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Healthcare in a Minute By George W. Chapman
Hospitals staggering in wake of COVID-19
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hat tends to get lost in all the headline-grabbing news related to the pandemic (PPE shortages, morbidity, testing, lingering long term effects, potential vaccines, opening and closing businesses and schools, etc) is the ongoing financial crisis facing our underappreciated frontline combatants — the hospitals. Prior to the pandemic, NYS hospital bottom lines were already barely profitable, averaging a razor thin 1% to 2%. If you exclude non-operating revenue or non-patient fees like grants, donations, and interest on investments, hospitals would run in the red. A stand-alone mid-sized hospital, 200 to 300 beds, will need hundreds of millions in bailout money from the federal government. Larger hospital systems will literally need billions in recovery funding. And hospitals are nowhere near being out of the woods yet. The number of cases and deaths related to the virus continue to spike in many states (not New York) primarily due to people ignoring safety recommendations. There is a $3 trillion hospital bailout bill being proposed by the House of Representatives, but its fate is not good. There are approximately 5,000 hospitals in the U.S. and that number is sure to shrink by the time we have defeated or at least controlled COVID-19.
End-stage renal dialysis
The pandemic is already being considered a “black swan” event, or something that ends up creating significant change in the world. Past examples of black swan events would be WWI, the internet, personal computers, the breakup of the Soviet Union, and 911. COVID-19 will undoubtedly make virtual medicine a staple in the delivery of healthcare. The pandemic black swan event also signals a change in dialysis. To minimize the chance of an already compromised dialysis patient getting the virus, Medicare is enhancing payments for home dialysis machines to encourage patients to stay home for treatment. There are 750,000 people a year affected by end-stage renal disease (ESRD) and 85% of them have to trudge to a dialysis center, often hours away, for treatment four to five hours a day, three days a week. Home dialysis would be a huge improvement in the quality of their lives. ESRD patients are 1% of the Medicare population, but 7% of Medicare expenses. ESRD creates all kinds of other medical problems other than dialysis. 100,000 people are on the kidney transplant list every year, but there are typically only 21,000 kidneys available. The need for donor kid-
neys is increasing 8% a year.
Harbinger of health care
If you want a reliable clue as to where we are headed, follow the money. Digital healthcare startups raised a record $5.4 billion in just the first half of this year, far exceeding amounts raised in the first half of any year since 2011. While the pandemic is driving this, one can clearly see where we are headed shortly and well beyond the end of the pandemic. “On demand” services, (just like streaming entertainment on TV), and digital remote monitoring of chronic diseases like hypertension, diabetes, cardiac arrhythmia, etc. lead the way with the lion’s share of investment. Digital behavioral health startups raised almost $600 million the first half of this year as the virus has created a significant increase in depression, anxiety and abuse. ACA and birth control While the future of the entire Affordable Care Act is expected to hit the Supreme Court sometime next year, the court recently ruled that any employer, not just churches, can qualify for the birth control exemption based on religious or moral convictions.
The removal of birth control coverage from an employee’s benefit package will have minimal if any impact on premiums. Interestingly, the Supreme Court vote was by gender with the three dissenters being the three female justices: Bader Ginsberg, Kagan and Sotomayor.
Opioid epidemic?
It’s back, but buried in the avalanche of COVID-19 pandemic news. Opioid-related deaths are spiking again in 30 states. Opioid-caused deaths are up almost 17%. The increase in drug abuse is most likely related to the stress and anxiety created by the pandemic. “Verily” is the science arm of Google parent company Alphabet. They are opening digital treatment and learning centers called OneFifteen to combat the crisis that just won’t go away. The curious name is derived from the fact that an average of 115 people died every day of an opioid overdose in 2017.
‘Retailization’ of health care
Walmart is getting into healthcare insurance. Yes, Walmart. Walmart Insurance Services will start selling Medicare plans this August in the Dallas-Fort Worth area market.
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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.
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The Balanced Body
By Deb Dittner
Granting immunity Take a look at integrative approach to building healthy immune system
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ntegrative medicine combines conventional Western medicine with complementary and alternative therapies. Some modalities used in integrative medicine include but are not limited to nutritional supplementation, lifestyle changes, mindbody medicine, and traditions such as acupuncture, massage, and traditional Chinese medicine (TCM). Functional Dittner medicine can also be included here as it searches for the “root cause” of presenting symptoms. Integrative approaches are used in an individual way. Let’s explore the variety of ways in which you can encourage a healthy immune system. — Self-care builds a healthy immune system as the body recovers from daily physical, emotional, mental and cultural stressors. Developing a daily self-care regimen just for you is important to build resilience. So, what do you like to do just for you? Reading a book or magazine, having a cup of tea, sitting on the beach watching the waves move in are just examples of what you can do for you. Physical movement and exercise have many benefits including improved mood, thus decreased anxiety, depression and panic. All activities count with your daily progress causing decreased physical stress on the body. If you’re just starting out, incorporate moderate movement if possible for 30 minutes or more. The most important step is the first step and you should continue to build upon that one day at a time. Movement also helps lubricate the joints and can reduce mortali-
ty by approximately five years. Of course, there are exceptions to the rule. Some activities can be exhaustive and may actually decrease immunity. Overtraining — stressful exercise that you fail to recover from before exercising again — will increase both your stress load and autoimmune symptoms. — Be one with nature. Get outside and enjoy the warm sunlight against your face. This is especially helpful in winter when seasonal affective disorder (SAD) may be a concern. Full spectrum sunlight will increase your mood and provide much needed Vitamin D that increases immunity. Grow a garden and get your hands dirty. Gardening can also be utilized as self-care in decreasing stress and physical movement is realized with all of the bending and stretching. And the dirt also promotes a healthy immune response. — Restorative sleep consisting of 7 o 9 hours nightly. Sleep improves all levels of your immune function,
reducing stress, the risk of infection, and improving outcomes when infection does occur. Develop a nighttime routine starting approximately one hour before turning in to bed. Eliminate all technology (TV, iPhone, iPad), have a soothing cup of tea, read a book, take an Epsom salt (full of magnesium) bath with added therapeutic grade essential oils, or possibly restorative yoga.
Time to relax
— Rest and relaxation support your immune function and the body’s ability to heal, while also decreasing blood pressure, heart rate, respiratory rate and providing an overall feeling of wellbeing. Sitting in quiet, sipping a cup of tea or using acupressure techniques are all good sources of relaxation. — Hydration and nutrition improve immune function and creates a healthy gut. Eating a diet of whole nutrient-dense foods in a rainbow of colors and drinking pure filtered water and herbal teas provide a healthy detoxification.
— Botanicals and nutraceuticals should be kept simple and chosen wisely. There are many respected resources with published guidelines such as the Institute of Functional Medicine, Hippocrates Institute, Andrew Weil Center for Integrative Medicine, and Dr. Mark Hyman’s UltraWellness Center. • Vitamin D3, also known as the “sunshine vitamin,” is needed for optimal immune function. A blood test, 25-OH Vitamin D, will determine your level and supplementation needs. Vitamin D is usually low at the end of winter, and in elderly and those with dark skin. • Vitamin C lowers your risk of respiratory and systemic infection, supporting immunity. Low levels are typically found in the elderly and diabetics. Kiwi is a fantastic source of Vitamin C as are citrus fruits, kale and broccoli. • Zinc is a mineral supporting healthy mucosa and immune function. Zinc may prevent viral entry into cells and may shorten the duration of colds when taken within 24 hours of initial symptoms. Low levels may be found in the elderly and vegetarians. Foods rich in zinc are oysters, beef and pumpkin seeds. • Selenium is a supportive nutrient for the immune system and can be found in beef, oysters, sunflower seeds and Brazil nuts. By incorporating an integrative approach into your daily lifestyle, you will be boosting your immune function and become resilient not only to live a better and longer life, but creating balance in the body. • 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.
Non-COVID-19 deaths rise during pandemic
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ore people in the United States are dying during the COVID-19 pandemic, but not just because of the coronavirus. One reason, experts say, is people with other ailments may not be seeking help. That conclusion is emerging from new research showing deaths are increasing from causes such as heart disease, stroke and diabetes — while emergency room visits for those conditions are down. “One factor that could be contributing to the increase is that people are afraid to come in for care,” said physician Steven Woolf, professor of family medicine and population health at Virginia Commonwealth University in Richmond. “We need to assure them that the danger of not getting care is greater than the danger of getting exposed to the virus.” Woolf led a study published July Page 4
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1 in JAMA that examined the number of deaths reported in the U.S. in March and April, when the pandemic began to take hold, compared with preceding years. The nationwide data showed there were 87,000 “excess deaths” — that is, more than would have been expected during the two-month period — but only two-thirds of the total were attributed to COVID-19. In 14 states, more than half of the excess deaths were from causes other than COVID-19. Moreover, the JAMA study found huge increases in excess deaths from underlying causes such as diabetes, heart disease and Alzheimer’s disease in Massachusetts, Michigan, New Jersey, New York and Pennsylvania — the five states with the most COVID-19 deaths in March and April. New York City experienced the
biggest jumps, including a 398% rise in heart disease deaths and a 356% increase in diabetes deaths. Other research underscores the findings. A new study published in JAMA Internal Medicine analyzed data from March through May and calculated that 22% of excess deaths were not attributed to COVID-19. Although data is still being gathered, “Upward trends in other causes of death (e.g., suicide, drug overdose, heart disease) may contribute to excess deaths in some jurisdictions,” the Centers for Disease Control and Prevention said. Woolf said he is certain those trends are continuing, and offered two explanations. The first is that COVID-19 did contribute to many of the deaths even though it was not listed on death certificates and people may not have been tested for
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
the virus. “We now know that the virus is not just a respiratory problem,” he said. “It causes other physical responses, such as damaging the immune system, blood clotting and arrhythmias. It’s possible some of these spikes (in excess deaths) were caused by COVID-19 and the doctors didn’t realize it.” The other factor, Woolf said, is some people may be avoiding or delaying treatment for medical conditions, as well as mental health or addiction problems. The CDC reported in late June that in the 10 weeks after the pandemic was declared a national emergency on March 13, hospital emergency department visits declined by 23% for heart attacks, 20% for strokes and 10% for uncontrolled high blood sugar in people with diabetes.
Kids’ Health
s d i K Corner
Does having a dog make for well-adjusted kids?
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f you’ve hesitated to get a dog because your kids are very young, new research suggests that the preschool years might be a good time to add a furry friend to the family. The study found that preschoolers with dogs at home had fewer problems with their peers or other behavior problems compared to youngsters without a family dog. “Young children who walked or played with their family dog were more likely to have pro-social behaviors, such as sharing and cooperating,” said study senior author Hayley Christian. She’s an associate professor and senior research fellow at the University of Western Australia and Telethon Kids Institute.
Christian added that past research has shown that pets may be helpful for children’s self-esteem, autonomy, empathy, trust and confidence. “For many children, pets are a source of unconditional love and loyalty. They can be social enablers and help teach children about responsibility through caring, training and looking after their pet,” she said. The Australian study used data from a survey of more than 1,600 families with children aged 2 to 5. Many — 42% — of the families had dogs. The surveys were done between 2015 and 2018. The findings were published July 5 in Pediatric Research journal.
Compared to children who didn’t have dogs at home, the researchers found that those with a family pooch were: • 23% less likely to have problems with emotions and social interactions, • 34% more likely to practice kind behaviors like sharing, • 30% less apt to engage in antisocial behaviors, • 40% less likely to have issues interacting with other kids.
Emotional support
Youngsters who went on dog walks with their family at least once a
week were about one-third less likely to have poor social and emotional development than those who didn’t go on at least one weekly walk. Kids who played with their dog three or more times a week upped their odds of regularly engaging in considerate behaviors by 74% versus youngsters who played with their dog fewer than three times each week. Christian noted that although the researchers considered factors in their analysis such as children’s age, sex, sleep habits, screen time and parents’ education levels, the study couldn’t prove a definitive causeand-effect relationship. Psychologist Lori Kogan, a professor of clinical science at the College of Veterinary Medicine and Biomedical Sciences at Colorado State University, said the findings are exciting. “I’m an advocate for research on the positive benefits of people and animals working together. And here it looks like in families that have a dog, their young children may benefit in many ways from having and walking with the dog,” she said. Christian said that in school-age children, having any pet helps prevent social and behavioral problems. But, she wasn’t aware of any research with cats and preschool-age children. She noted that the social and behavioral benefits seen in the latest study appeared to stem from playing and walking with dogs, which could be hard to duplicate with a cat.
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Kids’ Health In distress Show support for children through stressful times By Barbara Pierce
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hese times are stressful for us all. Our kids have a front row seat to our current struggles, experiencing the trickle-down effect of the stress we’re going through thanks to COVID-19. They feel the undercurrent of anxiety that is in most homes much of the time. It impacts them too. Being out of school, they no longer have the structure that comes from going to school every day. They aren’t able to be with their friends and get the support that comes from friends. They’re feeling worry, anxiety and fear — the same fears that we have, like a fear of dying and a fear of people close to them dying, or perhaps economic survival. Children show stress through changes in their behavior. A child may become clingy, easily frustrated, angry or irritable, cry, even pull away from you, or pull away from things they used to like doing. Changes in sleep patterns, or eating, headaches or other aches all could be signs of stress. It helps to remember that you are not causing this behavior; it is your child trying to deal with something that makes him scared and anxious. Janine Phillips, support group coordinator for the YWCA of the Mohawk Valley in Utica, offers parents these suggestions to help support their children through these difficult times: — Maintain structure-routine: “Structure gives your children something to hold onto in this stressful time,” Phillips said. “You don’t have to run a boot camp, but you do need some structure.” “I raised two children, so I know how important this is,” she added. Keep your routines for morning, mealtimes, and bedtime consistent. This gives kids a sense of consistency, normalcy, and it helps you too.
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— Communicate: “Talk about what’s going on in a way that’s age appropriate, and in a language that’s not over their heads. Wait until they ask, then answer their questions honestly. Don’t give them more information than they’ve asked for,” she suggested. Some children will want to talk about difficult things and some won’t. Encourage them to share their thoughts and questions and listen to them. It’s all right if you don’t know the answer to every question. Work together to find the answer. — Monitor TV and the Internet: TV and social media cover news in depth, and often include scenes that are inappropriate for children to view. “For younger kids, have conversations without the sensationalism of the news,” advised Phillips. “With your older kids, watch the news with them and start a conversation about it.”
Going virtual
— Keep in contact with extended family and friends: “Use Zoom or FaceTime with grandparents, cousins, aunts and uncles; arrange for them to have face time with their friends,” she suggested. Also, arrange virtual play dates. “Don’t forget notes, cards and letters to grandparents. It gives your kids something productive to do, and people love getting something besides bills in the mail,” she said. — Do fun things together: “Laugh together, play games together; do something positive, something fun. My kids and I drum; we play music and dance together,” Phillips noted. “Be active with your kids, especially now.” “Instead of your kids playing video games all the time, give them more to do. Give them ‘homework,’ learning work. Give them time for games and down time to read. Go outside with your kids, walk to the
park, to the river, get outside, even if it’s just in your back yard,” she said. “Talk with them about their life. If they like to play video games, watch them play, then ask about what they’re doing. Learn what they play and what they’re doing,” Phillips added. — Watch your language: “Don’t let them hear you talking on the phone or complaining to your friends. If they hear you saying: ‘I’m here stuck in the house all day with these kids!’ they’ll think you don’t love them, and they are a burden to you,” she said. “We can provide a sense of normalcy by the way we handle this traumatic time. If we’re freaking out, they’re upset. Kids will feed off the emotions we have,” Phillips said. — Encourage hope: “Give them a
sense that everything will be OK. Let them know that we live here in an area with fewer people. We’re seen rising death rates, but we’re fortunate to live in a place where we don’t have lots of people,” she said. “We are relatively safe as long as we wear our masks when we go out, keep apart from other people, wash our hands frequently, and don’t go places where others aren’t wearing masks.” For more from Phillips, see her blog “Staying safe when quarantined” at https://www.ywcamv.org. YWCA Mohawk Valley is a certified provider of domestic and sexual violence crisis services, offering a 24hour hotline, individual and group counseling, safe housing, and more. Services are confidential and free. See https://www.ywcamv.org or call 315-797-7740 in Oneida County, 315-866-4120 in Herkimer County.
The Long-Term Harm of Missing School
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issing lots of school between kindergarten and eighth grade may have consequences when kids grow up, a new study suggests. When they reached their early 20s, frequent absentees were less likely to vote and more likely to have economic problems and poor educational outcomes, researchers found. The results suggest early school absenteeism should be taken seriously. “There’s this misconception, especially among parents, that it doesn’t matter as much if kids miss school early on — that it only becomes important when they get to middle or high school,” said lead author Arya Ansari, an assistant professor of human sciences at Ohio State University. “This study shows that those early absences do matter, and in ways that many people don’t consider.” Ansari’s team reviewed government data on nearly 650 students from 10 U.S. cities who were followed from birth through young adulthood. The review found that school
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
absenteeism had no effect on criminal, risky or deviant behavior, but it did have associations with political engagement and educational and economic success. While the research did not prove a cause-and-effect link, students who were often absent from school were nearly 5 percentage points less likely to have voted in 2012. The absentees also reported having trouble paying bills and were more likely to use government assistance, such as food stamps. They had lower high school grade averages, were less likely to go to college and were less likely to have a job. Not showing up for school may set a bad precedent. “If you start out being disengaged with school, you may end up being less engaged with society more broadly. You’re less likely to vote, less likely to go to college, less likely to be employed,” Ansari said in an Ohio State news release. “We believe disengagement may be one of the key mechanisms linking early school absences to poorer outcomes in early adulthood.”
Kids’ Health Baby Talk Helping your infant learn to talk By Barbara Pierce
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s parents, we want our babies to learn to speak as soon as possible. After months of listening to them babble, it’s exciting when they finally say their first word. Talking to your baby from birth not only helps him or her learn to speak earlier, but you’ll have a more intelligent child. Talkative parents raise brainy kids, researchers say. A child’s capacity to speak and understand words is like any other skill — the more practice he or she gets hearing words and making connections to their meanings, the more they will be able to say and the more they will understand. Experts believe that talking with your baby is one of the best ways to give the child a head start in life. Babies in talkative families had higher IQs at age 3. Suggestions for you: — Start early: Talking to a newborn might seem pointless, but a baby’s ears and the part of the brain that responds to sound are well developed by birth. Talking as much as possible to your baby is the best way to develop his or her language. They are absorbing a lot more than you realize. Babies are highly receptive and can read your emotions and understand what you’re trying to explain. Use a combination of words, facial expressions, and actions to communicate with your baby, as they learn by hearing your words and observing your actions. For example, when you’re ready to feed him, ask, “Are you ready for your dinner?” They will begin to understand what this means at around 9 months. — Be responsive. Show enthusiasm. Your baby interprets your tone of voice, so make it encouraging. Respond in an upbeat tone to whatever noises they make. If they are crying, ask “What’s wrong? Are you hungry?” “Diaper needs changing?” If they are looking around or trying to grab something, respond by asking, “Do you want your car?” or “Are you looking at your brother? That’s your brother, Steven.” Exclaim when your baby does something. Say, “Wow, what a big smile! That makes my day!” — Be upbeat: Keep your tone warm and happy. He might not understand the words, but he will pick up on the sentiment. Make your
tone cheerful no matter what you’re saying. It’s OK to say, “Oh, darn! I spilled the milk!” as long as you say it in an upbeat tone. — Smile when you talk to your baby. Your actions are as important as your words. Reinforce your words with your face. A smile is especially important.
found that babies didn’t develop speech when they watched DVDs geared to infants. Why? It’s because the back-and-forth of social interaction is essential to speech development. A TV character doesn’t react to your baby, but when you smile and reply to your little one’s babbles, he
or she knows they did something right and are encouraged to do it again. There are mountains of data to show that the more human conversations a baby has, the further his or her language develops and the brighter they will become.
Sing to your child
— Sing to your baby. Singing is a great way to teach him words. Rhyming songs are good. Songs that use words with motion are great, like “Wheels on the Bus.” — Listen to your baby. Babies can tell when you are paying attention to them. Show that you are listening. Make eye contact and smile when they babble. — Share a book. In the early months, reading isn’t about the plot so much as the experience. As you cuddle, talk about the pictures any way you like —you don’t have to stick to the storyline. “Reading to your child has so many positive effects,” said Amanda Stewart, youth services director, Utica Public Library. “Not only does reading help your child learn about topics and about language, it also inspires their imaginations and creates bonds with caregivers.” “Reading to your child allows them to explore a larger world of people and ideas. Books are a gateway to start conversations, even for babies and toddlers. The impact of reading to your child will last their entire lives,” she added. “Books for Babies” is an ongoing project of the library. Newborns receive a free book at the hospital. Oneida County and Oneida Nation provide funding. Books are distributed to parents of newborns at St Luke’s in Utica and Rome Memorial Hospital in coordination with MidYork Library System. “We have many books that are appropriate for reading to babies — there are so many great ones to choose from,” added Stewart. “Whatever you choose, make sure it’s a book the baby can explore. Board books are wonderful because babies can handle the book themselves and it’s difficult to hurt the book. Even if it ends up in the baby’s mouth, it’s easy to clean.” Also, touch-and-feel books are great for babies 6 months and under; picture books with no words at all free you to make up your own stories. — Don’t flip on the TV: TV may actually be harmful. Researchers
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Kids’ Health Chart your child’s learning progress Recognizing early challenges, intervening appropriately will prove beneficial By Barbara Pierce
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Ever since my son was little, he had a speech problem, and I was the only one who understood what he said. But when I asked his doctor or other people, they told me that it wasn’t unusual, that boys speak later than girls,” said Octavina online. “But my feelings told me something was wrong. I was right.” Another mother said: “My daughter mixed up sounds. She had difficulty learning her colors and how to tie her shoelaces. We had concerns in preschool but were repeatedly told not to worry. It wasn’t until third grade that we had a definitive diagnosis.” Unfortunately, early signs like these aren’t always seen for what they are: symptoms of a larger issue. For many parents, the full diagnosis didn’t come until grade school. The road from when parents first notice a telltale clue to when their child is diagnosed often spans years. Parents and experts all agree that early intervention is imperative and the first step begins with a parent noticing something is wrong. Many children have difficulty with learning at some point, but those with a disability often have several signs that can start in preschool years. Recognizing them as soon as possible allows a child to get needed help and make better progress. Each child develops at his or her own pace and the range of normal is quite wide. Children don’t learn skills at the same pace — some babies walk as young as nine months, while others don’t take their first steps until 15 months. Both are normal. However, it’s helpful to be aware of red flags for potential issues. If your child experiences delays, early treatment is the best way to help him or her catch up or make progress. Some of the most common symptoms that predict future problems in young children may include: • Speech and language
skills: The ability to use and understand language. For babies, this includes cooing and babbling. In older children, it includes understanding what is said and using words correctly in ways others can understand. Speech delays in toddlers are common. An infant should respond to his or her name, point and wave goodbye by 12 months. As a toddler, he should be able to explain what he wants and follow directions. In addition to indicating a possible disability, other problems that may cause language and speech delays are exposure to more than one language, hearing loss, abuse or neglect. • Social and emotional skills: This is the ability to relate to other people, including being able to express and control emotions. In babies, it means smiling at others and making sounds to communicate. In
preschoolers, it means being able to ask for help, show and express feelings, and play with others. If a child does not make eye contact, does not smile when smiled at, and tunes people out, this could indicate a disability.
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Watch for signs
• Movement and motor skills: Rolling over, sitting up, crawling, and walking much later than developmentally appropriate could indicate problems. Poor coordination and poor ability to use fine motor skills could indicate problems, i.e. an infant who has difficulty grasping objects, or an older child who has difficulty holding utensils, coloring or climbing stairs. The timetable for skills to emerge is called developmental milestones that can be found online. • Cognitive (or thinking) skills: This is the ability to think, learn and
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
solve problems. In babies, it is curiosity. In older children, it includes learning to count, naming colors, learning new words and remembering things. Many parents are concerned that their child’s delays are somehow their fault, but circumstances beyond their control are usually the cause. There is no one cause of delays. Delays may occur because of a genetic defect, such as Down syndrome; premature birth or complications at birth; other medical conditions such as ear infections, vision problems and illness; and fetal alcohol syndrome caused by drinking during pregnancy. Often no cause can be found. Though it’s heart breaking to acknowledge that your child has problems and scary to go for an evaluation, it’s helpful to get a better sense of what may be going on. Developing a plan for your child starts with a profession evaluation, which will guide the types of services and supports that can help your child. If there’s an underlying medical reason causing the delay, identification and treatment of that may improve your child’s outcome. Early intervention, directed to the cause of the delay, is often effective to help kids catch up. “If you think your child is developing slowly, early intervention can help,” said a spokesperson for the early intervention program of the Oneida County Health Department. “Early intervention services for infants and young children who are delayed in one or more areas are critical for the child’s development,” she said. There is no cost to parents for these services. See https://www.ocgov.net// oneida/health/programservices for more information. If you are concerned about your child’s development, call 315-7985249 (Oneida County), 315-867-1430 (Herkimer County) and 315-366-2361 (Madison County).
Kids’ Health Money Matters Parents and guardians: It is worthwhile to teach kids about money By Barbara Pierce
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No one is teaching our kids how to manage money. Managing money is something important that they need to learn. Please help our kids.” This is what Craig Brown heard when he asked parents what their children needed. Like Randi Mazzella, online: “When my oldest daughter graduated from college, I was amazed to discover that, though her education helped her secure a prestigious job, she had no clue how to budget, do her taxes, or invest. Her experience is not uncommon.” Brown, 4-H youth development resource educator for Cornell Cooperative Extension, Madison County, found parents agreed that learning money management basics is important for their kids to learn. As a result, he planned a budgeting course for 4-H members in Madison County. Unfortunately, due to quarantine, this is postponed. 4-H does offer other opportunities for participants to learn about money and the value of being accountable. Raising kids with a healthy, positive view of money management, prepared for the real world, involves teaching them a variety of aspects from budgeting to planning, earning and saving. This is a vital life skill and it is never too early to teach kids. This can start at an early age — teaching delayed gratification while shopping by not caving and buying an action figure at the checkout. It can also occur later on, such as
helping a college-bound student establish a budget for books, entertainment expenses, etc. Here are some suggestions on how to get started: — Elementary school: Young children are often enthusiastic about earning money. Encourage them to have a project, like a lemonade stand, from buying the ingredients to counting the earnings. Help them understand what they spent versus their profit. Don’t micromanage; let them make mistakes and learn from their mistakes. Also, help them earn cash by paying for chores outside their normal routine, like washing the car and mowing the grass. Today’s parents have an extra hurdle. Thanks to conveniences like debit cards and automatic bill pay, money can be invisible to kids. There are a few simple ways to demystify money, like using cash as much as possible to help them grasp the real value of a dollar. Have your child set a goal like saving up for a souvenir on that trip to Walt Disney World or that necklace or video game he or she especially wants. Let them see their money grow by using a clear jar. Money from gifts and those extra chores should go in as well. After the goal is met, deposit the remaining money into a savings account. Head to an actual bank rather than online.
Money talks
— Middle School: Talk about fi-
Too Much Sitting Increases Risk of Cancer Death: Study
Kids are used to parents paying for everything; it’s eye-opening when they see how much things really cost. When your child wants a big-ticket item, like as an upgraded phone, use this opportunity to teach how to research prices and determine how long it will take to save enough money to buy it. — College: Your college student ought to understand a few budget basics before college. Sit down and map out daily, weekly, and monthly costs with them. Debit cards eliminate trips to the ATM, but kids can easily run through the money (Uber rides, pizza) without a tally. Free budgeting apps like Mint can also help your student stay on top of spending. A chat about how to build credit is key, too. Young adults should understand the consequences of using credit poorly, but they also need to know that credit can be good. Talk about how credit helped you buy a car or house but emphasize that credit comes with a huge responsibility. Give an example of someone who used credit poorly. There are few gifts you can give your children that are as valuable as sound money management skills.
Specialists in Integrative Oncology, General Integrative Health & Wellness, Acute Tick Bites & Treatment of Lyme Disease.
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itting too much could increase your risk of dying from cancer, a new study warns. It included about 8,000 people without cancer whose physical activity over seven days was assessed using a tracking device. They were then followed for five years, according to reports. During that follow-up, the least active people had an 82% higher risk of dying from cancer than those with the highest levels of physical activity, according to the study in the journal JAMA Oncology. “This is the first study that definitively shows a strong association between not moving and cancer death,” said lead author physician Susan Gilchrist, associate professor of clinical cancer prevention, MD An-
nance, frequently. This shouldn’t be a taboo subject. Let your kids in on the family’s financial goals — like saving for college, retirement, vacations — and challenges, such as credit card debt or medical bills. It can be a family project to work together toward a goal and see progress. For example, if the family agrees to save for a vacation, the parents might save to pay for the hotel and transportation; the kids save for special activities, like zip lining or souvenirs — High school: If your teen’s schedule allows it, encourage him or her to get a job, ideally a summer job. This will provide spending money and real-world experience. Set a good money management example. Let your children see bills that come in and you paying them. If you review bills together, they can learn a lot. They can see how utility bills fluctuate, depending on the season. Also, seeing the cable, Internet, or phone bill can help them appreciate how much things cost. Take them along to the supermarket and have them help you examine choices and make decisions. Teach them to be price conscious.
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IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper
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Meet
Your Doctor
By Chris Motola
Eunice S. Wang Roswell Park physician in charge of chemotherapy infusion, leukemia services, says certain cancer populations do much worse once they’ve contracted COVID-19
Mask up! Don’t let your guard down
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ven as the United States reopens, it’s crucial that people wear face masks when they can’t maintain proper social distancing, experts emphasize. “While it’s tempting to view [things] as being back to normal, that’s simply not the case,” said Patrick Gavigan, a pediatric infectious disease physician at Penn State Children’s Hospital. “The virus is still out there. We still have cases every day,” he said in a Penn State Health news release. In fact, 36 U.S. states were seeing increases in COVID-19 infections as of mid July, with Texas, Arizona and Florida posting record-breaking case counts in recent days. Much of that increase is being fueled by younger people testing positive for COVID-19, experts note. Wearing a face mask, social distancing and hand-washing are essential defenses against transmission of the coronavirus, the U.S. Centers for Disease Control and Prevention says. Face masks or other face coverings are especially important because research shows that people become contagious before they start having symptoms or feeling ill. And some people who test positive never have symptoms. Face masks should be worn by anyone 2 years and older whenever and wherever social distancing measures are not possible, the CDC advises. “It’s easy to get mask fatigue and fatigue from all of the COVID-19 restrictions,” Gavigan said.
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Q: What does infusion mean in an oncological sense, and under what conditions would you be getting one? A: My role at Roswell Park is chief of the clinical leukemia service. I’m also medical director of the chemotherapy infusion center. So my clinical practice is focused on patients with acute leukemia. Leukemia is a blood cancer. Blood cancers are usually acute, very aggressive or chronic. My focus is more on treating patients with the aggressive types. Patients who come into my clinic will oftentimes have blood work or a bone marrow biopsy. Acute leukemias are very fast-growing tumors, so patients usually need to initiate their chemotherapy within a few hours or days of getting a diagnosis. My clinical practice intersects with my administrative role. Our infusion services consist of our downtown location at Roswell Park as well as our satellite center in Amherst. Our main site sees up to 150 patients a day to receive any type of infusion, transfusion or chemotherapy treatment. Q: How long does a session take? A: It can vary. The infusion center does everything from blood count checks to growth factor shots, all the way to long-term antibody infusions, which can last upward of eight hours. One of our challenges is scheduling everything so that the person coming in for a shot in the arm can get in and out quickly, and the person getting an antibody infusion can get the appropriate attention during that time, and monitoring for possible reactions or side effects.
A: We have an extensive screening process. Very early on, we took a large number of measures to secure the safety of our employees and patients. We have procedures in place to screen employees as well as patients when they enter our facility. They have a temperature check, a mask, they get questions asked, such as about the travel advisory. In the chemotherapy clinic the nurses have all been pre-screened. We have the ability to do same day COVID-19 testing. We’ve made an effort to minimize visits whenever possible; obviously you can’t do that if the patient needs chemotherapy. Patients are being offered virtual visits for things like screening and some follow-ups. Q: Are chemotherapy patients more at risk from complications related to the virus? A: Cancer patients are at increased risk. In many studies there’s been data that patients who have recently had chemotherapy, even a few months ago, are at higher risk of contracting COVID, and certain cancer populations do much worse once they’ve contracted it. As you might guess, patients who have lung cancer, if they get infected, tend to not do very well. There’s been reports that patients with blood cancers may be at risk due to their impaired immune system. So we take the precautions I talked about earlier. In terms of treatment modalities, they’re limited overall. We’re all hoping for a vaccination, but this may not be an appropriate population to get those vaccinations.
Q: Given how time-consuming many of these processes are, how has COVID-19 affected scheduling?
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
Q: Has it been more challenging to get patients to come in for their chemotherapy? A: That’s definitely true. There are patients who know they’re at higher risk. Many of them are older, receiving chemotherapy and maybe treatments for other diseases. They hear the media reports and they
know they’re the patients who don’t do well. We’ve received — I can’t even tell you how many — phone calls telling us they’re not comfortable coming in, especially from areas outside Buffalo that may have lower infection numbers. As much as possible, we’ve tried to alter regimens. For example, we may substitute a regimen where patients come in once every three weeks instead of every week. So we’ve been trying to reassure patients we can seek out alternative ways to administer their chemo, but there have patients who have just refused to come in. I’ve had at least a few patients who were very sick who were finally starting to see come back. I spent 20 minutes trying to convince a patient to come in. When she came in, she actually felt much better. We were able to show her we could deliver her care under the conditions. Q: What lessons have you and your team learned from this unusual year that you would work into your longer-term plans? A: I think one of the lessons is when we think we know something, we may not. We’ve been completely taken aback by the emergence of a completely new disease. The last time something occurred on this level may have been in the ‘80s with HIV. I think this is an eye opener for us, and that the conventional ways we’ve been taking care of people have now been dramatically altered. We can better utilize the fact that most people have smart phones and is on the internet. I think telemedicine has been a gamechanger in helping us do our job. So I think we need to adapt and adjust, and we’ve had to do it even on a daily basis. You recently interviewed my colleague, Dr. [Igor] Puzanov [chief of melanoma services], and he talked about how we’ve repurposed some of our tools for immunological research into cancer for researching how to treat COVID. So there are great advances we can take from this time period and prioritize what’s really important when it comes to treating cancer.
Lifelines Name: Eunice S. Wang, M.D. Position at Roswell Park Comprehensive Cancer Center: Chief, leukemia service; medical director of infusion services; assistant member of tumor immunology program. department of immunology Hometown: Bedford, Massachusetts Education: Keck School of Medicine, University of Southern California; completed residency training in internal medicine at Yale-New Haven Hospital, Yale University; completed a clinical hematology-oncology and research fellowship at Memorial Sloan Kettering Cancer Center Affiliations: Roswell Park; Buffalo-area Catholic hospitals Organizations: Children’s Oncology Group, Society of Hematologic Oncology; American Society of Hematology; American Society of Clinical Oncology; American Association of Cancer Research Family: Husband; son (14), daughter (12) Hobbies: Travel, reading, family activities
Spiritual Health Milk & Honey
By Brooke Stacia DeMott
Land of Confusion In times of crisis, Christian values sorely needed By Brooke Stacia DeMott “Repent, for the kingdom of heaven is at hand.” (Matthew 4:17)
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he American church must repent of its lackluster commitment to Christ, its obsession with cultural relevance, its failure to discipline sin, and its love of money. Understand that when I say this, I am speaking as a Christian who has benefited enormously from the church, and it breaks my heart to watch these failings go largely unaddressed. Objectively, I can understand why. Often, when a believer calls the DeMott church to repent, it’s tantamount to treason. Since Satan is the accuser of the brethren, by this logic, any accusation must be from the enemy camp. Now the concerns of the believer are easily swept away as the catcalls of a dissenter, and justifiably ignored. But the most common response is a functional shunning. While you may not be made to leave, you can certainly be treated like you’re gone. No one likes rejection, and so, an uneasy, silent complacency reigns, even when we know better Nevertheless, a faith is tested by what it costs. In ancient days, God used men that we call prophets to boldly call his people to forsake their infatuation with pagan culture and lackluster devotion to God, and turn their wayward hearts completely to the Lord. Maddeningly, the message and the outcome were often the same — the prophet called for repentance and warned of judgment, the people ignored them (or in some cases, put them to death) and then all of a sudden, everything fell apart. Take a look around. The snowballing catastrophes of 2020 are, in my controversial opinion, directly tied to impotence of the modern church. A battle of world views has been simmering for decades now, erupting this year with two diametrically opposed ideologies on either side of the widening social cavern. One upholds the supremacy of the sovereign God, the primacy of the family, the sanctity of life, and the pursuit of truth. The other is in a full sprint away from anything that resembles historical Christianity, embracing a confusing spectrum of sexualities and genders, abortion, violence, and both social and economic Marxism.
One ideology is largely silent, while the other is a rising cacophony of deafening proportions. On Sunday morning, an increasingly small number of preachers might still address the severity the situation, but outside of those very specific boundaries, most believers are cowering. Why? We have ceased to be a fellowship on a mission to proclaim the righteousness and salvation of Christ. We pay lip service to that ideal, certainly, but we don’t live that way. And the reason we don’t live that way is that we have forsaken God in favor of worldly wisdom. The Christian church is the most powerful conduit in human history for change. More than that, it is the barricade between demonic attack and lost souls, whom we are called to bring to knowledge of salvation. Christ’s faithful followers supernaturally affect this world if they abide in him. “Abide in me and you will bear much fruit … but apart from me, you can do nothing.” (John 15:5) But the church has become obsessed with remaining relevant in a changing world, increasingly seeking out secular psychology and shifting cultural norms for guidance, in lieu of prayer and obedience to the scriptures. The church’s power comes from abiding in God. If the church severs itself from that life-giving vine and grafts itself to the wisdom of the world, it becomes impotent; and a
powerless church provides no stopgap for rampant evil.
Church reaction subdued
Back in March, I watched with bated breath, preparing for the fullscale revival that was certainly waiting in the wake of COVID-19. But it never came. In June I thought, surely, the increasingly violent race riots would sound the alarm. This time, the church was roused, rubbed its eyes and hit the snooze button. We’re awake in a sense, but groggy and stumbling. “You hypocrites! You know how to interpret the appearance of the earth and sky. Why don’t you know how to interpret the present time? And why don’t you judge for yourselves what is right?” (Luke 12:56-57) The time for subtlety has passed. This world is in the greatest state of confusion I’ve ever seen, and it’s getting worse by the hour. Christian, wake up! Get dressed for battle, because the enemy prowls like a hungry lion seeking whom he may devour, and if you aren’t ready, it will be you. We don’t fight against flesh and blood, but rulers and principalities, powers of the air that are agents of Satan, making calculated efforts to undermine your testimony to the living God. But while the wicked flee when no one is pursuing, the righteous are as bold as a lion. So even if you are
August 2020 •
the only one you know who will do what you ought to, then do it, and do it now. Pray for our nation. Tell your friends and family to reject sin and put their faith in Jesus Christ. Forgive your brother who has offended you, and ask his forgiveness of you as well. Do not validate another divorce, another abortion, or another violent outburst, but rather, love the Lord and the people around you enough to be a voice of sound reason and rebuke. Have honest, respectful conversations about what’s happening in our world and don’t be afraid to tell the truth, because the truth sets people free. Read your Bible, love your spouse, pray with your kids and ask God for the strength to live for him, with every moment that we have left here. Put down those vices that you know aren’t pleasing to God — drugs, porn, wrath and malice, envy and strife, complaining and discord, and beg his forgiveness. Repent. The kingdom of heaven is at hand. • 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.
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Page 11
Addiction Between You & Me
By Barbara Pierce
Road to Recovery Dual diagnosis of mental health illness, substance abuse disorder challenge for everyone affected
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e gave me a smile so big it wrinkled up his eyes. I immediately liked the 19-year-old. I worked with people with serious mental illness as a therapist in a mental health clinic. I read the paperwork he brought, from a behavioral unit. The police found him in a ditch after a suicide attempt. The voices had told him he must kill himself. He was diagnosed him with schizophrenia. After several days in the hospital, he was Pierce discharged. The hospital noted he was positive for cannabis. When I suggested that might be important, he blew me off. He was at the clinic to make sure he didn’t have a repeat. He wanted to live, to continue toward his career goal. Several months before, Bryan had left home for college, where he smoked a lot of pot. I suspected there was a connection between that and his hallucinations. Through research, I found there is a link. Marijuana can cause psychosis in a small number of people. Psychosis is a disconnection from reality, with symptoms that include hallucinations, delusions, disorganized behavior or speech. I was certain that Bryan was not schizophrenic, as he didn’t have the lack of emotion, general flattening and lack of interest that are typical of this disease. He was eager to get back to college; I was sad as we said goodbye. A few months later, he was back. He ended up hospitalized again, this time in worse shape. And then came a third time. Finally, he was finally convinced that pot was the cause of his prob-
lems. He stopped smoking, and continued successfully in college. Bryan’s story had a happy ending. For many people who have a combination of a mental illness and substance abuse, the story doesn’t go well. Most with co-existing mental illness and drug or alcohol abuse are in real trouble. Going through hell, putting their partners and families through hell, with two illnesses running simultaneously, each making the other worse. It’s not uncommon for a mental illness to accompany drug or alcohol abuse.
Hand in hand
Frequently, the diagnosis is bipolar disorder, but also schizophrenia, major depression, or anxiety disorder. Either the person begins to experience symptoms of mental illness and starts using substances because of his symptoms, or drug or alcohol abuse triggers a mental illness, as it did for Bryan. Drug or alcohol abuse is the substitution of comfort for an uncom-
fortable and incomprehensible pain, said one expert. In Nepal, when an elephant has a splinter in its foot, his handlers put chili in his eye. The elephant becomes so preoccupied with the pain of the chili in his eye that he stops paying attention to the pain in his foot. Thus, his handlers can remove the splinter without being trampled to death. For many with mental illness, drugs or alcohol are the chili — the thing that distracts from the intolerable. Like another client I worked with, Hannah. When I met her, she was 28 and had abused drugs and alcohol for about 12 years. She began when the abuse she was experiencing from her family became intolerable. Very depressed, she found alcohol and drugs took her away from the unbearable pain of her life. In and out of behavioral units, she would be temporarily sober. But staying sober was nearly impossible for Hannah, with a diagnosis of bipolar disorder. Then something changed. She made a decision to change her life
and stay sober. She began seeing me regularly. Her emotional pain was deep; the path she was on was incredibly difficult. I felt for her; she was so alone. She pushed everyone away. The drugs and alcohol changed her brain, making her irritable, angry, with an explosive temper. She lost job after job because of angry tirades. But she hung in there. She battled with herself daily, hourly, sometimes getting through minute by minute. She went to Alcoholics Anonymous most days and came to see me every week or more. Those things served as the rudder to help her stay on course. When she got mad at me, yelled and told me how despicable I was, I’d walk out of my office. She was by far the most difficult person I ever worked with. But she kept coming. She gets credit for getting herself through that very, very tough time. It took about a year for her brain to get back to normal — a year of being sober, taking prescribed medication, going to AA and therapy. How brave and determined she was. Several months after we said goodbye, she called to tell me she had moved to another state and was getting married. She sounded happy, finally comfortable in her own skin. When a person has a dual diagnosis of mental illness and substance abuse, both disorders have to be treated simultaneously. There is hope. Both mental illness and substance abuse are treatable. Recovery takes time, commitment and courage. People can and do get better. • 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.
NYS ends use of tobacco coupons, multi-pack discounts
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iscounts on the sale of all tobacco products, such as coupons and multi-pack price promotions, are prohibited in New York state beginning July 1. The law was passed as part of the state’s fiscal year 2021 budget. “We know that higher tobacco prices are linked to lower smoking rates. Putting an end to the tobacco industry’s ability to circumvent New York’s high taxes on tobacco products is a win for public health statewide,” said Joseph Potter, director at the Tobacco Action Coalition of the Page 12
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Finger Lakes. The Surgeon General has called raising prices on cigarettes “one of the most effective tobacco control interventions” because increasing price is proven to reduce smoking, especially among kids. “Tobacco use remains the No. 1 cause of preventable death and disease in the United States,” said Michael Seilback, the American Lung Association’s national assistant vice president for state public policy. “In New York state we can attribute 480,320 deaths to smoking annually
— and the economic costs of smoking to New York state is $10.3 billion. We applaud Gov. Cuomo and the state legislature for doing away with dangerous discounts that put money in the pockets of tobacco companies, while costing New Yorkers their lives.” A number of tobacco control measures passed as part of the state’s fiscal year 2021 budget, including a new law that stops the shipping or delivery of e-cigarettes and vape products to private residences beginning July 1, providing another
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
important protection for youth. Earlier this year on May 18, the state ended the sale of all tobacco products in pharmacies as well as the sale of flavored e-cigarettes statewide. The average age that teens first start smoking in New York state is 13 years old, and 90% of adult smokers first tried smoking by age 18. According to the New York State Youth Tobacco Survey, nearly 40% of high school seniors in New York state use e-cigarettes, and 27% of all high school youth vape.
Addiction Not-so-well known addictions Things you didn’t know you could get addicted to By Barbara Pierce
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Addiction” suggests gambling, drinking, and drugs. But there are other habits, behaviors, and even beauty products that are surprisingly addictive. • Diet soda: “Diet soda can become addicting, either to the caffeine or the artificial sweetener in it,” said registered dietitian Priya Mathew of Mohawk Valley Nutrition Services, Utica. Mathew Aspartame is usually used as the sweetener in diet soda, she explained. Although aspartame has no calories, it alters your brain chemistry by tricking your brain to think that you’ve consumed sugar. When your brain finds out that the sugar is missing, this makes your body crave “sweets.” The artificial sweetener essentially stimulates the dopamine center, or the reward center of the brain, just like real sugar or any other stimulants, which leads to craving more soda. Breaking the habit can be difficult. Mathew suggests taking it slow, though some can go cold turkey. Start your day with lean protein to help cut the cravings. Try adding coffee or tea midmorning, sweetened with honey or sugar. Or try club soda or fruit juice with club soda as you transition away from soda. Exercise also helps cut the cravings. • Chapstick: If you’ve ever watched as someone applied and then reapplied Chapstick or other lip balm repeatedly, there’s a reason. The ingredients can be super drying,
which is why they feel the need to keep reapplying in a vicious cycle. Also, they’ve become used to the feeling of that texture on their lips, and feel something is missing. Go slowly to wean yourself off it, gradually lengthening the time between applications, advises one person who did. • Moisturizer: If you moisturize more than twice a day, stop. What you’re doing is actually counterintuitive and may make your skin addicted to that product. Some believe constant use of thick moisturizers makes the skin “lazy;” the skin doesn’t have to work as hard as it normally would to maintain adequate hydration levels. In fact, it’s a myth that everyone needs to use moisturizer. If your skin looks and feels normal, you don’t need to use a moisturizer regularly. Only if you have a skin condition — like eczema, dryness, scaling or flaking, redness, or itching — will a moisturizer help. If you want to use moisturizer,
opt for a product that’s light and easy to spread, without a greasy, heavy feeling. • Visine: If you have chronic red eyes and routinely reach for eye drops like Visine, you could get addicted to these drops. Visine does “get the red out.” But it also has a rebound effect, say experts. Frequent use of Visine can cause redness. Some may find themselves in a cycle of using a product that initially helped the problem but now contributes to it.
Addicted to feeling good
• Tanning: Tanning addiction is common. Ultraviolet light triggers a release of endorphins, the feel-good hormone. If you’re craving that feeling of happiness, and find you’re going to the tanning salon more often or staying in the tanning bed longer, that could be a sign of dependence. • Online dating: If it’s as easy to find a date as swiping left or right, it’s easy to see how online dating could be very addictive. The design of dating apps mimics slot machines:
You take a gamble on who will appear. Like slots, they’re simple and fun to use. And, if a reward is unpredictable — a winning slot combo, or a match with a potential date — it’s all the more appealing. It’s no surprise that users end up talking to less than 10% of their matches. Some check for potential matches over 20 times a day. Other things we can get addicted to include video games, TV watching, sex, porn, posting selfies, shopping, tattoos, teeth whitening, and working out. These addictions, or patterns of behavior, are deeply wired into our brains. And they fire up the pleasure centers of our brain, making it difficult to simply eliminate them. The advice “just stop doing it,” rarely works. The key to breaking these addictions is breaking the pattern. Usually there is a clear trigger to start the pattern. For example, you see the TV and couch as soon as you hit the front door. Your brain connects the dots, and eating dinner in front of the TV on the couch is not far behind. So first, identify the triggers. Then, develop a plan to deal with the triggers. Replace the behavior with a new behavior that provides a similar benefit. As Mathew suggested, if you always grab a diet Coke when you settle down to watch Netflix, instead have a glass of fruit juice with club soda. The key is mapping this out before the triggers have a chance to kick in. Reward yourself for making small steps in the right direction. Be persistent and patient. Realize it takes time for new brain connections to kick in, for new patterns to replace the old. Don’t beat yourself up for slip-ups or use them as rationales for quitting. Take it one day at a time.
Eating before bedtime might pack on pounds
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f you have a late dinner and then head to bed, beware: You may gain weight while you sleep, a new study suggests. That’s most likely because your metabolism slows, boosting blood sugar and other chemicals that contribute to weight gain and Type 2 diabetes, researchers say. “It’s not just what you eat, but when you eat that may be a factor in promoting conditions like obesity,” said study author Jonathan Jun, a physician and associate professor of medicine at Johns Hopkins University in Baltimore. “You might eat the same number of calories in that 24-hour period, but your body will handle those calories differently depending on what time you eat them.” For the study, Jun’s team asked
20 healthy volunteers to eat the same dinner at 6 p.m. or 10 p.m. Both groups went to bed at 11 p.m. and got up at 7 a.m. Before the study, participants wore activity trackers. During the study, blood samples were taken hourly and sleep studies were conducted. The volunteers also had scans of body fats and ate foods containing compounds that allowed researchers to track fat burning. The upshot: Late diners had higher blood sugar and burned less fat. On average, their peak blood sugar level after a late dinner was about 18% higher, and the amount of fat burned about 10% lower, compared with eating earlier, the study found.
These effects might be even greater for people who are obese or have diabetes, Jun said. What’s not clear is whether it’s the interval between eating time and bedtime that accounts for the difference, he said. For example, if you have dinner at 10 p.m. but retire at 3 a.m., is that biologically the same as dinner at 6 p.m. and bed at 11 p.m.? And, Jun said, the effects of eating and sleeping might differ for each person based on their personal metabolism or body clock. “Instead of getting fixated on what time is late or what time it is on the clock to start or stop eating, we need to recognize that it is very dependent on the individual,” he said. Samantha Heller, a senior clinical
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nutritionist at NYU Langone Health in New York City, reviewed the findings. “It makes sense that eating close to bedtime alters glucose and fat metabolism, because you are sleeping and not physically active,” she said, adding that sleep has its own processes that involve cellular and molecular mechanisms to help the body stay healthy. Heller noted that people often get stuck in a routine of eating before dinner, eating dinner, and then snacking until bedtime — which means they have been eating for several hours. “It is an easy way to pack on the pounds,” she said. “We eat at night for many reasons, including stress, boredom, loneliness and anger.”
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Diet & Nutrition SmartBites
The skinny on healthy eating
Chicken Caesar Salad with Grated Parmesan For Salad:
Serves 4
3-4 skinless, boneless chicken breasts 3 romaine lettuce hearts, washed and torn into bite-size pieces ½ cup or more shredded parmesan cheese For Dressing: 2 garlic cloves, minced ½ teaspoon Worcestershire sauce 2 tablespoons fresh lemon juice 2 teaspoons balsamic vinegar 2 teaspoons mayonnaise 1½ teaspoons Dijon mustard ½ teaspoon salt ¼ teaspoon coarse black pepper 1 teaspoon anchovy paste (optional) 4 tablespoons olive oil
Parmesan cheese: nutritional powerhouse By Anne Palumbo
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rom nutritionists to cheese connoisseurs to sports trainers, parmesan cheese is favored by many and here’s why: It promotes bone health; it’s virtually lactose-free; it rocks with complete protein; and it’s loaded with flavor. True parmesan cheese (officially called Parmigiano-Reggiano) is a hard Italian cheese with a gritty texture and a complex fruity-nutty taste. Many artisanal and large cheese producers here in the U.S. also make decent parmesan. What makes this cheese stand alone (no matter its origin) is its lengthy aging process — a process that results in unique nutritional benefits. Time spent in the cellar helps protein develop, causing parmesan to have a higher percentage of this valuable nutrient compared with most cheeses. Thanks to its long aging, parmesan’s protein is easily digested, making it a good choice for infants and toddlers, seniors and others with delicate digestive systems. Likewise, this ready protein is favored as a quick energy source for marathon runners and weekend athletes alike. Parmesan contains virtually no lactose, which is deliriously good
news for those who are lactose-intolerant. Once again, parmesan’s lengthy ripening process contributes to this welcome benefit. Bones and teeth appreciate parmesan because it’s a decent source of two essential minerals: calcium and phosphorous. An ounce of this nutrient-dense cheese (roughly the size of your thumb) delivers about a third of your daily needs for calcium and a fourth for phosphorous. Both minerals help to keep bones and teeth healthy and strong. Interestingly, studies have suggested that eating harder cheeses like parmesan as the final food in your meal will help to reduce cavities. Chewing cheese stimulates saliva flow, which helps neutralize the acids that break down enamel. One heaping tablespoon of shredded parmesan has around 22 calories and 1.5 grams of total fat, most of which is saturated fat. Since saturated fat raises blood cholesterol levels, which may then increase your risk of heart disease and stroke, the American Heart Association recommends no more than about 13 grams a day. The good news is, parmesan’s intense flavor steers us toward moderation.
Preheat grill to medium high. Salt and pepper chicken breasts. Grill for about 10-12 minutes, flipping at the halfway point (meat is done when thickest part registers 165 degrees). Let cool; slice crosswise into strips. Make dressing: In a small bowl, whisk everything together but the olive oil. Slowly whisk in the olive oil until well blended. Assemble salad: In a large bowl toss together lettuce and half of the parmesan. Drizzle with desired amount of dressing and toss again. Plate, top with several slices of grilled chicken, and sprinkle each portion with remaining parmesan.
Helpful tips
If you’re after authentic Italian parmesan look for the branding on the rind: Parmigiano-Reggiano or Grana Padano. For best flavor, buy a wedge from a wheel rather than pre-grated cheese. If buying pre-grated parmesan, look for American producers with good reputations, such as Sartori and BelGioioso. Store leftover cheese in a small zipper-lock bag and squeeze out as much air as possible before fastening seal.
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.
Rome Police Department supports The Kelberman Center
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fficers Tom Medlin and Jeff Buckley of the Rome Police Department recently presented a check to the Kelberman Center in the amount of $4,055. The gift was in support of programs and services for children and adults with autism spectrum disorder and their families. A friend and past supporter of Page 14
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the Kelberman Center, Medlin has helped raise autism awareness and support in the Rome community through yearly sale of Rome Police Department autism awareness patches. Medlin and Buckley also participated in the Kelberman Center’s 2020 virtual Walk for Autism that occurred throughout June, helping Team Rome
Police Department in its fundraising efforts in support of the Kelberman Center. An affiliate of Upstate Caring Partners, Inc., the Kelberman Center provides state-of-the-art programs and services for children and adults with ASD and their families, with locations in both Utica and Syracuse.
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
Stroke: Time is of the essence Recognizing signs of stroke can speed treatment, limit damage
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nly one-third of adults in New York state say they can recognize the signs of a stroke, according to a review of self-reported data by Excellus BlueCross BlueShield. And that’s bad news since every 40 seconds someone in the United States has a stroke, according to the American Heart Association. Knowing when someone is exhibiting the symptoms of a stroke can lead to quicker treatment and a lower risk of disability or death. A stroke occurs when a blood vessel supplying oxygen and nutrients to the brain becomes blocked with a blood clot (ischemic stroke) or when a blood vessel bursts, causing bleeding within or around the brain (hemorrhagic stroke). The brain is deprived of oxygen, and brain cells die within minutes. The body cannot replace damaged brain cells, so the effects of a stroke are often permanent. “A stroke is a brain attack, and damage can increase with every minute that treatment is delayed,” said Excellus BCBS Medical Director Nicholas Massa. “The acronym F-AS-T is an easy way to remember what to look for and what to do if you suspect someone has had a stroke.” F = Face. Ask the person to smile. Does one side of the face droop? A = Arm. Ask the person to raise both arms. Is one arm drifting down or appearing weak? S = Speech. Ask the person to repeat a simple phrase. Is speech slurred or confused? T= Time. Time lost is brain lost, so call 9-1-1 right away if you detect any signs of stroke. Stroke is the fifth-leading cause of death in the U.S. after heart disease, cancer, accidents and chronic lower respiratory disease. Six thousand New Yorkers die each year from a stroke. Risk factors include high blood pressure, high cholesterol, diabetes, tobacco use and obesity. Among adults in Upstate New York, more African Americans and Hispanic Americans self-report experiencing a stroke compared with those who self-identify as white. “Anyone with any of the risk factors for stroke should speak with their doctor about medical interventions or lifestyle changes to reduce their risk,” said Massa. “And everyone should know the acronym F-A-S-T, so they can recognize when someone is showing signs of a stroke and can summon medical help.” For more information, visit the U.S. Centers for Disease Control and Prevention at https://www.cdc.gov/ stroke/communications_kit.htm.
Health Careers
By Barbara Pierce
Lisa Mancini M
Chief clinical officer for Helio Health
ohawk Valley In Good Health newspaper senior staff correspondent Barbara Pierce recently spoke with Lisa Mancini, chief clinical officer for Helio Health. The health care organization promotes recovery from the effects of substance abuse, mental health disorders and other health issues. It provides drug and alcohol withdrawal and stabilization services, inpatient rehabilitation, child and adolescent services, and counseling for mental health disorders. Its programs serve several counties in Central New York. Q.: What is your role at Helio Health? A.: As chief clinical officer, I work in administration. Helio offers a wide range of treatment, counseling, and support programs for persons with alcohol, drug, or mental health disorders. Our programs span a wide continuum of services, from inpatient and outpatient detoxification, inpatient and outpatient treatment for substance use disorders and mental health disorders, and services to children. We help people during every stage of their recovery. All of our programs are medically supervised and managed by accredited counselors and recovery professionals. My job is to support these programs in many ways, from training staff to overseeing the quality of the programs. I help ensure that all of our programs provide the highest quality of services to our patients, as well as implement improvements in services that will benefit our patients
Lisa Mancini and programs. Q.: What is a typical day like for you? A.: I attend meetings and group sessions. Many are meetings of state and local advocacy organizations; we work together for the benefit of our patients. I meet with the leaders of our programs to ensure that we are offering the right evidence-based practices. Evidence-based practice brings together the best available research, professional expertise, and input from patients to offer services that have been demonstrated to achieve positive outcomes for patients. Also, I meet with local colleges, nursing schools and medical schools to bring in interns, fellows, and residents. I coordinate with the schools to make this happen. We do use many interns, especially in the field
of social work and mental health counseling. Q.: What kind of training have you had? A.: My undergraduate degree was in psychology and public justice. I knew that I wanted to do something in a helping field, but I wasn’t sure what population I wanted to work with. After getting my degree, I interviewed with Helio. At that time, it was called Syracuse Behavioral Health. I liked them and working with them seemed to like a good way to go. That was 16 years ago. I started as a counselor in a supportive living program. I did counseling and case management with people who were recovering from substance abuse issues. That led me to decide to go back to school for a Master of Social Work degree at Syracuse University. After I received that degree, I became a credentialed alcohol and substance abuse counselor. Right now, I have only three courses left to get my master’s degree in business with Syracuse University. With this degree, I’ll be able to have more impact on the system.
with issues, such as cultural diversity. This helps me be a good clinician and a good executive. I’ve had several jobs here at Helio. I began as a counselor and then became our service director of inpatient detox. Six years ago, I came into my current position. My past experiences are most beneficial. I bring to the table my direct experience working with clients. I look at any new regulations from the perspective of a counselor; I’m able to think about how would this affect a counselor and a client. I can see things from an executive perspective as well as a clinical perspective.
Q.: What’s it like to work for Helio Health? A.: I’ve been with Helio for 16 years. I’ve found it to be a great place to work. They are supportive of continuing education and employee growth. One thing that is important to me is lifelong learning. In addition to working on my degree, I attend regular training so that I can keep current
Q.: Some professionals find it difficult to treat persons with substance abuse issues. You seem very comfortable with it. A.: This was never an issue for me. Addiction is a disease. This is a huge part of why I’m comfortable with it. It’s not a moral issue; it’s not a social issue. It is a treatable disease. Treating individuals from this perspective goes a long way.
Q.: What’s best about this job? A.: What’s best is being able to support organizations and make access to substance abuse treatment easier and more accessible in the community. I work with other agencies to do that. My goal in my role is to make our services as easy to access as possible. Services need to be available when the patient needs us, not just 8 to 5. This is a big change from the traditional clinic.
Why do more women have Alzheimer’s than men? Experts: It’s not just from living longer
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iddle-aged women are more likely than men to have changes in the brain related to Alzheimer’s disease, as detected by imaging, even when there are no differences in thinking and memory. This may be associated with hormonal changes due to menopause, specifically the loss of estrogen, according to a study published in the June 24 online issue of “Neurology,” the medical journal of the American Academy of Neurology. “About two-thirds of people living with Alzheimer’s are women, and the general thinking has been it’s because women tend to live longer,” said study author Lisa Mosconi, Ph.D., of Weill Cornell Medicine, New York. “Our findings suggest that hormonal factors may predict who will have changes in the brain. Our results show changes in brain imaging features, or biomarkers in the brain, suggesting menopausal status may be the best predictor of
Alzheimer’s related brain changes in women.” The study involved 85 women and 36 men with an average age of 52 who had no cognitive impairment. The men and women had similar scores on thinking and memory tests and measures such as blood pressure and family history of Alzheimer’s. Participants had positron emission tomography (PET) scans to see if they had amyloid-beta plaques in the
brain, a biomarker associated with Alzheimer’s disease. They also had detailed brain magnetic resonance imaging scans (MRI). Researchers compared the women and men in four key areas of brain health to assess their risk of having Alzheimer’s biomarkers: the volumes of both gray and white matter in the brain, levels of amyloid-beta plaques, and the rate at which the brain metabolizes glucose, an indication of brain activity. The women scored worse on all four of those measures. On average, the women had 30% more beta amyloid plaques in the brain, and 22% lower glucose metabolism than the men did. When measuring average gray matter volume, the women had 0.73 cubic centimeters (cc/cm3) compared to men who had 0.8 cm3, a difference of 11%. For average white matter volume, the women had 0.74 cm3 compared to men who had 0.82 cm3, a difference of 11%.
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“Our findings suggest that middle-aged women may be more at risk for the disease, perhaps because of lower levels of the hormone estrogen during and after menopause,” Mosconi said. “While all sex hormones are likely involved, our findings suggest that declines in estrogen are involved in the Alzheimer’s biomarker abnormalities in women we observed. The pattern of gray matter loss in particular shows anatomical overlap with the brain estrogen network.” Mosconi said one limitation of the study is that only healthy, middle-aged people without severe brain or cardiovascular disease participated. Larger studies that follow up with participants over a period of time are needed. This study was supported by the National Institutes of Health, the National Institute on Aging, the Cure Alzheimer’s Fund, and the Women’s Alzheimer’s Movement.
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Health News RMH names cardiologist as chief medical officer Rome Memorial Hospital recently appointed Russell Silverman as chief medical officer. A member of the St. Joseph’s Hospital Health Center medical staff in Syracuse for more than 35 years, Silverman has been a driving force to the growth and national recognition of the St. Joseph’s cardiac service line. He has served in a variety of leadership roles. Currently, he is the medical director of medical cardiology Silverman and a member of National Cardiovascular Services Clinical Excellence Counsel of Trinity Health. “Dr. Silverman will be instrumental in supporting the medical staff in pursuit of clinical excellence at Rome Memorial Hospital,” said president-chief executive officer Mark Murphy. “Dr. Silverman is experienced in uniting diverse teams to achieve excellence in patient care through collaboration and alignment of common goals.”
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Silverman earned his medical degree at SUNY Upstate Medical University in Syracuse, where he completed his residency in cardiovascular disease in 1983. In addition to serving as CMO, Silverman will continue to provide medical cardiology to Rome area residents in the St. Joseph’s Health Cardiolovascular Institute office located on the ground floor of Rome Memorial Hospital in the Dorothy G. Griffin Cardiovascular Center.
New director of talent acquisition joins MVHS Christine Young has joined the Mohawk Valley Health System as director of talent acquisition. In this role, Young will lead a team of recruiters responsible for sourcing, evaluating and hiring candidates in close partnership with hiring managers. Prior to joining MVHS, Young Young was the team leader of employment at Bassett Medical Center in Cooperstown.
Young was responsible for the recruitment of nursing and lab positions. Prior to that, she was assistant vice president of deposit operations at Partners Trust Bank. Young earned her bachelor’s degree in health care administration from the University of Phoenix as well as an associate’s degree from Herkimer County Community College.
degree from Charité - Humboldt Universität in Berlin, Germany. He received his training in cardiothoracic surgery in Germany and Vanderbilt University, located in Nashville, Tennessee. He received additional training in aortic surgery at the University of Pennsylvania in Philadelphia, Pennsylvania. He is board certified in surgery and thoracic surgery.
MVHS welcomes new cardiothoracic surgeon
SECON graduates 82 new nurses
Alexandros Karavas recently joined the Mohawk Valley Health System’s cardiac and thoracic surgery group as a cardiothoracic surgeon. Karavas has privileges at Faxton St. Luke’s Healthcare and St. Elizabeth Medical Center in Utica. Prior to Karavas joining the MVHS cardiac and thoracic surgery group, Karavas was a surgeon at the Catholic Heart Center in Buffalo. Karavas earned his medical
St. Elizabeth College of Nursing recently graduated 82 new nurses. Of the graduates, 58 attended weekday classes and 24 participated in the evening-weekend program. The valedictorian was Joshua Nash of Vacaville, California, and the salutatorian was Nash Erin Oakley of Whitesboro. SECON is accredited by the Middle States Commission on Higher Education and the AccreditaContinued on Page 17
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
Continued from Page 16 tion Commission for Education in Nursing, Inc., and registered by the New York State Education Department. Visit secon. edu/about/news for the full list of graduates. Oakley
OH names director of radiation-oncology center Roswell Park Comprehensive Cancer Center and Oneida Health continue to add to the cancer expertise available through their affiliation, announcing the hire of physician Maya Mathew as medical director of the Dorothy G. Griffin Radiation Oncology Center in Oneida, part of the Roswell Park Care Network. Mathew Mathew comes to Central New York after serving as a radiation oncologist at Memorial Hospital in Gulfport, Mississippi. She will lead a team that includes a Roswell Park medical dosimetrist and medical physicists, along with highly trained radiation therapy and nursing personnel. She will help in developing evidence-based and peer-reviewed treatment plans that follow the same quality standards patients can expect from the National Cancer Institute-designated comprehensive cancer center in Buffalo. Mathew earned her medical degree from Kerala University in Kerala, India, and completed a radiation oncology residency at Loyola University Medical Center in Chicago. “We look to Dr. Mathew to further the Roswell Park and Oneida Health mission of quality radiation treatment for patients who come to the Central New York center,” said
Health in good
Health News physician Michael Kuettel, chairman of the department of radiation medicine at Roswell Park. Roswell Park and Oneida Health opened the Dorothy G. Griffin Radiation Oncology Center in 2019. Oneida Health also operates a medical oncology center in affiliation with Roswell Park. Both organizations have worked closely together since 2016, when Oneida Health received a grant from the New York State Department of Health to expand oncology services to Central New York in partnership with Roswell Park.
SDMG recognizes outstanding employee Jennifer Hall was recently named employee of the second quarter at Slocum-Dickson Medical Group, New Hartford. Hall is a certified nursing assistant with nearly 17 years of medical experience. She joined the group in 2017 as part of the clinical staff, working in various offices where needed and eventually settling into the urgent care department. “She has always shown great flexibility in her work schedule in order to meet the needs of our urgent care patients,” an SDMG spokesperson said. “Jennifer’s work ethic is excellent and she conducts Hall herself in a professional, responsible and caring manner.” Hall rose to the challenges presented by COVID-19 and agreed to act as SDMG’s employee screener, checking temperatures and possible symptoms prior to entry. Hall continues to arrive early, don full personal protective equipment and provide this vital service. “Our employees are greeted by her positive and upbeat attitude each morning,” the spokesperson said.
HEALTH NEWS IN BRIEF
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DRIVERS WANTED We’re looking for dependable people to help us distribute copies of In Good Health, Mohawk Valley’s Healthcare Newspaper, in offices and other high traffic locations in the Utica-Rome-Clinton region. Great for active retirees or at-home moms in need of some extra cash. Work only one or two days a month during office hours (9 to 5). Compensation: $11.10/h plus 30 cents per mile. It amounts to about $150 per distribution.The paper is usually distributed at the beginning of the month. Drivers pick up the papers (in bundles of 100 copies) in North Utica and leave copies at various locations, following a list of places we provide. No heavy lifting. Drivers are required to have a dependable vehicle, be courteous and reliable. We audit all areas of distribution.
Call 315-749-7070 and ask for Nancy for more information.
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Company gets $1.6 billion from U.S. government for coronavirus vaccine
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accine maker Novavax will receive $1.6 billion from the U.S. government to provide 100 million doses of a coronavirus vaccine by early 2021, the Maryland-based company said recently. This is the largest deal announced by the Trump administration to date as part of its attempts to provide coronavirus vaccines and treatments to Americans as soon as possible, The New York Times reported. The $1.6 billion is coming from a “collaboration” between the Health and Human Services Department
MV’S HEALTHCARE NEWSPAPER
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and the Defense Department, according to a Novavax spokeswoman. In May, the Trump administration said it would give up to $1.2 billion to British drugmaker AstraZeneca, which has said it could have a vaccine available by October. Federal funding has also been given to four other companies — Moderna Therapeutics, Johnson & Johnson, Merck and Sanofi — for their experimental coronavirus vaccines, The Times reported. Novavax has never brought a product to market, the Times reported.
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Head, Heart, Hands & Health 4-H: Making the best better By Barbara Pierce
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adison County is home to a robust 4-H program. Though its roots are in agriculture and raising livestock, today’s 4-H features members who explore coding, create video games, build robots, work with drones, and even make maple syrup — all while developing life skills that will assist them to become responsible adults. “Head, Heart, Hands, and Health” are the four Hs in 4-H, the four values participants work on through fun and engaging programs. While 4-H began as an agricultural program, it has evolved to meet the needs of growing urban communities. 4-H is an opportunity for all kids aged 5-to-19 to expand their horizons with a variety of projects that encourage personal growth. “4-H is the largest youth program in the world,” said Craig T. Brown, 4-H youth development resource educator, Cornell Cooperative Extension, Madison County. “Every county has a 4-H, shaped on what the community needs. It’s different in every county.” “My son loves it,” said Vicki Markowski of Morrisville. Her 11-year-old son Landon participates in 4-H of Madison County. “He’s learned so much and enjoys it so much. He does a range of projects: he took a coding class, made maple syrup, is growing a vegetable garden, and helped create a trail in the wilderness.” “Two years ago, 4-H wasn’t well known in our community,” said Brown. “Up to then, we were club-driven by volunteer leaders.” Brown took over the leadership two years ago. “We’ve grown substantially — 20 to 25% of the kids in the county are now involved in 4-H,” he said. “We’re still growing.” “We’re fortunate to connect with the schools; we’re in every school district in Madison County,” he added. After-school programs are popular and how many kids become involved. Landon, who does not live on a farm, discovered 4-H through an after-school program, his mother said. That was three years ago, and he continues to be enthusiastic about what he does. “The biggest benefit is that he has gained self confidence in public speaking,” she said. He wasn’t good in that area; now he got 96%. We’re so happy; it’s so wonderful.” “He’s learned so much, things he might not know. He won a blue ribbon at the state fair,” she noted. “And he’s so proud of the work he did on the trail.” “4-H offers so much to help kids Page 18
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Craig T. Brown, 4-H youth development resource educator, Cornell Cooperative Extension, Madison County, reads to program participants recently. become adults,” she added. “I believe the biggest thing in Madison County is that the kids have input into what their program will be. We ask them what they want,” said Brown. “Whatever a child wants, we try to give them — they want to build rockets, we’ll build rockets.” “What’s popular lately, what the kids have asked for, is to learn coding
so they can make video games. And there is a lot of interest in dairy and equine,” he said. “We have guest speakers, vets, and Cornell professors coming to teach the kids what the kids want to learn. “The kids want something hands-on. They want to build stuff, make mistakes and figure out what works.” “It’s a challenge but awesome, what we do. It can be hard to achieve
Craig T. Brown, 4-H youth development resource educator, Cornell Cooperative Extension, Madison County, holds 3-week-old Nigerian Dwarf dairy goats recently during recent program activity.
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
a balance between having fun and learning essential skills. I do love what we do; it makes me smile just talking about it,” Brown said. “Also, we s collaborate with every other community program that serves kids. All of us are struggling, so anything we can do to work with each other is great.” 4-H of Madison County is open to any child in Madison or surrounding counties. Getting involved is easy and costs are kept to a minimum. 4H doesn’t require a uniform and there are no nationwide fees. The 4-H motto — “To Make the Best Better” — encourages each member to do his or her best and improve next time, so their “best” becomes “better.” Members stretch their abilities and capacities to reach their full potential. “The long-term benefits of 4-H participation include better grades, more engagement in school, greater likelihood of attending college and greater likelihood of pursuing a career in technology and STEM (science, technology, engineering, math) fields. I encourage students to join 4-H,” sums up Collier County 4-H leader Tish Roland online. 4H is a community for all kids, with programs that suit a variety of backgrounds, interests, budgets and schedules. Whether at home, in-school or after-school, or in clubs, 4H’s positive youth development programs are available in your local community, welcoming children who want to have fun, learn and grow. If you know a child in Madison County who may be interested in participating, visit http://madisoncountycce.org/4-h-youth or see the Facebook page: Madison County 4-H youth development. If you are outside of Madison County, to find more about your local 4-H, see https://4-h.org/find/.
Summertime, and the assisted living is easy Mohawk Homestead achieves license for assisted living beds get a higher quality of care with a nonprofit versus a privately owned facility with the goal of making a profit.
By Barbara Pierce
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he Mohawk Homestead, an adult care residence in Mohawk, has recently been licensed by the state of New York for assisted living beds. Mohawk Valley In Good Health newspaper senior staff correspondent Barbara Pierce spoke with administrator Joe Franco about the recent development. Q.: What is the significance of being licensed for assisted living beds? A: Twenty of our 41 adult care beds have been licensed as assisted living beds. I’ve been working toward this goal for some time and pleased that we finally achieved it. The New York State Assisted Living Program was instituted to provide long-term residential care for low-income New Yorkers. It’s intended for those who need assistance above and beyond what’s typically provided in an adult care facility. This also means we can now be reimbursed by Medicaid, which will add a significant increase in revenue for the Homestead. This will also help us to consistently sustain a census at or above the break-even threshold. Q.: What is the significance of this for your residents? A.: As this program is designed for persons who are medically eligible for nursing home care, we
A ribbon-cutting ceremony was held to recognize the opening of new assisted living space at the Mohawk Homestead. are able to care for residents in a less medically intensive setting than they would find in a nursing home. Our small, personalized setting is far more desirable to many than a nursing home. We provide a range of services, including personal care, room, board, housekeeping, supervision, home health aides, personal emergency response services, nursing, physical therapy, occupational therapy, speech therapy, medical supplies and equipment, adult day health care, a range of home health services and a registered nurse. We have a variety of activities going on every day, from sing-a-longs
and musical entertainment, to crafts, bingo, cards, Bible study, sports discussions and educational seminars — something to interest everyone. And we are able to provide assisted living program services at a lower cost than a nursing home. For low-income residents, basic services can be provided and subsidized through the Supplemental Security Income program at the level III rate and Medicaid subsidizes the ALP services. Q.: You are a nonprofit facility. Does that have any significance for residents? A.: In my experience, I think you
Q.: What else can you share about the Mohawk Homestead? A.: Our motto says it all: “Where your family becomes a member of ours.” In my over 20 years of experience working with the elderly, I believe our personal care aides to be the best I’ve ever worked with. And we have excellent staff retention, so residents are able to deal with the same staff over time. Our food is great; meals are all made from scratch with very little frozen food. Also, our building is one of the historical gems of the Mohawk Valley — a small Victorian-style adult home nestled in the quaint village of Mohawk. We provide both respite (temporary) and long-term care. I look forward to leading this facility into becoming the premier adult care home of the Mohawk Valley. I’m confident that the experienced, caring, and dedicated staff we have will allow us to provide services to residents that far exceed family and community expectations. I welcome everyone to visit our unique and historical Mohawk Homestead. (The Mohawk Homestead is located at 62 E. Main St., Mohawk. For more information, call 315-866-1841 or visit www.mohawkhomestead. org.)
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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Changing of the guard at Excellus James Reed of Skaneateles recently named Excellus’ new president/CEO-elect By Lou Sorendo
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rue leaders often step up to the plate during times of crisis. For Excellus BlueCross BlueShield, newly named president and CEO-elect James Reed is doing just that. Reed, who joined Excellus in 1996, succeeds Christopher Booth, who will retire on May 1, 2021. Reed most recently served as executive vice president of marketing and sales. “Health care is such an important part of our community, and so my previous experience in working closely with many different stakeholders has provided me with a much deeper understanding of the challenges that we all face,” Reed said. “It really provides me with a great foundation for going into this new role.” Reed has been working with Booth for the past 10 years. “This is really a great opportunity for the next 10 months or so to really continue to work collaboratively on transitioning during that time period,” he added. The staff at Excellus has been working remotely from home since March 17 due to the coronavirus pandemic. “Fortunately prior to the pandemic, we had a really robust business continuity plan,” Reed said. “While I don’t think anyone could have predicted what has happened so far this year, we did have a plan in place. Through various simulation exercises that we have done, it really put us in a good position to respond.” When the crisis hit, the Excellus leadership team quickly focused organizational efforts on several priorities. “The first one was servicing our customers. This is a pandemic, and the mission of our company is to provide access to high-quality and affordable health care,” he said. “If any of our customers are impacted by the virus, we need as a health plan to be there for them. We need to focus on servicing our customers.” The company also sought to protect its finances. “There has been so much uncertainty that has been introduced because of the pandemic in terms of costs, the economy and customers’ ability to pay their premiums,” he said. “We need to make sure that with the uncertainty, we have the financial wherewithal to continue to serve our mission.” Another priority for Excellus was to protect the jobs of its employees. “We took necessary steps at the very start of the pandemic to make sure we were doing our part in tightening our belts,” said Reed, noting this included a hiring and promotion freeze, as well as holding on merit raises this year. “We made sure we were as conservative as we could be knowing that our overall objective is servicing our customers, making sure we continue to service our mission and protecting the jobs of our employees,” he said. Page 20
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Reed
Premium increase
Excellus BCBS is a nonprofit, mission-based organization that strives to help people in the community enjoy healthier and more secure lives through access to high-quality and affordable health care. “The decisions that we make align to the mission of the company, and that’s the key to our long-term success,” Reed said. Excellus has responded to the pandemic by taking measures such as increasing reimbursement rates for telehealth; waiving out-of-pocket costs for telehealth; expediting payments of hospital claims, and implementing a 20% increase in reimbursement for COVID-19 admissions, all to reduce the administrative burden to the provider community; and providing employer group support to make sure people understand that if they are out of a job, they need to enroll in COBRA or need to understand what options are available in the individual marketplace, whether that is Medicaid or a qualified health plan. The coronavirus outbreak is expected to cost the U.S. health system a lot of money, which analysts suggest might mean dramatic increases in insurance premiums next year. Reed shared his thoughts in regards to what Excellus BlueCross BlueShield customers can expect in terms of premium increases in the future. “Periodic rate adjustments are necessary to enable our health plan, or any insurer, to produce sufficient revenue and reserves to ensure that the health care needs of our members are met, for both current health care needs and potential catastrophic cost situations,” he said. Although requested rate increases are typically due to annual increases in the cost and utilization of medical care, Excellus’ rate requests to the state Department of Financial Services for next year remained among the lowest in Upstate New York, Reed noted.
This occurred despite including a 0.5% increase for anticipated increased expenses from the unprecedented COVID-19 pandemic, he added. As for 2021, Excellus has submitted its request to the Department of Financial Services and is among the lowest rate adjustments filed for small group and individual products in New York state, he noted. “We want to be as competitive as possible on our prices,” he said. For four years in a row, Excellus’ premium requests have been below the state average for what competitors were asking, Reed said. He said the most important variables that will affect 2021 insurance premiums involve the number of members and number of claims. In 2019, for example, Excellus added more members and saw higher claims, Reed noted. Its medical loss ratio (MLR), meanwhile, went from 86% in 2018 to 88% in 2019. The MLR is the percent of premium dollars an insurer spends on medical services and quality improvements.
Striving to be the best
Reed said his philosophy for the past 25 years at Excellus has been fairly simple. “I really focused on doing the best job I could in the role that I was in, making sure I would seek to understand the big picture and understand the industry I was working in,” he said. Reed said his philosophy also involves knowing what his role is and where that role fits into the overall success of the company. From a philosophical perspective, Reed said he is a believer in focusing on the organization’s goals and not individual success. For Reed, that involves the desire and willingness to work on himself. “I think personal development is a lifelong journey, and if you are self-reflective and willing to improve yourself, then I think you’ll be well positioned to continue to grow inside the organization,” he said. Reed said 25 years ago when he started with Excellus, he didn’t quite envision becoming CEO someday. “But I think with each different step along the journey of my career, I made sure I was true to those core values and that leadership philosophy,” he said. With every new opportunity that came along, Reed began to see that as he continued to work, grow and be a beneficial member to the organization, good things continued to happen. Reed sees the personal development piece as probably the most important. He said nobody is perfect as a leader or simply as a human being. “If you understand that and are willing to self-reflect, learn and continue to grow, then I think that is the key for anybody to be a good leader,” he added.
IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2020
Lifelines Birthplace: Elmira Current residence: Skaneateles Education: Bachelor of Science in business administration from Le Moyne College, Syracuse; Master of Business Administration from Le Moyne College Affiliations: Reed is active on numerous local boards, including CenterState CEO, Greater Rochester Chamber of Commerce, HealtheConnections, Syracuse Stage and the Make-A-Wish Foundation of Central New York. Awards: Reed is a 2008 recipient of the Greater Syracuse “40 Under 40” award and the 2020 YWCA Champion of Diversity Award. Personal: Married with three children Hobbies: Cooking, coaching his children’s sports
Plant-based lifestyle
In terms of reaching a healthy work-life balance, Reed said it is important for any leader to recognize the need to attain this goal. “It is maybe more important to actually model the behaviors that lead to better balance,” he said. “It’s one thing to say, ‘we want to make sure our employees have balance’, but if you don’t model the behavior yourself, then what unintentional signals are you sending to folks who you work with or who work for you?” That behavior includes making sure to eat a healthy diet, getting enough sleep, exercising, and spending time with family and friends, Reed said. “To me, it means playing golf with friends, making sure I am home for dinner as much as possible and cooking dinner with my wife and spending good quality time there, regularly taking walks and taking my dog out for walks,” he said. At times over the years when Reed feels stressed out about what is happening at work, he takes the time to self reflect. At that point, “I can see that I have not been focusing on any one of those things, whether that is sleep, eating health, spending time with family or exercising,” he said. “To me, a good healthy balance includes a little bit of all those things,” he said. About a year and a half ago, Reed took on a challenge generated by Excellus employees to convert to a mostly plant-based lifestyle. “For the past 18 to 19 months, I have pretty closely stuck to that lifestyle. I’ve seen tremendous benefits from it in terms of energy level and evidenced by my different biometric screening results and numbers overall,” Reed said. “In general, through eating mostly a plant-based diet, I have tremendously benefited from it.”