Gv igh no121 sept15 by In Good Health: Rochester's Healthcare Newspaper

in good Injury Free Tips for keeping your children injury-free during fall sports season

Are our kids waking up too early to go to school? The CDC says yes

GVhealthnews.com

September 2015 • Issue 121

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Rochester’s Healthcare Newspaper

Aremarkable Nurse’s Life Nurse Theresa Bowick has been in the news recently as the founder of Conkey Cruises, the Rochester nonprofit that encourages people to bike around the city. But there is a lot more to her life. Growing up poor, overweight and without hope, she was able to turn her life around to become a community leader, a role model. She is now working toward her doctorate degree in nursing

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CONTROVERSY Coca-Cola Controversy: Is Exercising More or Eating Less Better for Weight Loss?

Rochester General & Unity Health Many hospital mergers have failed. In Rochester, last year’s largest merge — between Rochester General and Unity — continues strong and it’s here to stay, officials say

New Law Allows Students to Self-Manage Diabetes At School

The Healing Power of Horses The Rochester area has several facilities that use horses for therapeutic purposes

More Reasons to Gobble Up Chicken See SmartBite column on page 10

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True Grit

Churchville Mayor Nancy Steedman continues Page 12 public duties despite cancer diagnosis

Meet Your Doctor Physician Nancy M. Bennet, director of Center of Community Health, is devoted to helping people control their blood pressure Page 6 September 2015 •

New president of Monroe County Medical Society, physician Joseph DiPoala, Jr., stresses need for more cooperation between providers, patients

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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2015 - 2016 Public Flu Clinic Schedule Our experienced Registered Nurses will vaccinate all 3 years of age and older, plus pregnant women. Most insurance accepted. No up-front out-of-pocket cost. We bill insurance directly! Employers, call us today to schedule a flu clinic for your employees and their families! Flu Prevention Partners has expanded its locations and is now serving New York State areas from Buffalo to Albany and Downstate to New York City. We offer multiple cost-effective vaccination services for the community and employer organizations. Center for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older get a flu vaccination and for people to get vaccinated as soon as the vaccine becomes available. Please see below for a complete list of scheduled public flu clinics for the 2015-2016 flu season. Preservative-free vaccine will be available on request. If none of the clinics listed below work with your schedule, call us to make an appointment to get vaccinated. BRIGHTON 09/12 Legacy at Clover Blossom 09/17 Jewish Community Center 09/20 Brighton Fire District 09/23 Lifespan 09/27 Jewish Community Center 10/15 Jewish Community Center 10/17 Brighton Fire District 10/25 Jewish Community Center CANADAIGUA 10/27 Finger Lakes Community College FAIRPORT/PERINTON 09/09 Perinton Community Center 09/15 Perinton Community Center 09/28 Perinton Community Center 10/08 Perinton Community Center 10/17 Perinton Community Center 10/30 Perinton Community Center 11/14 Perinton Community Center FARMINGTON 10/14 Finger Lakes Race Track GATES 09/14 Italian American Comm. Center 09/24 Westside YMCA 10/14 Italian American Comm. Center 10/17 Westside YMCA GENEVA 09/29 Geneva CSD: North St. School 10/21 Geneva CSD: North St. School GREECE 09/11 Greece Town Hall 09/13 Ridge Road Fire District 09/19 Georgetown Pk. Apartments 09/24 Greece Town Hall 09/26 Ridge Road Fire District 09/29 Greece Town Hall 10/05 Greece Town Hall 10/10 Ridge Road Fire District 10/21 Greece Town Hall 10/24 Ridge Road Fire District 11/01 Ridge Road Fire District 11/02 Greece Town Hall

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HENRIETTA 10/02 Legacy at Erie Station 1545 Erie Station Rd HONEOYE FALLS 10/21 Honeoye Falls Volunteer Amb. 210 East St IRONDEQUOIT 09/12 Laurelton Fire Department 405 Empire Blvd 09/13 Herrema's Marketplace 125 Pattonwood Dr 09/17 Irondequoit Senior Center 154 Pinegrove Ave 10/01 Herrema's Marketplace 125 Pattonwood Dr 10/04 Laurelton Fire Department 405 Empire Blvd 10/10 Herrema's Marketplace 125 Pattonwood Dr 10/15 Irondequoit Senior Center 154 Pinegrove Ave 10/31 Laurelton Fire Department 405 Empire Blvd 11/05 Herrema's Marketplace 125 Pattonwood Dr PENFIELD 10/06 Eastside Family YMCA 1835 Fairport Nine Ml Pt Rd 10/22 Eastside Family YMCA 1835 Fairport Nine Ml Pt Rd PITTSFORD 09/13 Pittsford Fire Station #1 8 Monroe Ave 09/19 Pittsford Fire Station #1 8 Monroe Ave 09/30 Pittsford Fire Station #1 8 Monroe Ave 10/04 Pittsford Fire Station #1 8 Monroe Ave 10/18 Pittsford Fire Station #1 8 Monroe Ave 10/20 Pittsford Ambulance 40 Tobey Rd 8 Monroe Ave 10/31 Pittsford Fire Station #1 11/15 Pittsford Fire Station #1 8 Monroe Ave SPENCERPORT 10/01 BOCES II, ESC Bldg. 3599 Big Ridge Rd 11/03 BOCES II, ESC Bldg. 3599 Big Ridge Rd 12/03 BOCES II, ESC Bldg. 3599 Big Ridge Rd VICTOR 09/12 Legacy at the Fairways 681 High St 10/10 Victor Fire Department 34 Maple Ave WEBSTER 09/16 Hegedorn's Market 964 Ridge Rd 09/26 Hegedorn's Market 964 Ridge Rd 10/03 Hegedorn's Market 964 Ridge Rd 10/12 Christian Reformed Church 1344 State Rd 10/18 Hegedorn's Market 964 Ridge Rd 11/08 Hegedorn's Market 964 Ridge Rd

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Flu Prevention Partners accepts the following insurance plans:

● BCBS/EXCELLUS/RMSCO ● MVP ● AETNA ● BCBS of WNY ● CIGNA ● INDEPENDENT HEALTH ● ● MEDICARE ● POMCO ● UNIVERA ● UNITED HEALTHCARE ●

Please be sure to bring your insurance card. For those with different plans and for those who are uninsured, the cost is only $45 (cash or check). For more information about Flu Prevention Partners please visit www.flupreventionpartners.com or contact Rebecca Locke at 585-737-7673 or email Rebecca at rlocke@wpvinc.com. As we may add more public flu clinics, please visit us online for the most up-to-date schedule at schedule.flupreventionpartners.com or call us at 585-568-8340. Follow us on Twitter for flu tips and information at @flu_prevention.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Sept. 8

Chiropractor to discuss fibromyalgia treatments Chiropractor Daniel Williams III will be the guest speaker at a meeting sponsored by Fibromyalgia Association of Rochester New York at 7 p.m., Sept. 8 at Greece Town Hall Meeting Center, 1 Vince Tofany Blvd. in Rochester. It’s

titled “Fibromyalgia, Connection with Chiropractic Applications.” Williams III says he has successfully treated many with fibromyalgia through chiropractic manipulations, nutritional support, low-level laser therapy, exercise and soft tissue techniques. He practices at Krapf Chiropractic Associates. The meeting is free and open to the public. No prior registration needed. For more information, visit www.farny. org or call 585-225-7515.

Serving Monroe and Ontario Counties in good A monthly newspaper published by

Health Rochester–GV Healthcare Newspaper

Local News, Inc. Distribution: 30,000 copies. To request home delivery ($15 per year), call 585-421-8109.

In Good Health is published 12 times a year by Local News, Inc. © 2015 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Chris Motola, George W. Chapman, Jessica Gaspar, John Addyman • Advertising: Donna Kimbrell, Marsha Preston, Cassandra Lawson • Layout & Design: Chris Crocker • Officer Manager: Alice Davis 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.

Sept. 8

Hearing loss group holds first meeting of the season Hearing Loss Association of America, Rochester chapter, welcomes community members with an interest in hearing loss to the group’s first meetings of the season on Tuesday, Sept. 8 at St. Paul’s Episcopal Church, East Avenue at Westminster Road, opposite George Eastman House. The daytime meeting will be at 11 a.m. and evening at 7 p.m. Both will review the HLAA annual national conference held in St. Louis this June. Rochester delegates will comment on their experiences and reactions to workshops and exhibits designed to help hearing-disabled individuals deal with their communication problems. Among these are the deleterious effects of untreated hearing loss, smart phones as assistive technology, and new diminutive microphones to help hear in noise. For more information visit www.hlaa-rochester-ny.org or tcall 585-266-7890.

Sept. 20

Physicians to discuss vegan diet in Brighton The September meeting of the Rochester Area Vegan Society will feature physicians Thomas Campbell and Erin Campbell who will speak about “Nutrition in Medicine: Healing Lifestyles.” Thomas Campbell is the co-author of The China Study and author of The Campbell Plan (2015). Both he and Erin Campbell run the new UR nutrition in medicine program (urnu-

tritioninmedicine.com). The event will start at 5:30 p.m. with a vegan dinner; the program will start at 7 p.m. Dinner is a vegan potluck. Participants are encouraged to bring a dish with enough to serve a crowd, and a serving utensil. Organizers can help non-vegetarians or others uncertain about how to make or bring a vegan dish; please call 234-8750 for help. The event takes place Sept. 20 at Brighton Town Park Lodge, 777 Westfall Road. Free to RAVS members. $3 guest fee for non-members.

Sept. 29

Former NFL running back to speak at luncheon East House, the private, nonprofit rehabilitation agency serving individuals with mental health and substance use disorders, will hold its annual Hope and Recovery Luncheon Sept. 29 with famed former NFL running back and Heisman Trophy winner, Herschel Walker, as keynote speaker. The annual event celebrates and raises awareness about the efforts of individuals who live satisfying and productive lives in recovery from mental illness and substance use disorder. Tickets for the luncheon are available for $60 for an individual seat and $130 for the VIP reception, which offers an opportunity to meet Walker in addition to the luncheon. For more information on luncheon seat purchases and sponsorship opportunities, please visit www.easthouse.org or call 585-238-4800. Continued on page 18

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

Free WiFi and Computer Bar Coin-Counting Machine Drive Up ATM with Enhanced Deposit located at 1575 Mt. Hope Ave.

Coca-Cola Controversy: Is Exercising More or Eating Less Better for Weight Loss?

oca-Cola has given a $1 million to a new research organization that has pushed a message that lack of exercise is a bigger factor in the obesity epidemic than is calorie consumption. Science, however, still counts calories as the main driver of weight gain for most people. Although exercise makes people healthier, cutting calories usually plays a bigger role in weight loss, experts say. “There’s an overwhelming amount of research demonstrating that, from an individual perspective, the key is decreasing calories modestly to successfully lose weight over time,” said physician Pieter Cohen, an assistant professor of medicine at Harvard Medical School. “It’s certainly great to add exercise, but to suggest that it’s the solution to the obesity epidemic … is ridiculous,” Cohen said. The new nonprofit organization, called the Global Energy Balance Network (GEBN), received $1.5 million from Coca-Cola last year to help launch the organization, according to The New York Times. In a statement, Steven Blair, a professor of exercise science at the University of South Carolina Arnold School of

Public Health and a member of GEBN, said that although the media have focused on “blaming fast food” and sugary drinks for the obesity epidemic, “there’s really virtually no compelling evidence that that, in fact, is the cause.” On its website, the GEBN does not deny that good health involves both eating a healthy diet and doing exercise. But the organization’s website also says there is “strong evidence that it is easier to sustain at a moderate to high level of physical activity (maintaining an active lifestyle and eating more calories)” than it is to be sedentary and eat fewer calories. In an editorial published in 2014, several members of GEBN wrote that increasing physical activity “may be more achievable than reducing [calorie] intake” for energy balance. However, Cohen disagreed with this message. An exercise program by itself typically doesn’t lead to much, if any, weight loss, Cohen said. One reason for this is that exercise increases appetite, which can lead people to eat more, Cohen said. Exercise also causes the body to produce more muscle, which is heavier than fat tissue. In addition, it’s usually easier

to cut calories out of the diet than it is to exercise at the levels needed to burn enough calories for weight loss. For example, in general, experts say a person needs to cut 500 calories a day from his or her diet to lose 1 lb. (0.45 kilograms) a week. In theory, it would be possible to burn 500 calories through exercise instead of caloric restriction, Cohen said. But this would be

difficult, because burning this amount of calories through exercise takes time, and in order for the strategy to work, people could not consume a single calorie more than they do already, despite their increased activity. “It would be much easier to eliminate those 500 calories [from our diet] than to find the time to exercise enough to burn 500 calories a day,” Cohen said.

Healthcare in a Minute By George W. Chapman Telemedicine Mostly due to advances in technology, telemedicine is becoming more commonplace. What has been holding back the proliferation of telemedicine is reimbursement from insurance companies. While some insurance companies have been reimbursing for telemedicine, they have kept it fairly quiet. Slowly but surely, more insurers are paying physicians for telemedicine services. It has been estimated that telemedicine will save over $6 billion annually. This does not take into consideration the reduction in sick time and lost wages for patients. Telemedicine allows physicians and their support staffs to treat and monitor more patients that will alleviate the pending shortage of physicians. Many states are now pushing insurance companies to cover telemedicine. Primary care physicians Not surprisingly, those of us who see the same primary care provider fairly consistently — such as an internist, family physician or OB-GYN — have fewer hospitalizations and emergency room visits than those who do not. A study of 49,000 medical visits published in “Health Affairs” found that the more familiar a physician is with your medical history and chronic conditions, the more successful your overall care will be. As the saying goes, “Too many chefs spoil the broth.” Retail clinics According to The New York Times, CVS is now one of our largest healthcare companies. CVS operates 1,500 clinics among its 7,800 stores. Focusing

on population health, CVS no longer sells tobacco products. CVS actually resigned from the U.S. Chamber of Commerce when it learned the chamber was lobbying against anti-smoking laws. Sixty percent of Americans live near a CVS store, so the ability of CVS to have an impact on population health is tremendous. Despite criticism from traditional providers, consumer satisfaction with retail clinics is high. Healthcare strains state/local budgets An analysis by the Pew Charitable Trusts discovered that healthcare spending accounts for 31 percent of state and local government budgets. But don’t blame expanded Medicaid. The majority of healthcare spending is on public employees and retirees. It has increased 61 percent over the last six years. Medicaid spending has also increased and the federal government pays for most of it. A recent article in the Journal of Health Economics estimates the state liability for retiree health benefits is $1.1 trillion, or about one third of state annual revenues. Ninety-seven percent of this huge liability is unfunded. Premium review According to a study in “Health Affairs,” premiums are lower in states that have review authority over commercial insurers’ proposed rate increases. New York state has this regulatory authority. Big insurers get bigger The merger frenzy among commercial carriers reached a high point last month when No. 2 Anthem announced its intention to purchase No. 4 Cigna

for around $50 billion. This would create the largest health insurer in the United States with about 53 million covered lives. Also last month, Aetna bid $35 million for Humana. Both deals have to be approved by shareholders and federal regulators. If approved, the impact of these mergers on premiums would not take effect until 2017 as most carriers have rates for next year set. Federal regulators will pay particular attention as more seniors opt for rapidly growing Medicare Advantage plans that are offered through commercial carriers. While larger is essential considering the necessary huge investments in technology and health information systems, the reduction in competition could leave many communities with little to no choice when it comes to health insurance. Massachusetts General the “best” For what it’s worth, U.S. News and World Report named it the best hospital out of 5,000 nationwide. The Mayo clinic in Rochester, Minn. came in second. Johns Hopkins in Baltimore and the UCLA medical center in Los Angeles tied for third. Physician shortage The shortage is expected to be felt by 2020 although there is much debate as to degree. In the meantime, medical schools have done their part by expanding enrollment. By 2018, there will be over 21,000 medical students, which is about 4,000 more than now. Teaching hospitals have done their part by voluntarily expanding the number of residency slots. The key word is “voluntarily”

September 2015 •

because they have not been reimbursed for the costs associated with the additional slots because the federal government has not done its part to address the shortage. Since 1996, there has been a cap on the number of residency slots to be reimbursed through additional Medicare payments. With more budget cuts on the way, many teaching hospitals will be forced to discontinue the additional slots they have added. As more medical students graduate, there are not enough U.S. residency slots or jobs available to them. They will be forced to find residency jobs abroad. Hospitals must get bigger Stand-alone community hospitals are finding it harder to compete with nearby hospital systems and even harder to negotiate rates with dominant insurers. Many community hospitals will not survive unless they become part of a larger system of care. Consequently, hospital mergers and acquisitions continue on the upswing. Not to be outdone by insurance mergers, the number of hospital merger and acquisition transactions in 2014 increased by 18 percent — 637 to 752 — over 2013. GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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“Successfully helping the disabled obtain their Social Security Disability/SSI benefits for 23 years.”

Meet

Your Doctor

By Chris Motola

Mary Perry, ADR 585-385-6855

www.disabilityrep.com 57 Monroe Avenue - Suite C Pittsford, NY 14534

Spreading the News

Have a newsworthy item you want to share with our readers? Send an email to editor@GVhealthnews.com

In Good Health

Rochester’s Healthcare Newspaper

Report: Excellus members get more medical benefits than standards require

xcellus BlueCross BlueShield paid out $823 million more in medical benefits on behalf of its insured members than what federal and state standards required of the health plan for the three years ending in 2014, according to officials.. Under federal rules, health plans are required to report three-year cumulative amounts of premium revenue collected and the amount spent on medical benefits for 2012-2014. Federal and state regulations set standards for overall medical spending levels for insurers in order to maximize benefits for consumers while capping health plan profits and administrative costs. State and federal standards set the minimum level of medical benefits to be 82 percent of premium revenues in the individual and small group markets and 85 percent for large groups. “Our members get high value health coverage with us,” said Christopher Booth, chief executive officer of the health plan. The numbers show the health plan paid nearly 91.5 cents of the insured premium dollar on hospital and physician services, prescriptions and other medical benefits -- significantly more than the standards require. The health plan spent $10.4 billion on medical benefits from 2012 to 2014 on its insured members, $823 million more than the $9.6 billion requirement for the three years, officials reported. Page 6

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Nancy M. Bennet, MD Director of Center of Community Health devoted to helping people control their blood pressure Q: Can you describe the blood pressure advocacy program your organization has developed? A: This is a program that is designed to work with physicians and nurses to help promote the management of high blood pressure. As you probably know, many areas related to blood pressure are not specifically related to medication. Some of them relate to behaviors, physical activity, nutrition and medication compliance. Others relate to social barriers to managing high blood pressure. So we have been very interested in the use of community health workers to help administer counseling and address social barriers to health care. So we developed the blood pressure advocates program and have been administering it for the last three years. We work with four different clinical sites with a community health worker who works with patients who have had trouble managing their blood pressure. Q: What are some of the behavioral obstacles? A: One of the big ones we know is that many people don’t get sufficient exercise. They may also be eating a diet that’s very high in salt, or very high in fat and just not very nutritious. There are some people who still smoke. So those are the three main things we address. Additionally, however, some people don’t really understand why they have to take high blood pressure medicine. They may think, “Oh, I feel fine, why should I take the pill?” So a big part is making sure people know how important keeping normal blood pressure is to staying healthy and avoiding heart attacks and strokes.

a simple questionnaire we had him fill out helped us to identify the problem. Another example is a patient who was prescribed medication twice a day, but had a lot of difficulty remembering to take it twice a day. So we went to the physician and asked if it was possible to get the patient on a once-a-day medication. Could she be on a medication with a lesser co-pay? So those are some of the examples. Many people have social problems that need to be addressed before they can even think about their medical problems. Problems like not having heat, not having a place to live, not having access to Medicaid. Q: On that note, you’re dealing with a lot more than medical problems. How do you get around the problems that keep you from even beginning to address their medical issues? A: Just so your readers are clear, we are not a medical center. We are a center for community health. We do community interventions, but don’t actually deliver clinical care except in the areas of prevention. Community health workers are placed into health centers. So we help patients identify barriers to their health. There are many resources available, but many people don’t know about them. So we can refer our patients to the agencies that manage those resources. Similarly, there are many patients who don’t know how to start physical activities, so we can help them find affordable gyms or public trails, for example.

Q: Do you screen patients? A: All the patients we see already know they have high blood pressure, and many are on medication. So we initially test them for behavioral factors and then we also talk about why they may be facing barriers. We had one patient who thought he was following a very good diet and was decreasing his salt and calorie intake, but every morning he was eating a fast food breakfast sandwich, which has a lot of sodium in it. He just didn’t know that was a problem, but

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

Q: Do you help patients find primary

In the News The URMC Center of Community Health recently received the 2015 American Hospital Association NOVA Award for its blood pressure advocate program. It began in August 2012 as a partnership between the University of Rochester Medical Center and Rochester Regional Health System. Its goal: To improve blood pressure control among those seeking care at neighborhood clinics by assisting clinic staff in addressing the social and behavioral determinants of patients’ health. The program has involved more than 1,000 patients over the past three years.

care physicians? A: Our patients are usually already in primary care. Other versions of the program are done out of churches and community centers, but ours is based out of a clinical setting. We feel community health workers can add to the medical team, because a lot gets lost in translation. We find that the counselors can help out a lot with the translation, but also help keep the physicians informed of issues that may impede the medical care they’re trying to deliver. Q: How successful have your efforts been? A: It’s an ongoing process, so we’re always looking at our numbers and trying to find ways to improve. Essentially, we keep them in the program until their blood pressure reaches a healthy level, and most of our patients are able to do that with assistance. Q: Are there any new programs in the works? A: We are very interested in expanding the program to new sites and finding a good way to scale up the program. We’re also looking at broadening the topics that our counselors can address. In particular, we are interested in helping patients understand their total cardiovascular risk and any issues they have related to that. Q: Locally, what infrastructure is in place that has helped you to perform your mission? A: We collaborate with the Rochester Business Alliance, which has a number of initiatives in place to help with high blood pressure. One is community outreach to organizations to talk about blood pressure. Another helps clinical offices. So we’re not doing this alone. Q: Are you still practicing? A: I do research and I teach and do administration primarily. So it’s been awhile. I was practicing internal medicine.

Lifelines Name: Nancy M. Bennet, MD Position: Director of the Center of Community Health, associate vice president of the University of Rochester Medical Center Hometown: Philadelphia, Pa Education: New York University Affiliations: Strong Memorial Hospital, University of Rochester Medical Center Organizations: Advisory Committee on Immunization Practices, Clinical and Translational Science Institute Family: Married, three daughters Hobbies: Exercise, reading, gardening

Rochester General & Unity Health Several hospital mergers around the country have failed but local officials say the largest merger between hospitals in Rochester, which occurred last year, is here to stay By Ernst Lamothe Jr.

ny merger can fall apart at any time. That continues to be the case even as hospitals nationwide continue to consolidate in the wake of the Affordable Care Act. Just this year, more than a dozen hospital mergers fell through. The proposed deal involving the Marietta, Ga.-based WellStar Health System, the largest nonprofit system in Georgia, with Atlanta-based Emory Healthcare failed, as did the potential allegiance of Boston Medical Center, the largest safety-net hospital in Massachusetts, with Tufts Medical Center in Boston. These possible transactions, thought to be done deals, were put on the shelf for various reasons. However, the largest merger among hospital last year in Rochester — between Rochester General Hospital and Unity Health — went through successful mergers last Bieber year. “America’s health care industry is going through a period of unprecedented change, including rapid consolidation, as health care reform demands higher quality, lower cost and greater value delivered through integrated, coordinated and widely accessible provider networks,” said Hugh Thomas, chief administrative officer, executive vice president of Rochester Regional. “Our goal has been to lead the transformation of healthcare in our community. Our success is largely due to our ability to embrace change and maintain our focus on taking care of our patients in the most appropriate settings possible, and providing high-quality, high-value care in all the communities that we serve.” Eric Bieber, president and chief executive officer, came to the Rochester Regional Health System last year after being part of University Hospitals Health System in Cleveland. His former hospital just announced its own merger with Robinson Health System. The announcement culminated a yearlong process starting in June 2014.

An exciting time

While Bieber was not part of the Rochester Regional merger, he understands the excitement and challenges that comes with a large joint venture. “It’s been an exciting and productive year,” said Bieber. “We’ve made great strides toward our goal of creating an integrated system designed to improve the health and wellness of our community.” With any merger, the work isn’t finished just because the federal government has made its approval. Like any relationship, it takes time to learn

each other’s strength and weaknesses. It also takes time to truly integrate a health system when you bring in a new partner. “We have been and will continue to focus on building a truly integrated health system that is focused on providing care to patients, where they need it, when they need it, in the most convenient and accessible settings,” said Bieber. The past year has been spent improving access by adding physicians in key areas such as primary care, cardiology, orthopedics and interventional neurology. During the past year, United Memorial and Clifton Springs hospitals came into the system. In addition, they created system-wide specialty services in cardiology, neurosciences and cancer so patients can receive standard care no matter where they enter the system. Bieber said as a nonprofit health system, Rochester Regional is committed to staying on the forefront of innovation and quality. The merger has expanded the health system to include more than 100 primary and specialty practices, rehabilitation centers and ambulatory campuses. It also supports programs that promote health and wellness, such as food pantries, community gardens, school-based clinics and the Refugee Health Center. “As one of Rochester’s top employers, we also contribute to the fiscal health of the entire region as the area’s second-largest employer,” said Bieber.

Fifth Annual Wayne County

BABY BOOMER & SENIOR

EXPO

Wednesday October 14, 2015 2:00PM – 5:00PM

Lyons Community Center 4 Manhattan Street, Lyons, NY

Admission free with Pre-registration • $5.00 at the door

There will be exhibits; presentations on health insurance/penalties, tax policies, caregiver services and more. REFRESHMENTS!

2:00-2:30PM Public Hearing CELEBRATING 50th ANNIVERSARY OF MEDICARE!

For information call 315/483-3200 Sponsored by: Wayne County Rural Health Network and Wayne County Department of Aging and Youth

‘Economic engine’

“Rochester Regional is an economic engine that provides well-paying, sustainable employment for nearly 16,000 individuals who live in our community and generate local spending and taxes.” With any new endeavor there are challenges and opportunities. “Merging multiple health systems has required us to change the way we’ve traditionally done things,” added Bieber. “We believe that success goes to those organizations that embrace change, and that is exactly what we have done.” The ACA has forced medical organizations to think about offering high-quality healthcare, while lowering cost without compromising care. “We all know healthcare is expensive — even in our region, which is already known to be well below the national average,” said Bieber. “We’re working to remain as efficient as possible in our operations, while also working to keep people healthy and reduce their need for the most costly services. Improved community health benefits everyone.” September 2015 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

The Healing Power of Forgiveness

ho wouldn’t be angry beyond words? After 38 years of marriage, two children and a lifetime of memories, she arrived home from work one day to find a hand-written note on her nightstand. He had left her to “find himself.” Completely blindsided, she dropped to the bed stunned in disbelief. He was gone. His clothes closet empty. His home office cleared out. With no word about his whereabouts, she racked her brain, desperate to make sense of his bizarre behavior. Had she missed something? Was he ill? And where in the world was he? Days later, her anguish was replaced by anger when she inspected his computer history and discovered that he had met someone online. He and his newfound “soul mate” had scheduled a rendezvous in Florida. It has been four years now since this nightmare, but to hear her talk about it today is to bring everything immediately to the fore — the deep emotional wound, the humiliation and the loss of life as she knew it. The retelling of her ordeal quickly ignites a seething anger just beneath the surface. How could he have done this to her and the kids? How could he have betrayed them? While my friend’s lingering bitterness is understandable, it is also unfortunate. By dwelling on this hurtful event and hanging onto her anger, she

is allowing her resentment and hostility to fester. Left unchecked, she risks bringing negativity into current relationships and experiences, or worse — letting her anger hurt the connections with the people who matter most in her life. I feel for her. Are you holding onto a grudge? Does an abiding bitterness occupy your thoughts? Nearly all of us have been hurt by the words or actions of others somewhere along the way. The wounds may be deep, but if you don’t practice forgiveness, you might be the one who pays the biggest price. While it can feel almost impossible to let go of a long-standing grudge and feelings of resentment, I can tell you from my own experience that forgiveness can bring a measure of peace that may enable you to move on with your life. It might even make room for compassion and understanding. I’ve also learned that forgiveness doesn’t just happen on its own or overnight. You must choose to forgive. It’s a process of change that requires commitment, courage, and self-reflection: Acknowledge and share your pain. Let it all out. Share your suffering with

KIDS Corner Tips for Keeping Your Children Injury-Free During Fall Sports

any children return to sports such as soccer, football, cross-country and volleyball when they return to school. Physicians in the division of sports medicine at Cincinnati Children’s Hospital Medical Center say preparation before the first day of practice is critical in helping to reduce the risk of injury. According to the American Academy of Pediatrics, approximately 3.5 million children and adolescents 14 and under get hurt annually playing sports or participating in recreational activities. More than 775,000 children and adolescents 14 and under are treated in hospital emergency rooms Page 8

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for sports-related injuries each year. Most of these injuries are traumatic in nature and occur as a result of falls, being struck by an object, collisions, and overexertion during unorganized or informal sports activities. More concerning, say Cincinnati Children’s Sports Medicine physicians, is the exponential increase in the number of overuse injuries experienced by young children today. These types of injuries are often the result of excessive training year-round or a rapid ramp up of activity after a period of inactivity. This scenario is common at the onset of any sports season. Doctors in the Division of Sports

someone you trust, and don’t hold back. When there’s someone there to really listen, your pain can become tolerable and perhaps more likely to dissipate. Empathize with the person who hurt you. I know this may not be easy. But none of us is perfect. The person who hurt you may have been acting out of self-preservation, an unspoken fear or pain of their own. Take a hard look at yourself. We all know that there are two sides to every story. What was your role in the breakdown of your relationship or in whatever has contributed to your resentment? Taking personal responsibility for our words and behavior and, importantly, their results is an essential part of forgiveness — not just of others, but of ourselves. Holding onto a victim mentality may serve to validate an unhappy situation, but it can also keep you mired in anger and thoughts of revenge. Embrace the benefits of forgiveness. Forgiveness can be empowering. It can set you free from the past and release the control the offending person has had in your life. There may be health benefits, as well, when you carry

Medicine at Cincinnati Children’s suggest these tips to ensure children’s safety when they return to school sports: • Four to six weeks prior to the onset of any sports season, children should start exercising regularly to get ready for their season. • Acclimate children to hot weather workouts by gradually increasing time outdoors in the heat and humidity. Acclimatization should occur for about the first 10 days to two weeks of practice to help prevent heat injuries. • Make sure children drink plenty of fluids and take frequent breaks: every 10-15 minutes while participating in sports or physical activity. Also make sure they wear light clothing and limit their exposure to the sun in the hottest part of the day. Applying towels soaked in ice cubes and water to the head and neck helps to stay cool. • When heat illness is suspected, move the athlete into the shade or coolest area nearby. Try to cool them as quickly as possible by exposing the skin to ice/ cold water and cool circulating air. • Young

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

a lighter emotional load. The more I practice forgiveness, the less stress I experience and the better I feel. Focus on the future. Rather than focus on the past and your wounded feelings, seek out positive, healthy relationships and experiences. Put your energy into finding beauty and kindness around you. When you are ready, actively choose to forgive the person who hurt you. Remember, you can forgive the person without excusing the act. Forgiveness is not about condoning. It’s a gift you give yourself — to release yourself from bitterness and vengeful thinking. Reinforce your forgiveness with a symbolic act. In my Living Alone workshops, participants take part in a “letting go” ceremony, during which they symbolically release anger, negative attitudes and unhealthy behaviors into a fire burning brightly in my fireplace. Many capture their thoughts in writing and find some relief in seeing their past hurts go up in flames. Symbolic acts such as this can help the healing process. As you let go of anger, grudges, resentments, and thoughts of revenge, you may no longer define yourself and your life by your past hurts and grievances. When you embrace forgiveness, you are embracing the promise of renewed compassion, kindness, and gratitude. Even some tenderness. Forgiveness can be healing and set you free. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, N. Y. For information about her upcoming workshop, check out the Calendar of Health Events in this issue or contact me at 585-624-7887 or through my email, gvoelckers@rochester. rr.com.

athletes with asthma should use preventative inhalers 20-30 minutes before exercise, do a gradual warm-up and should have an inhaler available to them during practices and during competition. • Make sure children wear any recommended protective equipment and ensure it is well-fitted. Protective equipment, such as helmets, can help prevent severe injuries such as skull fractures. Many head injuries result from helmets not being fitted or used correctly. Athletic trainers can fit helmets in the sports where they are needed. • Remind children to immediately tell the coach or trainer if they feel dizzy, “foggy,” have a lapse in memory, or have a headache after taking a blow to the head. • Parents need to be mindful that athletes who have symptoms affecting their thought process after taking a blow to the head should not return to the same practice, game or contest and should be evaluated by a physician prior to return to play.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

SmartBites

By Anne Palumbo

The skinny on healthy eating

More Reasons to Gobble Up Chicken

et’s not beat around the chicken coop: Heart disease is the No. 1 cause of death for both men and women in the United States; and high consumption of saturated fats raises our risk for this disease. Many of us are aware of this risk and have decreased our consumption of foods high in saturated fat — such as red meats — as a result. In fact, for the first time in over a century, Americans are eating more chicken that beef. Chicken is loaded with lean protein, serving up about 30 grams per average serving of skinless breast meat and just a tad less for skinless thigh meat. Protein is a powerhouse building block for muscles, cartilage, bones, skin and blood. This essential nutrient also makes up the enzymes that power many chemical reactions in our body, from digestion to metabolism. What chicken is not loaded with is fat, especially saturated fat or calories. It’s why so many doctors and nutritionists recommend its consumption over red meat. An average serving of skinless breast meat has only 1 gram of saturated fat and 165 calories, while the same size serving of skinless thigh meat has about 3 grams and 210 calories. How much saturated fat are we

allowed in a day? The Dietary Guidelines for Americans encourage us to limit our saturated fat intake to less than 10 percent of our total calories. Chicken is super rich in niacin, an important B vitamin that helps keep our skin, hair and eyes healthy and also supports our nervous and digestive systems. In addition, niacin plays a key role in converting food to energy and influences how we process cholesterol. According to the Mayo Clinic, consuming a niacin-rich diet may raise our good cholesterol by 35 percent, while also lowering our bad cholesterol and triglycerides (another type of unhealthy fat). Lastly, chicken is a good source of selenium, a trace mineral that does wonders for our thyroid and immune system. A powerful antioxidant, selenium also helps make special proteins

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Buy chicken that’s well-wrapped and then put the poultry in a produce bag to prevent cross-contamination. After prepping the chicken (the USDA advises not to rinse before cooking), wash everything that touched the meat with hot, soapy water. Whatever cooking method you use, the chicken must reach a temperature of at least 165 degrees fahrenheit to make sure all bacteria are destroyed. Buying chickens raised without antibiotics (look for the “USDA Organic” label) supports farmers who keep their chickens off these drugs and also preserves the effectiveness of antibiotics in humans. No hormones are ever used in the production of any US chicken.

Asian Chicken Salad with Cabbage Adapted from The World’s Healthiest Foods 2-3 boneless, skinless chicken breasts 5 cups Chinese cabbage, sliced thin 1 red pepper, sliced thin ½-1 cup shredded carrot ½ cup minced scallion ½ cup sliced almonds, toasted ¼ cup fresh cilantro 2 tablespoons toasted sesame seeds Dressing 2 tablespoons olive oil 2 tablespoons soy sauce ¼ cup rice vinegar 2 tablespoons honey 1-2 cloves garlic, minced

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pinch of red pepper flakes salt and pepper to taste Preheat oven to 350 degrees F. Tent chicken in foil, place on baking sheet and cook for 45 minutes (or until internal temperature reaches 165). Remove, open foil, and let cool. While chicken is cooling, thinly slice cabbage and pepper and shred carrot. Place in large bowl. Add minced scallion, chopped cilantro, and sliced almonds to this mixture. Using your hands, shred chicken into bite-size pieces and add to bowl. Whisk together olive oil, soy sauce, vinegar, honey, garlic, red pepper flakes, salt and pepper. Toss with cabbage-chicken mixture and then sprinkle with sesame seeds. (Double dressing if mixture seems too dry.) 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.

Caffeine Drinks: Bad for Kids Among other problems resulting from intake or caffeinated drinks are dehydration and rapid heartbeat By Deborah Jeanne Sergeant

eeping up with school, activities and friends challenges lots of tweens and teens. Pulled in so many directions, many young people turn to caffeine for an easy pick-me-up. A favorite caffeinated beverage can help them stay alert and full of energy. Coffee, energy drinks or shots, and many kinds of tea and soda, all contain quite a bit of caffeine. While a few cups of coffee throughout your day may keep you humming, Molly Ranney, registered dietitian practicing at Breathe in Pittsford, said that kids respond differently than adults. “I don’t think any caffeine for kids is good,” she said. “It’s a nervous system stimulant. But it’s being consumed; there’s no question about it.” Beyond short-term symptoms of jitters, hyperactivity and difficulty sleeping, too much caffeine can cause dehydration rapid heartbeat. “Kids have been hospitalized for

rapid heartbeat and have actually died for consuming vast amounts eight-hour energy drinks,” Ranney said. “Energy drinks can have more than 500 mg. of caffeine, about 14 times the amount of some soda.” The American Academy of Pediatrics recommends that teens and children consume no more than 100 mg. per day. Health Canada recommends children aged 4 to 6 to consume less than 45 mg.; aged 7 to 9, 62 mg. and aged 10 to 12, 85 mg. daily. By comparison, 8 oz. of black coffee contains 95 mg. and larger sizes contain even more. “A teenager is growing and caffeine, to some degree, can pull calcium from bones,” Ranney said. “It’s a time when a person should put the best nutrients in his body. You could impact that in a negative way by drinking too much caffeine. Don’t buy these drinks. If it’s not in the house, they won’t have exposure.”

Reducing the amount of available caffeine will help; however, it’s also important to supply something to replace it, especially if your children have been accustomed to grabbing energy drinks. Amanda Tourtellotte, a registered dietitian practicing in Geneva, encourages parents to push the intake of more healthful beverages, such as water. “By having water available as the go-to beverage rather than soda, juice or other high calorie beverages, you can promote healthy habits and limit caffeine intake.” If your children are bored by plain water, flavor it by adding a few pieces of frozen fruit, slices of citrus or peeled cucumber to a pitcher of ice water. Herbs such as mint or rosemary may also add a bit of zip to plain water as well. Reducing their “need” for caffeine can also help wean them off it. “Our kids are so over-committed,”

Ranney said. “They get lots of homework and some don’t get home until 8 o’clock at night. Some stay up until one in the morning and drink energy drinks to stay awake. But these kids are growing. Lack of sleep is detrimental.” When sleep deprived, a body releases more of the hormone cortisol. Chronically elevated cortisol levels and can contribute to obesity. Make sleep a priority, and keep in mind that growing teens may need more sleep than an adult. Many caffeinated beverages also pack a wallop of sugar, including sweet tea, fancy coffee beverages, and soda. These add unnecessary calories to the diet without any nutritional value.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

True Grit

Churchville mayor continues public duties despite cancer diagnosis By Kristina Gabalski

or village of Churchville Mayor Nancy Steedman, being in the public sector and keeping a positive attitude have helped her through a battle with cancer that began in November of 2014. Steedman, 67, was diagnosed with stage 3-4 ovarian cancer during a trip to the emergency department at Strong West in Brockport. She was suffering from abdominal bloating and a simple blood test revealed the cancer. Since her diagnosis, the mayor has tried to keep looking and functioning as normally and healthfully as possible. “The fact I am in the public eye made me work harder to look OK,” she says. “I did not want to look sick. I wanted to look good, normal, like I could do my job.” For Steedman, part of that meant wearing a wig. She has two — one custom ordered from a nearby salon and another provided by the American Cancer Society for free. She is grateful for the support provided by the ACS and has also taken advantage of its “Feel Good Look Better” class. “That was such a good thing for me,” Steedman explains. She learned

how to apply makeup to improve her appearance during chemotherapy treatments, including how to draw in her eyebrows once they had been lost to chemo. “You really do look better with makeup,” she says. “I kept my smile on and people just didn’t know I never missed a village board meeting,” she said, until she underwent surgery in July. Steedman ran for re-election last March. She needed to decide whether or not to seek re-election shortly after her diagnosis while she was undergoing chemotherapy. Her surgeon told her to run and to keep her plans for a vacation in Alaska, which she had scheduled for early summer. “It gave me a positive feeling that he was going to be able to fix this,” Steedman said. She has kept going, motivated by her mini goals of continuing as mayor and traveling, and even continues to serve as the first woman elected to the board of the Municipal Electric Utilities Association of New York State. The flexibility of her schedule was crucial in continuing as a public official, she explains. Her mayoral work is part time. “It allowed me the freedom

Churchville Mayor Nancy Steedman was diagnosed with stage 3-4 ovarian cancer in November last year but kept her regular work schedule. “I kept my smile on and people just didn’t know,” she says. “I never missed a village board meeting.” She says she is cancer-free now. She is shown at her office at the Churchville Village Hall. that if I didn’t feel good enough, not to come in,” she says.

Caring for mom

Steedman, who cares for her 88year old mother in her home, explains that mornings have been a time to help her mother get to appointments; afternoons have been spent in the village office; and evenings have been for village board meetings or crashing at home. “At village board meetings, I could

sit and talk. In the office, I could sit and make phone calls and do paperwork,” the mayor says, noting her duties are not physically demanding. Along with a positive, fighting attitude, Steedman says support from family, friends, co-workers, the community and cancer support groups has been a tremendous help. “I can’t thank everybody enough,” she says. She noted that retired Churchville Village Clerk Sue Davis took her to her regular Friday chemo treatments at Highland Hospital. Steedman took Fridays off and following morning chemo, she and Davis would go out for lunch at Palmer’s Fish Market and then spend the afternoon shopping. “We looked forward to the excursions,” Steedman says. The volunteers at Highland Hospital were wonderful during chemo treatments, she adds. They provided her with everything from manicures to chair exercises to soup from local restaurants. When first diagnosed, Steedman received a goody bag from Edna’s Hope, with items such as a diary, Teddy bear, scarf and toothbrush. Gilda’s Club has been wonderful, she says, and members of the Ogden Presbyterian Church Stitching for a Mission group presented her with a prayer quilt that she has kept close ever since. “Their prayers, thoughts and well wishes were so important,” Steedman says. She draped the quilt over her abdominal area affected by the cancer and visualized those praying for her. “I could see the ladies and people wishing me well,” she said. Steedman’s positive attitude has worked wonders. During her follow-up doctor visit recently after her surgery, she was told she is cancer-free.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

Yawn! School Starts Too Early for Teens, CDC Says M

ost U.S. middle and high schools start the day around 8 a.m., which public health officials consider too early for teens, according to a new report from the Centers for Disease Control and Prevention. School start times that are too early can contribute to lack of sleep among teens, most of whom don’t get the recommended 8.5 to 9.5 hours of shut-eye, the report said. In 2014, the American Academy of Pediatrics (AAP) recommended that middle and high schools start no earlier than 8:30 a.m. “Getting enough sleep is important for students’ health, safety, and academic performance,” Anne Wheaton, an epidemiologist in CDC’s Division of Population Health and co-author of the agency’s new report, said in a statement. “Early school start times, however, are preventing many adolescents from getting the sleep they need.” The researchers analyzed infor-

mation from a survey of nearly 40,000 public middle and high schools (and combined schools, with both middle and high school grades) given in 2011 and 2012. The average school start time was 8:03 a.m., the study found. Only about one in five middle school students, and one in seven high school students started the school day at the recommended time of 8:30 a.m. or later. However, school start times varied greatly by state. In Hawaii, Mississippi and Wyoming, there were no schools starting at 8:30 a.m. or later, but in Alaska and North Dakota, more than 75 percent of schools started at 8:30 a.m. or later, the report said. Schools started earliest in Louisiana, where the average start time was 7:40 a.m., and latest in Alaska, where the average start time was 8:33 a.m. In New York, the average start time was 7:59 a.m., according to the report. Too little sleep in adolescents is

Home School Phys Ed YMCA and other organizations offer physical education to those studying at home By Deborah Jeanne Sergeant

ore than 1.7 million kindergarten through 12th grade students received their education at home in 2012, an 18 percent spike since 2007, according to The US Department of Education. The US Department of Education further states that in the 2013-2014 school year, 87,803 of the 3,107,831 school-aged children in New York received their education at home. Home school parents rely upon curriculum workbooks, virtual classrooms or videos for the academic portion of their children’s education. To fulfill their children’s physical education requirement, home school parents use a variety of local resources. Andrea Berman, a home school mom who lives in Rochester, has never sent her 13-year-old son or 8-year-old daughter to public school. She takes a less formal approach to PE, allowing her children to participate in physical activities they enjoy. She feels the hands-off approach has helped them become more active, as her daughter and son both like playing with Wii U Fit, swimming, biking, trampoline jumping, walking, parkour, playgrounds, water parks, and, in winter, playing in snow and sledding. Free play opportunities help the children build confidence in their physical abilities and lay the foundation for enjoying physical activity. But the Bermans also participate in structured PE time, which teach following rules, fair play and goal setting.

Berman’s daughter likes gymnastics and yoga classes, obstacle courses, Tough Mudder events, and high ropes courses. Her son also likes weight training, cardiovascular workouts, and TRX suspension training at the JCC. Especially for students not as physically coordinated as their classmates, gym class can be an emotionally difficult period. Berman likes that her children “both get to do what they enjoy and makes them feel good,” Berman said. The Rochester area is home to many types of dance, martial arts and yoga studios, all of which can teach home school children ways to stay healthy. The expense of lessons adds up for families paying for classes; however, by instilling a lifelong love of activity, the kids will likely stay fit. That’s the goal of organizations like the Canandaigua Family YMCA, which can offer home school families an affordable way to provide PE. “As long as a parent is willing to engage with their child and plan time, the YMCA can help fulfill their PE credit,” said Todd Freelove, Youth and family director at the Y. The facility offers swimming, martial arts, mini triathlon training, team and individual sports and more. Most of these are provided in two-month sessions, making it easier for parents to allow their children to try out an activity or sport to see if it clicks.

linked with health problems such as obesity, symptoms of depression and not getting enough exercise, as well as poor academic performance, the researchers said. “Among the possible public health interventions for increasing sufficient sleep among adolescents, delaying school start times has the potential for the greatest population impact by changing the environmental context for students in entire school districts,” the researchers wrote in the Aug. 7 issue of the CDC journal Morbidity and Mortality Weekly Report. Educating parents as well as those who make decisions on school start times about the impact of sleep deprivation on teen health and academic performance “might lead to adoption of later start times,” the researchers said. Other steps that can improve sleep in teens include setting regular bedtimes and waking times (even on week-

ends), and removing technologies, such as computers, video games and mobile phones, from teens’ bedrooms. Because the study looked at school start times in 2011 and 2012, it was not able to determine whether some schools had changed their start times in response to the 2014 AAP recommendation.

Most school districts require home school families to submit a syllabus outlining what their students will learn at home to ensure it complies with the school’s standard. “We’d be willing to help a parent develop a syllabus,” Freelove said. “We’ve worked with home school families in Bloomfield, Penn Yan and Canandaigua.” Community sports leagues and

teams can also allow home school students a chance to learn and compete while staying active. An example in Rochester is the organized and open sports programs, which includes baseball, basketball, flag football, ice and floor hockey, soccer, softball, tennis, wrestling and more. The JCC, YMCA and some churches offer sports leagues and activities as well.

New Law Allows Students to SelfManage Diabetes At School

s parents get ready to send their children back to school this fall, the parents of children with diabetes have more than backpacks and school supplies to get organized — they must also plan for how their children’s diabetes needs will be met while they are at school. This year, thanks to a new state law, children will be permitted to carry diabetes supplies and self-manage their diabetes at school and at any school function. In addition, school staff members may volunteer to be trained to administer glucagon in an emergency when a nurse is not present. “The school year is always a stressful time for families of children with diabetes,” said Renee Williams, assistant superintendent of the Honeoye Falls-Lima Central School District and advocacy chairwoman for the American Diabetes Association. “Hopefully this new legislation will reduce some of that stress for families, knowing their children will be able to self-manage their diabetes at school and have emergency back-up care in the event that a

September 2015 •

nurse is not available.” Under the new law, students who have obtained parental consent and written permission from a physician or authorized medical provider may carry and use diabetes supplies, equipment and food to treat hypoglycemia during the school day, on school property and at any school function. The new law also allows unlicensed staff in both public and private schools to be trained to administer glucagon when a nurse is not present. Severely low blood sugar is very serious. If it happens, loss of consciousness may occur and a person may be physically unable to eat or drink a rapid-acting source of sugar (glucose) to restore proper glucose levels. A glucagon injection would be necessary in this type of emergency. In a news release, the American Diabetes Association states that it fought hard to have these issues addressed in state law and has posted additional information on its website. For more information, visit www. diabetes.org/nyschools.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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The Fat Girl Who Grew Up to Be a Swan The remarkable story of nurse Theresa Bowick, who leads Conkey Cruisers By John Addyman

heresa Bowick doesn’t hold anything back. She has a story to tell, a way of life to proselytize, and she doesn’t need much of a runway to take off. “I was the fat girl,” she says simply. “I grew up a fat girl. My hope is that no other child will have to grow up with the pain of being the fat girl.” Raised in a family where second helpings were expected, everything was fried and most of it smothered in gravy, the pounds packed on easily. Her elders told her, “Don’t worry about your weight.” And for a long time, Bowick didn’t. But life laid some pitfalls in her path. The 43-year-old went off to college and came limping back home to Rochester — pregnant, with a grade point average of 1.52 from school. And at home, things were not good. Her mother died of heart disease, her dad from pancreatic cancer, and her brother lost a similar battle. Even her cat Vernon was so fat he had five feet — four paws and a belly — plus diabetes. Bowick knew she had to change to survive, for herself and for her daughter, Jacynta. “I came back strong,” she said. “I went to the Rochester Educational Opportunity Center to become a licensed practical nurse. I graduated number one in my class.” She went to Monroe Community College and got her associate’s degree in nursing, then her bachelor’s degree from Brockport. Now she’s working on her doctorate in nursing at St. John Fisher. And she’s a nurse with the Office for People with Developmental Disabilities. Bowick paid attention to her mind, and also to her body. “I had to get healthy,” she said. “I joined Weight Watchers,” and in 2010, Bowick literally became a poster girl. “I entered a contest for inspiring stories. I wrote an essay, ‘From Buffets to Bikinis,’ and I won a prize and was featured on the cover of Weight Watchers Magazine.” She had lost more than 75 pounds. Her nursing specialty was working with the developmentally disabled. But in her community, in the center of Rochester, she found that ignorance about everyday health issues was pervasive. She started a radio show on WDKX, ‘Health Beats,” to air discussions on common health issues. But one morning almost four years ago, she found her calling. “I was jogging down the street in an area near my neighborhood, just off Conkey Avenue. A little kid yelled at me, ‘Hey lady,

Theresa Bowick talks to kids who are signing up for a Wednesday night ride with the Conkey Cruisers. It’s obvious how excited they are.

Rudolph Harris — “Mr. Rudy” to the Conkey Cruisers — is Theresa Bewick’s co-partner in the neighborhood cycling program and now, finance. He gets the bikes ready for cruise nights, and does a lot of the behind-the-scenes organizing. Page 14

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

are you on probation?’ I looked at him and stopped. ‘Why did you ask that?’ I said to him. He thought I was running from the police. She gently told the child, “I’m just exercising.” “I continued on my journey, and when I got to Joseph Street, I stopped to talk to some people I knew and a gentleman approached and told the people not to talk to me. ‘She’s the police,’ he said.” Surprised, Bowick responded, “I’m not the police, I’m a nurse.” “Don’t be fooled by her in her jogging shoes,” the man told everyone. “She’s undercover police. Nobody exercises in this neighborhood.” Bowick was stunned. “I said to myself, ‘OK, Lord – what’s the assignment? Nobody has a day like this.’ A young child thinks you’re running from the police and another person thinks you are the police. There’s work to do.” That neighborhood where nobody exercised. “I called the president of city council, Lovely Warren, and said, ‘Let me tell you about this day I had…I’d like to start a bicycle program.’” Bowick’s thought was to ask the city to put bicycle lines on the streets. Warren had a better idea: how about running the cycling program on the soon-to-be completed El Camino Trail? “I didn’t even know that in my own back yard they were laying down this $3 million trail. We went right out and looked at it,” said Bowick. Warren — who is now mayor of Rochester — set up meetings between Bowick and Miguel Melendez, who introduced her to the Greater Rochester Health Foundation and other people and groups who might help. “And the checks started rolling in,” Bowick said. “The first check, for $3,500, came from Excellus BlueCross. It was like a million dollars to us — until then, we had no money.” With that check, the Conkey Cruisers were born. Bowick’s idea was to get the community up and moving on two- and three-wheel cycles, with riders starting at age 2 and end-

ing in their 80s. The bikes and trikes were purchased or donated, helmets were supplied to all, and every riding session (the cruisers are wheels-down every Monday, Wednesday and Friday at 6 p.m. through the summer) begins with warm-up exercises and tips on getting and staying healthy. “It’s fun,” she said. “I don’t beat health and wellness into you, I make them a fun activity.” On one night, everyone went to a grocery store and received $5 to purchase as many healthy snacks as they could. Bowick and a good number of volunteers, some of them in healthcare as well, stress that healthy lifestyles — especially involving some activity — “can be a fun way to help manage chronic diseases like hypertension, diabetes, arthritis and obesity.” “Obesity is a multi-faceted disorder,” she said. “It has to be dealt with in a multi-pronged approach.” In fact, Bowick wrote a book, “Collard Green Curves — a Fat Girl’s Journey from Childhood Obesity to Healthy Living.” “It’s about navigating life and learning how to shed the weight and it’s not necessarily the physical weight, it’s the emotional and spiritual weight — the stuff in my head was much heavier than the stuff on my hips.” A third of the Conkey Cruisers are 55 and older, and Bowick admits she specifically recruits that group because they are the ones who can benefit most from exercise. And as beneficial as the exercise is, it’s the fun that gets folks on the bikes and down the road in the first place. “It kind of gives some people their childhoods back,” she said. “They really get excited about cycling again later in life.” And for people with balance issues, Conkey Cruisers have dozens of good-looking adult, stable tricycles. The cruisers made national news they didn’t need in June when 150 of their bicycles were stolen, virtually wiping out the program. The Rochester area responded almost instantly and Bowick said the Cruisers now have — are you ready for this — more than 450 bikes, all donated. Congresswoman Louise Slaughter recognized Bowick in Washington, saying that as a registered nurse, Bowick “understands the health benefits of

regular exercise, particularly at a time when our nation is experiencing an epidemic of obesity. Her efforts are getting an entire neighborhood up and moving, all the while restoring safety and a sense of home back to the residents.” Bowick received the Get Outdoors Award this year, presented by Park & Trails New York. And last fall, when she was being inducted into the MCC Hall of Fame, Rudolph Harris took the microphone and asked her to marry him — and she accepted. “Mr. Rudy” is the co-captain on Conkey Cruiser nights. Theresa takes care of the front end of the events; he gets the bikes out and ready to go on the back end. He also does a lot of last-minute problem-solving. When he spoke to the adult volunteers helping on a July night he told them, “This is your program: take care of it. It’s a community program. We want everyone to enjoy themselves — that’s the bottom line.” He wades through kids looking for a favorite bike, and stops to hug and encourage kids of all sizes. In the second week of July, eight children from one family joined the ride — and promptly veered off the path and kept the Conkey Cruiser bikes. They were back to steal more bikes until Mr. Rudy spoke to two of the oldest children and warned them that wasn’t going to happen again. And things went smoothly. With a sea of smiling faces lining up to sign out bikes, it was clear the cruisers are a success story. Lorna Wright, director of conservation programs for the Genesee Land Trust, which helped build the El Camino Trail and is one of the volunteers, said the Conkey Cruisers are a remarkable neighborhood success story. “This is a great way to get out, be active and enjoy nature,” she said. “The Conkey Cruisers were the first organized group to use the El Camino Trail.” In the midst of all the kids, all the adults, all the bikes, all the music playing in the corner park and all the preparations, Theresa Bowick was everywhere, enjoying it all. “I’m the fat girl who grew up to be a swan,” she said. “Now I’m taking all these other swans along with me…I don’t want to swim alone.”

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The Joys of Pregnancy

s I close in on the halfway point of my first pregnancy, I do feel very fortunate. I did not have one moment of morning sickness. I have had no specific food cravings. Life had pretty much been the status quo. Until one Tuesday morning when I woke up with hands so stiff, they wouldn’t open. A million thoughts raced through my head. How would I work? How would I drive? I couldn’t even wash my face or bathe myself. As the morning progressed, my hands did eventually free up, but they were tingly and felt like pins-and-needles — that “falling asleep” feeling. When my OB-GYN’s office opened at 9 a.m., I called and they fit me in at 9:45 that morning. I met with the nurse practitioner of the practice, Mary Wadsworth. She was pleasant and reassuring. She told me it was likely swelling in my hands that was putting pressure on my nerves causing carpal-tunnel-like symptoms. (My feet and ankles have been swelling also, so I had to invest in some larger shoes.) As a precaution, she ordered me to restrict my sodium and salt intake. I have never salted my food, but having high blood pressure already, you know which foods are high in sodium and which foods aren’t. Those prepackaged ‘diet’ meals found in the freezer section at most grocery stores? Yeah, they’re packed with sodium. Fast food (or anything restaurant made) is another culprit. Suffice to say, those are no-nos for me. I have also been trying to drink about 100 oz. of water a day. The nurse practitioner also recommend unsweetened iced tea since tea is a natural diuretic and will help ‘flush’ my system. My hands have not fully recovered, but I’ve learned to manage. I have also invested in two wrist braces that have helped. I keep them on as I sleep. For about a week, my hands were still stiff each morning, but they have progressively improved. In fact, a few

mornings when I woke up, my hands moved freely. A few days after I saw the nurse practitioner, I was scheduled for my monthly prenatal visit with one of the doctors in my practice. My regular OBGYN, Jeffrey Fichter, was on vacation that week. His colleague was pleasantly surprised to see my weight gain was very minimal — about 3 pounds so far. She also suggested I take a yoga or Zumba class as they have many health benefits and, depending on the type and style, can be pregnancy-friendly. I did a little research before deciding to take a yoga class or not. There are a few heated yoga classes called vinyasa yoga. I was initially weary of taking a vinyasa class for a few reasons. First, it’s the middle of summer, and the heat has been killing me. Also, according to the American Pregnancy Association, pregnant women should abstain from saunas or hot tubs, which can raise the body temperature too high and could cause birth defects. With that thought in mind, I chose not to try vinyasa. I have taken a few unheated foundations yoga classes at Breathė yoga in Greece. It’s relaxing, and it helps focus on stretching and proper hip and shoulder placement. On my first visit, I actually felt both of my hips ‘pop’ back into proper alignment. I imagine this can only help during childbirth. Also at that July prenatal appointment, I was given a packet of paperwork for my hospital stay as well as paperwork for the birth certificate. I had to send that to Strong Memorial Hospital, where I will deliver, within a month. I was initially shocked they had me do this so soon since I’m not due until January, but I am a planner, so I was glad to have that part of the process out of the way. I went for my 20-week ultrasound on Friday, Aug. 8. So far, halfway through my first pregnancy, everything is going pretty well. The baby and I are both healthy.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

Men’sHealth Men, Too, Are Affected by Eating Disorders One-third of the approximately 30 million people struggling with eating disorders are men By Deborah Jeanne Sergeant

ost people think only young women concerned about a slim appearance experience eating disorders. Fact is, one-third of the approximately 30 million people struggling with eating disorders are men, according to the National Eating Disorders Association. “It’s under the radar,” said Molly Ranney, dietitian practicing at Breathe in Pittsford. “There is a lot of disordered eating in young men.” Typically, most eating disorders occur in younger people, although no age is immune. Ranney said that the reasons behind eating disorders differs between the genders. Among young women, obsession with appearance and weight drives many to eating disorders. “Among the young men I’ve seen, it can stem from being athletic, like wrestlers who manipulate their weight to ‘make weight’ and fit into the right weight class or male gymnasts who need a certain body type,” she said. While there’s some truth to the fact that a lighter body will result in a faster run time than a heavier one, a competitive person who wants to excel can easily fall into an eating disorder if other factors come into play. “Most of the kids I see with eating disorders are smart, bright young kids who are high achievers and food becomes another way to control Litchie things,” Ranney said. Though some of the reasons behind why women and men develop eating disorders differ, other reasons are similar, such as the deep craving for control, especially if other areas of life seem out of control. “Many people cope with mental disorders by developing eating disorders,” said physician Rich Kreipe with the University of Rochester Medical Center and medical director of the WNY Comprehensive Care for Eating Disorders in Rochester. “It’s not a mental illness but a developmental illness. They may feel like they can’t control anything, see ads for weight control products, and say they can do that on their own. It’s a sense of accomplishment that they cannot eat when everyone around them is eating.” Typically, overweight people trying to drop pounds or athletes who want

to perform better feel content once they reach their goals. People with an eating disorder, however, never “arrives” at the ideal body, according to the experts interviewed for this story. Males often focus on bulking up, if they’re football players or bodybuilders, so it’s not always about getting light but cutting bodily fat and building muscle in unhealthy ways. This can include excessive protein consumption or eliminating fat from the diet. Gaining control is also an important element to note. Kreipe said that eating disorders often manifest as tight control on how much food and what types of foods the individual eats.

Does Your Son Have Eating Disorder? Could your son have an eating disorder? Mildred “Mimi” Litsche, registered dietitian in Canandaigua, listed a few possible signs: • “A drastic, significant change from his baseline eating behavior: if he was a good eater and consumed three meals a day, and now there’s a significant change in how much and what types of foods he has previously chosen. • “If the meal frequency changes. • “Choosing ‘performance’ enhancing formulas over whole food choices as the staple in the diet. Staple food or dietary choices are those which are frequently used in the diet on a daily or even every other day basis, so if a person is using ‘performance enhancing’ meals; energy bars; beverages, as their staple foods when they did not before, there might be a reason to investigate this more completely. The evidence supporting ‘performance enhancing’ dietary choices is very murky indeed. It’s hard to beat healthy whole food choices for any athlete. • “It is important to have an appreciation of how the athlete is respected within his group, since the social pressure surrounding this social position may have far reaching impact on their food choices. Young people are particularly vulnerable if they are still deciding on how to make life choices.” Litsche encourages families to eat together at least a few times per week and to talk about bodily image.

Addressing the problem

Addressing possible eating disorders in a confrontational manner invites resistance. Kreipe encourages approaching the issue from the perspective of concern about health and seeing a medical provider. Instead of trying to diagnose, express concern about nutrition and observable health indicators, like lack of energy. Suggest that visiting a medical provider can help his sports performance. And reminding the athlete that losing too much weight can actually detract from his performance if he loses too much muscle tissue and nutrients. Asking the coach for help may backfire, as not all coaches are upto-speed on nutrition as it relates to health. Some fall into the trap of telling their athletes what to do to get the results they want instead of how to become healthy to perform their best.

Does Testosterone Improve Men’s Sex Lives?

estosterone may not rev up men’s sex lives as much as they expect it to: Older men with slightly low testosterone levels did not experience improvement in their desire or intimacy after they took testosterone supplements, according to a new study. In the study, about 150 men age 60 and older were given daily testosterone supplements, and another 150 took a placebo. The men’s testosterone level at the study’s start was a little over 300 nanograms per deciliter, on average, which is on the lower end of the normal range for men. Three years later, there were no

differences between the two groups in how the men rated their level of sexual desire, erectile function and partner intimacy. Although men in the testosterone group did report a slight improvement in their satisfaction with intercourse, the effect was small and could have been due to chance, the researchers said. The findings agree with previous research that found that men with testosterone levels at the lower end of the normal range don’t see improvements in sexual function after taking testosterone supplements.

September 2015 •

Elizabeth Kavaler, a urology specialist at Lenox Hill Hospital in New York City who was not involved in the research, said that testosterone supplements may have a benefit for men whose testosterone level is lower than that of the men in the study — between 150 and 300 nanograms per deciliter. But “beyond that, it’s not going to help,” she said. Although some men may have the perception that testosterone supplements will make them stronger or more virile, “giving a guy testosterone is not the fountain of youth,” Kavaler said.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Oct. 13

Plant-based diet: eating for happiness. health

Cost is $125 and seating is limited. For complete details and to register, visit https://rochesterveg.org. For more information, call 585-234-8750.

Oct. 14, 21, and 28

Rochester Regional Health is offering a six-week course on plantbased diet. Participants will learn the rationale behind eating a whole-food, plant-based diet and how it can help prevent, arrest, and reverse problems such as obesity, diabetes and heart disease. Participants will discover that a healthy vegan diet is abundant as well as optimal for human health. They will learn how to nourish themselves, and their families and friends, with a diet free of animal products, and will be given advice on shopping for food, and eating at restaurants and social gatherings. The classes will take place from 6:15 – 8:30 p.m. every Tuesday from six weeks (Oct. 13 though Nov. 17) at Twig Auditorium, Rochester General Hospital, 1425 Portland Ave. Each class will consist of two entertaining multi-media lectures with a 15-minute break in between. During the break, there will be sampling of dishes following recipes that are included with the handouts for that class.

Workshop for Women Who Live Alone

YMCA offers free ‘Healthy Weight and Your Child’

several locations at different dates in September. Healthy Weight and Your Child engages the whole family, so together they can understand how the home environment and other factors influence the choices that lead to a healthy weight. To be eligible for the program, each child must be between the ages of 7 and 13, have a body mass index greater than or equal to the 95th percentile, be cleared by a medical provider, and accompanied by a parent or caregiver at every session. Families interested in this free program can sign up for an orientation session at rochesterymca.org/healthyweight or stop into their local YMCA.

The YMCA of Greater Rochester is one of five YMCA’s throughout the country, and the only Y in New York state, to participate in its inaugural Healthy Weight and Your Child program. The program is aimed at empowering children aged 7-13, with the support of their families, to reach a healthy weight and live a healthier lifestyle. It is open to the entire Greater Rochester community, including non-YMCA members and is completely free of charge. It will take place at Page 18

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By Deborah Banikowski

Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own,” is a three-part workshop offered for women who want to rediscover joy and contentment, and to gain the knowhow to forge a meaningful life on their own. You’ll meet others in similar situations and learn practical strategies to overcome loneliness, rediscover your true self and socialize in a couples’ world. The workshop takes place from 6:30 – 8:30 p.m. at House Content Bed & Breakfast in Mendon on three consecutive Wednesdays: Oct. 14, 21 and 28. Light refreshment is provided. The workshop fee of $145 includes a Living Alone binder, empowerment exercises and helpful resources. To learn more, contact Gwenn Voelckers at 585-6247887 or email gvoelckers@rochester. rr.com. Voelckers is the author of the column “Living Alone,” published every month in this newspaper.

ancer can affect any one of us, at any time. Sadly, thousands of people under the age of 20 are diagnosed with cancer every year, and it remains the leading cause of disease-related death for children. In September, we honor the strength and courage of children who are battling the many forms of cancer, as well as the young Americans who have lost their lives to these terrible diseases. Social Security provides benefits for children who suffer from many disabling diseases, including some forms of cancer. These benefits could help with the additional costs of caring for an ill child. The Supplemental Security Income (SSI) program pays benefits to disabled children who have limited income and resources. If you wish to apply for benefits for your child, you’ll need to complete both an application for SSI and a child disability report. The report collects information about your child’s disabling condition, and about how it affects his or her ability to function. Here are the steps to apply. • Review the child disability starter kit. This kit answers common questions about applying for SSI benefits for children, and includes a worksheet that will help you gather the information you need. You can view the starter kit at www.ssa.gov/disability/disability_starter_kits_child_eng.htm. • The SSI program is a “needsbased” program for people who have low family income and resources. SSI

Q&A Q: I heard that my disability must be expected to last at least one year to qualify for Social Security disability benefits. Does this mean I have to wait until I’ve been disabled an entire year before applying for disability? A: No. If you believe your disability will last a year or longer, apply for disability benefits as soon as you become disabled. Processing your application can take an average of three to five months. If your application is approved, we’ll pay your first Social Security disability benefits for the sixth full month after the date your disability began. For example, if your state agency decides your disability began on Jan. 15, we’ll pay your first disability benefit for the month of July. We pay in the month following the month for which benefits apply, so you’ll receive your July benefit payment in August. For more information about Social

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

has strict limits on the amount of income and assets you can have and still be eligible for SSI. Contact Social Security right away to find out if the income and resources of the parents and the child are within the allowed limits, and to start the SSI application process. • Fill out the online child disability report. At the end of the report, we’ll ask you to sign a form that gives the child’s doctor(s) permission to give us information about his or her disability. We need this information to make a decision on your child’s claim. You can access the child disability report at secure.ssa.gov/apps6z/i3820/main.html. Social Security also has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that they obviously meet our strict disability standards. Social Security’s compassionate allowances program enables us to identify diseases and other medical conditions quickly that invariably qualify under the listing of impairments based on minimal objective medical information. The compassionate allowances list allows Social Security to identify the most seriously disabled people for allowances based on objective medical information that we can obtain quickly. Compassionate allowances is not a separate program from the Supplemental Security Income program. You can learn more about compassionate allowances at www.socialsecurity.gov/ compassionateallowances. No matter what month it is, Social Security is here to provide benefits those with severe disabilities. If you or anyone in your family needs assistance, visit www.socialsecurity.gov/disability.

Security disability benefits, refer to our publication, “Disability Benefits,” at www.socialsecurity.gov/pubs. Q: How do I apply for disability benefits? And, how long does it take to get a decision after I apply for disability benefits? A: You can apply for disability benefits online at www.ssa.gov/disabilityssi/apply.html. To get a decision on your disability application usually takes three to five months to. The time frame can vary depending on • The nature of your disability; • How quickly we can get your medical evidence from your doctor or other medical source; • Whether it’s necessary to send you for a medical examination; and • Whether we review your application for quality purposes. Learn your claim status at www. socialsecurity.gov/claimstatus.

By Jim Miller

Medicare Options for Retirees Who Travel Dear Savvy Senior, What are the best Medicare coverage options for retirees who travel a lot? Almost 65 Dear Almost, The best Medicare options for retirees who travel extensively depends on your destination. Let’s start with a quick review of the different coverage choices Medicare offers beneficiaries today.

One option is Original Medicare, which has been around since 1966, and covers (Part A) hospital services and (Part B) doctor’s visits and other medical services. If you choose Original Medicare, you may also want to get a Medicare (Part D) prescription drug plan (if you don’t already have coverage) to cover your medication costs, and a Medicare supplemental (Medigap) policy to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles. Or, you could get Medicare Advantage (Part C) plan, which is sold through private insurance companies, that covers everything Original Medicare covers, plus many plans also offer prescription drug coverage and extra services like vision, hearing and dental care all in one plan. To help you evaluate your options, the National Council on Aging offers an online tool at MyMedicareMatters. org, and your State Heath Insurance Assistance Program (SHIP) provides free Medicare counseling — call 800677-1116 for contact information. You can also shop and compare Medicare health and drug plans and Medigap policies at Medicare.gov/ find-a-plan, or call 800-633-4227. Also note that whatever Medicare plans you choose to enroll in, if you find that they are not meeting your needs or your needs change, you can always switch to a different plan during the open enrollment period, which is between Oct. 15 and Dec. 7.

U.S. Travel

If you and your husband are planning to travel domestically, Original Medicare provides coverage everywhere in the U.S. and its territories (this includes all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa)

as long as the doctor or hospital accepts Medicare. But if you have a Medicare Advantage plan, your coverage may be restricted. This is because most Medicare Advantage plans (which are usually HMOs or PPOs) require you to use doctors, hospitals and pharmacies that are in the plan’s network within a service area or geographic region. So if you’re traveling outside that area, you may need to pay a higher fee, or your services may not be covered at all. Before enrolling in a Medicare Advantage plan, check the benefit details carefully to see what costs and rules apply when traveling outside your service area.

Traveling Abroad

If you’re planning to travel abroad, Original Medicare does not provide coverage outside the U.S. including cruising, except in rare cases, and Medicare drug plans will not cover prescription drugs purchased outside the U.S. either. But, there are some Medigap policies that do provide limited coverage abroad. Medigap C, D, F, G, M, and N plans will pay for 80 percent of medically necessary emergency care outside the U.S., but only for the first 60 days of the trip, and you have to meet an annual $250 deductible first. There’s also a lifetime maximum benefit of $50,000, so you’d need to cover any costs above that amount. If you have a Medicare Advantage plan, your coverage outside the U.S. will depend on the plan. Some plans offer emergency care coverage while others don’t. You’ll need to check your plan for details. If you want additional emergency medical coverage when traveling abroad, some good shopping sites are squaremouth.com and insuremytrip. com, which compare policies from major travel-insurance companies. Prices vary considerably, ranging from under $100 to several hundred dollars depending on your age, what they cover and how long you’ll be away. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. 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. September 2015 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

oseph DiPoala, Jr., a board-certified internist who has been a partner at the Ridgeview Internal Medicine group in Irondequoit since 1992, has recently been elected president of the Monroe County Medical Society. He spoke with writer Ernst Lamothe Jr.

tracking our patients such as when they make an appointment, then they miss it and don’t decide to reschedule. We should consider making follow-up calls to ask why they canceled and to help them make another appointment if possible. The problem is that people decide not to reschedule and then let their health problems continue until it pops up again. But by the time they feel additional symptoms, they are starting down the road of chronic disease. I don’t want patients falling through the cracks of the healthcare community. We also want them to be their own advocate and know their medical issues as well as possible. We want them to go to the patient portal so they can see all their medical visits and monitor the exams they have taken.

Q: What are some of your goals as a Monroe County Medical Society president? A: I am focused on transitioning physicians to the new ICD-10 protocol in October. This advancement is necessary because we are looking to elevate documentation. Communication is essential between primary care and hospitals when it comes to the discharging process. Any way we can look to improve the situation, we must. It is critically important to document for stability purposes and we have to try to identify disease prevalence in patients. We have to get doctors nationwide to understand the essentialness of this change and to get caught up as quickly as possible.

Q: What do you think is the relationship between the medical community and insurers? A: I believe we have a pretty solid relationship with insurers. I will have to be honest. I don’t necessarily think the Affordable Care Act has made the situation with insurers positive or negative. We are fortunate here in Rochester and Monroe County remain solid because we do have opportunities to sit down together around the table and talk about the issues. We need to continue to find ways to stay on the same page with each other

Q: Why is the process so essential? A: Over the past decade, there has been a movement for using more hospitalists for the care of hospitalized patients. That has left many primary care physicians out of the loop. We have to know what is going on and the importance of communicating the kind of care we are getting. Any medical organization cannot say they are doing a great job communicating if the documentation is not where it needs to be.

Q: You are a pioneer in electronic health records. How did that come about?

Q: With so many changes in health care how do you manage? A: With any change, the Monroe County Medical Society does offer information to help anyone who needs it. We understand that with any change, you have to educate physicians, patients, the physicians staff and others on how rules change and how reimbursements have changes. Q: What are your thoughts on the Affordable Care Act? A: Personally speaking, I am a strong supporter of the act. It has been a very good thing. People who didn’t have insurance previously are now covered. I like the fact that they eliminated penalizing people with pre-existing conditions. I really like the focus on general preventive care and screening invention. When you have things that are universally covered like vaccines and colon cancer prevention then you succeed in making the larger population healthier. Transition is never going to be easy. But change can be very good. Q: What are some of the challenges you see with the Affordable Care Act? A: I am opposed to high deductPage 20

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A Conversation with Joseph DiPoala, Jr., New president of Monroe County Medical Society stresses need for more cooperation between providers, patients ible plan. There is no magic solution to making healthcare extremely affordable. It is something that we have all been trying to figure out for years. But the focus has to be prevention and early invention. We have to push people to have regular checkups and not just coming in when they start having problems with chronic illness. We have to let people understand that even if chronic illness like diabetes and blood pressure existed in their own families, it doesn’t mean that the same case is inevitable for you.

A: In this new healthcare era, collaboration is key. There are so many initiatives, moving parts and programs, our No. 1 job has to be giving the patients the best care as possible. Every hospital or every organization is not going to be able to do it on their own. In our community, there does seem to be a lot of collaboration if we want things to work efficiently and effectively.

Q: Can you talk about the importance of collaboration?

A: We have to look at the whole patient. We have to be focused on

Q: What advice do you have for patients?

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

A: It has always been a real passion of mine to make sure people get electronic health records. I thought it just made sense from the beginning to make records more usable to the patients and valuable to the doctors as well. In the medical profession, we should always try to improve communication between the hospital and its patients.

Lifeline Current residence: Victor Education: Graduate of Colgate University and received his medical degree from the Pennsylvania State College of Medicine in Hershey Pennsylvania. He completed his residency in internal medicine and the primary care program for internal medicine at the University of Rochester in 1992. Family: Wife Sally and three children aged 21, 22 and 24. Favorite restaurant: Black and Blue Steak and Crab, 3349 Monroe Ave, Rochester Hobbies: Running Favorite movies: Anything with Clint Eastwood Favorite television show: “American Ninja Warrior “and “The Office” Facts that people don’t know about me: There was a time when I was deciding between motorcycle road racing and medicine. I made the right choice.

H ealth News NYCC named great college to work for New York Chiropractic College in Seneca Falls has been named a 2015 Great College to Work For. This honor by The Chronicle of Higher Education puts New York Chiropractic College in elite company. According to a new survey by The Chronicle, New York Chiropractic College (NYCC) is once again one of the best colleges in the nation to work for. The results, released recently released in publication’s eighth annual report on The Academic Workplace, are based on a survey of 281 colleges and universities. Only 86 achieved Great College to Work For recognition for specific best practices and policies. NYCC has participated in the program for seven consecutive years and has been honored each time. This year NYCC was recognized in 10 of the 12 categories evaluated. Among them were job satisfaction, collaborative governance, work-life balance, and teaching environment. Institutions found to be particularly outstanding are further recognized as Honor Roll schools. NYCC has achieved this coveted status for six consecutive years. In its category (small four-year schools), only one other school — Gettysburg College with seven years on the honor roll — has done as well. In New York, only one other school was named to the honor roll. “I am humbled by this affirmation of NYCC — but our real goal is not recognition — it’s being an institution and a community that values the needs and contributions of every individual. Everyone at the college helps to make this a great place to work,” said NYCC President, Frank J. Nicchi.

Dental practice install cavity-detection technology Dentist Salvatore Guarnieri of Pittsford Dental Excellence Center said his practice is the first in the area to install new, state-of-the-art, laser-based technology to detect, track and monitor tooth decay on all surfaces. Called The Canary System, this instrument enables dentists to detect the presence of tooth decay before the problem is large enough to appear on dental X-rays. A low-powered, pulsating laser light is shone on the tooth during a 3-second scan. The pulses of laser light penetrate below the tooth surface to permit detection of a Guarnieri cavity as small as 50 microns (20 times smaller than a millimeter) and as deep as 5 mm from the tooth surface. Detection of cavities is not simply a case of shining a light on a tooth surface; rather the device enables the dentist to gather accurate information about the status of the tooth’s structure and then store it to facilitate

ongoing analysis and monitoring. “The benefits of this technology are outstanding. We can now detect cavities very early, non-invasively and without X-rays,” said Guarnieri. “Best of all, through early detection, we can ‘re-mineralize’ early lesions without drilling and filling. The Canary System is an optimal intervention tool as it generates an easy-to-understand color-coded report showing the condition of teeth, which engages patients in their own oral care and enables us to develop treatment plans proactively.” The dentist said the Canary System is FDA cleared and proven effective over 10 years of study and two clinical trials.

Practice recognized for breastfeeding effort Rochester General Hospital Pediatric Associates (RGPA), part of Rochester Regional Health, is the first pediatric practice in Rochester to be named a New York State Breastfeeding Friendly Practice by the New York State Department of Health. This is a newly created NYS designation to acknowledge achievement in the area of breastfeeding. “The time and energy you put into developing and implementing your policy is clear and we applaud your commitment to supporting and promoting breastfeeding,” wrote Barbara J. Wallace, a physician who directs the NYS division of chronic disease prevention. “We are proud to receive this honor,” said Amy Saglibene-Parmelee a register nurse and lactation consultant at RGPA. “Breastfeeding offers so many benefits to both mother and baby and all of our caregivers are committed to making the experience a positive and valuable one for our patients.” The designation as a New York State Breastfeeding Friendly Practice is valid for a five-year period. Rochester General and Newark Wayne Community Hospitals have also been designated as Baby Friendly Hospitals for their breastfeeding efforts by the World Health Organizations.

Assisted living community planned in Greece Rochester Regional Health and Columbia/Wegman Acquisition II plan to build and manage a 111-bed assisted living community at 45 Mill Road in Greece. The new two-story New York state-licensed community will consist of 79 assisted living apartments and a 32-unit memory care community serving residents who need specialized care for Alzheimer’s and other dementias. The $23 million project, which is scheduled to be complete in fall 2016, is expected to create 140 construction and 70 permanent jobs. Rochester Regional Health’s The Village at Unity will manage the community. The Village currently manages more than 300 independent living, assisted living, memory care units. Columbia/Wegman Acquisition II, September 2015 •

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H ealth News which is building assisted living communities nationwide, is a joint venture between Rochester-based Wegman Companies and Seattle-based Columbia Pacific Senior Housing Fund II. “My grandfather, father, and now my siblings and I, have been involved with Rochester Regional Health for many years—and we share similar values when it comes to senior care,” said Jay Wegman, vice president, Wegman Companies, Inc. “We are proud to partner with Wegman Companies as we share a commitment to excellence,” said Don Felter, president, Rochester Regional Health Housing Division. “Residents living in this new community will enjoy a state of the art facility, and benefit from our extensive experience and resources in support of their health, safety and well-being.”

Volunteering at Rochester General Hospital

Thompson orthopedic program recognized UR Medicine’s Thompson Health has earned The Joint Commission’s Gold Seal of Approval for demonstrating compliance with the national accrediting body’s state-of-the-art standards for both hip replacements and knee replacements. The Gold Seal of Approval is a symbol of quality reflecting an organization’s commitment to providing safe and effective patient care, and comes after a rigorous, on-site review at Thompson Hospital in April. Joint Commission experts were hosted by an interdisciplinary team that included not only Thompson staff members but surgeons from Canandaigua Orthopaedic Associates. The experts evaluated Thompson’s compliance with national disease-specific care standards as well as with specific requirements related to hip and knee replacements. Clinical practice guidelines and performance measures also were assessed. “Thompson is extremely pleased to receive disease-specific care certification from The Joint Commission, the premier healthcare quality improvement and accrediting body in the nation,” said President/CEO Michael F. Stapleton, Jr., FACHE. “The certification provides us with the framework to continue creating a culture of excellence for those in our community.”

One hundred and forty high school and college students (above) volunteered at Rochester Regional Health this summer. The students are part of the Medical Pathfinders program and they assist with the non-clinical needs of patients and family members at Rochester General Hospital. In all, the students contributed more than 11,000 hours of volunteer time.

Walk to End Alzheimer’s returns to four Rochesterarea communities The Alzheimer’s Association Rochester & Finger Lakes Region will host the Walk to End Alzheimer’s in four Rochester-area communities. It’s the nation’s largest event to raise awareness and funds for local Alzheimer’s care, support and research. Each Walk begins at 10 a.m. with registration and check-in at 9 a.m. • Sept. 26: More than 1,000 peo-

ple are expected to participate at the Rochester event. It begins and ends at Monroe Community Hospital, 435 E. Henrietta Road. It features a 1.1-mile and 3.5 mile route along the canal. • Oct. 17: More than 400 walkers are expected to participate in Canandaigua. It begins and ends at the Granger Homestead & Carriage Museum, 295 N. Main St. It features a 1.1 mile walk through the city’s historic neighborhoods and a 2.2-mile walk that extends into Sonnenberg Gardens and Mansion State Historic Park. • Oct. 24: More than 250 walkers are expected to participate in Brockport. It begins and ends at the College

at Brockport’s Alumni House, 142 Utica St. It includes a 1-mile route around the campus and a 2-mile route that extends into Main Street Brockport. • Oct. 24: More than 550 walkers are expected to participate in Geneseo. The walk begins and ends at Village Park on Main Street. It features a 1-mile route through town and a 3-mile route that includes the campus of the State University of New York at Geneseo. All routes are wheelchair accessible. Start or join a team at alz.org/walk or contact Vanessa Pschirrer at 585-7605472 or vpschirrer@alz.org.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

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The Healing Power of Horses The Rochester area offers several facilities that partner horses to help people — and many have found relief in working with the animals By Deborah Jeanne Sergeant

any people enjoy horses as recreational and competitive companions but a growing number of people are using them for therapy purposes. Experts say that the bond created between client and horse achieves results not possible otherwise. Therapeutic/adaptive riding refers to using groundwork or riding to help people with social problems, developmental delays, behavioral health or physical impairment improve their lives. Hippotherapy represents a medical treatment overseen by a person such as a physical, occupational or speech therapist who possesses further training in using horses for hippotherapy. The Rochester area offers several facilities that partner with horses to help people. Susan Taylor-Brown, serves as director of operations at EquiCenter, Inc. in Honeoye Falls. She’s also a clinical professor at Golisano Children’s Hospital. EquiCenter’s 200-acre ranch serves

100 clients from ages 3 to 89 with individual and group riding. Some clients are referred through their physicians or schools. The largest number of riders are on the autism disorder spectrum. Other clients include at-risk youth, those with developmental disabilities, neurological conditions, life-altering injuries and veterans. The facility boasts instructors who are certified by Professional Association of Therapeutic Horsemanship International (PATH) and has been recognized as a premier location by PATH. “It involves a focus on training and safety,” Taylor-Brown said. “We assess how a horse is doing with every ride, for example.” EquiCenter’s 200 volunteers keep operations humming. Many of the instructors are part time. Only a handful of staff members are paid. The organization carefully screens and trains horses, most of which come to EquiCenter as their “second career.” Taylor-Brown said that many of them are on loan from area horse owners who receive free boarding in exchange

At Purple Pony Therapeutic Horsemanship in Bergen, Karen Reeverts, an instructor and volunteer, uses her six equine “assistants” to help with about two dozen clients in group lessons. Page 24

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EquiCenter Inc. in Honeoye Falls serves 100 clients from ages 3 to 89. The location boasts instructors who are certified by Professional Association of Therapeutic Horsemanship International. The largest number of riders are on the autism disorder spectrum. for the horse’s use by the programs. While it may seem a lot of work to run a facility like EquiCenter — and it is — horses offer an experience that deeply affects clients. “Horses are an incredibly healing force for people, whether a 3-year-old with developmental disabilities or veterans coming back from tours of duty and having trouble dealing with themselves and reintegrating into the community,” Taylor-Brown said. “Horses provide a non-judgmental, personal mirror as how you feel. If you’re uptight, the horse is uptight.” At Windhorse Farm in Hilton, Joseph Lancia oversees equine assisted psychotherapy, as well as working with other animals. Even not mounted, clients connect to his four horses in ways hard to replicate without the animals, he said. “Horses work along more the prey continuum than predator,” Lancia said. “Their lives depend on being aware of their environment. They are very sensitive to emotions and intentions people carry. They are very responsive to emotions and intentions clients may not be aware of themselves.” Lancia works with veterans and private clients, about 12 weekly individually and in group sessions. At Purple Pony Therapeutic Horsemanship in Bergen, Karen Reeverts, an instructor and volunteer, uses her six equine “assistants” to help with about two dozen clients in group lessons. The 60 volunteer-run organization serves clients with cerebral palsy, mental and speech delays, traumatic brain injuries, and Down syndrome with both ground-based and mounted lessons.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2015

“There’s something the horse can provide as a living, breathing entity that has a relationship with riders that motivates and drives us to provide these riders with opportunities to be mobile and develop relationships with these horses,” Reeverts said. Heritage Christian Stables in Webster, which is recognized by PATH as a premier accredited center, primarily offers therapeutic horsemanship, and has been working on adding hippotherapy. Lorrie Renker, director and PATH master instructor, said that few therapists in the area have been trained in hippotherapy, so it’s been challenging to develop the program. Heritage Christian Stables serves about 100 clients annually, who have a wide variety of physical and mental challenges. Volunteers help care for Heritage’s 13 horses and facilitate lessons since many riders need someone to lead the animal and walk alongside riders to ensure their safety. Using horses to help clients “has a lot of cognitive, psychological physical, and emotional benefits,” Renker said. The horse’s gait, for example, mimics a human’s and gives the feeling of ambulation to someone who has never walked. That, combined with improving balance and core and leg strength, has helped some clients improve their ability to walk. “Horses are non-judgmental and honest in their interactions with people,” Renker said. “Some people would rather do something else. But for some, the horse is very motivational.” All of these organizations use volunteers. If you enjoy horses and helping people, consider lending your time to benefit others.