in good
SUPPLEMENTS Rochester–Genesee Valley Healthcare Newspaper
April 2014 • Issue 104
Menopause Experts suggest natural ways for menopause relief
Mammograms
Waste of Money?
Latest study says they are not effective. Some local doctors disagree
Pass More Peas, Please!
Dialysis
FREE
Medical journal editorial: supplements are a waste. Local experts disagree Page 18
His Heart Won’t Stop Him
Page 7
At home or at dialysis center?
Meet Your Doctor
Laurence Sugarman, RIT pediatrician and researcher, on how biofeedback and self-hypnosis help kids with autism
Diagnosed with arrhythmogenic right ventricular cardiomyopathy — or ARVC — a rare condition that has a generic origin, Gates man keeps running with the aid of medical device. Page 16 Page 11 April 2014 •
Learning Disabilities on the Rise Local experts discuss if trend is the result of better screening or other issues. Page 7
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 1
Having A Hard Day’s Night? No Matter What The Cause, We Can Help You Rise To The Occasion
Low Testosterone & Erectile Dysfunction Therapies That Work.
Call 585-287-5299
For Personalized Medical Treatments
www.VitalizeMedicalCenter.com
FDA Approves First Device to Prevent Migraines
T
he U.S. Food and Drug Administration in March approved the first device aimed at preventing migraines. The device, called Cefaly, is a headband-like device that runs on a battery and sits across the forehead and over the ears, the FDA said in a statement. “The user positions the device in the center of the forehead, just above the eyes, using a self-adhesive electrode,” the agency explained. “The device applies an electric current to the skin and underlying body tissues to stimulate branches of the trigeminal nerve, which has been associated with migraine headaches.” Cefaly is made by Belgium-based Cefaly Technology and is available by prescription only. The device is only indicated for use by adults and should only be used for 20 minutes per day, the FDA said. The agency also noted that “the user may feel a tingling or massaging sensation where the electrode is applied.” One migraine expert welcomed news of the device’s approval. “This device is a promising step forward in treating migraine headaches, as it addresses an important part of what we believe triggers and maintains a migraine attack,” said physician Myrna Cardiel, a clinical associate professor of neurology at NYU Langone Medical Center and NYU School of Medicine in New York City. She added that the rate of positive response to the Cefaly device “appear to be comparable to what we see with most oral migraine preventive medica-
tions.” Millions of Americans are afflicted by migraines, which typically involve intense, throbbing pain in one side of the head, along with nausea, vomiting and a sensitivity to light and sound. According to the U.S. National Institutes of Health, about 10 percent of people worldwide complain of migraines, with women affected three times more often than men. The FDA said Cefaly’s approval was based on the results of a clinical trial in Belgium involving 67 people who had more than two migraine attacks per month and who had avoided medications in the three months prior to trying the device. Compared to people using an inactive placebo device, people who used Cefaly had “significantly fewer” days spent battling migraines compared to nonusers. They also had less need for migraine medications, the FDA said. Approval was also based on a “patient satisfaction study” of more than 2,300 Cefaly users in Belgium and France. That study found that 53 percent of people who tried the device said they were satisfied with it and would buy one for continued use. By HealthDay News
IT’S ONLY SUPER IF YOU TAKE IT. According to the National Institutes of Health, up to 20 percent of patients fail to fill new prescriptions, and 50 percent of people with chronic health conditions discontinue their medication within six months. If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember: If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/ TakeAsDirected.
#TakeAsDirected A nonprofit independent licensee of the Blue Cross Blue Shield Association
Page 2
•
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
April 2014 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 3
CALENDAR of April 2 — May 28
HEALTH EVENTS
Grief support offered in Clifton Springs Grieving after the loss of a loved one is a healthy and normal process made easier by the company of others. The spiritual care department of Clifton Springs Hospital will present a series intended to make the grief journey an easier one to travel. Lead by Chaplain Gail Conners, the program consists of eight weekly sessions each Wednesday, April 2 through May 28. Participants may choose either a morning session at 9:30 or an evening session at 7. The program will be held in the hospital chapel, on the second floor of the main lobby. There is no cost for this program. Reservations are required; please call Chaplain Conners at 315-462-0142 to register.
April 7
Seminar in Rochester to focus on Alzheimer’s “Understanding and Managing the Challenging Behaviors” will be the topic discussed in a series of seminars about Alzheimer’s and dementia organized by Chris Albee, executive director at Atria Greece. It will be held from 6:30 – 7:30 p.m. April 7 in the room 9 at Greece United Methodist Church, 1924 Maiden Lane, Rochester. It’s free and open to the public. It’s designed for anyone dealing with aging issues or parents or anyone who wants to know more about Alzheimer’s and dementia. It takes place the first Monday of each week. For more information, call Deacon Dee or Sharon Neary at 585225-1880
April 13
Annual ‘Color Vibe Race’ takes place in Rochester The YMCA of Greater Rochester is a charity partner for the local installment of the Color Vibe race for the third year in a row. The Color Vibe 5K
run is one of the most unique races in the nation, turning participants into human canvases as runners are blasted with colors throughout their journey, and appeals to families, college students and runners who like to stay fit and have fun. The event shows families and runners of all ages that being active is fun, just in time for Healthy Kids Day on April 26. Participants will receive a customized T-shirt. Shirts are limited, so early registration is encouraged. All participants under the age of 18 must have a parent or guardian participating with them. Color Vibe races occur in more than 60 locations throughout the United States, as well as in Canada, United Kingdom, Australia and New Zealand. In Rochester, it will take place starting at 9 a.m. April 13 at Monroe Community College, 1000 E. Henrietta Road. For registration dates and other information, visit rochesterymca.org/colorvibe or call Rochester race coordinator Vanessa Martell of Monroe Family YMCA at 585-271-5323.
April 26
Event to raise awareness of pancreatic cancer Three local families, all having personally felt loss in their lives from pancreatic cancer, are working to create awareness of this disease and raise vital research dollars toward finding a cure. They are promoting the Fifth Annual Luau for Lustgarten Fundraiser from 5 – 11 p.m., Saturday, April 26, at the RIT Inn & Conference Center, 5257 W. Henrietta Road, West Henrietta. All proceeds will benefit the Luau for Lustgarten Foundation. Last year 300 attendees raised nearly $16,000 for the Lustgarten Foundation. Organizers say the new event will be larger than last year’s with good food, music, auctions, raffles. For more information, call Cheryl Marrese at 585-225-3088 or email her at luauforlustgarten@yahoo.com.
May 6, 13, and 20
Workshop for women who live alone
Do you live alone? Is it a challenge for you? “Living Alone: How
April Is Adult Learn-to-Swim Month
By Laura Hamel
I
f you had the good fortune as a child to enjoy opportunities to become safe, comfortable and skilled in the water, you might never have considered what it would be like to learn to swim right now at your present age. If you’re an adult who doesn’t know how to swim, then you might be at risk of becoming one of the 10 people who drown every day in the United States. And if you have children, you can unknowingly pass your fears or water avoidance behaviors on to them. According to the Centers for Disease Control, 37 percent of American adults can’t swim the length of a pool. And of the 10 people who drown every day, eight of them are adults or young adults. The Swimming Saves Lives Foundation, U.S. Masters Swimming’s charitable arm, wants to change these numbers. The foundation has declared the month of April “Adult Learn-toSwim Month” and has launched a nationwide campaign to promote the
to Survive and Thrive on Your Own” is a three-part workshop offered for women who want to find joy again and gain the know-how to forge a meaningful and enriching life on their own. Participants will meet others in similar situations and learn practical strategies to overcome loneliness, rediscover their true self, socialize in a couples’ world and think differently about
lifesaving benefits of swimming. The governors of Florida, Indiana, Nebraska, Washington, New Jersey and Vermont have signed proclamations in support, and more are on the way. April is when water recreation areas in many parts of the country are starting to open up, and when families will plan their spring and summer vacations at pools, lakes, and beaches. Acquiring basic swimming skills should be part of the plan. Once you learn to swim, you can use your swimming skills to participate in what swimmers around the world have known for a long time: swimming for fitness is lifesaving in the long run as well. It’s one of the healthiest and safest forms of exercise, with innumerable lifetime physical, mental, and social benefits. Find an adult learn-to-swim program in your community and learn more at usms.org/learntoswim. Laura Hamel is communications and publications director of U.S. Masters Swimming.
living alone. The workshop takes place at House Content Bed & Breakfast in Mendon from 7 to 9 pm. on three consecutive Tuesdays: May 6, 13, and 20. The workshop fee of $125 includes a Living Alone binder, empowerment exercises and lots of helpful resources. To register, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@ rochester.rr.com
New Excellus Campaign Calls For Taking Your Medications As Directed
C
all it a case of medicine imitating art. Spider-Man isn’t the only superhero in Rochester any more. Excellus BlueCross Blue Shield in February launched a community engagement campaign to help protect people against deteriorating health conditions, hospitalizations and sometimes deaths that can result when they don’t take their prescription medications as directed. The centerpiece of the campaign is a stylized prescription bottle called TAD, for “Take As Directed,” adorned with a superhero cape and utility belt. The TAD superhero conveys simple messages about the importance of Page 4
•
medication adherence. “When it comes to fighting chronic conditions, a prescription drug can be a superhero, but it only works if patients let it,” said pharmacist Mona Chitre, vice president and chief pharmacy officer, Excellus BCBS. “A key message of the campaign is that ‘If you’re not taking your prescriptions as directed, you’re taking a chance.’” “The superhero theme was selected because just about everyone likes superhero movies and generations of patients with chronic illnesses, for which medication adherence is particularly important, grew up reading comic books with superheroes,” Chitre add-
ed. “In fact, 10 new superhero movies are scheduled for release this year. ”Supporting the campaign include members of the Monroe County Medical Society, Rochester Area Society of Health-System Pharmacists, American Heart Association and American Diabetes Association. “Doctors can do remarkable things with prescription medications to improve the health and quality of life of people suffering from a wide variety of chronic medical conditions,” said physician Joseph DiPoala Jr., incoming president of the Monroe County Medical Society. “But too often, patients don’t take their medication as
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
directed,” added DiPoala of Ridgeview Internal Medicine Group in Irondequoit. “Patients worry about medication side effects or believe they feel fine without taking it. The key is to talk to your doctor about your concerns before doing something that could cause you irreversible harm.” From 2007 to 2010, about half of the U.S. population and 90 percent of adults age 60 and older used at least one prescription drug during the previous month, according to the Centers for Disease Control. Over the past decade, the number of people using five or more prescription drugs increased by 70 percent, according to the CDC.
U.S. Could Face Shortage of Cancer Doctors
P
eople fighting cancer might have to wait longer to see a cancer specialist in the coming decades, as demand for treatment outpaces the number of oncologists entering the workforce, a new report released in March warns. Demand for cancer treatments is expected to grow by 42 percent or more by 2025, while the supply of oncologists will only increase by 28 percent, experts found. The mismatch between supply and demand could result in a shortage of nearly 1,500 oncologists by 2025, according to the American Society of Clinical Oncology (ASCO) report. People living in rural areas will be hardest hit by the shortage, the report predicted. Currently, only 3 percent of oncologists are based in rural areas, even though that’s where 20 percent of Americans live. “We never want to have a cancer patient have to wait to get in to see a cancer physician,” said physician Richard Schilsky, ASCO’s chief medical officer. “Since we’re aware of the issue, we are beginning to think about how to mitigate it.” Schilsky said he believes oncolo-
gists will need to rely on primary-care physicians, nurse practitioners and physician assistants to handle basic cancer treatment and follow-up care as demand for services grows. “That will leave the oncologists time to deal with the more complex cancer patients,” he explained. Certain factors will likely combine to increase the number of patients seeking cancer treatment in coming years, Schilsky said, including: • The aging of the baby boomer generation. “They are now all in their 60s, and that’s the age at the highest risk for getting cancer,” he said. • Improved cancer treatment. A record 13.7 million cancer survivors now live in the United States, Schilsky said, and many want to maintain a relationship with their oncologist even though they are cancer-free. • Health care reform. “There are going to be millions of people who didn’t previously have health insurance and [who] will be seeking care for cancer,” Schilsky said. The total annual cost of cancer care in the United States is projected to reach $175 billion by 2020, an increase of 40 percent from 2010, according to the report. By HealthDay
Healy Counseling Services 1387 Fairport Rd, Bldg. 500, Fairport, NY 14450 • (585)388-3330 healycounseling@gmail.com • www.healycounseling.com KATHE HEALY, LMHC, CASAC • NYS Licensed Mental Health Counselor • License #000836
Individuals, Couples and Group Counseling In a Private Setting Kathe is a Certified Internal Family Systems Therapist and specializes in treating depression, anxiety, addictions, grief and loss, stress reduction and healing of relationships.
Do you live alone? Living alone can be a challenge, especially for women in mid-life who are divorced or widowed. But it can also be the start of a rich and meaningful chapter in your life. Need a jump start?
Living Alone: How to Survive and Thrive on Your Own Mondays, May 6, 13, and 20 7:00 pm - 9:00 pm House Content B&B, Mendon, NY
In the workshop led by Gwenn Voelckers — a women who’s “been there” — you’ll discover how to overcome loneliness and other emotional pitfalls, take charge of your finances, and socialize in a couples’ world. $125 fee includes manual, empowerment exercises and book. For more information, call (585) 624-7887 or visit www.aloneandcontent.com
Need a helping hand?
Learn about Enriched Living at Ashton Place. Advancing Medicine. Changing Lives.
Rochester Clinical Research | 500 Helendale Road, Suit L20, Rochester, NY 14609 | 585.288.0890 | www.RCRclinical.com
Serving Monroe, Ontario and Wayne Counties A monthly newspaper published by in good
Health Rochester–GV Healthcare Newspaper
Local News, Inc. Distribution: 30,000 copies. To request home delivery ($15 per year), call 585-421-8109.
In Good Health is published 12 times a year by Local News, Inc. © 2014 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers and Contributing Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Mike Costanza, Ryan Hoefen, MD, Matthew Liptack • Advertising: Donna Kimbrell, Marsha Preston Layout & Design: Chris Crocker Officer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
April 2014 •
Stop in for a Tour! • Personal Care Assistants • Medication ordering, assistance and supervision • Assistance with personal care needs • Case Management Services — Liaison with physicians and other health care professionals • Housekeeping, laundry and linen service • Chef Prepared meals • Transportation • And a host of other services
190 Ashton Court Clifton Springs, NY
1.800.819.5791 AshtonPlaceNY.com Licensed by New York State to provide enriched living A Heritage of Caring Spanning 3 Generations IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 5
Meet
Your Doctor
By Deborah Jeanne Sergeant
Laurence Sugarman, MD RIT pediatrician and researcher on how biofeedback and self-hypnosis help kids with autism Q. How does your research relate to autism? A. We are teaching parents skills in parenting that involves self-regulation, teaching children 8 to 18 using biofeedback and self-hypnosis. Our work is in using computerized biofeedback so people can see their own stress level on a computer screen so they can change their internal state and start regulating it. [This] has spawned more and more interest in using behavior and how people can change their own minds to help them do better. It’s most powerfully effective in autism. Q. Do researchers know what causes autism? A. The belief in immunizations causing autism is the most discredited scientific notion ever. The evidence is abundant that immunizations do not increase the risk of autism. There’s even a little evidence that not immunizing can increase the risk of autism. People want something to blame for their child’s autism and they lash out at this, though there’s no basis for it. It’s safe to say that autism is a final, common pathway from lots of causes. It’s clear from the data that addressing the apparent increase [in autism] is part of it is because we’ve broadened the diagnosis and we’re offering services to a wider variety of people. The other part of it — the other half probably — is either some action of environment and/or genetics that we don’t understand yet. We do have an important hypothesis about what is going on, but the group of causes effects a fundamental part in brain development in the ability to control the fight or flight mechanism, part of the autonomic nervous system. Kids with autism spectrum disorder share a problem in regulating that, which leads to pretty much all of the behaviors, sensitivities and problems. Teaching children how to change that with biofeedback and their ability to calm themselves, we may be able to change a lot with autism.
Q. What are a few commonly held misconceptions about autism? A. That they’re aloof, uncaring and incapable of empathy. No one “is autistic,” but people may have the behaviors of autism. Some people think that people who are not as verbally expressive with autism aren’t intelligent, sensitive or caring. This is common for a lot of people with communicative impairments. Verbal expressiveness doesn’t necessarily track with intelligence. With the increased awareness of autism spectrum disorder,
there’s a tendency to say a child has autism if the child has developmental difference, awkwardness or language delay. A child with some motor problems or language delays may not meet the criteria for autism. Q. What are some early signs of autism that parents tend to notice? A. An early sign is a difficulty of joint attention. If you are sitting next to someone and you point at something, that person looks at where you point. A child with autism looks at your finger, not where it’s pointing because of an impairment of interpreting social cues. The meaning of the gesture can be lost on them. Children with autism spectrum disorder don’t do as much facial regarding as parents would like or expect. It becomes more detectable after the first year. Children with autism spectrum disorder early on have a high level of internal stress. There’s a general sensitivity to things like touch or taste or being held and cuddled a lot. If a child settles better being alone, it isn’t because he doesn’t like people; it’s that the sensory input is irritating. A lot of kids have periods of tension or more interest in the crown molding that their parent’s face, but it’s consistency and endurance that indicate autism spectrum disorder. Early childhood manifestations don’t necessarily predict who that person will be. I’ve worked with really amazing, talented, brilliant older adolescents with autism who when they were younger, they lined up their LEGOS by color, not using them to build. But as a 19-year-old, they’re wonderful. But people believed in them, got out of their way, challenged them. The environment matters. What I really dislike is when people say early on, “Your son would never…” fill in the blank. That’s a terrible thing to say. We ought not to prognosticate.
Q. Why are more boys on the autism spectrum than girls? A. We think that part of it is related to how boys are wired to turn on fight or flight response and have a higher stress response. Guys are the hunter/ gatherers, and that’s the way we are built.
Page 6
•
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
Q. How has support of individuals with autism improved over the years? A. The most positive thing is that there’s increasing recognition of
Editor’s note: Since the 1970s, the Autism Society has celebrated National Autism Awareness Month in April. Autism is a spectrum disorder, meaning that people with autism may range from ones who need constant care to high-functioning individuals. The latter have been able to develop coping mechanisms limited to their chosen profession. The Autism Society estimates that one in 88 children in the United States is somewhere on the autism spectrum. Almost one in 54 boys are affected by autism. people with autism as capable. I think the most exciting thing that’s happening is that this is changing from an issue of disability to an issue of diversity. There are people going around the country talking not about autism so much but “neurodiversity.” When you’ve met one person with autism spectrum disorder, you’ve met one person with autism spectrum disorder. Everyone is unique. “Disability” infers something inadequate. “Diff-ability” says you do this differently. It isn’t necessarily a handicap as it is adding to diversity. Young people with autism spectrum disorder are not good at sucking up to the boss or lying or social strategy. If you go to the boss who’s in charge of hiring new people and you say, “Would you like an employee who’s incredibly punctual, precise, meticulous and will do what you need to have done on time? He doesn’t hang out by the water cooler and doesn’t try to get ahead by using other people and won’t engage in office gossip?” He says, “That would be great.” You could say, “That is the person you cut from the interview process because he wasn’t deferential to you.” Q. Why do you enjoy working with children with autism? A. Our research is developing skills to help them find comfort and a sense of control. We get to make a difference in a way that honors each individual. Parents really appreciate that we see their kids as talented.
Lifelines: Current Positions: Research professor and director of the Center for Applied Psychophysiology and Self-regulation in the Institute and College of Health Sciences and Technology at Rochester Institute of Technology and a behavioral pediatrician at the Easter Seals Diagnostic and Treatment Center in Rochester Education: Pediatric residency and chief residency at University of Rochester; medical school at the University of Missouri-Columbia; undergraduate studies at Washington University in St. Louis. Personal: Born in Washington, D.C., raised in Cleveland and lives in Rochester. Leading the MindMasters research project, which is developing a computer-based, role-playing game for young people with repetitive/preservative behavioral problems. The games’ physiological sensors control the game to help players better control their responses to stressful stimuli. Has played the banjo since age 7 and has made a few recordings. Also plays the fiddle. Bakes bread with his own milled flour.
Learning Disabilities on the Rise
Visit www.newhorizonsmusic.org for further details
T
“Successfully helping the disabled obtain their Social Security Disability/SSI benefits for 23 years.”
ulative and shows understanding of math, not just rote memory,” Lindauer said. “If you give children this kind of instruction, research shows it gives better understanding later for higher level of math. For parents, this may be challenging. There’s a lot more brain research about how people learn and instructional strategies now.” Overall, the educational system has supported children who have learning disability in reading and is beginning to develop more support for students who struggle to learn math. Lindauer is quick to remind parents that schools can’t “fix” or “cure” learning disabilities. They last for life. “’Learning disabilities’ is just a way for saying you have your own,
Learning Disability. How to Identify the Problem
J
Monday, May 19th at 7 pm in Kodak Hall at Eastman Theatre
Free Parking at East End Garage
By Deborah Jeanne Sergeant
ulie Murray, admissions and marketing manager for The Norman Howard School in Rochester, said that parents are often the first to notice their child is having some difficulties compared to siblings. “If they’re young and have a slow development of vocabulary, that could indicate a learning disability,” Murray said. “Do they have trouble buttoning, zipping and tying? Difficulty in familiar words, poor handwriting, inverting words? Do they have trouble making friends? Parents should go with their gut if they think there’s something amiss. Talk with the pediatrician and their teachers.” A formal evaluation can help parents better understand a child’s strengths and challenging areas. Jacqueline Lindauer, educational specialist with the University of Rochester Medical Center’s Neural Developmental and Behavioral Pediatrics, said that red flags can include struggling with reading by the end of second grade. “It’s part of typical development
Spring Concert 90 minutes of Broadway, Classics, Marches and Finale with 125 Members on stage Stars & Stripes Forever.
URMC expert attributes the fact to better screening
he Centers for Disease Control states that 6.4 million children aged 4 through 17 have received an ADHD diagnosis at some point, representing a 41 percent rise in past decade. A study by the University College London reports that up to 10 percent of children have some type of specific learning disability such as dyslexia, dyscalculia, ADHD, and autism. While the rising number may seem alarming, local educational specialist Jacqueline Lindauer said we’re keeping better track of the problem. “We’ve done a much better job of identifying and addressing a diverse array of learners,” she said. Lindauer works at the University of Rochester Medical Center’s Neural Developmental and Behavioral Pediatrics. Previously, students who struggled to learn were chided for laziness or marked as not intelligent. But people with learning disabilities typically work hard and do well in other areas, such as excelling in reading and writing, but failing math or bringing home A’s in science, but lagging behind in reading. Current technology such as recorded books, voice activated software and software geared toward a specific learning style aid learners. “Common core uses more manip-
New Horizons Band
for children to write their letters backwards. That’s not something to be concerned about,” she said. In math, “children who even after they’re worked hard just can’t memorize math facts” could have a learning disability in math. Or “children who are really struggling with understanding the difference between addition and subtraction at the end of second grade.” Other red flags could include “when you’re reading with your child, whether picture books or read-aloud-books, and you ask what happened, and they have difficulty remembering what the just heard. Maybe they weren’t paying attention, but it’s something to monitor.” Amanda Hartman, deputy executive director of LDA Life and Learning Services, Inc. in Rochester, said that earmarks of a learning disability could include avoidance of schoolwork or not wanting to go to school, issues with friendship, victim of bullying or being taken advantage of, and anxiety, especially about school or social situations.
unique pattern of learning and to be successful, you need to know the way you learn and develop strategies around the areas in which you struggle,” Lindauer said. Amanda Hartman, deputy executive director of LDA Life and Learning Services, Inc. in Rochester, views education as a team approach: the student, parents, teachers, pediatrician and perhaps a close aunt or uncle or other adult figure. “The more support a child can get to look at his strengths and support him in learning to help address things that are more of a challenge, the better,” she said. “Parent networking with other parents can really help, too.” Students with learning disabilities seeking higher education benefit from the academic accommodation most colleges offer. Susan Ackerman, disability services director with RIT Disability Service Office, encourages high school students to check out what schools offer before committing. Transitioning between high school and college challenges every student, especially those with learning disabilities. In high school, the school district ensures the student receives a good education. In college, the responsibility lies more upon the student to proactively seek an education. “Work with people at the prospective college and take a campus tour,” Ackerman said. “Going-to-college.org is a good site students can use to learn about the transition topics. Do some investigation with the college you’re thinking about going to. Talk directly to the disability people and find out the request process and the documentation they’ll need to present. Each college handles that a little bit differently.” Of the 800 RIT students registered through her office, most have attention deficit disorder and learning disabilities. “We have supports, like tutoring,” Ackerman said. “Accommodations may include a longer time to take an exam.” The school also offers students with learning disabilities general support for reading and studying and time management. And any student benefits from orientation class.
April 2014 •
Mary Perry, ADR 585-385-6855
www.disabilityrep.com 57 Monroe Avenue - Suite C Pittsford, NY 14534 Our Practice Welcomes New Patients. Your child will always be seen by a Pediatrician Clarene Cress, M.D. Alejandro Marchini, M.D. Michael Green, M.D.
Carol Gagnon, M.D. Gretchen Volk, M.D. Molly Hughes, M.D. Colette Barczys, M.D.
WESTSIDE
PEDIATRIC GROUP LLP 497 Beahan Road, Rochester, NY 14624 (585) 247-5400 Part of your community for over 60 years
Available 7 days per week
Extended hours during school year www.westside-pediatrics.com
GOLDEN YEARS SPECIAL EDITION Don’t miss the next issue of In Good Health—Rochester’s Healthcare Newspaper Call 585-421-8109 for advertising information
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 7
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Spring cleaning for the soul: Living alone can be simply beautiful!
O
ne of the beauties of getting older is that you’ve gained enough self-confidence to figure out what really matters to you and what really doesn’t. This is especially helpful, when making decisions about how best to simplify your life. As the light of day increases, I can’t help but think about spring cleaning and getting rid of all those things that clutter my conscience and physical world. With great anticipation, I look forward to shedding outdated clothing, time-worn routines and unhealthy habits. I am ready to clean up my act and de-clutter my life. Care to join me? Here are some tips: List your priorities. Write them down. Knowing what really matters to you will help you decide where to start first. One of my priorities is to live in the present. Holding onto that gorgeous, skimpy dress I wore in my 30s (but can no longer squeeze into) is not doing me any good. Off it goes to Volunteers of America. Start small. De-cluttering our lives can be daunting. I began by cleaning up my life one “corner” at a time. Today, it’s my desk. More specifically my desk top. I’ve gathered all the many docu-
ments, bank statements, post-it note reminders, cards, etc. into one big pile. Later today, I’ll sort it out and discard probably 90 percent of it, in favor of making space and time for the things I care about. Purge your email in-basket. My “digital” life can be as overwhelming as my real life. How did I get on so many automated email lists? Oh, I remember now . . . I made a fatal decision and purchased a pair of shoes online. That will do it! This morning, I spent worthwhile time unsubscribing to unsolicited email newsletters and shopping site promotions. Clear your counter. Not just your clutter, but your counter. Nothing sinks my spirit faster than seeing my kitchen counter covered with yesterday’s newspaper, mail, magazines and more. Ugh. I feel so much better and in control when I come downstairs in the morning to a clean and organized kitchen counter. Purchase help. This is so not “me.” I’m a do-it-yourselfer. But lately, I’ve
KIDS Corner Mouthguard Myths
A
fter every play, we all see the athletes adjusting their mouthguards, but what do they actually protect? Houston Methodist sports medicine experts discuss important facts about mouthguards. • Can wearing a mouthguard prevent a concussion? “No, mouthguards cannot prevent a concussion,” said Vijay Jotwani, a sports medicine-focused primary care physician. “Mouthguards do not affect the movement of the brain within the skull and cerebrospinal fluid, so they are ineffective at reducing the forces on the brain that cause concussions.” • Can wearing a mouthguard protect my teeth and jaw? While a mouthguard cannot protect the brain, it can dissipate the force of an impact over several teeth rather than just a few. “Several studies have confirmed that mouthguards help prevent dental trauma,” said oral and maxillofacial surgeon Jamie Gateno. “A mouthguard Page 8
•
should fit the teeth snugly and be made of a non-compressible material to help protect the teeth and jaw.” Gateno adds that dental trauma usually occurs along with other injuries, such as lacerations, contusions, and fractures. He recommends that a patient be transported to a hospital capable of treating all injuries. If a tooth is dislodged, it should be gently washed and placed back in its socket within 20 minutes. If the tooth cannot be implanted back in the socket, Gateno says the tooth should be placed in a cup of milk during transportation to a hospital or dentist’s office. If milk is not available, he recommends having the patient place the tooth between their gum and cheek to protect the tooth during transportation. • Which type of mouthguard — ready-made, boil-and-bite, or customized — provides the most protection? Jotwani and Gateno agree that a customized mouthguard is the best option for athletes in contact and collision sports, such as baseball, basketball, football, hockey and lacrosse.
made an investment in favor of efficiency and in keeping with my priorities. While I like to iron my own clothes (and find it peaceful and satisfying), I have found myself getting way, way behind. Shirts were piling up, and all this untended laundry was causing me stress! So I bit the bullet and decided to invest in pressing services offered by my local dry cleaner. It’s cheaper than full service and I feel on top of things again. Reduce your choices. This has made a big and positive difference in my life. One example: Like most women, I have makeup samples galore and have been reluctant to throw anything out. But, I’ve changed my ways. I’ve discarded (or donated) many of the free samples I’ve accumulated over the years and now only have my “go to” products within easy reach — one cleanser, one moisturizer, one mascara, one eye shadow, etc. How easy is that? My morning routine is simplified, and my sink counter is now easier on
the eyes. Carry around less stuff. Many of us would do well to lighten our loads. I am the worst culprit. I tend to live in a “what if” world: What if my car slides off the road and into a ditch? What if I needed to stay overnight with my mother who’s not feeling well? What if I get a spur-of-the-moment invitation to spend a weekend in Paris? (Ha! Not likely) Well, you get the point. My oversized purse and car have been filled with “just in case” provisions — emergency supplies, a change of clothes, a back-up curling iron, and Ativan for flight anxiety. But, no more. I’ve simplified my life. Now, I only carry Ativan. I’m kidding, of course, about the Ativan. Well, maybe not (smile). Life is much simpler now that I’ve lightened my load. Stay vigilant. Clutter can sneak up on you. Before you know it, your desk, your inbox, your counter, car and conscience can fill up with unwanted, unnecessary stuff. Routinely ask yourself: Will this make my life simpler or more complicated? If the answer is the latter, think twice, and consider making changes in favor of your priorities. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming May workshops, check out the calendar listing in this issue or to invite Gwenn to speak, call 585-624-7887 or email: gvoelckers@ rochester.rr.com.
Video Games Might Help Kids With Dyslexia Learn to Read, Study Suggests Sights, sounds may prove a distraction, researchers say
V
ideo games might help people with dyslexia improve their ability to read, a new study suggests. Dyslexia, which affects between 5 percent and 10 percent of people, is a learning disorder that causes problems with reading and writing. Standard methods of reading instruction might be counterproductive for people with dyslexia, according to the study, which was published Feb. 13 in the journal Current Biology. The researchers tested people with dyslexia and discovered that they have difficulty managing competing sights and sounds. “Imagine you are having a conversation with someone when suddenly you hear your name uttered behind you,” study author Vanessa Harrar, of the University of Oxford, in England, said in a journal news release. “Your attention shifts from the person you are talking to — the visual — to the sound behind you,” she said. “This is an example of a cross-sensory shift of attention. We found that shifting attention from visual to auditory stimuli is particularly difficult for people who have dyslexia compared to
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
good readers.” Harrar and her colleagues said programs to help people with dyslexia might need to take these findings into account. In traditional approaches to reading, letters are first seen and then heard, they said. “We think that people with dyslexia might learn associations between letters and their sounds faster if they first hear the sound and then see the corresponding letter or word,” Harrar said. The researchers also suggested that video games might prove useful in helping people with dyslexia improve their reading and writing skills. “We propose that training people with dyslexia to shift attention quickly from visual to auditory stimuli and back -- such as with a video game, where attention is constantly shifting focus -- might also improve literacy,” Harrar said. “Action video games have been shown to improve multitasking skills and might also be beneficial in improving the speed with which people with dyslexia shift attention from one task, or sense, to another,” she said.
DIALYSIS: At Home or at Dialysis Center? By Ernst Lamothe Jr.
M
ore hospitals and clinics are trying to encourage dialysis patients to do in-home treatment instead of going to a dialysis center. The reason for the effort ranges from financial relief for the institution to ease for the patients. Since 2002, there has been a gradual increase in the number of United States dialysis patients treated by home hemodialysis. Still it remains less than 2 percent. Hemodialysis is a life-preserving treatment for those with kidney failure. A patient sits in a chair and has their blood cleaned through filtration. For hemodialysis, the person is connected to a dialyzer by tubes attached to the blood vessel. The blood is pumped from the body into the dialyzer. It reBushinsky moves waste from the blood, extra fluid from the body and restores the proper balance of electrolytes in the blood. Peritoneal dialysis, a daily treatment that also removes waste, chemicals and extra fluid from the body, is another option for patients. This type of dialysis uses the thin, natural lining of the abdomen to filter the blood. The surgeon places a permanent tube called a catheter in the lower abdomen to carry out the solution. “The trend in our field is moving patients out of the dialysis centers and performing dialysis at home because it has been known to really help patients in so many ways,” said physician David Bushinsky, chief of nephrology at the University of Rochester Medical Center. “You can go out with your significant other and have a nice day and do dialysis in the evening if you choose. You have incredible flexibility on when you do dialysis and are not constrained by a strict schedule.”
In general, a dialysis center spends $100,000 a year per patient to have them come three times a week for four hours each treatment. That number typically drops down to $70,000 or less when dialysis moves to the home. “It is more expensive to pay the medical staff and run a facility than for a patient to have the process done at home by a family member or friend. That will add up to more than hundred of thousands of dollars of savings each year moving a patient to in-home dialysis,” said physician Philip Ondocin from Nephrology Associates of Syracuse PC. “Once you start doing it at home, a person typically only has to go to the center once a month.” Home dialysis is nothing new. It has been around for more than five decades, but the spotlight slowly dimmed on the practice once dialysis centers started popping up nationwide. Now there may be a push to aggressively change the trend. When a kidney patient Ondocin goes to a center, they are doing dialysis for between four to five hours each session because it is three days a week. At home, it increases to five days a week, but for only two and a half hours. “When you go to a center you have to factor drive time there and back and at least four hours of dialysis. That can create a long, taxing day for the person and whoever drove them to the center,” said Ondocin. “When you are at home, you control the time of day when it happens, you are more comfortable and dialysis as a whole takes up less of your day.” Home hemodialysis has similar complications as in-center dialysis. The only difference is that a patient goes from an expert medical field who have been trained and schooled
in dialysis to having a loved one trained between three to eight weeks to perform the same task at home. The most serious risk is the possibility of an air embolism, a condition where air is introduced into the bloodstream accidentally, preventing the heart from adequately pumping blood. Another serious risk is blood loss if a catheter separates. Both risks could end a person’s life. However the positives include renewed energy, strength and more uplifted moods. “There are some people who sleep much better when they are dialyzed five days a week instead of going to the center. This gives them a boost of energy that they didn’t have before when they were getting dialysis three days a week,” said Ondocin. Bushinsky does note that those who want the advantages of home dialysis also have to understand the culpability. “The disadvantage is that you have to do some of the things yourself like monitor conditions along with setting up and cleaning up the machine,” he added. “You have more flexibility, but you are more responsibility. There is
April 2014 •
a little fear because patients and their support systems might not have a medical background, but we train people and make sure they feel comfortable before moving to home hemodialysis.” Even though the trend is more toward home dialysis, the medical community understands that the majority still prefers a center. Bushinsky said more medical facilities are building additional dialysis centers so a patient doesn’t have to drive too far for better health. “Dialysis is a life-saving opportunity and we want to do anything we can to minimize the stress in that person’s life,” said Bushinsky. He advises people to keep their blood pressure low, eat healthy, exercise regularly and watch for symptoms that cause diabetes. “More than half the people in Rochester and the rest of the United States who are on dialysis either have high blood pressure or diabetes with many having both,” said Bushinsky. “If we can control those two symptoms then we can work on our ultimate goal to eradicate kidney disease.”
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 9
Medical Marijuana: Is It Safe? By Deborah Jeanne Sergeant
P
hysician Timothy Quill, a professor of medicine, psychiatry and medical humanities at the Center for Ethics, Humanities and Palliative Care with the University of Rochester Medical Center, said some patients “are quite interested in [marijuana use], particularly for those who have problems with nausea and appetite.” Cancer patients and others with pain control problems may be examples of those who could benefit from medicinal marijuana use. Quill said patients who have past experience with marijuana use seem the most comfortable discussing it because of their familiarity with the drug. Quill said inhaling marijuana would present inherent risks Quill to people with pulmonary disease. And for otherwise healthy people, “putting smoke in your lungs is not a good thing,” he said. “There’s potential for becoming dependant and some smoke it every day as part of their lifestyle. Those are long-term risks and why it’s a challenging issue if you’re looking at the general population.” Quill doesn’t envision legalized medical marijuana as restricted to only terminally ill patients, but that it would
also include seriously ill patients. State lawmakers would need to decide who would benefit from its use, the form in which it will be allowed (since a pill form is available), and how authorities would regulate its distribution and use. “It may be more efficacious smoked than in a pill form,” Quill said. “We don’t know the answer at this point. It’s not an easy thing to study because the patient is aware of what’s going on.” The placebo effect, in which test subjects experience a better outcome because they believe they will, would skew testing marijuana because of its inherent and well-known psychologi-
cal effects. “If we are going to legalize it, it should be studied to make sure it’s doing more good than harm and what patients will benefit the most,” Quill said. Research may start soon. One of Gov. Cuomo’s official 2014 agenda items announced Jan. 8 was to launch a medical marijuana program to research the feasibility of medical marijuana in New York state. To provide relief to patients suffering from serious illnesses, Gov. Cuomo will use existing statutory authority to launch a medical marijuana research program that allows up to 20 hospitals
to provide medical marijuana to patients being treated for serious illnesses. This program will allow qualified eligible participants to seek relief for their symptoms in a safe and legal manner, while also evaluating the effectiveness and feasibility of a medical marijuana system. Its findings will be used to inform future policy.
Who Wants to Comment on Medical Marijuana? Not Local Doctors
W
hether you approve, disapprove or hold no opinion on the topic, it’s easy to agree that medical marijuana use represents a hot button issue. Of the 13 health care organizations in the are contacted for this article, only one permitted an interview. A few of those who would not comment cited the issue’s very controversy as rea-
son enough to refuse an interview. “We have patients request it, but that is not something we want to discuss,” said a representative of one health care organization. “We just say to them, ‘No, we don’t offer that.’” Another said, “We would not touch this topic with a 10-foot pole because it is not legal. We cannot
comment unless the law changes on this.” It’s understandable how medical professionals squirm when the interview topic is so controversial; however, were marijuana to become a drug that physicians could legally prescribe, one area doctor thinks some area patients would want to try it if it would help them.
We specialize in hands-on personalized pain management and physical therapy.
(585) 396-1400
241 Parrish Street, Suite A | Canandaigua, NY 14424 | www.LakeCountryPT.com
Our experts, Robert Christakos, PT, DPT and Zoe Fackelman, PT, can help with a full range of conditions including:
• Head-to-toe orthopedic conditions • Sports-specific training & rehabilitation • Neck & back care • Incontinence for men & women • Pelvic floor tension, pain & trauma • Headaches
• TMJ/TMD disorders • Osteoporosis • Post-surgical care • Pregnancy-related pain • Vertigo, dizziness • Arthritis & more
Make an appointment and experience a difference. NO REFERRALS NECESSARY | HOME VISITS AVAILABLE Page 10
•
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
His Heart Won’t Stop Him Gates man keeps running with aid of medical device By Mike Costanza
B
ruce Rychwalski was running on a treadmill at a Gates health club back in 2011, when something suddenly went wrong. “My symptoms were profuse sweating, like I was in a sauna,” says the 64-year-old Gates resident, who is a member of the Greater Rochester Track Club. “I couldn’t catch my breath.” The symptoms persisted after he stepped off the treadmill, and the club called an ambulance. Checking Rychwalski’s heart rate, emergency medical technicians found it running as high as 300 beats per minute, a life-threatening condition. “When you heart goes that fast, you can go into cardiac arrest,” Rychwalski explains. By contrast, the normal rate for his age group is 78 to 117 beats per minute, and the avid runner’s rate usually runs about 45 beats per minute. Using a defibrillator, the technicians shocked Rychwalski’s heart back to a normal rate, making his body bounce on the gurney. “I was fully alert when they did it, and it hurt like hell,” he says. They then took him to a nearby hospital for a weeklong stay, where tests determined he was suffering from arrhythmogenic right ventricular cardiomyopathy — or ARVC. The rare condition, which has a generic origin, is characterized by structural and functional abnormalities in the right ventricle of the heart. In essence, the muscles in that part of the heart lose their cohesion, and cease to work together as they normally do. The dysfunction can result in irregular heart rhythms, tachycardia, (an abnormally high heart rate) and, potentially, cardiac arrest. Though ARVC generally afflicts young adults, especially men under the age of 40, it has been found in those in their 90s. Strenuous activity of any kind can bring it out. Rychwalski, who has long led a healthy lifestyle, never thought he would suffer a heart problem. After donning running shoes in the early
1970s, he ran on and off before deciding to enter local competitions about six years ago. Though he loved putting on the miles whether racing or not, Rychwalski chose to do it in relatively short, fast bursts of five kilometers, (about 3.1 miles) or five miles at a stretch. “I used to try to beat the 30- and 40-year-olds—and even younger,” he says, with a touch of pride. Cory Berardi, a friend and fellow runner, often watched over his shoulder as he raced with Rychwalski, despite their age difference.
“I was worried that he was going to beat me,” the 35-year-old Buffalo resident says. When Rychwalski’s ARVC appeared, he refused to give up the activities he loves. Instead, upon the advice of his cardiologist, he reluctantly had a battery operated device called an “implantable cardiac defibrillator” (ICD) surgically installed in his chest. “My cardiologist told me, ‘If you want to go back to your normal life, you’ve got to get this implant put into you,” he explains. The ICD, which is about the size
of a pack of cigarettes, can be seen beneath Rychwalski’s skin, but the leads that run from it into the muscles of his heart are hidden. The device monitors his heart rate. When it reaches 180 beats per minute or more, the ICD delivers two shocks intended to reduce that rate to normal levels. Though Rychwalski reduced his top speed from 7.5 to 8.5 minutes a mile, he continued to run with the help of the ICD. A few months after he had it implanted, he received a silver medal in his age group in The Father Murphy 5K in nearby Chili. From the time he received the device until last January, he ran 100 races all around the region, including the annual Karen Decker 5K Run, which raises money for research in the treatment of heart failure. Rychwalski did run into one pothole, just at the end of the Jingle Bell 5K Run for Arthritis at Monroe Community College in December, 2012. “No sooner did I cross the finish line, then, pow-pow, I got the shocks,” he explains. Though the ICD worked as expected, Rychwalski remained in the hospital overnight for observation. One week later, he was racing again. He took home a gold medal for his age group in his last 5K race of 2013, The Post Christmas Blues Run, which was held in December in Canandaigua. In addition to taking regular runs—indoors in the winter—Rychwalski regularly enjoys working out and riding horseback. Though he plans to ride more and run less in the coming years, he doesn’t seem ready to give up running altogether anytime soon. “When someone asks me if I had a good 5K, with humor I tell them, ‘any 5K where I don’t leave in an ambulance is a good 5K,’” he says. Last September, in recognition of his accomplishments as a runner, Rychwalski was inducted into the Gates Chili Central School District Hall of Fame.
Heart Matters By Ryan J. Hoefen, M.D., Ph.D.
Do Multivitamins Help Prevent Heart Attacks? Result of large clinical trials shows no difference in heart attacks between people taking multivitamins or placebo Multivitamins and other supplements are taken by increasing numbers of Americans. The sales of these products, now taken by an estimated half of all Americans, have become a multi-billion dollar industry. However, whether or not they actually improve our health has been the subject of intense debate, undoubtedly fueled by the financial implications. The results of two large clinical trials examining the effects of multivitamins were recently reported in medical journals. In each of these trials, some participants were given a
multivitamin and others were given a placebo. After several years, there was no difference in the occurrence of heart attacks. Interestingly, there was a slightly lower occurrence of cancer among those taking multivitamins, but only among the men and it would take 98 men taking multivitamins for 11.2 years to prevent one case of cancer. The United States Preventive Services Task Force (USPSTF), the government organization charged with evaluating the medical literature and making recommendations to doctors and individuals on topics of preventative health, declared in February that more research is still needed to reach a conclusion regarding the Hoefen effectiveness
April 2014 •
of multivitamins in the general population. While debate rages on about multivitamins as well as specific vitamins and minerals for the population at large, it must be remembered that there are particular situations in which vitamin supplements are essential, such as in conditions which decrease their dietary absorption (e.g. celiac disease or pernicious anemia), as well as pregnancy, where folate supplementation prevents birth defects. While the benefits of vitamin and mineral supplementation remains unclear, the importance of a healthy, well-balanced diet is well established. This, along with regular exercise, is the best known way to prevent heart disease and maintain overall health. Ryan J. Hoefen, MD, PhD, FACC is a cardiologist with UCVA Comprehensive Cardiovascular Care (ucva.com).
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 11
SmartBites
By Anne Palumbo
The skinny on healthy eating
Pass More Peas, Please!
Vitamin K, which helps blood clot properly, is a key ingredient in maintaining strong, healthy bones. Not everyone loves peas — point taken. But when you consider all the nutritious benefits, combined with how wonderfully low they are in fat, calories, cholesterol and sodium, well, all we are saying is…give peas a chance.
HELPFUL TIPS
A
h, spring. Nothing heralds this wondrous season quite like daffodils, bird songs and sweet, chubby peas. I’ve adored peas since I was a child, when I used to pluck them, fresh, from grandpa’s garden. These days, I’m an even bigger fan, because peas are loaded with the kinds of health-promoting nutrients that many better for the environment (plant-based of us care about: protein, fiber and foods take less water, energy and fuel several essential vitamins. to produce than animal products). Like other legumes, peas serve up Peas also pack a terrific fiber a decent amount of protein per cup: 9 punch, delivering about a third of our grams or about a fourth of our average average daily needs in one cup. Not daily needs. Although a pea’s protein bad for such a dainty thing. Fiber conis not complete (meaning it does not tributes to good health by stabilizing have all nine essential amino acids), blood-sugar levels, promoting reguit can easily be combined with, say, larity and ferrying bad cholesterol out. a whole grain to make it complete. Proteins build and maintain all the cells What’s more, some studies suggest that increasing fiber reduces our susceptiand tissues in the body and, in fact, are bility to diseases such as heart disease, responsible for almost all of the body’s colon cancer and diabetes. processes. Looking to make a dent in your Most of the protein I now consume daily dose of vitamins? Great news: is from plants. I prefer plant proteins Peas are a vitamin powerhouse, deover animal for three main reasons: livering admirable amounts of A, C, they’re healthier for hearts (no saturatseveral Bs, and K (nearly 50 percent of ed fats toRHSC_Ad_w-coupon_InGoodHealth(2014_03_18).pdf elevate cholesterol), they’re 1 3/18/14 AM our daily K needs10:56 in one small cup!). typically lower in calories, and they’re
If buying fresh peas, look for firm, plump pods that are a vibrant medium green. Use as soon as possible for best taste. Unwashed, unshelled peas will last several days in the refrigerator. Shell just before use. If using processed peas, choose frozen over canned: the texture, flavor and color are better. Steaming peas in as little water as possible helps to preserve the vitamin C.
Pea Guacamole 2 cloves garlic ¼ cup fresh cilantro (or 1 tablespoon dried) 1 medium shallot or small onion 1 red jalapeno chile juice of 1 lime 1 tablespoon olive oil ½ teaspoon salt ¼ teaspoon coarse black pepper ½ teaspoon red pepper flakes (optional) Place peas in medium saucepan with ½ cup water; cover. Bring quickly to boil. Reduce heat, stir and cook gently 4-6 minutes or just until tender. Drain and allow to cool slightly. While peas are cooling, place garlic in food processor and pulse to mince. Add cilantro, pulse several times; then
add shallot and jalapeno and pulse until the mixture looks finely chopped. Add remaining ingredients and pulse until the peas are crushed but not completely pureed. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
A Pregnant Woman Never Drinks Alone
If you're pregnant, don't drink.
Wear your new hearing aids for 30 days. If you don’t love them, we’ll refund the purchase price*.
If you drink, don't get pregnant.
is the leading known cause of preventable developmental disabilities.
585-271-0680 585-27
ive rece & 4 201 ay 1, M e r befo
ff o 0
0 5 $
Call
Page 12
•
hase purc Convenient Locations in d i a Brighton • Greece • Webster aring e h r you www.rhsc.org May not be combined with any other offer.* Refund includes purchase price less deposit. Unit must be returned at time of refund.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
Fetal Alcohol Spectrum Disorder
DEPAUL
National Council on Alcoholism and Drug Dependence — Rochester Area (585) 719-3480 • www.ncadd-ra.org
Natural Menopause Relief Soy, red clover, pomegranate-based supplements, herbal formulas believed to help women deal with menopause By Deborah Jeanne Sergeant
M
enopause represents a natural phase of life. But that doesn’t make it any easier for women suffering the hot flashes, night sweats, mood swings and other unpleasant side effects associated with ending menstruation. The risk of unwanted side effects from prescription hormones has caused many women to seek more natural ways to cope with The Change. Physician Adrienne D. Bonham, an associate professor in the department of obstetrics and gynecology at the University of Rochester Medical Center, suggested a few behavioral modifications that may help. “Anxiety may lead to hot flashes,” she said. “Try to increase relaxation using meditation, yoga or massage.” Taking time to reflect, read inspiring literature or meditate can improve one’s sense of calm. Exercise can also help reduce stress; however, the heat it generates can trigger hot flashes. Bonham recommends avoiding vigorous exercise because it increases body temperature. Walking, Pilates, yoga, and tai chi provide examples of low-impact forms of exercise. Keeping fit can help in weight control, too. Carrying extra pounds may increase hot flashes.
“Maintaining a healthy body weight through a combination of good diet and regular exercise is recommended,” Bonham said. Yet another good reason to avoid smoking: it leads to more hot flashes. When a hot flash occurs, it may help to practice what Bonham calls “paced respirations.” “These are slow, deliberate breaths from the abdomen which, if started at the start of the hot flash, may decrease its severity and length,” she said. The Food and Drug Administration does not regulate supplements; however, some have been shown anecdotally to support women’s health. Whether prescription, over-the-counter or natural products, patients should talk with their health care provider about anything they take to avoid complications from contraindications. Soy — both soy foods and isoflavone supplements — help some women, though the research data conflicts. “There is little risk involved in their use,” Bonham said. “Even though they bind to estrogen receptors in the body, they do not seem to increase the risk of breast cancer and do not increase the risk of breast cancer recurrence in women with a history of breast cancer. In fact, the data suggests that there may be a trend toward a protective effect.”
Red clover is another source of isoflavones that offer some women relief and “it has not been associated with significant side effects,” Bonham said. Studies about black cohash are also inconclusive, but anecdotally, many women find relief with this supplement. “It’s relatively safe, although women with active liver disease may wish to avoid it,” Bonham said. “The recommended dose is 40 to 80 mg. per day, and it may take up to 12 weeks to notice effects.” She also noted that studies on vitamin E are unclear as to its effectiveness in helping women in menopause, but “because there are few risks associated with its use, a short course of treatment using a dose of 400 to 800 [micrograms]
Women’s Continence Center of Greater Rochester
Fellowship-trained Urogynecologist only
Hilary J. Cholhan, MD FACOG “Board Certified, Female Pelvic Medicine & Reconstructive Surgery. [Urogynecology]”
Katrina L. Lelli, RPA-C Bladder Control Problems in Women Prolapse of Pelvic Organs Comprehensive Gynecological Care SPECIALIZING IN: Surgical & Non-surgical Treatment of Urinary Incontinence Pelvic Reconstructive Surgery
(585) 266-2360
500 Helendale Road • Suite 265 Rochester, NY 14609
RESTORING HAIR. Restoring Confidence. ■ Surgical Hair Restoration & Transplants ■ Non-Surgical Gradual Hair Replacement ■ Extensions, Wigs, and Hair Pieces ■ Topical Hair Loss Products ■ Laser Hair Rejuvenation
NEW-U
• Free Consultations • On Premise Service & Repairs • Easy & Affordable Financing
Hair Replacement Specialists
1425 Jefferson Rd • Saginaw Plaza, 2nd Floor Rochester, NY 14623 Baldness.com
Additional Locations: Clifton Springs • Greece
per day is an option. “Dong quai and evening primrose oil do not appear to have any benefit and may cause bleeding problems if used by women who are using blood thinners,” Bonham added. Marusia Marrapese, wellness consultant at Lori’s Natural Foods Center in Rochester, has 30 years of industry experience. She recommends clients to consider pomegranate-based supplements as supportive of good health. “In pomegranate seed oil, there’s mild steroid hormones, the exact same structure as the human estrogen,” Marrapese said. “It’s a different type of steroidal hormone. It’s a mild structural hormone that’s balancing. They yield a substantial difference in hormonal activity.” Although pomegranate juice and seed oils are fairly common, she promotes a supplement that includes the seed oil, fermented juice, peel and leaf to support female health. “My problems were vaginal dryness for several years after early menopause,” Marrapese said. “Supplementing with all four factions of the pomegranate in a dry, encapsulated powder supported normalized vaginal secretions. At 47, to have that balance returned was quite a joy and to realize that there was an effective way to address this without having to use drugs.” Grabbing the first supplement on the shelf may not bring relief. Consulting with someone knowledgeable in supplements can help. At The Springs at Clifton Springs, Mary Sarratori, who has a master’s degree in Oriental medicine and is a licensed acupuncturist, blends unique herbal formulas. “With Chinese medicine, we base our formulas on specific people and their constitution,” Sarratori said. “You might come to me with the same symptoms as someone else, and I might blend you something completely different.” As far as diet in general, reducing intake of hot and spicy foods is practical. Sarratori said that limiting heat, coffee, and alcohol will help, as will switching from black tea to green tea, which she said is more cooling since it’s not as processed.
272-7320
UNDETECTABLE RESULTS. COMPLETELY CONFIDENTIAL. April 2014 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 13
Women’s
issues
No More Belly Bulge! C
runches, sit-ups, crunches with a twist and anything that “jack knifes” the body such as straight leg lifts or holds while lying on your back can worsen your belly bulge, particularly if you have spinal alignment, low back pain issues. In addition, if your spinal alignment issues are accompanied by diastasis recti, your belly bulge will worsen. Diastasis recti (DR) is the separation of the rectus abdominus (six pack) abdominal muscle from the linea alba (mid-line connective tissue) at the front of the abdomen. DR is the result of excessive intra-abdominal pressure or loading and is common in the later stages of pregnancy, particularly second or subsequent pregnancies. The diastasis (gap) narrows naturally in the weeks following childbirth, but often doesn’t come back together completely on its own, resulting in instability and weakness of the core (your back and abdominal muscles) and a “pooch” stomach. Excessive intra-abdominal pressure also causes hernia and organ prolapse. The muscles separate as a result of increased pressure, the linea alba is stretched and weakened as it takes all other muscular and fascia support structures along with it. This leaves the front of the abdomen unsupported and unstable. The rectus abdominus is one of four layers of abdominal muscles: the transversus abdominus, the deepest layer; the internal and external oblique, the next two layers that shape the waist; and then the rectus abdominus is on the outside. Diastasis, “the gap,” is a symptom or a sign something is not working right in your spine and pelvis. It is not the problem in and of itself. It seems like binding or splinting the abdominal muscles and doing lots of abdominal exercises would be the obvious or direct way to deal with the abdominal muscles not doing their job. In fact, correcting the problem has to start with proper alignment of your spine and pelvis. If there is not proper alignment, the back, abdominal and pelvic floor
Page 14
•
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
muscles cannot function properly. As a result, there will be continued excessive intra-abdominal pressure that the abdominal muscles cannot withstand pushing the belly further out and down. So the remedy for DR is not a cure for the “gap” in isolation. It is an approach that properly aligns your body and conditions the entire mid-section to get the core in good working order. When you do this the gap narrows because the pressure pushing on the weak point decreases. If you are interested in having Lake Country Physical Therapy and Sportscare, PC help you with your bulging belly, call 585-396-1400 or email Zoe@ lakecountrypt.com or Robert@lakecountrypt.com. For more information about Lake Country Physical Therapy and Sportscare, PC, visit www.lakecountrypt.com. Submitted by Zoe Fackelman, PT and Robert C. Christakos, PT, DPT, Lake Country Physicial Therapy.
Women’s issues The Latest on Annual Mammograms:
They Are Not Effective But experts are divided about most recent study By Deborah Jeanne Sergeant
T
he latest findings from the Canadian National Breast Screening Study, published in February in the British Medical Journal, indicate that mammography used as a screening tool for women 40 through 59 made no difference in mortality compared with monthly self breast examination and a clinical breast exam. Researchers studied 89,835 women. Each received a clinical breast exam, then researchers divided them into two groups, one that received only clinical breast exams for four years and the other that received annual mammograms as well. For 25 years, researchers followed up with the women. The number of women in the control group who died was nearly the same as the women receiving clinical breast exams plus mammograms. “Mammography detected many more invasive breast cancers,” said lead researcher Cornelia Baines,
professor emeriti at the University of Toronto’s Dalla Lana School of Public Health. “Survival time was longer in women getting mammography.” “[However], the number of deaths from breast cancer was the same in both groups at 25 years,” she was quoted as saying. Physician Arnold Baskies, who sits on the national board of directors for American Cancer Society, said the study was poorly done in general. “Nine studies have looked at this question and only this one has come to this conclusion. The conclusion has been criticized at best,” she said. One widely criticized issue is that since the women received clinical breast exams before the study commenced, researchers could have favored women with noticeable lumps by putting them in the mammography group. Baskies also pointed out that the
population of the US is different ethnically than in the Canadian study; that US radiologists use more sophisticated equipment (especially considering the study began 25 years ago) and that US radiologists abide by a higher standard of methodology than that of Canadian radiologists; and that the Canadian researchers did not properly analyze their data. “Since widespread mammography screening became available in the US, there has been a decline in breast cancer deaths,” Baskies said. Physician Lori Medeiros, director of the Rochester General Breast Center, thinks the study may not be applicable today in part because “the questions they asked patients about their health 25 years ago aren’t the same questions doctors ask patients today. You have multiple other trials that were worldwide that demonstrate that mammograms do decrease mortality from
breast cancer. This is the only one that doesn’t.” “It’s a different setting compared to the general population that may not be doing a self breast exam, or may not do it correctly or may not have access to healthcare as the general population,” Medeiros said. To keep a study fair, researchers don’t consider the personal aspects of the subjects. In real life, “we really need to personalize surveillance, just as we’re trying to do with treatment,” said Michelle Shayne, breast oncologist at University of Rochester Medicine’s James P. Wilmot Cancer Center. “We need to look at each individual woman and see if she would benefit from mammography or not.” Some previous studies have followed women ages 50 to 74. The Canadian study looked at women 40 to 59. “I think that for women who fall
Continued on the next page
Got Drugs? Turn in your unused or expired medication for safe disposal Saturday, April 26th 10 a.m. – 2 p.m.
Visit www.dea.gov or call 800-882-9539 for a collection site near you.
Therapeutic Massage/Integrated Health Care
Make a hands-on difference. Prepare for a career that helps heal others through massage therapy. FLCC is one of only a few accredited schools in New York State to offer a massage program. At FLCC, you’ll also learn about life sciences, alternative therapies, and a holistic approach to well-being in a program that is less expensive than private massage schools in New York State. In addition to learning about different types of massage, the history of massage, and various massage techniques, you’ll also study anatomy and physiology, kinesiology and myology, psychology, and more. This comprehensive degree program will challenge you and prepare you for a career as a massage therapist. Visit www.flcc.edu/massage to learn more!
April 2014 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 15
Women’s issues
Sedentary Lifestyles Up Mortality Risks for Older Women
The Latest on Annual Mammograms from previous page in the younger group, we need to see if there’s strong family history or other compelling reason for mammogram for that group,” Shayne said. Judith A. Salerno, a physician who serves as Susan G. Komen president and CEO, offered a view on the study. “The Canadian study adds to a growing body of evidence that mammography is an imperfect screening tool for breast cancer,” she said in a statement released to In Good Health. “We agree. It is based on 1950s technology, and can lead in some cases to over-diagnosis and overtreatment of breast cancers. The problems with mammography have been established for many years.” Another unexpected finding from the study is that mammogram screening leads to overtreatment of breast cancer. The study indicated that between one in four to one in five cancers that appear on a mammogram would not need treatment; however, since the ability to tell the difference between fatal and non-fatal cancer isn’t foolproof, any discovered cancer receives treatment, whether it’s warranted or not. “The more important question, and the one we ask every time one of these studies is released, is what we can do to provide women with more reliable and cost-effective tests to detect breast cancer,” said Salerno. “Once detected, we need tests that can tell us, with
Page 16
•
more certainty, which tumors are likely to become invasive and which might not require extensive treatment. The search for better early detection methodologies is an important focus for research.” Regardless of detection via mammography, self breast exam or clinical breast exam, early detection is key for optimal treatment. “We encourage all women to learn about their risk, discuss the right screening schedule for them with their doctors, know the look and feel of their breasts and report changes to their healthcare provider,” Salerno stated. Salerno hopes that more women become aware of both their risks and what’s normal for their breasts so they can make better decisions about their health. Susan G. Komen’s breast self-awareness messages include knowing family health history and personal risk factors; talking with health care providers about screening tests; beginning clinical breast exams every three years starting at age 20 and annually at 40; and knowing what is normal for breast appearance. Further, women should maintain a healthy weight, exercise, breastfeed their infants, limit alcohol, exercise, limit menopausal hormone therapy, and perform regular self breast examinations.
As for when to start mammograms, Baskies said, “A certain percentage of women benefit from younger mammograms but we don’t know who they are.” That’s why discussing risk factors with a physician is critical for making these choices. The American Cancer Society guideline says to start screening at 40 because statistically, that’s when most cancers start. For women with sufficient risk factors, that age may be younger.
Are Your at Risk?
Susan G. Komen organization has identified factors that greatly increase breast cancer risk: • A mutation (or a first-degree relative with a mutation) in the BRCA1 or BRCA2 gene. • A strong family history of breast cancer, such as a mother and/or sister diagnosed at age 40 or younger. • A personal history of invasive breast cancer. • A personal history of ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS) or atypical hyperplasia. • Radiation treatment to the chest area during childhood or young adulthood. • A mutation (or a first-degree relative with a mutation) in the TP53 or PTEN.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
Older women who spend a majority of their day sitting or lying down are at increased risk for cardiovascular disease, coronary heart disease, cancer and death, finds a new study from the American Journal of Preventive Medicine. “Women who were sedentary more than 11 hours a day were most at risk,” said Rebecca Seguin, lead author and assistant professor in the division of nutritional sciences at Cornell University. Seguin and her colleagues analyzed the connection between a sedentary lifestyle and mortality risks of 92,234 postmenopausal women 50 to 79 years old. Between 1993 and 1998, participants in the Women’s Health Initiative Study were interviewed in person and with questionnaires that assessed how many hours they spent sitting or lying down in four categories: less than 4, 4-8 hours, 8-11 hours or more than 11 hours a day. The average amount of time spent sedentary was 8.5 hours a day. Women who spent the most time sedentary were more likely to be white, to have a college degree and have higher body mass indexes (BMIs), she added. Sedentary women were more likely to report fair to poor health, to be smokers and to have more falls in the past 12 months. Even when factoring in physical limitations due to chronic diseases, which are more likely to affect older women, being sedentary increased the risk of mortality.
Some of our patients have described walking into Finger Lakes Radiation Oncology Center like walking into their own family’s home. It’s true, the atmosphere here is unique. Every day we strive to create a warm, compassionate and friendly atmosphere to help guide you through your cancer journey.
• • • •
Board-certified radiation oncologists and radiation therapists Encouraging and supportive environment Comfortably close to home Take charge and make us your choice for treatments
7 Ambulance Drive Clifton Springs, NY 14432 (315) 462-5711 www.flrocenter.com
Visit our Facebook page
U.S. Home Births Continued Steady Increase in 2012: CDC
T
he percentage of U.S. women choosing to give birth at home or in a birthing center rather than a hospital has grown by 56 percent in less than a decade, according to a new government report. Although hardly the norm, out-of-hospital births accounted for 1.36 percent of U.S. births in 2012, according to the U.S. Centers for Disease Control and Prevention. A year earlier, 1.26 percent of births occurred away from a hospital, while just 0.87 percent of such deliveries took place in 2004. “That’s a pretty good jump in a single year, and it’s been a continuing trend since 2004,” said T.J. Mathews, a demographer with the CDC’s National Center for Health Statistics. The new numbers reflect the ev-
er-growing popularity of home births aided by midwives, said Lynn Johnson, midwife and administrator of Women’s and Children’s Services at Huntington Hospital in New York. “More people are talking about midwifery birth and having their experience as they would like to have it,” Johnson said, adding that some women worry about losing their autonomy and having a doctor call the shots during delivery. Two-thirds of the out-of-hospital births occurred at home, the CDC found, while another 29 percent occurred in a birthing center. Another 5 percent occurred in a clinic, doctor’s office or other location. The CDC also reports births outside the hospital carried a lower “risk
profile” in 2012, with a smaller proportion of preterm and low birth weight babies than in hospital delivery rooms. Other highlights of the report follow: • White women chose out-of-home births about four times more often than other ethnic groups — about 2 percent of whites versus half a percent of blacks, Hispanics and Asians. “They’ve consistently had higher rates for a while now,” Mathews said of whites. “If they’re getting good results and they’re talking to each other, it becomes more of a normal option for that population.” • The six states leading the charge in out-of-hospital births are Alaska, Pennsylvania, Idaho, Montana, Oregon and Washington, with 3 percent to 6
April 2014 •
percent of births occurring at home or in a birthing center. • Women in Rhode Island, Mississippi and Alabama accounted for only 0.33 percent to 0.39 percent of home births. • About 4 percent of out-of-hospital births were preterm in 2012, compared with almost 12 percent of hospital births. Similarly, about 3 percent of out-of-hospital births were low birth weight vs. more than 8 percent in the hospital. • In the 36 states that have birth certificates that note whether the delivery took place as intended, 88 percent of home births took place as planned in 2012. This indicates these home births were not surprises, Mathews said.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 17
Waste of Money? Editorial in The Annals of Internal Medicine says consumers are just wasting money on multivitamin supplements. Local expert disagrees By Matthew Liptak
A
well-regarded medical journal took the position in its December issue that spending money on multivitamin and mineral supplements is huge waste of money. That just isn’t so, says Syracuse’s Upstate University Hospital registered dietitian Maureen Franklin. “I have a differing opinion,” Franklin said. “I guess when I read the article it came across as in terms of there is no benefit whatsoever to supplements. I think supplements have a value depending on each individual case. I think there are people that possibly need supplementation. That’s something they need to talk to [about] with their medical provider.” The journal, Annals of Internal Medicine, published a blunt editorial titled “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.” It cited three separate studies it said shows that supplements are not helpful in prolonging life,
preventing cancer, heart disease and cognitive decline. The editorial concludes stating that “although available evidence does not rule out small benefits or harms or large benefits or harms in a small subgroup of the population, we believe the case is closed — supplementing the diet of well-nourished adults with most mineral of vitamin supplements has no clear benefit and might even be harmful. These vitamins should not be used for chronic disease prevention. Enough is enough.” The editorial has caused controversy and widespread debate. Many think supplements can be helpful. They cite conflicting studies they say show that supplements can be beneficial. Franklin believes taking a multivitamin can be a good thing. She takes one herself. She believes each individual should do the research themselves to make their own decision on taking
What They Want You to Know:
Cardiac Rehabilitation Nurses
By Deborah Jeanne Sergeant
A
ccording to the American Heart Association, “Cardiac rehabilitation (cardiac rehab) is a professionally supervised program to help people recover from heart attacks, heart surgery and percutaneous coronary intervention (PCI) procedures such as stenting and angioplasty. Cardiac rehab programs usually provide education and counseling services to help heart patients increase physical fitness, reduce cardiac symptoms, improve health and reduce the risk of future heart problems, including heart attack.” • “It’s rewarding when someone comes in a wheelchair or with a walker who thinks they can’t do anything and they no longer need it when they leave and they can get back to golfing. We impact their quality of life. People say, ‘I haven’t been able to do that for Page 18
•
years!’ • “It’s not just a gym. We monitor blood pressure and heart rate. If we see abnormality, we can help the doctor make adjustment. We see them on a regular basis. My advice to patients if they’re not sure if they should see us, come see us. If there are medication changes or if they find they have side effects like dizziness, we can call their doctor. At a gym, they don’t have that benefit of people like us helping them by monitoring their vitals and staying on top of their medication. • “We’re not here to replace the physician, but help the patients get back to the level of productivity that’s realistic for them in a safe manner. If they don’t have the right guidelines, they can hurt themselves.” Kathy Ross, RN, staff cardiology practice nurse with Unity Health System.
supplements and also consult their medical provider. “I think we’re looking for quick fixes sometimes or I think we’re looking for something that’s going to improve our health,” she said. “I think that’s important. They want to improve their health. I just think they need to do the research if they’re going to take a supplement. Why? Because somebody down the street went to take it? Or, do they actually need it?” Franklin cited three supplements that some people might need because they have a deficiency: vitamin B12, vitamin D and calcium. But, she noted, people should get tested by their doctor to see if they actually have a deficiency before buying them. Studies sometimes conflict and sometimes multiple studies need to be done before the truth can come out about a certain supplement, Franklin said. There have been occasions where
the medical community advised taking a vitamin or mineral supplement and then that changed. “For a while vitamin E was treated like miracle, heart-healthy type vitamin supplementation so we were recommending that,” she said. “Then there were enough studies that said ‘OK, it’s probably not the best thing that we need to be recommending to people.’” A Gallup poll conducted in December showed that Americans take more supplements as they get older. More than half of Americans aged 50 to 64 take supplements, and that figure climbs to 68 percent if they’re over 65. More adults also take them if they have a higher income. “As people get older they get more concerned in terms of their health and they’re looking at what can I do as far as preventive,” Franklin said. “As we get older we start to think about ‘Well, I’d like to live a little bit longer. I’d like to be able to enjoy my retirement. What can I do to help myself?’” Franklin said people are better off getting vitamins and minerals from what they eat and drink rather than taking supplements. A nutritious diet should be the goal. Some people can’t get the needed amount through food if they have a deficiency so they need supplementation. Getting your nutrition through food also has added benefits like introducing important antioxidants and other nutrients to your diet.
• “Patients should use us as a professional sounding board so we can be a liaison in working with their physicians. A lot of times, we do oneon-one [consultations] with people to individualize what people need. We see them over multiple days so they get to know us and they’re more willing to share information and ask questions and share concerns. • “Cardiac rehabilitation is a proven service. The more a person participates, the fewer issues the person has in the long run. That long-term effect really benefits clients and that’s why insurance companies are opening up to it more. Twenty years ago, a lot of times people would say, ‘Just go do a slow walk.’ • “Beyond exercise and medication, we offer a lot of education with rehab. We work on lifestyle modification like dining out. How do you still travel and continue with exercise program when you’re busy? How do you include stress management and how can you implement these things in your life? • “We want to be an arm to help the physician with all these concerns.” Karen Pyle, RN and manager of the cardio-pulmonary rehabilitation center, Unity Health System.
certified diabetic educator who teaches about heart healthy choices and low-sodium choices to prevent high blood pressure. • “People can join the rehab program if they have only two of the risk factors: stress, smoking, high blood pressure, diabetes, depression, overweight, high cholesterol and sedentary lifestyle. They just need a referral from their primary or cardiologist. • “High blood pressure is a silent killer in the US. A lot of people have it and don’t know because most people don’t have symptoms. Make a yearly physical appointment. Monitors at the store aren’t always accurate. It’s best to make an appointment with the primary physician to get a baseline reading for heart health and other health issues. • “We have a medical director, Dr. Seth Jacobson, a cardiologist, oversee the program. Also, we have exercise specialists that teach exercise guidelines. If it is hard for people to fit 30 or 45 minutes of exercise four to five times a week, split it up to two or three 15 minute times a day. Brisk walking is excellent exercise. Being able to carry on conversation is a good guideline as to how brisk.” Karen Muller, RN, administrative clinical leader of the cardiac rehabilitation program at Rochester General Hospital.
• “It’s a very vulnerable period after their heart event. We teach them safe limits with exercise and how to listen to their body. We help them learn a safe target heart rate. • “We prevent re-admission. About 25 percent of our patients are diabetic so we keep an eye on blood sugar, too. • “There’s a range of the type of event the person has, such as sudden event or surgery. The age range is huge, so some are younger and in denial. Some aren’t compliant in making better choices. • “We provide education on stress management, smoking cessation, cholesterol and diabetes. We have a
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.
By Jim Miller
Health Strategies for Preventing Alzheimer’s Disease Dear Savvy Senior, Are there any proven strategies to preventing dementia? My 80-yearold mother has Alzheimer’s which has me wondering if there is anything I can do to protect myself. Concerned at 53 Dear Concerned, While there’s currently no cure for Alzheimer’s disease, new research indicates that there are a number of healthy lifestyle strategies that can help most people reduce the risk of getting it. According to the Alzheimer’s Association, the key factors that increase the risk of getting Alzheimer’s are advanced age, family history and heredity, but research shows that our general health plays a factor too. While we can’t do much about our age, family or genes, we do have control over how we treat our body and brain. Some medical experts even estimate that by following these healthy tips now in middle-age, you can actually reduce your risk of developing Alzheimer’s by as much as 50 percent, or at least delay its onset by a few years. Here are the recommended strategies. Manage health problems: Studies have consistently shown that Alzheimer’s disease is closely related to conditions like diabetes and heart disease. So, if you have high blood pressure, high cholesterol or diabetes you need to treat them with lifestyle changes and medication (if necessary) and get them under control. Left untreated, these diseases over time will cause damage to the vessels that feed blood to the brain making them more vulnerable to damage, and increasing your risk of dementia. Exercise: Aerobic exercise increases blood flow to all parts of your body, including your brain, to keep the brain cells well nourished. So choose an aerobic activity you enjoy like walking, cycling, dancing, swimming, etc., that elevates your heart rate and do it for at least 30 to 40 minutes three times a week. Eat healthy: A heart-healthy diet, like the Mediterranean diet, will also help protect the brain. A Mediterranean diet includes relatively little red meat and emphasizes whole grains, fruits
and vegetables, fish and shellfish, and nuts, olive oil and other healthy fats. Also keep processed foods and sweets to a minimum. Sleep well: Quality, restful sleep contributes to brain health too. Typically, adults should get between seven and nine hours of sleep daily. If you have persistent problems sleeping, you need to identify and address the problem. Medications, late-night exercise and alcohol can interfere with sleep quality and length, as can arthritis pain, sleep apnea and restless leg syndrome. If you need help, make an appointment with a sleep specialist (see sleepeducation.com) who will probably recommend an overnight diagnostic sleep test. Challenge your brain: Research shows that mind challenging activities can help improve memory, slow age-related mental decline and even build a stronger brain. But be aware that mind-challenging activities consist of things you aren’t accustomed to doing. In other words, crossword puzzles aren’t enough to challenge your brain, if you’re already a regular puzzle doer. Instead, you need to pick up a new skill like learning to dance, play a musical instrument, study a new language or do math problems — something that’s challenging and a little outside your comfort zone. Brain-training websites like Lumosity.com and BrainHQ.com are excellent mind exercising tools because they continually adapt to your skill level to keep you challenged. Socializing and interacting with other people is another important way to stimulate the brain. So make a point to reach out and stay connected to friends, family and neighbors. Join a club, take a class or even volunteer — anything that enhances your social life. Reduce stress: Some stress is good for the brain, but too much can be toxic. There’s growing evidence that things like mindfulness meditation, yoga and tai chi are all good ways to help reduce stress. For more tips, call the National Institute on Aging at 800-222-2225 and order a free copy of their booklet “Preventing Alzheimer’s Disease: What Do We Know?” Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. April 2014 •
Take a step toward healthy eating! Subscribe now to a Community Supported Agriculture program! Receive a basket of fresh organic vegetables, fruit and herbs from the Fellenz Family Farm each week! CERTIFIED ORGANIC PRODUCE FARMSTAND U-PICK STRAWBERRIES
See us at the Rochester and Palmyra CSA Fairs Saturday March 8 1-3:00pm Brickstone • Wintergarden, 1325 Elmwood Ave., Rochester Tuesday March 18 6-8:00pm Palmyra Community Library, 402 East Main St., Palmyra
3 LOCATIONS
Pittsford • Canandaigua • Geneva 1919 Lester Rd., Phelps, NY 14532 585-260-2477 www.FellenzFamilyFarm.com
Rochester School for the Deaf 1545 St. Paul Street, Rochester, NY 14621
Where families expect more... and find it. u Private school for deaf and hard of hearing children, newborn to 21 years old. u New York State Regents-level education and support services provided for all students. u Safe and inclusive environment providing direct access to communication. u Individual attention from skilled professionals.
Building Futures...since 1876 Infant, Early Childhood, K-12 School and Sign Language Learning Programs Call: 585-544-1240 u Visit: www.RSDeaf.org u E-mail: info@RSDeaf.org
BEST PRICE • BEST QUALITY BEST SERVICE Call 585-385-0877 www.audiphone.info
Making quality hearing aids more affordable since 1927 We are always available to help you, M-F 9am-5pm 230 West Commercial St. • East Rochester, NY 14445 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 19
The Social Ask Security Office
Stay Home - Stay happy! • Assisting Angels make it happen • Companionship - Meal Preparation • Light Housekeeping-Beds, Laundry, Linens • Errands, shopping, doctor appointments • Care available morning afternoon and evenings. 24/7 We meet your schedule. Lowest hourly rates in Rochester area! www.assistingangelsseniorcare.com 585-329-4476 716-741-1330
Excellent Employment Opportunities
Dedicated to:
Degree Programs include:
• Academic Excellence • Quality Patient Care • Professional Leadership
• • • •
For more information call NYCC at 1-800-234-6922 or visit www.nycc.edu.
Doctor of Chiropractic Master of Science in Acupuncture Master of Science in Acupuncture and Oriental Medicine Master of Science in Applied Clinical Nutrition (online delivery) • Master of Science in Human Anatomy & Physiology Instruction (online delivery)
Academic Excellence. Professional Success.
Finger Lakes School of Acupuncture & Oriental Medicine of New York Chiropractic College
2360 Route 89 • Seneca Falls, NY 13148
Subscribe to In Good Health
Get Rochester’s Healthcare Newspaper at home for only $15 a year.
Name_____________________________________________ Address___________________________________________ City / Town___________________ State______ Zip__________ Your occupation:____________________________________ Where did you pick up In Good Health?__________________ _________________________________________________ _________________________________________________ Clip and Mail to:
P.O. Box 525, Victor, NY 14564 Page 20
•
Helping Americans With Disabilities
T
he World Health Organization held the first World Health Assembly in 1948, and, beginning in 1950, every year on April 7 the world comes together to observe World Health Day. Each year, World Health Day focuses on a particular subject of interest to global health. At Social Security, we focus on people’s health every day. Specifically, we provide benefits for people with disabilities. To help expedite the disability process, we recently announced the addition of 25 new “Compassionate Allowances” conditions. These new conditions include 12 cancers, such as prostate cancer, as well as disorders that affect the digestive, neurological, immune, and multiple body systems. The “Compassionate Allowances” program expedites disability decisions for Americans with the most serious disabilities to ensure that they receive their benefit decisions within days instead of months. By incorporating cutting-edge technology, the agency can identify potential “Compassionate Allowances” and quickly make decisions. To date, we have approved almost 200,000 people with severe dis-
Q&A
School of Applied Clinical Nutrition
In Good Health
Column provided by the local Social Security Office
$15 payment enclosed Please bill me later
Q: We adopted a baby girl overseas and brought her home with us to the United States. We need to get a Social Security number for her. What do we do? A: In general, to apply for a Social Security number for your child you must: • Complete an application for a Social Security card (Form SS-5), which you can find online at www.socialsecurity.gov/ssnumber; • Show us documents proving your child’s: – United States citizenship or immigration status; – Adoption; – Age; and – Identity. • Show us a document proving your identity; and • Show us evidence that establishes your relationship to the child if your name is not noted as the parent on the child’s evidence of age. The adoption decree or the amended U.S. birth certificate will suffice. In most cases, you can mail or take your application and original documents to your local Social Security office. Remember, all documents must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies of documents. You may not yet have
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
abilities through this fast-track disability process. “We are dedicated to providing vulnerable Americans with faster access to disability benefits through our ‘Compassionate Allowances’ program,” Acting Commissioner Carolyn W. Colvin said recently. “Social Security disability benefits are a vital lifeline for individuals who are facing severe diseases and we must ensure that they receive the benefits they rightly deserve.” While Social Security joins individuals, groups and organizations around the globe to observe World Health Day on April 7, we work all year round to help Americans with health issues live a healthier life. In addition to cash benefits, beneficiaries obtain Medicare coverage after 24 months, a vital element in preserving an individual’s health and, in the long run, world health. Learn more about disability benefits at www.socialsecurity.gov/disability. For more information on the “Compassionate Allowances” program, including a list of all qualifying conditions, please visit www.socialsecurity. gov/compassionateallowances.
proof of your child’s citizenship, but we can assign a Social Security number based on documentation issued by the Department of Homeland Security upon the child’s arrival in the United States. When you do receive documentation of your child’s citizenship, you can bring it to us, and we will update your child’s record. We will mail your child’s number and card as soon as we have verified your documents with the issuing offices. Q: How long do I need to work to become eligible for retirement benefits? A: Everyone born in 1929 or later needs 40 Social Security credits to be eligible for retirement benefits. You can earn up to four credits per year, so you will need at least 10 years of work to become eligible for retirement benefits. During your working years, earnings covered by Social Security are posted to your Social Security record. You earn credits based on those earnings. If you become disabled or die before age 62, the number of credits needed to qualify for Social Security benefits depends on your age at the time you die or become disabled. A minimum of six credits is required to qualify for Social Security benefits regardless of your age. You can create a “my Social Security” account to check and periodically monitor how many credits you have. Just go to www.socialsecurity.gov/myaccount.
H ealth News RHSC launches program to help those with autism Rochester Hearing and Speech Center (RHSC) is launching a comprehensive applied behavior analysis (ABA) program for children early intervention- and preschool-aged and diagnosed with autism spectrum disorder. The new program is under the direction of board-certified behavior analyst Jennifer Rymanowski, Ph.D. The ABA program, which is rooted in the science of understanding how behavior is affected by the physical and social environment, aims to increase adaptive behaviors that support independence and reduce behaviors that impact a child’s ability to learn and function so that a child with autism can be successful and Rymanowski happy in daily life. RHSC’s multidisciplinary team of speech pathologists, special education teachers, occupational therapists and physical therapists will collaborate as one team and work with families to design individualized treatment plans that are customized to each child’s
needs. The ABA program at RHSC offers home-based and center-based intervention sessions and an ABA developmental group, which allows parents to remain actively involved in their child’s intervention program while building each child’s competency across environments. Early, intensive, behavioral interventions have been cited as the key factor in successful treatment for autism. ABA programs that offer children with comprehensive, individualized and intensive intervention services at an early age have proven effective in significantly improving communication skills, academic and reasoning skills, social and play skills, and adaptive behavior as well as decreasing challenging behaviors in children on the autism spectrum. ABA is endorsed as best-practice for children with autism by a number of state and federal agencies, including the U.S. Surgeon General, National Institute of Mental Health, New York State Department of Health, American Association on Intellectual and Developmental Disabilities, American Academy of Pediatrics, and Autism Speaks. For more information about ABA services or to see if your child qualifies, contact Jennifer Rymanowski at 585271-0680 or jrymanowski@rhsc.org.
Excellus awards hospitals $24.5 Million Forty-seven Upstate New York hospitals and health centers last year earned $24.5 million in quality improvement incentive payments from Excellus BlueCross BlueShield as part of the health insurer’s hospital performance incentive program (HPIP). In the past 10 years, quality performance incentives from Excellus BCBS have exceeded $169 million. “With all the changes in health care brought about by the Affordable Care Act, we applaud our hospital partners for continuing to focus on improving the quality of care and patient safety,” said Carrie Frank, vice president of quality and health informatics at Excellus BCBS. Eight hospitals in the Finger Lakes Region participated in this program in 2013: Clifton Springs Hospital, UR
American Chiropractic Association President Keith Overland, NYCC President Emeritus Ken Padgett, and ACA Vice President Dr. Tony Hamm.
NYCC honored by ACA New York Chiropractic College has been named the American Chiropractic Association’s very first recipient of its “Chiropractic College of the Year Award” given at the organization’s recent house of delegates meeting held during the National Chiropractic Legislative Conference in Washington, D.C. The ACA is the largest professional association in the United States advocating for more than 130,000 doctors of chiropractic, chiropractic assistants and chiropractic students. It cited NYCC’s close working relationship with the ACA and the college’s favorable results in working with the VA system. “We’re thrilled to receive this
recognition,” said NYCC President Frank Nicchi.”It’s certainly an honor to partner with the ACA and extremely rewarding to enjoy success in our efforts to solidify relations with the Veteran’s Administration by advancing the integration of chiropractic.” Kenneth Padgett, past NYCC president, accepted the award on the college’s behalf. Subsequent recipients of the annual award will be chiropractic colleges and universities who will have similarly distinguished themselves for their demonstrated dedication, leadership and service to the ACA, to the chiropractic profession, and to quality chiropractic education. April 2014 •
Medicine’s F.F. Thompson Hospital, UR Medicine’s Highland Hospital, Newark-Wayne Community Hospital, Nicholas H. Noyes Memorial Hospital, Rochester General Hospital, UR Medicine’s Strong Memorial Hospital and Unity Hospital. “We are pleased to be able to collaborate with Excellus BlueCross BlueShield in improving the safety and efficiency of the care we deliver,” said physician Richard Magnussen, associate medical director, UR Medicine’s Highland Hospital. “Our patients are the direct beneficiaries of this continuous quality improvement initiative.” Launched in 2004, the HPIP program evaluates participating hospitals on over 250 performance measures. In 2013, hospitals achieved 89 percent of all target quality levels. In addition to required clinical and patient safety measures, other nationally-endorsed measures and target outcomes are jointly agreed upon by each hospital.
‘O.R. of The Future’ Unveiled at Rochester General Hospital
Keeping pace with technology’s impact on the evolution of health care, Rochester General Health System recently introduced a new surgical suite that is integrating numerous state-of-the-art applications. The “OR of the future” was unveiled March 13. The operating room encompasses a combination of equipment, technology, patient information and new processes that complements 10 years of leadership at RGHS in the field of robotic surgery. The combination of influences creates a safe, data-driven and efficient surgical environment that ensures superior clinical outcomes. “With the range of new technologies coming into medicine, we’re dedicated to applying each element within an appropriate niche,” said physician John Valvo, RGHS director of robotic surgery. “That allows us to provide an environment for our patients which is safer, smarter and more secure.” The new OR features handsfree motion sensing applications that make it possible for surgeons to review intraoperative imaging files without breaking scrub. High-definition visual equipment
includes laparoscopes for near-perfect resolution of inner organs during procedures along with video monitors that project images to the entire surgical team. Other enhancements include more efficient LED lighting and an ultraviolet disinfectant system that reduces the risk of infection. Additionally, upgrades to telemedicine improve the efficiency of procedures conducted off site. Nurses, administrators, mentors and colleagues can assist from multiple venues and improve the overall quality of care. The upgrades were made possible, in part, by a $1 million grant sponsored by former New York State Sen. James Alesi. Unveiling of the new OR was accompanied by the celebration of an upcoming milestone. Rochester General Hospital is approaching its 7,000th robotic surgical procedure, making it among the top 1 percent of hospital nationwide for high volume of robotic surgeries. These procedures are minimally invasive and reduce blood loss and post-operative pain. That frequently translates into shorter hospital stays and faster recovery periods.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 21
Rochester General, United Memorial to merge Rochester General Health System (RGHS) and United Memorial Medical Center in Batavia have recently confirmed their intent to formalize a comprehensive partnership. This agreement begins the process of making the Genesee County hospital a fully
integrated affiliate of RGHS. “Even given our sound financial position today, changes in health care will continue to negatively impact independent rural health care providers,” said Mark Schoell, CEO, United Memorial Medical Center. “The leadership of United Memorial remains committed to providing the best for our patients, and this expanded relationship will strengthen the future of health care in
Genesee County.” The hospital’s affiliation with RGHS will lead to a continued expansion of health care services in Batavia and on-site at United Memorial, and over time will result in fewer Genesee County residents needing to leave their community for vital health care. United Memorial will maintain its name and a local board, and will continue its longstanding tradition of providing
Now Available in Monroe County
Remain safely at home with help from HomeFirst.
a full range of medical and acute care services in Batavia after the affiliation is formalized. The announcement mirrors a trend among successful hospitals and health care systems nationwide. Community hospitals continue to be impacted by changes in the business of health care, and few have the size and scale necessary to support wide breadth of specialized services and technology required today. System affiliations address the economic realities that community hospitals face with health care reform, while ensuring patients have immediate and convenient access to a full range of primary and secondary services locally and a gateway to the best clinical care available when more highly specialized care and technology — like cardiac surgery, stroke services, neurosurgery, and other complex services — are required. “Progressive and forward-thinking rural hospital management teams and boards like United Memorial’s continue to recognize the value in partnering with larger systems, to ensure their patients have access to a full range of highly specialized technology and physician expertise,” said Mark C. Clement, president and CEO of RGHS. “This partnership will enable the residents of Genesee County to continue to have access to and receive world-class care, right at home here at United Memorial.”
ElderONE opens second pace center
More and more people on Medicaid who might otherwise be in a nursing home won’t have to because of HomeFirst. HomeFirst is one of the oldest managed long-term care (MLTC) plans in the state. Our Personal Care Workers provide assistance with bathing, dressing and meals. You can keep your own doctor, and we provide transportation to medical appointments. There is no cost to participate. HomeFirst is an affiliate of MJHS, which was founded on the core values of compassion, dignity and respect for every culture. Those core values date back to 1907, when MJHS began a tradition of caring every minute, every day.
Call 1-866-384-3509 or visit homefirst.org
Services covered by HomeFirst are paid for by New York State Medicaid. The services not part of HomeFirst benefits continue to be covered by Medicaid and/or Medicare benefits. All services are coordinated, even those not included in the MLTCP benefit package. EPHF13197 12062013 Page 22
•
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014
ElderONE, Rochester General Health System’s alternative to nursing home placement, is expanding its services with the opening of the North Park ElderONE PACE Center at 355 North Park Drive in Rochester. The launch of the center was celebrated at a dedication ceremony Feb. 20. Formerly known as Independent Living for Seniors, ElderONE is a program of all-inclusive care for the elderly (PACE), and has been approved by New York state as a managed longterm care (MLTC) program. By providing highly coordinated services from a single comprehensive care team, ElderONE enables participants to remain in their own homes and maintain their independence without compromising their medical care or safety. Seniors aged 55 and over in need of health care and assistance in the home may be eligible for enrollment in order to avoid nursing home placement. The North Park ElderONE PACE Center provides a full range of services, including access to on-site board-certified geriatricians and primary care physicians; physical, occupational and speech therapy; social work; recreational therapy; spiritual groups; and nutritional services, including hot meals. Transportation to and from the PACE Center is included as part of the ElderONE program. Similar services are also provided at the original ElderONE PACE Center, located at 2066 Hudson Street in Irondequoit. “This is an important milestone in the growth of ElderONE,” said Kathryn McGuire, RGHS senior vice president for behavioral health, long-term care and senior services. “As the demand for high quality managed long-term care continues to increase, this second PACE Center allows our program to provide high-quality services to even more participants in need.” For more information about the program, including eligibility criteria, please call 585-922-2831.
April 2014 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
•
Page 23
Are your child's immunizations up to date?
Shots
or
Spots Call your child’s doctor today!
Fidelis Care is working to keep our members and the community healthy. Measles and Chickenpox are just two of the diseases that you can prevent by having your child immunized. Children under the age of 2 don't have all the defenses they need to fight off infection. Immunizations (shots) protect them from dangerous childhood diseases like: • Whooping Cough • Hepatitis • Rotavirus
• Mumps • Diphtheria • Flu
• Polio • Measles • Chickenpox
• Tetanus and more...
Is Your Child Covered? Fidelis Care offers New York State sponsored free or low-cost health insurance coverage for children under 19 through the Child Health Plus program.
1-888-FIDELIS
• fideliscare.org
(1-888-343-3547) |
Some children who had employer-based health insurance coverage within the past three months may be subject to a waiting period before they can enroll in Child Health Plus. This will depend on your household income and the reason your children lost employer-based coverage.
Page 24
•
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2014