Gv igh 96 aug 13

in good Researchers link positive outlook to reduction in cardiac events such as heart attacks

Nurse Practitioners

What they want you to know

7 in 10

August 2013 • Issue 96

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Rochester–Genesee Valley Healthcare Newspaper

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Why NYS Ranks So Low?

Page Page177

Golden Years Issue

Number of Americans on prescription drugs

What My Garden Has Taught Me Living Alone author shares some wisdom abou life and gardening

Is a Colonic Something You Should Consider?

Meet Your Doctor Physician Thomas Carrol discusses role of palliative care

Page 13

Living for Others A nurse puts self aside while dedicating her life to the terminally ill

Marge Donhauser of Canandaigua is trained in hospice and geriatrics and has devoted most of her Page 18 life to caring for the elderly.

August 2013 •

Distracted Walking Most of us have done it.

Walking and texting. Either it’s a message we can’t wait to share with our kids or spouse or just checking emails or Facebook. It’s estimated that 1,500 pedestrians have been treated in emergency rooms in 2001 as a result of distracted walking — and officials expect this number to rise

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 1

Upcoming Flu Season: What You Need to Know Healthcare workers in NYS who do not get the flu shot will be required to wear a face mask when interacting with patients

T

he last flu season arrived four weeks early, was more intense than expected and resulted in the deaths of more than 110 children in the United States. In an effort to get ahead of the upcoming flu season, experts at Montefiore Medical Center are raising awareness about the importance of the flu vaccine, which remains the best option to reduce a person’s risk of contracting the virus. The flu season can start as early as late September and usually runs for about 12 to 15 weeks.

Infectious disease specialists already have identified the flu viruses that are the most likely to cause illness this season, and vaccines have been formulated. Experts believe about 90 percent of the viruses found during surveillance are well-matched to the current vaccines. However, there are several important factors Americans should know about the 2013-2014 vaccine: • The standard “three-strain” vaccine will be offered to healthy children and adults. This vaccine, which will be widely available, includes two strains of the more common A virus and one of

the B virus. By comparison, last year’s “three-strain” flu vaccine reduced the risk of flu-associated medical visits from Influenza A viruses by one half and from Influenza B viruses by two-thirds for most of the population.

• The new “four-strain,” or quadrivalent, vaccine was designed this year to include two strains of the A and B virus in response to the fact that there have been two predominant B virus strains circulating the past two years rather than the usual single strain. Influenza B infection is usually much less severe than Influenza A, but the extra coverage will be important for immune-compromised patients who are at risk of severe infection and complications from both strains. The vaccine is intended for people with chronic medical conditions such as asthma or heart disease and those with compromised immune systems. Only five million doses of this vaccine will be developed, so it will be restricted to the high-risk patient groups, and there likely will be shortages.

Also new this year is a New York state regulation requiring healthcare workers who do not get the flu shot to wear a face mask when interacting with patients. Low vaccination rates among healthcare workers prompted regulators to pass the health code amendment to protect patients.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

Nearly 7 in 10 Americans Take Prescription Drugs Germ fighters, antidepressants, opioids top list; women, elderly likelier to have prescriptions

N

early 70 percent of Americans are on at least one prescription drug, and more than half take two, Mayo Clinic and Olmsted Medical Center researchers say.

Antibiotics, antidepressants and painkilling opioids are most commonly prescribed, their study found.

Twenty percent of patients are on five or more prescription medications, according to the findings, published online in the journal Mayo Clinic Proceedings.

The findings offer insight into prescribing practices. The statistics from the Rochester Epidemiology Project in Olmsted County, Minn., are comparable to those elsewhere in the United States, says study author Jennifer St. Sauver, a member of the Mayo Clinic Population Health Program in the Mayo Clinic Center for the Science of Health Care Delivery.

“Often when people talk about health conditions they’re talking about chronic conditions such as heart disease or diabetes,” St. Sauver says.

“However, the second most common prescription was for antidepressants — that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a bit concerning considering their addicting nature.”

Seventeen percent of those studied were prescribed antibiotics, 13 percent were taking antidepressants and 13 percent were on opioids. Drugs to lower lipids, such as cholesterol, came in fourth (11 percent) and vaccines were fifth (11 percent). Drugs were prescribed to both men and women across

DID YOU KNOW ?

all age groups, except high blood pressure drugs, which were seldom used before age 30.

Overall, women and older adults receive more prescriptions.

Vaccines, antibiotics and antiasthma drugs are most commonly prescribed in people younger than 19. Antidepressants and opioids are most common among young and middleaged adults. Cardiovascular drugs are most commonly prescribed in older adults. Women receive more prescriptions than men across several drug groups, especially antidepressants: Nearly one in four women ages 50-64 are on an antidepressant.

For several drug groups, use increases with advancing age.

“As you get older you tend to get more prescriptions, and women tend to get more prescriptions than men,” St. Sauver says.

Prescription drug use has increased steadily in the U.S. for the past decade.

The percentage of people who took at least one prescription drug in the past month increased from 44 percent in 1999-2000 to 48 percent in 200708. Spending on prescription drugs reached $250 billion in 2009 the year studied, and accounted for 12 percent of total personal health care expenditures. Drug-related spending is expected to continue to grow in the coming years, the researchers say.

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Stress is recognized as the number one killer disease today. Stress was the basic cause of more than 60% of all human illness and disease.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Mindfulness is the topic of a seminar in Rochester Heartbeats for Life, a wellness support group that promotes a lowfat, vegetarian diet, combined with exercise, relaxation techniques, stress reduction and social interaction, is organizing a lecture titled “Mindfulnessbased Stress Reduction,” which will take place at 7 p.m., Sept. 9, at Rochester Academy of Medicine, 1441 East Ave. in Rochester. Physician Michael S. “Mick” Krasner, associate professor of clinical medicine at the University of Rochester School of Medicine and Dentistry, is the guest speaker. He has been teaching mindfulness-based stress reduction to patients, medical students, and health care professionals for eight years, involving nearly 800 participants. He is engaged in a variety of research projects, including the investigation of the effects of mindfulness practices on the immune system in the elderly and on medical student stress

mental health counselor, and physician Ivan LaMarque, among others . Cost is $270 per person based on double occupancy with two twin beds and a private bathroom. Rate for single occupancy is $290 with a twin bed. Included are two nights’ accommodations, all meals, activities and entertainment. For more information, contact Usha Shah at 585442-8141 or at email ushah@frontier. com.

and well-being, as well as the effects on health care professionals’ well being. A Q&A session will follow his lecture. For more information call 585-234-7076 or email www.heartbeats4life.org.

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Local residents are invited to participate in a program that teaches how to use mindfulness to promote improved health and healing. The mindfulnessbased stress reduction program will take place from 6:30 – 8 p.m. in eight consecutive Thursdays starting Sept.

19. The workshop’s content includes didactic teaching, experiential learning and discussion. Handout material will be provided in the first class and will include a CD with guided meditations. The didactic content of the classes include information about stress management, the brain/body’s response to stress and behavioral skills that are useful in managing stress. This workshop is open to the public, it is non-denominational and health focused. For more information or to register, call St. Stephen’s Episcopal Church at 585-328-0856 or send an email to sullybro@rochester.rr.com.

Caregiver retreat to take place in Canandaigua A “Caregiver’s Retreat” has been scheduled to take place at Notre Dame Retreat House on the shores of Canandaigua Lake in Canandaigua Sept. 13 through Sept. 15. Keynote speaker will be Rev. Justin Epstein, a senior pastor at Manhattan Unity Center and author of “SUPER YOU: 7 Steps to Profound Peace and Personal Power.” Rev. Epstein will explore the practices that will empower the caregiver to experience joy, peace and fulfillment every day while caring for others. He will teach keys to being centered, including forgiveness and acceptance of both others and oneself. Other speakers include Thomas Porpiglia, a licensed

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Don’t Worry, Be Healthy Researchers link positive outlook to reduction in cardiac events such as heart attacks

P

eople with cheerful temperaments are significantly less likely to suffer a coronary event such as a heart attack or sudden cardiac death, new Johns Hopkins research suggests.

Previous research has shown that depressed and anxious people are more likely to have heart attacks and to die from them than those whose dispositions are sunnier. But the Johns Hopkins researchers say their study shows that a general sense of wellbeing — feeling cheerful, relaxed, energetic and satisfied with life — actually reduces the chances of a heart attack.

A report on the research is published in the American Journal of Cardiology.

“If you are by nature a cheerful person and look on the bright side of things, you are more likely to be protected from cardiac events,” says study leader Lisa R. Yanek, an assistant professor in the division of general internal medicine at the Johns Hopkins University School of Medicine. “A happier temperament has an actual effect on disease and you may be healthier as a result.”

Yanek cautioned that cheerful personalities are likely part of the

temperament we are born with, not something we can easily change. While some have suggested it’s possible that people lucky enough to have such a trait are also more likely to take better care of themselves and have more energy to do so, Yanek says her research shows that people with higher levels of well-being still had many risk factors for coronary disease but had fewer serious heart events.

She emphasized that the mechanisms behind the protective effect of positive well-being remain unclear. She also noted that her research offers insights into the interactions between mind and body, and could yield clues to those mechanisms in the future.

For the study, Yanek and her colleagues first looked at data from GeneSTAR (Genetic Study of Atherosclerosis Risk), a 25-year Johns Hopkins project sponsored by the National Institutes of Health to

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

determine the roots of heart disease in people with a family history of coronary disease. They analyzed information gathered from 1,483 healthy siblings of people who had coronary events before the age of 60 and who were followed for five to 25 years. Siblings of people with earlyonset coronary artery disease (CAD) are twice as likely of developing it themselves.

Distracted Walking: Injuries Soar for Pedestrians on Phones Cell phone use not just dangerous for drivers, study finds

M

ore than 1,500 pedestrians were estimated to be treated in emergency rooms in 2010 for injuries related to using a cell phone while walking, according to a new nationwide study.

The number of such injuries has more than doubled since 2005, even though the total number of pedestrian injuries dropped during that time. And researchers believe that the number of injured pedestrians is actually much higher than these results suggest.

“If current trends continue, I wouldn’t be surprised if the number of injuries to pedestrians caused by cell phones doubles again between 2010 and 2015,” said Jack Nasar, co-author of the study and professor of city and regional planning at The Ohio State University.

“The role of cell phones in distracted driving injuries and deaths gets a lot of attention and rightly so, but we need to also consider the danger cell phone use poses to pedestrians.”

The study found that young people aged 16 to 25 were most likely to be injured as distracted pedestrians, and

most were hurt while talking rather than texting.

The problem with distracted pedestrians is likely to get worse, he said.

“As more people get cell phones and spend more time using them, the number of injuries is likely to increase as well. Now people are playing games and using social media on their phones too,” he said.

Nasar said he believes the best way to reverse these numbers is to start changing norms for cell phone use in our society. And that starts with parents.

“Parents already teach their children to look both ways when crossing the street. They should also teach them to put away their cell phone when walking, particularly when crossing a street.”

The study appears in the August issue of the journal Accident Analysis and Prevention.”

Exercise Up in U.S., But So Is Obesity

A

lthough Americans are exercising more, the obesity epidemic continues to expand, University of Washington researchers report.

Their nine-year study of data from two U.S. health surveys suggests that physical activity alone is not enough to combat the problem.

“While physical activity has improved noticeably in most counties, obesity has also continued to rise in nearly all counties,” said lead researcher Laura Dwyer-Lindgren, from the university’s Institute for Health Metrics and Evaluation.

The obesity problem is directly related to how much Americans eat, said senior author Ali Mokdad, a professor of global health at the Institute for Health Metrics and Evaluation.

“Americans are not doing enough to control what they eat,” he said. They still consume more energy than they burn off through exercise, he said.

According to the U.S. Centers for Disease Control and Prevention, more than one-third of U.S. adults are obese, and obesity contributes to serious chronic illnesses, high medical costs and premature death.

SERVING MONROE, ONTARIO AND WAYNE COUNTIES in good A monthly newspaper published by

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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. © 2013 by Local News, Inc. All rights reserved.

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• 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., Jessica Spies, Lynette Loomis Advertising: Jennifer Wise, Donna Kimbrell 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.

August 2013 •

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Meet

them where they are.

Your Doctor

By Lou Sorendo

Dr. Thomas Carrol Doctor discusses role of palliative care Q: You’re an expert in palliative care. How would you describe the field?

A: It basically falls into three categories. Palliative care got started a couple decades ago as a kind of endof-life hospice specialty. We still do that, but at the time that’s all it was. It turns out that doing that makes you pretty good at treating symptoms, so the second thing we do is take care of people who have difficult symptoms, like those undergoing chemotherapy and are dealing with nausea and pain.

The third thing we do is help people navigate difficult decisions in the sometimes-confusing world of medicine and help them make the decisions that are best for them. So if you can imagine two different people with the same symptoms, they may make very different decisions. I’m doing some of that now with outpatients as a new faculty member at Strong. I’m also going to do a month a year with inpatients at Strong.

Q: How much of palliative care is psychological?

A: There’s a lot of that. We really encourage engaging not only the patients but their family. What we’re really trying to do is relieve suffering, and suffering is more than just pain and just symptoms. It’s how the person reacts to those things. How the person reacts to those things is based on their support system, their family, friends, church, whatever is important to them. We’re trying to help the person come to terms with being sick, make sure they and their families understand the facts and then try to help them make the decisions that are best for them under the circumstances.

in general. It’s not a field where there’s a lot of technical advancement, but there has been a lot of philosophical advancement. Twenty years ago, it was considered almost unethical to treat people for pain the way we do now. I think we’re doing a much better job of treating that pain, relieving patients’ suffering and helping improve the quality of their life.

Q: Was there an event in your life or your training that led to your interest in palliative care?

A: It sort of dawned on me slowly during medical school that, with the best intentions, there are a lot of things that are done to people that may not actually be helping them. We probably shouldn’t do what we do for a young person with pneumonia what we do with an older person with incurable cancer. We need to consider that a ventilated breathing machine may not be a good idea for that older person. I just saw things being done to people that seemed like the right thing to do at the moment but, when you took a step back, it probably wasn’t the right thing for them as a whole. Yes, we want to keep them breathing, but are the things we’re doing actually helping? That’s what made me want to make palliative care a part of my practice.

Q: Is palliative care a field that advances medically in terms of relieving pain and discomfort, or is there only so much you can do?

A: It’s come a long way. Organizationally, it’s become an officially recognized sub-specialty of internal medicine, though many specialists come from outside of internal medicine. So it’s become more recognized in the medical field and the larger world

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

Q: Do you have to get to know your patient very well to figure out the best course of action, or is there more of a philosophical approach to palliative care?

A: I think there’s a general philosophical approach you can take that most people will fall under, but then we need to make sure we’re meeting

Q: Is it harder to understand what a patient a generation or two older than you needs vs. someone your age dealing with a disease?

A: There’s a lot of baggage everybody brings. When you see someone your age, it can be easier to identify with them and imagine yourself in their situation, but we always need to be careful not to stereotype anyone’s needs. I’m probably going to sound like a broken record, but everybody is different. You learn where the average is through experience, but you also learn that no one is really average.

Q: Do you still do much teaching?

A: Palliative care is about 30 percent of what I do. The rest of it is internal medicine, primary care. All day Tuesday, for two sessions, I supervise internal medicine graduates at Highland who have their resident practice there. That’s the bulk of the teaching I do at the moment.

Q: And your internal medicine practice?

A: I do four sessions every day but Tuesday at Strong. That practice is sort of unique, because I get to work with a group of other faculty who also have a diversity of interests; they all do primary care, but they also do something else. We share patients from time-totime when one of us is unavailable.

There’s a lot of interaction on a daily basis, which is a really positive thing for me.

Q: What do you typically treat in that practice?

A: The beautiful thing about this, and primary care, is that you never know. If I see a lot of anything, it’s probably chronic disease management: high blood pressure, high cholesterol, smoking, obesity. So part of the practice is to help people avoid the things that will harm them over time.

Q: Do you think obesity has been accurately categorized as a “disease?”

A: That’s a tough question and a recent development. We’ve asked this question over time about other things that exist on the border between disease and behavior. It’s like alcoholism.

How much of that is a disease and how much of it can you control cognitively?

I think obesity falls on that spectrum.

A lot of times we want that nice, clear dichotomy, but I think the world is much more gray than that. There are some genetic aspects that a person has no control of. But then there are also people who are overweight who come from skinny families. The answer is that we need to have a multi-modal approach to obesity, helping them modify their behavior while also looking for interventions that will help people with the uncontrollable aspects of obesity.

Lifelines Career: Assistant professor of Medicine at the University of Rochester Medical Center. Recently joined Geriatrics and Medicine Associates (GAMA) on the Highland Hospital campus.

Education: Bachelor’s degree in biochemistry from Nazareth College; medical degree and doctorate from the University of Connecticut Health Center; residency in internal medicine at URMC, serving as chief resident from 2011-12.

Organizations: American College of Physicians, Society for General Internal Medicine Family: Married, two children Hobbies: Volleyball, golf

New York is No 48 for Organ Donation Enrollees Cumbersome process to register as a donor cited as one of the problems for low enrollment

By Deborah Jeanne Sergeant

N

ew York ranks nearly last — 48th in the nation — for the percentage of residents who have signed up as organ donors. As a result, 118,190 people nationwide await anatomical donations, and 10,000 of those are New Yorkers. About 18 people die every day while on the waiting list. From Rochester to Rome and from the St. Lawrence to Elmira, 750 await life-saving transplants.

“If you’re on the current waiting list for a kidney, you’d probably be waiting four years,” said Rob Kochik, executive director of Finger Lakes Donor Recovery Network. “If you needed a liver, 26 months. And a new heart, at least a year. There are exceptions to that because depending upon the matches and how critically ill a patient is, some get organs quicker than that.

“In 2012, about 600 New Yorkers died on the waiting list because an organ wasn’t available in time. This is a healthcare crisis with a cure.”

Part of the reason is the surge in need.

As diseases such as hypertension and Kochik diabetes spike, more and more people need organs.

Many people don’t understand

how the enrollment works. They may recall they have documented it on their driver’s license, but unless they have done so since 2008, they have only listed themselves on what’s known as the “intent registry.” In these cases, medical professionals must ask your surviving family if they would like to donate your organs or tissues. If they say no, then none of your remains will be donated despite your wishes.

Aisha Tator, executive director with New York Alliance for Donation, thinks that the methods for enrolling are too difficult, including the cumbersome online process, which takes about 10 minutes, compared with the 60-second enrollment for residents of Texas. But that’s not the only reason.

“It is an awareness issue,” she said.

“I have seen people get involved in organ donation when it impacts them personally. When a business is impacted there’s a groundswell of support.”

Lauren’s Law, signed by Gov. Cuomo last October and taking effect this October, will make organ donation a required section in DMV paperwork so that everyone will have the opportunity to decide if they want to designate themselves as a donor or not.

“DMV staff want to be efficient so they often highlight the sections we must complete,” Kochik said. “We hear all the time that people miss the opportunity.”

If you have no plans to go to the

How to Become an Organ Donor To enroll as an organ donor, visit your local Department of Motor Vehicles, www. mydmv.gov, www.health.ny.gov (click on “Donate Life”), www.organdonor.gov or www.donorrecovery.org.

DMV for a while, you can enroll online or write it into your living will or health care proxy. Donor organizations often take enrollees at public events such as health fairs, too.

“When patients have made that decision, we hear that families are relieved that they didn’t have to make that decision,” Kochik said.

Improving awareness represents one way that the medical community hopes to raise the number of enrollees.

Amy James, community education coordinator for Finger Lakes Donor Recovery Network, often attends public events to offer information and help sign people up.

“Some are afraid to sign up because they think when they get to the ER, the first things doctors to is check to see if they’re on the registry,” James said. “That’s just not true.”

Even enrolled donors are not evaluated for suitability and the need of their organs or tissues until after

they have died. The family of those who have not enrolled must make the decision after the patient passes away.

James added that some people decline enrolling because of their advanced age or poor health; however donors may be of any age.

“If someone currently has cancer or are HIV positive, these are the only medical concerns that would disqualify someone,” Kochik said.

Under the current donor intentbased registry, family members may override the deceased’s wishes. Sharon Cerasoli, licensed master social worker at Rochester General Hospital, said, “Families are often traumatized after an accident. Some people just shut down. Others go to us before their loved one dies and they’re not doing well.

“Our organ donations specialists are so wonderful with the families. We work together to help them through the process.”

She believes that donation helps surviving family members find some purpose and meaning in their loved one’s death. One donor can save eight lives and eye and tissue donations can help many others.

“The families are supported and the gift is respected,” Cerasoli said.

“Our staff here at Rochester General looks at this as a very high priority and some of the most important care they can give a patient and a family.”

Local Doctor Wants to Spread the Word About Organ Donation Recently founded group, bLifeNY, to bring discussion about donations to new venues

By Ernst Lamothe Jr.

A

simple signature can save the lives of many. But nothing in life is ever that simple, especially when it comes to the issue of organ donation.

Whenever the conversation arises, people have strong reactions from both sides. There are those who have been saved or had family and friends saved by organ donations and believe in paying the gift forward in society. Then there are those who simply are freaked out by the notion of giving away their body parts.

Physician Christopher T. Barry wants to take away some of the discomfort from the donor conversation.

“Sometimes the reasons why people don’t become donors is because of fear.

We have to go into different areas and educate people so we start reducing the fear,” said Barry, a transplant surgeon at the University of Rochester Medical Center specializing in liver, kidney and pancreas.

Making matters worse, New York is ranked 48th nationally in state registration enrollment for organ donation.

More than 112,178 people in New York are waiting for a transplant. But only a third actually received one. Experts say New York ranks low because of its cumbersome process that requires someone to download a form and mail

it to become a donor instead of an easier, efficient electronic registration.

Every 13 hours someone in New York dies because of the lack of a needed organ.

“If you are not an organ donor when you die, you are taking a lot of people with you because your organs that are now in the ground can do so much for others,” said Barry. “One organ can save up to eight lives.”

That’s because you have one heart, two lungs, two kidneys, one liver, one pancreas and intestines. When you add tissue, valves and blood vessels that number dramatically increases to saving as many as 50 people.

Barry has traveled nationwide discussing the issue in different formats.

Whether he talks to young students and the older population at conferences or appears on Brother Wease Show locally, he believes it’s essential to take the conversation out into the public.

He has been at local events such as the Greentopia Festival, Memorial Art Gallery opening parties and concerts.

Typically, the Department of Motor Vehicles or the intensive care unit are the sole places where the issue is discussed. He wants a situation similar to voter registration where people have many different avenues to sign up.

“I think the vast amount of people

would be open to being donors. The problem is that when you are asking people at the DMV when they are already frustrated or in the ICU when they are already stressed, it becomes a problem. We need more comfortable venues to talk about and normalize the issues,” added Barry.

Along with physician Mark Orloff, Barry helped found bLifeNY, a grassroots organ donation awareness group.

Members include high school, college, and medical students, as well as transplant professionals, and advocates in the community. The primary aim is to increase awareness of organ donation and transplantation through creative venues and personalized education.

Finger Lakes Donor Recovery Network is partnering with the University of Rochester’s Transplant Program to develop and promote the new initiative.

Also in an effort to encourage more New Yorkers to become organ donors, Gov. Andrew Cuomo signed “Lauren’s Law.” The measure is named for a Rockland County girl, Lauren Shields, who received a heart transplant in 2009. Now 12 years of age, she was on a waiting list for a month and a half and became so sick waiting for the lifesaving transplant that she had to be put on life support.

The new law requires anyone over

August 2013 •

Barry

the age of 18 getting a new driver’s license to answer whether they would like to join the state’s donor list. The question is currently optional.

The organization recently started a FaceBook campaign, where donors, recipients or supporters of donation sent in pictures with the graphic “We Love You for Signing Up to Be an Organ Donor.”

So far the campaign has seen more than 23,000 views, reaching 120,000plus friends of friends, and followed in 20 countries and 16 languages.

Barry has seen the impact on recipients and their family members.

It has brought them profound comfort in the face of being so close to tragedy.

That renewal of life makes them even stronger proponents of organ donations.

“We know people don’t like to think about what they are going to do when they die. We know it is an emotionally charged, touchy subject,” said Barry. “But it’s worth talking about because being a donor is an incredible gift.”

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

What My Garden Has Taught Me

G

ardening is ripe with life lessons for those of us who live alone. It has taught me the value of planning, preparation, patience, and pleasure — four essential “P’s” for a bountiful garden and … a bountiful life.

Fertile ground exists in each of us, and a little tending can produce beautiful results. Here’s what I have learned: Plan. Realizing the garden of your dreams begins in your imagination, followed by careful planning. Diagram your garden and it will help you avoid planting bulbs on top of bulbs or mistaking a poppy for a weed. Likewise, envisioning your life goals and committing them to writing can help you flourish and grow.

Cultivate. Good, cultivated soil promotes healthy, deep roots. When you add fertilizer and mix it up you are rewarded with abundance. Adding essential ingredients to the foundation of your dream garden (and your dream life) will nourish all that follows.

You can’t go wrong with good, nutritious food and plenty of sunshine.

Plant. So many choices! Revisit your plan and embed your carefully selected seeds or seedlings with a tender, loving touch, being careful not to overcrowd or plant more than you can manage.

And remember: We reap what we sow, so follow your dreams. Plant a rose and you get a rose; plant a dandelion and you get a dandelion. Seed your future with healthy choices that promote well-being.

Weed. We all need room to breathe and positive space in which to blossom. It holds true for your garden and your life.

Gardening is all about consistent caretaking. Slack off, even for a few days, and all things unwelcome show up and take root.

Weed out the negativity and any dream-stealing toxins that contaminate your life, dash your hopes, or spoil

KIDS Corner 5 Tips for Toilet Training Avoiding common mistakes can help prevent potty problems

W

hen it comes to toilet training, there is no shortage of advice for parents. From mothersin-law to the Internet, everyone has a favorite tip. Despite all of the information, though, it turns out that children are often trained incorrectly, leading to potty problems that range from bedwetting and daytime accidents to urinary tract infections.

Physician Steve Hodges, a specialist in pediatric urology at Wake Forest Baptist Medical Center, says there are five common mistakes that parents make when toilet training their children.

1. Training too early. While early toilet training is popular, children younger than 3 don’t have the mental maturity to make good toileting decisions, says Hodges. “They don’t understand how essential it is to get themselves to a bathroom when nature calls.

Instead, they hold their urine and feces, which can lead to numerous problems, Page 8

•

including bedwetting.”

2. Train their child but don’t follow up with their toileting habits. Many toileting problems — from urinary tract infections to bedwetting — are often related to children holding their urine or feces. “Holding urine leads to smaller bladder capacity and sets a child up for accidents,” says Hodges.

He recommends having children urinate on a schedule, about every two hours. To help make the bathroom trip “successful,” Hodges suggests having the child count to 10 while on the potty and having some favorite books and puzzles nearby.

As for “pooping,” a high-fiber diet can make elimination less painful, so that children aren’t as apt to avoid it.

3. Ignore school bathrooms or bathroom policies. Unreasonable toileting requirements, restrictive bathroom policies and dirty bathrooms in schools compound children’s potty

your fun. When you pull out the bad, you can more easily focus on the good in your life.

Prune. When weeding is not enough, a major pruning may be just what the arborist ordered.

A job, relationship, or home that no longer satisfies or meets your needs may need a hard look. It may be time to pull out that pair of “life loppers.”

Mulch. Mulching keeps weeds at bay and the ground moist, and returns nutrients to the soil. It also adds a finishing touch.

Mulch offers a blanket of protection, in the same way that regular doctor appointments, insurances, and safety measures protect our lives. You can learn a lot from mulching.

Wait. We all know that “good things come to those who wait” and it’s not just what comes out of the Heinz

problems, says Hodges. He recommends that parents be aware of day care and school bathroom policies and advocate for their children. Suggestions include touring school bathrooms to identify potential issues, making bathroom cleanliness a PTA issue, and advocating for policies that allow children to use the restroom when they need to.

4. Miss signs of constipation. Up to 30 percent of children between 2 and 10 are chronically constipated. “Many parents mistakenly believe that if their child has daily bowel movements, they are not constipated,” says Hodges.

“But in kids, there’s a different definition of constipation known as ‘poop burden.’ It refers to poop backed up in their rectum that can press on the bladder and cause bedwetting and other problems.”

Symptoms of constipation in children include having extra-large bowel movements or bowel movements that are very firm, rather than mushy, like pudding or a milkshake; poop accidents; poop-stained underwear, and mild belly pain with no obvious cause.

5. Ignore signs of bladder trouble.

Common problems in children that shouldn’t be ignored are painful urination, frequent urination and blood in the urine. These symptoms are sometimes due to an infection or other problems and should be evaluated by a physician. Often, however, the culprit is constipation

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

ketchup bottle. When you exercise patience, go slowly, and enjoy the gradual unfolding of a flower, an idea, or a friendship, your life can be savored and more deeply appreciated. Each year, I look to my garden to remind me that growth takes time.

Enjoy. Before you know it, your labor of love and patience will pay off.

Take pleasure in the transformation as the colors, textures, and fragrances emerge. Too often, we fail to “stop and smell the roses” in our gardens and in our lives.

So get busy, then step back and take a good look. There’s nothing quite as satisfying as admiring what you’ve accomplished. It’s reason to celebrate!

By osmosis, gardening has taught me how to take better care of myself.

I have absorbed its rich messages and learned how to nurture my inner garden and growth as a women on her own. Why not grab a spade and join me? Beauty, growth, and an energizing sense of renewal can be yours, season after season after season.

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon. For information about her workshops or to invite Gwenn to speak, call 585-624-7887 or email gvoelckers@rochester.rr.com.

— one more reason to opt for a highfiber diet.

In addition, accidents of urine or stool should not be seen as normal and ignored.

“Often, parents have the impression that wetting, like throwing temper tantrums, is just something kids do,” said Hodges. “But accidents aren’t normal and potty-trained kids shouldn’t have accidents any more often than adults do.”

Hodges is the co-author of a book for parents on toilet training and other potty issues, “It’s No Accident: Breakthrough Solutions to Your Child’s Wetting, Constipation, UTIs, and Other Potty Problems,” and blogs about the topic at www.itsnoaccident.net.

Colonics. Is It Something You Should Consider?

By Deborah Jeanne Sergeant

A

t Gentle Pathways Colon Hydrotherapy in Webster, Annette Barber treats people who come to her for colonics for a variety of reasons. Some want relief for constipation. Others want to prepare for a colonoscopy without taking the oral laxatives typically recommended for preparation. Still others view colonics, also known as colon irrigation, and colon hydrotherapy, as a modality for maintaining health.

Barber has a bachelor’s in biology and is a certified natural health professional, and completed foundational and advanced certification in colon hydrotherapy.

She is also a member of Global Professional Association for Colon Therapy and International Association for Colon Hydrotherapy. New York does not license colon hydrotherapy practitioners.

Using a speculum inserted 2 to 2 1/2 inches into the rectum, Barber uses a closed system of sterile, oneuse tubing to direct a trickle of filtered water into the colon and flush waste out.

“Colon hydrotherapy, is a safe, effective method of removing waste from the large intestine, without the use of drugs,” Barber said. “By introducing filtered and temperature regulated water into the colon, the waste is softened and loosened, resulting in evacuation through natural peristalsis.

This process is repeated a few times Goldstein during a session.”

The process takes about an hour.

Whether or not a client wants a follow-up visit “depends upon the individual,” Barber said. “If their goal is to try to get their large intestine totally cleaned out, follow-ups would be no more than a week between visits.”

Barber said that colon hydrotherapy is a gentle modality and can be helpful for many people.

“In a perfectly functioning digestive system, the body should be able to deal with eliminating waste and eliminate without interference,” she said. “But we don’t live in a perfect world and most people don’t have perfectly functioning digestive systems so it aids people who don’t have perfectly functioning digestive systems.”

She carefully screens patients with paperwork and questions to ensure they do not have any contraindicated health issues. Barber also referenced colonics’ use in ancient times as further proof of its effectiveness and safety. But others disagree.

Controversial therapy

“Independent of the theory of what they’re trying to accomplish, they’re giving an enema and it’s high up, not knowing where you’re pushing and what you’re pushing against,” said physician Jeffrey Goldstein, chief of Digestive Center of Western New York in Rochester. “Could it be a diverticulum that they’re pushing against, a weak spot in the colon?

They could go through the anal canal.

Suppose a person has constipation because of a tumor?”

He also fears that if people receive too many colon treatments too close in succession that they could suffer an electrolyte imbalance.

Goldstein questions the premise of colonics since bacteria-laden stool passes through the colon.

“Those who want to clean it and purify it are misled,” Goldstein said.

“They want to take an alternative remedy that isn’t FDA approved and they could have serious, potential side effects. I think these patients are frustrated and seek it out those who have sought medical attention and we haven’t figured out their problem so they seek out their own medical answers.”

Some people hope a colonic will improve absorption of nutrients; however colonics have no effect since absorption happens in the small intestines.

Tammy McGarvey, family nurse practitioner with Hope Family Health, NP PLLC in Pittsford, offers health consultations using traditional and natural medicine. She does not offer colonics and does not recommend severe water irrigation of the colon.

“I recommend detoxification,” she said. “You can’t just eliminate the things that are causing the problem, such as processed foods. You have to heal the gut lining as well. Most of our immune system starts in the gut.”

She promotes the consumption of enzymes, probiotics, and fiber to help support a healthy digestive system.

Marusia Marrapese, wellness consultant at Lori’s Natural Foods Center in Rochester, said she’s “leery of colonics, unless the practitioner has lots of experience. I don’t believe it’s the right way to go for most individuals, especially with what we know about diet.”

She promotes internal “cleansers” such as raw aloe, high fiber and probiotics. As for manually flushing the colon with a colon irrigation enema, Marrapese said, “they should never be self-administered. A lot of people don’t understand how vulnerable those tissues are with the wrong velocity and amount of water. Two and a half inches is plenty deep into the colon.”

To maximize the efficiency and health of the colon, most people need 20 to 35 grams of fiber daily. As with making any other change in health habits and treatments, seek the advice of a medical professional before trying a colonic.

When you text a driver, you increase their risk of an accident by

TWENTY-

THREE TIMES

*

Visit URthatDistracting.org to see how you can help end distracted driving.

*SOURCE: DISTRACTION.GOV

STORY IDEAS?

Email them to Editor@GVhealthnews.com August 2013 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Think your kids won’t smoke?

Think again.

They see more tobacco marketing than you realize.

1 2 3 4

Posters, displays and rows of tobacco products behind the counter are all forms of tobacco marketing.

The Surgeon General’s Report warns that tobacco marketing is a known cause of youth smoking.

And studies show, the more tobacco marketing kids see, the more likely they are to smoke.

More than 135,000 New York teens are regular smokers.

1/3 of them will die prematurely from diseases caused by smoking.

The tobacco companies think there’s nothing wrong with this kind of marketing.

What do you think?

The Smoking & Health Action Coalition of Monroe County works in Monroe County, NY, to eliminate exposure to secondhand smoke, to educate youth about tobacco marketing and to promote living tobacco-free.

A Community Partnership of the New York State Tobacco Control Program.

smokefreemonroe.com

Page 10

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

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Page 11 5/9/13 1:18 PM

SmartBites

By Anne Palumbo

The skinny on healthy eating

Why Salmon Is Such a Nutritious Catch

S

almon is my go-to fish twice a week, and here’s why: It’s swimming with health benefits; it’s readily available in grocery stores; and it’s loaded with omega-3 fatty acid.

Let’s begin with the all-mighty omega-3s. By now, most are aware that we need to include these important unsaturated fatty acids in our diet. In a word, omega-3s may help us live longer by reducing the risks of heart disease, heart attack and stroke.

Fatty fish contain the most omega3s of all food, and salmon is at the top of that list.

Omega-3s are believed to provide these benefits by reducing inflammation throughout the body, by slowing the growth rate of plaque, by increasing good cholesterol, and by lowering blood pressure.

Something else to ponder: Omega3s are also good for brains. A large study in the journal Neurology revealed that a diet lacking in omega-3s may lead to faster memory loss and brain aging in older adults, as well as depression in all ages. Since we need

Page 12

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tect against heart disease and certain cancers.

Lastly, salmon teems with selenium, a powerful antioxidant that supports a healthy immune system and helps to prevent cell damage.

Helpful tips When possible, consume wildcaught salmon over farmed: it contains fewer contaminants, more vitamin D, and less fat. If buying farmed, choose U.S. farmed salmon over imported.

Canned salmon is a good way to get wild salmon cheaper and year-round.

Plus, when it comes with bones (soft and edible), it’s a super source of calcium.

Salmon with Roasted Asparagus and LemonCaper Sauce Adapted from Bon Appetit Serves 4 this particular fatty acid to build brain neurons, it’s no wonder omega-rich fish are often called “brain food.”

Salmon is also an excellent source of healthy protein, a nutrient we need to build up, keep up and replace tissues in our body. One-half a fillet (about 4–5 ounces) delivers a whopping 39 grams, nearly 75 percent of our average daily needs, for less than 300 calories.

Angling to increase your vitamin D? Good news: Salmon is one of the rare foods that boasts a decent amount, with a 4-ounce fillet providing a full day’s intake for most. Vitamin D promotes healthy bones and may pro-

2 tablespoons fresh lemon juice 2 tablespoons minced shallot 1 tablespoon olive oil 1 tablespoon drained capers, chopped 1 teaspoon dried thyme ½ - 1 teaspoon finely grated lemon peel 1 1½-pound salmon fillet (about 1¼ inch thick) 1 pound asparagus, trimmed 1 tablespoon olive oil Whisk first six ingredients in small bowl to blend. Season to taste with salt and pepper.

Preheat oven to 450 degrees. Cut

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

three ½-inch-deep slits crosswise in top of salmon (as if dividing into four equal pieces, but do not cut through).

Arrange asparagus in a single layer on baking sheet. Drizzle with oil and turn to coat. Sprinkle with salt and pepper.

Place salmon atop asparagus; sprinkle with salt and pepper. Roast until salmon is just opaque in center, about 20 minutes (longer if you like your salmon well-done.)

Transfer asparagus and salmon to platter. Spoon sauce over salmon. Cut salmon into 4 equal pieces along slits.

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.

Giving Boston Terriers a Second Chance Volunteers help nurture Boston terrier dogs

More abou t Boston Ter Northeast rier Rescue It was fo

rmed group of vo in 2001 by a small lu over 300 vo nteers and now has lu York, New J nteers from New e vania. For m rsey and Pennsylo http://www.n re information, visit ebostonresc ue.org.

By Jessica Spies

W

hile the volunteers of Northeast Boston Terrier Rescue are rescuing dogs, they may also be improving their own health.

Experts say there are health benefits in volunteering and the Centers for Disease Control and Prevention have found that pets can decrease one’s blood pressure, cholesterol levels, triglyceride levels and feelings of loneliness.

Those who volunteer with the organization see these health benefits firsthand. NEBTR member Betty Ann Manganello, 54, loves the company of Boston terriers.

“You really can’t help but smile when you see one,” Manganello, a Rochester resident, said. “They like to be close to their family — either on your lap, sitting next to you on the couch, by your feet when you are on the computer — but best of all, under the covers velcroed to your legs as you sleep.”

Not only do Boston Terriers, dubbed “Bostons,” offer health benefits, but they are also low maintenance for owners: they require little grooming and do not require a lot of outdoor activity, ideal for apartment living or for an elderly person. The dogs are low maintenance and typically adapt to their owners’ personality, Manganello said.

“They become velcro dogs,” Manganello said. “If you’re a very active person, they like the walking. They will adapt to your lifestyle.”

Because of their adaptable personality, Bostons make good therapy dogs.

NEBTR foster parent Heather Coursen has put her Boston, Copley, through the process to become a therapy dog.

In his free time, Copley is “young and playful — high energy and feisty when he has a playmate,” but as a

therapy dog, Copley puts on his business face.

“He knows he’s going to work at these places,” Coursen said.

Copley travels to libraries and nursing homes, including for those with dementia and Alzheimer’s. Coursen says it’s been rewarding for both her and Copley to visit the patients living in the nursing homes.

“They don’t remember you from month to month but remember Boston Terriers back in the day,” Coursen said. “Their faces light right up.”

The residents will put Copley on their laps, start petting him and talk about dogs they had in their childhood. “It brings them to life,” Coursen said.

Copley enjoys the time spent together as much as Joan Stark and her Boston Gidget, who is over 15 years old. those he visits.

“He loves people and to to purebred dogs. be cuddled and held,” Coursen said “Many people assume that pureCoursen, 31, of Wharton, New bred dogs are never dumped at shelJersey, contends that Boston terriers, or ters, given away by their owners or active dogs in general, help to improve abandoned and become strays,” but their owner’s health. this is not true, Manganello said.

“You get more active,” she said.

When NEBTR takes in a rescue, the “Bostons tend to be a high-energy Boston goes to a volunteer foster home breed.” for a minimum of two weeks or more Volunteers in Rochester area depending on any health issues.

While NEBTR includes volunteers Potential foster parents fill out an from New York, New Jersey and Pennapplication and provide references, sylvania, a number of the volunteers along with a phone interview and then live in the Rochester area. The rescue a home check, which involves NEBTR serves Boston Terriers most in need, placement counselors viewing the taking in abandoned and abused dogs home to see how the dog would live. that need a home.

It’s also about fitting the person with According to Manganello, there’s a the right dog, Manganello said. common misconception when it comes Foster parents take in a dog for at least two weeks but typically have a dog for a month to a month and a half. The longest Coursen had a foster dog was six months.

Betty Ann Manganello with her Boston, the Before her first foster, Coursen had no formal training, late Madison Hunter. but she really loved dogs and months. was willing to take the chal“It gives the dog a second chance,” lenge on.

Manganello said.

“It was trial by fire,” she Manganello got her first Boston said.

Terrier, the late Madison Hunter, from a Fosters volunteer to take in breeder in 2000. dogs providing them a tempo“She’s a Boston but she was my rary stable home while working kid,” she said. on any behavioral issues.

Manganello joined NEBTR after “They’re angels; they’re just realizing the struggles that other dogs incredible people,” Manganello have faced. When Madison Hunter said. died earlier last year, Manganello got Many of the Bostons that more involved with NEBTR and crethe organization take in need ated Madison’s Mission, a fundraising some kind of medical or surgigroup for dogs in need. cal care.

Manganello cannot speak enough NEBTR, which helps adopt to the dedication of the fosters and over 100 dogs a year, provides volunteers who support NEBTR. that money through fundrais“We will do anything to save these ing and has paid over $20,000 dogs,” she said. in medical care in just a few Jennifer Allen and her Boston Bela, nicknamed Beaner.

August 2013 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

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n April study published in “Neurology,” the official journal of the American Academy of Neurology stated that the U.S. will be grossly under supplied with neurologists by 2025.

“The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists.”

The study estimates the 11 percent shortfall in 2012 will increase to a 19 percent shortfall by 2025.

Researchers concluded, “In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times Feinberg and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future.”

Part of the reason for a shortage of neurologists is the rapidly growing number of baby boomers who will need neurological care as they age for health issues such as stroke, Parkinson’s and Alzheimer’s, along with the decrease in medical students specializing in neurology.

Locally, we may have less to worry about. A shortage of neurologists isn’t a concern of physician Jason S. Feinberg, who specializes in internal medicine and hospital medicine, and serves as

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•

vice president of medical affairs and chief medical officer for Finger Lakes Health.

Feinberg said that the six neurologists in this area work independently with privileges at the FF Thompson, Clifton Springs Hospital, NewarkWayne, and Geneva General.

“We’ve been successful in recruiting people into our practices,” Feinberg said.

He thinks the amenities of the region helped attract neurologists to the area.

“It’s a great area to live in and work,” Feinberg said. “They’re close to care centers in Rochester that have more specialized neurologic services.

If you’re recruiting and a young doctor, you need to have the volume of patients to serve.”

The doctors also cover for each other so they’re not on call every night.

“That is a very successful recruitment strategy, instead of working separately,” Feinberg said. “Their lifestyle is much better.”

Finger Lakes Health and surrounding health organizations also proactively recruit replacements for the area’s neurologists before anyone retires.

“There’s a nice hand-off and introduction period so patients can get transitioned better,” Feinberg said.

“Another reason the neurologists in our area offer such good coverage and service is their willingness to travel to local facilities to meet patients’ needs,” Feinberg said.

“Going to where the patients are is nicer rather than having the patients go to them,” Feinberg said. “You see a lot of groups that have one camp, but if you’re on the western side of the county, you may decide you will travel the same distance into Rochester or if you’re on the eastern side, you’d have to go to Syracuse.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

Qualified participants may receive up to $200.00 for their time and effort.

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Cancer Center. We’re involved in research that happens here. A lot of us are writing papers and have an area of specialty that’s of interest to us.

• “We see a lot of follow up patients who are in chemotherapy.

We’re trying to holistically look at the patients and take care of the whole person.

• “It’s helpful to know if patients are taking herbal supplements so we can know if they’re react or interact with medication they’re taking.”

Julie Berkhof, NP at the Wilmot Cancer Center

What They Want You to Know:

• “When a patient schedules a visit with their nurse practitioner, he or she should bring any evidence of past medical history available to them including their immunizations, medications, dates of surgeries, addresses and phone numbers of previous health care providers they have seen, and any other information relevant to their health. This will enable the NP to better assess the patient on the first and subsequent visits.”

Judith S. Neuderfer, Lead Nurse Practitioner, Rochester General Pediatric Associates

Nurse Practitioners

By Deborah Jeanne Sergeant

T

he American Academy of Nurse Practitioners states that nurse practitioners are “clinicians that blend clinical expertise in diagnosing and treating health conditions with an added emphasis on disease prevention and health management.” Nurse practitioners are trained at the master’s degree level with an emphasis on patient-centered wellness and care.

• “Legislation is pushing for nurse practitioners (NPs) to be totally independent. The way we’re going with Obamacare, NPs will be relied upon more and more because there are fewer physicians coming out and the need is becoming greater.

• “People ask all the time, ‘When can the doctor see me?’ and I say, ‘I’m it. I can treat you in the same way that your physician can treat you.’

• “Sometimes, NPs have a better outlook on communication with patients than doctors because we’re more on the patient’s level.

• “In New York state, NPs can open up their own practices. We can write prescriptions, diagnose and treat.

We can’t walk into a surgical suite and operate, but we see all types of diagnosis and conditions. If it’s above our scope, we have a way of knowing and we seek further advice from a specialist, just like a general practitioner.

• “I work on a short term rehab floor and in urgent care. Regarding urgent care, people always ask if they should go here or urgent care. I say if it’s not life threatening, it should go to urgent care. We also triage people to go to the emergency room.

• “I wouldn’t want to do anything else!”

Terri Haskins, nurse practitioner, Finger Lakes Health Transitional Care Unit • “I was fortunate to have become a nurse practitioner in 1976, just a few years after Loretta C. Ford, an educator and public health nurse, developed the NP role with Dr. Henry Silver, a pediatrician. These visionary leaders recognized that registered nurses, with additional education and training, were in an ideal position to provide primary care in the face of a shortage of physicians.

• “Over the decades, NPs have proven themselves to be highly acceptable and effective as primary care providers. The NP role has successfully expanded to acute care, behavioral health, and many other areas.

• “Nurse practitioners are a vital part of the health care team. We provide primary care in rural and urban areas, community and school based health centers, long-term care, and many other places. As a patient seeking care from a nurse practitioner, you will receive the benefit of our nursing perspective. Nurses have a long tradition of collaborating with patients and families, as well as other health professionals, to maximize health.”

Jane Tuttle, Ph.D, professor of clinical nursing and pediatrics and family nurse practitioner program director, the University of Rochester Medical Center

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.

• • • •

A

study by a University of Nebraska Medical Center researcher revealed that unauthorized immigrants have lower health care expenditures compared to legal residents, naturalized citizens and U.S. natives.

The study, which analyzed health expenditure data from the medical expenditure panel survey taken between 2000 and 2009, was conducted

by Jim Stimpson, director of the Center for Health Policy at UNMC. Results were published in the June issue of the health policy journal, Health Affairs.

It was found that U.S. natives spent $1 trillion on health care. By contrast all immigrants — unauthorized, legal and illegal — spent one-tenth that amount or $96.7 billion. Unauthorized immigrants accounted for $15.4 billion of that total, or 15.9 percent.

It also was found that an estimated 5.9 percent of unauthorized immigrants received care that providers are not reimbursed for, compared to 2.8 percent of U.S. natives in the same category. Stimpson speculated that this may be because unauthorized immigrants are much more likely to lack health insurance when compared to U.S. natives.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

Golden Years Living for Others A nurse puts self aside while dedicating her life to terminally ill

By Debra Graf

both in fundraising and diving in, staying under water the longest, and going out the farthest. She wrote 250 letters to friends asking for donations for the event, and Ross helped her log each donation she received.

Ross is also a philanthropist, and recently funded many renovations for Farmington Rehabilitation. A former physical therapist for the military, this is a cause close to her heart. Another of Donhauser’s ongoing projects is working on a committee to have a comfort care home in Canandaigua.

‘Doing something good’

Marge Donhauser with Natalie Ross, 90, both of Canandaigua.

Although Ross is confined to a wheelchair, that does not keep the pair from finding many things to do both in and out of the house.

W

hen Natalie Ross, 90, of Canandaigua, entered hospice in January of this year, she did not know she would be discharged less than two months later, happier and healthier.

But she was, and she gives all the credit to her live-in hospice nurse, Marge Donhauser.

Donhauser, 64, of Canandaigua, is trained in hospice and geriatrics and has devoted her life to caring for the elderly, 44 years to be exact. A former nurse at the Veterans Hospital in Canandaigua, a charge nurse at the M.M. Ewing Continuing Care Center and owner of Donhauser Nursing Service, Donhauser’s passion is taking care of the dying and trying to make people less fearful of death.

“No one likes getting old or dying.

I can’t change either but I hope I can make a difference in their comfort and quality of life,” says Donhauser. “I try not to focus on life’s difficulties that come with aging and the suffering and sadness that comes with dying. I try to make each day the best that I can for my patients. Then at the end of the day I know I did my job well.”

She continues to do that for Ross Page 16

•

and has for the last two years as her caregiver.

“We both have a verve for life. I don’t concentrate on dying, we are all going to die someday,” says Donhauser. “I concentrate each day on living it to the fullest. I take it day by day. I don’t worry about when anyone is going to die. I give the best I have to offer, and I try to bring the fun to them.”

Bringing the fun to her patients, or really her friends, is her specialty. Ross never knows what she is in for each day when she awakens.

“Marge plans unusual and exciting things like having a kangaroo and wallaby spend an afternoon with us, or putting 100 Valentine hearts all over the house with hand-written messages on them, or surprising me with a sixfoot Peter Rabbit reclining in my chair, holding a beautiful Easter basket,” says Ross.

Never a dull moment

But most recently she found two doughnut boxes on the kitchen table after getting up from her nap, but instead of donuts, there two baby chicks and two baby ducks inside.

“I went to the store and ‘rented’

two chickens and two ducks for the day,” says Donhauser. “We took very good care of them while they were here and I took them back after we played with them.”

Donhauser says her mind works overtime and she tries to do something fun and different every day. She loves dressing up to make people laugh, and makes interesting costumes by hand.

She has been a banana, a mermaid, a chicken, a corn stalk, and even an elephant.

In addition to devoting herself to her patients, Donhauser works hard for charity. She and Ross share that commitment, raising money and volunteering. Donhauser is the Secret Santa for the Happiness House in Canandaigua, an organization supporting children and adults with disabilities. Each Christmas, she buys and wraps 60 presents. Last year, Ross helped with the wrapping.

Her other winter endeavor is the Canandaigua Freeze Fest Polar Plunge.

Each year she jumps into the freezing waters of Canandaigua Lake to raise money for charities.

Donhauser raised over $8,000 last winter, beating her personal records

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

“When Marge is not helping me, you will find her somewhere in the house working on a project for charity or for a nonprofit organization, and I get to help her which makes me feel useful,” says Ross.

The pair recently won $1,000 from a $2 lottery ticket, and is going to give the money to a family whose child has cancer. This is just another example of “doing something good,” as Donhauser says.

Providing comfort by doing for others is what she does best. Families of former patients describe her as an angel with an immeasurable impact on others, and a person who makes the impossible bearable.

But Donhauser would tell you she simply cooks, cleans, does laundry, takes patients out driving and visiting, and helps people in need, something she has done since she was a young girl growing up on a dairy farm in Springville.

“I have lived out of a suitcase my whole life, living with people I care for in Canandaigua,” says Donhauser.

“I have never been married, I have not had time, I can’t work that in my schedule. I see people sitting on their porch and say, ‘I’d like to do that someday.’”

For the last 30 years, she has worked without a day off or a vacation. She may take a couple of hours to run errands or check the house she has owned for 25 years, but barely lived in for six.

“I have taken care of a lot of people who are supposed to not live long, but oftentimes they do,” she says. “Living in with people helps them. I think they have fun with me.”

Donhauser’s commitment to life can be seen even in death, and she feels everyone deserves to be recognized for living, no matter who they are. She says her only other great accomplishment other than helping the dying is when she helped bury Jane Doe, an unidentified woman in Canandaigua.

When she learned the woman could not be buried without contributions, she paid for the burial, citing everyone should have a closing to their life.

But right now Donhauser is focused on living each day with Ross, taking care of her needs and running the household.

These tasks are anything but easy for Ross, who is dependent on a walker, wheelchair and oxygen. She works hard, laughs, cries, and has a great sense of humor, and Ross loves every day with her.

“This is my life,” says Donhauser.

“If I had to do it over again, I wouldn’t do anything different.”

Golden Years Health Problems Can Disrupt Seniors’ Sleep Among the most commons are sleep apnea and restless legs syndrome

By Deborah Jeanne Sergeant

Y

ou’ve done all you can to improve “sleep hygiene,” the habits and environment that affect your ability to sleep.

The bedroom is quiet, dark and cool. Your bed is comfortable. You eschew afternoon naps, reading in bed, TV in the bedroom, alcohol, caffeinated beverages and heavy and spicy suppers.

You exercise earlier in the day, not right before bed.

You’re doing all of these great things to help you sleep yet you still can’t get 40 winks.

So what’s wrong?

Maybe it’s just you. No, not you personally, but health problems unrelated to sleep hygiene.

Some chronic health conditions common to older people and some of the medication used to treat them can disrupt sleep, as can sleep disorders, which “many people overlook,” said Kim Cruttenden, nurse practitioner with Sleep Insights, which operates sleep labs in the Rochester, Syracuse and Buffalo areas.

Sleep apnea and restless legs syndrome are the top sleep disorders Cruttenden sees and she said that many people are not even aware they have these problems.

“Usually, a member of the family will tell them they’re snoring or a bed partner will tell them they’re very restless,” she said.

Geriatrician Steve Ryan at Roch-

ester General Hospital said that the most common health conditions that awaken his patients are bowel and bladder issues.

“When these interfere with sleep, don’t drink and snack after dinner,” he said.

Gastrointestinal problems can also keep you awake. You don’t have to accept this as “part of growing older.” Talk to your doctor instead.

Arthritis aches and pains also waken some older adults.

Ask your doctor about what nighttime pain control methods and medications that can help you. They may be different than what you should use during the daytime. Topical rubs may help, for example, used with your regular analgesic.

“All medications have side effects and anytime you’re taking a prescription, write down the things in your life that are better and some are worse,” Ryan said. “That a gives your doctor complete information on how the medication affects you.”

Blood pressure medication may cause muscle aches that can bother you more at night. Some medication can cause nausea, for example.

Katie Jaenecke, pharmacist at Clinton Pharmacy in Rochester, said that many classes of medications can inter-

rupt sleep, such as anticholinergics, antidepressants, and steroids.

“We recommend to people to take them in the morning,” Jaenecke said, “as long as it’s okay with their doctors.”

It’s important to talk with your doctor to make sure taking a particular drug in the morning is okay and won’t interfere with a medication taken at that time.

If a particular drug is causing a problem that disrupts your sleep, don’t assume that your doctor will whip out

the prescription pad.

“There may be something else we can try,” Ryan said. “We make an effort to not try to prescript medication to counteract the effects of the first.

There’s always something that can help.”

You may be able to try a non-habit forming over-the-counter sleep aid if it does not interfere with any current medication. Most insurance companies don’t require a referral from your general practitioner before visiting a sleep lab.

People with Alzheimer’s Disease May Have Lower Risk of Cancer and Vice Versa

O

lder people with Alzheimer’s disease are less likely to also have cancer, and older people with cancer are less likely to also have Alzheimer’s disease, according to the largest study to date on the topic, which appears in the July 10 online issue of “Neurology,” the medical journal of the American Academy of Neurology.

“Since the number of cases of both Alzheimer’s disease and cancer increase exponentially as people age, understanding the mechanisms behind this relationship may help us better develop new treatments for both diseases,” said study author and phys-

cian Massimo Musicco of the National Research Council of Italy in Milan.

The study involved 204,468 people age 60 and older in northern Italy during a six-year period. During that time, 21,451 people developed cancer and 2,832 people developed Alzheimer’s disease.

A total of 161 people had both cancer and Alzheimer’s disease, whereas that number would have been expected to be 281 for cancer and 246 for Alzheimer’s disease when considering how often the diseases occur in the general population. Therefore the risk of cancer was cut in half for people with Alzheimer’s disease, and the risk

of Alzheimer’s disease was reduced by 35 percent for people with cancer.

“While other studies have noted this relationship before, this is the largest study to date and it has several strengths over previous studies, such as looking for the presence of the second disease both before and after the first disease was diagnosed,” Musicco said. “This controls for the possibility that the presence of one disease might obscure the diagnosis of other diseases because any new symptoms might be interpreted as a consequence of the already-diagnosed disease, or in the case of cancer, people might assume that memory problems were a side effect of

August 2013 •

chemotherapy.”

The researchers found the same result in people who died during the course of the study as well as those still living, controlling for the possibility that the reduced life expectancy for the first disease would also reduce the likelihood of living to develop the second disease.

The study was supported by the National Research Council of Italy and the Foundation IRCCS “Santa Lucia” in Rome.

To learn more about Alzheimer’s disease, please visit www.aan.com/patients.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

Golden Years Chair Exercise Can Support Seniors’ Good Health

By Deborah Jeanne Sergeant

M

obility or balance issues do not make it impossible to get some activity into your day. Though you may spend lots of time seated, you can still use these moves to maintain and improve your health as a senior.

Since losing muscle mass can negatively affect your health, it’s important to keep yours strong. Losing range of motion can also make daily life chores more difficult.

Becky Perrone, physical therapist and manager of Rehabilitation Services at Independent Living for Seniors, an affiliate of Rochester General Health System, said that it’s important to get clearance from your doctor before starting any exercise.

“You don’t want to aggravate or cause other medical issues,” she said.

You should also start slowly with gentle movements and low repetitions for each movement. Around 10 is doable for most people. Perform two to three sets of 10 movements and rest between sets.

Perrone recommends opening and squeezing hands, circling the arms to the side, and holding a ball and reaching forward and to the side with it.

“These moves will help with breathing, digestion and strengthening the muscles,” Perrone said.

If you can move your legs, try straightening them at the knee and

bending them back down.

“Put the ball between legs and squeeze 10 seconds,” Perrone said. “Go up on your toes and back onto your heels.

“Any little bit of exercise will help, whether increase muscles, strength, breathing or digestion,” Perrone added. “It has an overall positive effect.

It helps you build tolerance. As you’re able to do more, you may be able to do more.”

Michael Knapp, certified personal trainer and owner of At Your Home Personal Training in Rochester, is a big believer in “functional fitness,” performing movements that help clients improve their performance of everyday activities.

For example, he has clients stand up from a seated position, which uses 40 muscles.

“If they have an armchair or something they can push away from to work the upper body, they should flex their arms, putting their weight on their hands and do it 10 to 20 times daily.

It’s okay to do daily or every other day because these movements are low impact.”

Once standing, if you have balance issues, try holding a stable object and sway or shift your weight from one foot to the other.

“If you can maintain walking that

helps,” Knapp said. “Our bodies are made to move, like cars. if you don’t move, things break apart a lot faster, like car.”

At Pieters Family Life Center in Rochester, physical therapist Erin Allen recommends that seated seniors stretch their arms by alternately pulling them across the chest gently. For the arms legs, hold a strap or towel under the foot and pull on the towel with the leg straight.

Maintain range of motion with the neck by turning the head as if looking over your shoulders and raising and lowering the head.

“Do them seated if you have any balance issues,” Allen said.

She has observed poor posture as a contributing factor to the shrinkage many seniors experience.

“Opening up the chest and staying upright can help,” she said. “Being hunched over can contribute to falling because the weight is shifted forward.”

She encourages seniors to work on sitting on the edge of the chair and sucking in the belly button as if they are trying to make it touch their spines.

Rowing with a set of light dumbbells may also help.

How to Do It

Remember these general exercise tips from Erin Allen, physical therapist from Pieters Family Life Center in

Is Calcium Bad for the Heart?

Recent study shows men who took daily calcium supplements are 20 percent more likely to die of heart-related causes than those who did not take any at all

By Deborah Jeanne Sergeant

F

or years, geriatricians like Steve Ryan at Rochester General Hospital have preached calcium-rich diets and, as needed, supplementation to patients who have risk of osteoporosis.

After all, an abundance of solid, peer-reviewed, large trial group studies have proven that calcium supplementation and calcium-rich diets can help people prevent fractures in older adults.

But a few recent studies seem to indicate that for some older men, calcium could be bad for their hearts.

Ryan doesn’t want patients to take a knee-jerk reaction and arbitrarily stop taking calcium, especially if they have a high risk for osteoporosis and its complications.

“We have 15 years of data on calcium supplements and vitamin D in preventing hip fractures,” he said.

“The benefit of that is pretty clear.”

However, a recently released Page 18

•

National Institute of Health study followed nearly 400,000 middle-aged Americans for 12 years. Researchers found that men who took 1,000 mg. of calcium supplementation daily were 20 percent more likely to die of heartrelated causes than those who did not take calcium supplements. Researchers also factored in the men’s age, race, weight and lifestyle factors.

“It’s not saying calcium is bad, but supplementary calcium is bad when it comes to the heart,” said Christopher Cove, interventional cardiologist at the Heart & Vascular Center at University of Rochester Medical Center. “Dietary calcium showed no increase in heart disease. Some people take calcium because they think it’s good to take as many vitamins as they can. Increasing dietary calcium is beneficial.”

Most men have higher cardiovascular disease risks than most women and most women have higher osteoporosis risks than most men.

“Your physician will have to weigh the risk of calcium supplementation,” Cove said. “The risk may outweigh the benefits. There’s no harm in dietary calcium through natural food.”

Cove recommends eating 1,000 to 1,200 mg. of calcium daily as part of a balanced diet. It’s not as hard as you would think. One cup of skim milk contains 30 percent of the daily value of calcium most people need. One ounce of reduced fat mild cheddar cheese contains 40 percent. And two, sixounce cups of non-fat yogurt contains 30 percent. Adding these foods to one’s diet should supply enough dietary calcium.

Dairy items are not the only sources of calcium. Sardines, soybeans, almonds, broccoli, and dark, leafy greens such as spinach, kale, turnips, and collard greens also boost calcium intake.

The problem with supplemental calcium is how it’s absorbed.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

Rochester: • “Always listen to your own body.

• “If you’re looking for stretching and strengthening, be careful about doing things that increases the heart rate.

• “Don’t hold your breath when exercising.

• “Stretching and exercise shouldn’t be painful.

• “Drink lots of water.

• “If you don’t move it, you lose it.

A lot of times, people get into routines and don’t fit exercise into it. but you can get exercise into your routine and it makes it part of your day.”

“In one study, they saw that there was a high spike when taking a calcium pill,” Cove said. “With dietary calcium, the calcium level rises rather slowly.”

Marusia Marrapese, wellness consultant at Lori’s Natural Foods Center in Rochester, has 30 years of industry experience. She said that without the cofactors for properly absorbing calcium, such as vitamin D, magnesium, vitamin K and phosphorus, “it may be absorbed by the soft tissues and not the bones. It’s very, very important to look at the co-factors.”

The supplements seemed to not affect women in a similar way as men perhaps because women naturally have higher calcium needs or in general have lower calcium levels in their diet, Cove said.

Other studies indicate that postmenopausal women taking calcium supplements have equal elevated risk of heart disease as men who take calcium supplements. The National Institute of Health study could have contained more women who were postmenopausal by the end of the study than women who were not, which would have skewed the results.

“I don’t think we know the final answer,” Cove said. “I think that the best advice is to [obtain calcium] through dietary means. If you’re interested in supplements, talk with your physician.”

By Jim Miller

How to Choose a Home Stair Lift Dear Savvy Senior, My wife is having an increasingly difficult time going up and down the stairs in our house. We are interested in purchasing a stair lift, but aren’t sure what to get or where to look. Can you help us?

Need a Lift Dear Need, A good home stair lift is a wonderful solution for seniors with mobility issues who have trouble with steps. A stair lift will carry your wife up and down the stairs in a safe seated position, giving her easy access to the second story or basement level of your home. But with so many options available how do you choose one that best meets your needs and budget. Here are a few shopping tips along with some good companies that offer them.

Types of Lifts

There are two basic types of stair lifts that are sold today: straight and curved. The type you need will depend upon the design of your staircase.

A straight stair lift is one that travels in a straight line up a flight of stairs uninterrupted by landings, bends or curves, and costs between $3,000 and $5,000 installed. Curved lifts, however, are much more elaborate and will go around corners, bends and changes in direction. Curved lifts are also much more expensive typically running between $10,000 and $15,000 or more depending on the complexity of the installation.

Also available through certain companies are weatherproof lifts for outdoor steps, and standing stair lifts (also called perch lifts) for those who have trouble bending their knees.

You also need to know that all stair

lifts mount to the stair treads, not to the wall, so they are very sturdy and can be installed in almost any home.

If your wife is a large person, you may need to get her a heavy-duty lift with a wider seat and bigger lifting capacity — all companies offer them.

Or, if she’s tall, find out about raising the seat height during installation.

Most stair lifts available today also have seats, armrests and footplates that fold up out of the way, and swivel seats that make getting into and out of the chair easier. They also come with standard safety features like seatbelts, breaking systems and footrest sensors, push-button or rocker-switch controls located on the armrest for easy operation, and “call send” controls which allow you to call or send the unit to the other end of the stairs. Make sure the lift you choose has all these features.

Depending on the company, you may also have the option of choosing between an electric (AC) and a battery powered (DC) stair lift. Battery powered units charge at the base station (some recharge anywhere on the track) are quieter, smoother and better than electric lifts, and will work even if there’s a power failure in the home.

Where to Shop

While there are many companies that make, sell and install stair lifts, the most respected in the industry are Bruno (bruno.com, 866-345-7537) and Stannah (stannahstairlifts.com, 800877-8247), followed by Harmar (harmar.com, 800-833-0478) and Sterling (handicare.com, 866-276-5438).

Unfortunately, Medicare does not cover stair lifts, but many states offer Medicaid waivers that will pay for lifts to those that qualify, and the VA offers cash grants to veterans with disabilities for home safety improvements.

To save some money, you may want to consider purchasing a used or refurbished model. Or, if you need a stair lift for only a short period of time, consider renting one. Most companies offer these options, and many offer financing programs too.

To get started, contact some stair lift companies who will put you in touch with a dealer in your area. All dealers provide free in-home assessments and estimates, and can help you choose an appropriate lift.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

August 2013 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

The Social Ask Security Office

Sharp Rise in Drug Overdoses Among U.S. Women: CDC

Column provided by the local Social Security Office

More now die from prescription medications than from car crashes, study finds

T

he rate of fatal overdoses of prescription painkillers and other drugs among U.S. women quadrupled between 1999 and 2010, federal officials reported in July.

Long thought of as primarily a male problem, drug addiction is increasingly affecting women, and the new study from the Centers for Disease Control and Prevention estimates that 42 women in the United States die each day from prescription drug overdoses.

“Prescription drug overdose deaths have skyrocketed in women,” CDC Director Thomas Frieden said. “Mothers, wives, sisters and daughters are dying from overdoses at rates we have never seen before.”

The CDC said that nearly 48,000 women died of overdoses from any form of prescribed drug between 1999 and 2010. The annual death rate for women from drug overdoses now surpasses that of car crash deaths, the agency said.

Emergency room visits for abuse or overdose have also increased dramatically, Frieden added.

Much of this increase is due to the widespread abuse of prescription opioid painkillers such as Oxycontin or Vicodin, which have been more frequently prescribed in the past decade.

“The increase in opioid overdoses and opioid overdose deaths is directly proportional to the increase in prescribing,” Frieden said.

These drugs should be reserved for treating severe pain, as occurs with

debilitating illnesses such as cancer.

“But in many other situations, the risks [to patients] far outweigh the benefits,” he said. “Prescribing an opioid may be condemning a patient to lifelong addiction and life-threatening complications.”

Although men are still more likely to die from painkiller overdoses, since 1999 the percentage increase in deaths was greater among women — 400 percent in women compared with 265 percent in men, the CDC said.

Other statistics, based on 2010 data: • Suicides from these drugs accounted for 34 percent of all suicides among women, compared with 8 percent among men.

• More than 940,000 women were seen in emergency departments for drug misuse or abuse.

• More than 6,600 women, or 18 women every day, died from a prescription painkiller overdose.

• Narcotic painkillers accounted for four times more deaths among women than deaths linked to cocaine and heroin combined.

• More than 200,000 emergency department visits were for misuse or abuse of these drugs among women -- about one every three minutes.

“This is a major public health concern and it’s getting worse every year,” said Yves Duroseau, chairman of emergency services at Lenox Hill Hospital in New York City. “People are losing their lives unnecessarily.

High Rates of Burnout and Depression Among Anesthesia Residents

Spouses Have a Significant Benefit

S

ocial Security can be an important financial asset for married couples when the time comes to apply for retirement benefits. In many cases, one spouse may have earned significantly more than the other, or have worked for a longer span of years. Or it could be that one spouse stayed home to do the work of raising the children or caring for elderly family members while the other focused on a career.

Regardless of your situation, Social Security will look at all possibilities to make sure both spouses receive the maximum benefit possible.

Even if you have not paid Social Security taxes, it’s likely you’ll be eligible to receive benefits on your spouse’s record. If you did work and pay into Social Security, we will check eligibility based on your work record and your spouse’s to see which amount is higher.

You can apply for spouses benefits the same way that you apply for benefits on your own record. You can apply for reduced benefits as early as age 62, or for 100 percent of your full retirement benefits at your “full retirement age.” You can find your full retirement age, based on your birth year, at www. socialsecurity.gov/pubs/ageincrease. htm.

The benefit amount you can receive as

Q&A

Q: How do I know if I have worked long enough — to qualify for Social Security disability benefits?

A: You must have worked long enough — and recently enough — under Social Security to qualify for disability benefits. Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. The Forty-one percent of residents were amount needed for a credit changes from year to year. In 2013, for example, considered at risk of burnout, based you earn one credit for each $1,160 of on high scores for emotional exhaustion and depersonalization and/or low wages or self-employment income. scores for personal accomplishment. In When you have earned $4,640, you’ve earned your four credits for the year. addition, 22 percent of residents had The number of work credits you need possible depression, based on a standard screening test. Seventeen percent to qualify for disability benefits deof trainees were at risk of both burnout pends on your age when you become disabled. Generally, you need 40 and depression.

Compared to people of similar age, credits, 20 of which you earned in the last 10 years, ending with the year you anesthesiology residents were nearly become disabled. However, younger twice as likely to have screen positive for depression. They were also twice as workers may qualify with fewer credits. likely to report suicidal thoughts.

Both burnout and depression were Q: My grandmother recently died more likely for residents who worked and left me about $5,000 in cash. Will more than 70 hours per week, those this affect my SSI? with higher alcohol use (more than five A: Yes, it most likely will. We count drinks per week), and female residents. the money as income in the month you Smoking was an additional risk factor receive it, which means you will not be for depression. eligible for an SSI payment the month

Study raises concerns about impact on patient care and safety

R

esidents in anesthesiology training programs have high rates of burnout and depression, reports a survey study in the July issue of “Anesthesia & Analgesia,” official journal of the International Anesthesia Research Society (IARS).

The findings raise concerns that, “In addition to effects on the health of anesthesiology trainees, burnout and depression may also affect patient care and safety,” write physician Gildasio S. de Oliveira, Jr, and colleagues of Northwestern University, Chicago.

The researchers performed an Internet survey of U.S. anesthesiology residents nationwide. Confidential responses from 1,508 residents were analyzed to assess the frequency of burnout and depression, and whether trainees at high risk of these conditions would report more medical errors.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

a spouse, if you have reached your full retirement age, can be as much as one half of your spouse’s full benefit. If you opt for early retirement, your benefit may be as little as a third of your spouse’s full benefit amount.

If your spouse has already reached full retirement age but continues to work, your spouse can apply for retirement benefits and request to have the payments suspended until as late as age 70. This would allow the worker to earn delayed retirement credits that will mean higher payments later, but would allow you to receive your spouse’s benefit.

You can also apply for spouse benefits based on the earnings record of an exspouse or deceased spouse if you were married for at least 10 years. Spouses can consider a number of options and variables. We make it easier to navigate them. A good place to start is by visiting our benefits planner at www. socialsecurity.gov/planners. Take note of the “Benefits As A Spouse” section.

If you are ready to apply for benefits, the fastest, easiest, and most convenient way is to apply online! You can do so at www.socialsecurity.gov/applyonline.

Whether you receive benefits on a spouse’s record or your own, rest assured we will make sure you get the highest benefit we can pay you. Learn more at www.socialsecurity.gov.

that you receive the $5,000. Because there is a resource limit of $2,000 for an individual (or $3,000 for a couple), the amount you keep after the month you received it will count as a resource and may make you ineligible for a payment. As long as you have more than the resource limit, you will not be eligible for an SSI payment. It is important that you report to us the amount you receive and then let us know when your resources fall below the limit. Learn more about SSI by reading or listening to our online publication, “Supplemental Security Income” (SSI), available at www.socialsecurity. gov/pubs.

Q: I’m trying to figure out the best time to retire based on my future earnings. How can I calculate my own retirement benefit estimate?

A: We suggest you use our “Retirement Estimator” at www.socialsecurity. gov/estimator. It produces estimates based on your actual Social Security earnings record, so it’s a personalized, instant picture of your future estimated benefit. Also, you can use it to test different retirement scenarios based on what age you decide to start benefits.

For example, you can find out your estimated monthly payments if you retire at age 62, 70, or any age in between.

Try it out now at www.socialsecurity. gov/estimator.

H ealth News MVP Health has new VP, chief information officer James H. Poole, III has joined MVP Health Care as vice president and chief information officer, responsible for leading business information systems, including managing information technology (IT) infrastructure, computer systems/applications, information security and data/telecommunications.

Poole originally joined MVP in July 2012 and has served as Interim CIO since December 2012.

“I am pleased to officially welcome Jim to MVP’s executive team,” said Denise V. Gonick, president and CEO of MVP Health Care. “The upcoming Health Benefit Exchanges require many new and updated Poole IT systems and capabilities. We are fortunate to have someone of Jim’s caliber to ensure we have the technology infrastructure necessary to support our products and service.”

Prior to joining MVP, Poole was most recently vice president of operations for Connecticut-based information technology company The Cimino Group, and has served as vice president of the Enterprise Command Center for Cigna Corporation.

He has a strong background in health care and insurance information technology, having also worked for Howard Systems International, Private HealthCare Systems and Aetna Life & Casualty over the course of his career.

Poole describes himself as a nononsense leader with the single goal of delivering what the customer requires cost effectively and at the highest level of quality. “The health care industry is entering a new era with the implementation of the Affordable Care Act. MVP

affords me the opportunity to be on the front lines shaping IT implementation,” Poole said.

Poole works out of MVP’s Schenectady headquarters and lives with his wife, Annemarie, in Willington, Conn.

Doctor joins Highland Hospital Geriatrics Group Physician Jennifer D. Muniak has joined the Highland Geriatrics Group at Highland Hospital. The group consists of geriatric hospitalists who manage the care of elderly inpatients.

Most recently, Muniak completed her residency in internal medicine at the University of Rochester, serving as practice chief for the internal medicine resident clinic from 2011-13.

“I am interested in treating older people because they are some of the most complex patients,” says Muniak, Muniack adding that she enjoys incorporating families in patient care and focusing on the psycho-social aspects of medicine.

She earned her medical degree from SUNY Upstate Medical University in Syracuse and graduated cum laude from the University of Rochester with a bachelor’s degree in neuroscience and a minor in music.

Muniak also volunteers at Rochester Animal Services. In 2010, she earned the Community Service Award from the Medical Society of the State of New York.

Originally from Onondaga Hill, near Syracuse, Muniak lives in Rochester.

St. Ann’s Community Names New CEO Michael E. McRae, who serves as St. Ann’s Community’s executive vice president and chief operating officer, has been chosen as the new chief executive officer for the $80 million senior living community. He will take over the position after current CEO Betty Mullin-DiProsa retires in April 2014.

McRae joined St. Ann’s Community in 2010 as senior vice president and administrator. He was elected to succeed Mullin-DiProsa after a unanimous vote by McRae the organization’s board of directors earlier this month.

Mullin-DiProsa joined St. Ann’s Community in March 1997 and is responsible for leading the organization through its transition from a traditional skilled-nursing facility to its current position as Rochester’s largest senior housing

and long-term-care system. Under her leadership, the organization has grown to occupy two campuses in Irondequoit and Webster. The organization serves nearly 3,000 people annually and has 1,200 employees.

“Looking at my career at St. Ann’s Community over these past 16 years, I have had a wonderful experience and I have been committed to the success of this organization,” Mullin-DiProsa said. “The staff and I have had the privilege to be able to create many wide and varied programs, services and facilities, which are designed to meet the needs of those we serve. I am confident that Mike will continue this important work and maintain our keen focus on caring for ‘The Most Important People on Earth.’”

Lifetime Health recognized for patient care Lifetime Health Medical Group has received the National Committee for Quality Assurance’s (NCQA) PatientCentered Medical Home 2011 Recognition, achieving Level 3 status at all of the group’s practices. Lifetime Health first achieved this level of quality recognition (the highest NCQA offers) in 2010. NCQA requires recertification every three years and continually updates its standards for qualification.

“This achievement is a testament to the dedicated and ongoing efforts of our teams of physicians, other providers, nursing and office staff in delivering excellent care to our patients every day,” says Mark F. Perry, Lifetime Health’s chief medical officer. “Sustaining our recognition as a patient-centered medical home at the highest quality level is core to Lifetime Health’s vision of being a best in class medical group and is considered the ‘gold standard’ for primary care.”

NCQA recognizes primary care practices that function as patient-centered medical homes, a model of care that supports partnerships between individual patients and their personal physicians, and when appropriate, the patient’s family. Care is enhanced by registries, information technology, health information exchange and other means to help patients get appropriate care when and where they need it, and in a culturally and linguistically appropriate manner.

To achieve recertification, Lifetime Health had to demonstrate that its practices met a new set of robust standards put in place in 2011 which promote organizing care around patients’ individual health needs and goals, identifying available community resources for patients, working in teams and coordinating and tracking care over time.

Healthcare Association of NY has new president Dennis Whalen has recently became the new president of Healthcare Association of New York State (HANYS), a nonprofit organization representing healthcare networks and hospitals. Until recently he was the vice president and chief operating officer at the organization. He succeeds Daniel Sisto, who announced his retirement.

“During this time of dramatic health care reform, HANYS and our members will be well served by Dennis Whalen’s comprehensive understanding of New York state’s Whalen complex regulatory, financial, and political dynamics,” said HANYS’ board chairman Joseph McDonald, president and chief executive officer of Catholic Health System in Buffalo. “Seeing his contributions

August 2013 •

to New York state’s health care during 35 years of public service and his time with our association, we look forward to seeing his accomplishments in this new leadership role.”

Before joining HANYS in 2009, Whalen served in both Democratic and Republican administrations, earning a sterling reputation for his knowledge, credibility, and capacity to reconcile conflict and achieve consensus on contentious health policy issues. Most recently, he served as director of state operations, where he was responsible for overseeing the operation of all 78 executive branch agencies, directing the governor’s policymaking staff of deputy secretaries, and advising the governor on all state operational matters. Prior to this appointment, he served both Gov. Eliot Spitzer and Gov. David Paterson as deputy secretary for health and human services.

Whalen began his career in state government in 1974 as a public health educator at the Department of Health, where he later served as executive deputy commissioner for a decade, and as director of the office of health systems management and director of the New York State AIDS Institute. He is a graduate of Marist College and the National Preparedness Leadership Institute at the Kennedy School of Government.

Unity Perinatal Medicine receives accreditation Unity Health System’s Perinatal Medicine has been re-accredited as an American Institute of Ultrasound in Medicine (AIUM) site. It has also earned accreditation for the fetal echocardiography program.

“This is huge accomplishment for the practice and one we certainly are proud of and worked hard to achieve.

We are only the fourth practice to be accredited for fetal echocardiology in all of New York state,” said Shari Schuman, practice manager of Unity Perinatal Medicine. “ There are approximately 70 practices in total accredited throughout the U.S. with the majority located on the west coast. Unity’s practice opened in June of 2009.

Receiving accreditation through the AIUM implies that a practice has demonstrated that all of its interpreting physicians meet relevant ultrasound training guidelines, case volume requirements, and continuing education.

In addition, Unity Perinatal Medicine sonographers have earned accreditation in fetal echocardiography by the American Registry of Diagnostic Medical Sonographers.

Helendale Dermatology & Medical Spa expands Helendale Dermatology & Medical Spa, located in Irondequoit, announced the opening of the Hair Center at Helendale, which specializes in surgical hair transplants for men

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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H ealth News and women. In addition, the medical practice is the to first to bring the new minimally invasive, automated hair transplant technology, called NeoGraft FUE Hair Replacement, to the greater Rochester region.

After years of treating patients who suffer from hair thinning and loss, board certified dermatologist Elizabeth Arthur of Helendale Dermatology & Medical Spa, founded the hair center as an extension of her dermatology practice. The center is located at 500 Helendale Road in Rochester.

“The ‘Hair Center at Helendale’ was created to bring our patients the most advanced hair transplantation technology available that results in a full and natural-looking hairline and without the unsightly scars associated with traditional hair transplants,” said Arthur, who started performing hair transplants almost 20 years ago. ”NeoGraft is a breakthrough for hair loss patients and is the new standard of surgical hair transplants.”

Seniors donate 1,071 pounds of food Residents and staff members of 12 Rochester area senior living communities collected 1,071 pounds of nonperishable food recently with the goal of providing meals to hungry families in the area.

Margot Long of Your Best Move LLC, a move management company, along with Marabeth Galardi of Corrigan Moving Systems, organized the food drive, which was held in May. Participating senior living communities were Baywinde, The Highlands at Pittsford, Pinehurst, River Edge Manor, Rivers Run, Legacy at Clover Blossom, Legacy at Cranberry Landing, Legacy at Erie Station, Legacy at the Fairways, Legacy at Parklands, Legacy at Park Crescent, and Legacy at Willow Pond.

All donated food was delivered to Foodlink.

“I commend Margot Long and Marabeth Galardi for deciding to help out the community through this food drive,” said Adam Lowy, executive director of Move For Hunger, a nonprofit based in New Jersey. “Donating a few cans of boxes of food items may not seem like much at first, but when the whole community gets involved the donations really start to add up.”

Cardiology Department Opens at Unity Hospital

STORY IDEAS?

Unity Hospital officially opened its renovated and expanded cardiology department on July 2. The opening is part of the Unity Hospital modernization and expansion project.

The following services are available in the new Cardiology Department at Unity Hospital: electrocardiogram (ECG), Holter monitoring, echocardiogram (Echo), transesophageal echocardiogram (TEE), tilt table testing and stress test equipment, among others.

The opening of buildings two and three marks completion of the next phase of the four-year, $144 million Unity Hospital modernization and expansion project. Con-

Email them to Editor@GVhealthnews.com

Hospice Academy Graduates Learned How to Help at the End of Life

struction for the project began with phase I in 2010, which included the opening of Wegman Family Cottages at Park Ridge Living Center and the McCormick Transitional Care Center.

Construction is underway on the third and last phase of the project. The new Golisano Restorative Neurology and Rehabilitation Center, and a new Joint Replacement Center, are scheduled to open in 2014.

When the project is complete, patients will see improvements in a range of services—from cardiology and pharmacy, to improved nursing stations and larger parking lots—and all Unity Hospital patient rooms will remain private.

VNS Looking for Volunteers

J Nine home health aides graduated from Visiting Nurse Service’s Hospice Academy June 27. They each received eight hours of specialized training on what patients and families experience during the end of life and how the aides can best support them during their difficult time. The Hospice Academy began in 2009 thanks to a generous gift from Rachel LeChase in memory of Page 22

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her husband, Raymond F. LeChase.

In the photo are top row left to right: Mario Coureaux of Henrietta, Ashley Rose of Rochester, Flora Davis of Rochester, Rebecca Sanita of Rochester and Bailey Almekinder of Webster. Bottom row, from left, are Michelle Aratari of Webster, Luciano Murangi of Rochester, Paula Lotta of Greece and Marie Robinson of Rochester.

ean Klem of Webster has always known that volunteering with Visiting Nurse Service of Rochester and Meals On Wheels was good for her; it keeps the 85 year old busy and engaged with the community. Now, research is validating this feel-good activity by revealing a link between volunteering and heart health, and it comes at a time when Meals On Wheels is looking for more volunteers.

A Carnegie Mellon University study of approximately 1,100 adults showed that those between the ages of 51 and 91 who volunteered for at least 200 hours per year (a bit less than four hours per week) were 40 percent less likely to develop hypertension, or high blood pressure.

The lead author in the study cited that social connections, which are one of the benefits of volunteering, can promote healthy aging and may have contributed to the study’s findings.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

“Many volunteers come into Meals On Wheels a long time before their deliveries,” said Phil Shippers, director of Meals On Wheels. “They come in to talk and enjoy each others’ company.

Some of them tell us it’s just a happy place.”

Jean Klem, a clerical volunteer who started in 1994, one month after she retired, understands the camaraderie.

“When you’re in with a group, you feel like you’re a part of the family,” she said.

Meals On Wheels is currently looking for new volunteers to make deliveries in Greece, Brighton, Irondequoit and Rochester. Volunteers deliver meals with another person— enabling conversation and hearthealthy socialization.

If you are interested in volunteering, call 585-787-TEAM (8326) or complete an online application at www.VNSnet.com.

Services for Veterans Continued from page 28 residents receive vital mental health services and addiction treatment as the first steps toward making positive, long-term lifestyle changes.

“Veterans Outreach Center provides something for everyone,” Colonel Yaple said. “For many veterans, regaining a feeling of connection to community is one of the biggest challenges. As an Army veteran myself, I have personally experienced the transition from a lifetime of service to civilian life. Veterans Outreach Center gives our service men and women that sense of belonging, a real sense of home and the support they need across the board to make positive changes for themselves and their families.’

Vietnam Veterans of America

Started in 1981, the Vietnam Veterans of America Chapter 20 of Rochester is the largest, most active, and longest standing local chapters of the national Vietnam Veterans of America, Inc., a nonprofit veterans service organization chartered by the United States Congress.

“Our central focus is on maintaining a strong, united voice for resolving issues of vital importance to all Vietnam-era veterans, locally, statewide, and nationally,” said chapter president Valentino Gatto. “We also provide a positive local forum for social and emotional interaction among Chapter 20 members.”

The Patriot Guard Riders

Another important aspect of services is groups and programs that provide support to the families of servicemen and women.

The Patriot Guard Riders is a group of volunteers who have a unique mission — to attend the funeral services of fallen American heroes as invited guests of the family. Nigel Heaton, ride captain for region 2 in New York, explains that each mission they undertake has two basic objectives: to show their sincere respect for our fallen heroes, their families, and their communities and to shield the mourning family and their friends from interrup-

tions created by any protestor or group of protestors.

Sherri Goodenough, a veteran of the US Army, has been a member of the Patriot Guard Riders for three years.

“I volunteer and participate in the missions of the Patriot Guard Riders because “standing for those who stood for us” is the least I can do to honor our nation’s brave men and women who unselfishly sacrifice so much to keep our American freedom. This is my way to never forget our nations’ heroes.

Veterans Business Council

The Veterans Business Council offers opportunities to veteran business owners to network with other veteran owned/operated businesses in order to grow their business. The council sponsors monthly membership meetings and education programs featuring expert speakers from different industries.

Many counties provide identification cards to veterans that indicate holder’s veteran status which is shown to the many businesses that offer discounts to veterans. Later this year it is expected that the Department of Motor Vehicles will place a distinguishing mark on drivers’ licenses and nondriver ID’s to indicate the holder is a veteran.

How does a veteran and his or her family know where to turn? The organizations work cooperatively and collaboratively and a veteran may easily use the services of several programs depending upon the need. As one agency said “We’re all on the same side, we respect our veterans and want to serve them.”

Lynette M. Loomis is a certified coach, marketing consultant and free-lance writer and a board member of the Veterans Outreach Center.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Services for Veterans

By Lynette M. Loomis

I

n the Greater Rochester area, there are approximately 68,000 veterans and many organizations and groups provide support for them whether it’s advocacy, care for a medical issue, help with benefits, job placement or care for Posttraumatic stress disorder (PTSD).

The following provides highlights of some of the many organizations serving military veterans and their families.

VFW

The Veterans of Foreign Wars (VFW) began in the late 1800s as many wounded or ill soldiers from the Spanish-American War and the Philippine Insurrection retuned home. Veterans formed local organizations to help their peers secure rights and benefits for their military service. Their role as advocates for military men and women has continued in creating a GI bill for the 21st century, the development of the national cemetery system and the fight for compensation for Vietnam veterans exposed to agent orange and for veterans diagnosed with Gulf War syndrome. The VFW has also fought for improving VA medical centers services for women veterans and regularly provides scholarships for veterans.

American Legion

The 2.4-million member American Legion, founded in 1919, is the nation’s largest wartime veterans’ service organization and is a respected lobbying force advocating on behalf of America’s military veterans and active duty service members. The American Legion was responsible for the drafting and passage of the original G.I. Bill, which afforded higher education to millions of World War II veterans and in the bill’s successors, including the much expanded Post-9/11 GI Bill.

Currently, The American Legion is campaigning on behalf of women veterans and service members, seeking solutions to veteran homelessness and joblessness and encouraging states to adopt legislation to ease the transition from military to civilian employment through licensing and credentialing reforms. The American Legion maintains

Volunteers in Operation Welcome Home make greet retuning service personnel and thank them for their services. Families who know arrival times many contact Operation Welcome Home at the Veterans Outreach Center 866-906-VETS or 585-546-1081 for scheduling. watch over the Department of Veterans Affairs (VA) health care system with an emphasis on promoting improved care of former service members with PTSD or traumatic brain injury. The legion also maintains a vast network of service officers who provide counseling on benefits claims and related matters free of charge. Local legion posts assist veterans and military families.

One of the best known organizations is the government-supported Veterans Administration that offers a wide range of services to veterans with honorable discharges. These services include primary medical care, including vision, dental, mental health, specialty care, alcohol and drug abuse

rehabilitation, wellness programs, nursing home care and and help to work through PTSD. Dan Ryan, public affairs officer at the Canandaigua VA Medical Center, says that they have seen an increase in the demand for services. One new program, of which many veterans are unaware, is My HealtheVet, an online personal health record designed for veterans, active duty service members, their dependents and caregivers to help make informed decisions as well as manage their health care. There are different levels of the online tool, one of which offers “VA Notes” through which clinical notes, immunization records, lab reports and medical concerns are tracked.

The Patriot Guard Riders are volunteers and invited guests of the family of fallen soldiers who show their sincere respect for the heroes, their families, and their communities.

In the waning years of the Vietnam War, 17 communities stood up and created their own municipal and temporary veteran services offices. Of those, only one remains today. It operates as an independent 501c(3) nonprofit organization. Veterans Outreach Center (VOC) on South Avenue in Rochester was founded in 1973 and is recognized as the nation’s oldest communitybased nonprofit devoted exclusively to serving the needs of veterans and their families,” says Colonel Gary S. Yaple, president and chief executive officer of the 40 year-old Veterans Outreach Center, Inc. Posttraumatic stress disorder is not a new war-related phenomenon.

Few people are aware that the National Institute of Mental Health (NIMH) was established nearly 65 years ago to address the mental health issues of veterans after World War II. According to NIMH less than 1 percent of Americans have served in Iraq or Afghanistan — 2.7 million men and women over this past decade, most were under 25, many had never traveled before, and

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VA

Veterans Outreach Center

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2013

all were volunteers. For many of these soldiers, the war has left so called “invisible wounds” so that today more soldiers are dying from suicide than combat.

From a humble beginning as a grass roots organization focused on peer counseling, Veterans Outreach Center became a community pillar in the holistic treatment for PTSD after the condition was formally acknowledged in the 1980s. Today, licensed counselors offer a wide array of wellness services outside of those available through the VA, at no charge to veterans and their families.

One of the most widely used programs is the employment resource center, which helps veterans stabilize and re-enter the workforce through help translating military skills to today’s workforce needs.

The center provides career assessment and counseling, resume development and specialized vocational workshops. The Colonel Robert N. Abbott Veterans Community Technology Center is a state-of-the-art classroom facility where veterans access a full catalog of instructional opportunities in occupational skills, life skills and job readiness training. Recent additions to the course catalog have included OSHA certification in heavy machining and hazardous materials, CPR/AED first aid, and welding. Basic class offerings include everything from Internet and email literacy, word processing and office software, to Spanish language and architectural blueprint drafting.

For veterans whose emotional challenges have left them homeless, Veterans Outreach Center operates Richards House and Otto House to serve chronically homeless male veterans. The facilities accommodate up to 28 residents in a safe, homelike environment, where Continued on page 27