in good ‘Healthy Mondays’ Good Recipe for Central New York
Program started at Syracuse University wants to promote ‘Healthy Mondays’
High Blood Pressure Nation One in four Americans treated for high blood pressure
November 2011 • Issue 143
CNY’s Healthcare Newspaper
Why so many seniors have been diagnosed with chlamydia, herpes, gonorrhea, HIV and other sexually transmitted diseases. See inside SYRACUSE OASIS TURNS 10 Program that offers seniors courses ranging from computer to photography is celebrating 10 years
✓ Have you seen the lunch menu at your kid’s school? Be prepared to be surprised
Crouse Now Offering Bariatric Surgery Team from Community General moves to Crouse
More Teen Males Using Condoms
Hospice 101 Hospice care can help families, patients
Franciscan Companies launches initiative to help seniors live at home longer, independently
Robotic-assisted coronary angioplasties Michael Fischi talks about a new robotic-assisted coronary angioplasties at St.Joe’s November 2011 •
The percentage of teen males aged 15–19 years in the United States who used a condom the first time they had sex increased between 2002 and 2006–2010, according to a report from the Centers for Disease Control and Prevention.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
WHEN YOUR HEART IS ON THE LINE, GETTING HELP FAST CAN MAKE ALL THE DIFFERENCE. Chest pain isn’t the only sign of a heart attack. Shortness of breath; back, arm or jaw discomfort; severe nausea; or heavy sweating also may indicate a problem. As the first Accredited Chest Pain Center in Syracuse, St. Joseph’s knows just how important it is to diagnose and treat these symptoms quickly and accurately. Seeking medical help right away can help protect you from serious heart damage and create a more positive outcome from a potentially dangerous situation. So, don’t hesitate to call 9-1-1. Your heart—and your life—may depend on it.
HEART ATTACK? EVERY SECOND COUNTS. CALL 9-1-1. St. Joseph’s Hospital Health Center 301 Prospect Ave. Syracuse, NY www.sjhsyr.org St. Joseph’s Resource Line (Physician & Program Information): 315-703-2138 St. Joseph’s is sponsored by the Sisters of St. Francis. Franciscan Companies is a member of the St. Joseph’s Hospital Health Center network.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Have you seen the lunch menu at your kid’s school? Be prepared to be surprised
By Deborah Jeanne Sergeant
o your children eat healthfully at school? If you’re not sure, their daily lunch menu may surprise you. Some schools offer mostly fat- and calorie-laden fare and few vegetables. These lunches offer fewer nutrients than many parents would like to see on their kids’ plates. “They have high carb diets, soda machines, pizza, and macaroni & cheese at schools,” said Dennis Nave, a family practice physician with Family Medicine Associates of Central New York in Syracuse. “The choices aren’t that good. They need more vegetables, fruit and water.” George Franchell, a naturopathic doctor and volunteer wellness educator at Getting U Healthy, Naturally in Syracuse, said that “it likely varies from school to school, and while there might be a growing number of schools trying to improve their school lunches, there are way too many schools that not only do not provide adequate nutrition, but actually provide less-than-healthful meals.” Area experts said that the way to nudge children toward better food choices in the lunch line begins at home. “When a parent provides healthful choices in the home, they provide a template, or guide for children to model after when they are outside the home,” said Matt Kovach, president and founder of Renewal Nutrition in Syracuse. Nave agrees. “Kids learn from their parents,” he said. “The bad habits the parents have the kids will pick up on.” Don’t be discouraged if your small children do not like many vegetables, keep offering them. It can take up to 20 times of trying a new food before
children like it. “Talk to your children about the healthful food you purchase and serve at the table,” Kovach said. “Take your children shopping and make them part of the experience. Make the experience fun and rewarding and it will follow them for a lifetime.” Teach portion control by using child-sized plates for small ones and serving a small amount first. When the plate is cleaned, offer vegetables as seconds. Some families find that a junk food night can let their family indulge in “bad” food occasionally (no more than once a week) without guilt and teach their kids that moderation is the key to healthful eating. “When your child is buying lunch, look at the menu together,” Kovach said. “From the selections, what do they want to choose? Praise for healthy selections and give gentle encouragement if they have missed the mark a bit.” Equip older kids with smart strategies for selecting more healthful items from the lunch line. If the veggies at school aren’t seasoned, perhaps your children simply need to add condiments to improve the food’s appeal. “Some Italian dressing on beans or broccoli could be a much tastier option than plain,” said Cynthia Todd, a registered dietitian in private practice in Marcellus. “There is nothing wrong with dressing up your veggies. They don’t need to be eaten plain to be beneficial or healthy.” Kids need to make wise choices for the right reasons. Focusing too much on body image can spawn eating disorders or distorted self-image. Explain how the vitamins and minerals in healthful foods work to help them play sports better, perform better on tests,
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
and stay well. The nutritionally void calories in many processed foods will not help them achieve their goals. Tell them that selecting foods closest to how they are found in nature is a safe bet. For example, a piece of whole, unsweetened fruit is better than a fruit snack or a cup of sliced fruit in syrup. Processed, pre-packaged foods are more likely to be unhealthful. The same principle applies to sources of carbohydrates. Whole grain varieties offer more nutrition than processed white pasta, rice, crackers and bread. Baked potatoes (peels intact) are better than mashed potatoes sans peels. Kids need to choose lean sources of protein, such as broiled, roasted or grilled meat instead of breaded and fried meat. Modest portions of low-fat milk, cheese and yogurt help round out a balanced diet. Steer kids away from sugary drinks, flavored milk and fruit punch. As a compromise to soda-addicted teens, diet soda can be an option. Or making soda a treat, no a go-to beverage for hydration. If your children’s school lunches don’t provide adequate nutritious choices, get involved with your school. Todd urges parents to advocate for their kids to see that their schools offer nutritious, appealing food. Attend school meetings and voice your concerns. Volunteer to form a
committee that can explore ways to include more fresh fruits and vegetables such as tapping area farms for donations or discounts, starting a program of growing veggies as potted plants in the classroom or building a school greenhouse. In the meantime, send brown bag lunches with your children. “Make them part of the decision process and guide them along the way: a sandwich, with their favorite whole grain bread, colorful veggie, fruit and a ‘healthier’ snack,” Kovach said. Kovach periodically accompanies his nine-year-old to scholastic events. “I am quite encouraged to see the absence of soda machines,” he said. “Instead, vending machines provide much healthier alternatives, such as water and life water. “I’m still waiting to see the apple machines we had in the high school when I was growing up. After a grueling football practice, we’d drop in a quarter and keep the doctor away for another day.”
The following web sites can help your kids eat right at school and anywhere else: www.kidshealth.org www.eatright.org www.mypyaramid.gov
112 Million Annual Incidents of DWI CDC report shows 11,000 are killed every year in crashes involving alcohol-impaired drivers
dults drank too much and got behind the wheel about 112 million times in 2010—that is almost 300,000 incidents of drinking and driving each day—according to a CDC Vital Signs study released recently by the Centers for Disease Control and Prevention. “The four million adults who drink and drive each year put everyone on the road at risk,” said CDC Director Thomas R. Frieden. “In fact, nearly 11,000 people are killed every year in crashes that involve an alcohol–impaired driver.” The study also found that: • Men were responsible for 81 percent of drinking and driving in 2010. • Young men, aged 21–34, made up only 11 percent of the U.S. population in 2010, yet were responsible for 32 percent of all episodes of drinking and driving. • Eighty–five percent of drinking and driving episodes were reported by people who also reported binge drinking. Binge drinking means five or more drinks for men or four or more drinks for women during a short period of time. “Drunk driving is a public health problem with far–reaching effects,” said Linda C. Degutis, director of CDC’s National Center for Injury Pre-
vention and Control. “Drunk drivers, who have delayed reaction times and reflexes, put even the most responsible drivers and pedestrians in harm’s way. Public support to prevent drunk driving is strong. Thankfully, there are proven ways to protect everyone on the road.” Proven, effective strategies to prevent alcohol–impaired driving include: • Sobriety checkpoints: At sobriety checkpoints drivers are stopped to assess their level of alcohol impairment. According to the Transportation Research Board, more widespread, frequent use of these checkpoints could save about 1,500 to 3,000 lives on the road each year. • Minimum legal drinking age laws: These laws prohibit selling alcohol to people under age 21 in all 50 states and the District of Columbia. Keeping 21 as the minimum legal drinking age helps keep young, inexperienced drivers from drinking and driving. • Ignition interlocks: These devices prevent drivers who were convicted of alcohol–impaired driving from operating their vehicles if they have been drinking. Interlocks are effective in reducing re–arrest rates from drinking and driving by about two–thirds while the device is on the vehicle.
One in Four Americans Treated for High Blood Pressure
ne in four American adults (55.1 million) was treated in 2008 for hypertension, also known as high blood pressure, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. The federal agency also reported that for hypertension treatment in 2008: • About 29 percent of blacks were treated for hypertension in contrast to 25 percent of whites, 15 percent of Hispanics, and 20 percent of individuals of other races. • Total expenses were $47.3 billion, with $21.3 billion spent on prescription medicines; $13 billion spent on doctors’ office and outpatient visits; and anoth-
er $13 billion spent for hospitalizations, emergency department visits and home health care. • Average treatment costs were higher for Hispanic patients ($1,272) and for black patients ($1,037) and patients of other races ($1,211) in contrast to the average treatment costs for whites ($748). • The percentage with reported treatment for hypertension was higher for adults age 65 years and older (60 percent) than those in the younger age groups, 45–64 years (32 percent) and 18–44 years (5 percent). • Slightly more women received treatment for hypertension than men, 25 percent and 23 percent, respectively.
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In Good Health is published 12 times a year by Local News, Inc. © 2011 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: (315) 342-1182 • Fax: (315) 342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers and Contributing Writers: Suzanne M. Ellis, Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, Deborah Jeanne Sergeant, Anne Palumbo, Aaron Gifford, Joyce Gramza, Chris Motola, Melissa Stefanec • Advertising: Jasmine Maldonado, Tracy DeCann • Layout & Design: Chris Crocker • Proofreading: Shelley Manley • Ofﬁce Manager: Laura J. Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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Epilepsy group schedules ‘Dinner with a Doc’ events The Epilepsy Foundation of Rochester-Syracuse-Binghamton is hosting a series of four dinners in November to celebrate Epilepsy Awareness Month. These dinners are for individuals with epilepsy or a seizure disorder and their families as well as for service providers such as service coordinators, social workers and school personnel. They are free and open to the public. • The first of these series will be in Rochester at 6 p.m., Nov. 3, at Rustic Village Apartments Entertaining Center, 999 E. Henrietta Rd., Rochester. Dr. Michel Berg from the Strong Epilepsy Center in Rochester, will present “Living with Epilepsy.” • The second dinner will be held on Nov. 10 in Corning, the third on Nov. 15 in Ithaca and the fourth and final dinner in the series will be held on Nov. 29 in Syracuse. Visit www.epilepsy-uny.org for more details.
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Preference given for disabled veterans Page 6
Frailty conference features national speakers Frailty is a complex condition for aging adults. When combined with an injury, most commonly a fall, the effect can be devastating. The conference “Frailty and Falls: A Teaching Day for Professionals” will bring several professionals who will share new research, treatments and best practices to help older adults achieve healthy aging. The conference features experts from medicine, nursing and rehabilitation. A hands-on workshop and lunch are included. It will run from 8:30 a.m. – to 4:30 p.m., Nov. 5, on the Upstate Medical University campus in Syracuse. The six presenters include Sharon Brangman, division chief of geriatrics, Upstate Medical University and chair of the board of directors of the American Geriatrics Society; and Barbara Resnick chair of gerontology at the University of Maryland and president of the American Geriatrics Society. To see the agenda and to register visit: www.foundationforupstate.org/frailtyandfallsteachingday or call 464-5167 to request a packet.
‘Holiday Retail Therapy’ to beneﬁt Hope for Heather Hope for Heather, Central New York’s nonprofit organization that promotes awareness and education about ovarian cancer, is offering a day of “Holiday Retail Therapy and Pampering,” the second annual Heather’s Girls’ Day Out, to be held from 11 a.m. – 4 p.m., Nov. 6, at Tawn Marie’s Dance Center, 1216 Morgan Rd., Liverpool. There will be vendors offering jewelry, cosmetics, home goods and fashions;
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
manicures and pedicures will be available. A percentage of all proceeds will be donated to Hope for Heather to support ovarian cancer awareness and the Heather Weeks Memorial Dance Scholarship. For further information about the event, please visit www. hopeforheather.org or call 652-5411.
Foster care, adoption for LGBTQ people A foster care and adoption information session for LGBTQ people will be held from 6 – 8 p.m. Wednesday, Nov. 9, at the Q Center, 617 W. Genesee St. in Syracuse. Lesbian, gay, bisexual, transgender, queer individuals and allies with an interest are invited to come and learn more about the foster care and adoption process as a pathway to parenthood. Attendees will gain an understanding of the foster care certification and adoption process, hear from parents who have gone through the process, pick up free information, speak one-on-one with agency representatives, and have the opportunity to network with other LGBTQ parents and prospective parents. According to organizers, “Many LGBTQ individuals and couples may not be aware that the foster care system is open to them as a way to create or expand their families. In fact, say the organizers, more than 14,000 U.S. children are already living in lesbian- or gay-led foster families. Here in New York state, the child welfare system is in constant need of foster and adoptive families for the approximately 23,000 children in its care. A light dinner will be provided. The event is free but reservations are requested. To RSVP or learn more about the information session, contact Claudia Stallman, Lesbian and Gay Family Building Project, at lesgayfambldg@aol. com or 607-724-4308.
Scleroderma educational forum held in Liverpool Scleroderma Foundation, Tri-State, Inc. Chapter is sponsoring a scleroderma educational forum for patients, families, caregivers and medical professionals to keep up to date on scleroderma research and treatments. The forum will have the following presenters: Mary Abdulky, a physician with Arthritis Health Associates, who will discuss “Scleroderma, overview of symptoms and treatments,” Maria Erdman, a dietitian with Upstate University Hospital, who will discuss “Focus on Nutrition;” and Joe Camerino, chairman of the board, Scleroderma Foundation, who will focus on “Scleroderma Foundation Update.” The event is free and open to the public. It will take place starting at 12:30 p.m., Nov. 12, at Healthcare Network Building, 2nd floor, North Medical Center, 7246 Janus Park Dr. in Liverpool. For more information, email jpeak@scleroderma. org, call (800) 867-0885 or visit www. SclerodermaTriState.org.
Cayuga County offers free workshop for caregivers Cayuga County Office for the Aging will present its sixth annual Coping and Caring Workshop for Caregivers from 8:45 a.m. –noon Nov. 12, 2011, at the Holiday Inn, 75 North St., Auburn. The workshop is appropriate for family and friend caregivers and professional caregivers as well. Titled “What To Do When Caregiving Is Stressful,” the event will feature Jane Meier Hamilton, a nurse for 38 years and family caregiver for 20 years. Hamilton founded “Partners on the Path” in 2008 to help professional and family caregivers preserve their health, well-being and capacity to care. She has practiced clinically, taught psychiatric nursing and published numerous professional journal articles. The event is free. Call the Office for the Aging at (315) 2531226 or visit www.co.cayuga.ny.us/aging/events.htm to register. The event is free.
Free events mark 10th years of OASIS The Syracuse OASIS, a nonprofit organization that offers nearly 400 programs and activities for those 50 years of age and older, is celebrating its 10th year in the Central New York area. Several events will be held Nov. 16 including a classical music performance from 1 – 2 p.m. by pianists Patricia DeAngelis and Steven Rosenfeld. From 2:30-3 p.m., Dr. Gregory Eastwood of SUNY Upstate Medical Center will discuss “Dying Isn’t What it Used to Be.” And from 3:30 – 5 p.m., there will be a retrospective discussion on the beginning of Syracuse OASIS. Refreshments will be served, and the event is free and open to the public. The event is free and open to the public. OASIS is located at 6333 State Route 298 East Syracuse. For more information, call 464-6555. (see related story in this issue of In Good Health).
Elder Abuse Conference held in Liverpool The Syracuse Area Domestic & Sexual Violence Coalition’s Elder Abuse Committee is presenting its annual conference Dec. 2 at Double Tree Hotels, 6301 state Route 298 in East Syracuse. Titled “Elder Abuse Conference” the events will discuss a variety of topics related to seniors and aging. This year’s featured keynote speaker is state Sen. David Valesky, chairman of the NYS Senate Committee on Aging. In addition, there are f scheduled breakout sessions featuring 10 different workshop options. Some of the sessions are “Elder abuse in the LGBTQ Community,” “Role Play on Elder Abuse and Exploration,” “Current Legal Concerns and Update,” “Sexual Abuse & the Elderly,” and “Substance Abuse & Elder Abuse: Signs & Symptoms.” Fee is $40 and includes breakfast, lunch and snack. Deadline for application is Nov. 18. Link to an online brochure with descriptions of all sessions can be found at www.verahouse. org/news-events/2011-elder-abuseconference-brochure. For questions, call Jenny Hicks at 425-0818 ext. 212 or email her at firstname.lastname@example.org.
More Teen Males Using Condoms
he percentage of teen males aged 15–19 years in the United States who used a condom the first time they had sex increased between 2002 and 2006–2010, according to a report from the Centers for Disease Control and Prevention. The report, “Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2006–2010 National Survey of Family Growth,” from CDC’s National Center for Health Statistics, found that eight in 10 teen males used a condom at first sex, an increase of 9 percentage points from 2002. The study also found that 16 percent of teen males used a condom in combination with a female partner’s hormonal method, a 6 percentage point increase from 2002. Other findings include: • In 2006–2010, about 43 percent of never–married female teens (4.4 million), and about 42 percent of never–married male teens (4.5 million) had had sexual intercourse at least once (were sexually experienced). These levels of sexual experience have not changed significantly from 2002, though over the past 20 years there has been a decline in the percentages of those who were sexually experienced.
• Seventy–eight percent of females and 85 percent of males used a method of contraception at first sex. With a few exceptions, teenagers’ use of contraceptives has changed little since 2002, and the condom remained the most commonly used method. • One exception was an increase among males in the use of condoms and in dual use--the use of a condom combined with a partner’s use of hormonal contraceptive at first sex. • Another exception was a significant increase in the percent of female teenagers who used hormonal methods other than the pill, such as injectables and the contraceptive patch, at first sex. Six percent of teen females used a non–pill hormonal method at first sex in the latest survey compared to 2 percent in 2002. • Despite long term improvements in pregnancy risk behaviors among teens, differences still exist among Hispanic origin and race groups. Non–Hispanic black males have the highest percentages who are sexually experienced, and Hispanic males have the highest percentages using no contraceptive method at last sex. The report is available at: www. cdc.gov/nchs.
U.S. heart disease prevalence down
he prevalence of heart disease in the United States is declining, the Centers for Disease Control and Prevention reports. However, the incidence of the condition varies widely depending on gender, race, geography, and level of education. The CDC reported in October in its “Morbidity and Mortality Weekly Report” that the rate of coronary heart disease fell from 6.7 percent in 2006 to 6 percent in 2010. The CDC says the decline in five years time is significant. The incidences of heart disease were most prominent in men, American Indians, native Alaskans, those with less than a high school education, and Southerners, according to the CDC report. Those with the lowest rates were women, Asians, Hawaiians, Pacific
Islanders, those with advanced degrees and residents in Hawaii in Connecticut. The findings also revealed that the prevalence of heart disease in men was much greater than among women: 7.8 percent for men vs. 4.6 percent for women. Education level also appeared to have a big impact. Among those with less than a high school diploma, 9.2 percent reported having heart disease. That was in comparison with 4.6 percent for people with more than a college degree. Kentucky had the highest rate of the condition at 8.2 percent, followed by West Virginia with 8 percent. Hawaii had the lowest at 3.7 percent, followed by Connecticut with 4.4 percent. The CDC says that while the declining rate is good news, the bad news is much still needs to be done to narrow the wide disparities.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
By Chris Motola
Dr. Michael Fischi Doctor discusses new robotic-assisted coronary angioplasties being performed at St. Joe’s Q: Tell me about your specialty. Are you a surgeon? A: I am an interventional cardiologist. We do angioplasties and stenting of blockages of arteries in the body with catheters. It’s a little different than surgery per se in that we’re never actually cutting people open. It’s a lot like surgery, but we’re not actually surgeons.
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Q: Is the distinction a matter of the size of the incisions? The invasiveness of the procedure? A: I think it’s semantics, to be honest. Some dentists call themselves surgeons when they pull a tooth and we do coronary procedures and yet it’s not surgery. If you were to look it up in Webster’s, I think a surgeon is considered someone who works primarily with a scalpel. What we do is all through a small hole in the skin, with a catheter that goes into the artery. We don’t actually make large cuts into the patient and everything is done through the skin, into the artery, with a catheter. I think that’s the key differentiating characteristic. Q: How do you clear blockages that way? A: We’re inserting a very small balloon into that artery, inflating it, expanding the plaque outward and then we implant a small metal tunnel called a stent to provide the structural support to keep that passage open. Now, when a surgeon does bypass surgery, they do things a little differently. They make a cut somewhere in the chest and they’ll directly bypass the artery using a piece of graft material, which is vein or an arterial bypass graft and they’ll use it as a conduit to bypass the blockage. Q: What are the pros and cons of these procedures? A: With the stent procedure, it’s minimally invasive and can be done on a outpatient basis. The bypass surgery involves multiple days in the hospital, including several days in the intensive care unit. It involves general anesthesia. There are risks with the surgery itself, including bleeding, stroke. We have some of the same risks, but generally to a lesser extent. The upside with surgery is that they’re able to treat
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
more blockages at once and they can bypass large areas of diseased artery. So patients that have a lot of artery disease, technically advanced blockages in the main trunk, or if all three of their major arteries have blockages, those are usually people who get referred for surgery. But if they have local in disease in one or two arteries, we usually refer them for stenting. Q: Can you describe the research trial at St. Joe’s you’re a part of right now? A: What this device [the CorPath PRECISE] is — normally when we put a catheter in one of the hard arteries of the patient, we manipulate the catheters by hand. So we have a little tube that goes into the artery in the wrist or groin area. If we see blockage we want to fix, we extend a wire across the blockage, through the tube. Using that wire as a guide wire, we send the balloon over that wire and then compress the blockage to the sides of the artery wall, and then insert a stent. All of these maneuvers are done manually. What this robotic device does is actually advances them for you, remotely, through the use of a console. There’s a very sophisticated piece of engineering that actually holds the catheters and advances them for you. It allows for very precise stent placement. It also allows you to be remote from the source of the radiation, which allows us to reduce our radiation procedure—normally when we do these procedures we’re wearing lead because this is a procedure that requires the use of an X-ray. We inject contrast dyes that we can see on the X-ray, which makes the artery look like a black line. So when we’re doing the procedure, we’re wear-
ing lead and getting a certain amount of occupational X-ray exposure. It also saves us from orthopedic injuries that can result from being hunched over a patient for hours a day, wearing lead. So there are some ergonomic advantages too. Q: Are there advantages for the patient? A: The precision is important for outcomes, especially if the patient is moving around. Sometimes they’re just uncomfortable, sometimes they have restless leg syndrome. This device anchors everything to bed, not the patient, so they can move around and we can still advance the device. The down side is cost. It also adds set up and take down time. It does make the procedure a little more involved, but my personal experience is that it’s pretty easy to use. Those of us who are doing this have had experience of working on a simulator and on a pig. So by time the team actually began to use it on people, we had a lot of experience. It’s not really reinventing the procedure, just offering a new tool for doing it. Q: How do you feel about the tool, personally? A: I like it. I think it has some advantages. There are some patients on whom we couldn’t use the device, for example, patients with complex lesions. The device is only available in a research format right now, so it limits us to using it only on patients with simple lesions. But on those patients, I’ve really enjoyed using it. Q: How long will the trial last? A: We’re going through the end of the fall or early winter. It depends when we meet our enrollment figures. One of the nice things is we’re going to be one of the sites that is going to be on the cutting edge of using this when it goes on to the next phase. So after this particular study is complete, there’ll be other phases. Q: How many stenting procedures do you do each year? A: I probably do around 400 a year. Q: How long a procedure is it usually. A: On average, about an hour.
Lifelines: Name: Michael Fischi Education: SUNY Upstate Medical, Duke University, University of Rochester MedicalvHospital Afﬁliations: St. Joseph’s (primary). Privileges at University, Oswego, Cortland Other afﬁlations: Fellow of American College of Cardiology; of American Society of Cardiac Catheterization and Intervention; member of Onondaga County Medical Society Family: Married with two daughters and a son Hobbies: Painting, guitar
‘Healthy Mondays’ Good Recipe for Central New York Syracuse University’s Lerner Center for Public Health Promotion to promote “Healthy Monday” events and activities throughout CNY
Bonnie Miner, right, and Diane Kwaczala discuss data on the decrease in central line infections in the Pediatric Intensive Care Unit at the Upstate Golisano Children’s Hospital.
By Joyce Gramza
hen Syracuse University alumnus Sid Lerner came up with the idea of “Meatless Mondays” in 2003, it just made sense to him that Monday is a good day to start something new. The campaign, begun at Johns Hopkins University School of Public Health, has since gone international and viral, expanding to include the numerous other positive lifestyle changes promoted by “The Monday Campaigns.” Now Lerner hopes to turn what has so far been a promotional movement into an evidence-based medical prevention initiative. He’s establishing a permanently endowed new research center at SU’s Maxwell School of Citizenship and Public Affairs. SU was an early adopter of “Meatless Mondays,” and has added a number of other Monday campaigns on campus, including “Meditation Mondays” in conjunction with Hendricks Chapel, and “Move-It Mondays,” which does just what it sounds like— encourage exercise by offering free exercise classes to students, staff and faculty every Monday. “Mile Monday” takes it somewhat further. The new Lerner Center for Public Health Promotion will promote such “Healthy Monday” events and activities throughout Onondaga County and Central New York. And, in conjunction with the Maxwell School and SUNY Upstate Medical University, it will scientifically document the effectiveness of the campaigns. “We will be evaluating the impacts, publish the results, develop strategies other communities can use,” says Tom Dennison, director of the new Lerner Center. “And we’ll be happy to share everything we’re doing with the public with no limitations at all.” The center will soon solicit the public’s involvement in a series of forums to help plan its projects.
Lerner doesn’t take much credit for the original idea for “Meatless Mondays,” which has caught on in 21 countries and counting. “We didn’t approach any of them—they just picked it up,” he says. “It makes sense… A week is the only man-made time, it’s a lifestyle behavior, a chance to start all over. Most people go to the gym on Monday, quit smoking on a Monday, do lots of good things on Mondays.” Indeed, according to Dennison, a recent survey conducted by the beef industry — an opponent of “Meatless Mondays” — found that 50 percent of
Americans were aware of the idea of skipping meat for one day a week to benefit both their health and the environment. Dennison, influenced by the campaign, says he has a session with a personal trainer each Monday. “There are lots of organizations promoting good things,” says Lerner. “What we’re doing is giving them Lerner a simple message to reinforce on the calendar. If you fall off the wagon, you don’t wait ‘til your birthday or New Year’s, you just start again on Monday,” he says. He calls this “the Monday motivation” idea. He says the idea was intuitive for a marketing man told by his doctor that his high cholesterol and blood pressure were risking his health. “I was in an advisory group at Johns Hopkins at the time, and the USDA came out with the fact that Americans were eating more meat than they needed,” Lerner says. “I asked how much is too much? They said 15 percent. “I did my SU education and figured 15 percent of 21 meals equals three meals a week,” he says. That led him to recall some American history. “Being an old advertising guy, I thought about a simple concept. During World War II, President Roosevelt declared ‘Meatless Mondays’ and ‘Wheatless Wednesdays’ to encourage voluntary food rationing… actually, he got it from Wilson in World War I,” Lerner says. But those campaigns didn’t have Internet access. “The beauty is, the Internet let us do things we couldn’t do in the old days… be able to put something out there and get a huge and diverse audience.” Via social media, including a Facebook page and Twitter account, leading to a plethora of blogs and recipes, the idea was embraced by such luminaries as Oprah and chef Mario Batali, who introduced “Meatless Mondays” into all 14 of his restaurants. The list of participating campus and school food services has multiplied to scores nationally and hundreds globally. But what if the phenomenon is more than just a viral trend?
Promotion and Prevention
What if — to follow up Lerner’s second intuitive idea — health promotion is actually an effective way of combating the promotion of unhealthy behaviors, particularly, fast food marketing? “I think that if we were selling prevention as opposed to stuff that
makes us fat and sick, we wouldn’t be so fat and sick,” says Lerner. “If the liquor industry promoted their booze as aggressively, we’d all be rolling around drunk in the streets… or if we all drove the way we see in car ads we’d all crash every day. That’s why we have speed limits. We should try to have limits on other unsafe behaviors, too.” Lerner thinks that with scientific documentation, the Monday Campaigns will also become second nature in the medical community. “I’m a liberal arts person dealing with scientists,” Lerner says. Health practitioners nowadays need more than a “wouldn’t it be nice concept?” “We need to get evidence-based proof that Monday is better than Thursday to get people to start exercising or stop smoking.” In 2005, researchers at Johns Hopkins published a study that supported “the power of periodic prompting in promoting healthy behaviors,” says Rebecca Bostwick, the Lerner Center’s program director. Bostwick explains that “Monday is like the January of our week,” but many national health promotion campaigns use “a dedicated week or month to engage in or promote healthy behaviors,” when more continual “cyclical messaging” might be more effective. The Lerner Center will go after objective measures to evaluate the effectiveness of “Monday Campaigns” for not only health behaviors, but other positive initiatives.
“Its Time Has Come”
“Its time has come because the numbers are getting horrendous world wide with kids with diabetes, cancer, stroke and heart disease — and most are behaviorally caused,” Lerner says. He believes the Monday Campaigns have discovered “a new marketing way to get people to be healthy.” Lerner, Dennison and Bostwick believe that the Lerner Center will prove it in Central New York. As for Lerner, he continues to skip meat each Monday, is on an anti-cholesterol medication, and keeps “trying to get more exercise than I do.” “I’m 80-and-two-thirds years old now and feeling pretty good,” he says. Program director Bostwick says the upcoming forums are open to the public, but they need folks to RSVP to help them in planning. They’ll be listed on the website, lerner.syr.edu under “Events.” November 2011 •
Upstate Joins National Quality Effort Focused on Hospitalized Children
pstate Golisano Children’s Hospital is part of a collaboration of more than 80 hospitals nationwide that has worked to reduce and prevent central line infections in hospitalized children. The collaboration—Quality Transformation Network (QTN)—is an initiative of the National Association of Children’s Hospitals and Related Institutions (NACHRI). The network’s goal is to eliminate catheter-associated blood stream infections among hospitalized pediatric patients. “We are proud to be associated with this critical initiative that allows us to continually find new, proven ways to provide quality care to our pediatric patients,” said Thomas Welch, medical director of the Upstate Golisano Children’s Hospital. “We have made great strides in decreasing the number of infections that have an extraordinary impact on the quality of care delivered to our patients.” Since joining QTN, the pediatric intensive care unit went nearly a year without an infection and the hematology/oncology unit currently is at 291 days free of a catheter-associated blood stream infection. “This project has allowed us to share our successes and challenges with others across the country and ensure a level of consistency across all of our care areas at the Upstate Golisano Children’s Hospital,” said Leola Rodgers, associate administrator of the Upstate Golisano Children’s Hospital. Catheter-associated blood stream infections (CLABSIs) occur in the central intravenous lines used to provide long-term treatment to patients, such as medications and fluids. Such preventable infections are costly and can put patients at greater risk for serious complications. In adult intensive care, CLABSIs have been decreased significantly through intervention. The NACHRI initiative is the first coordinated effort to deal with CLABSIs among the pediatric population.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
If you or someone you love is unable to shop for or prepare their own meals, contact Meals On Wheels.
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The Arrival of Respiratory Infection Season
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he return of kids to school and the arrival of cooler weather heralds the arrival of respiratory infection season. How can you tell whether you have a cold, or something more serious, like pneumonia? Pneumonia is an inflammation of the lung tissue, usually due to infection. It affects the alveoli, small air-filled sacs deep inside the lungs. Worldwide, pneumonia is the leading cause of death. In the US, influenza and pneumonia combined are the eighth most common cause of death. Typical pneumonia symptoms overlap with the symptoms of other respiratory illnesses. Most patients have a cough. Mucopurulent sputum (looks like mucus with pus) suggests pneumonia. Patients with pneumonia often have fever (over 100 degrees), a rapid heart rate (over 100 beats per minute), fast breathing (over 20 times per minute), and abnormal or decreased lung sounds. Not every patient with pneumonia — especially the very young or the very old — has typical symptoms. Some people have fever without respiratory complaints. Others have abdominal pain. Older people may become weak or confused without other symptoms. Most of the time, a doctor who suspects pneumonia will order a chest X-ray to confirm the diagnosis and to assess disease severity.
Often people ask whether they have “walking pneumonia.” That’s not a medical term; it’s an outdated phrase to refer to someone who had pneumonia but wasn’t sick enough to be in the hospital. Fortunately most people can be treated with antibiotics without hospitalization, Severely ill patients, who have rapid breathing, low oxygen levels in the blood, confusion, wide spread disease on X-ray, and underlying chronic illnesses, may require hospitalization for treatments like IV antibiotics and fluids, oxygen, and assistance from a breathing machine. The most common infectious cases of pneumonia are bacteria and viruses. It’s not always possible to tell which organism caused a particular bout of illness. And for people not sick enough to require hospitalization, testing to determine the cause isn’t usually needed. Empiric treatment-selection of an antibiotic based on the most common culprits usually works, along with rest, fluids, and treating other symptoms like fever, cough and wheezing. If you think that you have pneumonia, don’t just start any old antibiotic that you find hidden in the back of the medicine closet. The drug left over from your urine infection, skin infection, or toothache might be the wrong choice for pneumonia. The most common bacterial agents that cause pneumonia are Streptococ-
cus pneumonia, Mycoplasma pneumonia, Chlamydophila pneumonia, and Legionella species. The first of these, often called pneumococcus, is the target of the pneumonia vaccine. So while the vaccine reduces your chance of getting pneumonia from this serious bug, it doesn’t protect against the other causes of pneumonia. The influenza vaccine reduces your chance of contracting pneumonia, because people weakened by flu are easier prey for the bugs that cause pneumonia. Quitting smoking also reduces your chances of pneumonia. Common sense hygiene measures like covering your mouth when you cough, hand washing, and staying home when you’re sick also combat the spread of illness.
Eva Briggs, a board-certiﬁed physician, works on the staff at Cayuga Medical Center in Ithaca, in its two urgent care centers: one in Ithaca, and the other in Cortland.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
the Tsunami of Diseases More than Half of All Americans Will Have Diabetes by 2020. Ranks Could Swell to 135 million
alf of all American adults are destined to develop diabetes or pre-diabetes by 2020 if they don’t make dramatic lifestyle changes, according to a dire new prediction from the Centers for Disease Control and Prevention. If current trends continue, the ranks of American adults with excessive blood sugar levels would swell from 93.8 million this year (about 28 million diabetics and 66 million more with pre-diabetes) to 135 million in 2020 — and cost society $3.35 billion by decade’s end. In addition, diabetes is becoming one of the most common chronic diseases in children and adolescents. According to the American Diabetes Association, one in every four children is currently diagnosed with diabetes. Experts believe that unless people improve their diet and start exercising more regularly, diabetes could become an epidemic of tsunami-like proportions.
treating pre-diabetes. The condition is diagnosed in patients when blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes, placing people at high risk for diabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes.
What is Diabetes Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With Type 1 diabetes, your body does not make insulin. With Type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes. Symptoms of Type 2 diabetes may include fatigue, thirst, weight loss, blurred vision and frequent urination. Some people have no symptoms. A blood test can show if you have diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your glucose level and take medicine if prescribed.
November 2011 is Diabetes Awareness Month
The Diabetes Prevention Program (DPP), a study published in The New England Journal of Medicine by scientists at Montefiore and Albert Einstein College of Medicine, found that metformin, the drug typically used to treat diabetes, combined with lifestyle changes, can effectively delay the onset of diabetes. As a result of these findings, the American Diabetes Association now recommends use of this medication for
November is Epilepsy Awareness Month Celebrate at a free epilepsy education event hosted by the Epilepsy Foundation. Tuesday, November 29 from 6 to 8 pm at the EF ofﬁce at 1045 James Street. RSVP and ﬁnd more details at www.epilepsy-uny.org or (315) 477-9777.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Alone with Loss: The Healing Power of Gratitude
e was only 60. A son, husband, father to eight children, and grandfather to 13. He was an admired entrepreneur, a dear friend to many, a great guy. He was also my brother. Mark died unexpectedly of pneumonia just weeks ago. It feels like yesterday, and I’m still shaking my head in disbelief. But the terrible shock is slowly subsiding, giving way to sadness and grief. I know that, with time, the healing will come. Writing for me has always been an important outlet and coping mechanism. Sorting out my feelings on paper helps me slow down, release pent-up pain and emotion, and gain perspective. It helps me heal. Writing also gives me a chance to help others who may find themselves grieving alone. Coping with loss poses a special challenge for those of us who live alone. At the end of the day, when others might return to busy households, we return to quiet, empty homes. The solitude, while welcome or at least tolerable on happier days, is not so welcome when heartache shows up on the doorstep. It’s at times like this when it’s so important to pick up the phone, be with others, and take good care of ourselves. And that’s what I did. I practiced what
I preach: I called friends, huddled with family, made an appointment with my therapist, and went back to work. I also made a decision to approach the loss of my brother with an open heart and a focus on gratitude. My hope was that in doing so, I could tame my swirling emotions, find some measure of meaning in this loss and, most importantly, honor Mark’s spirit.
I am so, so grateful for . . .
• My brother’s happy, generous spirit. He’s still with me in my heart. • His strong, devoted, and devout wife Cathy, who led us through the painful goodbye. • The Mormon Church, which my brother joined after he met Cathy, and how it wrapped its arms around their family. • Mark and Cathy’s beautiful children and grandchildren in whose faces I can see Mark’s light. • My mother’s incredible strength, grace, and reassuring words: “Mark’s influence will live on.” • My sister Ellen who traveled home and stood by mom. She doted on her, filled her pantry with comfort food, and kept her company. • The amusing memories of Mark shared during his service that brought laughter and a brief respite from the sadness.
“Coping with loss poses a special challenge for those of us who live alone. At the end of the day, when others might return to busy households, we return to quiet, empty homes.” • My sister Anne’s hand in mine and the comfort I felt when she looked at me and softly mouthed the words, “I’m your person.” • The gray sky and drizzling rain during Mark’s burial. A bright, sunny day would have felt all wrong.
And I’m so thankful for . . .
• Tears — flowing, cathartic tears and more tears. • The light touch on my shoulder during the viewing and offer of a real, cloth handkerchief. • The comforting condolence cards, emails, and phone calls. • My best friend Terry’s steadfast support and loving acceptance of my need for “alone time.”
• The empathy expressed by the kind woman who helped me when I ran out of gas on my way to pick up flowers for the funeral. “Of course you’re distracted,” she shared. • My friend Kate. Together on the phone, and without restraint, we railed against the random, senseless, unfairness of life and death. I needed that. She was there for me. • The anonymous visitor who left a sweet bouquet of wildflowers on my front porch, along with a simple note, “I’m so, so sorry.” • Cathy’s dear friend Mary who cautioned us that anger may well up. She was right. It has. • My colleague Kathy who’s “been there.” She continually checks in with a sincere “How are you doing?” and then she really, really listens. One day, a fresh vase of flowers was left on my desk; days later, a package of herbal tea. Sometimes twice a day, a hug. • Mark’s British Auto customers and fellow gearheads who shared his passion for MGBs, Austins, Triumph Spitfires, Minis, and vintage Jaguars. They showed up at the funeral to express their respect: “He was one of the best.” “Mark knew everything there was to know about British cars.” “He’ll be missed, big time.” With each passing day, I am finding more acceptance and feeling a little more at peace with Mark’s death. I have so much to be grateful for, but today, I am especially grateful for this opportunity to share my loss, thoughts, and gratitude with you. It has helped me tremendously. If you, too, are suffering alone with loss, I encourage you to embrace the power of gratitude. Let’s count our blessings and heal. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, you can call her at (585) 624-7887, email her at firstname.lastname@example.org.
KIDS Corner Children of Older Dads Fare as Well in School as Other Kids Findings contradict other research that found paternal age could negatively impact children’s IQ
en who become parents later in life are not putting their children at risk for academic problems, a new study suggests. Researchers in Sweden found children born to fathers in their 50s performed no worse in school than kids with fathers in their 30s. The findings, Page 12
they noted, challenge previous studies that suggested a father’s older age can have a negative impact on his children’s IQ. In the study published online in PLoS ONE, researchers collected data on the school performance of more than 135,000 children in Stockholm.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
Researchers also considered how the social advantages of being raised by older parents would come into play in how well the children did in school. “To the delight of fathers choosing to wait before having children, our results suggest that children of older fathers perform no worse in school,” said study leader Anna Svensson, of the Karolinska Institute’s Department of Public Health Sciences, in a news
release. “When we studied children’s final year-nine grades we could see no difference between children of fathers in their 50s and children of fathers in their 30s.” The children of fathers younger than 30 performed slightly worse in school than kids of other men. This could be explained by differences in the educational background of the parents, researchers said.
Crouse Starts Bariatric Surgery Program Program is led by former Community General bariatric team By Suzanne M. Ellis
besity has reached epidemic proportions in the United States, with more than six of every 10 Americans fitting that description. And, according to Kenneth Cooper of Fayetteville, one of two bariatric surgeons who recently joined the surgical team at Crouse Hospital, only about 5 percent of those defined as “morbidly obese” ever see a bariatric surgeon. “As bariatric surgeons, we have limited ability to reach the people who need to be reached,” Cooper said. “Crouse has proven that it is a leader in everything they do, and they are extremely dedicated to the new program. We look forward to having that kind of commitment and financial support behind us so that we can reach as many as possible in the obese population.” The other bariatric surgeon now operating exclusively at Crouse is Jeffrey DeSimone, of Manlius. The doctors are among nine partners who make up Central New York Surgical Physicians, a private-practice surgical group that maintains local offices but will soon perform all its surgeries at Crouse. The other seven are general surgeons, Cooper said. He and DeSimone are the two general surgeons in the practice who specialize in bariatric (weight loss) surgery. “Weight-loss surgery is a new venture for Crouse, and we are excited to welcome Dr. DeSimone and Dr. Cooper to the Crouse family,” said Bob Allen, vice president of communications and government affairs at Crouse. “They have an individualized, personal approach to weight-loss surgery which fits well into our overall philosophy of patient care.” DeSimone and Cooper, who formerly practiced at Community General
Bariatric surgeons Jeffrey DeSimone (with glasses), and Kenneth Cooper (directly opposite), perform their ﬁrst weight loss surgery procedure in Crouse Hospital’s Witting Surgical Center in Syracuse. Their ﬁrst Crouse patient was 93Q radio morning host Ted Long, who co-anchors the Ted & Amy show. Both surgeons, partners in CNY Surgical Physicians, have moved their weight loss surgery program from Community General Hospital to Crouse. Hospital, said there had been ongoing discussions about a possible relocation for some time. When news of the takeover of Community General by Upstate Medical University was announced, they decided the time was right to make a move. “University Hospital has its own bariatric program and there are some differences,” DeSimone said. “We felt that to preserve our identity, individuality and integrity as Central New York
Facts about Obesity
t is estimated that more than 93 million Americans are obese, according to the Obesity Action Coalition (OAC), a non-profit organization formed in 2005. Here are a few more statistics from the OAC: • Obese individuals are at a higher risk for impaired mobility and experience a negative social stigma. • Socioeconomic status plays a significant role in obesity. Low-income minority populations tend to experience obesity at a higher rate and are more likely to be overweight. • Almost 112,000 deaths a year are attributed to obesity. • In the United States, 40 percent of adults do not participate in any leisuretime physical activity.
Morbid Obesity • Being overweight, obese or morbidly obese significantly increases the risk of developing many other diseases such as diabetes, hypertension, heart disease, stroke and osteoarthritis, to name a few. • Morbid obesity is characterized by individuals weighing more than 100 pounds over their ideal body weight or
having a body mass index (BMI) of 40 or higher.
Childhood Obesity • More than 9 million adolescents (defined as those who are 6 to 19 years old) in the United States are overweight. • Children considered obese are 70 percent more likely to continue obesity into adulthood. • Children who are obese at a young age are predisposed to obesity and morbid obesity in adulthood. • Environmental factors, such as a lack of physical activity and technological advances have led to a more sedentary lifestyle. • Obese children are much more likely to develop Type 2 diabetes. • African Americans, Hispanics and American Indians have been experiencing the highest rates of increase in childhood obesity. On average, 25 percent of children in these ethnic groups are obese. • More than 40 percent of children watch two or more hours of television every day.
Surgical Physicians, and our weightloss surgery program, it would be best to move away from the influence of Upstate.” Cooper agreed. “The [takeover] was one of the final factors that made us realize this was the perfect time to do this,” he said. “Upstate has an excellent program, but we didn’t really feel we would be included in it because of our private-practice roots. Community has been struggling financially and that made it very difficult for us to grow our program. Bariatric surgery is an elective procedure, and people have to know that you exist.” A person’s body mass index, better known as BMI, determines whether they are overweight, obese or morbidly obese. A person is considered morbidly obese if their BMI is higher than 40, the doctors said. Anyone with a BMI over 25 is considered overweight, and a BMI over 30 is considered obese. “We take a patient’s weight in kilograms and divide it by their height in meters, and then we square that number,” DeSimone said. “You can’t just go by weight because a person who’s 4 feet 10 inches tall and weighs 250 pounds isn’t the same as a person who is 6 feet 10 inches tall and weighs 250 pounds.” There are four types of weight-loss surgery considered appropriate by the American Society for Bariatric and Metabolic Surgery. In their practice, the two physicians generally perform two types of bariatric surgery that are commonly known as gastric banding and gastric bypass, DeSimone said. Last year, they did a total of about 150 of those two surgeries. “Obesity has reached epidemic proportions, and the cost, both in quality of life and in dollars and cents, is staggering,” DeSimone said. “The only technique [for weight loss] that has proven to be successful is surgiNovember 2011 •
cal intervention. It is the best option there is, and we are hoping to provide that option to the broadest number of people we can.” Bariatric surgery has been practiced in one form or another since the 1950s, but it remained a relatively uncommon treatment in the United States, according to Web MD. But with the skyrocketing rate of obesity, the number of people having the surgery has increased dramatically. In 1998, 13,000 weight-loss surgeries were done in the U.S.; five years later, that number was more than 121,000. And in 2007, according to the American Society for Bariatric and Metabolic Surgery, 250,000 morbidly obese patients had the surgery. “Doctors and patients need to know that this kind of thing exists, and that all the major insurance carriers, including Medicare and Medicaid, will cover the costs of bariatric surgery,” Dr. Cooper said. “The last decade has seen a revolution in new techniques and improvement to existing techniques, and insurance companies are now covering these procedures.”
Informational Seminars As part of its new bariatric surgery program, Crouse Hospital is hosting two free informational seminars each month. The sessions on weight-loss surgery are 4:30 to 6:30 p.m. on the first Tuesday and third Thursday at Marley Education Center, 765 Irving Ave., Syracuse, at the corner of Waverly Avenue. The first seminars, which will continue in 2012, are set for Nov. 1, Nov. 17, Dec. 6 and Dec. 15. For directions or information, call 472-2464.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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By Melissa Stefanec
The 3-months Milestone. My Daughter is Officially an Infant
t’s been three months. Three glorious, tiring, frustrating and amazing months. As I sit down to write this column, I find myself wondering if there is a way I can strap my laptop on and type as I do laundry and sweep. The thought of dictating this column to a typist or recording device enters my mind. Then I remember; I’m not a high-paid executive with assistants to do my work for me. I’m a making-ends-meet working mom, who will have dirty laundry around the house for one more day because she is busy bringing home the bacon. It’s tough but I wouldn’t trade my life for anything. In a few days my little girl will no longer be a newborn. She will be officially recognized as an infant. Already I’m seeing babies younger than her in stores and asking myself if she was ever really that tiny. I’ve already had to put away a bag of clothes that are too small (and by put away I mean stack in the corner of her nursery in a messy pile). I knew being a new parent would be a challenge, but I’m facing some unexpected obstacles. Yours truly is batting with two scary monsters, mainly the milestone and undone monsters. Three months seems like some sort of milestone. If other new parents are anything like me, their lives have become all about milestones. As parent you are constantly bombarded with information. This information clutters you brain with long lists of “should” and “should not” milestones. My baby should have this many vaccines. My baby is in this or that percentile for her weight. My baby should be lifting her head at 45 degree angle. My baby should be laughing. My baby should not have clenched fists. It’s as though all of the magazines, Internet lists serves and health professionals want to turn my time with my child into a science experiment. Sometimes I feel as though being a good and attentive mother entails standing over my child with a clipboard, a checklist and a controlled subject baby lying next to her. I want to make sure my baby is developing into a healthy child, but I have to remember it’s more important to enjoy and entertain her than it is to log every jerky and uncoordinated movement. I’m constantly reading that no two children develop at the same pace or in the same way, so why should I let myself worry if it took my daughter one week longer to hold her head up than
the experts said it would? The answer is I shouldn’t. I’m learning to take the all the milestone checklists and advice with a grain of salt. I’m quite certain I will notice if something is truly wrong with my child. It’s great to be an informed parent, but being an over-informed parent is bound to drive you crazy. As a new mother, I’m learning to push a lot of that information to the back of my mind so I can make room in my mind for enjoying my daughter. It isn’t easy, but I’m fairly certain it’s something really great moms have to learn to do. A really great mom lets her daughter enjoy life and feel loved, even if she isn’t meeting every milestone. The second scary monster is the undone monster. For me, one of the hardest things about being a new parent isn’t the loss of sleep, sacrificing my time or being messed on; it’s being able to let things go undone. Before I was a parent I was one of those people who left no page unturned and had all of her ducks in a row. Now I’m the sort of person who occasionally forgets what day of the week it is with cat fur tumbleweeds rolling across her kitchen floor. Obsessing about details has been replaced obsessing about the baby. Although I may be flunking housecleaning 101, I’m scoring high in provoking smiles and first giggles. Taking a step back and letting the unimportant things go is something my husband has been urging me to do for a long time, but it took a 12pound, wordless creature to make me understand how important it is to stop sweating the small stuff. I’m hoping parenthood will have a lot to teach me. I want to be an authority figure for my daughter, but I don’t want her to be the only one learning. I want to learn to fight some of the monsters that have been plaguing my life. In its first few months parenthood has tried to teach me I can’t do it all. Things will be left undone and tasks will be put off until tomorrow (or until the clothes pile in her nursery tumbles under its own weight) and that is fine. In fact, it’s more than fine. I’m learning to prioritize and choosing rightly. The laundry can wait, but there will only be one first laugh. If I’m lucky enough to watch her crawling across my cat hair-covered floors without worry about whether or not she’s on schedule, I’ll know I’m doing something right.
Send your item by the 10th of each month to “firstname.lastname@example.org”
By Anne Palumbo
The skinny on healthy eating
Surprising News About Cranberries
rinary tract infections. It’s what comes to mind when I think of cranberries. Although I don’t suffer from UTIs, I have plenty of friends who do, and they all swear by cranberry juice. Just another old wives’ tale? Hardly. Cranberries contain unique compounds that inhibit the adhesion of bacteria to the urinary tract wall. Less bacteria means less chance for an infection to take hold, hence the benefit of consuming cranberries or cranberry juice at the first inkling of a UTI. Of course, if the threat of a UTI is not high on your list, you’ll be interested to know that the antiadhesion properties of cranberries may also inhibit the bacteria associated with stomach ulcers, gum disease, and tooth decay. A berry hearts by lowering blood pressure and that could avert a trip to the dentist? by reducing LDL cholesterol, the “bad” Show me the way to the bog! cholesterol that contributes to hardenApart from its bacteria-blocking ing of the arteries and heart disease. benefits, cranberries are surprisingly And like other brightly colored good for hearts. Recent research sugfruits, cranberries are loaded with gests that the antioxidants found in health-boosting anthocyanins, comcranberries (the same polyphenols pounds that Lynn Goldstein, a dietitian linked to cardiovascular benefits in tea, at Weill Cornell Medical College, says red wine, and chocolate), may protect “are believed to strengthen the immune
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system, fight disease and help prevent conditions such as cancer.” Nutritionally speaking, no-fat cranberries rank right up there with other berry superstars. Low in calories (about 50 per cup) and high in cholesterolclearing fiber, cranberries are a great source of vitamin C and manganese (good for strong bones). What they are not a great source of is ready consumption by the handful, at least not the fresh ones. But that’s where dried cranberries come in. Although the drying process alters the nutritional profile a bit and the added sugar ups the calories (130 per 1/3 cup), dried cranberries remain an excellent source of energy, fiber, and antioxidants.
Avoid bags that have a lot of soft or brown berries. They should be shiny, plump, and range in color from light to dark red. Good, ripe cranberries will bounce. Store fresh cranberries in a tightly sealed plastic bag in the refrigerator for up to two months. Replace traditional croutons with dried cranberries next time you have a salad.
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 email@example.com.
AMERICAN DIABETES MONTH November 2011
Put your hand up to Stop Diabetes by getting involved with the local American Diabetes Association’s ofﬁce as a Volunteer, Advocate, Rider in our Tour de Cure or a Walker in our Step Out Walk.
DID YOU KNOW: 65,700- of non-traumatic lower-limb amputations are a result of diabetes related complications. 140,000- children and adults in CNY have diabetes. 231,404- people die annually from diabetes and related complications, taking more lives than Breast Cancer and Aids combined. 1,857,120- Americans will be diagnosed with diabetes this year, that’s one every 17 seconds. 26 million- Americans have diabetes. 9 million- more are pre-diabetic. 174 billion- dollars, annual USA cost due to diagnosed diabetes.
The numbers just keep getting bigger. Take one simple step to stop this killer. Take the pledge at Diabetes.org/syracuse
Your Central New York ADA Ofﬁce: 6390 Fly Rd., Second Floor, East Syracuse NY 13057 315-438-8687 ~ 1.800.DIABETES
Central New Yorkers, OASIS Members and Friends are Invited to Attend a Special 10th Anniversary Celebration, FREE and Open to the Public
Is Marriage Good for The Heart?
Wednesday, November 16, 2011 1:00 pm - 2:00 pm Classical Music Performance by Concert Pianists Patricia De Angelis and Dr. Steven Rosenfeld Showcasing the beautiful Ivers & Pond eight-foot concert grand piano, generously donated to OASIS by Dr. Harold and Barbara Jones
2:30 pm - 3:30 pm “Dying Isn’t What It Used To Be” Presented by Gregory L. Eastwood, MD SUNY Professor of Bioethics, Humanities and Medicine Past President, SUNY Upstate Medical University
3:30 pm - 5:00 pm Retrospective Discussion “Syracuse OASIS Then and Now” Refreshments will be served during the discussion Come join Upstate’s OASIS program as we mark this milestone! 6333 State Route 298, East Syracuse For more information call 464-6555
iving your heart to a supportive spouse turns out to be an excellent way to stay alive, according to new research from the University of Rochester. Happily wedded people who undergo coronary bypass surgery are more than three times as likely to be alive 15 years later as their unmarried counterparts, reports a study published online August 22 in Health Psychology, a publication of the American Psychological Association. “There is something in a good relationship that helps people stay on track” says Kathleen King, professor emerita from the School of Nursing at the University of Rochester and lead author on the paper. In fact, the effect of marital satisfaction is “every bit as important to survival after bypass surgery as more traditional risk factors like tobacco use, obesity, and high blood pressure,” says coauthor Harry Reis, professor of psy-
chology at the University of Rochester. But the marriage advantage plays out differently for men and women. For men, marriage in general is linked to higher survival rates and the more satisfying the marriage, the higher the rate of survival. For women, the quality of the relationship is even more important. While unhappy marriages provide virtually no survival bonus for women, satisfying unions increase a
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Study: Supportive spouses most likely help by encouraging healthy behavior, like increased exercise or smoking cessation wife’s survival rate almost fourfold, the study found. “Wives need to feel satisfied in their relationships to reap a health dividend,” explains Reis. “But the payoff for marital bliss is even greater for women than for men.” Some studies have suggested that marriage is not beneficial for women, Reis explains. But by factoring in the level of satisfaction, this research provides a more nuanced picture. “A good marriage gets under your skin whether you are male or female,” he says. The researchers tracked 225 people who had bypass surgery between 1987 and 1990. They asked married participants to rate their relationship satisfaction one year after surgery. The study adjusted for age, sex, education, depressed mood, tobacco use, and other factors known to affect survival rates for cardiovascular disease. Fifteen years after surgery, 83 percent of happily wedded wives were still alive, vs. 28 percent of women in unhappy marriages and 27 percent of unmarried women. The survival rate for contented husbands was also 83 percent, but even the not-so-happily married fared well. Men in less-thansatisfying unions enjoyed a survival rate of 60 percent, significantly better than the 36 percent rate for unmarried
men. “Other research has shown that women are more physiologically sensitive to relationship distress than men, so an unhappy marriage can take a greater toll on their health,” explains Reis. “Coronary bypass surgery was once seen as a miracle cure for heart disease,” says King. “But now we know that for most patients, graphs are a temporary patch, even more susceptible to clogging and disease than native arteries. So, it’s important to look at the conditions that allow some patients to beat the odds.” King is skeptical of the widespread belief that a major health scare like going through bypass surgery leads to life-changing behavior. “The data show that many people go back to the lifestyle that they had before,” she says. King says that this study points to the importance of ongoing relationships for both men and women. Supportive spouses most likely help by encouraging healthy behavior, like increased exercise or smoking cessation, which are critical to long-term survival from heart disease. She also suggests that a nurturing marriage provides patients with sustained motivation to care for oneself and a powerful reason to “stick around so they can stay in the relationship that they like.” These are qualities of the relationship that likely existed before bypass surgery, and continued afterward, says King. The study cites earlier research showing that people with lower hostility in their marriages have less of the kind of inflammation that is linked to heart disease, which may help explain why people in this study benefited from satisfying marriages.
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November 2011 •
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Study Looks at Link Between Alzheimer’s and Exercise Syracuse University and SUNY Upstate are teaming up for study, looking for volunteers who will get paid to participate By Deborah Jeanne Sergeant
yracuse University and Upstate Medical University researchers have undertaken a joint study that is exploring the link between exercise and Alzheimer’s disease. Funded by Syracuse University, National Institutes of Health and Upstate Research Fund, the study is being conducted by Syracuse University students and clinicians from Upstate. The researchers will examine 60 total participants with 15 in each group: exercise, sedentary, Alzheimer’s patients and healthy. So far, six subjects have joined the study and researchers hope to recruit six to nine more in the next few weeks and additional subjects in subsequent weeks. The participants’ exercise includes stretching and biking initially and will gradually increase in intensity over the next three months. “We are measuring fitness level, quality of life and cognition by questionnaires and biochemistry markers by blood draw and muscle biopsies,” said Stefan Keslacy, assistant professor of exercise science at Syracuse University and principal investigator of the study. The entire program should take about five to six months per participant and researchers stay in contact with participants until the end of the study. “We are hoping to better understand the effect of exercise on Alzheimer’s disease,” Keslacy said. “We will correlate changes in cognition and quality of life with gene expression regulation. This study could lead to discover new therapeutic target for Alzheimer’s disease.” Cathy James, CEO of the Alzheimer’s Association Central New York Chapter in Syracuse, believes that this study and others like it can help the medical community better understand the disease and, in turn, better help Alzheimer’s patients and their families.
“The prevention side of things is something researchers are still investigating,” James said. “There is promising research. A lot of the studies are helping us understand the benefits of mental and physical fitness.” Alzheimer’s disease has been linked to general poor health and exercise decreases some of those risk factors such as high blood pressure and diabetes. “It seems to be a beneficial strategy to help lower the risk,” James said. As for helping people who have already been diagnosed with Alzheimer’s disease, James is aware of no largescale studies that look at how exercise affects them. “We do know physical and mental fitness helps with the brain,” she said. “For someone with Alzheimer’s, we do know a good flow of oxygenated blood helps the brain. We can’t say it necessarily reduces your risk as a definite correlation or stay at the point at which you are. The studies are examining these areas.” Since exercise benefits mental and physical health in general, engaging in regular fitness activities only make sense. James looks forward to the results of the Upstate/SU study. “It’s very exciting to have research of this magnitude to help us understand the role physical exercise will play in fighting Alzheimer’s,” she said. “We need to have more studies such as this to help us better understand what we can do to make sure we’re on the right path to help us decrease the risk.” Anyone at least 65 years old with or without mild memory loss may qualify to join the study. The exercise program will take place at the Institute for Human Performance. All participants will receive compensation. For details, contact John Holohan at 1-888-851-4872 or by email at firstname.lastname@example.org.
Why I Smile …
My headaches are gone! Do you suffer from chronic headaches that disrupt your personal life? Your head, neck or facial pain may be caused by a poor bite – the way your teeth come together. A dental problem like TMJ (temporomandibular joint disorder) could be causing your pain. If nothing you’ve tried has helped long term, perhaps it’s time to see a dentist. Drs. Juan and Dorothy Kassab of Smile Solutions can offer complete screening, and based on the findings, offer you treatment options. Page 18
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
Contact Smile Solutions by Drs. Kassab to set up an appointment for an evaluation or go to their web site for more information.
8 Easy Tips to Avoid Supplement & Medication Mishaps By Deborah Jeanne Sergeant
avigating the supplement and medication maze can get confusing especially when you have multiple prescriptions. It is important to organize yourself with your medications and supplements to prevent unnecessary mishaps. Physicians Lorraine J. Gudas and Mark S. Lachs offered these key tips on how to stay on track with your medications and steer clear of unsafe drug interactions at NewYork-Presbyterian/ Weill Cornell Medical Center’s 29th Annual Women’s Health Symposium:
Keep a list of your medications with you at all times.
Make sure to include brand and generic names as well as dosages and frequency.
Include all vitamins and supplements on the list.
Share the list with every health care provider you come in contact with, whether or not he or she suggests new medicines or medicine changes.
Never mix medications in the same bottle even if traveling; taping an actual pill to your medication list can help you identify which medicine is which.
When you hear about a new drug or a health tip, ask yourself: Is this based on a clinical trial, an observational study, or only personal endorsements?
Don’t make health decisions on the basis of observational studies. They are interesting to think about, but they
November 2011 •
don’t prove anything.
If you are thinking of buying a supplement or drug, ask your doctor’s opinion. Don’t take them on the basis of personal testimony. Gudas is chairman and Revlon pharmaceutical professor of pharmacology and toxicology of the Department of Pharmacology at Weill Cornell Medical College, and Lachs is director of geriatrics at NewYork-Presbyterian Healthcare System and author of “Treat Me, Not My Age.”
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Hospice care can help families, patients By Deborah Jeanne Sergeant
lthough many people write a will, few consider how they want to spend their last days if they become ill with an incurable, imminently fatal disease. Hospice care is one option when it’s clear that there will be no recovery. By planning ahead, you can choose what you would like and make your wishes known to your loved ones. If you or a loved one has been diagnosed with a terminal disease, it’s important to decide what you want while it’s still possible to make these decisions together. Planning will ensure that the patient care is exactly what patient wants and give peace of mind to family members. Hospice care can help families enjoy loved ones more and help patients take care of the end-of-life tasks important to them. For some people, taking Blomgren care of paperwork gives them peace of mind. Others may want to contact old friends, relive happy memories one more time or fulfill lifelong wishes. “Hospice isn’t about dying but choosing how they want to live,” said Kim Blomgren, admissions patient care manager at Hospice of Central New York in Liverpool. “It’s better to call us early, not the last 48 hours.” Although most people do just that, most hospice providers welcome patients who may have weeks and months yet to live. Calling early “helps patients and families understand what the criteria are,” Blomgren said. “We are open to questions. We can tell them what our agency can provide to them. It gives us a chance to build that relationship and helps us give better care
because they trust us as the experts.” Norma Olcott, a nurse and case manager with Hospice of the Finger Lakes Cayuga County in Auburn, agrees. “It’s good to have an informational visit,” she said. “People can do that any time. It doesn’t have to be when someone’s diagnosed terminally.” Typically, hospice care provides comfort and pain management to patients rather than aggressively treating their illness. Hospice care can take place in any number of settings: private homes, group homes, nursing homes or hospitals. Most people prefer their own private home. The choice is up to the patient and family. Since different communities may offer different hospice options and each hospice provider may offer different services, it pays to look around and find out the different levels of care each offers.
How to Contact Your Hospice ■ Hospice of Central New York 990 7th North St Liverpool, NY 13088 (315) 634-1100 www.hospicecny.org ■ Hospice of the Finger Lakes 1130 Corporate Dr Auburn, NY 13021 (315) 255-2733 www.hospiceofthefingerlakes.org ■ Oswego County Hospice 70 Bunner St Oswego, NY 13126 (315) 349-8259 (315) 349-8269 (fax) oswegocounty.com
“There’s a big misconception as to what hospice provides,” Blomgren said. “A lot think that hospice comes in to take over care. The hospice team helps direct families in caring for their loved ones at home. Our job is to support families.” Usually, hospice providers supplement the home care families give by caring for the patient a few hours a day. “We’re available for assistance and advice 24-7, but the family is pretty much responsible for the care of the person,” Olcott said. “When hospice comes on board, typically the family or friends are primary caregivers. Some people think when hospice comes in, they do 24-hour care and that’s not the case.” Hospice residences, both independent and ones inside nursing homes, can provide back-up care in case in-home care doesn’t work out. Or patients and families may decide from the start that residence-based care is the right choice. Visit with hospice providers to both understand better how hospice works and evaluate their series. “Some hospices are for-profit and some are nonprofit, but it shouldn’t make any difference in the type of care
Excellus Launches New Senior Exercise Program
xcellus BlueCross BlueShield has selected Silver&Fit as the new senior exercise and healthy aging program for its 84,000 Medicare Advantage members in Upstate New York, including those enrolled in Medicare Blue Choice and Medicare Blue PPO. Silver&Fit is provided by American Specialty Health Incorporated, one of the nation’s leading health and wellness organizations. Silver&Fit offers memberships at one of more than 11,000 participating fitness clubs and exercise facilities. Silver&Fit membership includes all of Page 20
the standard amenities offered by that club’s standard membership, such as access to weight equipment, cardiovascular equipment and, where available, pools, saunas and whirlpool facilities. In some full-service fitness clubs, members may also participate in a fitness program specifically designed for older adults. Excellus BlueCross BlueShield Medicare Advantage members who are not able to participate at a fitness club or simply prefer to work out at home may participate instead in the Silver&Fit Home Fitness Program. Upon enrollment, those seniors
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
receive a home fitness kit that may focus on core strength, exercise, walking, aqua aerobics, Pilates, yoga, tai chi or stress management. Each kit includes tools to help members perform exercises at home. Home Fitness Program members may receive DVDs or Internet access to a variety of fitness classes, all of which are designed specifically for seniors. All Silver&Fit members receive The Silver Slate quarterly newsletter, access to the SilverandFit.com website, and a toll-free hotline to provide information and answer questions about the program.
they receive,” Olcott said. It’s a two-way interview to see how well you both fit together. Although a family can change hospice care providers at any time, it’s easier to stick with one. An informational visit can give you “a feel for how hospice works,” Olcott said. “I have never met anyone doing hospice care who isn’t compassionate. You need to be empathetic with the families and patient. Most have a connection in their past where they can empathize because they’ve been through it.” If it’s a residential hospice, you may also be able to talk with other families there. Your doctor or other trusted health experts may have good advice about hospice services, too. State licensure is mandated for hospice caregivers and Joint Commission accreditation is a good sign that quality care is how they do business. Keep in mind that hospice providers are there to make this life transition easier for everyone, including the families of patients. Their service is not only about the patient’s comfort but helping the entire family. Denise Rife, director of patient and family services at Hospice of Central New York in Liverpool, said that their hospice team is there to “help them navigate through the system. If they need medical supplies and that kind of thing we can arrange to make that delivered.” The hospice provider will help with or refer clients to another entity who can help with anything related to patient care or helping the family through this period. Olcott listed among the providers that are part of a hospice team as “bereavement counselors and social counselors “who can help with legal aspects like power of attorney and placement if someone needs it.” Although end of life decision making isn’t easy, it does ease the burden of family members and make the patient more comfortable with his care and surroundings once he is past the point of being able to make decisions.
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By Deborah Jeanne Sergeant
n its hospice care page, Nursesource.org states, “The focus of hospice care is on comprehensive physical, psychosocial, emotional, and spiritual care to terminally ill persons and their families.” Hospice nurses are an important part of the hospice team. • “We can help them define their goals of care when they have a life-limiting prognosis like cancer, COPD or any life-limiting illness. • “Patients and families are pretty good about asking questions. Some ask everything and others say, ‘Tell us what we need to know.’ • Hospice doesn’t just provide care at home. We also provide care at nursing facilities where we have contracts, and at Francis House. We can start the process when someone’s hospitalized. We can provide care in group homes. So it’s for anybody with a life-limiting illness. It’s not just for home. • “I think the hospice 101 lesson is, ‘We can’t fix it if we don’t know it’s broke.’ We’re enabling and empowering families to tell us what they need so we can meet them. Without them being the captain of the ship, we can’t go where we need them to. It’s their job to direct us in what they need. Kim Blomgren, admissions patient care manager at Hospice of Central New York, Liverpool • “We as a hospice team can help [and] maybe improve quality of life when there’s no reasonable hope for a cure. There’s no aggressive treatment. I wish people knew more about us and how we can help before the very end stages of a disease. • “People think we’re there to help them die, which is partly true, in the sense of helping them have a good and
comfortable death, but we’re there to help them live in the last stage of life. We can help them stay comfortable. • “We’re not just there for cancer patients.” Norma Olcott, registered nurse and case manager with Hospice of the Finger Lakes Cayuga County in Auburn • “It’s very important that we are updated on any changes that are going on with the patients and any concerns the family has. The sooner we are aware, the more proactive we can be in meeting their needs. • “One thing we like to emphasize with patients and family is that we like to think of hospice care as one-stop shopping. You can make one phone call. If your family member has a hospital bed that’s not working, we can make arrangements for the manufacturer to fix the bed. Or if you need prescription refills. The family can call us and we can take it from there. Sometimes, they’re waiting for a call back from a doctor’s office and we can facilitate that and maybe get that call more quickly.” Denise Rife, registered nurse at Hospice of Central New York, Liverpool
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Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.
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STDs on Rise Among Seniors
The Social Ask Security Ofﬁce
Why more seniors are diagnosed with chlamydia, herpes, gonorrhea, HIV and AIDS
By Deborah Banikowski, District Manager in Syracuse.
Autumn Offers Lessons For Retirement
By Deborah Jeanne Sergeant
ypically, sexually transmitted diseases (STDs) are associated with young people who through carelessness or ignorance become infected through promiscuous behavior. But the rate of infections has been increasing sharply among members of a different age group: those 55-plus. Sharon Brangman, geriatrician with SUNY Upstate Medical University, has observed the trend. “There are a lot of myths about older people not being intimate, but they are sexually active into their 80s and beyond.” The rates per hundred thousand of reported cases of chlamydia, gonorrhea, and primary and secondary syphilis increased from 10.76 in 1996 to 14.99 in 2009 nationwide, according to statistics released by the Centers for Disease Control. The CDC reports that for the same time period in New York, the rate of chlamydia grew from 23.01 per 100,000 to 45.86. Primary and secondary syphilis increased from .75 to 4.10. Only gonorrhea decreased from 18.28 to 17.26. The CDC also stated that “in 2009, the highest percentage of new HIV diagnoses were among those aged 40-44 years.” More people are living longer with AIDS, thanks to medical advances, so the number of seniors with HIV/AIDS will continue to rise. Many different factors influence the numbers of older STD patients, including how seniors age in modern times. “People are entering older age healthier,” Brangman said. “We can manage chronic diseases, and people are more active and more likely to engage in sexual activity. “Women tend to live longer so many people are widowed or divorced and more actively looking for partners,” Brangman added. “We know that in a lot of senior communities, there are a lot more women than men. Men are suddenly surrounded by women who are very interested in them.” More than any other generation, this group of seniors has greater availability to potential partners since fewer stay with a mate exclusively for life. While not socially acceptable, marital unfaithfulness bears fewer stigmas than it used to. “There’s also social media out there that makes it easier to find dates,” said Tina Bourgeois, a licensed practical nurse with Oswego County Health Department. Bourgeois provides STD testing and counseling for the local health department. Diane Rothermel, director of the Bureau of Disease Control, Onondaga County Health Department, adds that online dating has made finding sexual partners easier for seniors, but ironically, many “find sexuality and sexually transmitted disease difficult or embarrassing to discuss with a new partner.” Numerous senior-oriented clubs and organizations help seniors make friends and facilitate developing new romantic relationships after widowhood or divorce. Seniors also have greater ability Page 22
to engage in intimate relationships because of new medications. Viagra, Cialis, Revatio and Levitra can help men remain sexually active for as long as they are otherwise healthy. For menopausal women, libido can plummet for a variety of reasons, including change in hormonal levels and drier tissues. Some women have found improvement with medication that helps stabilize their hormones, using lubricants to combat dryness, and using herbal or other alternative health preparations to help improve mood and libido. Today’s seniors have fewer social or moral qualms about sexual relationships outside of marriage than did previous generations. Their grandparents typically stayed married for life and remained monogamous. In their parent’s generation, pre-marital sex, divorces and affairs were still scandals. Now that the 60s-era flower children are in older adulthood, a “free love” philosophy can have greater health implications since they may not be as likely to use condoms. “They aren’t using condoms because there’s no chance of pregnancy,” Bourgeois said. Because they have little education on STDs, some may mistake the symptoms as old age or other conditions that mimic those of STDs. It’s not surprising that seniors are misinformed as to how to prevent or recognize STDs. Most public service information regarding STDs is geared toward young people, but the means of preventing STDs is the same regardless of age. “It’s just like when you’re 20,” Bourgeois said. “Use condoms and know who your sex partners are and their history.” Rothermel of the Onondaga County Health Department also reminds seniors that “sex with too much alcohol or mood-altering drugs can be dangerous as it may lessen your ability to make responsible choices.” Maturity doesn’t equal an ability to “hold liquor” or overcome the tendency for alcohol to loosen inhibitions. Condoms can help but cannot offer 100-percent effective protection from all STDs. Some can still be transmitted in spite of condom use. “Talk with your partner about sex before the heat of passion,” Rothermel said. “Don’t let your partner remain silent. Find out about your partner’s health and sexual history. Make conversations about health a natural part of your sexual relationship. Watch out for the smooth talker.” The only way to be absolutely safe is to avoid intimacy or to have monogamous relations only with another person who also has been 100-percent faithful. Some STDs take years to manifest symptoms, so a disease transmitted during long-forgotten fling can remain unnoticed until a new partner becomes infected. Websites such as WebMD.com, CDC.gov and Mayoclinic.com offer reliable information on this and many other health topics.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
Social Security is the foundation for a secure retirement, but was never meant to be the solesource of income for retirees
n autumn, animals know winter is coming and take the steps to prepare. Bears grow thicker fur and settle in for peaceful hibernation. Squirrels collect and store acorns and other nuts. Birds, favoring warmer weather and having the means to make it possible, fly south for the winter. When it comes to preparing for retirement, we can learn from the animals — making sure the transition into the later years of our lives is as smooth and comfortable as possible. The best place to start is a visit to www.socialsecurity. gov. You can get an instant, personalized estimate of your future Social Security benefits at www.socialsecurity. gov/estimator. To prepare for a Banikowski comfortable retirement, you should start saving as early as possible. Social Security is the foundation for a secure retirement, but was never meant to be the sole-source of income for retirees. In addition to Social Security, you also
Q&A Q: I live in a hurricane zone and there’s always a good chance I’ll have to evacuate. What should I do if I’m expecting my check and a hurricane disrupts the mail? A: To avoid this situation altogether, get your payments sent electronically. Direct deposit and direct express are the fast, easy and secure ways to receive your benefit payment. For more information, see www.socialsecurity. gov/deposit. Q: How long does a person need to work to become eligible for retirement benefits? A: We base Social Security benefits on work credits. Anyone born in 1929 or later needs 40 Social Security credits to be eligible for retirement benefits. You can earn up to four credits a year, so you will need to work at least 10 years to become eligible for retirement benefits. Learn more by reading the publication How You Earn Credits at www.socialsecurity.gov/pubs/10072. html. Q: Will my son be eligible to receive benefits on his retired father’s record
will need savings, investments, pensions or retirement accounts to make sure you have enough money to live comfortably when you retire. Learn about retirement planning and how to save at www.socialsecurity.gov/retire2/other2.htm. But wait, there’s more. If you decide you’re going to be a “snowbird” when retirement comes, and go to warmer climates during winter weather, make sure that your Social Security payment goes with you. The best way to do that is to use direct deposit. You never have to worry about where your monthly payment will be delivered — it will show up in your bank account whether you’re in the Dakotas or the Florida Keys. Learn all about electronic payments at www. socialsecurity.gov/deposit. Whether you’re in the spring, summer, or entering the autumn of your life, the best time to start preparing for retirement is always the present. A good place to start is at www.socialsecurity. gov. Even the animals know they can’t wait until the last minute to prepare for a comfortable winter. Take a lesson from our furry and feathered friends and prepare for your own comfortable retirement.
while going to college? A: No. At one time, Social Security did pay benefits to eligible college students. But the law changed in 1981. We now pay benefits only to students taking courses at grade 12 or below. Normally, benefits stop when children reach age 18 unless they are disabled. However, if children are still full-time students at a secondary (or elementary) school at age 18, benefits generally can continue until they graduate or until two months after they reach age 19, whichever is first. If your child is still going to be in school at age 19, you’ll want to visit www. socialsecurity.gov/schools. Q: My brother had an accident at work last year and is now receiving Social Security disability benefits. His wife and son also receive benefits. Before his accident, he helped support another daughter by a woman he never married. Is the second child entitled to benefits? A: The child may qualify for Social Security benefits even though your brother wasn’t married to the second child’s mother. The child’s caretaker should file an application on her behalf. For more information, visit us online at www.socialsecurity.gov.
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By Jim Miller
New Flu Vaccine for Seniors Provides Better Protection Dear Savvy Senior, I’ve read that there is a new extra-strength flu vaccine being offered to seniors this year. What can you tell me about it, where can I find it, and does Medicare cover it? Flu-Conscious Connie
For more information contact: Penny Foster-Pratt at 598-4710, ext. 1094 OCO, Inc. • 239 Oneida St., Fulton www.oco.org
HOME DELIVERED MEALS ARE A LIFELINE TO MANY FRAIL ELDERLY SENIORS Nutritious, hot noon meals are available throughout Cayuga County for those seniors unable to prepare a meal for themselves. Meals can be home delivered or available at one of six senior meal sites. (There is a suggested donation)
your doctor or pharmacist, or check the online flu-shot locator at flu.gov for clinics or stores offering flu shots. Then, contact some in your area to see whether they have the High-Dose vaccine. CVS, Walgreens, Safeway, Kmart, Rite Aid and Kroger are among some of the chains offering the High-Dose shot. You’ll also be happy to know that if you’re a Medicare beneficiary, Part B will cover 100 percent of the cost of your High-Dose vaccination. But if you’re not covered the cost is around $50 to $60 — that’s about double of what you’d pay for a regular flu shot.
If you know someone who could beneﬁt From a hot noon meal, call the: Cayuga County Ofﬁce for the Aging Senior Nutrition Program 253-1427
Dear Connie, The new extra-strength flu vaccination you’re inquiring about is called the Fluzone High-Dose, and it’s designed specifically for seniors, aged 65 years and older. Here’s what you should know.
Fluzone High-Dose Manufactured by Sanofi Pasteur Inc., the Fluzone High-Dose vaccine was approved by the U.S. Food and Drug Administration in December 2009, and was first made available last flu season on a limited basis. The main difference between the Fluzone High-Dose and a regular flu shot is its potency. The High-Dose vaccine contain four times the amount of antigen (the part of the vaccine that prompts the body to make antibody) as a regular flu shot does, which creates a stronger immune response for better protection. This extra protection is particularly helpful to seniors who have weaker immune defenses and have a great risk of developing dangerous flu complications. The CDC estimates that the flu puts more than 200,000 people in the hospital each year and kills around 24,000 — 95 percent of whom are seniors. As with all flu vaccines, Fluzone High-Dose is not recommended for seniors who are allergic to chicken eggs, or those who have had a severe reaction to a flu vaccine in the past. To locate a vaccination site that offers the Fluzone High-Dose, ask
Another important vaccination the CDC recommends to seniors — especially this time of year – is the pneumococcal polysaccharide vaccine for pneumonia and meningitis (the vaccine is called Pneumovax 23). Pneumonia causes more than 40,000 deaths in the U.S. each year, many of which could be prevented by this vaccine. If you’re over age 65 and haven’t already gotten this one-time-only shot, you should get it now before flu season hits. Pneumovax 23 is also covered under Medicare Part B, and you can get it on the same day you get your flu shot. If you’re not covered by insurance, this vaccine costs around $75 to $85 at retail clinics. This vaccine is also recommended to adults under age 65 if they smoke or have certain chronic conditions like asthma, heart disease, lung disease, kidney disease, diabetes, sickle cell disease, have had their spleen removed, or have a weakened immune system due to cancer, HIV or an organ transplant.
Savvy Tips In addition to getting vaccinated, the CDC reminds everyone that the three best ways to stay healthy during flu season is to wash your hands frequently with soap and water, cover your mouth and nose when you cough or sneeze and stay home if you’re sick. For more information on the recommended vaccines for older adults see cdc.gov/vaccines.
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.
Get Back to Your Life When recovering from a hip or knee replacement, stroke or other medical condition, you want to get back to your life and home as soon as possible. The road back home starts at The Centers at St. Camillus. The team of rehabilitation experts in the RehabPathTM Subacute Program provide comprehensive short-term inpatient rehabilitation to help you build strength and independence for a successful and speedy recovery. For more information about the RehabPathTM Subacute Program at The Centers at St. Camillus, call 488-1500.
813 Fay Road • Syracuse, NY 13219 • www.st-camillus.org November 2011 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
“Embracing Age” Launched to Help Seniors Remain at Home Program designed to offer services to help seniors live independently and healthy while avoiding nursing homes By Aaron Gifford
nother program is in place to help Central New York seniors remain in their own homes
longer. Franciscan Companies, an affiliate of St. Joseph’s Hospital Health Center, recently launched the “Embracing Age” initiative, which offers a variety of services to help seniors live independently and healthy while avoiding nursing homes. Chief Executive Officer Frank Smith thought of the idea after noticing an influx of calls from older adults seeking referrals for roofers, snow plow contractors, reliable transportation providers, financial advisers — even someone to explain how to use a computer or smart phone. “Growing old brings new challenges and needs — not just in health care, but in legal, financial, social and spiritual matters,” Smith said. “Finding the right services and the right answers from knowledgeable and supportive people can be difficult. Members and caregivers alike can have peace of mind and comfort knowing that Embracing Age is listening to their concerns and ensuring their well-being.” Initially, the idea was to do the leg work in investigating the credentials, price, availability and reputation of those service providers and recommending choices to seniors. As that preferred provider service was being developed, however, Franciscan employees realized that there was a need for a more comprehensive program. Mary Gualtieri, Embracing Age eldercare specialist, said the program was officially launched in September. The first two members enrolled a short time later and area physicians are making referrals to the program. Here’s how it works: Eldercare specialists receive inquiries by phone and answer initial questions interested seniors may have about the program. The next step is a free informational meeting. If the person decided to enroll, an eldercare specialist then visits the home for a comprehensive assessment to examine how the home is equipped and managed. “Do they have section rugs they could trip over? Do they have night lights for safety? Are the rooms well-lit? Are there railings? Are the chairs easy enough to get in and out of? Should there be grab bars in the bathroom? What about smoke detectors? These are the things we look for,” Gualtieri said. Next, an eldercare specialist looks at the client’s day-to-day functions, including overall health, vision, their Page 24
ability to drive a car, take a bath, dress and groom themselves, eat a nutritious diet, exercise, socialize, manage their money and take medications according to the proper instructions. Existing support networks, such as the number of relatives in the area and the frequency of their visits, is also factored into the mix. Then a plan is written for the client. It would include what, if any, modifications should be made to the home and how often Embracing Age representatives should stay in touch with them. There is also an advances planning component where the client selects or at least narrows in on options for if and when they reach the point where they can’t function in their own home. “Our goal is to keep them at home as long as possible,” Gualtieri stressed, “but we have to be proactive if there’s a need to change.” “The specialists will follow someone on an ongoing basis,” she added, noting that inquiries from potential clients are kept confidential, and visits or meeting would never result in a client being taken out of their home against their will. “We follow their lead, and honor their independence and their privacy. Our purpose is to honor their wishes and respect their needs for independence.” Members pay $500 a year for the program. That fee includes the free installation of the optional Lifeline Medical Alert system, which links the resident’s home to a monitoring center that can contact rescue services, medical providers, relatives and the Embracing Age office in emergencies. The Lifeline service fee is $38 a month. Gualtieri said she expects that the program will eventually service a wide variety of needs. For example, an older married couple recently enrolled just for the purpose of the preferred provider service to help them find home repair contractors and possible insurance providers. The husband and wife are avid golfers and very active with a local senior center, and don’t currently require any Embracing Age services related to their health or mobility at this time. On the other side of the spectrum, there have been inquiries from elderly widows who don’t have any living relatives in the area and need help getting out of the house. Angie Howe, 86, of Cicero, is the program’s first member. Her husband passed away in March. Howe still drives and has four grown children in the area who visit her often, but she
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
People attending a news conference Sept. 28 where the program Embracing Age was announced. Pictured from left are Tim Carroll, director of mayoral initiatives; Kathyrn Ruscitto, president & CEO of St. Joseph’s Hospital Health Center; Frank L. Smith, Jr., president & CEO of Franciscan Companies; and state Sen. John Defrancisco. still wanted to expand her support network for emergency situations. She likes the fact that she can depend on Gualtieri if she encounters an unexpected situation. After a recent wind storm left piles of debris on her lawns, for example, she called Gualtieri, who in turn contacted a landscaper who cleaned up the yard the same day. “She’s wonderful,” Howe said. “I couldn’t have a better contact.” Embracing Age prides itself on the preferred provider service and its ability to forge caring relationships between eldercare specialists and clients. Embracing Age is not, however, the first or only program in Central New York aimed at keeping seniors in their homes as long as possible. The PACE CNY program, a collaborative effort by Loretto and St. Joseph’s Hospital Health Center that was first implemented in 1997, provides home care services and transportation to a day care center where participants can socialize and engage in various activities with their peers. And it appears that in the years to come there will be plenty of room for additional programs that help seniors
avoid or prolong moving into nursing homes. A 2011 AARP nationwide survey found that the vast majority of adults 50 and over would prefer to remain in their homes as long as possible, and four in five support shifting government money used for nursing homes to home care or communitybased care. A study commissioned by Loretto determined that the population of Onondaga County residents between 65 and 74 is on track to increase from 30,860 in 2010 to 36,256 in 2014, or 17.5 percent, while the population of those between 75 and 84 decreases by 6.4 percent in the same five-year period, from 21,298 to 19,922. The number of those 85 and over is expected to decrease from 10,235 to 9,016, or 11.9 percent. This means that in the short term, there’s a need to assist older adults who are not necessarily elderly. Loretto is also in the midst of a $40 million “Green Community” initiative where more than 100 of its nursing home beds will be replaced by 13 small homes. About 12 residents will occupy each assisted living facility.
Upstate Golisano Children’s Hospital issues therapy dog trading cards
ards featuring Sebastian, a poodle; Coletrain, a shih-tzu mix; and Daphne, a golden retriever; may soon take their place in shoeboxes of trading card collectors, but you have to be a patient to get one. Upstate Golisano Children’s Hospital is issuing trading cards of therapy dogs that regularly visit the young patients. The front of each card features the dog’s photo; the back of the card includes interesting tidbits, such as the dog’s hometown and favorite activity. For example, Coletrain hails from Skaneateles and likes to eat canned pumpkin. Sue Karl, a certified child life specialist at Upstate Golisano, is the human behind the idea of featuring the four-legged friends on their own calling card. “We give the cards to the kids in anticipation of the dog’s visit,” Karl said. “The cards take the uncertainty out of the visit, and uncertainty is a big fear in a hospital for kids. So the cards are a great way to start the relationship between the child and dog.” And the relationship is, well, some would say “puppy love.” “It’s amazing how a sweet, friendly dog can motivate a child and brighten his or her day,” Karl said. “It’s almost instantaneous, the big smile that comes across a child’s face when Daphne, Coletrain or Sebastian come to visit.” Karl recalls how one child who was downcast and frowning for most of their stay, lit up with the brightest smile when the dog walked in their room. “This child had not smiled in days and in walked one of our dogs. Wow, this child was so upbeat, there was a measurable change in the child’s demeanor from this one special visit.” When the dogs come to the hospital they usually see about 15 children with each visit lasting about 10 minutes. For some, Karl says, the visits are too short. “Many of the kids—and parents, too—don’t want the dogs to leave.” But now, thanks to the therapy dog trading cards, patients at Upstate Golisano Children’s Hospital will have an official reminder of the furry friend who helped them get well.
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OASIS Celebrates 10 Years in CNY Big milestone for nonprofit in East Syracuse. OASIS offers nearly 400 different activities for those 50 and older, with classes ranging from personal finance, to foreign language, to music, to how-to guides like Snowbirding 101 By Aaron Gifford
t was mainly by chance that an OASIS education program for area residents 50 and over set up shop in Syracuse. But luck has had nothing to do with the program’s growth and success over the past decade. “The stars were aligned,” recalled OASIS Executive Director Lauren Feiglin. “I guess I was in the right place at the right time.” That was back in 1997. Feiglin, then the executive director of OASIS in Cleveland, Ohio, moved to Syracuse after her husband landed a job at Upstate Medical Center. Feiglin persuaded Upstate to sponsor a charter here. Coincidentally, Upstate had just completed a study that determined more lifelong learning programs were needed locally to keep seniors mentally and physically fit. OASIS, Feiglin said, was an easy sell. The Syracuse charter was established and ran a few classes in borrowed space at different locations before its center officially opened in Shoppingtown Mall in November 2001. As part of the national organization’s model that dates back to its 1982 inception, department stores covered the costs for space. Kaufmann‘s provided Syracuse OASIS $500,000 for the DeWitt space. Upstate, meanwhile, pledged a long-term commitment to the agency. OASIS began in 2001 with 11 different programs, mainly in the areas of art, fitness and health. Today it offers nearly 400 different activities, with classes ranging from personal finance, to foreign language, to music, to how-to guides like “Snowbirding 101” and deciding between a laptop computer and an iPad. It also coordinates intergenerational activities Feiglin where seniors mentor youth. In the active generations program, for example, OASIS volunteers visit Syracuse city school to teach the students about nutrition and physical activities as an alternative to unhealthy snacks and television or video games. “People over 50 are amazing,” Feiglin said. “They have so many years of experience in running their lives. They have so much they can teach children.” All told, OASIS has 9,000 members, with 1,200 people enrolled in classes for the current trimester. That’s an increase of almost 600 participants from this time last year. The average OASIS participant takes about four classes per year. OASIS only has three full-time paid employees; only one position has been added since 2001. The number of volunteers, meanwhile, increased from 54 to 165 in the same time period, and this year they are on track to donate more than 9,500 hours of their time. The total enrollment for programs in the past decade now exceeds 86,000. Last year, the center moved from
Some of the OASIS volunteer leadership team members in a photo taken while they were hosting the OASIS annual volunteer recognition luncheon, one of the many events the organization holds. Shoppingtown to an 11,000 square foot space on the first floor of the former Telergy building on Route 298 in East Syracuse. That facility includes a 140seat lecture hall, studio space for art and writing classes, a fitness room, four desks for the volunteer receptionists and clerical workers, a break room for volunteers and employees, and a technology lab that will eventually house 20 computers. Upstate’s HealthLink education program is located there as well. Many of the classes fill up quickly and are offered repeatedly to accommodate the demand. Some of the presenters are so engaging that snowbirds have returned from Florida early to catch a class. Feiglin knows of members who have rescheduled surgeries to avoid missing a class. Recently, a regular participant went to the center immediately after returning home from Italy and stayed up for 20 hours straight in order to catch a presentation. And there’s no shortage of volunteers when those who offer their services to OASIS free of charge are rewarded with the benefit of enrolling in a class before others. “Syracuse is a smaller city, but the people here are so engaged in their community in one way or the other,” Feiglin said. “It’s just astounding.” “We’ve had many people who started with us in their 70s that are now in their 80s,” said Feiglin, 60. “It’s not just a social center — people come here with a purpose.” There are program fees because most of the teachers or presenters are paid. But even so, the economic recession has not had a negative impact on OASIS, explained Tracie Alexander, the agency’s program and volunteer manager. “It’s an affordable activity,” she said. “I’ve heard people say that instead of taking a vacation, they come to OASIS.” Alexander added that OASIS will waive the $20 program processing fee for those who cannot afford it. As a nonprofit agency, OASIS receives some funding from its national office, though a significant chunk of its November 2011 •
budget comes from local fund-raising via the Friends of OASIS campaign. This is the last year the agency will receive money from Macy’s, which has tallied about $30,000 annually for facilities costs in recent years. Nancy George, 76, of Manlius, has volunteered on OASIS’ reception/clerical desk for almost eight years now. She also serves on its Leadership Team that trains and supervises new volunteers. When she’s not volunteering, George spends a few hours a week taking classes or participating in one of the organization’s many book discussion groups. “It’s a great place,” George said. “It keeps your brain alive. People keep coming back because they are all interested in what’s happening in their world and what’s important for their mental and physical health. Syracuse OASIS is unique because no place else has a facility like this.” OASIS also has locations in Rochester and Albany. Nationwide, more than 40,000 adults 50 and over are enrolled in OASIS classes in different cities across the country. The organization also boasts more than 9,000 volunteers who have provided more than 550,000 hours of community service annually, teaching classes, mentoring youth, heading peer support groups and teaching other seniors how to use computers. The tutoring program alone has served more than 300,000 children, 90 percent of which have demonstrated academic performance. The Syracuse OASIS 10-year anniversary celebration is planned for 1 p.m. until 5 p.m. Nov. 16 at its East Syracuse center. Programs include a classical music performance from 1 p.m. to 2 p.m. by pianists Patricia DeAngelis and Steven Rosenfeld. From 2:30-3 p.m., Dr. Gregory Eastwood of SUNY Upstate Medical Center will discuss “Dying isn’t what it used to be.” And from 3:30 – 5 p.m., there will be a retrospective discussion on the beginning of Syracuse OASIS. Refreshments will be served, and the event is free and open to the public.
IN GOOD HEALTH – CNY’s . Healthcare Newspaper
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Hematology-Oncology Associates of CNY Receives Recognition Largest oncology society in United States says practice delivers highest quality of care for cancer patients Hematology-Oncology Associates of CNY (HOA) has been recognized by the Quality Oncology Practice Initiative (QOPI) certification program, an affiliate of the American Society of Clinical Oncology (ASCO). The QOPI certification program provides a three-year certification for outpatient hematology-oncology practices that meet the highest standards for quality cancer care. “Our practice remains committed to the highest level of quality care in a loving and healing environment for our patients. We are differentiated from other cancer practices for a multitude of reasons and we’re extremely proud to Roefaro receive this certification from ASCO and QOPI which underscores our commitment to excellence,” said Maryann Roefaro, CEO of HOA. “Cancer patients and their families should expect nothing less than accountability and the highest standards from their cancer care providers,” said Dr. Allen S. Lichter, CEO of ASCO and president of the QOPI certification program. “QOPI participation reflects a commitment to quality of care that leads to fundamental changes in the clinical practice of oncology. Oncology practices that commit to quality and safety are those that provide the most optimal cancer care. The certification program helps practices determine whether they are providing the best treatment and care possible to their patients, and demonstrates a commitment to excellence and ongoing quality improvement in the hematology-oncology outpatient practice.” QOPI is a voluntary, self-assessment and improvement program launched by ASCO in 2006 to help hematology-oncology and medical oncology practices assess the quality of the care they provide to patients. Through the QOPI program, practices abstract data from patients’ records up to twice per year and enter this information
into a secure database. More than 700 oncology practices have registered in the QOPI program. The QOPI certification program (QCP) was launched in January 2010. This certification for outpatient oncology practices is the first program of its kind for oncology in the United States. Oncologists can achieve certification by demonstrating practice consistent with the highest standards of care. The QCP seal designates those practices that not only scored high on the key QOPI quality measures, but meet rigorous safety measures established by ASCO and the Oncology Nursing Society (ONS). Hematology-Oncology Associates is one of 98 cancer practices in the country and one of six in New York state who have received certification. HOA is the only QOPI certified cancer center in Central New York. QOPI analyzes individual practice data and compares these to more than 100 evidence-based and consensus quality measures. The information is then provided in reports to participating practices. Individual practices are also able to compare their performance to data from other practices across the country. Based on this feedback, doctors and practices can identify areas for improvement. To become certified, practices have to submit to an evaluation of their entire practice and documentation standards. The QCP staff and steering group members then verify that the evaluation and documents are correct and that the practices met core standards in all areas of treatment, including: • treatment planning; • staff training and education; • chemotherapy orders and drug preparation; • patient consent and education; • safe chemotherapy administration; • monitoring and assessment of patient well-being.
Practice to Celebrate 30th Anniversary in 2012 Hematology-Oncology Associates will celebrate its 30 year anniversary in 2012. The practice will also celebrate 25 years of being a CCOP — Community Clinical Oncology Program through the National Cancer Institute. In addition to being the only CCOP in Central New York, HOA has the greatest number of active clinical research trials available in our community. This prestigious affiliation allows cancer patients in the community to access clinical research trials and collaborate with major cancer centers across the nation. Through the CCOP, staff
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
and patients maintain the opportunity to contribute to the improvement of cancer care and prevention. The American Society of Clinical Oncology (ASCO) is the world’s leading professional organization representing physicians who care for people with cancer. With nearly 30,000 members, ASCO is committed to improving cancer care through scientific meetings, educational programs and peer-reviewed journals. For ASCO information and resources, visit www.asco.org. Patient-oriented cancer information is available at www.Cancer.Net.
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H ealth News NYCC now offers advanced program in sport science
made possible by a generous grant from the Central New York Community Foundation.
New York Chiropractic College has received approval from the New York State Education Department to offer an advanced certificate program in sports science and human performance. The program is designed to provide the student with a solid foundation of exercise science and sports medicine principles that leads to unique hands-on clinical workshop experiences at a variety of sporting events. The program was created to prepare the NYCC graduate with the opportunity to serve the growing national interest in attaining and maintaining optimal physical fitness from the professional athlete to the casual exerciser, according to Executive Vice President and Provost, Michael Mestan. The advanced sports and human performance certificate program may be completed while the student is matriculating in the doctor of Chiropractic degree program at New York Chiropractic College. According to the college, the additional clinical competence and experiences by recipients of the sports and human performance certificate will provide them with the competitive edge to obtain affiliations with sports organizations, professional and semiprofessional teams, and collegiate and high school athletic programs, looking for a healthcare provider.
E. Syracuse audiologist earns pediatric certiﬁcation
RSVP of Madison County receives award The Nation Senior Corps Association announced the winner of the 2011 Innovators Award for the Retired Senior Volunteer Program to RSVP of Madison County. The award commends RSVP Volunteers of Madison County as a “shining example of creativity and the ability to forge new ground in Senior Corps project development.” The agency also received a $650 prize. The NSCA Innovators Award is designed to identify and publicize innovative practices in Senior Corps program management. Winning entries must be existing practices that address issues common to Senior Corps program management. They must be replicable, realize a concrete or measurable outcome, and lead to superior program performance. Innovative practices are distinguished by their creativity and contribute to the improved performance of the RSVP program. RSVP of Madison County’s winning entry was the “Building Nonprofit Capacity Through Volunteer Engagement” project. The program implemented a four-pronged marketing approach for volunteer recruitment, including convening focus groups, offering new volunteer opportunities, publicizing volunteers profiles, updating the website and including social media in volunteer recruitment efforts. The project helped RSVP Madison County enlist 106 new volunteers in 2010 and add four new projects with measurable community impact. The marketing and recruitment project was
Arlene Balestra-Marko recently earned the distinction as an audiologist with a pediatric audiology specialty certification from the American Board of Audiology. She becomes one of seven nationally who has earned this designation by demonstrating expertise in a rigorous and comprehensive examination process. A news release Balestra-Marko states that with over 15 years of experience in childhood hearing loss, BalestraMarko combines a solid foundation of both clinical and educational domains to assess the whole child from diagnostics to educational impacts. She is a graduate of Syracuse University and received her clinical doctorate from Salus University. Balestra-Marko is the founding director of Hear 2 Learn and Hear for Life in East Syracuse. She is active in community collaborations that provide digital amplification to children and seniors of low-income. She frequently lectures on topics pertaining to childhood hearing loss and is an approved trainer of New York State Early Intervention: Clinical Practice Guidelines-Hearing Loss.
Alzheimer’s group names new board of directors The board of directors of the Alzheimer’s Association, Central New York Chapter voted to appoint six individuals to two-year terms. They are: • Robin Bennett, director of clinical services for the Loretto Adult Community. She is a registered nurse, who has been a nursing supervisor at Syracuse’s Loretto’s Heritage Apartments and Iroquois Senior Nursing Facility. Bennett is responsible for Loretto’s quality control programs and internal audits. She holds a master’s degree in nursing from Le Moyne College and resides in Cazenovia. • Jean Carnese, practice administrator for Family Practice Associates PLLC of Liverpool. She oversees a staff of 95 individuals at the primary care practice. Carnese has volunteered on the diabetes board at Crouse Hospital and is a member of the Medical Group Management Association’s local chapter. She holds a bachelor’s degree from the University of Rochester and a Master’s of Business Administration from Syracuse University. She lives in Baldwinsville. • Julie Crowley of Ithaca is the owner of Triphammer Wine and Spirits and the Ithaca Coffee Company. Her businesses annually sponsor “An Evening to Remember,” a fundraising event to benefit the chapter. Crowley is an active member of the Tompkins
Oneida Healthcare Physician Assistant Receives State Award Gregory Wright of Oneida Healthcare was recently honored as the 2011 Physician Assistant of the Year by the New York State Society of Physician Assistants during its annual CME conference in Saratoga Springs. Wright, an emergency department PA, is described by colleagues as “a role model for innovation, dedication, and responsiveness.” Janet McMahon, director of the Oneida Healthcare emergency department, had high praise for Wright. “Greg has been an invaluable asset to our ED for the Peter Kummell, NYSSPA president (right), last six-seven years. He is an excellent practitioner, but presented Gregory Wright with the Physician his greatest attributes are his Assistant of the Year Award. caring and compassionate giving back to his local community bedside manner. He always goes through his work at Greater Lenox the extra step for every patient no Ambulance Service and even to the matter how large or minor the complaint. He is also a tireless instructor international community with a medical mission to Haiti, in addition and mentor to PA students,” she to leading yearly medical missions said. to Nicaragua. He received standing OHC President & CEO Gene ovations before and after his accepMorreale said: “All of us at Oneida tance remarks and said that he was Healthcare are so proud of Greg, not just for being recognized for this a little uncomfortable with all of the award, but also for being the person attention and accolades. “As I have said to many of my friends and colthat he is. His attitude and clinical leagues, I can think of PAs who are expertise allow him to function at a better than me clinically and acahigh level and his patient-centereddemically that should receive this ness approach is appreciated by our award. It is one of the most humpatients and their loved ones.” bling events in my life.” Wright was also recognized for County Chamber of Commerce, serving as its treasurer and vice-treasurer. She is currently on the board of Challenge Industries. Crowley is a caregiver for her mother, who has been diagnosed with Alzheimer’s disease. She holds master’s degrees in business administration and management information systems from Boston University. • Thomas J. Grooms is a retired attorney from the law firm of Bond, Schoeneck and King PLLC. His specialty was labor law, having first worked with the National Labor Relations Board before going to BS&K, where he retired as a senior partner. He earned his law degree from Syracuse University, and he and his wife live in Syracuse. • Christina Hasemann is a certified dietitian who specializes in senior nutrition. She owns her own business, NY-Penn Nutrition Services, Inc., and is an adjunct at a number of colleges in the Southern Tier. She is joining the chapter board for the second time. Central New York Chapter by-laws state that a board member can serve up to four two-year terms. She served eight years from 2002 to 2010, and previously served an eight-year term on the Southern Tier Chapter board prior to its merger with the Central New York Chapter. She holds master’s and doctoral degrees from Marywood University and lives in Binghamton. • Elizabeth Perry is an attorney with Bond, Schoeneck & King’s estate and financial planning team. Her specialties are estate planning, estate November 2011 •
and trust administration, fiduciary litigation and guardianships. She is on the board of directors at Elmcrest Children’s Center and was an associate board member for the Make-A-Wish Foundation of Central New York. Perry holds a bachelor’s degree from Union College and earned her law degree from the University at Buffalo. She resides in Syracuse. Also at the June meeting, Mary Pat Oliker of Manlius and Ellen Somers of Syracuse renewed their terms on the board. Oliker was also appointed the board secretary. The board’s executive leadership team was also appointed. Oliker and Somers, the board’s member-at-large, joined Paul Stepien, president, Camillus; Keith B. Rung, interim president, Syracuse; Scott Harris, vice president, Camillus; Karl Jacob, treasurer, Baldwinsville. Board members may be appointed to a maximum of four two-year terms. Executive positions on the Central New York Chapter board are one-year appointments.
Alzheimer’s Association hires volunteer specialist The Alzheimer’s Association, Central New York Chapter announced the hiring of Vanessa Malone as its volunteer specialist. She will oversee the chapter’s volunteer program, including
IN GOOD HEALTH – CNY’s Healthcare Newspaper
H ealth News the recruitment and retention of volunteers within its 14-county area in support of the organization’s strategic plan. Malone is also part of the chapter’s Walk To End Alzheimer’s team, where she is responsible for committee recruitment and volunteer train-
mentoring program. Open to all area youth the CYO program offers a safe, well-supervised, friendly environment where youth can participate in a variety of programs that promote positive development and offers youth the opportunity for healthy interaction with their peers.
Malone formerly oversaw volunteers for the Zoological Society of San Diego, as well as the Rancho Coastal Humane Society. She has also designed and managed websites for Smartflex Solutions. A Syracuse native and resident, Malone graduated from SUNY Geneseo.
Helen Hoefer has been named director of community services programs at Catholic Charities of Oswego County. She joined Catholic Charities in 2001 as a parent educator and has been serving as director of the agency’s emergency services program since 2009. She will be responsible for both the emergency services and the CYO program. The CYO provides a safe, supervised, friendly environment that provides area youth with a variety of programs that promote positive development “We are happy to have Helen in this position,” said the agency’s executive director, Mary-Margaret Pezzella-Pekow. “Helen has been excellent as the director of our emergency services Hoefer program. Under her guidance the program has undergone a number of positive changes, including the remodeling of our thrift shop and a complete makeover for our food pantry, and the establishment of a client choice system.” Recently, Hoefer oversaw yet another upgrade to the Catholic Charities’ food pantry. In September the
Catholic Charities names new CYO supervisor Stacie Roberts has been appointed supervisor for Catholic Charities of Oswego County’s CYO program. Roberts holds a Bachelor of Arts degree in public justice and a master’s degree in education from SUNY Oswego. She previously worked as a teacher’s assistant in the Red Creek School District and as a tutor with Wayne-Fingerlakes BOCES. No stranger to Catholic Charities, Roberts worked in the agency’s Kinship program from 2005 to 2007 and most recently served as the coordinator for the CYO’s Roberts
Helen Hoefer named Catholic Charities director
Outstanding Employees at OCO
Oswego County Opportunities’ recently recognized its outstanding employees in education services. Nominated by fellow employees, the four were honored for their commitment, resourcefulness, and dedication to OCO and those they serve. Awardees are, from left, Tina Eusepi-Bennett, Mary Lou Hasto, Carol Genalo and Wendy Wilson, and Beth Kazel, director of OCO’s education services Page 28
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
food pantry moved to a new location inside Catholic Charities’ main office in Fulton. The new space provides even easier access and more privacy its consumers.
New administrator named at Michaud Residential Jeff Toczek has been named administrator at Michaud Residential Health Services in Fulton. He will oversee all operations at the 89 bed residential skilled nursing and rehabilitation facility. “I am excited about joining Michaud and have received a wonderful welcome from everyone thus far,” said Toczek. Prior to assuming his position at Michaud, Toczek was employed in a similar capacity with the Loretto organization in Syracuse, where he functioned as administrator for the Nottingham RHCF. Toczek “One thing that attracted me to the new position was the small town community feel and the opportunity to make a difference in the lives of Michaud residents. I feel that I can lend my expertise and help enhance the already great level of care we provide.” Toczek earned his master’s degree from the University at Buffalo and brings 12 years experience to the health care field. He has previously held roles as a registered dietitian and food service director. Toczek currently resides in Liverpool with his wife Laura and three children.
Aurora welcomes new staff members Aurora of CNY Inc. announced the addition of several staff member. They are: • Lise Mayo of Syracuse joined as placement coordinator in Aurora’s blind employment services department. She previously worked as a psychiatric rehabilitation counselor and supervisor for the supported employment department at St. Joseph’s Hospital Health Center. She has a master’s degree in rehabilitation counseling from Syracuse Mayo University and is a certified rehabilitation counselor (CRC). She is a board member of the Association for Persons in Supported Employment (APSE) and the National Rehabilitation Counseling Association (NRCA). • Akemee Capers of Manlius joined as Capers employment special-
ist in Aurora’s deaf services department. She has a bachelor’s degree in business administration from SUNY Oswego. • Leeandia Nunn of Syracuse joined as scheduler in Aurora’s Marjorie Clere Interpreter Referral Service. She previously worked as a certified medical assistant. • Kaitlyn McElwee of Camillus joined as social worker in Aurora’s blind services department. She has a bachelor’s degree in psychology and Spanish from St. Bonaventure University and a master’s degree in social work from Syracuse Univer-
Aurora of CNY, Inc. is the only non profit that works exclusively with people in Central New York who are deaf, blind, visually impaired or hard of hearing. Aurora is a United Way agency of Central New York and Oswego and Cayuga counties.
Bariatric Surgery Team Moves to St. Joe’s — St. Joseph’s Hospital Health Center announced the weight loss surgery practice of William A. Graber, MD, PC will move to its medical office centre, located at 104 Union Ave. in Syracuse, and will begin seeing patients there Nov. 4. The office will be located in suites 809-810 on the eighth floor of St. Joseph’s medical office centre. The office, which specializes in weight loss surgery, has treated 4,000 patients. Board-certified surgeons specialize in laparoscopic bariatric surgery, and use the most advanced techniques to perform weight loss surgery. The surgeons —William Graber and Dmitri Baranov — have earned the American Society for Metabolic and Bariatric Surgery Center of Excellence designation. They perform surgeries at St. Joseph’s Hospital, which also is designated as a Bariatric Surgery Center of Excellence. To learn more about bariatric surgery at St. Joseph’s, call William A. Graber, MD, PC, toll free at 1-877-2690355 or through St. Joseph’s Resource Line at 703-2138. Michael Oxley Is the New Director Of Environmental Services — Michael Oxley has been named director of environmental services. In this role he will be responsible for housekeeping services for St. Joseph’s. Oxley, a resident of Cicero, has more than 25 years experience in environmental services, working in several hospitals along the East coast. In addition to serving in leadership roles, he also has directed training programs and successfully implemented waste reduction programs
H ealth News
that reduced costs for health systems, one by up to 56 percent. Oxley also has significant experience in improving patient satisfaction scores related to room cleanliness; at one hospital, he improved the score from 40 percent to 80 percent in just one year.
Hastings Nurse Susan Baum Wins Award — St. Joseph’s Hospital Health Center announced that Hastings resident Susan Baum, a surgical intensive care unit nurse at the hospital, is the first nurse to win the hospital’s DAISY Award. The DAISY Award is a nationwide program that rewards and celebrates the extraordinary clinical skill and compassionate care give by nurses every day. According to the hospital, Baum “is dedicated to helping patients and their families through often difficult critical care hospitalizations. For example, she created the ‘Seeds of Hope’ program, which eases the stress and perceived burden of a patient’s passing from life.” Baum also pioneered the creation of the Critical Care Awareness and Recognition Day. As part launching of the award, the hospital hosted the founders of the DAISY Foundation, Bonnie and Mark Barnes, who established the foundation in their son’s memory. J. Patrick Barnes died of complications of an auto-immune disease at 33; DAISY is an acronym for diseases attacking the immune system. The family was awestruck by the care and compassion his nurses provided to him and their family. The DAISY Foundation is focused on recognizing extraordinary nurses everywhere. Winner of 2011/2012 Consumer Choice Award — St. Joseph’s Hospital Health Center was publicly named by the National Research Corp. (NRC) as a 2011/2012 Consumer Choice Award winner; this is the 11th time in 12 years the hospital has earned the award. The award identifies hospitals that healthcare consumers have chosen as having the highest quality and image in more than 250 markets throughout the United States, and places St. Joseph’s as the highest consumer-ranked hospital in the Syracuse area. Ginny Martin, president of NRC’s Healthcare Market Guide Division, said winners are determined by consumer perceptions on multiple quality and image ratings collected in the company’s Healthcare Market Guide Ticker study. Of the 3,200 hospitals named by consumers in the study, the winning facilities rank highest in their Metropolitan Statistical Areas (MSAs), as defined by the US Census Bureau. The Healthcare Market Guide Ticker study surveyed over 200,000 households representing over 400,000 consumers in the contiguous 48 states and the District of Columbia. New Kitchen, Room Service Program — St. Joseph’s Hospital Health Center served its first meal from a brand new, state of the art kitchen Oct. 19. The $6 million kitchen is configured for on-demand room service for all hospital patients, which will launch in early December. St. Joseph’s is the
first hospital in Syracuse to offer room service to all patients. St. Joseph’s currently services 1,000 inpatient meals a day, plus it runs a cafeteria and provides catering services to the organization. The patient meals are prepared in advance, placed on trays and delivered to patients at set times during the day. A traditional method for hospital food delivery, this system does not take into account the different in individual eating patterns or the need to deliver food while taking into account a patient’s diagnostic testing schedule, surgeries or late admission times. The new food service delivery program will include a professionally staffed call center to receive meal orders anytime between 6:30 a.m. and 6:30 p.m. From a selection of menus for regular and modified diets, meals will be prepared and delivered fresh to the patient’s room within 45 minutes by a host/hostess. Healthgrades Names Hospital Among The Top 5 Percent In The Nation For Joint Replacement — A report released recently by HealthGrades, the nation’s most trusted, independent
Upstate’s John McCabe Ranked Among Top Healthcare Executive — Upstate University Hospital Chief Executive Officer John McCabe has been named to Becker’s Hospital Review’s list of “291 Hospital and Health System Leaders to Know,” which recognizes individuals leading prominent American healthcare organizations. It’s the second time this year that Becker’s has recognized McCabe. In March, Becker’s named McCabe to a McCabe list of 130 Hospital and Healthcare System CEOs to Know. This past year, McCabe oversaw
source of physician information and hospital quality ratings, named St. Joseph’s Hospital Health Center among the top 5 percent in the nation for joint replacement two years in a row (20112012). St. Joseph’s has also been ranked No. 1 in the state of New York for vascular surgery. HealthGrades’ report found that patients treated at 5-star rated hospitals experience a 73 percent lower risk of mortality and a 63 percent lower risk of complications compared to 1-star rated hospitals. A quality comparison of doctors and hospitals in the Syracuse can be found online at HealthGrades.com/ratings/Syracuseny. New Doctors — The following doctors recently joined St. Joseph’s active medical staff: Muzeyyen M. Ercanli, obstetrics & gynecology, a resident of Fayetteville; Marilyn Glauber, internal medicine Jamesville; Klishani H. Heller, emergency medicine, Charlottesville, Va.; Bradley S. Raphael, orthopedic surgery, Fayetteville; Spirithoula D. Vasilopoulos, nephrology, Manlius; Clelia Ilacqua, dental surgery, Syracuse.
Upstate’s acquisition of Community General Hospital, creating the largest hospital in Syracuse. McCabe was appointed chief executive officer of Upstate University Hospital and senior vice president for hospital affairs of Upstate Medical University in August 2009. Highlights of his 22-year career at Upstate include the development of an emergency medicine residency training program, overseeing the opening and transition of patients into the Upstate University Hospital’s East Tower and Golisano Children’s Hospital, the development and opening of a mass casualty unit and upgraded infirmary at the New York State Fairgrounds, the development of an emergency medicine simulation center for training medical residents and the expansion of the hospital’s emergency room. McCabe’s national leadership positions include service as chair of the board of directors of the American Board of Medical Specialties, the organization that oversees the certification of physician specialists in the United States. McCabe resides in Cazenovia.
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Crouse Hospital Receives Grant From Jim And Juli Boeheim Foundation It will promote healthy eating among Syracuse city school children Childhood obesity has tripled in the last 30 years across the United States and here in our community. In an effort to address this major health issue, the Jim and Juli Boeheim Foundation has awarded Crouse Hospital a $10,000 grant to expand nutrition education activities at Hughes Magnet Elementary School. The grant will provide funding for a monthly after-school program to educate parents and children on how to move in the direction of better eating, specifically by using portion control and adding more fruits and vegetables into their daily diet. “Healthy Habits at Hughes” kicked off Thursday, Oct. 6 during an open house at the school. That evening, some 300 students and parents learned about the program and enjoyed healthy food samples. Open to all Hughes’ families, the program will be presented monthly from November 2011 through June 2012 during parent meetings at Hughes and feature a presentation by a Crouse Hospital registered dietitian and cooking demonstration by the hospital’s executive chef. Information presented will include healthy food choices, how to shop for and prepare healthy food and portion control. A different topic and recipe will be focused on each month. “Each family will have the opportunity to see the recipe prepared, taste the food and receive a meal to take home or eat before they leave that evening,” says Leesa Kelley, manager of the hospital’s community health outreach program. “A variety of fruits and vegetables will be available to add to the meals, to emphasize the value of these foods, as part of a healthy diet. The next day, the entire student body will receive samples of the same fruits or vegetables we served.” Each student and parent in the program will be given the option to have their body mass index (BMI) taken and then tracked during the program to demonstrate progress toward preventing obesity. The students and their parents also will complete eating habit/activity surveys at the start and finish of the program. For more information about the healthy Habits at Hughes program, contact Leesa Kelley at Crouse Hospital at 315/470-7105 or firstname.lastname@example.org.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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EMPLOYMENT “I had cancer. Cancer never had me.” Yesterday, I got out my ﬁshing rod. I couldn’t help thinking of everyone at HOA. It was last spring when I found out. I was overwhelmed, distraught - and scared. I thought my ﬁshing days were over. Then I went to HOA. My medical team all said, “We have the technology to ﬁght this thing!” and showed my the CyberKnife. It sounded scary, but when I learned how it worked and how safe it was, I had hope for the ﬁrst time. Your attitude really inspired me, your staff always encouraged me and your plan of action worked. I may have had cancer, but cancer never had me. Today, my kids and I are heading up to the lake.
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We currently have part-time, full-time and per diem positions available in our Adult and Pediatric Emergency Departments for: Nurse Managers, RNs and Nursing Assistants. Shadowing opportunities are available. • Tuition Assistance • Membership in the NYS Employees' Retirement System • Excellent Wages and Benefits
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
November 2011 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2011
Published on Oct 27, 2011