adapting to telehealth. Most likely, some of these temporary changes below will become permanent. Physical, occupational and speech therapists can provide services via telehealth. Hospitals may provide and bill, as the originating site, for telehealth services provided to registered outpatient in their home. The patient’s home becomes an extension of the hospital’s outpatient department. Services provide remotely include counseling, education and
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020
therapy. Telehealth may be provided by audio only (telephone) versus audio and visual. Medicare is now covering some services when provided as audio only — this includes behavioral and patient education services. CMS has (finally) increased payments to providers for telephone encounters to match payments for traditional office visits. This is retroactive to March 1. CMS has promised to add to the list of approved telehealth services and to accelerate the approval process on a “sub-regulatory” basis. (As providers and consumers adapt, I think it will be very difficult for CMS to go backwards on telehealth once the pandemic subsides.) CMS is now paying rural clinics and federally qualified community health centers for providing telehealth services. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
Petrified Patients
Doctors seeing fewer patients because of new coronavirus fear By Barbara Pierce
“
Patients are hesitant and fearful about going to doctors’ offices for care and treatment that is not related to the coronavirus,” said Richard Chmielewski, head of the Falcon Clinic for Health, Wellness, and Recovery in New Hartford. He is concerned about this. “At the Falcon Clinic, we’re seeing fewer patients these days. Many of the doctors have stopped seeing patients. Emergency rooms and urgent care centers are finding that people are afraid to come in,” he said. Many people are not going in for routine health care during the COVID-19 pandemic. A recent poll found that people are avoiding or delaying medical care due to fear of contracting COVID-19. A survey found that 55% of persons over 70 put off routine medical care. “People have postponed a needed visit, to the point that there was, or might have been, irreversible damage to their health,” said Chmielewski. “People still do need routine medical care.” Experts say this trend could lead to an increase in the number of people who die because of the pandemic, but not from the virus itself. The Falcon Clinic is a primary care clinic, offering general medical care with a major focus on osteopathic principles and on prevention and treatment of behaviors that are destructive to health. They offer primary care treatment for any medical illness including hypertension, diabetes, thyroid disorders, skin diseases, stomach and intestinal problems, neurologic disorders and minor injuries. The Falcon Clinic is continuing to provide care by adapting to this pandemic in remarkable ways. “We follow the CDC [Centers for Disease Control & Prevention] guidelines for sanitation, social distancing and disinfection. If people have symptoms, we don’t have them come in. We see patients only by appointment,” Chmielewski said. One of the remarkable things
Oneida, Herkimer In Good
UVC deemed effective
When Chmielewski was in Japan as an emergency room physician, he learned that hospitals and clinics there used ultraviolet lights to kill bacteria and viruses; he was surprised to know it is not well known
and
Health MV’s Healthcare Newspaper
they have done for the safety of patients and staff is to install specialized ultraviolet light treatment units in the exam rooms to further increase the level of sanitation. “This is another measure of protection,” Chmielewski explained. “They aren’t like a black light. They are a UVC [deep ultraviolet] light that kills off 99.9% of the bacteria in five minutes. After a patient leaves the room, we leave them on for 15-30 minutes and no one can be in the room during that time.” “The CDC has said the COVID-19 virus is in droplets and can live on surfaces. Now they think it might stay airborne and live in the air. With the UVC light, we are killing off anything on surfaces or in the air,” he added.
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in the United States. “I’m surprised more doctors here don’t use it. It’s so effective in killing bacteria and viruses,” he added. Also, to protect patients, the Falcon Clinic is seeing patients through telemed visits rather than in person whenever possible. “We can do the initial visit with you by a teleconference,” said Chmielewski. “Quite a few of our new patients are coming in via telemed.” Telemed, or telemedicine, allows the patient to have a virtual visit to the clinic. Basically, it means the visit is accomplished using audio and video over the internet rather than meeting in person. You open an application that has been designed specifically for this purpose on your smart phone, tablet or computer that has high-speed internet access and a camera. High-quality video transmission allows the health care provider to visually evaluate you and do a quick assessment to decide on further treatment or tests. The practice of telemedicine is
quickly gaining popularity as people become aware of it and take advantage of it. Medicare and most insurances have expanded their coverage to cover telemed visits. “After we see you on a telemed visit, we can call in a prescription if you need medication,” added Chmielewski. “We do give injections here, and of course you would have to come in for an injection; however, we’ll get you in and out quickly. We are carefully following the CDC guidelines to protect people who come in.” “We don’t have people waiting in the waiting room, so you won’t have to be near anyone but our staff. Our staff must wear masks and wash their hands before and after seeing each patient. Each room is sterilized with the special ultraviolet light before the next patient comes in,” he noted. The Falcon Clinic in New Hartford can be reached at (315) 507-4651 or visit http://falconclinic.com/.
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Organ transplants plummet during COVID-19 crisis
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he coronavirus pandemic has affected all areas of medical care, and a new study finds it has delayed potentially life-saving organ transplants. Across the United States, transplants from deceased donors dropped 51% from early March to early April, amid the COVID-19 outbreak, the researchers found. In France, meanwhile, those procedures plummeted 91%. Experts said the findings, published online May 11 in The Lancet, come as no surprise. The figures, they said, largely reflect efforts to protect patients, and to deal with the diversion of hospital resources to COVID-19. Much of the decrease was in kidney transplants, partly because they are the most common organ transplant. But it’s also because people with advanced kidney disease can be maintained on dialysis while they await a donor organ, explained physician David Klassen, chief medical officer for the United Network for Organ Sharing (UNOS). So there is generally less urgency around a kidney transplant, compared to a heart, liver or lung transplant, Klassen said. UNOS is a nonprofit that man-
ages the U.S. organ transplantation system. The new findings are based on its data, but it did not conduct the study. “Transplants in the U.S. have not shut down,” Klassen said. “But, clearly, we want to do them as safely as possible.” Physician Peter Reese, an associate professor of medicine at the University of Pennsylvania in Philadelphia, was part of the study team. “The good news is, we’ve carried on through the worst of COVID-19,” he said. However, Reese added, while some transplants can be delayed, patients on waiting lists for donor organs undoubtedly missed out on opportunities. “The tragedy is, there were deceased-donor organs that patients did not receive, and that we’ll never get back,” he said. Right now, more than 112,000 Americans are on the waitlist for a donor organ, according to UNOS. More than 94,000 of them need a kidney. And while kidney patients can receive dialysis, it doesn’t always buy the time they need: Each year, around 9,000 patients on the waitlist either die or have to be removed from the queue due to worsening health.
When COVID-19 hit the United States, most transplants from living donors — which can be rescheduled — were put on temporary hold. One reason was to protect donors from possible exposure to the virus in the hospital, Klassen said. Transplant patients also require many hospital resources, including intensive care beds. If a living donor is involved, that means two patients for each procedure. And at the start of the outbreak, U.S. transplant centers did not know whether every city was going to “look like New York,” said physician Stephen Pastan, medical director of the kidney and pancreas transplant program at Emory University in Atlanta. “Hospitals were preparing for the worst,” said Pastan, who is also a board member of the National Kid-
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IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020
ney Foundation. “At Emory,” he noted, “we took a cautious approach and closed our kidney program.” It also took time, nationally, for testing protocols to be put in place. Transplant recipients need to be tested for coronavirus infection, Pastan said, to ensure they don’t bring it into the hospital. Meanwhile, organ procurement organizations started testing donors for the virus, according to the American Society of Transplantation. Now, Pastan said, “programs are slowly ramping up again.” The current study, which looked at data through April 10, does not capture more recent trends. According to Klassen, of UNOS, there has been no indication of further declines in U.S. transplants.
Summertime Fun Marco ... Polo! Stay safe, healthy in pool this summer By Barbara Pierce
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oon, those enjoying the sunshine this summer will hear those familiar chants of “Marco” and “Polo.” Marco Polo is an American form of tag played in a swimming pool. While eyes shut, the player who is “It” shouts “Marco” and the other players must all respond by shouting “Polo”, which “Marco” uses to try to find them. On a hot summer day, a swimming pool seems like the greatest invention known to man. Hanging out around the pool is a fantastic way to stay cool when temperatures climb. Swimming is a staple of summertime. Though the clear turquoise water might look completely harmless, there are a lot of dangers associated with swimming pools. “Unfortunately, the Centers for Disease Control & Prevention reports that more than 3,400 people drown each year in the United States,” said Hank Leo, CEO, YMCA of the Greater Tri-Valley. Drowning is a leading cause of accidental death for children of all ages. Here is some pool safety advice to keep everyone safe as they have summer fun in the pool.
Watch children at all times
Children are drawn to water and can drown even if they know how to swim. “I have a preschooler who climbs bookshelves or runs out of buildings when you turn your back for like three seconds,” said Joy Auch online in “A Healthier Upstate. “What if he tries to get into the pool when I’m not looking?” If you’re a parent, you know how quickly young children get around. “People assume if their child
falls into the pool, they’ll hear lots of splashing and screaming, and have time to react. In reality, a child slips into the water and goes under the surface quickly and silently — without warning,” said Hal Stratton online, former chair, U.S. Consumer Product Safety Commission. Although it seems obvious, never leave children unsupervised near water, including a bath. The families of drowned children know that it happens in seconds. Watch them constantly, even if they can swim. Don’t rely on water wings, noodles or inner tubes to keep children safe. For older children, an adult should be paying constant attention and free from distractions, like texting, socializing or drinking alcohol.
Teach children to swim
Although swimming lessons don’t necessarily prevent drowning and are not a substitute for adult supervision, it’s important to teach children to swim. “Teaching children to swim at a young age prepares them to be safer and more confident around water,” said Leo. The best thing you can do to be safe in and around water is to be able to swim – this applies to both children and adults. “Swim lessons help adults and children become more comfortable in the water, and teaches them to float and safely operate in the water. This also empowers them to participate in neighborhood pool parties and enjoy social times with their friends in the water,” added Leo. “We provide swimming lessons at both our Rome and Oneida branches of the YMCA, totaling over 350 participants,” he said. “YMCAs have been teaching people to swim for more than a century. In YMCA aquatics programs, children learn
to be safe around water and they feel the sense of accomplishment that comes with learning something new.” In addition to youth swimming, other aquatics programs include infant-parent classes, preschool classes, classes for people with disabilities and classes for teens and adults, and group as well as private lessons, Leo said. The key to preventing pool tragedies is to provide layers of protection: limiting pool access, using pool alarms, closely supervising children, and being prepared in case of an emergency.
Keep pool area secure
A fence should surround the entire pool area. It shouldn’t be climbable and nothing should be placed alongside the fence, like lawn furniture, that could be used to climb it. Kids are very good problem solvers, Auch said. There shouldn’t be more than four inches between slats. Gates should be self-closing and self-locking and well out of reach of children. If you have an above ground pool, take the ladder down and cover the pool whenever it’s not in use. Keep safety equipment easily
accessible. Make sure that you have life jackets and other flotation devices like a ring buoy at the pool in case you need them, and know how to use them. Have a phone near the pool so that you can call 911 if necessary. Time is of the essence if someone gets hurt or has a drowning incident. Don’t mess around with weather. Thunderstorms and swimming pools are not a good combination. If you hear thunder or spot lightning, everyone needs to get out of the pool and stay out for at least 30 minutes. If you hear another boom or see another flash, the 30 minutes start over again.
Maintain clean pool
Pools get dirty and germy. Make sure that you maintain and clean your pool properly. Some general guidelines for ensuring that the pool stays clean: — Keep up with pool filters. — Chemically treat the pool by following the instructions. — Keep pets out of the pool. — Don’t allow people with open wounds to go swimming. — Babies must wear swim diapers. — No peeing in the pool. With these tips, you can have a great safe summer in your pool!
Venturing out? Guard against disease-carrying ticks
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s pandemic-related restrictions ease and people return to parks and other outdoor spaces, remember to protect yourself against another threat — ticks. “With our latest mild winter, ticks have been active in much of the region on warmer days all winter long,” said Jody Gangloff-Kaufmann, an entomologist at Cornell University in Ithaca, who said it’s too soon to predict population trends for 2020. She added that it is clear, however, that ticks are expanding their geographic range and moving into colder regions. That’s why it’s important to know how to recognize them, take preventive steps and do a tick check each time you venture out. “Although ticks aren’t everywhere, they can be anywhere so be aware of your surroundings,” Gangloff-Kaufmann said in a news release. Though no notable change in
distribution or density has been reported in the past year, there is one exception, according to Laura Harrington, director of the U.S. Centers for Disease Control and Prevention Northeast Regional Center for Excellence in Vector-Borne Diseases at Cornell. Harrington said the Asian longhorned tick is expanding its range and has moved into New York state. “So far, it hasn’t been found infected with human pathogens, but it does transmit a hemorrhagic viral disease in Asia,” Harrington said. The bacterial infection that causes Lyme disease is the most important tick-borne illness in the United States, with an estimated 200,000 to 300,000 cases reported each year, she said. “The blacklegged tick or ‘deer tick’ is the vector of Lyme disease in most of the U.S.,” Harrington said.
Female deer tick on human skin. It can transmit Lyme disease. It also transmits other disease-causing organisms, including agents that cause babesiosis, anaplasmosis and Powassan disease. These ticks are most common in forested areas and shaded trail edges where there
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are lots of fallen leaves and shrubs, she said. As such, you need to take steps to protect yourself when you’re headed outdoors. Harrington recommends wearing repellent, light-colored clothing and tucking pants into your socks. “You can also treat your clothing with permethrin or purchase permethrin-treated clothing,” she said. But don’t stop with those steps. It’s important to check yourself for ticks often. “For Lyme disease, time is on your side,” Harrington said. “It usually takes 24 to 48 hours after the tick has attached and started feeding before it can transmit Lyme bacteria. For some other pathogens, like Powassan virus, transmission can happen quickly, so check yourself periodically for attached ticks even when you are still outside.”
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Nurses Week The Balanced Body
By Deb Dittner
Beauty of Sleep There’s nothing like getting plenty of Zzz’s and feeling refreshed, ready to go
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leep is the cornerstone for recovery as a key element in the regeneration, aging and healing process. Without adequate and proper sleep, the recovery process is negatively impacted and ultimately the consequence is sub-par daily performance. Research has also shown that most adults need between seven and nine hours of quality sleep each Dittner night. Sleep is essential to maintain a healthy immune system, keeps you more alert, allows your body to make necessary repairs, improves memory and mental health, and decreases stress. A good night’s sleep can also help to manage hunger, cravings, anxiety and mood. Poor or lack of sleep can lead to
hormone imbalances which in turn can lead to more severe issues such as obesity, depression and diabetes. Sleep ranks up there as one of the most important variables when it comes to general health, recovery and optimum performance. When everything is in balance, you will experience a good night’s sleep. When you sleep well, you will find balance throughout the remainder of your life. A magnesium-rich diet consisting of plenty of leafy greens and nuts will aid in that balance. Melatonin is a hormone produced in the body that is released naturally as exposure to sunlight decreases. It reduces alertness, helping your body prepare for sleep. Limiting the exposure to light before bed may be extremely beneficial in your quality of sleep, especially if you are a person that has difficulty falling asleep. Develop a routine at bedtime approximately 30 minutes to an hour before you actually climb into bed
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as this will help to release the day’s stress. — Avoid the use of electronic devices (TV, computer, iPhone, iPad) at least one hour prior to bed time. These devices are stimulating and will not allow for a restful night’s sleep. — Avoid the use of stimulants such as alcohol, caffeine (avoid after 1 p.m.), sugar and smoking. — Avoid eating “bed time snacks” or going to bed on a full stomach. This can cause sleep issues and can create difficulty with fat burning.
Consider the essentials
— Take a warm bath with Epsom salts infused with therapeutic-grade essential oil to help induce sleep. Essential oils have been found to ease mental fatigue, encouraging a more restful sleep. The oils are uplifting and calming, and can be put through a diffuser or directly inhaled. Essential oils of benefit are lavender (the mother of all essential oils), frankincense (the father of all essential oils), chamomile, clary sage, rose, orange, lemon and basil, just to name a few. — A relaxing cup of non-caffeinated tea may help you drift off with more ease. — Reading a book or magazine can also create relaxation. — You may want to incorporate breathing techniques into your presleep routine to quiet the mind. — Relaxation yoga postures such as child’s pose, legs up the wall, and corpse pose are very soothing. — Calming, relaxing music or a sound machine of nature’s effects can quiet a busy mind. — Keep a regular schedule. — Rise at the same time each morning, if possible. — Limit exposure to light before bed. — Create a bedroom atmosphere that will enhance sleep:
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020
— Sleep in a bed consisting of a good quality mattress and a firm pillow. — Remove computers, television, iPhone, Blackberry, Smartphone. — Block out all light by installing darkening shades or curtains. — Maintain an average room temperature of 70 degrees (not too hot and not too cold). Insomnia is the inability to fall asleep or sleep uninterrupted early. Even one night of being unable to fall asleep can throw off your hormones by increasing the stress hormone cortisol, and throwing off fat-burning hormones as well. It can be very hard to turn off your mind and fall asleep. There is no one answer to remedy this problem. Finding that balance for restful sleep is individual and can comprise of many actions. Going to sleep on a full stomach is not recommended but there are some foods that can help with sleep on those difficult nights. — Almonds contain magnesium that works as a natural muscle relaxant and destressor. — Bananas are also rich in magnesium, potassium and tryptophan (like turkey on Thanksgiving which makes you drowsy after your holiday meal) aids in sleep, — Oatmeal is another magnesium and potassium-rich food that tends to warm the soul, creating calmness. — Cherry and cherry products such as tart cherry juice have been found to increase melatonin, improving sleep. • Deborah Dittner is a family nurse practitioner and health consultant. Her mission is to transform as many individuals as possible through nutrition and lifestyle changes. For more information, check out her website at www.debdittner. com or contact her at 518-596-8565.
Stinky feet?
A sole concern
Let’s examine cause of embarrassing foot odor By Barbara Pierce
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melly feet can happen to anyone of any age, said Dr. Gregory Rorick of Rorick Podiatry in New York Mills. He explained the cause of foot odor: Our feet sweat a lot. They can produce as much as a half a pint of sweat in a day. There are two types of sweat glands on our bodies: apocrine and eccrine. Apocrine glands are the kind where there is hair — on your scalp, armpits, and groin. Rorick Apocrine glands transfer the sweat into a hair follicle. The glands on your feet are eccrine glands. Eccrine glands transfer the sweat directly onto the surface of your skin, Rorick said. Sweat is mostly water and salt. When a bead of sweat runs down your face, taste it, and you’ll find it tastes salty. Sweat by itself doesn’t smell. The smell comes after we put on shoes and socks. In our shoes and socks, we’re creating a dark, warm, moist environment where bacteria grow and multiply. Bacteria thrive on the dead skin cells and oils from your
skin. They produce the acids which cause the cheesy smell, he explained.
What you can do?
So how can you stop your feet from stinking? Cut down on the sweating and you’ll discourage bacteria and cut down on the odor. There are three parts to stopping the odor, Rorick said: your foot, your shoes, and your socks. He recommends these steps: — Your feet: The most important thing you can do is to wash your feet every day. Folks get in the shower and they wash their underarms, most of their body, and their genital area, but they don’t usually wash their feet. It’s important to scrub your feet good, wash between your toes, and the back of your heels. Scrub enough so that you’ll remove the dry skin cells. It helps to use a pumice stone to get rid of all these dry skin cells. However, if you have poor circulation or diabetes, do not use a pumice stone as you could injure your skin, Rorick cautioned. Then, as you dry yourself, dry your feet thoroughly. Often people ignore their feet when they’re drying. Do dry your feet well, including between your toes. — Your socks: Cotton socks are best — good old-fashioned cotton that breathes and wicks moisture. “They do make synthetic fiber
socks, but I’ve tried them and I find cotton socks do better and are cheaper,” he said. Avoid polyester, nylon or rayon panty hose, tights, or socks. These fabrics do not breathe well so they don’t allow the sweat to evaporate off your feet. And they don’t absorb moisture either, so your feet will stay wet and sticky, which can cause blisters. Constantly wet feet and socks provide a breeding ground for the bacteria which make your feet smell. Put on a fresh pair of socks each day. If your socks get wet, take them off and put on a dry pair. Some folks with bad foot odor need to routinely change socks twice a day.
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— Your shoes: We jam our feet into our shoes and go here and there; we’re active. Then we come home, we take off our shoes and throw them into the closet. The closet is not a good place for them. Leaving your shoes out to dry in the air will kill the bacteria. You can wipe down your shoes with rubbing alcohol to make sure you kill the bacteria and odor, or spray with Lysol. Just be careful not to ruin the finish. If the shoes are washable, this is a great way to kill odors and get clean-smelling shoes again. Be sure to dry them completely before wearing. Some insoles may be washable. But you can’t throw most shoes into the washing machine, and as it’s not feasible to buy new shoes every time they start smelling. There are a couple of things you can do. • Alternate your shoes; don’t wear the same shoes day in and day out. The bacteria colonies get larger if you wear your shoes every day. Let them dry out a day or two before wearing them again. • Make sure your shoes aren’t too tight. If they are, this could cause your feet to sweat more than normal. • Avoid plastic shoes — Plastic and some human-made materials don’t let your feet breathe. For some people, even taking all of these measures may still not get rid of the foot odor. If that’s so, consult a podiatrist. “There are medications we can prescribe that will help. Also, sometimes we prescribe antibiotics to kill the bacteria,” Rorick added.
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Health Careers Peter Schachtler Licensed Massage Therapist Mohawk Valley In Good Health newspaper senior staff correspondent Barbara Pierce recently spoke with licensed massage therapist Peter Schachtler about his career. Schachtler is the owner and operator of Mohawk Valley Massage Therapy in New Hartford. A.: It’s physically tough on the body, especially the hands. In training, I learned ways to overcome these challenges. And it’s a tough career for a male. Some men, and some women too, have difficulty seeing a male massage therapist.
Q.: How did you become involved in a career as a massage therapist? A.: I knew that I wanted to become a massage therapist ever since I was in high school. As I didn’t have the funds to go to school right out of high school, I worked for a few years until I could go to school. I was an athlete, racing in motocross. As I was frequently injured in this career, I looked to massage therapy for pain relief. Massage can do incredible things for people — as it did for me — and that’s what inspired me to become a massage therapist. I’ve always been interested in the body, how it works and how it performs, and in learning ways to boost the performance of the body. Q.: What inspired you to start Mohawk Valley Massage Therapy? A.: When I graduated from the School of Therapeutic Massage, I worked for someone else. The owner encouraged me to go into business for myself. She saw how well I did with patients and felt I had the skills to operate my own business. I give her credit for pushing me in this direction. Three years ago, I opened Mohawk Valley Massage Therapy. Q.: We understand that you graduated with honors and won awards? A.: I graduated in 2016 with honors. I received awards for best treatments as well as best sports massage from my peers.
Q.: What kind of training did it take? A.: I went to the Onondaga School of Therapeutic Massage for one year. That involved 500 hours of classroom learning and 500 hours of hands-on practice, clinical work. The New York State Education Department’s Office of the Professions licenses massage therapists.
Schachtler Q.: What is most rewarding about your career? A.: The best thing is that, as a massage therapist, I truly can, and do, change the lives of people who see me. People come in through the door in pain, hobbling along. They go out through the door, loose and happy, with a big smile on their face. That’s rewarding. Sometimes it takes more than one visit to get results, and I see people weekly. I can see the change that happens, and it’s incredible. Q.: What are the challenges of this career?
Q.: You offer several different massage techniques, including sports massage, soft tissue therapy, relaxation massage, deep tissue release, cupping, and Swedish massage. Do you specialize in any one of these? A.: I specialize in sports massage and in working with athletes to help them achieve their goals and excel in their sport. Sports massage uses a variety of massage techniques that are designed to help your body move more freely and feel stronger. It is particularly great for those with active lifestyles. I don’t limit myself to working only with athletes. Q.: How would I know what type of massage to ask for? A.: I offer a free analysis to figure out what type of massage would work best for you. One technique that is popular is the basic relaxation
massage I do, a classic massage that eases muscle tension, eases stress, and creates many health benefits. Q.: What is a typical day like for you? A.: Typically, I limit myself to four or five patients per day so not to tire myself. Appointments are each 30 to 90 minutes, and I schedule a 30-minute break between patients so I can be sure each patient gets my best. Q.: What characteristics should one have to succeed in this career? A.: You must be an empathetic person who cares about people and their concerns; a person who is able to feel what they’re feeling. Q.: You’ve been closed because of the coronavirus pandemic. When do you anticipate reopening? A.: If things go as planned, we’ll be able to reopen June 1, in Phase 2. In the meantime, many of my patients are purchasing gift certificates to be used after we reopen. Q.: Any thing you wish to add about you and Mohawk Valley Massage Therapy? A.: The techniques we provide are beneficial to everybody. We offer a multitude of different massage techniques to be sure we have just the right service for you. We’ll help you decide which is best for you. For more information, contact Mohawk Valley Massage Therapy at 315-982-7087 or visit www.massagebook.com.
Exercise safe for those at risk of knee arthritis
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eople at high risk for knee arthritis don’t need to avoid jogging and other types of vigorous exercise, a new study suggests. Some folks hold back on physical activity because they fear it will increase their chances of developing knee arthritis, so researchers from Northwestern University’s Feinberg School of Medicine in Chicago took a closer look. “Our study findings convey a reassuring message that adults at high risk for knee [arthritis] may safely engage in long-term strenuous physical activity at a moderate level to improve their general health and well-being,” said study author Alison Page 12
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Chang, associate professor of physical therapy and human movement sciences. The study included nearly 1,200 people from several U.S. cities, ages 45-79, who were at high risk for knee arthritis but had no evidence of the condition. Obesity, previous joint injury, surgery, aging and chronic knee symptoms increase the risk of developing arthritis of the knee. Participants were followed for up to 10 years. Chang and her colleagues found that long-term participation in strenuous physical activities such as jogging, swimming, cycling, singles tennis, aerobic dance and skiing was
not associated with risk of developing knee arthritis. In fact, those who did vigorous exercise had a 30% lower risk of knee arthritis, but that’s not considered statistically significant, according to the authors. Lots of sitting wasn’t associated with either an increased or reduced risk of arthritis. “People suffering from knee injuries or who had arthroscopic surgical repair of ACL or meniscus are often warned that they are well on the path to develop knee [arthritis],” Chang said in a university news release. “They may be concerned that participating in vigorous activities or
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020
exercises could cause pain and further tissue damage. To mitigate this perceived risk, some have cut down on or discontinued strenuous physical activities, although these activities are beneficial to physical and mental health,” she said. The bottom line? “Health care providers may consider incorporating physical activity counseling as part of the standard care for high-risk individuals at an early stage when physical activity engagement is more attainable,” Chang said. The study findings were published May 4 in the journal JAMA Network Open.
Health Careers Brianna Schneider Office Nurse/LPN Mohawk Valley In Good Health newspaper senior staff correspondent Barbara Pierce spoke with licensed practical nurse Brianna Schneider, office nurse for the Falcon Clinic for Health, Wellness & Recovery in New Hartford. The Falcon Clinic is a primary care clinic. branch of alternative medicine. When I completed school three years ago, I first worked at a nursing home. That job just wasn’t for me. This job is a good fit for me.
Q.: How did you become involved in a nursing career? A.: I wanted to become a nurse since I was a young girl, because both of my parents struggled with medical conditions. My mother had breast cancer and my father has Type 2 diabetes. From a very young age, I wanted to help people. At the age of 16, I started out as a certified nurse assistant. When I was in my senior year of high school, I decided to apply for the LPN program through Oneida County BOCES and was accepted. I worked as a CNA until I became a nurse at age 19. Q.: What training did it take to become an LPN? A.: The program through Oneida County BOCES is an 11-month program with 1,260 hours of schooling and training. It started with 11 weeks of classroom work, learning about anatomy, physiology, different systems of the body, and lab skills. Then the focus was on hands-on work and learning clinical skills. My clinical experience took place at area skilled nursing facilities and hospitals. Q.: Is this position what you expected it would be when you were in nursing school? A.: No, it’s not what I expected. I’ve learned so much more on the job since I completed the nursing pro-
Schneider
Q.: What is a typical day like for you? A.: A typical day for me starts at 7:40 a.m. I go into the office to get the rooms ready for patients with a thorough cleaning. Next, I get charts ready for patients that are scheduled for that day. The patients start coming in at 8 a.m. Office staff sees anywhere from 25 to 50 patients per day. A lot of people think office nurses don’t really do much, but we do. I’m busy all day working with patients, doing telephone triage and making phone calls. I also do injections; there are days when I do 10 to 15 injections. I also assist with minor procedures like cyst extraction and skin tag removals.
gram. At the Falcon Clinic in New Hartford, we offer osteopathic treatment for various musculoskeletal disorders, primary care, acupuncture, addiction treatment, and hepatitis C treatment. I didn’t know anything about osteopathy at all before I took this position. Now, I have a good understanding about the philosophy of this
Q.: What do you like best about your career? A.: What I love about my job is that every day is different. I wouldn’t like a job where I did the same thing over and over, day after day. The best days for me are when I see patients who come in for osteopathic manipulative medicine and they tell me their pain is getting better or it’s completely gone.
And I like that I’ve learned a lot about the job. (Editor’s note: The philosophy of osteopathic medicine is to promote the body’s natural tendency toward self-healing and health.) Q.: What are the challenges of this career? A.: There are some challenges. It can be difficult to help people. It can be especially difficult trying to help people with addiction diseases. Occasionally, individuals do succumb to their disease, and that makes it tough. But it makes me want to help more. Q.: What characteristics should one have to succeed in this career? A.: To succeed as an LPN, you need to be a caring person, warm hearted, and a person who cares about other people. And you can’t be doing it just for the money; there are a lot of other things you can do and earn more money. Q.: Is there anything you wish to add? A.: Being a nurse doesn’t make you just a nurse. It makes you a counselor, a teacher, a patient advocate, and a leader. Nursing is my greatest skill, but caring is forever my passion. For more information on the Falcon Clinic, visit http://www.falconclinic.com or call 315-507-4751.
MVHS Stroke Center recognized for its role in saving lives
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he Mohawk Valley Health System spotlighted its Stroke Center with Comprehensive Capabilities at the St. Luke’s Campus — the only one in the Mohawk Valley — during National Stroke Awareness Month in May. The Stroke Center has continuously received the American Heart Association-American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award with Target: StrokeSM honor roll elite for its commitment and success in providing excellent care for stroke patients, according to evidence-based guidelines. The stroke and neuro endovascular program excels in patient care due to its partnerships with Midstate Emergency Medical Services, emergency department, radiology, critical care services and other hospital departments that support patients in their journey.
With stroke, immediate treatment is critical to prevent loss of function. The stroke team uses standardized and timely protocols to ensure that stroke patients are diagnosed quickly and are treated within 60 minutes of arrival in the ED. Therapies including clot-busting TPA and catheter-based interventional stroke rescue are available locally at the St. Luke’s Campus. The COVID-19 pandemic has added to the number and complexity of strokes. “Although typically considered a lung infection, COVID-19 has shown to increase the tendency to form blood clots which can lead to severe strokes,” said Varun Reddy, MVHS stroke and neuro endovascular service line director. “We see this phenomenon in patients regardless of age or traditional risk factors, and even in those with few or no symptoms. People with COVID-19
who are in their 30s are experiencing strokes even when symptoms were mild. “The addition of this complication from the COVID-19 pandemic makes it vital for the community to remain vigilant for the signs and symptoms of stroke and seek treatment as quickly as possible. When it comes to stroke, time is brain. We are aware, due to the current situation, that people are hesitant to seek medical attention,” Reddy said. “However, the importance of treating a stroke as quickly as possible cannot be emphasized enough. MVHS is taking every measure possible to ensure the safety of those needing care — from restricting visitors and instituting blitz cleaning throughout the facility, to screening, taking temperatures and providing masks to all those entering our buildings.” Stroke signs and symptoms can
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be remembered by using the acronym FASTER: — FACE: Uneven smile. One side of the face droops or is numb. — ARMS: One arm drifts down when raising both or is weaker and number than the other. — STABILITY: Dizziness; hard time keeping balance; trouble walking; loss of coordination — TALKING: Slurred words; unable to speak; hard time being understood or understanding speech — EYES: Difficulty seeing out of one or both eyes; double vision — REACT: Call 911 immediately. Call even if symptoms go away and remember when symptoms first began. “Strokes are treatable and preventable; seeking treatment for them should not be postponed regardless if it is unclear the symptoms are stroke,” said Angelina M. Roche, stroke program clinical coordinator.
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SmartBites
The skinny on healthy eating
Red Snapper Pops with Healthy Benefits
H
ere’s a quarantine surprise: More people are cooking seafood, especially now that certain meat products are becoming harder to find. Here’s a surprise of a different nature: Snapper, a popular white fish with a firm texture and a distinctive sweet, nutty flavor, has a nutritional profile that’s bound to intrigue. To begin, snapper is an excellent source of lean, high-quality protein, with an average serving delivering about 40% of our daily needs. What makes snapper’s protein particularly attractive is that, unlike, say, a comparable serving of ground beef, it’s much lower in fat, calories and sodium. What’s more, it has an admirable water footprint: snapper, 0 gallons; one hamburger, 450-600
By Anne Palumbo prevent cell damage, selenium is required for the thyroid gland to work properly and plays an important role in the health of our immune system. This flavorful fish is also a good source of omega-3s — healthy fats that have been linked to a lower risk of many life-threatening conditions. According to experts at the Cleveland Clinic, omega-3s have been shown to increase levels of good cholesterol and reduce blood clots, blood pressure, and inflammation. While all fish, including snapper, contain some cholesterol, they can still be part of a heart-healthy diet. The good news is, it’s the saturated fat in food that raises blood cholesterol levels, not so much the dietary cholesterol, and snapper is super low in saturated fat. It’s also relatively low in cholesterol: an average serving of snapper, 37 mg of cholesterol; an average serving of shrimp, 190 mg. As for its mercury levels, snapper is a “good choice” to eat once a week, according to the FDA. This advice is particularly helpful for women who are pregnant, breastfeeding mothers, and young children.
Grilled Red Snapper with Black Beans
gallons. We need protein to build and repair tissues, regulate hormones and increase feelings of fullness. Snapper is a vitamin B12 superstar. This high-priority vitamin helps to produce red blood cells and DNA, keep nerves healthy, promote bone health and synthesize serotonin — the “happiness” chemical. Many studies support that vitamin B12 may boost energy, slow mental decline and improve moods. Since many older people suffer from a B12 deficiency — whether through diet or poor absorption — it’s good to know that seafood is a great source of this essential B vitamin. Another nutritious hook? An average serving of snapper contains 50% of our daily needs for selenium. A powerful antioxidant that helps
Serves 4
1 teaspoon olive oil 2 red snapper fillets (halved) 1 teaspoon paprika 1/4 teaspoon cayenne (optional) 1 teaspoon salt 1/2 teaspoon garlic powder 1 teaspoon dried thyme 1 teaspoon dried oregano 1/2 teaspoon coarse black pepper 15 oz. can black beans, rinsed and drained 3 tablespoons chopped red onion 1 garlic clove, minced 1 tablespoon olive oil 2 teaspoons red wine vinegar 1 teaspoon Dijon mustard 1/2 teaspoon salt 1/4 teaspoon coarse black pepper
MVHS resumes elective surgeries By David L. Podos
T
he Mohawk Valley Health System recently resumed elective surgeries and procedures at the St. Elizabeth and St. Luke’s campuses in Utica. And in keeping patient safety at the forefront, MVHS created a “Safe Path to Surgery” which is a special “path” out-patients take when coming in for elective surgeries and procedures. As the statewide numbers of hospitalized COVID-19 patients continue to decline, New York state has permitted hospitals that have the capacity and resources to resume elective procedures in regions without significant risk of a COVID-19 surge. Anesthesiologist Melany Rookstool of Sunset Anesthesia Associates on the Faxton Campus and Dr. Kent Hall, chief physician executive for MVHS, expressed some real concerns about people in need of elective surgeries during a recent press conference. “People might be feeling fearful coming to the hospital, even now Page 14
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since we have opened up for elective surgeries,” she said. “What we are seeing at times is what was originally an elective procedure now becomes an emergency situation.” Patients have been delaying surgeries out of fear of contracting COVID-19 in a hospital setting. “We want to ensure people that we can keep them safe. They should come to the hospital and get the treatment and procedures they need,” Rookstool Hall said. Another concern for Rookstool was the lockdown restriction prohibiting visitors and family members into the hospital and how that would impact patients. “Even though we restrict visitors and family members at this time to be with their loved ones, we have been very thoughtful about that situation, helping all our patients navigate the system from beginning to
end,” she said. “We have our patients immediately escorted as soon as they enter into the hospital. If they have any questions, we are there to answer them so they feel supported. We have safety officers assisting our patients through their elective surgery stay, so no patient is ever really alone.” Hall also mentioned the safety factor as well. “We created a safe path to surgery with a team consisting of a number of medical doctors and nurses from MVHS,” he said. “I want to assure everyone that we are taking steps to make our patients safe as we start to do non-essential surgeries again.” “As everyone knows, COVID-19 continues to exist not only here but all over the world,” Hall said. “So, we put together a governance group that consists of physicians from different specialties including anesthesiology, surgery, nursing and infectious disease specialists to make sure we did this the safe way.” Caitlin McCann, vice president of marketing and communications for MVHS, said the global pandemic has disrupted numerous businesses as
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020
Helpful tips
Snapper fillets are readily available fresh and frozen. Fresh fish should be cooked the day it is purchased; however, it will keep for two days in the refrigerator if properly wrapped. Although it’s best to eat snapper the day it’s prepared, any leftovers will last three to four days in the refrigerator. Using a “grill pan” facilitates cooking snapper on the grill. Lightly coat both sides of snapper with olive oil. Mix together the paprika, cayenne, salt, garlic powder, thyme, oregano and black pepper. Sprinkle over each side of the red snapper. Set aside. Before grilling, coat your grates with a high-heat cooking oil, such as canola oil (spray or a paper towel coated with oil will work). Do the same if using a grill pan. Preheat the grill to high heat for 10-15 minutes. While grill is preheating, combine the beans, onion, garlic, olive oil, vinegar, mustard, salt and pepper in a medium saucepan. Cook, uncovered, over low heat for 10 minutes, stirring occasionally. Remove from heat and cover. Grill the snapper about 5 to 6 minutes on each side or until the fish reaches an internal temperature of 145 F. Serve topped with black bean mixture. (No grill? Heat 2 tablespoons canola oil in a large skillet over medium-high heat. Place snapper fillets in skillet and cook about 5 minutes on each side.)
Anne Palumbo is a lifestyle colum-
nist, 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.
well as delayed new business projects in many areas. However, the new MVHS hospital being built in downtown Utica has continued on schedule.
Unified effort
Over the past few weeks, multiple departments within MVHS have been working to put together a plan to safely resume elective surgeries and procedures in accordance with direction from New York State Governor Andrew Cuomo and New York State Department of Health. “Having the ability to resume elective surgeries and procedures is vital for our health system as it allows us to bring staff back to work and will significantly impact our finances in a positive way,” said Darlene Stromstad, president and CEO for MVHS. “But more importantly, it also allows us to continue providing our community the services they need to maintain a good quality of life, and that’s the real reason we’re here.” MVHS’s Safe Path has extensive measures in place to ensure the safety of those coming in for elective surgeries and procedures as well as anyone who enters the facilities.
Telehealth trends high at Oneida Health amid COVID-19 pandemic
T
o help meet the needs of patients during the COVID-19 pandemic, Oneida Health has implemented telehealth at all of its primary care offices, Quick Care, and many of its specialty practices throughout Madison and Oneida counties. Telehealth gives patients an opportunity to have a face-to-face visit with their medical provider without a traditional visit to the office. Using telehealth, a provider can evaluate, develop a treatment plan, order medication, and if needed, schedule a follow-up appointment. Patients can access telehealth by clicking on a link sent to their smartphone, computer, or tablet from the comfort of their home just prior to the start of their appointment. “During this unprecedented time, it remains important for us to continue our mission to find ways to deliver care to the communities we serve,” said Gene Morreale, CEO and president at Oneida Health. “Telehealth is a convenient, secure, and user-friendly option to receive quality health care from a remote location while maintaining social distancing.” Current patients of their primary care office or specialty practices can schedule a telehealth appointment by calling the office. Individuals seeking urgent care for non-life threatening conditions can call for an on-demand telehealth visit at one of Oneida Health’s Quick Care locations. Quick Care offers telehealth
visits seven days a week during open office hours. Those who require a face-to-face visit can still come directly to the closest Quick Care location, if needed. Some common conditions that can be treated using telehealth in a primary care setting or at Quick Care include allergies, asthma, colds and flu, diarrhea, rashes, sore throats, toothaches, urinary tract infections, sinus infections and vomiting, to name a few. Telehealth services can vary by a health provider’s specialty. A gynecologist might use telehealth to provide birth control counseling. An endocrinologist may use it to discuss recent test results and follow-up. Each patient is triaged to determine if a telehealth visit is appropriate for the level of care they are seeking. “As a health care provider, it’s important for us to address barriers to care,” said Morreale. “We have seen a number of patients recently suffer unnecessarily due to putting off care due to the pandemic. We hope that by implementing telehealth, patients will be more likely to access care when they need it and when it is the most treatable. For patients who require care for life-threatening conditions, our emergency department is always open.” Oneida Health has 32 medical providers throughout its network providing telehealth with more being added each week.
FREE LIVING WELL WORKSHOPS AVAILABLE Living Well Programs will be offered weekly for 6 weeks with phone support. Each participant gets a tool kit as part of the program. We offer the following programs this way: 1.Chronic Pain Self-Management mailed toolkit with weekly phone support 2.Diabetes Self-Management mailed toolkit with weekly phone support 3.Better Choices Better Health mailed toolkit with weekly phone support 4.Smoking cessation weekly phone support with mailed toolkit/resources. 5.Zoom call/video option for all programs are also available
HealthNet is offering our Living Well programs, to register call 315-867-1552. Smoking Cessation is a 3-week program with weekly phone support. 6-week programs with weekly phone support: Living Well with Diabetes Living Well with Chronic Pain Better Health Better Choices
For more information please contact: Herkimer County HealthNet. 320 N Main St, Herkimer, NY 13350 (315) 867-1552 www.healthnetinc.org
s d i K Corner
Kids’ ER visits for mental health problems soar
C
hildren treated in America’s emergency rooms for mental health disorders jumped 60% over a recent decade, a new study finds. Between 2007 and 2016, visits for self-harm like suicidal thoughts and cutting soared 329% and treatment for drug abuse rose 159%, according to the study led by Charmaine Lo, from Nationwide Children’s Hospital in Columbus, Ohio. “This is happening in all emergency departments all across the country and in kids of all ages,” said Lo. “And regardless of whether it’s a children’s hospital or a general hospital, and whether or not they’re in an urban location or in a rural location.” Lo thinks that social media has put a lot more pressure on children. “Children, particularly teenagers, are feeling that. Also, there’s a lot more
awareness of mental health, and children know that there are resources in place for them to seek help and get help,” she said. The coronavirus pandemic is only going to make things worse, experts say. “Although this study was conducted prior to the onset of the COVID-19 pandemic, the increase in social isolation and household stressors caused by the pandemic are likely to further worsen children’s mental health” said physician Jennifer Hoffmann from the emergency medicine division at the Lurie Children’s Hospital of Chicago. A study from China showed that children affected by the COVID-19 pandemic had more symptoms of anxiety and depression, Hoffmann said.
The study researchers worry that emergency departments aren’t equipped to handle mental health problems in children, especially small hospitals in rural areas. “Preparation could be as simple as a screening training program for the nurses and doctors, because you don’t have to be a psychologist to take care of these kids, you just need to recognize whether they’re dangerous to themselves or others,” said study co-author physician Rachel Stanley, division chief of emergency medicine at Nationwide. “Those tools are currently available through various agencies, although they aren’t being used by most of the places that are taking care of these kids,” Stanley said. For the study, Lo and her colleagues analyzed data for children aged 5 to 17 from Nationwide’s emergency department databases. The researchers found that, while
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the number of children seen in the emergency rooms remained stable between 2007 and 2016, visits for mental health problems increased dramatically. Visits for alcohol problems actually fell 39%, while overall drug use visits grew substantially. This bears more investigation, the researchers said, given the opioid epidemic still raging in the United States. The types of mental health problems reviewed included adjustment and anxiety disorders; attention-deficit, conduct, and disruptive behavior disorders; impulse control and mood disorders; and psychotic disorders like schizophrenia. One in five U.S. children has a mental health disorder, according to background notes. Children with mental health disorders make up about 2% to 5% of all pediatric ER visits nationally.
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Spiritual Health Milk & Honey
By Brooke Stacia DeMott
Those good ol’ days Every COVID-19 cloud has silver lining “I wish there was a way to know you were in the good old days before you actually left them.” — Andy Bernard, “The Office”
N
ostalgia is bittersweet. I don’t think any of us fully appreciates what we have until something of our expectant normal is lost, either abruptly, or by degrees. Even with all of my relatively young children still living at home, my heart aches a bit when I see videos of them as chubby-legged toddlers and cooing infants. At the time, there were so DeMott many frustrations that came with meeting the needs of several babies that I probably wished it away more than I realized. And even as a fulltime homeschooling mother, when I
look back on those precious days, I still feel that somehow, I missed it. We rarely immerse ourselves in a moment. In fact, one of the greatest tragedies of the modern age is that we measure the value of our experiences by Instagram likes, pandering to a (largely anonymous) internet audience for validation. There’s often more effort spent in filtering and cropping our lives for praise and approval, than in soaking in those precious, fleeting moments of joy. Tragically, as we look past the frustrations of today toward the hope of a supposedly brighter tomorrow, the beauty of the present becomes blurred. Glazed eyes pass over the handful of dandelions offered up in adoration by chubby little fingers, the poems written in our honor for Mother’s Day, and the tiny ballerinas begging us to watch them dance. And often, when tomorrow finally arrives, we spend it sighing over our shoulders at those fading memories, longing for what were truly the best days of our lives. I almost wrote an article about
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endurance; about how we should power through and look forward to the day when this difficult time is a distant memory. But what if this isn’t a moment that we ought to look past? What if God has used this unforeseen crisis to reset our thinking? Now listen, you who say, today or tomorrow we will go to this or that city, spend a year there, carry on business and make money. Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes. Instead, you ought to say, “If it is the Lord’s will, we will live and do this or that” (James 4:1315). Three months ago, the economy was the strongest it has been in a decade; unemployment in America had reached record lows, and as a nation, we anticipated uninterrupted success, making our plans accordingly. And out of nowhere, the world came to a screeching halt. Enterprise was sucker-punched and sent reeling backwards, gasping for air as the wheels of commerce slowed to a standstill. The streets went silent; the calendar, America’s relentless taskmaster, was suddenly deposed.
Secular view
All of our plans have been delayed indefinitely. Unfortunately, we’ve become so conditioned to secularism that we are more apt to believe that life will resume “if COVID-19 wills it” or “if the state wills it.” We fail to recognize that both disease and governing authority fall under the control of a sovereign God who orchestrates world events by his power and for his purposes. The story of Joseph in the book of Genesis illustrates this beautifully. His jealous brothers woefully mistreated Joseph, the favorite son of his father Jacob. As a young boy, he was sold by
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020
those brothers to Ishmaelite slave traders, wrongfully accused of attempted rape by his master’s wife, thrown into prison unjustly, and forgotten about for years. Eventually, by way of his good conduct, Godly giftings and wise counsel, Joseph was elevated to second-in-command directly under the Egyptian pharaoh. This made him the second most powerful man in the entire ancient world. As such, he was able to save thousands of lives in Egypt and the surrounding areas by God’s directive to prepare for what would’ve otherwise been a crippling seven-year famine. Suffering the effects of the famine, Joseph’s brothers were forced to journey to Egypt to buy food. Unbeknownst to them, it was their own younger brother, cast aside and counted for dead, who would hold their lives in his hands. Initially, Joseph kept his identity a secret, but after wrestling down his anger by the power of forgiveness, he declared himself to his brothers. The men were understandably frightened at this revelation, aware that their powerful younger brother had both the right and means to exact terrible retribution. But Joseph, tempered by years of suffering and close fellowship with the Lord, says this: “As for you, what you intended against me for evil, God intended for good, in order to accomplish a day like this — to preserve the lives of many people” (Genesis 50:20). Every hardship is an opportunity for growth. The mind that is bound by the world system looks to that system for hope, and so when it fails, hope fails with it. But the mind — which has been freed by Christ — can see heavenly purpose in earthly tragedy. Examining the pages of history through the lens of providence, it’s clear that the Lord has always used stumbling blocks erected by Satan as stepping stones for the faithful to scale and ascend closer to God. Perhaps what powerful men or demonic principalities have intended for evil — disease, poverty, civil unrest — God is using for good, to remind us of two truths lost to modernity: That time is irrevocably precious and fleeting, and ought to be spent with purposeful intention on those whom we love the most; and that no matter who we are, our lives are at the mercy of the will of God. • Brooke Stacia DeMott is a columnist with In Good Health newspaper. Got a question for Demott? Feel free to email her at brooketo@aol.com. The beliefs and opinions expressed in this column are those of the writer and do not necessarily reflect the official policy or position of this newspaper or any other agency, organization, employer or company.
By Jim Miller
What older diabetics should know about COVID-19 Dear Savvy Senior, My husband and I are both in our late 60s and have diabetes. We would like to find out if our diabetes increases our risk of getting the coronavirus. Concerned Diabetics
Dear Concerned, Currently, there’s not enough data to show that people with diabetes are more likely to get COVID-19, the disease caused by the coronavirus, than the general population. But the problem for diabetics is, if you do happen to contract the virus, your chance of developing serious complications are much higher. This is especially true if your diabetes isn’t well-controlled. Here’s what you should know.
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Diabetic Risks Health data is showing that about 25% of people who go to the hospital with severe COVID-19 infections have diabetes. One reason is that high blood sugar weakens the immune system and makes it less able to fight off infections. Your risk of severe coronavirus infection is even higher if you also have another condition, like heart or lung disease. If you do get COVID-19, the infection could also put you at greater risk for diabetes complications like diabetic ketoacidosis (DKA), which happens when high levels of acids called ketones build up in your blood. Some people who catch the new coronavirus have a dangerous bodywide response to it, called sepsis. To treat sepsis, doctors need to manage your body’s fluid and electrolyte levels. DKA causes you to lose electrolytes, which can make sepsis harder to control.
How to Avoid COVID-19 The best way to avoid getting sick is to stay home as much as you can. If you have to go out, keep at least 6 feet away from other people. And every time you come back from the supermarket, pharmacy or another public place, wash your hands with warm water and soap for at least 20 seconds. Also wash your hands before you give yourself a finger stick or insulin shot. Clean each site first with soap and water or rubbing alcohol. To protect you, everyone in your June 2020 •
house should wash their hands often, especially before they cook for the family. Don’t share any utensils or other personal items. And if anyone in your house is sick, they should stay in their own room, as far as possible from you. The CDC also recommends that you stock up on medications and diabetes testing supplies to last for at least a month. The same goes for grocery supplies and other household necessities. Also know that Medicare is now covering the cost of telehealth visits, so if you have questions for your doctor, you can ask by video chat or phone instead of going into the office.
If You Get Sick The most common symptoms of COVID-19 are a dry cough, fever or shortness of breath. If you develop any symptoms that are concerning, call your doctor about getting tested. If you find that you have contracted COVID-19, the first level of care is to stay home and check your blood sugar more often than usual and check your ketones too. COVID-19 can reduce your appetite and cause you to eat less, which could affect your levels. You also need more fluids than usual when you’re sick, so keep water close by, and drink it often. You should also know that many over-the-counter medicines that relieve virus symptoms like fever or cough can affect your blood sugar levels one way or the other. So, before you take anything check with your doctor. And be aware that if you start experiencing severe shortness of breath, high levels of ketones or DKA symptoms like severe weakness, body aches, vomiting or belly pain, you need to see your doctor or get to an emergency room right away. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Addiction Are you an Enabler? Enabling: a dirty word, with a powerful, positive impact in the world of addiction By Ambi Daniel Addiction expert Dr. Robert Meyers is the creator of CRAFT, community reinforcement and family training. Recently in a zoom meeting about CRAFT, I began a journey into understanding the concept of addiction enabling. It serves such an important purpose and at the same time, it has become such a stigmatized dirty word. We hear loved ones being called “enablers” because they made a choice that others perceive as wrong, or because that choice may be making it easier for a person to continue their use. When I bring up the option of exploring enabling, many family members hang their head and say, “Oh yeah, that’s me. I’m an enabler.” And it breaks my heart every time. What this response tells me is that they haven’t had the opportunity to understand where enabling comes from and the purpose behind it. Meyers shared his thoughts on CRAFT in our training. He defined enabling as, “The unintentional support of a negative behavior.” And I love this. How many of us actually want to support a negative behavior? The answer is none. No parent, or loved one, who wants to help a person succeed in recovery, wants to support the negative behavior. That said, enabling is the product of something that is monumentally important; it’s only half the story. The definition of “enable” is “to make possible,” or “to provide means,” or perhaps “to provide an opportunity.” And this is a part of enabling. This is the part that many people focus on when they engage in stigmatizing shame language or feelings — the accusation that it’s your fault they continued addictive behavior. The reality is, enabling has little to do with impacting our loved one’s
recovery journey. It’s about our journey and the motivation behind it. Ready for the key to why we do it? When we unintentionally support the negative behavior of a loved one, we are receiving a benefit, an important one, at that. Actions in general are about the benefit of the person doing the act. If I buy someone a gift, my benefit is feeling good and appreciated. If I give my begging dogs treats, my benefit is the joy I feel from their excitement. If I clean for someone, I feel purpose. If I hug you, especially after this hug-free COVID-19 time, I’ll feel comfort and joy and get a boost of oxytocin. It’s about feeling good, joy, purpose, comfort, power or a thrill, such as what I gain when I beat my husband at chess or tennis. Most human beings can relate to wanting to feel these things. Many times, people don’t always have healthy ways to achieve these benefits. Now let’s look at this with some substance use issues: What is the benefit to the wife who buys the bottle of wine for the
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alcoholic? Why would a dad give his son struggling with heroin $25? Why would a mom drive her daughter to her dealer? Why would a sister give her brother keys to her car when she knows he’ll drink and use marijuana? What’s the benefit to the wife, dad, mom, and sister? These are all real types of scenarios that I’ve encountered multiple times in my career. The wives buy the wine so the husband won’t buy liquor. Wine keeps the peace and she doesn’t have to deal with even more significant drunkenness or arguments.
Containing the situation
Dad knows that if he gives his son $25, the son won’t steal and use more, or be arrested. For the dads it is about peace of mind, feeling like they made an impact to how much they use and avoiding possible legal ramifications. The moms drive their children to the dealers so they can sleep at night knowing their loved one is alive. The keys are given so another argument and blow up can be avoided. Often, this is a bad temper-driven disaster that loved ones want to avoid for their own safety and anxiety. Not to mention, they get a break. The benefit is security, peace of mind, reduction of anxiety, a break — it’s about survival for the loved ones. When we look at it this way, we are helping more than one person survive. It’s not just about a person avoiding overdose and death; it’s about the security, safety, and mental health of everyone involved, including the family. This also tells us that sometimes it’s important that loved ones continue enabling. Take a minute with that statement. They may be unintentionally supporting use or addiction, but very importantly, the reason that enabling happens is that they are actually taking steps for their own wellness, safety and health.
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020
We cannot overlook the importance of this. Our survival is important. In order to take care of the people we love, we have to be OK. On a plane, we put the oxygen mask on ourselves before we put it on the child. Next time you feel yourself thinking or calling yourself or someone else an “enabler,” I encourage you to think about what it is you or they are really trying to do. There is so much power in recognizing the motivation and benefit and also remembering, the last thing they want to do is make it easier for their loved one to use. When we start to pay homage to the motivation, we can then start the process to decide if we want to change it, and how do we meet those very important needs that drive it.
Crafting a plan
CRAFT was created by Meyers to help family members with three key goals: — Help someone reduce his or her use. — Help get a loved one to treatment or other recovery programs. — Increase wellness and decrease stress for the whole family. As loved ones, we have a unique experience and with that a unique expertise. We know them, know their “why”; we can see behaviors, actions, and their use a mile away. We can use this expertise to help move someone into his or her recovery journey. At the same time, when we’ve been fighting so hard, we also know that our wellness takes a hit and that this family journey is a delicate balance between our fight for them and our fight for our own wellness. CRAFT gives us an amazing set of tools that tackles both. If you’d like to join our CRAFT Zoom sessions at 1 p.m. on Tuesdays, reach out to me at adaniel@cflinc. org and join our Facebook group at https.//www.facebook.com/WhenTheresHelpTheresHope. Each week, we move through a different CRAFT tool with discussion, practice, healing, and most importantly community. We are not alone. This class is specifically for loved ones supporting someone in their recovery process. It is at no cost to the participant. Family support navigation services help families work on this and many other challenges related to loving someone who struggles with a substance use disorder. If you need help for your family, please call 315-733-1709 and ask for an appointment with our family support navigator. — Ambi Daniel is a family support navigator at Center for Family Life & Recovery, Inc., 502 Court St., Suite 401, Utica, New York 13502. She can be reached at 315.768.2665 or by emailing adaniel@cflrinc.org.
Health care Heroes: RNs on front lines Continued from Page 5 ing is the gratitude from the patient knowing you made a difference in their life at their weakest moments. Just overall, it’s being a part of their healing process so they can return to their daily life. Samantha Groom-Cardone South Utica Q.: Just how hectic has your work schedule been during the coronavirus outbreak? A.: I wouldn’t say my work “schedule” itself has necessarily been hectic, but my assignments at work have been hectic. I think more than anything else, the stress of the known and unknown alike with the novel coronavirus outbreak make for a hectic environment. Q.: What sort of help or assistance do you provide to patients infected with COVID-19? A.: I think the main thing I try to help or assist those patients with besides physically caring for them is to provide them some bit of peace. I think that it’s hard for these patients who are struggling to recover from this virus to be in a room alone without friends or family to comfort them or remind them that they are safe and cared about. I try to spend even a minute or two extra talking with the patients that are in isolation for suspected or positive coronavirus. They know someone is there to listen to them and be concerned for their overall well-being. Q.: What is the experience like working at the hospital during this outbreak? Is it nerve-wracking or do you remain calm? A.: I think the overall atmosphere is uneasy due to policies changing rapidly and most of us feeling as if
we’re just waiting for “the worst of it” to come. It’s frightening worrying about bringing the virus home to my family, but while at work, I generally stay pretty calm and keep a level head. Q.: How far are you willing to go to help a patient fight through the symptoms of the virus? A.: I would be willing to do anything I could within my scope of practice to assist my patients in fighting the virus and its symptoms. As nurses, that is what we chose to do when deciding our profession. Q.: How do you and the rest of your staff prepare for scenarios like this? A.: I can say the night shift on the special care unit at St. Elizabeth’s has a great group of nurses who really help each other out whenever needed. I think that we do well at being prepared because we’re always ready and willing to help each other when things get busy. Q.: What sort of challenges and tasks do you and your staff face while helping a COVID-19 patient? A.: I think one of the main challenges is suiting up in personal protective equipment, heading into the room, and realizing that you’ve forgotten something that you need. Due to the process of putting on and taking off your PPE, the time that it takes to do so, and the overall lack of PPE, no one wants to be going in and out of the patient’s room multiple times. We’re trying to remember everything that we’ll need going in and without fail, will always forget something. So then you’re calling the desk or knocking on the window from the inside of the door and waiting for someone to bring you what
you need. Another major challenge is how long it takes someone else to suit up to come into the room if you urgently need assistance from someone else. There is no such thing as “come right here” when it takes 2 to 3 minutes to put on your gown, gloves, masks, and face shield. Q.: At what point in your life did you decide on a career in the health care industry? What were your primary motivating factors and influences? A.: My primary influence in becoming a nurse was my grandfather, my papa. He was diagnosed with pancreatic cancer when I was 20 years old and was given 9 to 12 months to live with chemotherapy treatments. I was his primary, and usually sole, caregiver throughout his nine-month battle and the more time we spent in hospitals, the more he would tell me that I was meant to be a nurse. It wasn’t until I met and started dating my wife two years later that she became my main motivating factor and convinced me to apply to complete my prerequisites for nursing school. Being a nurse will always be one of my favorite things about myself, thanks to them. Q.: Why did you choose your particular location to practice in? What are the benefits of your current environment both from a personal and professional standpoint? A.: I applied to the special care unit before I graduated from St. Elizabeth College of Nursing, mostly because of my preceptor and experience on that unit during my final semester of school. I wanted to acquire a position in nursing that would challenge me and allow me to learn and grow in. I’d be lying if I said that there weren’t days
as a brand new nurse I didn’t question my decision and thought I had gotten in over my head. Looking back, I’m appreciative of the tough assignments and long nights as it helped me to grow as a nurse and as a person. Personally, the benefits of my current environment are the nurses that I get to work with on nights and the teamwork that pulls us through the worst of shifts. Q.: What do you feel are the keys to being a nurse on a highly successful level? A.: I feel the keys to being a successful nurse are to always be willing to learn and to never lose sight of the importance of your patient care and bedside manner. I try to be conscious of the things that I have yet to learn and the things that I can improve upon as a nurse. At the same time, I try to never lose sight of the reason I became a nurse and that my patients are always the priority. I think a successful nurse continues to seek educational opportunities throughout his or her career and holds on to the urge to always be better for yourself and for your patients. Q.: What kind of advice would you give a nursing student who is embarking on a career as a health care professional? A.: I think my main advice to a nursing student right now would be to stick it out. There will be days that you question your career choice, capabilities, skill level and mental sanity. Just remember, you wouldn’t have gotten through nursing school if you weren’t able to do it, so put your feet on the ground and push through. There will come a day when you’re on a shift and feel pride in how far you’ve come and all that you’ve made it through to become the nurse that you are. That makes it all worth it.
Oneida Health Rehabilitation and Extended Care remains COVID-19 free
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ecently, Oneida Health agreed to participate in a voluntary COVID-19 testing of its skilled nursing facility as part of a collaborative effort lead by Madison County and New York state health officials. The initiative was a result of growing concern related to the recent increase in the number of both COVID-19 positives and deaths occurring in skilled nursing facilities throughout the state. Oneida Health, which has a 160-bed extended care and shortterm rehabilitation center in Oneida, recently announced that its 134 residents and 207 staff members all tested negative for COVID-19. “We couldn’t be more proud of the negative testing result for our entire facility,” said Fred Scerbo, Oneida Health Rehabilitation Center and Extended Care administrator. “To have no residents or staff test positive and remain a COVID-19-free facility during the pandemic is a testament of our commitment to the safety and care of our residents.” Early in March, Oneida Health
activated a strict no visitor response plan and implemented a daily employee symptom monitoring tracking system. The tracking system allows Oneida Health to actively monitor all employees to determine their daily health status both when they arrive and when they leave. Screening includes checking an employee’s temperature twice daily and screening them for additional symptoms related to COVID-19. Any employee who has minor symptoms or an elevated temperature is asked to remain home as a safety precaution until his or her symptoms subside. “Our employees recognized from the onset the importance of being diligent about their own health and practicing social distancing in order to keep COVID-19 out of our facility,” Scerbo said. “We also have a distinct advantage by being connected to the hospital. It has allowed us to adhere to strict infection control strategies and access to protective personal equipment that stand-alone
nursing homes may have difficulty attaining once the pandemic began.” Oneida Health skilled nursing employees routinely wear facemasks, face shields and gloves. During the start of the pandemic, nursing homes were required by executive order to accept any resident even if they tested positive for COVID-19 prior to admission. To maintain a COVID-19-free environment, Oneida Health established an isolation unit on its second floor with dedicated staff to test and monitor new residents for symptoms prior to introducing them to resident areas. On May 10, the executive order was reversed and skilled nursing facilities are no longer required or permitted to accept COVID-19 positive residents. Scerbo said Oneida Health plans to continue to use the isolation unit for the indefinite future as a means of continued precaution when accepting new residents. “With the current rate of false negative testing and asymptomatic
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COVID-19-positive patients, this proactive measure will continue to provide one more layer for keeping COVID-19 from being introduced to our resident community,” Scerbo said. Other measures taken by Oneida Health during the COVID-19 pandemic which Scerbo credited to its success include adopting social distancing in their dining, activities, and transportation services as well as improved education and training for both staff and residents pertaining to infection control strategies. He also credited resident family members for their success. “Our efforts to date would not be possible without the trust and corporation we have received from our resident family members during this time,” Scerbo said. “Though this has been a challenging time for everyone involved, the sacrifices of the many has resulted in the health and safety of every one of our residents during this unprecedented time.” For more information, visit oneidahealth.org or call 315-361-2018.
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Stressing Out Experiencing high-level stress can make anxiety, depression even worse an unexpected health crisis or chronic illness can all bring on stress. — Personal relationships: Everyone is stressed at times by personal relationships, even when relationships are basically good. Couples argue, parents and children fight and occasionally conflict among friends or co-workers can create stress.
By David L. Podos
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tress. We all experience it. But is stress always a bad thing? Nature has hard-wired us to use stress in positive ways and in some situations, it can actually save our lives. For instance, if you are being threatened, your stress levels spike. This becomes a warning mechanism producing the flight-or-fight response while pumping adrenaline into the bloodstream. Usually once the perceived threat is gone, our stress levels then come back down. This is acute stress, and usually passes quite quickly. When stress becomes chronic, then it can have long-term damaging affects upon the body and mind. Amber Keefer of livestrong.com, an expert in human services and health care administration, lists some of the top circumstances that cause major stress. — Childhood trauma: Some individuals experience long-term stress as a result of a traumatic childhood where there was mental and or physical abuse by a parent. — Death of a loved one: The death of a spouse can be one of the most stressful events a person can face. Stress is compounded when a couple has a lot of debts and the remaining spouse must worry about finances on top of grieving the loss of a spouse.
Parents’ worst nightmare
— Divorce: Divorce is another leading cause of stress among men and women. In addition to dealing with a variety of stressful emotions, divorce usually means that one or both spouses must leave their home. Individuals also may be dealing with disagreements involving division of property, finances, child support and custody issues. — Finances: Finances, particularly the threat of mortgage foreclosures, are another leading cause of stress. People who live in poverty and individuals who face overwhelming debt or bankruptcy usually experience high levels of stress. — Job stress: Work-related stress is common among men and women who have demanding jobs and work long hours. — Health: Personal health issues can be stressful on both children and adults. Working to get well, worrying about medical costs or dealing with
— Chronically Ill Child: Parents who have a child with a serious health problem or injury frequently are under a great deal of stress. They worry about the recovery of their child, and may find it difficult to see their child suffering or in pain. There can be financial worries associated with a child’s illness as well. — Danger: Dangerous situations such as fires, automobile accidents or being the victim of crime can cause stress. Any hazardous event that is out of the ordinary for an individual can cause either short- or long-term physical or emotional stress. The good news is stress — even chronic stress — can be drastically reduced. Dominick Nicotera, executive director of DRN Counseling and Consulting Services, Utica, said many of his clients experience chronic stress. He touched on how stress can exacerbate an already existing mental health condition, how stress affects the body, and ways to reduce stress. “Behind most disorders, you find some kind of stress. When stress
goes up, whatever mental health disorder a person has, the level of his or her disorder also goes up,” he said. “For example, let’s say someone is dealing with depression. When their stress levels go up, their level of depression and anxiety also increases.” “When people are dealing with chronic stress, they can have higher blood pressure, a lower immune system which makes them more prone to getting sick, and an increase in headaches and migraines,” said Brooke Lewis, a licensed master of social work and mental health administrator at DRN. “They are also associated at risk for cardiovascular disease.” DRN features several modalities to help clients reduce stress. “Most doctors recommend cognitive behavioral therapy, which is one of the therapies we at DRN utilize,” says Nicotera. “This therapy interrupts the thinking process with the goal of changing one’s thinking in a more positive way. If you change your thinking, then usually behavior changes as well.” “We are trying to change one’s perception about the stressors that cause them the stress in the first place,” Lewis said. “We also use dialectical behavior therapy, which helps the client to stay more focused in the present moment. In turn, this supports them to better cope with stress and regulate emotions.”
We did it.
Twice.
Oneida Health is ranked among America’s Top 2% of Hospitals for Patient Safety & Experience
Visit oneidahealth.org/awards to learn more
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IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • June 2020