MV-IGH#179 january 2021 by In Good Health: MV's Healthcare Newspaper

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JANUARY 2021 • ISSUE 179

Pandemic returns for encore

Providing resources for domestic abuse victims during COVID-19

See Pages 3-9

YWCA Mohawk Valley Chief Executive Ofﬁcer Dianne Stancato says abuse proliferates during pandemic.

See Page 5

Stem cell research wave of future See Page 20

Isolation, lack of interaction takes its toll Dr. Jodi Mullen, founder of Integrative Counseling Services PLLC in Oswego, says isolation suffered by elderly, lack of stimulation for kids damaging during pandemic.

See Page 3

Healthier Chicken Wings? Do they really exist? See Page 11

Stem cell technology regenerates hope in medical field See Page 20 January 2021 •

Seeking fertile ground Dr. Ruben Pinkhasov of Upstate Urology at Mohawk Valley Health System addresses infertility.

See Page 13

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper

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One is the loneliest number Social isolation, loneliness hitting seniors especially hard Megan Plete Postol

he ill effects of social isolation are hitting seniors especially hard as COVID-19 restrictions continue to keep people apart. A new study released from the National Academies of Sciences, Engineering, and Medicine reports that more than one-third of adults aged 45 and older are feeling lonely, and nearly onefourth of adults aged 65 and older are considered to be socially isolated. Mullen Isolation is measured in terms of how much social contact a person has, whereas loneliness is the consequence of an unsatisfying connection with others or lack thereof. Older adults are at increased risk for loneliness and social isolation because they are more likely to have factors that include living alone, the loss of family or friends, chronic illness, and hearing or vision loss. The current pandemic is exacerbating mental health issues. “People who already feel lonely, isolated, unloved, or different in any way are more likely to experience the negative effects of isolation,” said Dr. Jodi Mullen, founder of Integrative Counseling Services PLLC in Oswe-

go. “This would include the elderly and the inﬁrmed. Isolation and lack of social and emotional stimulation also affects children in different ways based on development and the stability and consistency of relationships in their lives. Children with instability and inconsistency in any areas of their lives are more apt to experience negative mental health implications of loneliness and isolation.” Social isolation is not the way humans are wired to live and thrive, Mullen points out. “We are social animals,” she said.

“We understand who we are, what is important to us, and what helps and hinders us from our interactions with others. Our nervous systems are set up for this; we are set up to be able to respond to others, particularly facial expressions and touch.

Major disconnect

“When we are isolated we don’t have those opportunities to learn about ourselves, reﬂect on our feelings, behaviors or thoughts; therefore, we are left with limited resources. Our default system is to listen to

our self-talk. Typically, our self-talk reverts to our inner critic versus our inner coach. “Our inner critics are mean and judgmental. Mental health is susceptible to the barrage of these negative and unacceptable messages particularly without the alternative messages that we get from others.” The NASEM report indicated that other groups at risk for negative effects of social isolation are vulnerable older adults, including immigrants; lesbian, gay, bisexual, and transgender populations; minorities; and victims of elder abuse. Although most people are not connecting in-person, they can still be on the lookout for cues that indicate deteriorating mental health and loneliness in loved ones. “I would be concerned about dramatic changes in appearance (including weight gain or loss), new or increased use of alcohol or substances, and/or personality,” Mullen said. “If you are reaching out to someone who chooses to isolate when there are opportunities to connect, that would be a red ﬂag as well.” There are some actions that can be taken to mitigate the negative effects of social isolation and loneliness. “Be creative about connecting,” Mullen said. “Reach out to others and extend the invitation for them to connect to you. Be a connection detective — seek out ways to connect and re-connect to others.”

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ith the surge in hospitalizations expected to continue beyond the holidays, Rome Memorial Hospital is encouraging retired health care professionals who are interested in rejoining the workforce temporarily to contact its human resources department at 315338-7219. All skill sets and specialties are needed. If your registration has lapsed, registrations will be renewed at no cost for health care professionals who complete the questionnaire through the state Department of Health portal at https://apps.health.ny.gov/pub/ servny/. “The hospital’s leadership team meets twice a day to evaluate our stafﬁng needs to ensure that we have enough people to care for our patients. Our dedicated frontline professionals are taking on extra shifts. Directors, managers and educators have returned to the bedside,” said vice president clinical services/chief nursing ofﬁcer Samantha Vining. “Retired health care professionals, including nurses, respiratory therapists and aides, can provide

that extra assistance to support our current staff because they already understand the importance of infection prevention and patient privacy,” Vining said. Since Thanksgiving, RMH has seen an increase in the number of COVID-positive patients requiring hospitalization and the number continues to rise, she added. The hospital established a separate COVID unit to isolate patients. In addition, patients who are critically ill receive care in the intensive care unit. “The challenge for us and all hospitals is having enough staff if hospitalizations continue to increase exponentially. That’s why it’s so critically important that our community take steps to prevent the spread of COVID,” she said. — Wear a mask anytime you leave the house. — Don’t congregate with people outside your household. — Stay at home if you are sick. — Limit trips outside the home. Take advantage of pickup and delivery.

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Winter forecast: High probability of more COVID-19 Mohawk Valley residents have greater chance of getting virus this winter By Daniel Baldwin

hings are somewhat back to normal in the Mohawk Valley, as a majority of businesses and restaurants that closed at the start of the pandemic have opened. The Mohawk Valley reportedly had the lowest COVID-19 indicator in New York state. The percentage of positive coronavirus cases in Oneida County, one of the six counties in the Mohawk Valley, dropped from 21.8% in April to 5.2% in December, according to the Oneida County COVID-19 dashboard on Ocgov. net. The number of COVID-19 patients at Mohawk Valley Hall Health System hospitals dropped 8% from last March to July, and that number continued to drop from July to October, according to MVHS Chief Physician Executive Kent Hall. Despite the health and business improvements last summer, the Mohawk Valley is expected to have another coronavirus case surge this winter. While MVHS experienced a decrease of coronavirus cases and patients at their hospitals and facilities last summer, the number of COVID-19 positive patients went up signiﬁcantly from 10 in October to 129 in December, according to MVHS Vice President of Marketing and Communications Caitlin McCann. The coronavirus is more likely to spread in enclosed spaces and drier climates, according to TheAtlantic. com. Although spending more time indoors and using an indoor heating system will help keep you warm during these cold times, it could also increase your chances of getting the

virus. The heat that comes out of a radiator or electronic heating system is dry heat, according to Refinery29. com, and that sort of heat will dry a person’s nasal passage and make him or her more likely to catch a cold or get the coronavirus. A person also has a greater chance of getting COVID-19 when he or she is enclosed in a room with other people. “As the weather gets cooler, people move indoors, and they’re closer together and not outdoors where the wind carries things away, you’re going to see more spread,” Hall said. “People getting congregated into enclosed areas because of cold weather is the only reason that it increases the chances of getting COVID-19 that we know of,” Hall said. “There is a theoretical possibility that when you’re in an environment that is less humid, it actually dries out your nasal mucosa and makes you potentially more susceptible to COVID-19.” The winter season, according to CDC.gov, is also the most common time for people to get the cold and flu. If people already have a difficult time figuring out if they have COVID-19 or not, it could also be hard for them to determine

RMH names 2020 Nurse of the Year

mma Ingalls, director of infection prevention at Rome Memorial Hospital, was recently named 2020 Nurse of the Year. “In the midst of a pandemic, Emma set the bar for excellence,” vice president clinical services-chief nursing ofﬁcer Samantha Vining said. “She is calm, caring and collaborative. She is an advocate, a leader and a pioneer. She possesses a steadfast will and one of the most compassionate hearts.” Ingalls joined RMH in 2016 as a registered nurse working in the emergency department and intensive Page 4

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care unit. She was promoted to director of infection prevention in March 2019, just a year before COVID-19 became a global public health emergency. “Emma is fearlessly and ﬂawlessly leading us through a once-in-acentury pandemic,” Vining said. Vining extended her appreciation to the entire team for its continued dedication. “You continue to adapt to the ever-changing demands of caring for our patients with an unwavering spirit that deﬁes the challenges that you face each day,” she said.

whether they have the virus or flu. The symptoms of the coronavirus closely align to the symptoms of the flu, according to the Asthma and Allergy Foundation of America. They include a fever, sore throat, runny nose, headache, fatigue, and the loss of taste. The only thing a person does not get from the cold and flu, according to Asthma and Allergy Foundation study, are asthma attacks and shortness of breath.

Determine the difference

“There is a lot of overlap,” Hall said, “especially when you first get it. COVID-19 tends to start as a cough, some congestion, some fever and body aches, which really sounds like the flu. What happens with COVID-19 is that it ramps up significantly. Patients end up with shortness of breath and they get fatigued very easily. With the flu, you may get two-to-four days where it just hits you really bad, but then you start to feel better. With COVID-19, that doesn’t happen. You get bad over two-to-three days, but then it continues to get worse.”

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Although the symptoms between the flu and COVID-19 are similar, the flu does not make a person more vulnerable to getting the coronavirus. “There isn’t any indication at all that the flu increases your susceptibility to getting infected or having a severe infection,” Hall said. “That really depends on what your underlying health state is. People who are relatively healthy should do OK.” Those who are sick but cannot determine if they have the virus or flu are advised to go to their local hospital or medical facility and get tested for COVID-19. “The only way that you could do that is with a test,” Hall said. “If you’re having those symptoms and feel like you’re really getting sick, then you should be tested to see whether it is the flu or whether it is COVID-19.” But one way for people to avoid getting both the flu and COVID-19 is to follow the virus guidelines. “You want to do all the things that people learned about during the outbreak,” Hall said. “That includes wearing a mask, proper hygiene and social distancing. Those are the things that will definitely decrease the likelihood that you’re going to be infected, whether it is a cold or COVID-19.” Hall said he expects the number of COVID-19 cases to increase in the Mohawk Valley during the winter, but he has faith that a majority of the valley’s residents will continue following virus guidelines and the COVID-19 damage will not be severe. “There will be an increase in the number of cases within the community,” Hall said, “and that will translate to a certain extent to having more patients in the hospital. I really have faith and trust in this community that we’re going to do the right thing for everybody, and it’s not going to translate into what I would call a ‘surge,’ but we are going to see some more cases.”

MADISON

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Editor & Publisher: Wagner Dotto Associate Editor: Lou Sorendo Contributing Writers: Barbara Pierce, David Podos, Deb Dittner, Jessica Arsenault Rivenburg, Brooke Stacia Demott, Daniel Baldwin, Traci DeLore Advertising: Amy Gagliano Layout & Design: Dylon Clew-Thomas Office Assistant: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement — not to take the place of — the recommendations of your health provider.

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021

1-2 punch Megan Plete Postol

ﬁnancial support,” she said. “We are always grateful for our donors and supporters as they make this work possible. Also, please write your senator and Congressmen or woman and demand they reauthorize VAWA, the Violence Against Women Act. Women need the protections of VAWA now more than ever before.”

omestic violence incidents are on the rise during the pandemic. Locally, the YWCA reports a 30% increase in demand for services, and projected a 50% increase by the end of 2020. “Abusers like to isolate and control their victims, and with families in lockdown, the pandemic created a perfect opportunity to achieve that goal,” YWCA Mohawk Valley Chief Executive Ofﬁcer Dianne Stancato said. “In addition, because they were unable to leave their homes where they were often Stancato living with their abusers, victims did not have access to domestic violence services or their support systems, such as co-workers, family, friends, and possibly even their medical health professionals. With the added tensions of job insecurity or loss, housing or food insecurities and more, the abuse could be exacerbated by stress from these factors and fear.” The YWCA Mohawk Valley has worked ceaselessly to care for those affected by domestic violence in the region, she noted. “I am proud to say are serving clients throughout this pandemic,” Stancato said. “Our hotlines and advocacy are available 24/7 and our emergency shelters are open.

There are many red flags and warning signs of domestic violence. They can include: — Controlling behaviors such as not allowing the victim to talk to friends or relatives, go to an appointment, have a conversation on the phone, etc.) — Verbal abuse and name calling; embarrassing, demeaning and humiliating their victims in private and in public — Blaming the victim for the abuse (“If you didn’t provoke me, I wouldn’t have”) — Controlling the finances — Possessiveness, extreme jealousy — Unpredictability, bad temper — Cruelty to pets/animals — Controlling what the victim wears — Sabotaging or blocking the victim to go to school or work — Sabotaging or blocking the victim from getting health care, medical attention or birth control — Extreme manipulation — Makes the victim ask for permission to see family and friends — Tries to isolate the victim and make the victim have to only rely on them for finance and emotional support — Forces sex — Past history of domestic violence and violent crimes — Threats of harm to family members and friends and the victim — Constantly having to know where the victim is at all times

Domestic violence exacerbated by COVID

Red flags waving

Our therapists are ‘seeing’ clients on videoconference, our support groups are meeting virtually, and victims can reach us through our new text and web chat services as well. Our advocates continue to work within the court systems. Our staff at the Herkimer County Child Advocacy Center is available for cases, as well as those at the Oneida County Child Advocacy Center. This has been a full-on team effort to serve the community.” She and her staff have developed new routes of communication and connection with the clients they serve. “The only thing that has changed is delivery: We meet with clients via video, text, and web chat options as

often as possible, meeting in-person on occasion when necessary,” Stancato said. “We are still working to ﬁnd creative ways to deliver our emergency services. Thinking outside the box, we launched our free and conﬁdential text and web chat services. We’ve partnered with other agencies to continue advocacy services, even when hospital and law enforcement requests for assistance increased throughout quarantine.” Domestic violence is a serious crime that can include physical and emotional abuse. Stancato has suggestions about how to support the YWCA in a meaningful way. “We have so many options to support our efforts on our website, ywcamv.org, including asking for

Visitors restricted from MVHS due to resurgence of coronavirus

hroughout the COVID-19 pandemic, the MVHS has adhered to the strictest standards of safety through its Our Safe Path to Care, which protects patients and their families, employees and providers. This has enabled community members to access all the health care services needed on a safe basis. However, as the number of individuals testing positive for COVID-19 in Oneida County has been steadily increasing recently, MVHS has taken additional measures to continue to keep patients, employees and providers safe. One such action was to suspend visitation to MVHS hospitals (including emergency department and inpatient hospital units) and outpatient facilities. “We are making this change out of an abundance of caution since the way in which COVID is spreading in our community has changed,” said Kent Hall, MVHS chief physician ex-

ecutive. “Prior to this, when we saw spikes in the number of COVID-19 positive individuals, they primarily came from residential facilities. However today, the majority of those testing positive for COVID-19 are coming from private homes and residences. This indicates that the virus is spreading throughout our community and not just as isolated clusters. Thus, we made the decision to play our part to limit potential spread of the virus in the community by suspending visitation.” The MVHS visitation policy is as follows: • No visitors are allowed for patients in inpatient hospital units, with the following exceptions: — Patients in the intensive care unit — Patients in labor, delivery, and the remainder of the patients’ admission — Pediatric patients

— Patients for whom a support person has been determined to be essential to the care of the patient (medically necessary) including patients with intellectual and/or developmental disabilities and patients with cognitive impairments including dementia — Patients in immediate end-oflife situations — Patients who are being discharged (visitors will wait in the lobby). Visiting hours for those individuals who meet the exceptions criteria are 4-6 p.m., seven days a week. Only one visitor is allowed during this time. • No visitors are allowed to accompany a patient into the ED with the following exceptions: — Pediatric patients: One parent/guardian may accompany the patient throughout his or her ED visit.

January 2021 •

— Patients for whom a support person has been determined to be essential to the care of the patient (medically necessary) including patients with intellectual and/ or developmental disabilities and patients with cognitive impairments including dementia – one support person may accompany the patient throughout his or her ED visit except when otherwise directed by medical personnel. — Patients in immediate endof-life situations: One support person may accompany the patient throughout his or her ED visit except when otherwise directed by medical personnel. — A support person may accompany patients undergoing same-day procedures or testing if it is determined to be medically necessary. That support person/companion may not be present for procedures or testing (with some exceptions).

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Working at home has health perils: Survey Adjusting to new realities of COVID-19 packed with challenges on the home front

orking from home may take its toll on mental and physical health, but making some tweaks to your workspace and your headspace may help maximize the potential benefits and minimize any downsides, a new survey suggests. Nearly 65% of people who were working from home due to COVID-19 restrictions reported new physical woes including “tech neck” and lower back pain, and about 74% said they had one new mental health issue, such as anxiety or depression. These risks were heightened among women and parents of toddlers and infants, who were juggling work and life responsibilities. The findings were published online recently in the Journal of Occupational and Environmental Medicine. Overall, telecommuters felt that more was expected of them and that the distractions were far greater at home. “The shift to work from home was abrupt when COVID-19 first

hit, and no one was truly prepared,” said study author Burcin BecerikGerber, co-director of the Center for Intelligent Environments at the University of Southern California, Los Angeles. “It is super stressful and the demands and work expectations didn’t go down, plus many of us also have to be a teacher and a parent,” said Becerik-Gerber, who is also a

mother of three who now works from home. Work from home does have it perks, namely more ﬂexibility, no commute and more family time. And it is likely here to stay even after the pandemic ends now that many companies have systems in place, she said. In the study, Becerik-Gerber and her colleagues asked close to 1,000 people who transitioned to work from home due to COVID-19 how the new arrangement affected their physical and mental well-being. They asked about overall mental and physical health. The survey spanned many occupations and took place during the early days of the pandemic. On average, workers spent about 1.5 hours more per day at their work station when they worked from home. Telecommuters also reported getting less physical activity and eating more than they did before the shift. “Improperly ﬁtted desks and chairs, and extended periods of sitting and sedentary behavior can

increase risks for physical problems,” Becerik-Gerber said. In the study, just one-third of respondents had a dedicated area for their work, while close to 50% shared their workspace with others. Those who scheduled their work around others were more likely to report new physical or mental health issues. Other factors that can increase productivity and boost physical and mental health while working from home include adequate natural lighting, which helps regulate your sleep-wake cycle, BecerikGerber said. “Having access to nature is extremely important, and setting your work station up where you can see trees may help offset mental health problems,” she explained. In the pre-COVID-19 days, coworkers provided social support, and telecommuters are feeling this loss, she noted. “All of those interactions with co-workers or even seeing people on the way to a meeting are the things that take your mind off of work and are very important to mental health,” Becerik-Gerber added.

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IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021

Between You & Me

By Barbara Pierce

Do you need anybody? COVID-19 fallout: People need people now more than ever

“

What do you do when you’re feeling down or distressed during this pandemic?” the online survey asked. I volunteered to participate in research on how to cope. Yes, during this pandemic, I do have days of feeling down — feeling like the world is grey and life is on hold. How do I manage to get past these bad days, I thought? What helps me move on to a better place? I remembered a few weeks ago, when I mentioned to my sister I was feeling down, she suggested: “Call a friend.” Good idea, I thought, and ran through the few friends I had, choosing Jackie. Jackie and I talked, commiserated and laughed a lot. When I hung up, my world had perked up; my mood was considerably better. So, I knew the answer to the question of what I do when I’m feeling down: “Call a friend.” Next to my family, my friends are most valuable in my life right now. Their value rises when life gets especially tough, like now. The Beatles’ song, “With a Little Help From my Friends,” is especially relevant. The list of my friends is short. Each is so valuable. It’s short because, a few years ago, after a divorce, I left my current friends behind to step into a new life. I moved to the Florida Everglades, to a home isolated deep in the rural tropical wilderness. “It’s going to be up to me to create a life here in the middle of nowhere!” I thought with a mixture of excitement and apprehension. I knew no one in this remote area except the man with whom I would be sharing a home. I was eager to put people into my new life. Though I’m introverted and reserved, I do have a deep need to be around people. Before I retired, making friends was easy at work. Without a job, it would be harder, but I was conﬁdent I could do it. I’d moved to new areas before and started over: I’d lived on a boat in Mexico, crafting a life with new friends. Then again, after leaving the boat. But, this time, it was to be much harder than I anticipated. “Volunteering will be a great way to meet people,” I said to myself. “I’ll start with that.” I didn’t like to drive, so ﬁnding

“Oh, I get by with a little help from my friends Mm, I get high with a little help from my friends Mm, gonna try with a little help from my friends — The Beatles something that didn’t require a long drive was my ﬁrst criteria. However, there was nothing except homes and nothing else for many miles around. Possible places to volunteer all were nearly an hour’s drive, one way. I bit the bullet and started volunteering at a few, but met no one to hang out with. I was so lonely; they say you have to identify your need to fulﬁll it. I longed for a woman friend to meet for lunch. I sat alone day after day, deeply longing for people with whom I could have relationships.

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“Churches are always a good way to get people in your life,” I thought. So I tried several; they were mostly unfriendly places. I missed people. If two or three days went by as I sat home alone, I ached for people; I went a little crazy. I went to the supermarket or the library just to be around people. I was achingly lonely. “I’ve got to ﬁnd people; I can’t live this lonely life,” I said. “Surely there’s got to be a church that will welcome me.” I found another church to try; it was small and friendly. I volunteered to stand at the door and welcome people and began attending the women’s group. Jackie was the ﬁrst one who I hooked up with. The retired nurse was calm, nurturing, and our connection occurred probably because she thought the same as I did on major issues. Then Lynn came into the women’s group as a newcomer. I was attracted to her outgoing personality as she readily talked about details of her life with a group of strangers, a contrast to my quiet self. Then Marylou, Daisy, and Junaice. Seeing these friends every Sunday became the highlight of my week. Going out for lunch with one

January 2021 •

or the other. Sharing joys and sorrows, laughs and hugs. My life was complete. Finally, now I have people who care about me, and I about them. I’ve ﬁnally found what I was looking for and I’m so happy. Right now, they’re my lifelines. When I’m feeling discouraged, or don’t see any color in the world, I call one of them. Though we don’t get together in person, we talk, lament, laugh, and bring each other hope. As this pandemic drags on, it becomes harder to cope. Talk with a mental health professional if you aren’t getting over your down times. 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.

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Healthcare in a Minute By George W. Chapman

Meet new secretary of Health and Human Services P

resident-elect Biden has nominated current California Attorney General Xavier Becerra for the post of secretary at Health and Human Services. Becerra will replace former big pharma executive and lobbyist Alex Azar. As California AG, he was a strong champion for consumers. Becerra sued giant Sutter Health System for driving up prices causing Sutter to settle for $575 million. He sued Teva pharmaceutical for a “pay and delay” scheme causing Teva to settle for $70 million. Becerra will inherit a surging pandemic, overwhelmed and ﬁnancially stressed providers and the mass distribution of COVID-19 vaccines. He will oversee rule changes for expanded telehealth services, hospital pricing transparency and provider reimbursement that is transitioning away from traditional fee for service to pay for performance and bundled care reimbursement. Industry trade associations like the AMA, AHA and Association of Health Insurance plans (AHIP) have lauded the nomination hoping Becerra hits the ground running. They see him as a much-needed consumer advocate in that position.

Geographic Direct Contracting

The new HHS secretary will oversee the rapidly increasing transition from fee-for-service volume-based reimbursement to more cost-effective models that require coordination and risk assumption among providers in a speciﬁc region. The goal is to improve the quality, access, integration and outcomes of medical services delivered to Medicare and Medicaid members while also lowering costs. Physicians and hospitals serving a deﬁned region would coordinate management services, telemedicine, provider recruiting, purchasing and develop a preferred panel of quality providers. The new entity would be paid via capitation, $xx per member per month, based on the area’s historical claims. The entity can keep any savings it creates based on the amount of risk it assumes. The incentive for Medicare members to join the newly formed integrated network is improved care and a reduction in the amount of health premium deducted from their social security check. CMS, which determines physician reimbursement, recently proposed a “budget neutral” fee-forservice schedule. What that means is increases for some services, typi-

cally primary care, will be offset by decreases in other services, typically specialty. While the AMA has registered disappointment, CMS is sending a clear message that fee-for-service reimbursement is being phased out in favor of alternative payment models as herein described.

New CDC Director

Biden has nominated current chief of infectious disease medicine at Massachusetts General, physician Rochelle Walensky, for the post of CDC director. She will replace Robert Redﬁeld. Walensky is also on the faculty at Harvard. Two thirds of us live in areas with limited to no access to an infectious diseases specialist. There has been a critical shortage of I.D. physicians. Thanks to the notoriety of colleague Anthony Fauci and her recent nomination, applications to medical school are up 18%, an all time high. The expectation is many medical students will elect to specialize in infectious diseases.

Retail Primary Care Accelerating

Retail druggist Walgreens has invested $1 billion in primary care provider VillageMD. The partnership plans to expand beyond their Hous-

ton-based pilot market and open up 40 more pharmacy/primary care centers by summer and 500 more over the next five years. The business model intends to increase the involvement of pharmacists in the delivery of effective primary care to its members with emphasis in underserved areas. The entry of these well-financed for-profit retail medicine clinics into the market presents a competitive threat to typically under-financed private practices, federally sponsored clinics and hospital-sponsored practices. Tech oriented primary care startup Carbon Health recently received a $100 million infusion from investors in addition to the initial $28 million infusion in May. The goal is to open 1,500 clinics by 2025 and 100 pop up COVID-19 clinics now. Carbon Health will offer “omnichannel” care via retail clinics, video, phone apps and work place clinics. Traditional providers of care have their reimbursements controlled and set by Medicare and commercial payers which prohibits them from amassing decent profits and building huge cash reserves for expansion. The entry of cash laden for-profit corporations, which have been free of price controls of any kind, creates an unfair playing field.

Vaccine Distribution

“Operation Warp Speed” has accomplished the “easier” part of the mission: development and approval of a COVID-19 vaccine by the end of 2020. Several drug manufactures — including Pfizer, Moderna, Astra Zeneca and Johnson & Johnson — met the challenge. The harder part of the mission will be the efficient distribution and storage of the vaccines in 2021. The plan is to have 100 million of us vaccinated by the end of February, which should cover healthcare workers and nursing home residents. The challenges are: ensuring the second dose of Pfizer and Moderna vaccines are available and given within the recommended follow-up period; storing the Pfizer vaccine in super sub-zero refrigerators; (Moderna can be stored in regular refrigerators); ensuring providers, typically clinics and physician practices, that give the vaccines are adequately trained and prepared for the onslaught; and determining priorities based on: age, comorbidities, essential, military, school, etc.

ICU Nurses Give Perspective

The Washington Post recently ran interviews with ICU nurses from across the country: Idaho, Mississippi, Iowa, Illinois, Utah and Ohio. Most of us are far removed from the battle zone in hospitals and need to be reminded what it is like for our ﬁrst defenders and healers. The nurses revealed what it’s like to work in their highly stressful environments. Here is the gist of the interviews. Some people arrive barely short of breath and tell the nurses they feel ﬁne. Within just hours, many of these patients go into rapid oxygen decline and end up on a vent or deceased. Nurses are used to processing death, but they say the pace of death caused by the virus is overwhelming. (As of this writing we are over 3,000 deaths per day.) Nurses and physicians are getting sick, but it’s not from lack of PPE. It’s from community spread. They are angry at people who believe the virus is no big deal or even a hoax and bristle at the mixed messages from our leaders. As the surge in hospitalizations increases, and vents are fully utilized by COVID-19 patients, nurses worry about treating incoming heart attacks and other serious illnesses or injuries requiring an ICU bed. They are pleading with us to do our small part and follow CDC guidelines.

Music can soothe

A survey by music streaming service Pandora, with about 65 million users, revealed 80% of respondents said music has helped them cope with the pandemic. 58% of the respondents said music was their “go to” coping mechanism. The average time spent listening to music was 40 minutes. Experts report music can ward off or mitigate anxiety and depression, improve blood ﬂow and lower stress-related hormones

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IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021

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.

MILK & HONEY By Brooke Stacia DeMott

Seeking serenity

Can we really have peace in any situation?

“

If our minds are stayed upon God, his peace will rule the affairs entertained by our minds. If, on the other hand, we allow our minds to dwell on the cares of this world, God’s peace will be far from our thoughts.” — Woodrow M. Kroll Driving around last week, preoccupied with a dozen last-minute holiday errands necessary to the maintenance of my large family’s slew of traditions, I absently flipped through the radio and found my attention arrested by a curious preacher named Alistair Begg. If you were to pass him on the street, it’s not likely that you’d give this unimposing Scottish transplant a second glance, save for his comforting accent. But over the airwaves, his gripping intensity seizes one’s attention, and his confident authority shatters the notion that he’s just another face in the crowd. The witty and commanding Begg began to preach a sermon that was unnerving in its honesty. He first read off several graphic examples of human suffering from his local Cleveland, Ohio newspaper, the likes of which were so disturbing that it brought me to tears in the post office parking lot. “I know what you’re thinking to yourself,” Begg asserted. “You’re thinking, ‘Pastor that’s awfully heavy. I came here looking to be encouraged on a Sunday morning!’ You know what? So did I. And yet I see this, and I ask myself, how can we be encouraged when this is the reality of the world we live in?” Alistair begs the question that we all ask ourselves from time to time, perhaps this year more than ever. Yet, even prior to global economic fallout, a suspiciously overblown pandemic, and outrageous confusion over governmental processes and the reach of its authority into the private sector, all was never as it should be. Have we forgotten, then, that all of history showcases a motif of shattered lives, brutal power struggles, toppled empires and dirty back-door politics since the very beginning? What if I told you that it not only can get worse, but that it’s codified into the God’s eternal plan for humanity that it undoubtedly will? Can you sense the careening toward some sort of “grand finale”?

“ … There will be great distress, unequaled from the beginning of the world until now — and never to be equaled again. If those days had not been cut short, no one would survive, but for the sake of the elect those days will be shortened … … False messiahs and false prophets will appear and perform great signs and wonders to deceive, if possible, even the elect. See, I have told you ahead of time … … The sun will be darkened, and the moon will not give its light; the stars will fall from the sky, and the heavenly bodies will be shaken. At that time the sign of the Son of Man will appear in the sky, and all the nations of the earth will mourn. They will see the Son of Man coming on the clouds of the sky, with power and great glory.” (Selections of Matthew 24) Here, Jesus gives a sober prediction of the events that will immediately precede his return to earth, ushering in the judgment day of the Lord. Considering the world events around us, the passing moments of our lives before us, and in the promise of hardship that awaits us, to the temporal eye, hope seems nefariously out of reach. But look a little harder. No one is born with a longing for something that cannot be satisfied. Hunger exists, because food exists. Thirst anticipates water. A desire to be loved can be fulfilled by marriage, family, and community. So it follows that this universal yearning for purpose and hope for the future must, somehow, have a balm to sooth it. How are we to reckon the desire for hope with a world that delivers only loss? “If we find ourselves with a desire that nothing in this world can satisfy, the most probable explanation is that we were made for another world.” — C.S. Lewis The very existence of a desire is the security that it can be filled. The problem is, we are holding our cups under dry fountains when we seek for hope’s consummation in the world around us. “As a deer longs for flowing streams, so my soul longs for you, O God.” Psalms 42:1 A longing for nutrients can be

subdued for a little while if you eat a candy bar, but constant misinterpretation of the need for healthy sustenance will leave you sick and frustrated. We must rightly identify that our craving is for God himself, and cease efforts to satiate that desire with “food that perishes” but seek after “food that leads to eternal life”, that is, Jesus Christ. (John 6:27) In the meantime, we continue to traverse this world of fear and loneliness, loss and regret. In doing so, it’s quite easy to lose focus on the horizon of eternity. How can we maintain an unwavering hope for the future, even in the midst of the bleak days that lie ahead? Begg gives an answer that is both a challenge, and a comfort to his listeners. “How can we have hope? Inevitably, when I have begun to falter as I survey the world around me, it is because I have failed to remember

the sovereignty of God. The psalmist ﬁnds solace in God’s providence, declaring, ‘My times are in your hands.’ (Psalms 31:15) The Lord is overruling all things according to his purpose. And yet! That doesn’t leave us off the hook. You and I are still responsible to him for all that we are, and all that we do While it is the Lord’s to pen the epochs, it is ours to submit our spirits to his purpose, and in so doing, we ﬁnd our own. 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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IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper

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Page 9

Ask The Social

Security Ofﬁce

From the Social Security District Office

Get Your New Standardized Benefit Verification Letter Online

Golden years not all glitter Majority of Americans are concerned about being able to afford retirement Megan Plete Postol

recent Wells Fargo survey has revealed that for the majority of American workers, the pandemic has elevated financial fears about running out of money in retirement. The survey, which was conducted by the Harris Poll, found that 76% of workers are concerned that Social Security may be raided to pay down government debt. The high costs associated with the pandemic had led some to worry that the government will use the money set aside for Social Security to offset some of the ecoCooley nomic damage. Financial experts recommend early preparation as the best way to avoid late stage worry, but COVID-19 has rocked some of those best-laid plans. Makenna Cooley, financial adviser at Northwestern Mutual in New Hartford, has some advice for those concerned about being able to afford to live during retirement. “When doing your retirement planning, ratchet back your expected Social Security payout,” she said. “If you’ve logged into the Social Security website recently, try reducing the benefit by 25-50% and see how that would impact your ability to live comfortably in retirement. If you do not like the result, consult a financial adviser about what options exist to fill that gap.” Cooley has some real-world tips that workers can use to protect themselves from running out of money in retirement. Her tips include: — Save as much as possible as Page 10

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early as possible. — When you get closer to retirement, make sure you have a strategic plan to transition money to safer locations that will withstand a long retirement. — Consult professionals who can hold you accountable. — Workers who have been laid off or had their hours reduced amid the pandemic are particularly concerned about their future. The survey reported that 61% of workers are much more afraid of life in retirement than they were before COVID-19 and the pandemic took the joy out of looking forward to retirement. These financial anxieties can be overwhelming, but financial experts can help workers wade through the worry to create a plan for self-funded retirement. Cooley said there are ways to save so that retirees are not solely dependent on Social Security. “I think it’s important to understand that Social Security was only designed to supplement retirement, not be retirement,” she said. Workers should understand investment options available and pay attention to employer-provided benefits that already exist. “Overall, I find that people do not know how much they should be saving for retirement or in general,” Cooley said. “That’s not a class in high school, nor is it in college. We all need to self-fund retirement to live the lifestyle we want to live and people need to know they can do it. If you need to elicit the help of a professional to do it, there is no shame in that.” The Wells Fargo survey was conducted via online interviews. Interviewees consisted of 2,660 workers whose employment was not affected by the pandemic, 725 workers whose employment was negatively affected, 200 investors with at least $1 million in investable assets, and 1,005 retirees.

f you receive a benefit verification letter, sometimes called a “budget letter,” a “benefits letter,” a “proof of income letter,” or a “proof of award letter,” we have good news for you! A new standardized benefit verification letter is now available when you need proof of Social Security benefits, Supplemental Security Income or Medicare. In addition to name, date of birth and the benefits received, the new benefit verification letter includes other identifiers to prevent misuse and fraud. This is an added benefit to you as proof of income for loans, housing assistance, mortgage and other verification purposes. The same standardized letter is

Q&A

Q: Are Social Security numbers reassigned after a person dies? A: No. We do not reassign Social Security numbers. In all, we have assigned more than 500 million Social Security numbers. Each year we assign about 5.5 million new numbers. There are over one billion combinations of the nine-digit Social Security number. As a result, the current system has enough new numbers to last for several more generations. For more information about Social Security, visit our website at www. socialsecurity.gov. Q: I prefer reading by audio book. Does Social Security have audio publications? A: Yes, we do. You can find them at www.socialsecurity.gov/pubs. Some of the publications available include “What You Can Do Online,” “Working While Disabled — How We Can Help,” “Apply Online for Social Security Benefits,” and “Your Social Security Card and Number.” You can listen now at www.socialsecurity.gov/pubs. Q: I haven’t received my Social Security Statement in the mail the last few years. Will I ever get one again? A: We currently mail Social Security statements to workers age 60 and over who aren’t receiving Social Security benefits and do not yet have a my Social Security account. We mail the statements three months prior to their birthday. Instead of waiting to receive a mailed statement, we encourage people to open a my Social Security account at www.socialsecurity.gov/myaccount so they can access their statement online, anytime. Q: What type of information will I need to provide if I’d like to apply online for

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021

also available if you need proof that you do not receive benefits, or proof that benefits are pending. If you are an individual representative payee, you can use the my Social Security representative payee portal to access the same standardized benefit verification letter online for your beneficiaries. This new standardized benefit verification letter is another example of our commitment to improve our service to you. No matter how you request your letter, whether calling our National 800 Number, your local office, the interactive voice response system, or online with your personal my Social Security account at www.ssa.gov/ myaccount, the benefit verification letter now contains a seamless look.

Social Security retirement benefits? A: Whether you apply for retirement beneﬁts online or by phone, we suggest that you have the following information at hand when you do it. This will make completing the application easier for you: • Your birthdate, place of birth, and Social Security number; • Your bank account number and your bank’s routing number, for direct deposit; • The amount of money you earned last year and this year. If you are applying for beneﬁts in the months of September through December, you may also need to provide an estimate of what you expect to earn next year if you plan to continue working; • The name and address of your employer(s) for this year and last year; • The beginning and ending dates of any active military service you had prior to 1968; and • The name, Social Security number, and date of birth of your current and any former spouses. Depending on your situation, you may need to provide additional documentation with your application. We’ll give you instructions on how to mail it to us. To get started, visit our Retirement Planner at www. socialsecurity.gov/retire2. Q: If I call 1-800-772-1213, can a Social Security representative take my application for Medicare prescription drug help over the phone? A: If an interviewer is available when you call the 800 number, he or she can take your application over the phone. If an interviewer is not immediately available, we can schedule a telephone appointment for you. For the fastest and most convenient way to apply for Medicare prescription drug help, go online to www. socialsecurity.gov/prescriptionhelp.

SmartBites

The skinny on healthy eating

Healthier Chicken Wings Do Exist!

re you sitting down? Last year, on Super Bowl Sunday, we Americans consumed 1.4 billion chicken wings. Holy hot sauce! That’s a lotta wings! But no surprise, right? Football and wings go together like chips and dip. Decades ago, before kids, my husband and I wolfed down a basket of chicken wings every Friday. We were on a mission to ﬁnd the best wings in town. Our focus? Taste and crisp-factor. Our lack of focus? Nutrition. Never, not once, did we even wonder about fat, calories or sodium back then. Chicken wings can have that effect. They’re so delicious, so addictive, so (for some) special-occasion, that you just want to enjoy them without the guilt.

Are you still sitting down? Chicken wing consumption doesn’t have to be riddled with guilt! With a few tweaks here and a few bad-for-you ingredients slashed there, you can easily make this popular appetizer a whole lot healthier. But before we delve into wing do-overs, let’s talk nutrition. While clearly there are healthier parts of the chicken to be had, wings still have something to cluck about. When roasted in the oven, one drumette with skin provides about 100 calories, 9 grams of protein, and decent amounts of both niacin and selenium. An essential nutrient that powers many chemical reactions in our body, protein helps to keep our muscles and bones strong, which is important for maintaining balance and mobility

as we age. Niacin, a B vitamin, helps convert food to energy and inﬂuences how we process cholesterol, while selenium, a powerful antioxidant, plays an important role in the health of our immune system and helps to protect our body from damage caused by oxidative stress. Unadulterated, chicken wings are super low in sodium and fairly low in cholesterol. Wings are, however, the fattiest part of the chicken, delivering about 6.5 grams per wing (2 grams saturated). So, what happens to sodium, cholesterol and fat when wings are drenched in ﬂour, deep-fried in oil and slathered with hot sauce? All levels skyrocket. As an example, a popular chain restaurant posts the following amounts for 10 fried Buffalo wings: 5,020 mg of sodium, 515 mg of cholesterol, and 69 grams total fat (18 grams saturated). To shed perspective on these amounts: The USDA recommends that healthy adults limit their sodium intake to less than 2,400 mg per day, their cholesterol intake to no more than 300 mg per day, and their total fat intake from 44 to 78 grams per day (with saturated fat making up no more than 22 grams). Again, that’s per day, not per appetizer!

Healthy Cooking and Eating Tips Grill or bake wings. Read wing sauce labels, opting for one with less sugar, sodium and calories. If recipe calls for adding butter to the sauce, replace it with heart-healthy olive oil or better yet, skip it altogether. Make your own blue cheese dipping sauce with Greek yogurt. Be mindful of your intake: calories quickly add up!

2 teaspoons onion powder ¼ teaspoon cayenne pepper (optional) 1 ½ teaspoons kosher salt 1 ½ teaspoons coarse black pepper Celery, trimmed and cut into sticks Hot sauce of choice (optional)

Blue Cheese Dipping Sauce 4 tablespoons blue cheese or gorgonzola crumbles ½ cup nonfat Greek yogurt 2 tablespoons fresh lemon juice ½ teaspoon garlic powder ¼ teaspoon each salt and coarse black pepper pinch of cayenne pepper (optional) Preheat oven to 400 degrees F. Line a large rimmed baking sheet with foil and place an oven-safe rack on top of the foil. Coat the rack with cooking spray or a light layer of canola oil. Pat chicken wings dry to remove moisture. Place wings in a large bowl and rub olive oil well into each piece. Combine all seasonings in a small bowl; sprinkle over wings; toss until thoroughly coated. Arrange wings in a single layer on the prepared rack and bake for 30 minutes. Flip wings and bake 20 minutes more or until the skin is crispy. To make the dip: Combine all the ingredients in a small bowl and mix well. Serve wings with celery, blue cheese dip and (optional) a small bowl of hot sauce for dunking.

Anne Palumbo is a lifestyle colum-

Crispy Baked Chicken Wings 2 pounds chicken wings (about 20 drumettes and wingettes) 1 tablespoon olive oil 1 tablespoon chili powder 1 tablespoon smoked (or regular) paprika 2 teaspoons ground cumin 2 teaspoons garlic powder

Pot stronger now than in decades past, study finds

arijuana packs a lot more punch than it did 50 years ago, making it a greater threat to health, researchers say. “As the strength of cannabis has increased, so too has the number of people entering treatment for cannabis use problems,” said study co-author Tom Freeman, director of the addiction and mental health group at the University of Bath in England. In Europe, more people now enter drug treatment because of pot than heroin or cocaine, Freeman said in a university news release. He and his team assessed how concentrations of THC (the marijuana component that causes a high) has changed over time in different types of cannabis. They analyzed data from tests on more than 80,000 street samples collected in the United States, United Kingdom, Netherlands, France, Denmark, Italy and New Zealand over the past 50 years. THC concentrations in herbal cannabis increased by an average of 14% from 1970 to 2017, primarily due to a rise in stronger varieties, according to the authors. They previously found that

frequent use of cannabis with higher THC levels increases the risk of addiction and psychotic disorders. The study also found particularly large THC increases in cannabis resin, with a 24% jump between 1975 and 2017. Cannabis resin is extracted from herbal cannabis and is now typically stronger than herbal cannabis, the researchers said. “Cannabis resin — or ‘hash’ — is often seen as a safer type of cannabis, but our ﬁndings show that it is now stronger than herbal cannabis. Traditionally, cannabis resin contained much lower amounts of THC with equal quantities of CBD [cannabidiol],” said study co-author Sam Craft, also from the addiction and mental health group at the University of Bath. “However, CBD concentrations have remained stable as THC has risen substantially, meaning it is now much more harmful than it was many years ago,” he said in the release. CBD is not intoxicating and may have potential medical uses. Marijuana – the most widely used illicit drug in the world – is legal in many countries and a number

of U.S. states. “As the strength of cannabis has risen, consumers are faced with limited information to help them monitor their intake and guide decisions about relative beneﬁts and

January 2021 •

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.

risks. The introduction of a standard unit system for cannabis – similar to standard alcohol units – could help people to limit their consumption and use it more safely,” Freeman said.

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper

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Page 11

Vice Squad

American Heart Association pushes for increased taxes on cigarettes, tobacco products By Daniel Baldwin ith the coronavirus pandemic, protests, business shutdowns, and many other natural disasters that occurred in 2020, it is no surprise to see more and more Americans stressed out by the outcome. According to CNBC. com, more than half of all Americans said they are more stressed now than they were before the COVID-19 outbreak. Although O’Brien many people and tobacco companies said smoking is one good way to relieve stress, it actually makes you more stressed, according to mentalhealth.org. No matter how many problems or how much stress a person is dealing within the past year, he or she still cannot resort to smoking, as it will not only increase their risk of getting heart disease, stroke, and lung cancer, but it will also make them more vulnerable to getting the coronavirus. “The World Health Organization recently said smokers are likely more vulnerable to severe and potentially life-threatening cases of COVID-19,” Dr. Disha Mookherjee, a cardiologist

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at Saratoga Hospital and member of the Capital Region board of directors of the American Heart Association, said. “I see the damaging effects of tobacco use in my work everyday.” While a majority of hospitals and health organizations in Central New York are busy treating COVID patients and creating rules and restrictions to reduce the spread, the AHA has been hard at work trying to persuade New York State Gov. Andrew Cuomo to increase taxes on cigarettes and other tobacco products in the state. AHA advocates, which included teens, former smokers, cardiologists, and Mookherjee herself hosted a Zoom rally recently to ask the state governor to include a $1 per pack tax increase on cigarettes and provide tax parity on other tobacco products in the state’s 2021 executive budget. Caitlin O’Brien, government-relations director for the AHA, was also in attendance at the Zoom meeting. She said the heart association has been a long proponent of increasing tobacco taxes. They were heavily involved in advocating for the $1.60 cigarette tax increase in 2010, and they were actively involved in the efforts to establish a tax on e-cigarettes.

Higher tax supported

“Ten years without a real change in the tax on tobacco products like cigarettes and cigars means New Yorkers have simply adjusted to the cost and continued their addiction,” O’Brien said. “In terms of youth, they

have grown up only knowing one price, thereby accepting it without a second thought. This means tobacco taxes are no longer having their intended effect. “Tobacco taxes are so effective at reducing rates of tobacco use and preventing new smokers from starting because they act as a deterrent. When smokers grow accustom to these prices and are no longer fazed by them, it’s time for us to step in.” The amount of high school students using tobacco products in New York state increased from 2016-2018, and nearly 13 percent of the state’s residents are smoking and struggling to break this habit, according to O’Brien. The rate of Americans smoking hit a record low in 2019, according to CNBC, but with the pandemic and other problems, O’Brien assumed that the number of smokers in the state and U.S. could increase in 2020. “We can assume there will be an increase in the use of tobacco products given the increased stress,” O’Brien said. “This is particularly

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021

alarming given the World Health Organization has stated that smokers are likely to suffer from severe cases of COVID-19.” The main reason why the association started this tobacco tax rally and has constantly urged the state governor to increase taxes on cigarettes is to of course encourage people to quit smoking. The increase in the states’ tobacco taxes could scare more smokers away from purchasing a cigarette box and help them break their bad habit. “An increase in the state’s cigarette tax alone, by just $1, means 29,500 youth under age 18 would be kept from becoming adult smokers,” O’Brien said. “It would also mean a reduction in young adult (18-24 years old) smokers by 6,500. Even more reductions will occur by establishing tax parity between the cigarette tax and the tax on e-cigarettes and cigars. State residents who want to help can join the association’s online advocacy platform at http://www. yourethecure.org/.

Burden of being barren Frustrated couples bear pain of infertility

By Barbara Pierce

“

I feel like a failure as a woman because I can’t have children,” says Katy Lindemann online. “I’m a feminist. So how have I become so utterly possessed by this fervent desire to become a mother?” Actor Anne Hathaway recently came forward about her struggles getting pregnant because “infertility is really painful, very isolating and full of self-doubt. I went through that.” The 38-yearold Hathaway Pinkhasov recently gave birth to her second child. “You cannot understand this until you go through it. Period!” said Susan Bisno Massel on resolve.org. A research study showed couples dealing with infertility identiﬁed it as the most upsetting experience of their lives. “Struggling to build a family can be so isolating because people don’t talk about it enough. This silence makes people feel more alone and contributes to the stigma and shame associated with infertility,” said Betsy Campbell, CEO, RESOLVE: The National Infertility Association. “Infertility is much more than just a medical condition. Hearing about a possible infertility diagnosis is overwhelming. Infertility can deplete your ﬁnances, affect your relationship, and have an impact on you or your partner’s emotional health,” she added. Approximately one couple in eight in the United States has an issue with infertility, experts say. If infertility is an issue, a couple attempting to conceive should have

an evaluation for infertility if pregnancy fails to occur within one year of regular unprotected intercourse, Dr. Ruben Pinkhasov of Upstate Urology at Mohawk Valley Health System said recently about male infertility. If she is 35 or older, the evaluation should begin after six months of trying unsuccessfully to conceive. By age 30, fertility starts to decline. This decline becomes more rapid once you reach your mid-30s. The woman often carries the burden of infertility, though males often share responsibility, Pinkhasov said. Fertility experts agree that, on average, 30% of the cases of infertility can be attributed solely to the female, 30% solely to the male, and 30% a combination of both partners. In 10%, the cause is unknown.

Timing is everything

Understanding when you’re ovulating can improve your odds of conceiving.

Ovulating is when an egg is released from the ovary. The egg can be fertilized for about 12-to-24 hours after release. Your chances of getting pregnant are dramatically increased if you have intercourse on the day of ovulation or two days before. Knowing when you ovulate can help you plan for sex at the right time and improve your chances of getting pregnant. You can keep track of your menstrual cycles on a chart, in a diary, or on a free period-tracker app. Consider trying an over-thecounter ovulation kit to take out the guesswork; it’s precise and easy to use. Walgreen’s in Utica carries the kit. How treatable is infertility? Nearly 90% of infertility is treatable with therapies such as medication, surgical repair of reproductive organs, and assisted reproductive techniques such as intrauterine insemination and in vitro fertilization. IVF is the process of combining an egg and sperm in a laboratory dish for fertilization. This combined

sperm and egg are called an embryo. The embryo is transferred to the uterus for development. “You don’t know how you’re going to feel about any treatment or any part of it until you get there,” said Massel. “One minute you may say ‘no way’ to IVF, and then you ﬁnd yourself giving yourself shots and counting follicles.” A weight loss of even 5%-to-10% may dramatically improve ovulation and pregnancy rates. Recurring miscarriages and pregnancy loss may indicate underlying problems; however, 60% of women with miscarriages go on to have healthy pregnancies and births. Coping with infertility can be extremely difﬁcult because there are so many unknowns. The journey can take an emotional toll on a couple. “Providing meaningful support for those struggling to build families is RESOLVE’s mission,” said Campbell. “It’s important to talk to others who understand what you are going through. Our virtual support groups have been very well received; most reporting that the meetings improved their sense of well-being and community.” “Letting people in and talking about this pain can really ease the burden,” said Massel, who has since had a healthy pregnancy and birth. Baby showers, baby pictures, and new moms should be removed from your life, she suggests. Allow yourself to feel jealousy and intense dislike, then move on. Have talking points ready when people ask if you have kids or plan to, she added. “Mine were: ‘It doesn’t look like it’s in the cards for us.’ That seemed to make people feel a little bad for asking (which I have to admit I wanted) and let folks know we’d tried, which, for some reason, I also wanted.” See RESOLVE.org for more helpful information on infertility.

Calorie Count: Eating Early Doesn’t Boost Weight Loss Timing isn’t everything when it comes to losing extra pounds

f you’re overweight, eating most of your calories early in the day won’t boost the beneﬁt of a healthy diet, new research suggests. In a 12-week study, 41 people ate the same healthy diet, but one group ate 80% of their calories before 1 p.m. and the other group ate 50% of their calories after 5 p.m. All participants consumed the same prepared, healthy meals. Weight and blood pressure were measured at the beginning of the study, and again at four, eight and 12 weeks. The analysis found that people in both groups lost weight and had decreased blood pressure, regardless of when they ate. “We have wondered for a long time if when one eats during the day affects the way the body uses and stores energy,” said researcher physician Nisa Maruthur. She’s an associate professor of medicine, epidemiology and nursing at Johns Hopkins

University in Baltimore. “Most prior studies have not controlled the number of calories, so it wasn’t clear if people who ate earlier just ate fewer calories. In this study, the only thing we changed was the time of day of eating,” Maruthur explained. The findings were presentated in November at the American Heart Association›s (AHA) virtual annual meeting. Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal. “We thought that the time-restricted group would lose more weight,” Maruthur said in an AHA news release. “Yet, that didn’t happen. We did not see any difference in weight loss for those who ate most of their calories earlier versus later in the day. We did not see any effects on blood pressure either.” January 2021 •

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper

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Page 13

By Jim Miller

What You’ll Pay for Medicare in 2021 Dear Savvy Senior, I know there will be a small cost-of-living increase in Social Security beneﬁts next year but what about Medicare? What will the Medicare Part B monthly premiums be in 2021, and when do the surcharges kick in for higher income beneﬁciaries?

Noticing Memory Problems? What to Do Next

Inquiring Senior Dear Inquiring, The Centers for Medicare and Medicaid Services recently announced their cost adjustments for 2021 and the increases for premiums and out-of-pocket costs for most beneﬁciaries will be modest. But if you’re a high earner, you’ll pay more. Here’s what you can expect starting in January.

Medicare Part B While Medicare Part A, which pays for hospital care, is premium-free for most beneficiaries, Part B, which covers doctor visits and outpatient services does have a monthly premium. Starting in 2021, the standard monthly Part B premium will be $148.50, up from $144.60 in 2020. That $3.90 bump represents a 2.7% increase, which is more than double the most recent Social Security cost-of-living adjustment which was 1.3%. But if you’re a high earning beneficiary, which makes up about 7% of all Medicare recipients, you’ll have to pay more. Medicare surcharges for high earners are based on adjusted gross income from two years earlier, which means that 2021 Part B premiums are determined by 2019 annual income. So, if your 2019 income was above $88,000 up to $111,000 ($176,000 up to $222,000 for married couples filing jointly), your 2021 Part B monthly premium will be $207.90, up from $202.40 in 2020. Monthly premiums for singles with an income between $111,000 and $138,000 ($222,000 and $276,000 for joint filers) will rise from $289.20 to $297. Individuals earning above $138,000 up to $165,000 ($276,000 to $330,000 for joint filers) will see their monthly premium increase from $376 to $386.10. Those with incomes above $165,000 up to $500,000 ($320,000 to $750,000 for joint filers), you’ll pay $475.20 per month in 2021. And Page 14

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single ﬁlers with income of $500,000 or more ($750,000 or more for joint ﬁlers) will pay $504.90 per month next year.

Medicare Part D If you have a Medicare (Part D) prescription drug plan, the average premium in 2021 will be about $30 per month for most beneﬁciaries. But, again for high earners with annual incomes above $88,000 ($176,000 for joint ﬁlers) you’ll pay a $12.30 to $77.10 monthly surcharge on top of your regular Part D premiums.

How to Contest Income Beneficiaries that fall into any of the high-income categories and have experienced certain life-changing events that have reduced their income since 2019, such as retirement, divorce or the death of a spouse, can contest the surcharge. For more information on how to do this, see “Medicare Premiums: Rules for Higher-Income Beneficiaries” at SSA.gov/benefits/medicare/medicare-premiums.html.

Other Medicare Increases In addition to the Part B and Part D premium increases, there are other cost increases you should be aware of. For example, the annual deductible for Medicare Part B will see a bump from $198 to $203 in 2021. The deductible for Medicare Part A, which covers hospital services, will increase from $1,408 in 2020 to $1,484 in 2021. There are no surcharges on Medicare deductibles for high earners. For more information on all the Medicare costs for 2021 visit Medicare.gov and click on “2021 Medicare Costs,” or call 800-633-4227.

any seniors worry about memory lapses as they get older, fearing it may be the ﬁrst signs of Alzheimer’s disease or some other type of dementia. To get some insight on the seriousness of the problem, here are some key warning signs to be vigilant of and some resources you can turn to for help.

Warning Signs As we grow older, some memory difficulties — such as trouble remembering names of people or places or forgetting where you put your glasses or car keys — are associated with normal aging. But the symptoms of Alzheimer’s disease are much more than simple memory lapses. Knowing the early warning signs is a good first step in recognizing the difference between typical age-related memory loss and a more serious problem. To help you evaluate your condition, here’s a checklist of some common early symptoms to watch for: • Asking the same questions repeatedly. • Getting lost in familiar areas. • Failing to recognize familiar people. • Having difficulty following directions. • Misplacing items in inappropriate places, for example putting keys in the microwave. • Having difficulty completing familiar tasks like cooking a meal or paying a bill. • Having trouble remembering common words when speaking or mixing up words. For more information, see the Alzheimer’s Association list of 10 early signs and symptoms at 10signs. org. Another good tool to help you evaluate your situation is the Self-Administered Gerocognitive Exam (SAGE test) that was developed at The Ohio State University

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021

Wexner Medical Center. This free test helps identify mild cognitive impairment and early dementia and can be taken at home in about 10 to 15 minutes. The SAGE test can be taken online at BrainTest.com.

Get Help If you would rather have professional assistance in evaluating your problem, the Alzheimer’s Foundation of America (see alzfdn.org) is another good resource you can turn to. Every Monday, Wednesday and Friday they provide free, confidential virtual memory screenings done via video chat in real time. The test-taker will need a phone, tablet or computer with a webcam and internet capability to complete the screening. The screenings are given by healthcare professionals and take about 10 to 15 minutes to complete. Once the screening is complete, the screener will review the results with test-takers and let them know if they should see a doctor for further evaluation. To set up a memory screening for your situation call 866-232-8484 and make an appointment. If you find that you do need further evaluation, make an appointment with a primary care doctor for a cognitive checkup and medical examination. Depending on what’s found, you may be referred to a geriatrician or neurologist who specializes in diagnosing and treating memory loss or Alzheimer’s disease. Keep in mind that even if you are experiencing some memory problems, it doesn’t necessarily mean you have early-stage Alzheimer’s. Many memory problems are brought on by other factors like stress, depression, thyroid disease, side effects of medications, sleep disorders, vitamin deficiencies and other medical conditions. And by treating these conditions you can reduce or eliminate the problem.

Dental assistants enjoy wide range of responsibilities, including patient care Something to Smile About: A Paid Dental Assistant Training Program

R Medicine’s Eastman Institute for Oral Health has recently announced an innovative new program, designed to provide employment and paid training opportunities while helping treat the area’s increased number of dental patients. The pandemic has created a critical need for dental assistants locally and nationally because many current employees need to be home with their school-age children, among other reasons. In addition, the many unemployed workers in hospitality, sales and service industries don’t have the ability or resources to obtain training in a different field. “This new dental assistant training program solves that problem, because those accepted into the program will receive full-time pay and benefits while getting on-the-job training,” said Holly Barone, Eastman’s chief operations officer. “It’s a win-win for the Rochester community.” Eastman Institute for Oral Health was one of the few in the region to stay open during the pandemic. But since routine and elective procedures re-opened, staff shortages coupled with new challenges have resulted in

higher demand for emergency and routine dental treatment, thus limiting the ability to treat non-emergency patients in a timely fashion. The new, one-year training program begins Jan. 19, when participants will have two hours of classroom learning, followed by observation and hands-on training each day. Upon completion, they can then work independently as a chairside assistant, help the dentist provide patient care, work in the lab, take X-rays, sterilize equipment and many other responsibilities. Dental assistants enjoy a wide range of responsibilities including patient care. “Because people are so busy, we purposely designed the program to be strictly on-the-job training,” added Barone. “No homework, no tests and no prior dental or health experience necessary. The goal is to make it convenient to learn valuable new skills while serving our community.” The training will be conducted in Eastman Dental’s General Dentistry Department at 625 Elmwood Ave., near Strong Memorial Hospital. For more information and an application, visit dentalassistant.urmc.edu.

Oneida Health sets precautionary visitation restrictions All routine visitation at Oneida Health and its extended care facility will be restricted as a precautionary measure due to the increased prevalence of COVID-19 in nearby communities. This also includes individuals accompanying patients during outpatient visits throughout their network. “The safety of our patients, residents, and staff continues to be our top priority,” said Gene Morreale, president and CEO of Oneida Health. “As the number of COVID-19 positive cases rise in surrounding counties, we need to be vigilant in taking

the necessary precautions to maintain a safe environment to provide care.” Visitor restrictions at the hospital and extended care do include some exceptions for critically ill and endof-life patients. The extended care will maintain scheduled window and virtual visits for residents. Inpatient virtual visits will also be available at the hospital. Patients who are 17 and under as well as those who are developmentally disabled are allowed one visitor to accompany them while receiving care, including emergency room visits. Obstetrical patients will continue

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: $11.80/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.

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to be permitted one individual to participate in the birth. “We do not take the decision to restrict visitors from seeing or accompanying their loved ones lightly,” said Morreale. “The rising number of cases requires us to take immediate precautions to limit its impact on the health and safety of those we serve.” He noted that the restriction on visitors should only be temporary. “We will continue to work closely with New York state and the Madison County Department of Health to monitor COVID-19 trends with the goal of reinstating routine visitation as soon as it is safe to do so,” he

noted. Morreale also commented on the importance of community members continuing to seek care when needed and remaining diligent in proper hand washing, social distancing, and wearing masks when necessary. “It’s just as important today as it was in April for community members to take the necessary precautions to maintain their health, including seeking care where and when they need it,” said Morreale. For more detailed information about visitor restrictions and exceptions throughout the Oneida Health network, visit oneidahealth.org.

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January 2021 •

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MILK & HONEY By Brooke Stacia DeMott

Can We Really Have Peace in Any Situation? “If our minds are stayed upon God, His peace will rule the affairs entertained by our minds. If, on the other hand, we allow our minds to dwell on the cares of this world, God›s peace will be far from our thoughts.” Woodrow M Kroll Driving around last week, preoccupied with a dozen last minute holiday errands necessary to the maintenance of my large family’s slew of traditions, I absently flipped through the radio- and found my attention arrested by a curious preacher named Alistair Begg. If you were to pass him on the street, it’s not likely that you’d give this unimposing Scottish transplant a second glance (save for his comforting accent.) But over the airwaves, his gripping intensity seizes one’s attention, and his confident authority shatters the notion that he’s just another face in the crowd. The witty and commanding Begg began to preach a sermon that was unnerving in its honesty. He first read off several graphic examples of human suffering from his local Cleveland, OH newspaper, the likes of which were so disturbing that it brought me to tears in post office parking lot. “I know what you’re thinking to yourself,” Begg asserted. “You’re thinking, ‘Pastor that’s awfully heavy. I came here looking to be en-

couraged on a Sunday morning!’ You know what? So did I. And yet I see this, and I ask myself, how can we be encouraged when this is the reality of the world we live in?” Alistair begs the question that we all ask ourselves from time to timeperhaps this year more than ever. Yet, even prior to global economic fallout, a suspiciously overblown pandemic, and outrageous confusion over governmental processes and the reach of its authority into the private sector, all was never as it should be. Have we forgotten, then, that all of history showcases a motif of shattered lives, brutal power struggles, toppled empires and dirty back-door politics since the very beginning? What if I told you that it not only can get worse, but that it’s codiﬁed into the God’s eternal plan for humanity that it undoubtedly will? Can you sense the careening toward some sort of ‘grand ﬁnale’? “…there will be great distress, unequaled from the beginning of the world until now—and never to be equaled again. If those days had not been cut short, no one would survive, but for the sake of the elect those days will be shortened… … false messiahs and false prophets will appear and perform great signs and wonders to deceive, if possible, even the elect. See, I have told you ahead of time…

…the sun will be darkened, and the moon will not give its light; the stars will fall from the sky, and the heavenly bodies will be shaken.’ At that time the sign of the Son of Man will appear in the sky, and all the nations of the earth will mourn. They will see the Son of Man coming on the clouds of the sky, with power and great glory.” (Selections of Matthew 24) Here, Jesus gives a sober prediction of the events that will immediately precede His return to earth, ushering in the judgement day of the Lord. Considering the world events around us, the passing moments of our lives before us, and in the promise of hardship that awaits us, to the temporal eye, hope seems nefariously out of reach.

But look a little harder. No one is born with a longing for something which cannot be satisfied. Hunger exists, because food exists. Thirst anticipates water. A desire to be loved can be fulfilled by marriage, family, and community. So it follows that this universal ache for purpose and hope for the future must, somehow, have a balm to sooth it. How are we to reckon the desire for hope with a world that delivers only loss? “If we find ourselves with a desire that nothing in this world can satisfy, the most probable explanation is that we were made for another world.” C. S. Lewis The very existence of a desire is the security that it can be filled. The problem is, we are holding our cups under dry fountains when we seek for hope’s consummation in the world around us. “As a deer longs for flowing streams, so my soul longs for you, O God.” Psalm 42:1 A longing for nutrients can be subdued for a little while if you eat a candy bar, but constant misinter-

pretation of the need for healthy sustenance will leave you sick and frustrated. We must rightly identify that our craving is for God Himself, and cease efforts to satiate that desire with ‘food that perishes’ but seek after ‘food that leads to eternal life’- that is, Jesus Christ. (John 6:27) In the meantime, we continue to traverse this world of fear and loneliness, loss and regret- and in so doing, it’s quite easy to lose focus on the horizon of eternity. How can we maintain an unwavering hope for the future, even in the midst of the bleak days which lie ahead? Pastor Begg gives an answer that is both a challenge, and a comfort to his listeners. “How can we have hope? Inevitably, when I have begun to falter as I survey the world around me, it is because I have failed to remember the sovereignty of God. The psalmist ﬁnds solace in God’s providence, declaring, ‘My times are in your hands.’ (Pslam 31:15) The Lord is overruling all things according to His purpose. And yet! That doesn’t leave us off the hook. You and I are still responsible to him for all that we are, and all that we do.” While it is the Lord’s to pen the epochs, it is ours to submit our spirits to His purpose- and in so doing, we ﬁnd our own.

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.

s d i K Corner

Teen Smoking Rates Drop, E-Cig Use Rises: Study

merican teens’ use of tobacco cigarettes and smokeless tobacco has dropped to record lows, even as their use of electronic cigarettes increased, new research shows. For the study, researchers analyzed nationwide data on tobacco product use among 8th-, 10th- and 12th-graders from 1991 to 2019. Daily smoking rates among 12thgrade boys rose 4.9% a year between 1991 and 1998, but fell 8% a year between 1998 and 2006, and 1.6% from 2006 to 2012. There was a 17% annual decline from 2012 to 2019. Overall, daily smoking among 12th-graders Page 16

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fell to about 2% by 2019, the study found. “This is an astoundingly low rate, and our goal from a public health perspective should be to keep smoking at this rate or lower,” said study co-author David Levy, a professor of oncology at Georgetown University in Washington, D.C. Similar results were seen for boys and girls in all grades and for both Black and white teens. The researchers also reported similar rapid decreases in teen use of cigars and cigarillos, along with consistent declines in smokeless tobacco use in the last ﬁve years.

Lead study author Rafael Meza said, “While the increases in e-cigarettes are indeed concerning and is something we need to address and reverse, the decreases in other tobacco products, in particular, cigarettes — the most concerning form of tobacco use — are accelerating.” Meza is associate professor of epidemiology and global health at the University of Michigan in Ann Arbor. The across-the-board decline in cigarette smoking is something to highlight and celebrate, and it “suggests that it’s a general pattern, that kids are just not into smoking anymore,” Meza added.

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021

There have been concerns that increased e-cigarette use among teens could lead to a resurgence in use of traditional cigarettes and other tobacco products. “But, in contrast, what we found is that the decline in smoking has accelerated,” Meza said. “So I think the good news is that the rapid increase in e-cigarette use has not yet resulted in a reversal of the decreasing trends of cigarette smoking and smokeless tobacco use, and if anything, those trends have accelerated.” The report was published online Dec. 2 in JAMA Network Open.

The Balanced Body

When loss is a gain By Deb Dittner

Weight loss slims risk of disease, improves quality of life

osing weight can be a difficult task. Maintaining weight once lost can also be difficult. But gaining weight back, sadly to say, is easy. Some studies estimate that only 1% to 3% of those who have lost weight are able to keep it off. There are a multitude of factors that go into weight loss and weight gain but losing weight and keeping it off may lower your risk of developing disease. Studies have shown positive effects in cholesterol, fasting blood sugar and HgA1c (tells you average level of blood sugar over the last two to three months), blood pressure readings, lipids, liver enzymes, high-sensitivity C-reactive protein (inflammatory marker), and waist circumference. Weight loss lowers the risk of heart disease, stroke, and diabetes and keeping the weight off increases those benefits. Once achieving and maintaining a healthy body, the benefits only get stronger. Effective and healthy weight loss approaches and strategies create optimal health and well-being. Losing weight and keeping it off can help you in evading disease. Many have asked me, “How many calories should I eat in order to lose weight?” I don’t recommend calorie counting but do recommend whole nutrient-dense foods filling your plate with vegetables and clean, lean protein providing food to fuel your everyday needs. You also need to note how the foods you consume make you feel. Removing inflammatory foods from your daily intake is crucial. Foods such as peanuts (mold and fungus), frozen yogurt (sugar and dairy), agave (sugar), barley, rye, and seitan (gluten), nightshades, seasoning mixes (sugar and gluten), and most products in a box with a long list of ingredients are inflammatory. The top anti-inflammatory foods recommended are celery, kale, extra virgin olive oil, lentils, hemp seeds, grapefruit, turmeric, ginger, pistachios, whole grains, beets, avocado and fatty fish. A low carbohydrate, high-fat diet such as the ketogenic plan may be of benefit. A clean, well-developed keto diet may lower your feeling of being hungry, provides sustainable energy for your metabolism, and allows you to burn fat instead of sugar. The

keto diet lowers inflammation and improves brain function. Your health care provider can test for food sensitivities as not everyone can eat everything. Food intolerances can be determined by exposures, genetics and overall health status. Food sensitivity testing will provide the information needed to make proper nutritional choices, helping to decrease inflammation and improve absorption. Eating foods that nourish your body will allow you to feel better while losing the necessary weight. Intermittent fasting basically occurs during the times you are not eating. If you have your last meal at sundown (@6-to-7 p.m.), then fast until 8 a.m. when you would be “breaking the fast” known as “breakfast”, you would have fasted for 13 hours. Another approach to intermittent fasting would be to eat your first meal at 2 p.m. and your last meal at 6 p.m. giving you a 4-to-6 hour eating window. And another approach to intermittent fasting is to eat during an 8-hour period and fast during the remaining 16 hours of the day, which is the number of hours needed to heal and regenerate. As an example to this approach: first meal at noon, snack at 3 p.m., and dinner at 6-7 p.m.

Seek out nutrition

• Eat nutrient-dense whole foods consisting of the colors of the rainbow, plant based, ﬁber rich, lean

clean protein, healthy fats, carbohydrates with a low glycemic index, and herbs and spices. Be mindful when eating and slow down. Take a forkful, put down the fork, chew and enjoy the taste and texture. Boosting the immune system by eating a nutrient-rich diet will improve your metabolic health, decreasing inflammation and chronic disease, and improve blood sugar and lipid values. Lifestyle changes to focus on include: • Physical movement for a minimum of 2½ hours per week or at least 20 minutes per day. You need to find a source of exercise that you enjoy and will do. If you don’t like running, for example, you’re probably not going to do it. You also need to change things up during the week. You need to get the heart pumping and make the muscles strong. • A well-hydrated body will increase your performance as well. Aim for half your body weight in fluid ounces. So, if you weigh 150 pounds, you will need to drink 75 ounces of mostly water daily. Herbal teas count into your daily intake. If your urine is dark in color, you are not drinking enough. On the other hand, if your urine is pale yellow and clear, your intake is good. • The quantity and quality of sleep aids in a healthy body. It is recommended to sleep 7-to-9 hours nightly. Sleep hygiene can include an Epsom salt bath with therapeutic grade essential lavender oil, no blue

light (from the television, iPhone or iPad, computer), calming herbal tea, a darkened cool room, avoid stimulants (alcohol, caffeine, sugar and smoking), avoiding bedtime snacks or going to bed on a full stomach, reading a book or magazine, breathing techniques, restorative yoga, calming music or sound machine, and the use of melatonin. • The importance of stress management in today’s world needs much attention. Chronic stress will increase cortisol levels and add to weight issues. Reduce stress by practicing breathing techniques (deep breath in to the count of four, hold for the count of four, and breathe out for the count of four for example), meditation, journaling (gratitude), and counseling. • Include community as much as possible into every day. Balancing your body with lifestyle changes should include the support and connection between family and friends. — Find a health care provider who encourages lifestyle changes to improve your weight loss journey. Providers in functional medicine search for the root cause of symptoms and will personalize your plan toward better health. When embarking on a health journey, a variety of approaches can be personalized to improve your overall health and well-being. Weight loss, boosting your immune system, and lowering your risk for chronic disease is necessary in today’s complicated health environment. The information provided is for educational purposes only. Any changes you wish to make should be discussed with your healthcare provider. 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.

AHA kicks off America’s Greatest Heart Run and Walk 2021 The date for America’s Greatest Heart Run and Walk is changing, but the mission of the event remains the same. The American Heart Association announced its plans for America’s Greatest Heart Run and Walk in a digital kickoff recently. America’s Greatest Heart Run and Walk will take place from 9 a.m. to noon on May 15, 2021. There are currently three options for the event: — If the AHA, state and federal guidelines permit, the event will be in person at Accelerate Sports in

Whitesboro. — If in-person gatherings are not permitted, the event will be digital. — If guidelines allow, the event will be a hybrid event, with some in-person and some digital events. Participants can register to be part of America’s Greatest Heart Run and Walk at UticaHeartRunWalk@ heart.org. For now, the AHA and volunteers are planning for a digital event. A Facebook event page has been set

up, https://www.facebook.com/ events/706368326938393/, featuring events leading up to and on May 15. The page will contain information from sponsors, and on May 15, will host the health expo and feature opening ceremonies. During the morning of May 15, people will have time to run or walk wherever they are and are encouraged to post their pictures on the Facebook event page. “We may have a new venue and things may look a little different,

January 2021 •

but it is this community that makes this event such a great success every year,” said Steve Gassner, administrative ofﬁcer at Mohawk Valley Water Authority and logistics chair of America’s Greatest Heart Run and Walk. He is also the chair of the Mohawk Valley Board of Directors of the AHA. The radiothon and telethon will still be part of America’s Greatest Heart Run and Walk, although they will be presented earlier in the year.

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Cancers in U.S. Teens, Young Adults Up Study shows incidence of cancer among young adults up by 30% since 1970s

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ancer cases among U.S. teens and young adults have shot up 30% since the 1970s, new research reveals. Kidney cancer has risen at the greatest rate, increasing more than threefold among young men and women, according to the researchers. Breast cancers were the most common cancers among women and testicular cancer was the most common among men. Using data collected by the U.S. National Cancer Institute, the investigators looked at half a million cancer cases diagnosed between 1973 and 2015 among people aged 15 to 39.

What explains the dramatic rise in this age group? Other research has pointed to a range of potentially problematic lifestyle factors. They include a rise in obesity, worsening diets, insufﬁcient exercise and UV/tanning bed exposure, said study co-author, physician Nicholas Zaorsky, an assistant professor of radiation oncology at Penn State Cancer Institute. Many of those issues were also cited by physician Archie Bleyer, a clinical research professor in radiation medicine at Oregon Health & Science University, in Portland. Bleyer added substance abuse and risky sexual activity to a list of behavioral trends “that may cause cancer [and that] occur predominantly in older adolescents and young adults.” He said, “Cancers that are related to obesity in older adults are frequent cancers in young adults. And obesity has been steadily increasing in American young adults. Also, diagnostic imaging [CT scans, MRIs, ultrasound scans, etc.] has increased in young adults, leading to diagnoses of a ‘cancer’ that would not have created a problem for the rest of the person’s life.” In other words, Bleyer said, “overdiagnosis” may play a role.

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Heart Disease Is World’s No. 1 Killer Heart disease cases worldwide nearly double— China leads as the country with highest incidence

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eart disease is the leading cause of death worldwide — accounting for one-third of deaths in 2019 —and the death toll continues to rise, a new paper says. China had the highest number of heart disease deaths in 2019, followed by India, Russia, the United States and Indonesia. Heart disease death rates were lowest in France, Peru and Japan, where rates were six times lower than in 1990. Countries need to create cost-effective public health programs to reduce heart disease risk through behavior changes, according to the report’s authors, who examined 30 years of data. Heart disease cases nearly doubled over the period — from 271 million in 1990 to 523 million in 2019, and the number of heart disease deaths rose from 12.1 million to 18.6 million. In 2019, the majority of heart disease deaths were attributed to ischemic heart disease and stroke, with a steady increase from 1990. (Ischemic heart disease is a term for heart problems caused by narrowed arteries.) In 2019, heart disease was the underlying cause of 9.6 million deaths among men and 8.9 million deaths among women globally. More than 6 million of those deaths occurred in people between 30 and 70 years of age. The ﬁndings were published Dec. 9 in the Journal of the American

IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021

College of Cardiology. Along with being the leading cause of death, cardiovascular disease (CVD) — especially ischemic heart disease and stroke — is a major cause of disability and rising health care costs. There was a signiﬁcant increase in the heart disease-related years of life lost and the number of years lived with heart disease-related disability doubled to 34.4 million from 1990 to 2019, the study found. “Global patterns of total CVD have signiﬁcant implications for clinical practice and public health policy development,” said lead author, physician Gregory Roth, an associate professor of cardiology at the University of Washington in Seattle. “Prevalent cases of total CVD are likely to increase substantially as a result of population growth and aging, especially in Northern Africa and Western Asia, Central and Southern Asia, Latin America and the Caribbean, and Eastern and Southeastern Asia, where the share of older persons is projected to double between 2019 and 2050,” he said, calling for increased attention to promoting heart health and healthy aging throughout life. “Equally important, the time has come to implement feasible and affordable strategies for the prevention and control of CVD and to monitor results,» Roth said in a journal news release.

Women’s Health

Older motherhood offers benefits, problems

Study: Later maternal age for a woman’s last child may indicate greater longevity

study published in Menopause, the journal of The North American Menopause Society, suggests that later maternal age for a woman’s last child may indicate greater longevity for the mom. While it is yet unknown if the ability to naturally achieve a later pregnancy indicates a healthier woman or if the later pregnancy causes a longer life, it is still an interesting ﬁnding. Most news for older moms is not as positive. For many reasons, it is ideal for the health of moms and babies for mothers to become pregnant younger; however, life does not always happen that way. “From what we know so far, if you’re 35 or older, it presents more challenges and you’re at greater risk for birth defects, premature birth, getting pregnant with multiples and complications in pregnancy,” said Darcy Dryer, director of maternal and child health for March of Dimes across the region from Buffalo, Rochester to Syracuse. She said one of the reasons behind the uptick in complications is that many women as they hit their mid-30s are more likely to have chronic health problems such as diabetes, hypertension and high blood pressure. Fertility also begins to decline. Dryer encourages women who want to have a baby to get healthy before getting pregnant. “Everyone should try to get healthy, but if you’re hoping to have a baby, these things carry more weight. Get a pre-conception health check up at the OB-GYN and manage any chronic health conditions.” If left untreated and unmanaged, chronic health conditions can contrib-

ute to more problems; however, the age of the mom also matters. A woman’s eggs are formed when she is developing as a baby in her mother’s uterus. She is born with all the eggs she will ever have. New eggs do not develop. The eggs age along with the woman, so with many women, eggs fertilized at age 37 are more likely to have suffered age-related degradation than those fertilized at age 27. To an extent, her lifelong health habits do play a role in the health of her eggs. Physician Ahmed I. Ahmed is an assistant professor with University of Rochester and is board-certified in both clinical genetics and genomics and obstetrics and gynecology. He works with at-risk pregnant women. He said that a major risk of later conception is “having a baby with a chromosomal abnormality, mainly Down Syndrome, trisomy 13 and trisomy18. The higher the age, the higher the risk.” According to the National Institutes of Health (NIH), most children with trisomy 13 die before their first month of life and survivors commonly experience lifelong disabilities and complications, including breathing issues, deafness, feeding problems, heart failure, seizures and vision problems. Those surviving infancy may also have intellectual disabilities and developmental delays and higher risk for cancer. The NIH describes trisomy 18 as a chromosome disorder that can cause a hole in the heart, wasting syndrome, permanent flexion of the finger and cognitive impairment. Ahmed added that mothers above 40 also have higher risk for preeclampsia, gestational diabetes, premature labor, premature rup-

ture of membranes, labor problems, post-partum hemorrhage, labor problems, and prolonged labor. While some younger mothers experience complications and it is impossible to eliminate risk during pregnancy, it is helpful for any mother to take care of herself prior to and during pregnancy. Ahmed said this includes achieving a healthy weight before conception as well as managing any pre-existing conditions. “If she’s diabetic, or has thyroid problems, she should have strict control of them at least three months before the pregnancy,” Ahmed said. “Optimal control of health problems before pregnancy will be a major factor in improving the outcome of pregnancy.” He also recommends a healthy lifestyle, including avoiding tobacco use, alcohol, contraindicated prescription and over-the-counter drugs and street drugs. Exercising regularly before pregnancy and as advised during pregnancy, along with taking prenatal vitamins support healthy pregnancy. “See your provider for prenatal appointments,” Ahmed said. “Mental health is very important. If she has anxiety, depression or if she’s on any medication, she should discuss it with her primary care provider as not all are safe with pregnancy.” Birth defects can occur even before a woman knows she is pregnant, so pre-conception care is vital. Ellen Derby, certiﬁed birth doula, post-partum doula and breastfeeding counselor in Clifton Springs, has

worked with numerous mothers near or over age 40. The oldest was 45. “It generally goes pretty well,” she said. “I think for women — whether 22 or 42 — it’s always good to practice good nutrition, maintain good health and get some movement and chiropractic in your life.” She urges women to choose their provider wisely. “If you have a doctor who views you as ‘older maternal age’ and they assume because of that you will have complications, it may help you to ﬁnd someone who’s supportive and doesn’t think there will be complication upon complication upon complication despite your good health. Some are 40 and unwell and some are as healthy and active as at 29 because they have a good weight and are healthy.” She said that most moms near 40 experience more fatigue while pregnant and after delivery, so resting more is important; however, at this age her parents may be elderly and not as able to help them. Hiring a post-partum doula may help, as these professionals assist the mom with caring for the baby and light housekeeping right after the baby is born. At this point in her life, a near40 mom is likely better ﬁnancially situated to afford the help, compared with when she was in her 20s. They may lack the energy of the 20-something mom, but older moms are more likely to have more patience and maturity to cope with the nearly overwhelming changes a new baby brings to a household.

U.S. Moms-to-Be Are Much Less Healthy Now I n the past 30 years, U.S. women have been in progressively worse physical shape as they become pregnant, a new study ﬁnds. A combination of obesity, high blood pressure, diabetes and having children later in life have led to potentially more complications, and even infant and maternal death, researchers say. Obesity is a major driver of these complications, said lead researcher, physician Eran Bornstein. He’s vice chairman of the department of obstetrics and gynecology at Lenox Hill Hospital in New York City. “They’re also going to have more hypertensive disorder [high blood pressure] because older women are at a higher risk for all of these complica-

tions,” he said. “Basically, we showed that over the last three decades, women’s health in the United States has worsened.” For the study, Bornstein’s team used data from the U.S. Centers for Disease Control and Prevention to calculate risk factors and trends in pregnancies from 1989 to 2018. During that period, the prevalence of high blood pressure disorders rose 149%, the investigators found. Speciﬁcally, chronic hypertension increased 182%, diabetes increased 261% and having babies at an older age rose 194%. Also, the number of twin and triplet births increased 33%.

The increase in chronic hypertension was mostly seen in the past 20 years. High blood pressure tied directly to pregnancy and having more than one baby was seen largely in the last 10 years, the findings showed. The rates of all these conditions were highest among women who had children later in life, the study authors noted. “Hypertensive disorder is associated with significant morbidity to the mother and significant complications for the baby,” Bornstein said. “Hypertensive disorders of pregnancy are one of the three major risks for maternal mortality.” The advice to women is twofold, he said. “First of all, even before

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pregnancy, young women should concentrate on improving their health and their metabolic status. That means that they watch their weight, diet, exercise – just the basics in good health care,” Bornstein said. Second, women should be aware of the potential consequences of delaying childbearing, “and try to complete childbearing at a younger age,” he said. It’s difﬁcult to tell women they need to complete childbearing by a certain age, but childbearing at 40 is associated with major complications, Bornstein said. The report was published online recently in the journal E Clinical Medicine.

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Stemming disease

What are stem cells? Why are they important? By Barbara Pierce

ou’ve heard about stem cells in the news. You’ve probably wondered what they are exactly, whether they’re being used to treat diseases, and how are they controversial. A. Gulhan Ercan-Sencicek of the Masonic Medical Research Institute, Utica, helped us understand this exciting new area of medicine. World renowned for its high-quality research, the MMRI conducts research for the development of medical treatments of the future. Stem cells are innovative in medicine because of their potential to regenerate and repair damaged tissue. Grown in the lab then transplanted into the patient, these cells could provide insulin-producing cells for people with Type 1 diabetes, provide cardiac muscle cells to help people recover from a heart attack, or repair damaged nerve cells for those with Parkinson’s disease. What exactly are stem cells? “Stem cells are called the body’s master cells,” said Ercan-Sencicek. “They are unspecialized cells that are present both in embryos and in adult cells.” “Stem cells are different from other cells by two important characteristics. First, they have the ability to self-renew through cell division, even after long periods of inactivity,” she continued. “Next, they can differentiate

into specialized cell types — they can develop into many different cell types in the body. For example, while stem cells in the gut and bone marrow constantly divide to repair and replace worn out or damaged tissues, stem cells in the pancreas and the heart divide only under special conditions,” Ercan-Sencicek said. “These unspecialized stem cells cannot pump blood through the body (like a heart muscle cell) or carry oxygen around your body (like a red blood cell). However, they can give rise to specialized cells, including heart muscle cells, blood cells, or nerve cells, etc.” Stem cells are the body’s raw materials — cells from which all other cells with specialized functions are generated. These cells either become new stem cells or become specialized cells with speciﬁc function. No other cell in the body has the ability to generate new cell types. Where do stem cells come from? “Scientists are working with three types of stem cells from hu-

mans,” explained Ercan-Sencicek. Human embryonic stem cells are derived from embryos, usually ﬁve days after in vitro fertilization, through a process in which immature eggs and sperm are placed together in a culture dish to allow fertilization. At this stage, an embryo is called a blastocyst and has about 150 cells. They can divide into more stem cells or can become any type of cell in the body. This versatility allows embryonic stem cells to be used to regenerate or repair diseased tissue and organs. Adult stem cells are found in small numbers in most adult tissues, such as bone marrow or fat. Compared with embryonic stem cells, adult stem cells have a more limited ability to give rise to various cells of the body. The third type are specialized adult cells that are reprogrammed in the lab to assume an embryonic stem cell-like state. These cells can then be differentiated into different cell types that are needed for therapeutic purposes. For example, they can be

prodded into becoming blood cells to create new blood that is free of cancer cells to treat leukemia. This reprogramming of adult cells is a potentially valuable tool for generating replacement cells for therapeutic purposes, explained Ercan-Sencicek. “We have hope that stem cellbased therapies will one day be effective to treat serious medical conditions such as Parkinson’ disease, diabetes, degenerative diseases such as amyotrophic lateral sclerosis (ALS), to people paralyzed by spinal cord injuries,” she said. “Several clinical trials are under way and preliminary results are promising.” “Despite these cells holding great promise for regenerative medicine, clinical use of stem cells raises some ethical and safety concerns,” said Ercan-Sencicek. In this regard, adult stem cells avoid some of the ethical issues of embryonic stem cells. However, there are challenges involved with adult stem cells as well, she added. Adult stem cells are unable to produce the numbers of cells that are needed. They are not as versatile and durable as embryonic stem cells. They may not be able to be manipulated to produce all cell types, which limits on how they can be used. They are more likely to contain abnormalities due to environmental hazards. The only adult stem cells currently used widely are from bone marrow or blood and are used to treat leukemia, lymphoma, several inherited blood disorders, and improve cardiac repair, she said. The embryos used in embryonic stem cell research come from eggs that were fertilized in vitro, but never implanted in a woman’s uterus. They are donated for research with informed consent.

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IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • January 2021