in good Plavix, Singulair, Other Drugs to Go Generic
January 2012 • Issue 145
CNY’s Healthcare Newspaper
Doctor Turned Patient
Her father had it and so did her mother, brother, sister and other relatives. Now, Suzi Campanaro, a Liverpool podiatrist, suffers from the same rare disease, PKLD. Story on page 9.
MAMMOGRAMS Should you test at 40 or wait until you turn 50?
Vestal surgeon discusses innovative endoscopic spine surgery Tricks Learned at Urgent Care – also at Home
Upstate Pediatrician Writes Book About Teens Robert Cavanaugh, an Upstate Medical University pediatrician, has written a survival guide for parents and teens. “Dying to be Perfect: How Teens Can Stay Happy, Healthy and Alive is a call to arms to combat the powerful societal pressures that threaten the health and well being of young people today,” reads a press releases issued the university.
✓ Weight Loss: Why women do worse than men ✓ Brestfeeding: How I deal with it January 2012 •
Finding the Right Fitness Facility in 2012
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 • January 2012
SYRACUSE’S FIRST ACCREDITED CHEST PAIN CENTER
A Higher Level of Care
A message from the workers at Auburn Memorial Hospital: Auburn Memorial Hospital has been part of our city for generations. Through good times and bad, we have been here to deliver our babies, take care of our illnesses and provide comfort when you need it most. We want to continue to take care of the community that we love. The board of the hospital is considering afﬁliating or merging with an out of town facility. While in some ways, this may be a good development - in other ways, it may be a disaster for our community. We need to ensure that our hospital stays OUR hospital; the only one in our County.
YOU CAN HELP US CONTINUE TO PROVIDE QUALITY CARE! Log on and send a message at the following address: www.1199seiu.org/save_amh Your online signature will be presented to the board so that they know that Auburn needs its own hospital! January 2012 •
1199 SEIU United Healthcare Workers East 250 South Clinton Street, Syracuse, NY 13202
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Dana-Farber Launches Cancer Blog
ana-Farber Cancer Institute recently launched “Insight” (blog. dana-farber.org/insight/), a blog providing expert commentary on the latest news in cancer research and care and insight on issues and topics relevant to cancer patients and their families. Dana-Farber is the first New England hospital to publish a blog that focuses exclusively on cancer-related topics. “Insight” will feature expert perspectives on the latest discoveries and treatment options, practical tips for patients and families coping with cancer and inspiring patient stories. One of the goals for the blog is to provide information that is not available in traditional media outlets, including on-the-scene commentary from the nation’s largest medical conferences, where major breakthroughs are announced. “The stories of our patients, the discoveries in our laboratories, and the progress in our clinics inspire us every day,” says Steven Singer, senior vice
president of communications. “By sharing this information and these stories in “Insight,” we can help people affected by cancer to be better informed about new advances.” Current posts on the blog include a video commentary from Dana-Farber’s Harold J. Burstein, on the highlights from the San Antonio Breast Cancer Symposium, tips for coping with cancer during the holidays, a report on notable research advanced being presented at the Annual Meeting of the American Society of Hematology (blog. dana-farber.org/insight/2011/12/ blood-cancer-research-may-lead-tonew-treatments/), and a video interview with Siddhartha Mukherjee, the Pulitzer Prize winning author of “The Emperor of All Maladies: A Biography of Cancer.” Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States.
BRIGHTON PHYSICAL THERAPY, PLLC Kevin L. Gretsky, PT
■ Orthopedic Rehabilitation ■ Neck & Back Pain ■ Pre and Post Surgical Care ■ Sports Injuries ■ Injury Assessment ■ Worker Compensation/No Fault ■ Total Joint Replacement Care ■ 20+ Years of Experience ■ Most Insurances Accepted & Filed Including Medicare
181 Intrepid Lane Syracuse, NY 13205 • (315) 498-5510 • Hours By Appointment • Free Parking
4,000-plus weight loss surgeries. That’s a lot of smiles. Our program has successfully met the highest standards set forth by the American Society for Metabolic and Bariatric Surgery and is recognized as an ASMBS Center of Excellence. Surgeries are performed at Faxton-St. Luke’s Healthcare in Utica, and at St. Joseph’s Hospital in Syracuse. Dr. Graber is the Director of Bariatric Surgery at both hospitals.
Visit drgrabermd.com, or call 877-269-0335 to discuss ������������������������������������������������������������ atients w seeing p We are no ������ ��������� � � � r� u o in n Street at 104 Unio in our As well as ��������� ���������� ad rrstone Ro at 1724 Bu
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
Jan. 3, 16, 19, 28
Weight loss surgery seminars in Syracuse Crouse Hospital is sponsoring four seminars about weight loss surgery. The seminars will discuss bariatric and other surgical ways to lose weight. The free seminars will take place from 4:30 – 6:30 at the Marley Education Center, 765 Irving Ave., Syracuse, on Jan. 3, 16 and 19. A fourth seminar will be held from 9 – 11 a.m. Jan. 28, also at the same location. Physicians Jeffrey DeSimone and Kenneth Cooper will coordinate the seminars. They performed weight loss surgery at the former Community General Hospital until late last year when they moved their practice to Crouse. Free parking in Marley’s garage. For more information, call 4722464 or visit crouse.org/weight-losssurgery.
Jan. 12, 18
Seminar in Camillus on how aging can be slowed Chiropractor Bernard Straile is inviting the public to “start 2012 right and combat aging with information.” He is sponsoring two free seminars that will address what can be done to ensure quality of life with old age and how aging can be slowed. Participants will become aware, among other things, of the stressors that accelerate aging. Titled “Doc Straile Health Seminar,” it will be presented by Bernard Straile between 7–8 p.m., Thursday, Jan. 12, at Total Wellness Center, 5631 W. Genesee St., Camillus. The seminar will be repeated at the Maxwell Memorial Library, 14 Genesee St., Camillus, from 6:30 – 7:30 p.m., Jan 18. For registration and more information, call 468-2422 or visit www.docstraile.com.
AIDS Community sponsors ‘Sled for Red’ event AIDS Community Resources will hold its second annual Sled for Red Cardboard Sledding Derby at Four Seasons Golf & Ski Center in Fayetteville Jan. 21. The event kicks off at 5 p.m. and is followed by a tubing party and hot chocolate, food and drink sampling party. Each team (up to five members) may use only regular cardboard, duct tape, masking tape, scotch tape and paint to construct the cardboard sleds. Each sled team needs to raise $250 to enter the derby. The tubing party following the competition is $10 per person. The fee to attend the hot chocolate, food and drink sampling event is also $10 per person. All money raised will support AIDS Community Resources’ youth prevention programs and emergency client needs. For more information or to register, call 800-4752430 or go to www.AIDSCommunityResources.com.
Lupus Alliance of America offers scholarships The Lupus Alliance of America, Inc., Upstate New York affiliate, is now accepting applications for the annual lupus scholarship. Applicants must meet the following qualifications: be diagnosed with lupus or be the child of a person diagnosed with lupus with acceptance into professional or graduate school or be in undergraduate school with a minimum of two semesters of college completed and a cumulative GPA of 3.0 or higher. The deadline to submit applications is Jan. 31. For information and applications call the Lupus Alliance of America, Inc., Upstate Affiliate at 800-300-4198.
Vegetarian group to discuss Conference to highlight organic veggies models of patient care The public is invited to attend the January meeting of the Rochester Area Vegetarian Society and meet local organic farmers who offer farm shares. Titled “Where do I get my organic veggies?” the program will feature a panel of organic farmers who offer community-supported agriculture. The Jan. 15 event will start with a vegan share-a-dish dinner at 5:30 at Brighton Town Park Lodge, 777 Westfall Road, in Brighton, a Rochester suburb. The program will include a slide show and Q&A period with informational and registration materials. Free to members. For dinner, $3 fee for non-members in addition to bringing vegan food to share; fee is waived if you join at the meeting. You may attend either the dinner or the lecture, or both, and there is no need to reserve for either.
Utica College and the Central New York Area Health Education Center invite area health care professionals to the second annual health care administration conference, “Innovative Models of Delivering Patient Care.” The conference will be held March 23 at the Radisson Hotel Utica Centre, Utica. Designed for health care professionals employed in acute, long-term and home care settings, this leadership conference will provide participants with the opportunity to learn about successful models of delivering patient care from the leaders who developed them. For more information, contact the Office of Corporate and Professional Programs at Utica College at (315) 7923344 or CNYAHEC at (607) 756-1090 or visit www.utica.edu/healthleader.
Unnecessary ER Visits 700,000 trips to ERs potentially avoidable
pstate New Yorkers make more than 700,000 potentially avoidable trips to emergency rooms for sore throats, earaches and other minor medical problems annually, according to an analysis issued today by Excellus BlueCross BlueShield. “For the second year in a row, our detailed analysis of ER visits in which patients don’t stay overnight found that two out of five visits are potentially avoidable,” said Marybeth McCall, vice president and chief medical officer, Excellus BlueCross BlueShield. “True emergencies belong in the ER,” McCall added. “But most sore throats and earaches, for example, should be seen by your primary care doctor. Your doctor will likely see you more quickly, and your copay for a doctor visit will be less.” The “Facts About Potentially Avoidable Emergency Room Visits in Upstate New York” took a New York University formula used to classify ER visits and applied it to hospital data collected by the New York State Department of Health to determine the number of ER visits that were potentially avoidable.
According to the report: • One out of four ER visits in 2009 in which patients were treated and released on the same day was for a medical issue, such as a back problem, that didn’t need care within 12 hours. • Another 19 percent of visits were for medical conditions that needed treatment soon — such as ear infections — but could have been treated in a primary care setting. • A significant amount of health care dollars could be saved in Upstate New York if patients went to the physician’s office instead of the ER for minor problems. Potential annual savings for commercially insured patients range from $8.1 million to $10.7 million if 5 percent of patients currently going to an emergency room for minor problems instead went to a physician’s office and from $40.5 million to $53.5 million if 25 percent of patients currently going to an emergency room for minor problems instead went to a physician’s office.
“Many of the figures in the analysis are conservative,” McCall added. “The number of potentially unnecessary ER visits in Upstate New York is likely larger, because the report did not include visits the NYU formula deemed ‘unclassifiable,’ such as injuries.” The report also looked at health insurer payments for care rendered to commercially insured patients to see how much would be saved if these patients went to a physician’s office instead of the ER for minor medical issues. More health care dollars would likely be saved if the analysis also looked at the uninsured and those who have Medicare and Medicaid.
CNY’s Healthcare Newspaper
THERAPY SERVICES, P.T., P.C.
Tackling the problem The report highlights efforts nationwide to reduce the number of potentially avoidable ER visits, including efforts by The Rochester 2020 Performance Commission. Efforts under way in Rochester include projects to help patients manage their own minor medical problems and initiatives to increase access to ER alternatives, such as telemedicine programs. Excellus BlueCross BlueShield shared the findings with the Medical Society of the State of New York. The medical societies of Monroe, Herkimer and Oneida counties, the Finger Lakes Health Systems Agency and Excellus BlueCross BlueShield also launched a public service campaign in December in the Utica and Rochester regions. The campaign features television and radio advertisements urging people to first call their physician for non-urgent issues. “The goal of effective health care policy is providing to patients the highest quality of care at the lowest possible cost in the most appropriate environment,” said Paul A. Hamlin, president, Medical Society of the State of New York. To view the report, go to excellusbcbs.com/factsheets. To view the Utica and Rochester campaign advertisements, go to youtube.com/excellusbcbs.
ONONDAGA, OSWEGO, CAYUGA AND MADISON COUNTIES in good A monthly newspaper published by
Local News, Inc. Distribution: 35,000 copies. To request home delivery ($15 per year), call 342-1182.
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.
Mauro-Bertolo Therapy Services is pleased to announce an expansion of our rehabilitation program for incontinence and pelvic pain, with the addition of Darryl Kay Leach, DPT, specializing in pelvic ﬂoor dysfunction. Mauro-Bertolo continues to provide comprehensive, state of the art rehabilitative services for urinary and fecal incontinence, pelvic pain, obstetrical low back pain and orthopedic pelvic pain syndromes. Treatment is provided by physical therapists with specialized training and extensive experience in the area of urinary incontinence and pelvic ﬂoor dysfunction/pain. Our therapists will assess your patients and recommend a personalized rehabilitation program, which may include biofeedback, electrical stimulation, pain modalities, myofascial release and a progressive exercise program for individual speciﬁc needs. This quality service is provided in a caring and sensitive environment.
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Suzanne M. Ellis, Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, Deborah Jeanne Sergeant, Anne Palumbo, Aaron Gifford, Chris Motola, Melissa Stefanec, Mary Beth Roach, • Advertising: Jasmine Maldonado, Tracy DeCann • Layout & Design: Chris Crocker • Proofreading: Shelley Manley • Ofﬁce Manager: Laura J. Beckwith
Should you wish to discuss your speciﬁc issues prior to making an appointment, please feel free to contact our ofﬁce to speak with either Sharon Ricco, PT and Director of Pelvic Rehabilitation or Darryl Kay Leach, DPT.
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.
Cicero Professional Building – 6221 Route 31, Suite #103 – Cicero, NY 13039
Phone (315) 699-1009 • Fax (315) 699-1094 January 2012 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Your Doctor Dr. Matthew Bennett Surgeon discusses innovative endoscopic spine surgery Q: What is endoscopic spine surgery? A: Endoscopic spine surgery is a minimally invasive surgical procedure that allows you to get relief from pinched nerves in the spine. When a spinal nerve gets pinched, the burning stabbing pain can be very debilitating. This procedure allows a tube the size of a pencil to be inserted into the spine through an incision the size of a fingernail. With some minimally invasive surgery the incision size is really just a gimmick and what happens under the skin is really not too minimal. However, with this technique, the muscles are not cut or torn. They are literally pushed aside to allow this small tube to enter the spine. From there we use a “high-def” camera to see into the spine and “un-pinch” the nerve under direct view. It’s really amazing to watch a distorted pinched nerve fall back into a natural position — some patients will immediately feel relief. Q: How is it better than traditional spine surgery? A: Those of us who are good at using the scope to treat spinal problems have recognized several advantages. First of all, endoscopic spine surgery has been very effective at relieving pain. Some patients will leave the hospital several hours after the procedure with a complete relief from their pain. The most striking example was a patient of mine who had literally been in bed for two months because of the severity of his leg pain. By 5 pm the night of surgery, he was out walking his two dogs – it was really amazing. Secondly, there is very little structural damage or “collateral damage” from the spinal surgery. Realistically, most patients with pinched nerves require only a few millimeters of decompression to obtain pain relief. With traditional spine surgery, important stabilizing spinal muscles are cut or stretched. Bone and ligament are then cut away, leaving an area of exposed nerve tissue that is at risk to develop scar tissue. That nerve sack is then pulled to the side and the few millimeters of disc material or bone spurs can then be removed. The endoscopic technique bypasses all of the above — we take advantage of an opening that already exists in the side of the spine called the neuroforamen. Very often I’ll enlarge that opening by a few millimeters to make even more room for the nerve and then remove the ruptured disc or bone spurs without taking the natural structure of the spine apart. We have seen very little development of scar tissue. With traditional spine surgery, a technically wonderful operation can be performed only to develop scar tissue and the return of pain as the nerve gets tethered back down inside the spine. This isn’t the fault of Page 6
the spine surgeon — unfortunately it’s the body’s own response to the trauma. Patients can usually maintain their range of motion after endoscopic spine surgery. Muscles are not being disconnected, screws and rods are not being placed, and incisions are small enough that healing is usually not a factor. Patients like being able to return to an active lifestyle quickly. These days, many people want to return to work as quickly as possible. People just can’t afford to stay out of work. Q: Do you still do traditional spine surgery? A: I try to customize the operation for the patient. So yes, I still perform traditional spine surgery when I think it matches the patient’s needs better. I think that it’s important not to pigeonhole every problem into something that can be treated with one procedure. Some clinics around the country have done just that — they’ve turned more into a marketing machine — spending millions of dollars a year to promote their own “customized” procedure. I put my patients needs first. Q: Who is a candidate for endoscopic spine surgery? A: People who have leg pain from a ruptured or herniated disc, or bone spurs may be a candidate. It really needs to be decided on a person-byperson basis. But there are certain types of disc herniations that in my experience are almost always better served with an endoscopic approach — neuroforaminal or far-lateral disc herniations, contained disc herniations, and many extruded or sequestered disc herniationss. Q: Are there any patients who are not candidates for traditional spine surgery that can benefit from endoscopic spine surgery? A: There are definitely patients who present with what I call the “Princess and the Pea phenomenon.” These patients have pain and real
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
structural problem in the spine. However, the structural problems in the spine may be quite small — for instance, just a small disc bulge. For these patients, the risks of traditional open spine surgery just don’t make sense and many of these patients are told to live with their pain. Some of these patients can potentially be helped with this lesser invasive surgery. Some people cannot tolerate or survive a general anesthesia. People treated with this endoscopic technique do not need to undergo a full general anesthesia. They don’t need to be put to sleep and they don’t need a breathing tube. There are many patients who really need a spinal procedure but are not healthy enough to tolerate a major anesthesia — these patients can now get the relief they need. Q: What are the risks? A: Any operation or procedure has risks. This one is no different. Anesthesia has risks and your medical doctor can help to stratify this risk — but the amount of anesthesia is so much less than with traditional spine surgery. This is often done under a twilight anesthesia. Bleeding and infection risks are small. In fact, we have seen very few infections with this approach, probably because blood flow to the spine is not interfered with and the fact that the procedure is done under continuous antibiotic bath irrigation. The risk of nerve irritation is low because the patient is able to tell us right away if the nerve is becoming irritated by the procedure. Some patients may require a more invasive traditional open surgical approach. But it is rare that any bridges are burnt with this less destructive approach. Certain risks are inherent with any spine operation — the disc herniation can recur, the disc can become degenerative over time, or the spine can become unstable. So far, we have seen fewer complications with endoscopic spine surgery than with open spine surgery, but that really needs to be proven with solid scientific data. Q: Is anyone working on clarifying the results with solid scientific data? A: Our combined international efforts have already provided quite a bit of solid science. I am excited to be one of 5 sites around the US that is studying exactly how patients do over time. We want clarify outcomes, try to determine who exactly are the best candidates, and document any real downsides to the procedure. We basically want to improve spine treatment, and we want to do it the right way.
Q: Is special training required? A: I’m a board certified orthopedic surgeon. I did my residency training at Upstate Medical University in Syracuse — where the spinal training is really top notch. Then, I did a specialized spinal fellowship at the Texas Back Institute outside of Dallas — another world famous institution. I’ve spent a lot of time learning endoscopic spine surgery. I’ve learned from very accomplished surgeons here in the US as well as international surgeons. I’ve been to Germany where the current procedure was invented and spent time learning directly from the German surgeons. I’ve been very fortunate in that regard. The international community of endoscopic spine surgeons is still relatively small. We routinely meet at select user meetings as well as at societies such as SMISS (Society for Minimally Invasive Spine Surgery). I’ve been a teaching instructor for other surgeons for several years now. Q: Why did you dedicate the time to learn this technique? A: As spine surgeons, we see patients in the office who have problems that vary in intensity and severity. It seemed to me that we really didn’t have enough options to successfully match our patients’ needs to our operative procedures. I want to put my patients’ needs first, so I will usually be sure that the patient doesn’t have a problem that can be treated non-operatively first. Physical therapy, chiropractic care, medications, and injections may be enough to treat the majority of patients. When these options fail, a traditional open surgery like a laminectomy or a microdiscectomy used to be the next step. If the problem was significant enough a fusion connecting the bones of the spine together may be needed. In many cases I wished that I had something different to offer — something with less risks. That’s what was so alluring about the endoscopic option. The spine is such a wonderful structure when everything functions normally. Unfortunately, the spine is also a complicated and linked structure. When one thing goes wrong other areas of the spine can be effected. Traditional spine surgeries can magnify this domino effect, and in some cases we believe that screws, rods, and cages can even accelerate the degenerative cascade. Can endoscopic spine surgery help to avoid fusion surgeries? Well that’s exactly what we are trying to understand and I am honored to work with professional organizations like the Society for Minimally Invasive Spine Surgery who are trying to understand these important questions. If we look at many common surgical procedures patients have done much better with lesser invasive options. People have been able to move quicker, return to life quicker, and avoid a lot of collateral damage. For instance, before laparoscopy a gall bladder surgery used to be very traumatic and challenging for patients to recover from. The same is true for knee surgery. Now, with the laparoscope or arthroscope these procedures have become common. We are seeing urologists able to take out prostate cancer with a robotic scope. In each of these cases, surgery has evolved. I believe that spine surgery is evolving too — and endoscopic spine surgery is going to be part of that process. Bennett can be reached at 100 Plaza Drive; Vestal, NY 13850 (Binghamton area). For more information, visit www.tierorthopedics.com or call 607-798-9356
More Generic Drugs, More Savings for Upstate, Says Excellus
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Plavix, Singulair to have generic versions in 2012
nnual health care spending in Upstate New York can be reduced by $500 million to $1 billion by increasing the percentage of all drug prescriptions that are filled with a generic by just a few points, according to a fact sheet issued today by Excellus BlueCross BlueShield. “Last year  in Upstate New York, 72.1 percent of prescriptions were filled with a generic,” said Joel Owerbach, vice president and chief pharmacy officer, Excellus BlueCross BlueShield. “Increasing that rate to 75.8 percent, which is the percentage in the combined Finger Lakes and Western New York region, would reduce annual health care spending by $500 million, and raising it to 80 percent would reduce health care spending in upstate New York by $1 billion.” In Central New York, where the 2010 generic fill rate was 68.6 percent, the estimated annual savings opportunity ranges from $204 million with a 75.8 percent generic fill rate to $325 million with an 80 percent generic fill rate. “At first glance, raising Upstate New York’s generic fill rate from its 2010 level to the 75.8 percent benchmark that represents the Upstate New York area with the highest generic fill rate may seem ambitious,” Owerbach noted, “but it’s by no means impossible.” A historic overview of generic fill rates in Upstate New York detailed in “The Facts About Opportunities to Save With Generic Prescription Drugs” shows that the generic fill rate has steadily risen in every Upstate New York region between 2005 and 2010. In Central New York, for example, the generic fill rate grew from 47.3 percent in 2005 to 62.6 percent in 2008 and 68.6 percent in 2010. For the first eight months of 2011, the Central New York generic fill rate stood at 71.3 percent. The upward trend in Upstate New York’s generic fill rate is accompanied by another up shift — in the share of generic prescription drugs as a percent of all prescriptions written by physicians in Upstate New York. Generic medicines represented 52.5 percent of all prescriptions written in 2005; the number was 72.1 percent in 2010. Brand-name drugs now make up a smaller portion of all prescriptions written in Upstate New York (27.9 percent in 2010). Some of the savings achieved through the growth in generic prescribing are offset by yet another turn, which reveals that the average cost of a brand-name drug has risen 73 percent during the past five years (from approximately $120 in 2006 to $208 in 2011) and 12 percent in the past year. Generic medicine costs, by contrast, on average decreased by 7.5 percent (from $19.63 in 2006 to $18.16 in 2011). “Even though the cost of brandname prescription drugs is higher, no less than 42 brand-name drugs either have or will become available as generics in 2011 and 2012,” pointed out Owerbach, “which easily can mean a 2point to 4-point increase in the Upstate
New York generic fill rate.” In 2011 the largest potential longterm prescription drug savings came from Lipitor, used to treat high cholesterol, which has 154,000 users in Upstate New York. “When generic atorvastatin became available on Nov. 30, 2011, that alone was expected to eventually offer an estimated $162.5 million annual savings opportunity,” said Owerbach. In 2012, the largest potential longterm savings will come from Plavix, which has 80,000 Upstate New York users, and Singulair, with 102,000 users. Added together, generic versions for these popular brand-name prescription drugs will save Upstate New Yorkers more than $200 million annually. “The fact that these three, blockbuster prescription drugs already have or soon will be available as generics will certainly help move us toward the 80 percent generic fill rate mark,” commented Owerbach. “I believe greater public acceptance of generics and acknowledgement of their savings potential will also help fuel the trend.” The Excellus BlueCross BlueShield report details specific action steps that Upstate New Yorkers can take to bring the generic fill rate to 80 percent and thereby help save residents $1 billion in health care costs. Recommendations include: If you’re a health care consumer: Asking your doctor, pharmacist or nurse practitioner whether a generic drug alternative or option is right for you. If you’re a physician, member of a physician group or work in a hospital: Avoiding or reducing the use of brand-name drug samples, prescribing generics when appropriate and using eprescribing to help identify lower-cost medications. If you’re an employer or belong to an employer coalition: Providing an employee drug benefit design that offers incentives to use lower-cost generics, helping people understand the value of generics, distributing informational materials and fostering community discussions on the importance of generics. If you’re a pharmacy: Frequently discussing generics with patients, alerting patients and physicians when new generics are available, working with patients and their prescribers to identify generic options and alternatives and providing low-cost generics programs where feasible. If you’re a health plan: Educating the community on the value of and savings opportunities available with generics; creating tools for employers, physicians and members to promote the use of generics; offering incentives for generic drug use through benefit design, copay differences and free generic trial programs; sending reminders and action plans to members who have opportunities to save with generics.
We offer training, 24-hour support, and monthly tax-free compensation of more than $1,500.
The reference guide is available at go.excellusbcbs.com/generics under “Tools and Resources.” excellusbcbs.com.
Contact Chris Schell at firstname.lastname@example.org or 315-253-5383 ext. 1203
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These people are all host parents in the Treatment Foster Care Program at Cayuga Centers
What does that mean? It means they have big hearts, and they have opened their doors to an adolescent between the ages of 12 and 17 who needs some help in a safe, supportive home environment.
A big heart & A safe home All day & night Be a mentor. Become a host parent. formerly Cayuga Home for Children
January 2012 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
By Eva Briggs
Tricks learned at urgent care — also for home
obert Burns wrote in 1785, “The best-laid schemes o’ mice an’ men gang aft agley.” I guess that’s an early form of Murphy’s law, “Anything that can go wrong will go wrong.” It certainly keeps us busy at the urgent care. Below I will describe two little known tricks, just in case you find yourself in the predicaments described. I learned a new trick this past week, thanks to Google and YouTube. A young man came in with a ring that was too tight, and he couldn’t get it off his finger. That’s a common occurrence, so we went to plan one: immerse the hand in ice water to reduce any swelling and use dish soap to wiggle the ring off. That didn’t work, so we proceeded to plan two: wind string tightly around the finger, slip the end under the ring, then unwind, working the ring up and off. Alas, no luck again. We got out the ring cutter and my nurse went to work. She returned a short
time later, and reported that the ring was made of something so hard that it might take weeks to saw through it with the ring cutter. The patient didn’t know what his ring was made of. We had exhausted the methods that came quickly to mind. But I didn’t want to send the man to the emergency room, because I figured that we have the same tools as an emergency room. I turned to Google, and learned that perhaps the ring was made of tungsten. The YouTube video in the search results showed a man shattering a ring easily with vice grips. Usually things that look that easy turn out to be trickier than suspected, but I thought we’d give it a whirl. Luckily my nurse drives a typical Central New York winter rat. She had a pair of vice grips in her car to use when popping the hood because her hoodlatch lever was rusted out. We followed the video directions carefully. First, adjust the vice grips to just close down on the ring. Remove them, turn the
adjusting screw one-half revolution, and grip again. Repeat as needed. After just two adjustments, the ring shattered — exactly like the ring on the YouTube video. If you try this at home, wear safety goggles. The pieces will go flying. To reduce the chance of a stuck ring, be sure to remove all rings if you injure any part of the arm on which you wear the ring. An injured finger, hand, wrist, arm or elbow can cause your finger to swell. It’s better to get rings off before swelling creates an urgent situation. Here’s a second trick, for removing cactus spines, that I read long ago in some forgotten magazine. I never really thought that I would need this in Central New York. It’s not exactly the hot dry climate one associates with cacti. Years ago I won a houseplant, a prickly pear cactus, in a fund raising raffle from my local nature center. The plant lived several years on a tall narrow bookshelf in the corner of our
kitchen. One day, a particularly klutzy and ill-behaved dog that we owned, ran into the shelf, knocking the whole thing and its contents in a diagonal across our kitchen table, narrowly missing injuring any dining humans. I instinctively threw up my hand to block the falling plant. I was rewarded with a handful of tiny cactus spines. It might have required all day and a powerful magnifying lens to pull them out with tweezers. Then I remembered that magazine article. Following their directions, I slathered on some white glue, like Elmer’s glue. One of the perks of having children at home is that glue always seems to be a required school supply. When the glue dried to a flexible film, I peeled it off, pulling out the cactus spines. It took several applications, but my hand was soon restored to a relatively pain-free functional unit.
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.
Robert Cavanaugh, an Upstate Medical University pediatrician, writes a survival guide for parents and teens Book tries to help teens and their parents navigate through teens’ different stages
Dying to be Perfect: How Teens Can Stay Happy, Healthy and Alive” is a call to arms to combat the powerful societal pressures that threaten the health and well being of young people today. More than just a survival guide for teens and their parents, “Dying to be Perfect: How Teens Can Stay Happy, Healthy and Alive” (Author House) is a new book by physician and father Robert Michael Cavanaugh, Jr. of Upstate Medical University. Utilizing the three stages of space flight as a metaphor for the stages of adolescence, “Dying to be Perfect” takes readers on an imaginary voyage into the mind of an adolescent. “It is often not fully appreciated that the brains of young adults are also going through dramatic changes, just like the physical changes in their bodies,” writes Cavanaugh. “As with puberty, the maturing of the adolescent mind can be divided into three stages—early, middle, and late—each of which is quite different from the other. Teenagers should not be expected to think like adults until this process of development is complete. It must be expected that adolescents will respond to the pressures of daily living in a unique and personal way, which is highly influenced by the stage of mental growth they have reached.” Page 8
By explaining the hazards and temptations of each stage, Cavanaugh prepares teens and their parents for the journey ahead. The mission of this journey will be to return adolescent voyagers back safely, as happy, healthy adults. Cavanaugh has used this metaphor with success in his practice for many years. Teens have much in common with astronauts, including the need to keep open channels of communication and stay connected to the home base for the best chance of avoiding accidents and completing the mission successfully. Cavanaugh hopes that “Dying to be Perfect” will serve as a powerful signal to cut through the smog and pollution of a culture in decay to revive the spirits and lives of adolescents today, giving them a chance to take flight as happy, healthy individuals. Cavanaugh is a professor of pediatrics at Upstate Medical University in Syracuse, where he has been the director of adolescent medicine for the past 30 years. He is a board-certified pediatrician with a sub-board certification as an adolescent medicine specialist. Cavanaugh is widely published in prestigious pediatric and adolescent journals. He and his wife of 42 years, Marilyn, have four children.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
Doctor Turned Patient Dr. Suzi Campanaro besieged by health problems
By Richard Block
or over 20 years, Suzi Campanaro has been a podiatrist in Liverpool. But now, the respected and popular doctor has become the patient. She suffers from a rare disease: polycystic kidney and polycystic liver disease (PKLD). Campanaro says PKLD is hereditary. Her mother, father, brother, sister, aunts, uncles, and cousins have all dealt with it. “I actually grew up thinking that everyone owned a kidney dialysis machine, because that is how frequent it was in my family,” she said. “My symptoms started in my late 30s. The usual protocol is that when your kidneys start malfunctioning, because of all the cysts that grow on it, you either need to be on dialysis or get a kidney transplant. My mother was successful in having a transplant. It lasted a good 10 years until she passed away. My brother and sister also had transplants and have done really well.” Campanaro said she had been on a waiting list to get a transplant. By then, she had been on dialysis for almost two years. “Unfortunately, I came home from work one day last year and could not lift my head off the pillow. I knew something was wrong. So, my husband brought me to the emergency room,” she said. “That is when we started getting indications that it was not just a kidney disease but a liver disease. It became PKLD and my family had not had any history of it. We started to learn that there was a long road ahead of us, because when you have the liver involved, you will not only need a kidney transplant, you will also need a liver transplant.” A few hospitals and many more doctors later, she ended up in the Mayo Clinic in Jacksonville, Fla.
On March 11 last year Campanaro received a double transplant—a new liver and a new kidney. While the new liver did well, her body rejected the kidney. Therefore, she returned to dialysis with the possibility of another kidney transplant. But, other organs in her body have not done well at helping out as she had hoped. As a result, she now has heart problems. Campanaro says one of the physical symptoms associated with PKLD is that “because organs grow millions and millions of cysts, you physically take on the look of a nine-month pregnant woman. Your belly is so huge and to get around is a little bit inconvenient. Sleeping is uncomfortable and you have nausea.” Originally, Campanaro received dialysis at Liverpool Dialysis three times a week for three to four hours each time. Following the nephrectomy (the removal of a kidney), because it was so large, she and her husband learned how to do dialysis at home. But, as her health deteriorated, she returned to receiving dialysis at a clinic. Once it was determined that she indeed had liver disease, Campanaro and her husband started doing research and concluded the best place to go was
Strong Memorial Hospital in Rochester.
Emotions run rampant
Campanaro became quite emotional talking about her illness and its impact. “Even with my family’s health problems, I was always the first person called to care for the family. Over the last 20 years, I was always the one in complete control,” she said. “I think the hardest thing is asking for help when you are really convinced that you should be able to do it yourself, because you are in the field. So, I definitely prefer to be on the other side. Then again, I have learned a lot as far as letting people help me. “It is almost a cliché—doctors make the worst patients. The truth is, we know too much. Sometimes, there is something to be said for ignorance is bliss. As the doctors are telling you what is ahead, you can anticiStan Munro and his wife, Dr. Suzy Campanaro, at a recent fund-raising event in Greece, near Rochester. pate when you do not know what is going to happen. “However, as a physician, being cam for me to see from my living room. tion. Campanaro says the entries from well aware of complications that can I watched as 500 people showed up family, friends, and even strangers happen, or having seen issues that do to raise money so that our medical totals 15,000. not turn out as well, I was definitely—I expenses and flights back and forth She says when she no longer do not want to say worrisome—just a to the Mayo Clinic in Florida could be thought she could continue, or endure little bit more skeptical at times. And, I feasible and we could continue keeping more pain, she would read the entries had to really entrust a lot of times that our home in North Syracuse,” she said. and be inspired to continue fighting. the decisions made by my husband and “We were flabbergasted at the turnout. Although Campanaro and husfamily were the right ones.” I have a CD of the event. There are no band are childless, they do have four Campanaro adds, “My husband, words to describe how overwhelmed I dogs, all of whom they regard as “our my sister, my father, my family, my was with the turnout. It just made me children”. friends were very, very important. I fight harder. I’ve gotten word of anothBoth appreciated hearing from cannot thank the doctors and obvier group—grammar and high school family and friends how “their chilously the donor who gave me my new friends planning another fundraiser. I dren” were doing and what was going liver enough. It is really my family and feel slightly embarrassed. They always on. friends who got me to the right place say, ‘It’s for them.’ I know people want Despite all her health problems, at the right time and make it easier to to help.” Campanaro remains positive about the fight through it. I am learning to be less Regarding advising others in her future, even hopeful. in control. You have to be willing to ac- situation or a similar health crises, Her office is located at 4955 W. Taft cept help from others.” Campanaro says, “I think you have to Road, North Syracuse. be an advocate for yourself. You need “I absolutely cannot imagine not Shy of fundraisers to do research and investigate. Gather returning to work,” she said. “I miss Not being fond of drawing attenas much information as you can and my patients. I miss my job. I love dotion, Campanaro was understandably educate yourself. I think education is ing what I do. Feasibly, I would have uncomfortable with the thought of her the most important thing. Sometimes, to get back to work slowly. My heart family and friends even considering a you even need to go away from home condition right now will rule my next fundraiser. to really get the right answers and the step,” she said. “Every time we see the “However, my husband [Stan right care.” cardiologist, we get new news. So, I am Munro, a former Rochester TV renot definite about anything. Currently, Taking it to the Internet porter] lovingly explained to me another doctor, Ronald D’Amico, is that we were in a financial bind and Initially, Campanaro was not treating several of my patients. I have needed help,” she said. “About 25 close thrilled when her husband started a to decide, do I treat the heart condition friends, in particular Sue Thomas and Web page. Through Caringbridge, it with open heart surgery and wait to Michele Hammond who is also my allows her to keep an updated journal. return to work, or do I go back to work nurse manager, gathered enough volShe says that took some pressure off and then take time off again for the unteers to put together a fundraiser.” her to keep her family and friends apheart surgery when it becomes neces“Smiles for Suzi” at Barbagallo’s, prised of what was going on without sary? a restaurant in East Syracuse, recently spending a lot of time on the telephone. “In the meantime, I have gained 10 raised a surprising $50,000. It also served as a great outlet for pounds, so things are looking up.” “My husband hooked up a Web her husband. There is a guest book secJanuary 2012 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
New to Living Alone? What Not to Do
ave you seen the popular TV show called What Not to Wear? Fashion experts Stacy London and Clinton Kelly transform fashionchallenged women into stylish personalities. Watching the show is one of my guilty pleasures. I just love seeing the participants learn and grow during the weeklong makeover, which often results in renewed self-confidence and empowerment. In addition to receiving plenty of fashion and makeup “do’s,” the participants are cautioned against fashion “don’ts” and advised what not to wear. This highly instructive, sometimes painful, yet very funny part of the show (when participants’ existing wardrobes are literally thrown out) is what inspired this column. I’ve shared lots of “do’s” in the past to help people live alone with more success. Here are a few “don’ts” — some lighthearted — that may also help you on your journey toward contentment:
Don’t isolate. Get up, get dressed, get out of the house or get on the phone. We humans are social animals; we’re meant to be with others. Don’t go on a shopping spree to fill an emotional void. Your savings account will thank you. Don’t make ice cream your main course for dinner. Well . . . maybe on occasion. But as a general rule? No. Create a nice place setting, fill your plate with something healthy, light a candle, and enjoy some well-deserved time to yourself. Don’t label yourself a loser just because you are spending Saturday night alone. It’s not the end of the world. It doesn’t define you. Rent a DVD and call it a night. But, if the prospect of a weekend night alone is too difficult, reach out to a friend today and make
KIDS Corner Kids and Cholesterol: What You Need to Know
ecently, the U.S. Department of Health & Human Services shocked parents around the country when they issued new guidelines regarding children and cholesterol. Their recommendations, joined by those of The National Heart, Lung and Blood Institute, outline guidelines that suggest all children between the ages of 9 and 11 should have their cholesterol levels checked. The move, which came about because children today are being seen with abnormal cholesterol levels and even the beginning stages of artherosclerosis, has left many parents seeking answers to their questions. “It is a big change, because formerly the recommendation was only for those who had a family history of high cholesterol,” explains Pamela McCullough, a pediatric nurse practitioner and the director of the nursing Page 10
program at Stratford University’s Woodbridge campus in Virginia. “This should be seen by many parents as a sign of our times and what is going on with the lifestyles we are raising our children to lead. It is also a great time for families to learn all they can, and to make changes in order to live a healthy lifestyle.” The two most important things that parents need to know in order to address this issue are 1) to learn all they can about cholesterol, and 2) to make healthy lifestyle changes. Cholesterol is a waxy substance that is produced in the body’s liver. While the substance is important to cell function, having too much of it can lead to a narrowing of the arteries, as it builds up inside the body. In addition to the cholesterol our body makes, we end up getting more of it through our diet and lifestyle choices.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
plans for next Saturday. Don’t put too much stock in that Dreamcatcher. If bad dreams keep you up at night, try meditation, journaling or aromatherapy. If they don’t do the trick, there’s always warm milk or a good, boring book. Don’t avoid dancing lessons because you don’t have a partner. Good teachers know how to incorporate singles into their classes by making introductions or by partnering with single members to demonstrate steps. Lucky you! Don’t jump into someone’s arms out of loneliness. Feelings of desperation can make you easy prey for a “suitor” with dubious intentions. It’s a risky place to be. Getting good at living alone will improve your chances of meeting someone who values and appreciates your strengths, not your weaknesses. Don’t get behind the wheel after a night of drowning your sorrows with friends. Self explanatory. Don’t be afraid to travel alone. Some of my best trips have been taken with my favorite traveling companion: myself. I create my own itinerary, go at my own pace, and meet all kinds of interesting people along the way. Don’t neglect your car’s needs. Get
The first thing families will want to do is focus on eating a healthy diet. This will help reverse and prevent obesity, which should also lead to a reduction in cholesterol levels. Dietary cholesterol is found in animal-based foods, such as meat, seafood, eggs, and dairy products. Focusing the family diet on healthy meals that include minimal amounts of animal products is ideal. The goal is to eat a lot of fruits, vegetables, whole grains, and low-cholesterol sources of protein (e.g., beans, tofu, nuts, lentils, etc.). Additionally, families are advised to increase their child’s activity level. Today, children often spend more time engaged in sedentary forms of electronic entertainment than they do in physical activity. Parents should aim for their children to get at least one hour of physical activity per day, which includes such things as running, brisk walking, playing sports, bike riding, etc. “This is a serious issue for parents to be aware of, because high cholesterol problems in a child today can lead to
that oil changed, fill those tires, check out that funky engine sound. Similarly, don’t neglect your body’s needs. You’re no good to anyone, especially yourself, if your health suffers. Make that appointment, fill that prescription, and get that screening. Don’t decline an invitation because it means walking in (and walking out) alone. You can do it. Make a beeline for the fondue and before you know it you’ll be engaged in conversation. Go and have fun! Don’t act your age. You’re free and on your own. What better time to spread your wings, be silly, and otherwise express yourself. Don’t take these “don’ts” too seriously. You’re in the best position to decide what to do or not to do — no shoulds, musts, or other people’s agenda. That’s one of the glorious benefits of living alone! Don’t I know it! 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 email@example.com.
major problems as an adult,” adds McCullough. “The sooner parents help their children to be in control by living a healthy lifestyle, the better off they will be. Once you focus on making these healthy lifestyle choices, the rest usually falls into place.”
Dome Balance Ball Works Core and More
If you or someone you love is unable to shop for or prepare their own meals, contact Meals On Wheels.
By Deborah Jeanne Sergeant
t first glance, it looks like a halfinflated ball, but the exercise dome is actually a clever workout tool. The original BOSU Balance Trainer (www.bosu.com) was invented by David Weck, who began selling the half-spheres in 2000. The name is an acronym for “Both Sides Up” or “Both Sides Utilized” since users may exercise with both the rubbery, dome side and the rigid, flat side of it. The BOSU brand has become so popular that most people simply call any exercise dome a “BOSU.” John Timmerman head fitness trainer at Trillium Wellness Center in East Syracuse, said that the BOSU Balance Trainer is frequently used at his facility. “They’re the best for different push-up variations and core work,” he said. “Those are the main two exercises we use them for. We also use them for lower body balance exercises. You can also use them for stability exercise
where you can stand on the BOSU ball.” The personal trainers working for Randy Sabourin, owner of Personal Fitness, Inc. in Syracuse, uses BOSU Balance Trainers “every day, mostly to enhance balance with their clients. “We have found the BOSU to be a very effective training device for improving ones balance, core stability and strength,” Sabourin said. The equipment’s many possible functions is what Sabourin likes best. “The versatility is awesome,” he said. “You can do exercises in the standing, seated, prone, supine and side-lying positions, and we use it in conjunction with weights, resistance bands, medicine balls and even stability balls.” Michael Knapp, personal trainer with At Your Home Personal Training in Syracuse, likes using the exercise dome for a variety of movements, too. “You can even flip it around and use both sides,” he said. “You use your hands to do pushups off it with either side down. I use it a lot for calorie burning exercises where you’re going against gravity with it.” Jumping on and off the ball side are more advanced movements. The BOSU brand ball comes with an exercise video. Knapp said that the exercise dome is such a good exercise tool because “it provides a way to go against gravity. When you’re working against gravity, you’re burning calories. “They’re great for balance, you can use them for flexibility, core work,
and essentially they provide a unique twist to stimulate your body in different ways.” Since the body automatically compensates for its unstable surface, the exercise dome strengthens joints and muscles. “It forces you to have to work more,” Knapp said. “It’s a way to change the surface you’re standing on so it stresses your joints a little and forces them to strengthen in different ways to stabilize you.” Certain people should approach using the exercise dome with caution. “They’re more for sport training for someone who has very good balance and wants to do more core stability work,” Knapp said.
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“Children won’t always use it properly. Or someone whose ankles aren’t strong enough and they might roll their ankles.” Timmerman advises anyone with balance issues related to the inner ear, not just coordination issues, or those who are going through ankle or knee sprain recovery to “seek supervised to make sure they have proper technique.” People may wear shoes to perform exercises on an exercise dome, go barefoot, or alternate both. “Traditionally we use sneakers, but you can go barefoot,” Timmerman said. “For people with foot strength issues, we have them go barefoot for strengthening the feet.” Before starting any new exercise program, consult your doctor, especially if you have health problems.
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January 2012 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Websites Help Smokers Kick Habit By Deborah Jeanne Sergeant
nstead of lighting up, log on. A number of websites to help you quit offer free assistance. Russ Sciandra, New York State Director of Advocacy for the American Cancer Society, said that online help “is one of many tools that are available to people who are trying to quit.” Dr. Geoffrey Williams of the University of Rochester Medical Center Healthy Living Center and member of the advisory board for the New York State Tobacco Control Board, is studying the effect of traditional one-on-one counseling vs. counseling with an additional online component. The study is Williams funded by the National Institute on Drug Abuse and has completed recruitment. The online model used in the study provides participants with the ability to read up on smoking cessation and enter much of their health background and personal information prior to meeting with a counselor. “We look at what their risk factors are,” Williams said. “We ask them what their blood pressure is, whether they’ve had any angina or heart attacks in the past and what their cholesterol is — we ask them to have it checked — age, and gender. It’s like a medical interview. That’s the initial part. We can spend more time talking about what they want to do instead of why they might want to do it.” The participants learn about how the cigarette works, the properties of nicotine, content of the cigarette and its health effect, and what withdrawal
is like. “We try to teach them the health benefits if they try to stop,” Williams said. “That is extremely well documented but not as well understood. The risk of heart disease falls in half within a year of quitting smoking. We ask people if that is meaningful to them.” By understanding the factors that are important to participants, their counselors and doctors can tailor their live sessions to make them more effective and help them develop a plan that could include behavioral and medicinal tactics for success. Study participants come to the center for at least two visits in addition to their time online. The control group only visits with counselors. “We believe it will be a helpful tool in assisting people quit,” Williams said. The study has integrated the Treating Tobacco Use and Dependence guideSciandra lines with a theory of motivation called the “self-determination.” “We put it in a virtual environment. We can deliver much in this format that will require less face-to-face time and give people the freedom to do this in their home or wherever they get online.” Williams foresees the technology as especially appealing to younger people comfortable with technology and timecrunched people who can’t spend the time in multiple live meetings. “We don’t do [online] chatting, but that could be added someday,” he said.
Texting could also be integrated as part of the program. “How well any one tool works depends a lot on the person,” Sciandra said. “I would say to a smoker, if that sounds like an intriguing way as to how to quit, there’s a good chance it will help you. If someone says ‘I never go online,’ then probably without a lot of assistance, they won’t be able to make productive use of that tool. There are many, many ways to quit; there’s something out there for everyone.” Patricia Briest, nurse practitioner with St. Joseph’s Hospital Health Center Cessation Center, said that the success of an online smoking cessation site depends upon the individual. “Some want someone to talk with and bounce ideas off of. Other people want a chat room where people can get support from one another. “The nice thing about an online program is it’s accessible 24 hours a day. People can get a lot of information. It also depends upon how self motivated the person is. “People have to have an idea of what they want when they go on the site. They have to have a reasonable timeline. They have to have a realistic idea of when they want to quit.” The sites do not simply tell smokers why the habit is bad for their health, but they also give other practical tools include calculators to show how much money they would save if they quit. Quitter sites also help save healthcare dollars since videos, peer chatting and forums don’t require paying a person to give the one-on-one attention. But technology may also make oneon-one interventions more cost-effective, too, with Skype and video chatting becoming more popular. Counsel-
Finding the Right Fitness Facility in 2012
any holiday party goers will likely start 2012 searching for the perfect fitness facility to shed the holiday weight gain and fulfill a New Year’s resolution. Finding the right fitness facility can be a tricky task if you’re looking for more than just the lowest-cost option. “You need to assess your fitness goals before selecting the best gym for you,” said Janette Westman, health and wellness consultant, Excellus BlueCross BlueShield. “Do you want a basic gym with treadmills for a daily run or walk, for example, or do you prefer a gym with varied classes or state-ofthe art equipment to keep you motivated?” Westman, a former personal trainer, offers the following tips for finding the right fitness facility: • Location: People often stop exercising because they lack the time. If you exercise after work, select a gym close to your employer. Weekend warriors in the battle against the bulge may want a gym close to home. • Hours of operation: The gym should be open when you plan to exercise. Early birds, for example, may need a gym with early hours to allow for the 5 a.m. swim Page 12
before work. • Cost: Ask if the gym will waive the enrollment fee so that you’re only responsible for the monthly dues. • Free trial pass: Test the gym during the times you’ll likely exercise. Is the gym too crowded? Are the classes, equipment and atmosphere right for you? Are showers and changing facilities up to par? • Equipment quality: Check if the cardio and weight machines are clean and in good condition. • Staff: Are staff members qualified with the right certifications? You may want a gym with fitness trainers and dietitians to help you get healthier. • Classes: Ask if classes such as spinning and yoga cost extra. If you’re solely interested in classes, a studio instead of a fitness facility may be a better option for you. “Once you secure a gym membership, keep your fitness goals S.M.A.R.T — specific, measurable, attainable, realistic and timely — and remember to have fun!” Westman added. “You’re more likely to continue exercising if you stick to activities you enjoy.”
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
ors could “meet” with clients from a home office environment, for example. Briest cautions smokers to never use an online program sponsored by a tobacco company “I’ve had people tell me they’ve used them and they start receiving coupons from them!” she said. “It’s a conflict of interest. “Be wary of a site that’s selling something like electronic cigarettes. They’re not manufactured to help people quit. If they want to sell you something get off the site. You should not have to pay anything or give your personal information, other than if you want patches but the New York State Smoker’s Quitline is a reputable site.”
For Help in Quitting There are several websites designed to help smokers quit smoking. Here are some of them: New York State’s website: www. nysmokefree.com 1-866-NY-QUITS or 1-866-697-8487 American Cancer Society www.cancer.org, 1-800-227-2345 American Legacy Foundation www.americanlegacy.org Great Start (for pregnant women) 1-866-667-8278 American Lung Association www.lungusa.org, 1-800-586-4872 National Cancer Institute www.nci.nih.gov, 1-800-422-6237
Men Vs.Women Why women don’t do as well as men when it comes to losing weight By Deborah Jeanne Sergeant
adies, does it seem like you struggle to lose weight but the pounds easily melt off your husband? It’s not your imagination. There’s science behind the notion. “Men have more muscle mass,” said Laurel Sterling Prisco, registered dietitian and wellness educator for Natur-Tyme in Syracuse. “Therefore, it’s easier to lose weight with more metabolic tissue.” Unfair? You bet! But you can fight back against your body’s low muscle mass and build it up to torch calories. Include musclebuilding exercises such as resistance movements and strength training. Resistance movements use your body and gravity as the “weight.” Strength training involves using weights such as dumbbells, hand weights or kettle balls. Many women eschew weights, fearing they will end up looking too bulky; however, women are not capable of looking muscle-bound unless they spend several hours a day lifting. Don’t let the number on the scale fool you. Since muscle weighs more than fat, you may actually gain weight once you start lifting weights or performing resistance movements.
Lift a weight heavy enough that your muscles are fatigued after about 12 to 15 repetitions. That is one set. Perform three sets per muscle group you work, and alternate which muscle groups you work each day. Hormonal fluctuations throughout your lifetime can also help you gradually pack on pounds. “Peri-menopause and dipping progesterone which contributes to weight gain, and HRT [synthetic estrogen and progesterone] can increase weight,” Sterling Prisco said. Many women still carry “baby weight” gain through having children who are now Prisco school-aged and older. Although gaining weight is a normal part of a healthy pregnancy, gaining too much makes it harder to lose the weight post-partum, especially for moms who do not breastfeed since lactation burns a few hundred calories per day. Other hormonal times can include during menstruation, and while using some kinds of contraceptives, none of which are factors men experience. Talk with your OBGYN if you find your weight creeping up on you. You may be able to switch contraceptives or plan ways to keep your weight under control. Sterling Prisco said she sees “more women with thyroid issues and adrenal fatigue which leads to increased cortisol, weight issues, and sleep issues.” Unexplained weight gain is a symptom of malady. Although the metabolism slows gradually as one ages, adjusting the diet and exercise frequency should keep weight under control. Packing on pounds is not normal. Make sure you address any health issues such as these with your doctor. Some women eat as a
means of comfort or so hurriedly that they’re not fully realizing what or how much they’re eating. “Be aware of the potential to eat fast,” said Maureen Franklin, registered dietitian with Upstate Medical University at Community General Hospital. “Remember to slow down and chew your food. Be mindful, not mindless. Other general lifestyle issues can play a role for women regarding weight loss. “Women tend to put their needs last,” Sterling Prisco said. “Healthy eating and exercise can go to the wayside.” In many families, traditional roles still persist despite both Franklin spouses working. Women who find themselves doing the lion’s share of the childcare, housework, laundry, grocery shopping, and cooking may have little time to take care of themselves. Add to that a fulltime job and time for regular exercise and careful meal planning evaporates. Cooking ahead on weekends may help incorporate more healthful meals into the week. Focus on vegetables and fruits, whole grains, lean sources of protein and modest portions. Set small goals, such as skipping the cream and sugar in coffee, not buttering your toast, or eating a piece of whole fruit instead of an unhealthful snack. Every week, add another small goal to improve your diet. “Eliminating 500 calories per day is one pound of body fat per week or simply eliminating 100 calories per January 2012 •
day can help you to lose 10 pounds per year,” said Matthew Kertesz, registered dietitian and certified diabetes educator in private practice, Your Health Your Choice, PLLC in Camillus. “So the importance of eliminating calories from what your eating can keep you on your weight loss goal.” He advises eating 20 percent on the food from your plate, drinking water when you first start feeling hungry (since this is often thirst in disguise) and never skipping meals (which often leads to overeating) as easy ways to start lowering your overall caloric intake. If you don’t know much about nutrition, take the initiative and time to research and learn from reputable sources such as the American Dietetic Association website (eatright.org) and the government’s MyPlate site (www. choosemyplate.gov). “I’ve always had the theory that when kids start kindergarten, nutrition should be part of their curriculum,” said Sharon Hoff, registered dietitian with Oneida Healthcare. “Most people don’t know much about nutrition.” Carve out time to exercise by instituting an hour of “Daddy time” or swapping babysitting with a friend a few times per week so you can get out to the gym or exercise at home undisturbed. Ideally, work out first thing in the morning. Perhaps before everyone gets up, you could follow an exercise video or jog for half an hour. But if evenings work better for you, plan it and do it. Or consider power walking with baby in the stroller, playing actively with the children in the yard or hiking around the neighborhood.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Women’s issues Confused About Mammograms?
states that women with certain gene mutations (BRCA-1 and BRCA-2) have 60 percent chance of developing breast cancer in their lifetime vs. the general population’s 12 percent chance. “Women who are at higher risk of breast cancer should talk with their healthcare provider about whether to have mammograms before age 40 and how often to have them,” said Mark Franklin, physician and chief of Os-
Continues on page 16
Should you start at 40 or 50? By Deborah Jeanne Sergeant
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ost women know that mammography can be a life-saving screening for breast cancer. But confusion as to when to begin mammograms and their frequently arose in 2009 when the U.S. Preventive Task Force recommended women asking their physicians about delaying screening until age 50. For many women, this implied that the golden rule of “start annual screenings at 40” didn’t apply anymore. The purpose behind the task force’s recommendation was to save medical dollars for what could be unneeded tests. Nearly one in eight American women will have breast cancer at some point in her life, meaning that seven in eight will receive negative mammograms their entire lives. Costly? Yes. But not compared with facing cancer once it’s at its most advanced, hard-totreat stages. That’s why Deepa Masrani, a physician who directs Women’s Imaging and the Department of Radiology
wego Health Radiology. Oswego Health provides digital mammogram testing in Oswego, Pulaski and at its new women’s services department in the Fulton Medical Center, which opened Dec. 12. Beginning screening before 40 should be discussed with one’s health care provider, especially for women
��������������� ������� �� ���� �� ���� �� ���������� ������� ������� � ���������� ������������ ������������ at Upstate Medical University, urges women to obtain mammograms according to the traditional schedule. “Starting at age 40 has been the standard,” Masrani said. “[Starting at age 50] was opposed by the American Cancer Society, Society of Breast Imaging and American Society of Radiology.” Some women are the exception and should start sooner. The National Cancer Institute
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who have: • Family history of breast cancer with a first-degree relative such as mother, sister or aunt. • Previous breast cancer. • Given birth to the first child after age 30 or never having a child. • Menstruation before age 12. • Late menopause beyond the age of 55. • Combination hormone therapy with estrogen and progestrone. • Increased risk associated with obesity, alcohol (more than one drink a day), oral contraceptives. • Increased risk associated with prior radiation therapy to the chest such as for Hodgkin’s lymphoma or tuberculosis. • Caucasians have slightly higher risk for developing breast cancer. For some, proving the risk factors to their insurance company will make a difference in coverage. “A patient needs a 20 percent or greater risk factor to be covered by most insurance companies,” said E. Mark Levinsohn, radiologist with Well-
spring Breast Center of Upstate Medical University at Community General Hospital. For women between the ages of 40 and 50, “some insurance companies only pay for every two years,” Levinsohn added, instead of the recommended annually exams. The task force’s study may have also influence some insurance companies to scale back coverage. “It was not a very valid study and caused a lot of uproar among American women,” Upstate’s Masrani said. “It made them more confused.” The problem with a 40- to 50-yearold asking her doctor if she needs to start having annual mammograms is many women don’t have a family history of breast cancer or any other risk factors and still get cancer. One in eight American women will have breast cancer at some point in her life. “Mammography is a time-tested screening been in place for 35 years,” Masrani said. “It has been proven beyond doubt that mammograms have decreased mortality from breast cancer by 30 percent.” Some may argue that 20 years ago, treatment methods were not as effective as they are now, however, early detection and improving treatment methods are two sides of the same coin. Both are needed to effectively fight
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
cancer. The same task force recommended that women should not continue mammography after 70; however, Masrani disagrees with that notion since many women live vibrant, active lives for at least another decade beyond 70. A simple lumpectomy prompted by a positive finding on a mammogram could easily extend a 70-year-old’s life. “There is no age at which you should stop having mammograms,” Masrani said. For a screening mammogram, patients typically fill out a breast history sheet which asks about age at first menstrual period, child bearing and age of first pregnancy, hormone therapy, breast surgery history and family history of breast cancer. Technicians ask women to disrobe
from the waist up and don a gown. The technician takes two low-radiation scans of each breast, one top to bottom and one side to side. A plastic compression device helps the technician get a better view of what’s inside the breast. “Within a couple days she will get a letter in the mail to let her know the results with either negative or a suspicious finding,” Masrani said. “If it’s suspicious, we have her to come back in.” A follow-up exam can help identify whether the suspicious material is benign or requires further investigation. “A digital mammogram is one of the most important tools physicians have to diagnose breast cancer,” Franklin said. “Early breast cancer detection through mammography likely results in improved outcomes.”
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PROBLEM SOLVED FOR GOOD? My weight decreased immediately, and it wasn’t difﬁcult. After a couple of visits, I knew it was on the level. They did their part and I did mine. Finally, I was in control! I think I’ve got it licked for good, as long as I remain committed. I couldn’t have done it on my own. I lost 3 pant sizes, and people say I look fantastic--20 years younger. I went to Montana and walked on an average of ﬁve to twelve miles a day, where before walking to the mailbox was a chore. DOCTORS’ PRAISE My doctors have all praised my accomplishment. My heart medications are down by 75%, and my blood pressure is down to normal. I still have arthritis, but my joints feel much better. I SAVED MONEY!!! I’ve already saved more than the fee in junk food and medical expenses. The only extra money I spent was in the pleasure of buying smaller clothing! YOU DO IT, TOO! Success removed my skepticism. I recommend that you go to Alternative Hypnosis. Tell them Al sent you.
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Successful clients shown or quoted are not compensated and share their personal stories freely. Individual results vary. The testimonials or photos represent the experience of the speciﬁc client. Each individual is different, as is each one’s individual result. A typical client may expect many different types of results, including possibly better results or no results. The client(s) in the testimonial(s)/photos followed our treatment plan.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Women’s issues Sexual Violence, Stalking, and Intimate Partner Violence Widespread in the US New survey finds these types of violence affect the health of millions of adults
n average, 24 people per minute are victims of rape, physical violence, or stalking by an intimate partner in the United States, according to findings released in December by the Centers for Disease Control and Prevention. Over the course of a year, that
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equals more than 12 million women and men. Those numbers only tell part of the story — more than 1 million women reported being raped in a year and over 6 million women and men were victims of stalking in a year, the report says. “This landmark report paints a clear picture of the devastating impact these violent acts have on the lives of millions of Americans,” said Secretary of Health and Human Services Secretary Kathleen Sebelius. The National Intimate Partner and Sexual Violence Survey, or NISVS, is one of CDC’s latest public health surveillance systems and is designed to better describe and monitor the magnitude of sexual violence, stalking and intimate partner violence victimization in the United States. It is the first
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survey of its kind to provide simultaneous national and state-level prevalence estimates of violence for all states. Key findings in the NISVS 2010 Summary Report include:
• High rates of sexual violence, stalking, and intimate partner violence were reported by women. • Nearly one in five women has been raped at some time in her life. • One in four women has been a victim of severe physical violence by an intimate partner in her lifetime. • One in six women has experienced stalking victimization during her lifetime in which she felt very fearful or believed that she or someone close to her would be harmed or killed. Much of stalking victimization was facilitated by technology, such as unwanted phone calls and text messages. • Almost 70 percent of female victims experienced some form of intimate partner violence for the first time before the age of 25. • Approximately 80 percent of female victims of rape were first raped before age 25. • Female victims of violence (sexual violence, stalking, intimate partner violence) were significantly more likely to report physical and mental health
problems than female non–victims. • Across all forms of violence (sexual violence, stalking, intimate partner violence), the vast majority of victims knew their perpetrator (often an intimate partner or acquaintance and seldom a stranger).
• About one in seven men has experienced severe physical violence by an intimate partner at some point in their lifetime. • One in 19 men has experienced stalking victimization at some point during their lifetime in which they felt very fearful or believed that they or someone close to them would be harmed or killed. • Almost 53 percent of male victims experienced some form of intimate partner violence for the first time before age of 25 • More than one-quarter of male rape victims were first raped when they were 10 years old or younger. • Male victims of violence (sexual violence, stalking, intimate partner violence) were significantly more likely to report physical and mental health problems than male non-victims. For more information about sexual violence, please visit www.cdc.gov/ violenceprevention/sexualviolence/
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
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or those of you who think feminine issues should be kept in the dark, this month’s column is not for you. My little girl is about to turn 5 months old and at some point in her fifth month of life I plan to begin the process of partially weaning her. With this process on the horizon, it’s the perfect time to discuss my adventures in breastfeeding. The decision to breastfeed is a personal one, but most mothers in the U.S. do it. According to the U.S. Department of Health and Human Services, about 75 percent of mothers breastfeed their children at some point. About 44 percent of mothers are still breastfeeding those children at 6 months of age. By the time the child is 12 months that number drops to about 24 percent. This means there are a lot of mothers out there who are putting forth loads of effort and time to provide their babies with the healthiest food in existence. Delivering the healthiest food is no easy charge. I was lucky enough to have a daughter who (almost) naturally latched, but that didn’t stop the pain. There were tears, especially during the first few weeks. Once we had the process under minimal control, we started exploring position options. We started out with the standard cradling method, but that soon proved to be unsatisfactory. Should I hold her like a quarterback racing down the field (football hold) or should I lie down when I feed her and tease my body with the one thing it truly needed (sleep)? At the time it all seemed so overwhelming. My daughter and I settled on the side-lying method, because she has a tendency to get over-stimulated at meal times and lying down restricted some of her movement. This worked great at home, but not so great in the field. In fact, there were times when I fed her lying in the grass at a parking area or park. I also took over my friends’ beds and floors when visiting. I could feed her sitting up, but that usually resulted in my having to feed her every 15 minutes since she protested and ate so little. Public breastfeeding was always an adventure. I found it best to completely tune out everyone around me. If I was getting shameful or disgusted looks, I was too busy keeping my baby alive to care. It wasn’t glamorous; it was necessary. Once we had position and on-location logistics squared away, I was back to work. Continuing to provide my daughter with breast milk means
I have to pump three times a day at work. Milking myself is far from my favorite pastime, mostly because of the inordinate amount of time it demands. Balancing work and a personal life as a new mother is daunting. Sprinkling 20 to 30-minute pumping sessions in that mix often seems insurmountable. By combining an understanding employer with a lot of patience, I have thus far been able to make this happen and with only limited meltdowns. When you are breastfeeding, life revolves around breastfeeding. Once this sunk into my own brain, the real challenge was getting others to understand it. You can’t skip a feeding and just give the baby a bottle (if you do this you have to pump). You can’t be away from the baby for more than a couple of hours without having your pump on hand. My breasts were always in hot demand and for the past five months they have dictated more than one person’s life. Before motherhood I never would have dreamed my breasts would have so much weight (cue the corny cymbal crash). I could go into more examples, but the picture is drawn: breastfeeding is very challenging. It can be painful, inconvenient, embarrassing and trying, but there is a reason so many moms do it. Breast milk has nutrients and antibodies for the baby. It’s the easiest food for a baby to digest. It helps fight disease and protects babies from illness. It wards off gastrointestinal disease, respiratory infections, asthma, obesity, Type 2 diabetes, skin rashes, some forms of cancer and sudden infant death syndrome. There is also the cost-savings factor. Besides the health and cost benefits, breastfeeding wasn’t always challenging. Sometimes lying down with my daughter and feeding her is the best part of my day. It is our quiet time together. It’s something I can give her that nobody else can. She saves her best smiles for when she is breastfeeding. When I look at her chunky thighs and rubber band wrists, I can take pride in knowing I did that. She is proverbially fat and happy due to me and my hard work. It’s a great feeling. Even when breastfeeding isn’t all rainbows and lollipops, I know the trials and tribulations are worth it. The best things in life are monetarily free, but this mom knows the real price is worth paying.
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Dr. Verma is currently taking new patients. Major insurances accepted. Please feel free to speak with your Primary Care Provider for referral. January 2012 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Suicide Prevention Saves Lives Detecting signs that a person may be contemplating suicide is crucial in prevention By Deborah Jeanne Sergeant
n 2008, the American Association of Suicidology reported that every 14.6 minutes, one person in the United States has killed himself. It’s the third raking cause of death for the young and the 10th ranking cause for older adults. When interviewed later, most family members and friends of suicide victims relate that they “never saw it coming.” They may not have known the warning signs of someone considering suicide or even known that their loved one suffered emotionally at all. Wendy Stine, director of communications for Contact Community Services in Syracuse, said that common signs of people who are contemplating suicide include “giving things away, feeling depressed, indicating a sense of hopelessness and helplessness,” she said. “Another is considering themselves a burden to friends and family. They may indicate there’s nothing to live for and no reason to go on.” Certain behaviors that are often overlooked can make it hard to recognize someone who is contemplating suicide. These could include suddenly
Keep it secret? Debra Graham, chairwoman of the Central New York Chapter of the American Foundation for Suicide Prevention in Phoenix, addressed whether or not a friend or family member should agree to keep suicide plans secret. “Absolutely not! Never keep it a secret. Never ever. Often, young people will be sworn to secrecy because they’re afraid of putting a friendship in jeopardy. The person contemplating suicide makes them promise to not tell and the friend doesn’t want to tell on them. But better to lose a friend for revealing the secret than to lose them forever to suicide. Most people considering suicide want help but don’t know how to ask for it. There’s an ambivalence to taking their life. It’s not that they want to die but they don’t want to live with the unbearable emotional pain they’re in.” Page 22
purchasing a firearm, gathering items that could be used to take a life, or setting final affairs in order to take care of loved ones. Debra Graham, chair woman of the Central New York Chapter of the American Foundation for Suicide Prevention in Phoenix, Oswego County, adds, “Sometimes, there are extreme changes in an individual’s typical behavior, especially if someone has shown signs of depression and suddenly they’re very happy. “There could be increased use of alcohol and other substances. Quite often, they say their farewells or reach out to someone they haven’t spoken to in a long time with whom they had a disagreement to make amends.” Of course, what is a regular behavior for one person may be very unusual for another. For a person who’s usually very through in matters of paperwork and orderliness, writing a will may not be strange. But for someone who seldom keeps track of paperwork to act oddly and get his affairs in order and suddenly show interest in firearms could signal trouble. Many people experience periods of sadness, but long bouts of depression and lack of interest in formerly avid hobbies and activities could be a sign of suicide risk. They may slack off in their grooming, lose interest in eating and sex, overeat or express numerous physical complaints. Depression is often accompanied by physical pain. Not everyone who is depressed acts sad. Some express their depression with angry outbursts. Observable signs of serious depression may include unrelenting low mood pessimism, hopelessness, desperation, anxiety, psychic pain and inner tension, withdrawal, sleep problems, worthlessness, loneliness, extreme sadness, feelings of guilt, increased alcohol and/or other drug use, recent impulsiveness and taking unnecessary risks, and threatening suicide or expressing a strong wish to die. Expressions such as “I can’t take anymore,” “You would be better off without me,” “I’ve got it all figured out,” “I wish I could just go to sleep and never wake up,” “All of my problems will end soon,” or “No one can help me now” may indicate someone who is considering suicide. People contemplating suicide may give away possessions, cancel future plans for no apparent reason, and gather items needed to carry out their own death: a weapon, medication or a rope, for example. Usually, the person has suffered one or more significant losses: job, health, money, relationship, home, reputation or something else. What is significant to someone considering suicide may not be important to you. That is why it’s important to look past the loss and notice the person’s reaction. Long before a loss or building stress pushes a person to consider suicide, friends and family members should help him by acknowledging what a tough time he’s had and asking
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
how he’s working through it. Offering practical help, such as a monetary gift to someone who has experienced job loss or rides to the hospital to someone battling an illness, can demonstrate a caring spirit and alleviate some of the stress. “Don’t be afraid to ask the question, ‘Are you thinking of killing yourself?’” Stine, the director at Contact Community Services, said. “Don’t try to mask it by asking ‘Are you thinking of hurting yourself?’ Don’t try to soften it. It really helps to de-stigmatize it and normalize it. It allows the person to express how they feel. If they’re not suicidal, they will be quick to say it and say they want their lives to change but aren’t sure how to do it.” Your question may help him start thinking about alternatives. It can only help and won’t hurt to ask. Some people fear that asking about suicide directly will make the hurting person consider suicide as an option. Cheryl Giarrusso, who directs telephone services at Contact Community Services, said, “That’s the biggest myth. It won’t put the idea in their heads. It’s the most effective way to help someone: address it directly. “It lets the person who has those thoughts to know you’re safe to talk to. What they want to do most of all is express the despair they’re feeling.” People contemplating suicide already feel isolated and as if no one understands them. That’s why it’s important to build a bridge of understanding to them by listening. “Listening is key,” Giarrusso said. “Listen and do as little talking as possible. Give the person adequate time so they can process their thoughts and share them. Listen as non-judgmentally as possible and give them your full, undivided attention. If you don’t, you tell them that you’re not safe and that you can’t help them because you can’t even think about those thoughts yourself.” It’s far better to honestly tell the person if you can’t deal with this type of conversation and give him a hotline number than to reaffirm their false belief that no one cares or can understand. “A family member or friend who’s concerned about someone can call the hotline and get advice as to how to talk with their loved one,” Stine said. Dismissing the person’s feelings, minimizing their depression or trying to immediately convince them of all they have to look forward to usually places distance between you and the person suffering. Blurting, “How could you think of that!” risks alienating the person. “Avoid judgmental comments,” Stine said. “Be as open as possible to what the person has to say. Invite them to express their feelings. Many people feel they have to immediately have to jump to a solution-based conversation. Give the person as much time as they need to process.” Instead of berating the person, ask, “Can you tell me more?” “If you’re aware someone’s trying
to take their life, seek professional help,” Graham said. “Don’t leave them alone. Take it seriously. You can call 911. Help them get connected to the right care. “People think that if someone’s talking about suicide that they really won’t do it. Every suicide threat needs to be taken seriously. Sometimes, that’s the only cry for help that person will give.” Members of the medical community can play a key role in preventing suicide. During a routine general practitioner visit, for example, noticing and asking about the patient’s mood can help begin a conversation about depression or suicidal thoughts. Giarrusso wishes more primary care doctors received training in suicide prevention, but many of the methods for recognizing suicide risk are the same for them as the general public. “If someone comes in not feeling well, they should first check for medical issues, but if [medical issues are] non-existent, they should talk about emotional issues and do a suicide screening.” Symptoms such as sad expressions, wanting to sleep all the time, lack of appetite, lack of interest in living and doing the things they once enjoyed can all be signs of a suicidal patient, along with general malaise. “It’s so important to rule that out first, especially for teenagers and folks who are older.” She explained that teens’ rapid development can cause them to evidence signs of being suicidal, and seniors’ life changes such as the loss of friends, isolation, loss of spouse, the inability to get out and be with others can lead to feelings of depression and sadness. Although people considering suicide have traveled a dark path, “There is absolutely hope for those thinking of taking their own life,” Graham said. “Research has proven suicide is preventable if the intervention is early enough and the person is diagnosed.”
Resources For more information about suicide prevention, visit the following sites: • Contact Community Services 24hour hotline at (315) 251-0600. • American Association of Suicidology: www.suicidology.org • American Foundation for Suicide Prevention: www.afsp.org • National Suicide Prevention 24-hour hotline at 1-800-273-TALK (8255)
with so many foods, is moderation. By Anne Palumbo
The skinny on healthy eating
The Perks of Drinking Coffee
t the beginning of every new year, I used to contemplate my coffee consumption, vowing to drink less. It’s not that I drink that much — about three to four cups each morning — it’s just that I drink it more regularly than any other beverage. But all that mulling came to a screeching halt when, after some serious investigation, I got to know the upside of my beloved joe. According to a growing body of research, coffee drinkers, compared to nondrinkers, are less likely to have Type 2 diabetes, Parkinson’s disease, and dementia, including Alzheimers disease. What’s more, researchers have found strong evidence that coffee may reduce the risk of heart disease, strokes, and certain cancers. Frank Hu, nutrition, medical doctor and epidemiology professor at the Harvard School of Public Health, recently stated that “all of the studies have shown that high coffee consumption is associated with decreased risk of liver cirrhosis and liver cancer.” Although researchers have not been able to pinpoint exactly how coffee works its magic, they have identified compounds in coffee that may contribute to the aforementioned health benefits.
For starters, coffee teems with antioxidants, those beneficial free-radical-gobbling compounds most often associated with beans, fruits, and vegetables. While coffee’s antioxidant levels are indeed lower than most acknowledged sources, it’s the top source of antioxidants in the U.S. diet, according to Joe A. Vinson, a professor at the University of Scranton, because we drink so much of it. Coffee also contains minerals such as magnesium and chromium, which help the body use insulin, a hormone that lowers the level of glucose in the blood. Since, with Type 2 diabetes, the body loses its ability to use insulin and regulate blood sugar effectively, it’s no wonder that coffee has been linked to keeping this disease at bay. On the downside, heavy coffee consumption — 5 to 7 cups a day — can cause problems such as restlessness, anxiety, irritability, heartburn, and sleeplessness. The key here, as
Exposure to air is coffee’s worst enemy, followed by heat and sunlight. That said, you’ll want to store your coffee in an airtight container and place it in a cool, dark place. Large quantities may be frozen, but do divvy up the amount into weekly portions, as once you remove it from the freezer, it should never go back in. Looking to lower your caffeine intake? Choose dark roasted coffees, as the longer a bean is roasted the less caffeine it contains.
Easy Bean-and-Coffee Chili 1 tablespoon olive oil 2 tablespoons chicken broth 1 large onion, chopped 3 garlic cloves, minced 1 tablespoon chili powder 2 teaspoons ground cumin ¼ teaspoon cayenne pepper (optional) 2 teaspoons dried oregano 1 28-ounce can diced tomatoes, undrained (recommend: fire roasted) 1 tablespoon honey ½ cup strong coffee 1 15-ounce can black beans, drained, rinsed 1 15-ounce kidney beans, drained, rinsed 1 roasted red pepper (from jar), chopped ½ cup chicken stock Salt and pepper, to taste Heat olive oil and 2 tablespoons chicken broth in a large pot over medium heat. Add onions and sauté until tender, about 8 minutes. Add garlic and
sauté another minute. Mix in chili powder, cumin, cayenne and oregano. Cook 1 minute. Add tomatoes, honey, coffee, drained beans, red pepper and remaining chicken broth. Bring to simmer, then reduce heat to low, and cook for 20 minutes, uncovered, stirring occasionally. Stir in more broth if mixture seems too thick. Add salt and pepper, to taste. Optional: Top with chopped green onions, low-fat sour cream, or shredded low-fat cheddar cheese. 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.
REACH THE MEDICAL COMMUNITY. ADVERTISE WITH IN GOOD HEALTH Email inquiries to editor@CNYhealthnews.com
Have You Winterized Your Kids? C
old winds, icy rain and, in some places like Upstate New York, snow, tons of snow—Old Man Winter has arrived. His entry reminds us to get our furnaces checked and winterize our car, but what about the kids? “Children are even more vulnerable than adults to cold-weather and winter-related injuries,” said Karen Judy, pediatrician at Loyola University Health System and professor of pediatrics at Loyola University Chicago Stritch School of Medicine. Judy offers some tips to keep kids safe while playing outside in the cold. • Dress your child in layers. If one layer gets wet the child can remove it to keep moisture away from the skin. • Avoid cotton clothes as they will not insulate if wet. Fleece and wool are better options. • Warm boots and mittens are extremely important as extremities are more prone to frostbite. Tips of the ears and nose are often forgotten and also are vulnerable to frostbite. Make sure they are covered. • Wear a hat. Children can lose 60 percent of their body heat if their heads are not covered. • Make sure kids come inside often to limit exposure to the elements. • Change children out of wet clothing as soon as possible. “We spend a lot of time in our cars in winter and this can be dangerous if we are not prepared,” said Judy. “In
cold weather, parents to need to take additional precautions to keep kids safe while traveling even if it’s just to the grocery store. Never leave kids in a car unattended and keep a winter survival kit in the car with blankets, extra socks and gloves, snacks, and a first-aid kit in case the car breaks down or you are stranded in your car.” According to Judy, some of the most common and dangerous winterrelated dangers are hypothermia and frostbite.
Hypothermia happens when a person’s body temperature falls below 90 degrees Fahrenheit. “Kids already have a lower body temperature than adults so they are more susceptible to this deadly condition, especially when wet,” said Judy. Symptoms of hypothermia include: • Shivering • Drowsiness • Slurred speech • Confusion “If a child exhibits these symptoms, get them inside immediately, out of wet clothes and into warm, dry clothes. Wrap the child in a blanket and call 911 immediately,” said Judy.
Frostbite is frozen tissue and can cause damage to the skin and often is associated with hypothermia. There are varying degrees of frostbite. Frostnip is a milder form of injury. January 2012 •
It usually affects areas that are exposed to the cold, such as the cheeks, nose, ears, fingers, and toes, leaving them red and numb or tingly. If you suspect frostnip: • Bring your child indoors immediately and remove all wet clothing. • Immerse chilled body parts in warm (not hot) water until all sensation returns. • Don’t use heating pads, stoves, fireplaces, or radiators. Affected skin can be numb and easily burn. • Call your doctor if sensation does not return or there are signs of frostbite and/or hypothermia. Symptoms of frostbite needing immediate medical attention include: • Skin that looks white or gray; it may become blistered • If a child’s skin has a burning or numbing sensation Get medical help immediately if you suspect your child has frostbite. While waiting for medical help to arrive: • Place the affected area in warm, not hot, water. • Do not rub the skin as it is fragile and this could damage it. • Give your child something warm to drink “Because of low blood supply fingers, toes, ears and nose are the most vulnerable to frostbite. Parents should ensure those areas are well covered,” said Judy.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
What They Want You to Know:
Registered Dietitians By Deborah Jeanne Sergeant
he American Dietetic Association states that “registered dietitians have completed academic and experience requirements established by the Commission on Dietetic Registration, ADA’s credentialing agency, including a minimum of a bachelor’s degree from an accredited college or university and an accredited preprofessional experience program. RDs must successfully complete a rigorous professional level exam and must maintain ongoing continuing education to maintain their credential. Some RDs hold advanced degrees and additional certifications in specialized areas of practice.” The site also states that the services registered dietitians provide include “reliable, objective nutrition information, separate facts from fads and translate the latest scientific findings into easy-to-understand nutrition information.” • “When it comes to dieting we all know weight loss is not easy and therefore it will not be easy to get the weight off. It takes hard work and dedication in making lifestyle changes. This means changes in eating and physical activity to establish healthier
behaviors. If behaviors do not change then we will not be successful for the long term. • “If you are having trouble recognizing those behaviors to change in order to lose weight then seek help from a dietitian. A dietitian can help create an individualized plan in helping you make healthier habits. • “To find a dietitian in your area log into eatright.org and click on ‘Find a Dietitian.’ • “The success with weight loss comes from having a plan in place that you work on every day. It is not how fast you got the weight off but the behaviors you changed to keep it off long-term.” Matthew Kertesz, registered dietitian and certified diabetes educator in private practice, Your Health Your Choice, PLLC in Camillus. • “As an integrative dietitian, I am very fortunate and grateful to be able combine what I love to do and ‘pay it forward!’ • Throughout the day I educate clients one-on-one, and through radio shows, TV spots, blogs, and lectures out in the community. I love to em-
CENTENARIANS Resident Of The Nottingham Celebrates 100th Birthday! Family members, friends and staff recently gathered at the Residential Health Care Facility of Loretto’s The Nottingham Senior Living Community in Jamesville to celebrate the 100th birthday of Nottingham resident Barbara “Bobbie” Morton. Morton was born on Dec. 2, 1911 in Syracuse and became the wife of the late William Morton (who was CEO of the former Onondaga Savings Bank, now M&T Bank). She was a homemaker and mother of their three children. Morton has 11 grandchildren and 14 great-grandchildren. Once very active with the congregation of Park Central Presbyterian Church in Syracuse, Morton’s favorite life-long interests include fishing throughout New York state’s 1000 Islands region and golf and tennis at the Onondaga Golf and Country Club in Fayetteville.
power others to achieve optimal health through diet, exercise and supplementation. • “A good colleague, friend and mentor said to me she saw a quote once that said ‘One can’t drug oneself into health.’ I agree with that, and I live by the quote from Hippocrates (460370BC) ‘Let thy food be thy medicine and thy medicine be thy food.’ It is important to realize everything that affects our health such as: our emotions, stress (family, finances, jobs), dietary choices, physical activity, medications, spirituality, and relaxation. • There are two great movies out there that people should see for awareness. Food Inc is one, and the other is “Food Matters.” In “Food Matters,” they discuss the topics of nutritionally depleted foods, chemical additives, and our tendency to rely upon pharmaceutical drugs to treat what’s wrong with our malnourished bodies. They go on to state it’s no wonder that modern society is getting sicker through this worldwide ‘sickness industry.’ We need to take charge of our health through education. Knowledge is power, and the more we know and bring to our doctors the more it forces them to learn about other options.” Laurel Sterling Prisco, registered dietitian and wellness educator for NaturTyme in Syracuse • “Be careful about nutrition misinformation. Nutrition, like all other sciences, is constantly evolving. • “Registered dietitians and diet technicians, registered are the best source of accurate and up-to-date nutrition information. • “Learn to read food labels. Nearly all the information you need to know about a food is on the label. • “Stick to serving sizes noted on food labels. If you do so, you can fit nearly all foods into your diet. • “Registered dietitians (RDs) use a holistic approach when providing nutrition advice. RDs take into consideration all chronic and acute diseases, medications and supplements, blood test values, and lifestyle when providing individualized nutrition advice. • “Ask what symbols on menus
mean. The heart symbol may not always mean the food is both low cholesterol and low sodium. Some symbols may be misleading.” Maureen S. Fauler, registered dietitian and manager clinical nutrition for Crouse Hospital • “A calorie is a calorie. It’s like a bank account. • “I wish people would eat more fruits and vegetables. You’ll feel full and more satisfied. Before you buy the calorie-laden foods, buy a few fruits and vegetables you’ve never tried before. • “With the Internet, you can go onto all kinds of sites to find foods and recipes and look for different types of things that can make you feel full but not give you the extra calories. • “You have people that cook with sticks of butter like Paula Dean, but you could reduce the butter to 1/4 the amount. That’s the nature of my business. • “People don’t put enough time or energy into what they put into their bodies. If you’re not planning or educating yourself on what you’re eating, you won’t get a good result. • “Many people eat out and don’t really know what they’re eating. If people just cooked it themselves and found better ways to prepare it that could be the activity than going to the movies! We need to get back to sitting around the kitchen table and making a home-cooked meal.” Sharon Hoff, registered dietitian with Oneida Healthcare Deborah Jeanne Sergeant is a writer with In Good Health. “What They Want 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.
2011 is one for the weather record books
he year 2011 will be one talked about when discussing weather extremes. It is tied for the 10th hottest year since record keeping began in 1850, according to a United Nations agency. 2001 has also been a year of severe weather. Droughts in East Africa killed tens of thousands; deadly floods in Asia left scores dead; and 14 separate weather catastrophes in the United States swept the country and left behind damage topping $1 billion in each incident. World temperatures keep rising and are heading for a threshold that could lead to irreversible changes of the Earth, the World Meteorological Organization (WMO), the UN weather office, stated. The weather agency also noted that Arctic sea ice has shrunk to record volumes in 2001, adding that the 13 hottest years on the books have all occurred in the last 15 years. The WMO’s preliminary report,
based on the first 10 months of the year, was released in Geneva and at the UN climate talks in South Africa. The WMO report noted that high temperatures heated the Earth in 2011 despite the presence of a cooling La Nina effect. In a separate report, the authoritative Intergovernmental Panel on Climate Change reported this month that extreme weather-related events and frequency will intensify as the Earth continues to warm. Both reports show that climate change is real and its manifestation in weather and climate patterns are already being observed around the world. Weather experts are seeking ways to limit pollution blamed for global warming, and are discussing how to raise $100 billion a year to help poor countries move to low-carbon economies and cope with the effects of global warming.
Home Care by Seniors for Seniors There’s a huge difference in the kind of home care you can receive from someone who really understands what your life is like as a senior. The concerns you have. The need for independence. Someone who, like you, has a little living under his or her belt. Our loving, caring, compassionate seniors are there to help. We offer all the services you need to stay in your own home, living independently. • Transportation • Shopping • Doctor Appointments • Companion Care • Housekeeping services • Meal preparation/cooking • 24-Hour Care • and more
By Jim Miller
Call us today. Like getting a little help from your friends.
How to Find and Research Doctors Who Accept Medicare Dear Savvy Senior, What resources are available to help seniors locate and research Medicare doctors? My husband and I are approaching age 65 and need to find a new internist or primary care doctor who accepts Medicare. Our current doctor is not enrolled with Medicare and will not continue seeing us as Medicare patients. Looking For Care Dear Looking, Depending on where you live, finding a new primary care doctor or specialist that accepts Medicare patients can be challenging. Because of low reimbursement rates and greater paperwork hassles, many doctors today have opted out of Medicare or they’re not accepting new patients with Medicare coverage. With that said, Medicare is now offering a service that makes finding Medicare-approved doctors a little easier. And, there are a number of good resources available today that can help you check up on prospective doctors for free. Here’s what you should know. Medicare Doctors
The government’s new online “Physician Compare” tool is one of the easiest ways to locate doctors in your area that accept traditional Medicare. Just go to www.medicare.gov/find-adoctor where you can do a search by physician’s name, medical specialty or by geographic location. Or, if you don’t have Internet access, you can also get this information by calling 800-6334227. Keep in mind, though, that locating a Medicare-approved doctor doesn’t guarantee you’ll be accepted as a patient. Many doctors limit the number of Medicare patients they accept while others have a full patient roster don’t accept any new patients. You’ll need to call the individual doctor’s office to find out. Another option you may want to consider is to join a Medicare Advantage plan. These are government approved, private health plans (usually HMOs and PPOs) sold by insurance companies that you can choose in place of original Medicare. These plans may have more doctors available than original Medicare does. See www.medicare. gov/find-a-plan to research this option.
Doctor’s Check Up
After you’ve found a few Medicare-approved doctors that are ac-
cepting new patients, there are plenty of resources available today that can help you research them. Some of the best include HealthGrades, Vitals and RateMDs. These are free doctor-rating websites that provide important background information as well as consumer comments and ratings from past patients. Here’s a breakdown of what each site offers: • Healthgrades.com provides indepth profiles on around 750,000 U.S. physicians including their education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records. It also offers a 5-star ratings scale from past patients on a number of issues like communication and listening skills, wait time, time spent with the patient, office friendliness and more. • Vitals.com provides some basic background information on around 720,000 U.S. doctors along with unedited comments from past patients and ratings on things like promptness, bedside manner, accurate diagnosis and more. • Ratemds.com primarily offers ratings and anonymous comments from past patients. It’s a good idea to check out all three doctor-rating sites so you can get a bigger sampling and a better feel of how previous patients are rating a particular doctor.
Another good resource to help you gather information is at angieslist. com (888-888-5478). This is a fee-based membership service that also offers doctors ratings and reviews from other members in your area for $7.60 for one month or $25 for the year. Or, consider purchasing a copy of the “Consumers’ Guide to Top Doctors.” Created by Consumers’ Checkbook, a nonprofit consumer organization, this book will help you find top-rated doctors that have been recommended by other doctors. Their database lists 24,000 physicians, in 35 different fields of specialty, in 50 metro areas. The cost for this guide is $25 plus shipping and handling (call 800-2137283 to order a copy), or you can view the information online at checkbook. org/doctors for $25.
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.
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The Social Ask Security Ofﬁce By Deborah Banikowski, District Manager in Syracuse.
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All About Retirement
ocial Security is as American as baseball and apple pie. Not everyone likes apples or baseball games, but almost every American who reaches retirement age will receive Social Security retirement benefits. In fact, 96 percent of Americans are covered by Social Security. If you’re ready to retire in the near future, this article is for you. We’d like to share with you a few important items about Social Security retirement benefits and how to apply for them. When you work and pay Social Security taxes, you earn “credits” toward Social Security benefits. If you were born in 1929 or later, you need 40 credits (10 years of work) to qualify for retirement benefits. To qualify for retirement benefits, 10 years is the minimum. However, the amount of your benefit is determined by how long you work and how much you earn. Higher lifetime earnings result in higher benefits. If there were some years when you did not work or had Banikowski low earnings, your benefit amount may be lower than if you had worked steadily or earned more. Also, your age when you retire makes a difference in your benefit amount. The full retirement age (the age at which full retirement benefits are payable) has been gradually rising from age 65 to age 67. You can retire as early as age 62, but if benefits start before you reach your full retirement age, your monthly payment is reduced. Find out what your full retirement age is by referring to the convenient chart in our publication, Retirement Benefits, at www.socialsecurity.gov/
Q: I prefer reading by audio book. Does Social Security have audio publications? A: Yes, we do. You can find them at www.socialsecurity.gov/pubs. Some of the publications available include What You Can Do Online, How Social Security Can Help You When A Family Member Dies, Apply Online For Social Security Benefits, and Your Social Security Card And Number. You can listen now at www.socialsecurity.gov/pubs. Q: I am receiving Social Security retirement benefits and I recently went back to work. Do I have to pay Social Security (FICA) taxes on my income? A: Yes. By law, your employer must withhold FICA taxes from your paycheck. Although you are retired, you do receive credit for those new earnings. Each year Social Security automatically credits the new earnings and, Page 26
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
pubs/10035.html. It’s in the second section. Just as you can choose an early retirement and get a reduced payment, you also can choose to keep working beyond your full retirement age to take advantage of a larger payment. Your benefit will increase automatically by a certain percentage from the time you reach your full retirement age until you start receiving your benefits or until you reach age 70. The decision of when to retire is an individual one and depends on a number of personal factors. To help you weigh the factors, we suggest you read our online fact sheet, “When To Start Receiving Retirement Benefits,” available at www.socialsecurity.gov/ pubs/10147.html. You may want to consider your options by using our Retirement Estimator to get instant, personalized estimates of future benefits. You can plug in different retirement ages and scenarios to help you make a more informed retirement decision. Try it out at www.socialsecurity.gov/estimator. When you decide to retire, the easiest and most convenient way to do it is right from the comfort of your home or office computer. Go to www.socialsecurity.gov where you can apply for retirement benefits in as little as 15 minutes. In most cases, there are no forms to sign or documents to send; once you submit your electronic application, that’s it! In addition to using our awardwinning website, you can call us tollfree at 1-800-772-1213 (TTY, 1-800-3250778) or visit the Social Security office nearest you. Either way you choose to apply, be sure to have your bank account information handy so we can set up your payments to be deposited directly into your account. To learn more, please read our publication, “Retirement Benefits,” at www.socialsecurity.gov/pubs/10035. html. if your new earnings are higher than in any earlier year used to calculate your current benefit, your monthly benefit could increase. Q: How are my retirement benefits calculated? A: Your Social Security benefits are based on earnings averaged over your lifetime. Your actual earnings are first adjusted or “indexed” to account for changes in average wages since the year the earnings were received. Then we calculate your average monthly indexed earnings during the 35 years in which you earned the most. We apply a formula to these earnings and arrive at your basic benefit. This is the amount you would receive at your full retirement age. You may be able to estimate your benefit by using our Retirement Estimator which offers estimates based on your Social Security earnings. You can find the Retirement Estimator at www.socialsecurity.gov/estimator.
H ealth News Seniors Helping Seniors opens several ofﬁces Seniors Helping Seniors in-home services is opening its doors to help older seniors stay self-sufficient in their own homes, in the Oswego, Cayuga, Seneca, Warren counties and the Baldwinsville area. The non-medical home care organization provides as much or as little help as someone needs, including cooking assistance, light housekeeping, shopping, doctor visits, transportation, computer assistance, house maintenance, yard Mike Turner work, small repairs, pet care, 24-hour care and, most importantly, companionship, all by seniors who get paid for their work. “Our providers, who are seniors themselves, understand what aging is about. They often come from a long history of caring Deb Turner professions, nurses, social workers, teachers and craftsmen. All our providers say they receive as much as they give,” said Deb Turner, a new franchise partner with Seniors Helping Seniors in-home services. “It’s simple. When seniors who want to help, meet and care for seniors who need help, everybody wins.” Because of their personal experiences watching their own mothers care for loved ones, Mike and Deb Turner
knew they wanted to provide services that would help fulfill the needs of older adults and, at the same time, provide support for their families. “I often thought to myself how Seniors Helping Seniors services would have been so helpful to my mom,” said Deb Turner. “She would have been able to get a break, even for a few hours each week, which would have been time for her and would have improved everyone’s quality of life.” Mike and Deb Turner live in Marcellus. Mike is a senior engineering manager at Welch Allyn in Skaneateles. Deb has always worked in the service industry and loves running her own business. She was drawn to Seniors Helping Seniors because of their caring approach, she said. For more information, call 720-4441 or email email@example.com.
Amaus Health Services wins Excellus prize The 2011 Howard J. Berman Prize has been awarded to Amaus Health Services at the Cathedral of the Immaculate Conception and Lynn-Beth Satterly, its founding medical director; Frances Bergan, its founding nurse administrator; and Monsignor Neal Quartier, rector. The Howard J. Berman Prize, a $10,000 cash award and a handcrafted statue, is named for the former chief executive officer of The Lifetime Healthcare Companies, parent company of Excellus BlueCross BlueShield. Financed through private donations from more than 160 of Berman’s colleagues and admirers, the prize was established to reward Upstate New York community-based, nonprofit organizations
Kidney quilt project unveiled at Upstate Medical
that pursue local initiatives to improve public access to health care. It honors Berman’s leadership and vision of “assuring affordable access to needed, effective health care services regardless of health status or ability to pay.” “For this year’s prize, the selection committee reviewed a wide variety of very impressive organizations from across Upstate New York,” said Sandra Parker, chairwoman of the committee. “Amaus Health Services represents exactly the type of grassroots program that embodies Howard Berman’s lifelong passion to make a difference for those who are most at risk of falling through the cracks of our health care system.” Founded in 2007, Amaus Health Services is a free medical clinic located in the City of Syracuse that serves people who are without insurance and who have limited access to health care. Amaus is an all-volunteer clinic that serves more than 1,500 patients annually. The clinic also performs advocacy services, helping patients access additional care and services so that they can live healthier and more dignified lives. “All of us at Amaus are honored and grateful to receive the Howard Berman Prize,” said Satterly. “As a grassroots organization with a grassroots budget, we rely on funding from generous individuals and faith communities in the area and the Berman Prize funding will be a tremendous help. Such generous souls enable us to do what we do day to day.” “It is a privilege to work with Dr. Satterly, the other providers, and staff,” added Richard W. Weiskopf. “I find it a great way to take direct action to help those who are not provided for by our present health care system.” The Howard J. Berman Prize fund is administered by the United Way of Greater Rochester. To date, more than $200,000 has been pledged to the fund. Donations to the fund are still being accepted and may be made payable to the Howard J. Berman Fund, care of the United Way of Greater Rochester, 75 College Avenue, Rochester, NY 14607. In addition to the $10,000 cash award, the Berman Prize also features a handcrafted statue designed by Rochester-based sculptor, Leonard Urso. “I crafted the Howard Berman Prize to portray the spirit of humanity. It is a heroic, elegant figure evoking the strength, beauty and goodness of human beings.” The sculpture was formed by hand from a copper sheet.
Nutritionist joins Riverview Wellness in Oswego
Frank Froschauer and Lyn Livermore of Madison present quilts to kidney donor Jim Miller and kidney recipient Lisa Stankus at Upstate University Hospital Nov. 18. Livermore’s quilting guild is creating quilts for kidney donor/recipient pairs to raise awareness for the need for more living donors. Livermore also created the quilts as a tribute to her friend Mary Ellen Froschauer, who died of a heart condition in 2008. Livermore donated one of her kidneys to Mary Ellen Froschauer in 2002.
Ashley Cowden is a new nutrition practitioner at Riverview Wellness Center in Oswego and is now offering nutritional counseling services. Cowden uses nutrition response testing to help best understand the body and what it needs for optimal health and healing. Cowden helps design personalized eating plans, whole food supplement programs and lifestyle recommendations tailored to meet individual needs. In addition, each month Cowden facilitates a 21-day weight loss and detoxification program which serves as a great kick start to better health. The program is taught in a group January 2012 •
setting and is held at Riverview Wellness Center in the evenings. “I am passionate about health and wellness,” she said. “I am looking forward to providing nutritional services to the Oswego community. I believe that we all deserve to Cowden be healthy and feel good. I am enthusiastic about helping people to achieve their best health and to live in optimal wellness.” Cowden holds a master’s degree in applied clinical nutrition from New York Chiropractic College in Seneca Falls. She is also a usui reiki master.
3 dentists join Northeast Dental Group Three new dentists have joined Northeast Dental Group, LLC (NDG) to practice general dentistry, They are: • Ahmed A. Badawy, who joins the organization’s Cicero office. Badawy, earned his Doctor of Dental Medicine degree from the Temple University School of Medicine. He also holds a bachelor’s degree in general science from Portland State University. • Lydia Mihovilovic-Humes joins the practice’s Central Square office. She earned her Doctor of Dental Surgery degree at the New York University College of Dentistry. She also earned her Doctor of Stomatology degree at the University of Belgrade, Yugoslavia. Stomatology is the branch of medicine of dentistry concerned with the structures, functions and diseases of the mouth. • Mark H. Hsu earned his Doctor of Dental Medicine degree from the University of Pennsylvania School of Dental Medicine. He also holds a bachelor’s of dental surgery degree from Mangalore University Dental School, India. He joins the practice’s offices in Fulton.
Sports Medicine Doctor Joins Crouse — Brad Raphael has joined the medical staff of Crouse Hospital. Raphael’s specialty is orthopedic surgery, sports medicine and shoulder injuries. He is a partner with his father, orthopedic surgeon Irving Raphael in Elite Healthcare Medical Associates, Syracuse, and currently serves as assistant team physician for Syracuse University Athletics. His father is head team physician for SU, Raphael a position he has held for nearly two decades. Raphael received his medical degree from Yale University Medical School in 2005 and completed his orthopedic residency at the Hospital for Special Surgery, New York. He com-
IN GOOD HEALTH – CNY’s Healthcare Newspaper
H ealth News pleted a sports medicine fellowship at Kerlan Jobe Orthopedic Clinic, Inglewood, Cal., and a surgical internship at Weil Cornell New York Presbyterian Medical Center in New York. While in Los Angeles, Raphael served as assistant team physician for a number of California sports teams, including the L.A. Dodgers; L.A. Angels; L.A. Lakers; L.A. Kings; and the Anaheim Ducks. Crouse Hospital Adds 2nd Surgical Robot — Crouse Hospital recently added a second da Vinci surgical robot. The new system — the latest in robotic surgical technology — features a skills simulator, which contains a variety of exercises and scenarios specifically designed to give users the opportunity to improve their proficiency with the system’s surgeon console controls. According to the hospital, Crouse performs more robotic surgeries than any other CNY hospital.
St. Joseph’s Wins Prestigious Patient Satisfaction Award — St. Joseph’s Hospital Health Center announced that
Press Ganey Associates, Inc. has named St. Joseph’s ambulatory surgery program as a 2011 Summit Award Winner, one of only seven ambulatory surgery facilities in the country to receive the award. The Summit Award recognizes St. Joseph’s as a top performing facility, sustaining the highest level of customer satisfaction for three or more consecutive years. This is the second year the program has earned the award. Press Ganey measures and improves the quality of care in more than 10,000 health care facilities, which includes 50 percent of U.S. hospitals. With the largest database of hospitals in the industry, the company allows facilities to benchmark their results against peer organizations. St. Joseph’s is one of 87 Press Ganey client facilities to receive this honor in 2011. “The Summit Award recognizes St. Joseph’s strides to provide positive and memorable experiences for our patients,” said Kathryn Ruscitto, president of St. Joseph’s. “Our initiatives focus on beneficial improvements for both patients and staff to have a rewarding experience.” The Summit Award recognizes St. Joseph’s approaches to improve patient satisfaction through continuing education for all medical providers, actively soliciting and acting on patient feedback, and organizational changes for increased customer satisfaction. St. Joseph’s plan focuses on “caring”
Crouse Hospital’s Engineering Department Professionals Receive 2012 FMXcellence Recognition Program Honors “Operating Management” magazine, the nation’s leading magazine for commercial building owners and facility managers, has named Crouse Hospital as one of four honorees selected to receive this year’s FMXcellence Recognition Award. The annual award recognizes facilities management teams that add significant value to their organizations by helping to achieve broader goals. Crouse is the only hospital to be named and will be honored at the National Facilities Management & Technology Conference, to be held in Baltimore in March. The hospital’s engineering department was selected for its planning and implementation of upgrades to the hospital’s emergency power and chilled water systems, a $13 million project that took 23 months to complete. This year’s honorees were judged by the editorial staff of Building Operating Management magazine. “FMXcellence gives facility managers the opportunity to receive recognition for using facilities to add value to their organizations,” said Building Operating Management Editor Edward Sullivan. “We have two goals for FMXcellence: to publicly recognize successful facility management teams as strategic partners that benefit our nation’s buildings, campuses and institutions, and to spread the word about best practices so that facility managers can learn from their peers.” According to Crouse Hospital Engineering Director Jeff Tetrault, CHFM, CHC, the FMXcellence recognition is reflective of his team’s commitment to helping the hospital meet its mission. “Our focus is to support the hospital in providing the best in patient care, which we do through our planning and work to ensure Crouse facilities are up-todate and functioning at peak performance,” says Tetrault. “We have a great team, and it’s gratifying to see their work and efforts recognized on a national level.” Details of the winning projects are posted on www. facilitiesnet.com/bom/” Page 28
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
to enhance the patient experience and energize the health team. The plan provides compassion, accountability, respect, intent, and growth (CARING) to Central New York. “I am most honored to work with the staff at North and Northeast Surgery Centers who truly practice by the belief that we should always give patients and their families more than they expect to get,” said Jodi Donahue, director of surgical services for St. Joseph’s. “Being awarded the prestigious Press Ganey Summit Award recognizes not only their ability to obtain an extraordinary level of patient satisfaction, but also their ability to sustain this high level over time. We are fortunate to have these dedicated and high performing individuals at St. Joseph’s.” St. Joseph’s outpatient surgery centers are located at North Medical Center in Liverpool, and Northeast Medical Center in Fayetteville. They offer the quality of a hospital with the accessibility of a physician’s office. Routine surgical and endoscopic procedures are performed quickly and conveniently. The North Surgery Center specializes in a progressive pain management program. The Northeast Surgery Center provides an aesthetics surgery program. Together, the centers performed nearly 6,000 outpatient surgical procedures in 2010.
St. Joseph’s Designated An Aetna Institute of Quality for Cardiac Care Facility — St. Joseph’s Hospital Health Center has been designated an Aetna Institute of Quality Cardiac Care Facility for comprehensive heart and vascular treatment. The organization received IOQ status for cardiac medical intervention, cardiac surgery, and rhythm disease diagnosis and treatment. Aetna makes information about the quality and cost of health care services available to its members to help them make informed decisions about their health care needs. In line with this goal, Aetna recognizes hospitals and facilities in its network that offer specialized clinical services for certain health conditions. Facilities are selected for consistently delivering evidence-based, safe care. Certified Home Health Care Listed In Top 500 Agencies — St. Joseph’s Hospital Health Center’s Certified Home Health Agency is again one of the top 500 home care providers in the United States, according to the 2011 HomeCare Elite Top 500 List from Outcome Concept Systems (OCS), the leading post-acute healthcare information company. This is the sixth year in a row that St. Joseph’s Home Care has received this honor. Melissa Allard, director of patient services at St Joseph’s Hospital
Health Center’s Certified Home Health Agency, credits the dedicated and skilled staff with the company’s ability to rank as one of the HomeCare Elite. She said, “The hard work and dedication of the entire team at the home care agency proves to be our biggest asset as we strive to improve quality of care allowing the agency to provide a positive impact and improved quality of life to the patients we serve.” Now in its sixth year, the HomeCare Elite identifies the top 25 percent of agencies and further highlights the top 100 and top 500 agencies overall. Winners are ranked by an analysis of performance measures in quality out-
comes, process measure implementation, and financial performance. “It is increasingly challenging to manage the cost/quality equation. The 2011 HomeCare Elite winners demonstrate a commitment to providing patients with the best possible care while managing their business efficiently and effectively,” said Amanda Twiss, CEO of OCS and My InnerView. “This year, we updated our methodology to reflect industry focus and, based on this rigorous analysis, we congratulate St. Joseph’s Hospital Health Center’s Certified Home Healthcare Agency on being one of the top home care agencies in the country.”
Upstate’s Christopher Turner Receives SUNY’s Highest Scholarly Accolade Christopher E. Turner, professor of cell and developmental biology and a member of the Upstate Cancer Research Institute at Upstate Medical University, has been afforded the state university’s highest academic rank as SUNY Distinguished Professor. Turner resides in Chittenango. The distinction, given by the State University of New York board of trustees, acknowledges Turner for his significant contributions to the research literature, national and international prominence, and for his role in elevating the standards of scholarship among his students, postdoctoral fellows and colleagues. SUNY named only six faculty to the distinguished professorship in November. Turner has held numerous national grants and has received continued support from the National Institutes of Health since joining Upstate in 1991. His research has earned him an international reputation as an authority in cell adhesion and migration. He is credited with discovering the focal adhesion scaffold protein paxillin and characterizing its role in coordinating the cell migration machinery. This work has led to greater scientific insight into the mechanism that allows cancerous cells to move away from the primary tumor and colonize or metastasize to one or more distant sites elsewhere in the body—a critical step in tumor progression. His laboratory has since identified and characterized numerous other paxillin-associated proteins involved in the process. These discoveries may pave the way for new therapies targeting tumor cell invasion. Turner has trained numerous young investigators in the cell adhesion and signaling fields, including several who are faculty members at other leading academic institutions. His post-doctoral and pre-doctoral fellows have also obtained national recognition and funding for work in his laboratory. Turner received a bachelor’s degree from the University of Sheffield, England, in 1983, and a doctorate degree in cell biology from the University of Oxford, England, in 1986. He was a postdoctoral research fellow in the laboratory of Dr. Keith Burridge in the department of cell biology and anatomy at the University of North Carolina, Chapel Hill from 1987 to 1991. He then joined Upstate as an assistant professor in the department of cell and developmental biology in 1991. Turner is Upstate’s second faculty
Christopher Turner, Ph.D., a member of the Upstate Medical University faculty, was named a SUNY Distinguished Professor in November. It is SUNY’s highest honor for its faculty. member to attain the rank of SUNY distinguished professor. Richard Cross, Ph.D., received the honor in 2007 for his work in bioenergetics, the study of biological energy transfer and conversion at the cellular and molecular levels. Throughout the years, Upstate has had numerous faculty members selected as SUNY distinguished teaching professors and SUNY distinguished service professors. The SUNY distinguished professorship, one of the four designations comprising distinguished faculty rank, is a tenured academic rank above that of full professor. It was created by the SUNY board of trustees to recognize and reward the scholarship and research of SUNY’s finest and most accomplished faculty.
Clinical Assistant Professor Clinical Assistant Professor at SUNY Upstate Medical University (Syracuse, NY): Perform clinical care in the Pulmonary/Critical Care Division. Perform and teach the evaluation of patients and procedures. Offer clear and effective instruction within areas of expertise to students and medical residents in the College of Medicine and Graduate Studies. Contribute to medical scholarship by supporting clinical research through participation in clinical trials and contributions to medical literature, including educational, ethical or research reports. Reqs: M.D. or Foreign Equivalent and three (3) years of experience as a Medical Resident. Completion of a ACGME residency program in Internal Medicine. Completion of Fellowship in Critical Care and Pulmonary Disease. Board certification/Board eligibility in Internal Medicine; Board certificaton/Board eligibility in Pulmonary/Critical Care Medicine; and License/Permit to practice medicine in the State of New York. Please send CV to: Stacy Mehlek, Faculty Affairs & Faculty Development, 750 E. Adams Street, Syracuse, NY 13210. SUNY Upstate Medical University is an AA/EO employer engaging excellence through diversity. Women and minorities are encouraged to apply.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Revolution in Bone Health Promises Strength and Independence! Finally...An All-Natural Drug-Free Treatment Proven to
Reverse Osteoporosis and Osteopenia So why doesn’t regular exercise alone, produce the same effect? This cutting edge technology allows a person, regardless of age and physical condition, to safely perform a ﬁve second movement of maximum self-imposed loading (no external weights to contend with) in each of four positions…. a chest press, a leg press, a core pull (crunch) and a vertical lift. This is all done under the watchful eye of a medical professional, making this program the safest, most time efﬁcient and effective program available. Once a week for ﬁve minutes and it reverses osteoporosis and increases bone density? Surely, there must be some side effects to this treatment! The biggest side effect is increased strength. Increased strength, of course, means stronger core muscles. Stronger core muscles read to improved posture which leads to better balance, better circulation and organ function. Better balance leads to a decreased chance of falling. Not falling means no hospital stays to heal broken bones. Strength, balance, improved posture, better circulation and organ function nd less chance of falling means a better quality of life and greater independence for seniors.
Push harder! ...You can do it! In a medical setting this sounds like childbirth, not necessarily building bone and muscle tissue. However, with Dr. Gardner, this is a medical professional coaching a session with a new technology called bioDensity™. This treatment promises to help the patient help themselves in a way other systems can’t – build “healthy” bone tissue the natural way without drugs. And the promise is to do it in one ﬁve minute session per week. Sound unbelievable? Not according tom one medical professional, Dr. Gardner. He states, “Research has proven that weight bearing exercise stimulates the body to build stronger layers of bone tissue. (According to the Surgeon General Report – Maximal loading has been shown to increase bone mass density which reverses the process of osteoporosis¹) Osteoblastic activity (osteoblasts are cells your body uses to make new bone tissue) happens when the bones are loaded during weight bearing exercise. bioDensity™ allows the body to be placed in the proper biomechanical position to perform these movements and thereby maximize the results.
“People are seeing amazing results after only3 or 4 sessions,” stated Dr. Gardner. He sitesone example, a 78 year-old patient of his. She had two goals when starting this program: One – to be able to carry in a full case of bottled water from her car to the kitchen when she returned from grocery shopping; Two – to increase her time of future independent living. She has already achieved the ﬁrst which has her thinking she can realistically achieve the second. While this doesn’t sound like such a big deal to some, to our ever growing population of seniors, independent living has become increasingly important. Maintaining our independence and the ability to do the things we enjoy is the goal of all seniors in retirement.
Four simple movements... There are four simple movements which
strengthen the large muscle groups that support the core of the body. The progress of these sessions is measured by the computerized component of the machine. Each session is tracked by an easy-to-read graph report that is then given to the patient after each visit. According to Dr. Gardner, recent evidence indicates the difference between the pharmaceutical approach and bioDensity™ is that bioDensity™ builds bone tissue that is much stronger when stimulated naturally through maximum loading of the musculoskeletal system. Medication produces a more mineralized bone tissue. The problem with this approach, he says, is while it makes the outer layer stronger, the center core of the bone remains porous and weak. Research has found that some people, even though they are following a prescribed medication regimen, will sometimes still suffer from fractures. Osteoblastic activity builds the bone naturally from the inside out making a stronger, denser bone the way nature intended.
Reverse Osteoporosis in only 5 minutes per week
Improves BONE and MUSCULAR Density
In summary, you can stop and reverse osteoporosis, it takes as little as ﬁve minutes a week, you don’t have to change clothes, or sweat, or muss your hair or makeup. The side effects are you will get stronger, improve your posture, your balance, your circulation, your organ function and decrease your risk of falling thus giving you a better quality of life and greater independence. And, according to bioDensity™ distributor Bill Cunningham, Dr. Gardner has the ﬁrst and only machine in the entire Central NewYork region.
“I’ve used the bioDensity™ machine for 3 weeks now, and I feel wonderful!” Marion Huling
Dr. Frederick Gardner, D.C. 8402 Oswego Rd, Liverpool, NY 13090 315.622.0102
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2012
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