in good Meet Your Doctor Upstate’s new pediatric trauma medical director talks about traumas in children, adults and explains why she would ban the use of ATVs among children
December 2016 •
CNY’s Healthcare Newspaper
Holiday Blues or Depression? Why do many people feel sad during the ‘happiest season of all’? Is it just holiday blues or depression? Experts weigh in and suggest ways to stay positive page 15
GMO Labeling Law to allow labeling GMO food doesn’t please critics, supporters
Want to Raise a Puppy? Guide Dog Organizations Need Help Page 22
Losing Weight This Time of the Year?
Daily can of soda boosts odds for prediabetes, new study finds
Weight Gain & the Holidays
For most people, losing weight in December is next to impossible; however, maintaining the same weight is an achievable goal, experts say. See what tips they offer
Forget about losing weight this time of the year. The main challenge, experts say, is not to gain too much
SPANKING Fewer parents are spanking their kids. More are relying on timeouts to discipline children, study shows page 10
New, Unique Procedure at Crouse
Skull-based Surgery to Remove Brain Tumors
page 11 8 page
U.S. Heart Disease Rates Fell 20 Percent Since 1980s
Researchers chalk it up to better meds, prevention efforts a large pizza, but now it’s a medium
ER Death Rate in U.S. Drops by Nearly Half
ospital emergency room deaths in the United States plummeted by nearly half over a 15-year period, with several factors likely accounting for the drop, a new study indicates. The upshot: It’s unlikely you’ll die in the ER, say researchers who analyzed almost 368,000 emergency department visits by adults between 1997 and 2011. They found a
48 percent reduction in deaths over that period. Increasing use of home hospice care and improvements in emergency medicine and public health are among the factors that might help explain the results, study author physician Hemal Kanzaria said. “This was a descriptive study, essentially looking at trends,” said Kanzaria, an assistant professor of emergency medicine at University of
ew research shows that cases of heart disease have dropped 20 percent in the United States in the last four decades. Experts credit the trend to better detection and prevention of risk factors that endanger heart health. “That means all the efforts are paying off,” said senior researcher Michael Pencina. He is director of biostatistics for the Duke Clinical Research Institute at Duke University, in Durham, N.C. However, most major heart risk factors — bad cholesterol, high blood pressure and smoking — remain strong contributors to heart disease, showing that more can be done to protect patients, Pencina added. “Coronary disease was the size of
pizza,” Pencina said. “But in terms of slices, what portion of the pizza you can attribute to the risk factors, it’s about the same,” he explained. “There is definitely room for further improvement. We can get maybe to the smaller personal pizza size, to keep to the analogy,” he continued. “Because risk factors still matter, intervening in these risk factors should drive further reductions.” About 610,000 people die of heart disease in the United States every year — about one in every four deaths, according to the U.S. Centers for Disease Control and Prevention. The study was published Nov. 15 in the Journal of the American Medical Association.
California, San Francisco. “Finding a nearly 50 percent reduction was thought-provoking, and I think there are many possible explanations. [But] dying in an emergency department is rare, and it’s important to highlight how rare an event it is overall.” More than 136 million emergency room visits took place in the United States in 2011, the latest year for which data are available, according to the U.S. Centers for Disease Control and Prevention. About 40 million of those visits were injury-related,
and almost 12 percent resulted in hospital admission. Kanzaria and his team analyzed data from the National Hospital Ambulatory Medical Care Survey. They found that ER mortality rates fell from 1.48 per 1,000 U.S. adults in 1997 to 0.77 per 1,000 U.S. adults in 2011. Compared to ER patients who survived, those who died tended to be older, more likely to be male and white, and were more severely ill or injured when brought into the emergency room.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
Is Weight Loss Surgery Right for You? Upcoming FREE Seminars: December 5 • December 15 To register: crouse.org/weightloss 315/472-2464
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December 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Red Cross to honor CNYâ€™s real heroes
he American Red Cross of Central New York will honor several people for extraordinary courage at its 18th annual Real Heroes Breakfast from 7:30 to 9 a.m., Dec. 7, at the Oncenter in Syracuse. The Real Heroes Breakfast celebrates the Red Cross mission of alleviating human suffering by recognizing people from throughout Central New York who have performed heroic acts in life-threatening situations. The honorees include first responders as well as ordinary citizens who are directly responsible for saving a life or multiple lives. Proceeds will benefit the Red Cross, which provides relief to victims of disasters and helps people prevent, prepare for, and respond
to emergencies. The CNY chapter serves Cayuga, Cortland, Madison, Onondaga and Oswego counties. To purchase a table or tickets, call 315-234-2225.
2016 Real Heroes:
â€˘ Nick DeMartino Attorney created a volunteer advocate program for abused animals, ensuring that victims of animal cruelty are represented in the legal system by lawyers who are volunteering their time and expertise.
â€˘ Al Stirpe He has hosted a community blood drive for 10 years. This yearâ€™s event collected 181 units, a record for the region. He has personally donated more than 30 units.
Adult Good Samaritan
â€˘ David Goetzmann â€˘ Eric Marcinkowski While boating on Skaneateles Lake, they heard screams from a nearby boat, and helped rescue an 8-year-old girl and her father who were seriously injured.
Youth Good Samaritan
â€˘ Fallon Breed â€˘ Leshae Breed When a mother had a heart attack at home, her 8-year old and 16year old children called 911 immediately and responders arrived in two minutes.
2017 CNY Healthcare Guide Reach Health Consumers, Providers â€˘ Donâ€™t Miss It â€˘
â€˘ Barb VanSanford Bus driver who was stopped to pick up a child noticed that a tractor trailer coming from behind was going to hit the bus. She screamed for the child to run, avoiding a potential tragedy.
â€˘ Nicholas Cherchio â€˘ Nick Wolfe Firefighters rescued a father and two children â€“ aged 4 months and 7 years â€“ from the second floor of a burning home.
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â€˘ Sean Dunlap Volunteer firefighter awakened by neighbors screaming for help. Their home was on fire and he helped them safely escape.
â€˘ Trooper Shaun Smith While off duty, he was swimming laps at a YMCA and came to the aid of a young swimmer who was in distress.
â€˘ Peter Bianco â€˘ Thomas Molinari â€˘ Melanie Thornton Dispatchers all played significant roles in locating and aiding a 5-year-old victim of an automobile crash who dialed 9-1-1 to report the incident.
â€˘ Mackenzie Heath â€˘ Robin Holmes â€˘ Sierra Rickert â€˘ Cheryl Sickles â€˘ Nicole Vanderhoff When a fire started in a portion of the Cortland Park Rehabilitation & Nursing Center, staff evacuated several residents. Due to thick smoke, some residents were kept in their rooms behind closed doors.
â€˘ TSgt Christina F. Watson While dining at an area restaurant, Watson was made aware of an unconscious woman in the restroom. She administered CPR until EMS units arrived.
â€˘ Larry Judkins â€˘ Lynn Morris â€˘ Robert Smith â€˘ Chrishell Steward When a co-worker went into cardiac arrest during a holiday luncheon, they performed CPR and administered AED to save his life. For more information on the 2016 Real Heroes Breakfast, visit www. redcross.org/wcny.
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IN GOOD HEALTH â€“ CNYâ€™s Healthcare Newspaper â€˘ December 2016
Is An Antibiotic for You? Is an Right ANTIBIOTIC
righttofor you? Upstate New Yorkers not immune antibiotic-resistant ‘super bugs’ “Too often, antibiotics are prescribed for the flu, ntibiotic-resistant bacteria the common cold, or acute are infecting an estimatbronchitis, all of which are ed 30,000 Upstate New caused by viruses,” said Yorkers each year and causing Lockwood. “The overuse about $300 million in excess health and inappropriate use of care spending and potentially 350 antibiotics results in the dedeaths, according to research by velopment of antibiotic-reExcellus BlueCross BlueShield. sistant strains of bacteria, “These drug-resistant ‘super BACTERIA VIRUS such as MRSA.” bugs’ are a global problem,” said MRSA (methicillin-reAntibiotics treat illnesses Antibiotics won’t treat physician Richard Lockwood, vice caused by bacteria, such as illnesses caused by a virus, sistant Staphylococcus president and chief medical officer strep throat, whooping cough like the flu, common cold or aureus) outbreaks have ocor urinary tract infections. most cases of acute bronchitis. of Excellus BlueCross BlueShield’s curred in hospitals, schools Central New York region. “Bacteand even on cruise ships. ria are becoming resistant to the were prescribed. ThoseTAKING rates were Patients not taking their preWHAT’S WRONG WITH ANTIBIOTICS antibiotics we have, and there are then applied to U.S. Census Bureau WHEN YOU DON’T NEEDNew THEM? scription antibiotics as directed also few new antibiotics in development.” population figures for Upstate contribute to the development of Estimates were derived using York. drug-resistant super bugs. Not taking national prescribing data issued by Antibiotics treat such illnesses as antibiotics for the full course of treatthe Centers for Disease Control and strep throat and urinary tract infecment can result in a bacterial infecBacteria can become effects may An increase in Prevention and its finding that about Side tionssuch that bacteria.antibiotic-resistant resistant toby antibiotics, occur, as are caused tion coming back in an even more 30 percent of antibiotic prescriptions diarrhea, resulting in severe bacteria puts the entire Theynausea, do nothing to treat illnesses virulent form. are unnecessary and inappropriate antibiotic-resistant vomiting and in community at risk of caused by a virus. infections, like MRSA. some cases, having ineffective “Sometimes patients will stop for the conditions for which they allergic reactions. antibiotics.
taking their antibiotics when they begin to feel better and save the remainder of the pills for the next time they don’t feel well,” said Lockwood. “That also contributes to the development and spread of antibiotic-resistant bacteria.” When antibiotics are prescribed, Lockwood urges patients to take them as directed and to complete the entire course of treatment. “And when the doctor says that an antibiotic isn’t needed,” said Lockwood, “know that he or she is making the decision to not prescribe antibiotics by keeping the patient’s health and the health of the entire community in mind.” Learn more about antibiotics from an Excellus BlueCross BlueShield infographic, “Is an antibiotic right for you?” at http://tinyurl. com/zut6kwk. An animated version of the infographic can be viewed athttps://www.youtube.com/user/ ExcellusBCBS. Submitted by Excellus BlueCross BlueShield.
Healthcare in a Minute EVERY YEAR IN UPSTATE NEW YORK, APPROXIMATELY…
By George W. Chapman
2015 cost of employersponsored care
compared to about $6,000 a year or a out of business as a result. Fourth, typical employer-sponsored plan. A all for-profit carriers have stock 25 percent premium increase will reholders to please. United is a perfect 4,000,000 1 in 3 2,150 antibiotics are are in a premium of $500 a month or ACA exchange costs E.R. visitssult example. They are pulling out of the The annual Milliman Medical In- antibiotic prescriptions dispensed in the unnecessary. from reactions $6,000 a year which is just where the exchanges claiming losses of $720 dex is regarded as one of the most re- are outpatient setting. to antibiotics. average employer plan is. In 2009, The exchanges continue to be million, which is a lot on face value liable sources of actuarial, analytical eight years ago, the Congressional the most misunderstood compobut relatively insignificant when put and financial research for employer Budget Office predicted a 2017 silver into perspective. United reported sponsored health insurance. Here are nent of the Affordable Care Act, plan premium of about $5,500. Close. an overall a profit of $11 billion better known as “ObamaCare.” some of their key findings for 2015. Why was the CBO so much better at The exchanges were established to on revenues of $157 billion, so the The average cost to insure a typical estimating premiums than the huge provide individuals under 65, who exchange is a small portion of their family of four was $24,671. This is commercial carriers? Most, 83 perdon’t receive insurance through an business. CEO Stephen Hemsley three times the cost in 2001. The cost cent, of the 13 million people who are earned $66 million in 2014, but that employer or Medicare, the ability to of care rose 6.3 percent in 2015 due 350 effected by the 25 percent increase purchase30,700 an individual commercial is way down from $102 million in largely to unrestrained/unregulatpeople develop deaths are due to qualify, based on their income, for a plan. Recently, the purported aver2010. Many states claim they will ed increases in drug costs, which antibiotic-resistant antibiotic-resistant infections. infections. subsidized discount. The subsidized age 25 percent increase in exchange be down to one or two carriers next increased almost 14 percent from premiums has brought “ObamaCare” amount is paid to the commercial year. The potentially bad news is less 2014. Since 2001, drug prices have Antibiotic-resistant infections cost upstatecarrier. NY The average premium actual- competition. But the potentially good under more scrutiny. Here are some increased at an average annual rate ly paid by the 13 million people this facts and some perspective. 20-plus news is one or two healthy carriers of 9.4 percent — exceeding the 7.7 year is $113 a month or $1,356 a year. with enough members to absorb risk. million people are currently covered percent average increase for all other by “ObamaCare.” Of the 20-plus mil- With discounts still available in 2017, The more insured lives a carrier has, services. While employers still pay and all other things being equal, the lion, about 7 million are covered by the more apt it is to survive. Finally, the lion’s share of the premium, (58 average net premium actually paid, expanded Medicaid. Consequently, our president-elect has promised to percent) an employee’s out-of-pocket in excess direct health care costs. factoring in the 25 percent increase, repeal and replace “Obamacare.” He cost has increased 43 percent over the they do not pay any premiums and will be around $141 a month. That is are not impacted by the 25 percent should first get an understanding of last five years while employer costs a net increase of $28 a month. premium increases. That leaves about what that is and how it works. At a increased 32 percent. Of the $24,671 ONLY TAKE ANTIBIOTICS WHEN NEEDED 13 million people, not covered by pre-election rally he called the ACA a cost for a family, the typical employAND Medicaid, TAKE THEM CORRECTLY. ACA exchange carriers expanded who do pay “disaster.” adding all his employees ee paid about $10,400 (42 percent). for their insurance and are the ones are negatively impacted, especially That includes about $6,400 in payroll Several commercial plans are by the 25 percent increase. Shortly deductions ($533 a month) and about impacted by the 25 percent increase. pulling out or threatening to pull The average insurance premium ofthereafter, one of the directors of $4,000 in out-of-pocket expenses for out of the exchanges because of fered on the exchanges has increased all Trump properties corrected his deductibles and copays. losses. (Again, they miscalculated 2 percent in 2015 and 7 percent in boss and confirmed all employees their own rates.) Many are pulling are covered by normal employer2015 components of employer- 2016. If you factor in the anticipated out for other reasons. First, it is 25 percent increase for 2017, that is sponsored insurance. sponsored care your prescribed medication as directed. far easier to sell and administer a Take three-year average of 11 percent. Don’t stop taking it if youdoes start to group or employer-based insurance The federal government notfeel setbetter. Physicians and other profesbecause of clear economies of the premiums. Commercial carriers sionals accounted for 31 percent of scale. Individual policies are like BCBS, Aetna, Humana, United, all costs, followed by hospitals also George W. Chapman administratively more expensive and Cigna, etc. set their own premiums. at 31 percent, outpatient services at is a healthcare conThe 25 percent increase is due to time consuming. Second, there are 19 percent, drugs at 16 percent and sultant who works two factors: the rates were way too no sales commissions for their agents “other” at 4 percent. Other includes with hospitals and low to begin with and the insurers on insurance purchased on the mostly durable medical equipment, medical groups. He grossly underestimated the health exchange. Third, with hundreds of supplies, ambulance and home care. operates GW Chapman status (sicker) of their new members. carriers (local and national) fighting Again, drug costs increase almost Get recommended Don’t save antibiotics Consulting based in vaccines and flurates shots,had tofor Consequently, gothe upnext in timeover 13 million people, many may 14 percent last year and almost all Syracuse. Email him at wash your sick.The If you have 2017and if insurers were toyou’re survive. not think the effort is worth it. Many of this increase was due to price gwc@gwchapmanconhands frequently. extra national average premium for medication, a stan- insurers came into the exchanges increases vs. increases in utilization. sulting.com. safelytype discard. with artificially and unsustainable dard “silver” or basic employer Physician costs increased only 3.6 plan in 2016 on the exchange was low premiums in order to attract percent. Hospital costs increased 5.4 about $400 a month or $4,800 a year percent. Most notable stat: over the Talk with your doctor and start the more business. Some have gone conversation about what’s best for you. To learn more about when you needDecember 2016 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 5 antibiotics and when you don’t, visit http://tinyurl.com/Using-Antibiotics last five years, hospital utilization has increased only 0.5 percent.
By Chris Motola
Where Independent Living meets Personalized Care. 81 South St., Auburn, NY 13021
Kim Wallenstein, M.D. Upstate’s new pediatric trauma medical director talks about traumas in children, adults and explains why she would ban the use of ATVs among children
In the News Physician Kim Wallenstein was recently appointed as the pediatric trauma medical director at Upstate University Hospitals’ ACS Verified Level I Trauma Center. Wallenstein is board certified from the American Board of Surgery in both general and pediatric surgery and is an assistant professor of surgery. She is certified in pediatric advanced life support (PALS) and advanced trauma life support (ATLS) and is a member of the American Pediatric Surgical Association and the International Pediatric Endosurgery Group.
WestminsterManorAdultHome.org Q: Tell us about your new position and how you came to it. A: I was appointed as the pediatric trauma medical director in August. It was previously filled by one of my partners, Dr. Ahmed, who did a great job with it for the past five years. He was involved when we received our accreditation as a level one trauma center, so he did some great work with that. He stepped down during the summer, so I stepped into the vacancy. Q: What got you interested in your specialty? A: It goes way back. Obviously it’s a big decision to make. The first big decision was to go into surgery in the first place. During my residency, I discovered that I really enjoyed working with kids and the types of problems that occur in pediatric surgery. That made this appointment a nice fit, because I really get to merge a few of my interests. Q: What is different about childhood traumas vs. adult traumas? A: As we’re fond of saying, ‘children are not just small adults.’ That holds true for traumas as well. The mechanisms are somewhat the same, but there are differences that we see. We cover children 14 and under, so we see a lot of falls. We see a lot of car accidents, sports accidents, biking accidents, whereas with older teens you’d probably start seeing more of the penetrating injuries like knives and guns. When you’re dealing with the elderly, you start seeing the falls again, so it sort of mirrors childhood in some ways. But the kids have their own mechanisms.
Advertise in the 2017 CNY Healthcare Guide firstname.lastname@example.org Page 6
Q: Are children generally more resilient when it comes to injuries? A: It depends, but generally I would say that kids tend to be more resilient. They recover faster in some cases, in part because they don’t necessarily have all the underlying medical problems that adults have. A lot of times, adults will come in with a list of medications a mile long. They might be dealing with highblood pressure
IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
and heart disease. You don’t usually see that in pediatric patients. Q: I understand that a lot of your efforts are focused on prevention now. What kinds of initiatives are you trying to take? A: Right, obviously prevention is the key to dealing with any medical problem. So we do a lot with injury prevention. We’ve been collaborating with the national organization Safe Kids. We have done bike helmet handouts at the State Fair. This winter we’re extending that to ski helmets. There’s now a law that kids are required to wear ski helmets on the slopes, so we’re trying to support that. Q: How much do helmets help? A: Can’t give you absolute numbers, but they’re essential to preventing serious head injuries. It’s really the best way we have to prevent it at the moment, but they need to be fitted and worn correctly. Q: How well can a child usually recover from a serious head injury? A: They’re usually able to recover even from severe head injuries. Of course, there have to be mechanisms in place at home to make sure they aren’t reinjured, because reinjuries can make the injury much more severe. But kids usually bounce back pretty well. Q: I imagine the average adult who comes to the ER with a trauma is calmer than the average child. A: In the social sense, kids are a lot different. Adults who come in with an injury will often come in alone, while kids are usually accompanied by their family. The family is a huge part of
pediatric trauma and, in many ways, might be as traumatized as the child. So not only do you have to deal with a frightened child, but you have to be reassuring
and caring to the family. So we try to keep that in mind and have staff on hand to help deal with that like social workers and child-life specialists. They also try to make sure the child is going home to a good environment, as we do see traumas that are related to child abuse. Q: Are there regional “epidemics” when it comes to injuries? Is Syracuse much different than Boston, for example? A: The kinds of injuries tend to be pretty similar. We see a lot of falls, car crashes and sport injuries. Once you get to the older kids, you start to see some differences. There tend to be more penetrating injuries in the inner cities. Rural environments will see more farming-related accidents. But for kids, they tend to be really similar. Q: If you had your way, what’s one childhood activity that you erase from existence in the interest of reducing childhood traumas? A: I would say ATVs, even though I know they’re lots of fun and kids and adults both enjoy them. We see a lot of kids who are too young to drive them effectively — sometimes even too young to be a passenger — with ATV-related injuries. It’s one of the less-regulated activities. It’s easy to think that it’s not as serious a vehicle as a car or motorcycle, so they tend not to drive as safely or take safety precautions like helmets. So we see a lot of bad accidents from those.
Lifelines Name: Kim Wallenstein, M.D., PhD Position: Pediatric trauma medical director at Upstate University Hospital Hometown: Brookline, Mass. Education: MD/PhD: Tufts University School of Medicine, 1998, Biochemistry/ Medicine; fellowship: St. Christopher’s Hospital for Children, 2010, Pediatric Surgery; additional training: University of Louisville, Kentucky Lions Eye Center, 2007, pediatric surgery; fellowship: Cincinnati Children’s Hospital Medical Center, 2005, fetal surgery; residency: East Carolina University/Pitt County Memorial Hospital, 2004, general surgery. Affiliations: Upstate University Hospital; Crouse Hospital Organizations: American Pediatric Surgical Association; International Pediatric Endosurgery Group Family: Married, two step-daughters, a dog and a cat Hobbies: Traveling, baking, reading
Get Ready for Flu Season By Deborah Jeanne Sergeant
Flumist inhaled flu vaccine is out this year, but there are other types vaccines, especially for seniors, expected to be more effective
re you ready for flu season? February usually represents the month with more cases of influenza than any other, according to the Centers for Disease Control. You still have time to get ready. “There’s still time,” said Kelly Toya, pharmacist with Gifford & West Pharmacy Inc. in Syracuse. “Some wait to get vaccinated until March.” Toya recommends people get vaccinated sooner than later, for maximum protection. Like many area pharmacies, hers offers walkin availability to flu vaccination for anyone 18 or older. A few factors have changed since last year. Flumist inhaled flu vaccine, though popular with children and anyone who hates needles, won’t be offered this year. “Upon reviewing the data for the last three years for the use of Flumist, it wasn’t effective for the past three years,” said physician Nancy Bennett, chairwoman of the Centers for Disease Control’s advisory committee on immunization practices. “We’re suspending the use pending additional data. Flumist is a wonderful technology we’d like to see used.” Other major topics have been vaccines for those over the age of 65. Two new formulations may prove to offer better protection. “Both have been studied in older people to see if they’d be more effective,” said Bennett, who is also director for community health at the University of Rochester Medical Center. “The hope is that they will elicit more immunity than the standard vaccine. We’ve noted for years it’s not as effective in older people as younger. “The goal has been finding new technology that make it more effective for older people. Older people have less strong immune response to vaccine. They’re at much higher risk for complications from influenza, so it’s especially important that they get vaccine and that it’s effective in them.” While most people recognize that influenza vaccine is important for children and the elderly, Bennett said everyone should receive vaccine to avoid infecting these populations, who can become critically ill because of their lower immunity. “If we don’t get vaccinated, we can transmit the flu to people less able to fight it,” Bennett said. “It’s
very important for everyone to get vaccinated. Flu makes you very, very sick. It’s not a cold. It’s much more severe.” Physician Lynne Humphrey, St. Joseph’s Family Medicine residency medical director at Heritage Family Medicine in Fayetteville, said that some research shows “that the high-dose vaccine gives a better immune response in the elderly than the standard dose Bennett vaccine.” Some people fear that flu vaccine is unsafe. Thimerosal, an ethyl mercury-based preservative, was once erroneously linked to autism in children. The amount used was so minute that everyday foods can legally contain more mercury. Most vaccines no longer contain thimerosal. Beyond vaccination, avoiding people who have the flu is the best way to avoid the flu. And, should you feel you have flu-like symptoms, stay home to avoid possibly spreading it to others. “It’s a good idea to stay away from work, school and family gatherings if you are sick with flulike symptoms,” Humphrey said. “Be good to yourself by having good nutrition/hydration, getting enough rest, exercising moderately, and striving for balance in your life. I’m a big believer that this will help to boost your immunity. And as always, hand washing and protecting others from your sneezes and coughs will help.”
December 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Skull-based Surgery to Remove Brain Tumors
of the skull-based surgeries at Crouse Neuroscience Institute.”
Is there pain for the patient when you do these surgeries? “With the minimally invasive procedure, we’re able to do it through the sinuses. Every surgery has pain, but it’s often controlled with a little bit of Tylenol. Because we do this so often we’re able to make the incisions smaller and smaller over time and take out less and less of the skull to get to where we need to go because we’re so familiar with those areas.”
8 Questions to Eric Deshaies, M.D. By Matthew Liptak
hysicians Eric Deshaies, Parul Goyal and Brian Nicholas do approximately three skull-based surgeries a week through the Crouse Neuroscience Institute. Minimally-invasive skull-based surgery addresses a variety of tumors that can be found deep in difficult-to-access areas of the brain near the eyes and nose. The procedure replaces time-consuming surgeries. Patients may be able to go home a day after the surgery.
Why is this skull surgery such an advancement? “The skull-based surgery in and of itself is not too much of an advancement. Traditionally it’s a difficult neurosurgery where often we need to take people’s faces apart or [go to] deep areas of the skull to get to these tumors. But now with minimally-invasive techniques we have used tiny little scopes to get to these deep areas of the skull and the bottom of the brain. It’s extremely delicate because at the bottom of the brain lie some critical structures called the brain stem, which is just above the spinal cord. In this area lies the seat of the breathing center and the heart center and the area for being awake and not being in a coma. We work with a
team of ear, nose and throat specialists as well as specialists in surgery of the eye and plastic surgery.
Has it decreased surgical time? “It significantly decreases surgical time to probably 10 percent [of what it was]. We’re able to take these tumors out through the nose in adults and children. Traditionally, the patient will be in the hospital a week or more with hours of surgery. [Now] we’re able to get them done in one to two hours and the patient goes home in the next day.
Might it have applications for other types of surgery down the road to access the skull through the nose? “Yeah, there are other surgeries that can potentially be done, but it needs more work, where we can treat brain aneurisms this way and some other complex tumors in the minimally invasive way. But again it hasn’t been perfected yet.”
What kind of tumors can be operated on this way? “Pituitary tumors, any tumors of the base of the front of the skull. That includes the sinuses and part of the brain, people with spinal fluid leaks; people with tumors called Rathke’s cleft cyst, the meningiomas, benign tumors as well as some malignant tumors in this region — anything that essentially goes deep to where the nose and the eyes lie we can reach. It doesn’t matter what type of tumor it is, it all has to do with the location.
Is Crouse the only hospital that does this? “It really doesn’t have to do with the hospital. It has to do with the surgeons. There’s myself and Dr. Parul Goyal and Dr. Brian Nicholas. We’re the ones who do a lot
Is the minimally invasive surgery through the nose less risky than the invasive surgery? “If you don’t know what you’re doing, you’d be at much more risk because you’re going through a very tiny hole rather than a much bigger exposure.”
How many of these minimally invasive surgeries have you done? “We do a few a week. We do them very often. Over time I’ve been able to see this field evolve from doing maximum invasive procedures in neurosurgery to one of the least invasive. The least invasive surgery we’ve been doing for probably about five years. With Dr. Goyal’s expertise — he’s one of the only fellowship-trained surgeons with the endoscope in the region — and having both of us here with expertise, [it] has allowed us to hone in.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
New Tobacco Reports Show Good, Bad News
By Matthew Liptak
he good news: The number of adults smoking declined by almost nine million people between 2005 and 2015. In 2005, 45.1 million adults smoked compared to 36.5 million adults in 2015. The bad: Nearly half of those still smoking — or about 18 million smokers — could die prematurely from tobacco-related illnesses. The data was included in two studies released in November, one from the Centers for Disease Control and Prevention and the other from the National Health Interview Survey. Figures show that across the state tobacco smoking is down to 16.6 percent, according to Chris Owens, director at CNY Regional Center for Tobacco Health Systems at St. Joseph's Hospital in Chris Owens Syracuse. In Central New York, data collected in 2014 shows that smoking habits varied for adults between counties. • Cayuga County has the highest number of smokers in CNY: 30.6 percent of adults smoking. • Oswego County is at 28 percent, followed by Onondaga County at 20.3 percent and Madison County with 17 percent. Owens said that the less education and the less money people have, the more likely they are to smoke. In Central New York there is a bump in the number of young adults who smoke compared to other regions of the state. On average 29 percent of CNY residents smoke, compared to only 13 percent in the state. “I'm not exactly sure why there's a higher prevalence precisely, but we do know it is inversely related to education and socio-economic status,” he said. “That could be part of it. The
other factor that really contributes is mental health status. I don't have good stats of what the prevalence of mental health diagnosis is in this area, but I imagine that could also be playing a part.” Those with a mental health diagnosis tend to smoke at a much higher rate, he said. Owens and others are working each day to ensure the numbers of tobacco users keep going down. One focus is working with providers to integrate tobacco education into doctors' visits. “The one thing that really makes a difference for individuals is once they engage their health care provider in making a quit attempt,” Owens said. “That way they can be linked to the resources in their community to help them quit, as well as getting the clinical advice from their health care team addressing their nicotine dependence...making sure an appropriate quit plan can be put into place.” He said studies show that smokers who are trying to quit who use help provided by their doctors have a higher chance of staying off tobacco for a longer period. That's why he is working with major providers to integrate tobacco-related protocols into electronic medical records. That way, if a smoker visits a doctor, they can find the most effective path to quitting if that's what they choose. “It's a much more comprehensive approach than just waking up one morning and deciding I want to not smoke anymore and trying to quit cold turkey,” he said. “Even interventions that last three to five minutes talking with the patient about their tobacco use has been proven to significantly increase the person's ability to quit and stay quit for an extended period of time. That's the great news for clinicians.” He said it takes smokers an average of seven tries to successfully quit smoking in New York state. Owens remains upbeat that smoking will continue to decline, but he knows there's challenges ahead. A lot depends on efforts to help smokers quit. Between 2009 and 2013 alone 343,000 Americans died from cancer caused by tobacco use, according to the CDC.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
A Dozen Don’ts for December and Beyond
’ve shared lots of dos 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 as you approach the New Year: n Don’t become a hermit. Get up, get dressed, lose the PJs or sweat pants, and get out of the house (or get on the phone). We humans are social animals; we’re meant to be with others. Solitary confinement is for criminals, not for people who live alone. Stay connected! n Don’t go on a shopping spree to fill an emotional void. Your savings account will thank you. n Don’t make Fruit Loops 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, pour yourself a glass of wine or cranberry juice, and enjoy some well-deserved time to yourself. A favorite magazine, book, or crossword puzzle can make for a nice dining companion. Bon appetite! n Don’t label yourself a loser just because you are spending a Saturday night alone. It’s not the end of the world. It doesn’t define you. Stream a Netflix movie or clear some clutter and call it a night. If the prospect of a Friday or Saturday night alone is too difficult, reach out to a friend today and make plans for next weekend. n Don’t put too much stock in that Dreamcatcher. If you find yourself wide awake in the middle of night fighting demons, you
KIDS Corner Fewer Parents Are Spanking Their Kids More are relying on timeouts to discipline children, study shows
panking and hitting children to discipline them has been on the decline among U.S. parents — rich and poor alike — since 1988, a new study finds. According to the researchers, the number of mothers with an average income level who considered physical discipline acceptable decreased from 46 percent to 21 percent over two decades. Page 10
At the same time, mothers who felt timeouts were a better type of discipline rose from 51 percent to 71 percent, the investigators found. “Parents seem to be using more reasoning and nonphysical discipline strategies with children, which is in line with what the American Academy of Pediatrics recommended in 1998,” said lead researcher Rebecca Ryan. She’s an associate professor of
IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
might try meditation, journaling or aromatherapy. I fill my diffuser with lavender oil and do some deep breathing while I repeat the phrase, “Sleep is healing.” If that doesn’t do the trick, I get up and prepare myself some warm milk or herbal tea. I return to bed with fingers crossed and eyes closed. If all else fails, consider sleep aids. n 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! n 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 build your self-esteem and improve your chances of meeting someone who appreciates your strengths, not your weaknesses. n Don’t get behind the wheel after a night of drowning your sorrows with friends. No explanation needed. Drink and drive responsibly. n 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. Even a small jaunt can boost your confidence. On your own, you’ll discover your own resourcefulness, ability to solve
problems, and capacity to spend some time alone. It can be an enlightening adventure in self-discovery. I highly recommend it. n Don’t decline an invitation because it means walking in (and walking out) alone. You can do it. Make a beeline for the host to say “hello” and ask for an introduction to someone, if you are surrounded by strangers. Or get in line at the refreshment station. You’ll be engaged in conversation before you know it. Be yourself, be sincere, and be curious about others. Go and have fun! n Don’t act your age. You are free, unencumbered and on your own. What better time to spread your wings, be silly and otherwise express your glorious, awesome self. Put yourself with people who make you laugh. For me, that’s my sister Anne. So keep your sense humor. After all, life can be funny. n Don’t take these don’ts too seriously. You are in the best position to decide what to do or not to do — no shoulds, musts, or other people’s agendas. That’s one of the best benefits of living alone. Don’t I know it!
psychology at Georgetown University in Washington, D.C. “At all income and education levels, parents’ attitudes toward physical punishment have changed over the last 20 years and, very likely, their behavior with their children,” she said. For the study, Ryan and her colleagues reviewed four national studies of kindergarten-age children — about 5 years old. The studies were conducted between 1988 and 2011. Although a cultural shift away from physical discipline has occurred, some parents still believe spanking and hitting is the best way to control unwanted behavior, the findings showed.
More low-income parents than high-income parents still believe in hitting children to discipline them. Yet poorer parents, like richer parents, are increasingly using timeouts, the study authors noted. Nearly one-third of mothers with the lowest incomes still spanked or hit kindergarten-age children. Almost 25 percent reported using physical punishment in the last week, the researchers said. Parents with the highest incomes are less likely to endorse or report using physical discipline than those at the bottom of the income scale, the study found. The report was published online Nov. 14 in the journal Pediatrics.
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 workshops or to invite her to speak, call 585-624-7887, or email email@example.com.
Urinary Incontinence: a Common Problem Affecting Women
A team of female urologists at Upstate Urology cares for women with urinary incontinence, pelvic organ prolapse or other related issues
any women suffer on a daily basis with urinary incontinence or pelvic organ prolapse, sometimes called “dropped bladder” or “dropped uterus.” Urinary incontinence is a common problem, affecting up to 50 percent of all women. Vaginal prolapse affects between 10-15 percent of all women. While commonly experienced, fewer than half of affected women seek treatment for these problems. Studies have shown that urinary
incontinence and vaginal prolapse are associated with a significant negative impact on quality of life, yet long-term data have revealed them to be highly treatable conditions. Reasons why women do not seek care for these conditions are myriad. “For many women, seeing a urologist can be a difficult and embarrassing proposition. Discussing intimate and personal medical problems with a male physician may be especially challenging,” said Natasha Ginzburg, assistant professor and director
of female pelvic medicine and reconstruction at Upstate Urology. Current data reflect that only 8 percent of practicing urologists nationwide are female. Upstate Urology in Syracuse has recognized that many women are unnecessarily suffering in silence. As part of the only tertiary care academic center in Central New York, it is working to ensure that women have access to exceptional care in a comfortable, understanding environment. Upstate urologists offer stateof-the-art diagnostics and treatment options, many of which are available in the office setting. Not all patients require surgery for their pelvic floor problem. Behavioral modifications, medical management, and pelvic floor physical therapy are also available options. If surgery is elected, the female urologists at Upstate are trained to perform a variety of procedures, including non-mesh options, minimally invasive surgical techniques, and state-of-the-art-robotics. By placing a focus on the unique urologic needs of women, and ensuring a comfortable and caring environment, Upstate hopes that more women will stop suffering with urinary incontinence and pelvic floor disorders. Considering a variety of women’s urologic needs, Upstate Urology has expanded its practice to include three female urologists, two female nurse practitioners, and one female physician’s assistant reflecting the distinct needs and diversity of our community. “Women in Central New York deserve the highest level of urologic care,” said urologist Gennady
Bratslavsky, who has been serving as professor and chairman of the department of urology at Upstate for the past five years. “Upstate Urology is dedicated to fulfilling that need locally, which is why we have recruited these highly trained surgeons, including Natasha Ginzburg, the only female pelvic medicine and reconstructive surgery fellowship-trained provider in the region with focus in urinary incontinence, bladder or uterine prolapse; Jessica Paonessa, the only female fellowship-trained endourologist in the region who specializes in treatment and prevention of kidney stones; and Liz Ferry, who specializes in women’s general urologic health, including care from inability to hold urine to recurrent urinary tract infections to treatment of kidney or bladder cancer,” said Bratslavsky. “All three female doctors are trained in the best programs in the country, all three perform some of the most complex urologic care and surgery, and all three use robotic surgery to minimize discomfort and assure early recovery should intervention be needed.” The most important aspect of all is the “woman’s touch” of the new program “Women Caring for Women,” Bratslavsky said. Women of Central New York no longer need to travel outside the region for superior urologic care or to see a woman in a private, comfortable setting. New patients are welcome. To get a consultation with one of the three female urologists you may call at 315-4641500. • Submitted by department of urology at SUNY Upstate Medical University.
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December 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
The skinny on healthy eating
Flour Power: What’s Good, What’s Not
s flour good for you? Now that the holidays are here — a time deliciously devoted to baking and consuming products made of flour — we wanted to shine a light on this popular grain. Let’s begin with our considerable consumption. According to some studies, the average American consumes between 400 to 500 cups of flour a year, which translates into about 1¼ cups (or 10 ounces) a day. “Six ounces of grains” is what the USDA recommends that we consume each day for all grains, not just flour, with an added recommendation that half of those 6 ounces be whole grains. So, 10 ounces from flour alone is both sobering and noteworthy. Because, like many, I get a good dose of my daily grains from flour — from bread (two slices equal 2 ounces) to pasta (one cup equals 2 ounces) — I made a conscious decision years ago to stop eating foods made with refined white flour in favor of those made with the more nutritious whole wheat flour. It’s mostly what I bake with, too. That’s not to say that white flour, which has been stripped of its bran and germ, has no merits. Much like whole wheat flour, a quarter cup of enriched white flour provides about 100 calories, 3 grams of protein and a slew of B vitamins and some minerals. Some enriched white flours, in fact, have more iron and certain B vitamins (such as folic acid) than their whole wheat cousins.
these chemicals, but the US has not. Food in California that contains potassium bromate, however, must bear a warning label. Although the research is still out on the potential health risks of consuming these chemicals, numerous US flour companies no longer use them. So, is wheat flour good for you? Yes; although some kinds are better than others. Whole wheat is more nutritious than white; enriched white is better than non-enriched white; and any flour that has not been bleached or bromated is better than the alternative.
What refined white flour doesn’t have, however, is fiber — the nutrient that keeps us regular, helps with weight control, stabilizes blood sugars and assists with the removal of bad cholesterol. Most whole wheat flours provide about 3 grams of fiber per quarter cup. Health-promoting phytochemicals and antioxidants such as vitamin E are also removed in the making of white flour. Studies have shown that both may help to protect against cancer, cardiovascular disease and Type 2 diabetes. Again, whole wheat flour boasts many of these beneficial compounds. Lastly, many flour companies add benzoyl peroxide or chlorine dioxide to chemically whiten (bleach) their flours. Some add potassium bromate to chemically strengthen their flours. Several European countries, Canada and Japan have banned the use of
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To prolong shelf life, transfer flour from its paper bag to an airtight plastic or glass container. Store refined flour in a cool, dry place. Store whole wheat flour in the fridge or freezer. Flour that has gone rancid smells sour. Bakers’ hints for baking with whole wheat flour: Make sure flour is fresh; add two teaspoons of liquid (water, milk, orange juice) per cup of whole wheat flour (to combat dryness); substitute some of the whole wheat flour in a recipe with all-purpose flour (for a lighter texture); and use “white whole wheat flour, “ which is simply whole grain flour that has been milled from white wheat (for a lighter color and milder taste).
Chocolate-Nut Thumbprints Adapted from America’s Test Kitchen; Makes two dozen cookies 8 tablespoons (1 stick) unsalted butter, softened ½ cup sugar ¼ teaspoon salt ¼ teaspoon cinnamon 1 egg yolk
1 teaspoon vanilla extract 1 tablespoon milk ½ cup pecans, toasted and ground 1 cup white whole wheat flour* ¼ cup all-purpose flour ½ cup semisweet chocolate chips ¼ cup heavy cream or milk 1 tablespoon corn syrup
Heat oven to 350 degrees. Line baking sheets with parchment paper. With electric mixer on medium speed, beat together butter, sugar, salt and cinnamon until smooth. Add yolk, vanilla, milk and nuts and beat until well blended. With mixer on low speed, beat in flour just until dough forms a cohesive mass. Roll dough into 1-inch-thick balls and place 1 inch apart on prepared sheets. Bake for 10 minutes, remove from oven, and press indent into each cookie using thumb or bottom of rounded ½-teaspoon measure. Return to oven and bake 7 minutes more. Remove to a wire rack to cool. In a small saucepan over medium-low heat, combine chocolate chips, cream or milk, and corn syrup, stirring constantly until smooth. Cool 20 minutes. Fill the thumbprints with the chocolate mixture; let sit for another 30 minutes. *New to cooking with whole wheat flour? You may want to start with a ratio of ¾ cup whole wheat flour and ½ cup all-purpose flour for this recipe.
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 firstname.lastname@example.org.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
By Eva Briggs
Are Cranberries Good to Treat Urinary Tract Infections? How about turkeys? Are they good to cure insomnia?
s I write this, Thanksgiving is approaching. This leads to thoughts of traditional Thanksgiving foods such as cranberries. These familiar red berries grow on low shrubs or vines. The name derives from “craneberry” because the shape of the flower and associated structures reminded early European settlers of the neck, head, and beak of a crane. They’re cultivated for food and juice. At one time it was thought cranberries could treat or prevent urinary tract infections. But a recent study of nursing home patients given cranberry capsules confirms yet again that there is no evidence that cranberries will treat or cure urinary tract infections (UTIs), and only minimal to no evidence that they will prevent UTIs. This myth came about because cranberries contain A-type proanthocyanidins (PACs). PACs block the attachment of the bacteria E. coli to the lining of the urinary tract. But there isn’t enough of the substance in juice or supplements actually reaching the right spot to be effective. Women with recurrent UTIs who take
cranberry supplements might have a very slight decrease in the number of infections. But once symptoms start, cranberries won’t help. Supplements are not regulated by the FDA, so it’s hard to know how much active ingredient any particular supplement contains anyway. Check out the label of a cranberry supplement and you will read something like the misleading and meaningless statement “Promotes urinary tract and immune health.” That’s followed by an asterisk, which will lead you to the disclaimer, “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.” Yet still I often see people who delay their care by trying to fix urinary tract symptoms with overthe-counter cranberry supplements. Although most people who think they have a urinary tract infection are correct, other diseases can cause similar symptoms. So see a medical provider for diagnosis and treatment. Other myths regarding UTI prevention include avoiding tight pants, urinating after intercourse, avoiding
urologyIGH.10.25x6.75.qxp_Layout 1 8/19/16 1:12 PM Page 1
hot tubs and bubble baths or avoiding tampons. There’s no scientific evidence that these measures help.
Turkey Well, what about turkey then? Will turkey treat insomnia? It turns out that’s also a myth. It came about because turkey contains a protein building block called L-tryptophan. That substance was marketed in the 1980s in supplement form as a sleeping aid. But it was pulled off the market in 1990 when an L-tryptophan supplement from China turned out to cause eosinophilia-myalgia syndrome. This disease involves the rapid onset of symptoms including muscle pain and trouble breathing, and can progress to a chronic condition lasting for months. L-tryptophan is metabolized to serotonin, a brain chemical that can be associated with drowsiness. But turkey doesn’t contain more L-tryptophan than any other poultry. And even if it did, not enough of it makes
it from intestinal tract to the blood stream and then into brain to cause sleep. It’s more likely that the “food coma” sleepiness following a big Thanksgiving dinner comes from the calorie and carbohydrate load.
Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
MEET THE UPSTATE UROLOGY TEAM Chairman Urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
General urology andrology
GENNADY BRATSLAVSKY, MD ZAHI N. MAKHULI, MD Female and reconstructive urology, urinary incontinence in women, pelvic floor treatment and neurourology
NATASHA GINZBURG, MD Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities
MATTHEW D. MASON, MD
Urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
RAKESH KHANNA, MD General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn.
RYAN SIDEBOTTOM, DO
Urologic oncology and endourology, robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal; renal stone disease
OLEG SHAPIRO, MD
Nephrolithiasis (kidney stones), enlarged prostate, urination problems, voiding dysfunction, bladder and kidney surgery
JESSICA E. PAONESSA, MD
DMITRY NIKOLAVSKY, MD
Male reconstructive surgery, urinary diversions, general urology
General urology, female and reconstructive urology
ELIZABETH FERRY, MD
JONATHAN RIDDELL, MD
Incontinence, urethral stricture disease, pelvic organ prolapse, vessico vaginal fistula, reconstructive surgery
General female urologic health
TIMOTHY K. BYLER, MD
Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities
STEPHEN BLAKELY, MD
Male infertility, erectile dysfunction, andrology, general urology
JC TRUSSELL, MD
IMAD NSOULI, MD
FOR QUESTIONS OR TO MAKE A REFERRAL CALL 315.464.1500 UROLOGY
December 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Parenting By Melissa Stefanec
Parenting When You Don’t Know How
here are probably thousands, dare I say millions, of books and blogs out there about parenting. Most of these offer advice on cut-and-dried situations. There are books about derailing
tantrums, stopping biting, navigating common core, curbing teenage angst and potty training. For just about every parenting topic, there is person who offers a book or Internet site full of potential answers.
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However, there are some situations in parenting that don’t come with fool-proof advice or easy answers. There are some events that don’t lend themselves well to science and analytics. Death, afterlife, sickness, atrocities — these are the parenting waters that none of us know how to perfectly navigate. When you are just as devastated, or even more devastated, by something than your child, it can be tough to help them. When your children want answers, and you simply don’t have them, what is a parent to do? You can ask friends or family members how they have dealt with similar circumstances in the past. You can look back on how your parents helped you through difficult times. However, chances are, your parents failed you at some crucial and difficult points in your life. There were times your parents or loved ones felt so defeated or were so leveled by an event they weren’t able to make that same event easier for you. These were undoubtedly some the most difficult things to wrap your young mind around. Very recently, and for the first time in my five-plus-year parenting career, I am leveled. Certain circumstances are upon us that I cannot justify, rationalize or endorse. My daughter is 5 years old, and she has questions. She has simple questions, but I have found those simple questions are the most difficult ones to answer. There are certain values I pride myself on, and recently those values have been set aside by many people in our country. I am the sort of person who tries to see the good in almost anyone. I am the kind of person that gives others the benefit of the doubt. When people try to cast stones, I am often the one to stand up and ask what it must be like on the other side of that stone. I look for ways to help others. I am not perfect, but I swear I try each and every day to be a better person. I impart these same values on my children. I ask them to be empathetic, helpful, strong and yet open-minded. I ask for them to walk away from bullies, never throw the first punch and take care of themselves, all while taking care of others. I teach them to treat others with respect, even if they don’t agree with or particularly like someone. I try to help them manage their emotions and control their reactions to undesirable situations. These are values and mechanisms that are not especially easy to teach to young ones, but I don’t let that stop me
‘There are some situations in parenting that don’t come with fool-proof advice or easy answers.’ from trying. Recently, I have been questioning everything I pride myself on. I have questioned why I should bother teaching my children the values I hold so dear. It feels like my values are losing traction, and I’ve found myself losing the hope and optimism that I try to approach life with. When my daughter comes to me with easy questions, I don’t have any answers. When my 2-year-old son sees me crying and thinks I am laughing and wants to laugh along, I have no words. As a writer and lover of conversation, I almost always have words. However, lately my words have been as hard to come by my optimism. So, what is a parent to do when she doesn’t have answers? For the first time, I told my daughter I couldn’t answer her questions. I let her know that she will see and experience things in life for which there will be no words. She will sometimes ask questions and get no good answers. I let my children see me cry, because it’s OK to cry. It’s OK to be sad and angry and confused all at once. It’s something we all have to deal with from time to time, and our children need to learn that. Life isn’t always easy, whether you are 2, or 5 or 34. The coming months may not be easy, but I will reach deep into myself and find resolve. When I want to cast off my cherished values because someone stole my hope, I will instead show my children who I truly am. This is the time to lead by example and to be stronger, kinder and more dedicated to my causes than ever. I need to teach my children that when you have suffered a loss, you can’t give up. You have to stay true to yourself and fight harder. Character is being resilient in the face of adversity. It’s easy to be good when things are going well; it’s not easy when times are dark. I may not have any good answers for my children, but now is the time to teach them about character and strength. It’s time to lead in my home and set expectations here, because, right now, I can’t count on the world to do the same. To that end, I will be the change I want to see.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
Holidays Holiday Blues or Depression?
Why the ’happiest season of all’ brings sadness and depression. Experts weigh in
By Deborah Jeanne Sergeant Instead of Joy to the World, some people feel sad, lonesome and overwhelmed during the holiday season. It may seem strange to those not experiencing those feelings, but for some, the season elicits symptoms that mimic depression or actually trigger depression. Carrie Scholz, licensed clinical social worker and founder of Health Navigation of CNY in Skaneateles, said that a few key factors differentiate holiday blues from major depression. “With serious depression, it impairs your ability to function with daily activities,” Scholz said. “With holiday blues, there are a lot of triggers with anticipation. Symptoms are usually not as debilitating as for impacting your regular daily activities.” Clinical depression typically lasts longer and is typified by deeper, more profound sadness accompanied by five or more of the following symptoms: sadness, crying, changes in sleep patterns, lack of concentration, anxiety, increased or decreased
appetite, feelings of guilt and worthlessness, lower energy levels and lower motivation. Some people experiencing depression contemplate self-harm. Feeling sad during the holidays seems incongruent with the “happiest season of all,” but for some people, it’s stressful in a negative way. If the family always gathered at Mom and Dad’s to celebrate, but Dad died and now Mom lives in a condo, it can be hard to adjust to the new normal. “The whole focus is on family, so if you’ve lost someone, you feel that loss more,” Scholz said. “Acknowledge what’s going and celebrate that person.” Or perhaps the entire family is intact but has never gotten along well. Those Hallmark-perfect memories never happen. Instead of lamenting what cannot be, embrace what works for you and let go of the rest. For
example, attending a family celebration filled with put-downs and verbal arrows can cause plenty of stress. Briefly making an appearance can help keep the tradition without enduring hours of emotional pain. For others, anticipating a terrible holiday can cause stress, according to physician Ronald W. Pies, professor of psychiatry and lecturer on bioethics and humanities at SUNY Upstate Medical University. “This is the flip-side of the ‘Hallmark greeting card syndrome,’” Pies said. “Some people expect the worst from the holidays, and it becomes a kind of self-fulfilling prophecy.” It’s important to identify the source of stress and develop healthy means of addressing it. Avoidance, turning to alcohol, poor food choices or overspending represent unhealthy coping mechanisms that only make problems — whether actual or anticipated — worse. “These may provide a couple of hours of elevated mood, but it’s often all downhill after that — and alcohol in large amounts can be a mood and brain depressant,” Pies said. He advises people to plan for the holiday season to avoid the blues. “Keep your expectations reasonable. The holidays don’t have to be perfect,” he said. He added that it’s important to avoid over-committing in time, energy and money by knowing how much of each is available. “Try to maintain your usual eating, sleeping and activity schedule as much as possible,” Pies said. “Learn to say no to unreasonable demands and expectations from others. Take breaks from the stress — even a
15-minute walk or a warm bath can help restore energy and spirits.” By finding meaningful ways to celebrate, such as volunteering, and delegating responsibilities, the season can feel less like a to-do list and more like holidays. Of course, some people may experience depression coinciding with the holidays. “People who have a history of clinical depression or major depressive disorder probably are more susceptible to holiday-related stress and sadness, and the winter holidays can sometimes precipitate a major depressive episode in these individuals,” Pies said. It’s important to note that in Central New York, seasonal affective disorder (SAD) influences how some feel. Lack of sunlight can trigger the mood disorder since the body does not receive sufficient natural sunlight. Another medical condition such as thyroid issues, could cause symptoms like those of depression. That’s why a medical exam is so important. Although depression is a medical condition usually treated by medication and talk therapy, neither depression or holiday blues should be ignored. “If you are feeling seriously depressed or unable to function adequately, seek out professional help— especially if the holiday blues morph into a major depressive episode in the post-holiday period,” Pies said.
Stress Reduction, Key to Happy Holiday Season
Author and president of mental health organization talks about dealing with holiday blues, depression By Matthew Liptak
appearing. It can be really subtle because there’s a lot of things that goes on in people’s heads that you can’t really see. You have to be in touch with those small little cues. Also I’ve been with loved ones who say they just can’t do an event. Instead of trying to argue with them, I’m like ‘That’s cool. I get it.’ You have to be ready and willing to accept that.
n Good Health sat down with the president of the local chapter of the National Alliance on Mental Illness, Karen Winters Schwartz, to talk about holiday stress. NAMI is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness, according to its website. Schwartz has written several character-driven novels whose protagonists had mental health issues. 1) How can families, especially families under mental stress, deal with holiday visits? “We generally tell people who have family that are dealing with someone with mental health issues to limit their stress. It’s important to remember that a person who has a mental illness is usually stressed or overstimulated. The stress of having a lot of family members, a lot of noise, a lot of children running around really, really is hard on them. Many times the loved one can’t deal with that and the time visiting should be limited. It really, really
Karen Winters triggers stress for anybody, but for people dealing with mental illness it can be really bad. 2) What are some signs you may need help? “I think it can be obvious if the person is becoming symptomatic or causing family drama — it’s time to disengage. There can be more subtle signs as far as withdrawing or dis-
3) What are the traditional sources of holiday stress? “Money and time management can be stressors — trying to get everything done. One of the things you can try to do is cut down. I make literally 1,000 or more cookies every year. I’ve already decided I’m cutting down on what I make this year. Look at what you normally do. Where can you cut back? What really needs to be done? How much do we actually really need to spend? There are other things you can do to show people that you love them than running around like a chicken with your head cut off trying to get all of this stuff done. Think about what the holidays are really about. Accept and realize that these holidays really have become huge money-making endeavDecember 2016 •
How to Contact NAMI For more information about NAMI, call 315-487-2085 or visit www.nami.org. For other support groups, visit 211CNY.com or call 211. ors for so many people it’s really lost what it was all about to begin with. Cut it down to the basics of what it’s all about. 4) Where can people go to get help when it’s too much? If you’re talking about NAMI, we have our Christmas party. We have meetings every month, support groups anyone can go to. Health care workers and psychologists are overwhelmed right now with people trying to get in to see them. Turn to the people you trust and turn to the people that you know love you and support you and come together. That’s my biggest thing—gathering people around you who can boost you up.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
ACR Health: Be Holiday Angel
CR Health is recruiting volunteers who want to serve as “holiday angels” this season. “We have found ourselves in a tough spot — we have run out of holiday angels and we have 74 people left on our list who will go without this holiday season without your support,” read a news release issued by the organization. The long-standing holiday angel program pairs community members (angels) with a qualified ACR Health client and their family. The holiday angel gets a list of needs the family has, and then makes holiday purchases based on the list.” The lists usually contain requests for basic needs like clothing, bathroom items such as towels, kitchen supplies or personal items like shoes or a coat. Participating angels can buy as many or as few of the items on the list as they wish. Many community groups, churches, or extended families pool their resources every year to sponsor an ACR Health client and members of their family. Several hundred people rely on holiday angels for whatever holiday gifts come their way. “We are immensely grateful for the generosity of the angels,” said ACR Health Deputy Executive Director of Operations Carrie Portzline-Large. “Poverty is a constant companion for some of our clients and their families, who struggle financially yearround. They have nothing to give their loved ones at holiday time. Thanks to the Angels, they do.” ACR serves Cayuga, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, and St. Lawrence counties. Holiday angels are needed across the nine-county service area. If you would like to be a holiday angel, email events@ ACRHealth.org or call 800.475.2430.
Holidays Toy-buying Season. But How Safe Are These Toys?
Experts say consumers have to be careful with what types of toys they buy for children By Deborah Jeanne Sergeant
re children on your gift list? Keep them safe by purchasing appropriate gifts. Laz Benitez, representing New York State Division of Consumer Protection, advises buyers to look at toy packaging for guidance. “It is critical that toys given to children be age appropriate,” Benitez said. “Toys marked ‘3+’ or ‘3 and up’ should not be given to children under 3. Also, consider the ages of all the children who might have access to it. A toy with small parts purchased for an older child can find its way into the mouth of a sibling under 3 and become a choking hazard. Children’s developmental stage can vary. Some children may not be mature enough to play with toys that are rated for their age. For example, a
IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
3-year-old who still frequently places toys in his mouth may need to wait on a toy rated for his chronological age. Look for sturdy construction, non-toxic materials and UL (Underwriter’s Laboratories ) approval for electric toys. Toys that make noise can damage kids’ hearing. Some toys sold from a bulk bin lack packaging, as do vintage toys, and handmade toys lack this information. “Many of us had vintage or handed-down toys as children,” Benitez said. “Yet, consumers should be alert that these toys are age-appropriate, function properly, are not broken, clean and do not pose a safety problem. It is especially important to keep these items out of the mouths of children since you may not know if they were manufactured to today’s well-established safety standards.” Most experts agree that any toys or parts of toys smaller than a fist presents a choking hazard. Look for removable parts or parts that may be broken off. US-made toys made more recently than the 1970s won’t contain lead; however, those made before and overseas may still have lead which is harm-
ful to children’s development. The Consumer Product Safety Commission has worked to tighten inspection of imported toys, but if you purchase them directly on the Internet, you can’t know if the toys contain lead or not. Pay special attention to toys purchased on Amazon.com or eBay. com, as some are used and may not include the packaging or be up-todate with current safety standards. Some manufacturers post their safety data online, so if you want to save money buying a used toy, research the company’s available information. By looking on www.cpsc.gov, Kelly Dobson, owner of Wear It Again Kids in Cicero, researches recalls for incoming toys she sells on consignment. “A lot of times, you can find any recalls online,” she said. She also checks to make sure everything looks like it’s fastened together well and all the pieces are present. “I put on my tags 3-plus if it has small pieces,” Dobson said. Any pieces smaller than a fist may present a choking hazard. Dobson also looks for chipping paint or peeling plastic. “We do our very best to do what we can to make sure everything is in good shape,” she said, “but it is up to parents to check things over.” With electronic toys, “be wary of toys containing small magnets, even if the magnets are encased in the product,” Benitez said. “If swallowed, these magnets can be very dangerous to children.” Carefully inspect larger toys such as a playhouse for sharp edges and corners. Don’t modify the assembly information as that may compromise the toy’s safety. Complete the warranty registration process so you’ll be notified in case of a recall. “In addition, you will have some coverage for replacements if there is damage to the product during the given period of time,” Benitez said. Skip gifts that are too fragile for children to play with. The glass angel ornament may thrill your little girl, but will she resist playing with it? If someone gives your child a toy you don’t feel is safe, you can put the toy away until he is mature enough for it. With all the hubbub of opening gifts, he likely won’t notice one toy is “missing” anyway. If you’re in doubt, give that grandchild, niece or nephew a gift card to a toy store so the parents can help guide the gift choice.
Holidays Avoid Holiday Weight Gain If You Can
For most people, losing weight in December is next to impossible; however, maintaining the same weight is an achievable goal, experts say By Deborah Jeanne Sergeant
he Jolly Old Elf may be part of your celebration, but you don’t want to end up looking like him after New Year’s. Many people find it hard to keep weight off during the last month of the year for different reasons. Susan Brisk, Upstate Medical University Pathway to Wellness coordinator, cited a few different reasons many people gain weight from Thanksgiving through New Year’s Day: portion sizes, overeating, poor food choices and lack of activity. “People often allow themselves treats because it is the holidays,” she said. “Stress can increase the amount of cortisol in your blood stream, and it has been shown to increase appetite, increase craving for sugary foods and comfort foods. We also get out less during colder weather.” She recommends getting the family together for a hike, snow shoeing or other outdoor adventure. Though it may be harder to get active outside, taking a fitness class or engaging in an active hobby or sport can help
improve fitness, as can engaging in calisthenics. These include movements such as air squats, burpees, and sit-ups. Callisthenic movements like these are portable for anyone traveling during the holidays, too. “Find ways to keep activity into your routine by taking the stairs or moving more throughout the day,” Brisk said. To prepare for a party or holiday meal, engage in an extra workout that week and stick with healthful choices when possible can offset a few treats. For most people, losing weight during November and December is next to impossible; however, maintaining the same weight is certainly an achievable goal. “Take a portion or serving and then keep the special food item out of your reach,” Brisk said. “Writing or tracking your food in a journal will help you keep track of over-indulgences.” Most smartphones come preload-
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ed with a food tracking app. Eating a light meal that includes healthful fat, fiber and protein before leaving home can help you avoid arriving famished and making poor food choices. If it’s a casual gathering, bring your own platter of cut-up veggies or fruit, or shrimp and cocktail sauce. Go easy on alcohol, as its high caloric content and ability to impair your judgment can spell disaster for your healthful eating plan. “[Alcohol consumption] is a problem and tends to happen every year,” said Kelly Springer of Kelly’s Choice, a nutrition business based in Skaneateles. “The average American will consume over 600 calories in alcohol daily between Thanksgiving and New Year’s. That’s an extra 500 calories a day or 1 pound per week.” Springer recommends using seltzer water as a mixer. Her other key tips include plating everything instead of nibbling, filling up on protein (shrimp is a great choice) and vegetables before eating carbohydrates. It’s also vital to stay hydrated at gatherings. Many people crave salty or sweet foods when actually, they’re hungry. “When you start eliminating sweets or carbohydrates, you can go a little crazy,” Springer said. “When you have protein and vegetables, you can still have a cookie.” At home, altering recipes can decrease their calories. Instead of pumpkin pie, skip the crust and pour the filling into individual glass ramekin to bake. With parties to plan, attend, gifts, decorations and events, it’s easy to get so busy that grabbing fast food sounds like an easy solution for meals. But Heather Neely, registered
dietitian in the Bariatric Weight Loss program at Crouse, advises clients to carry healthful snacks with them in the car or bag to tide them over, such as a couple bottles of water, washed grapes or nuts in pre-portioned, 100-calorie bags. “Bring a small cooler with string cheese or yogurt or raw veggies or single-serving cups of peanut butter with whole wheat crackers” Neely said. “You can have good choices to make. “For kids, 100-cal. granola bars are a good choice. They won’t always want to eat fruit all the time.” If you forget to grab chow before you go, you still have good choices at the drive-thru window. At McDonald’s, for example, choose a single patty hamburger without cheese, side salad (go easy on dressing), apple slices, Fruit ‘N Yogurt Parfait and unsweetened tea for a meal under 450 calories. Subway sells chopped salads, which ratchets down the calories compared with a sub sandwich. Many supermarkets sell soups, salads and light fare and provide instore dining areas. By keeping a few of these strategies in mind, you can avoid high calorie choices. “Holidays and these special meals are once a year, but not a make-or-break with your weight,” Neely said. “The healthy habits you do all year long leave a little room for indulgences.”
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In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Matthew Liptak, Anne Palumbo, Melissa Stefanec, Chris Motola, Ernst Lamothe Jr. Eva Briggs (M.D.), Paul Rice • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler 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.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
The Social Ask Security Office By Deborah Banikowski District Manager, Syracuse
Social Security’s Gift to Children Is Security
his is the season of caring. No matter your religion or belief, December is also considered a time to focus on the children we love. Whether we’re wrapping Santa’s gifts, buying Hanukkah treats, decorating the house in celebration of Kwanzaa or volunteering for a toy drive, children add joy to the holiday season. And we at Social Security definitely know a thing or two about helping children. Often overlooked in the paperwork that prospective parents fill out in preparation for a child’s birth is an application for a Social Security number and card. Typically, the hospital will ask if you want to apply for a Social Security number for your newborn as part of the birth registration process. This is the easiest and fastest way to apply. The Social Security card typically arrives about a week to 10 days after that little bundle of joy! You can learn about Social Security numbers for children by reading our publication, Social Security Numbers for Children, available at www. socialsecurity.gov/pubs. A child needs a Social Security number if he or she is going to have a bank account, if a relative is buying savings bonds for the child, if the child will have medical coverage, or if the child will receive government services. You’ll also need a Social Security number for a child to claim him or her on your tax returns. If you wait to apply, you will have to visit a Social Security office and you’ll need to: • Complete an “Application For a Social Security Card” (Form SS-5); • Show us original documents proving your child’s U.S. citizenship, age and identity; and • Show us documents proving your identity.
Q: I noticed that my date of birth in Social Security’s records is wrong. How do I get that corrected? A: To change the date of birth shown on our records, take the following steps: • Complete an “Application For A Social Security Card” (Form SS-5); • Show us documents proving: U.S. citizenship (if you have not previously established your citizenship with us); age; and identity; and • Take (or mail) your completed application and documents to your local Social Security office. Note that all documents must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies of documents. For details on the documents you’ll need, visit www.
Remember, a child age 12 or older requesting an original Social Security number must appear in person for the interview, even though a parent or guardian will sign the application on the child’s behalf. Children with disabilities are among our most vulnerable citizens. Social Security is dedicated to helping those with qualifying disabilities and their families through the Supplemental Security Income (SSI) program. To qualify for SSI: • The child must have a physical or mental condition, or a combination of conditions, resulting in “marked and severe functional limitations.” This means that the condition(s) must severely limit your child’s activities; • The child’s condition(s) must be severe, last for at least 12 months, or be expected to result in death; • If your child’s condition(s) does not result in “marked and severe limitations,” or does not result in those limitations lasting for at least 12 months, your child will not qualify for SSI; and • The child must not be working and earning more than $1,090 a month in 2016. (This amount usually changes every year.) If he or she is working and earning that much money, your child will not be eligible for benefits. Learn the details about benefits for children by reading our publication, Benefits for Children with Disabilities, available at www.socialsecurity.gov/pubs. Visit www.socialsecurity.gov/ people/kids to learn more about all we do to care for children. Caring for the next generation is a central part of securing today and tomorrow, during the holidays and all year long. socialsecurity.gov/ss5doc. Q: How can I get a copy of my Social Security Statement? A: You can get your personal Social Security statement online by using your my Social Security account. If you don’t yet have an account, you can easily create one. Your online statement gives you secure and convenient access to your earnings records. It also shows estimates for retirement, disability, and survivors benefits you and your family may be eligible for. To set up or use your account to get your online Social Security Statement, go to www.socialsecurity.gov/ myaccount. We also mail statements to workers attaining ages 25, 30, 35, 40, 45, 50, 55, 60 and older three months prior to their birthday if they don’t receive Social Security benefits and don’t have a my Social Security account.
New Legacy APARTMENTS By Jim Miller
Thyroid Disorders Often Missed in Seniors Dear Savvy Senior,
Can you write a column on the overlooked problem of thyroid disease? After struggling with chronic fatigue, joint pain and memory problems, I was finally diagnosed hypothyroidism. Now, at age 70, I’m on thyroid medication and am doing great. Five years of feeling lousy. I wish I’d have known. Frustrated Patient Dear Frustrated,
I’m glad to hear that you’re finally feeling better. Unfortunately, thyroid problems are quite common in older adults but can be tricky to detect because the symptoms often resemble other age-related health problems. In fact, as many as 30 million Americans have some form of thyroid disorder, but more than half of them aren’t aware of it. Here’s a basic overview: The thyroid is a small butterfly-shaped gland located at the base of your neck that has a huge job. It produces hormones (called T3 and T4) that help regulate the rate of many of your body’s activities, from how quickly you burn calories to how fast your heart beats. It also influences the function of the brain, liver, kidneys and skin. If the gland is underactive and doesn’t produce enough thyroid hormones, it causes body systems to slow down. If it’s overactive, and churns out too much thyroid, it has the opposite effect, speeding up the body’s processes. The symptoms for an underactive thyroid (also known as hypothyroidism) — the most common thyroid disorder in older adults — will vary but may include fatigue, unexplained weight gain, increased sensitivity to cold, constipation, joint pain, muscle stiffness, dry skin and depression. Some patients may even develop an enlarged thyroid (goiter) at the base of the neck. However, in older adults, it can cause other symptoms like memory impairment, loss of appetite, weight loss, falls or even incontinence. And the symptoms of an overactive thyroid (or hyperthyroidism),
which is more common in people under age 50, may include a rapid heart rate, anxiety, insomnia, increased appetite, weight loss, diarrhea, excessive perspiration, as well as an enlarged thyroid gland. Too much thyroid can also cause atrial fibrillation, affect blood pressure and decrease bone density, which increases the risk of osteoporosis. Those with the greatest risk of developing thyroid disorders are women who have a family history of the disease. Other factors that can trigger thyroid problems include: autoimmune diseases like Hashimoto’s or Graves disease; thyroid surgery; radiation treatments to the neck or upper chest; and certain medications including interferon alpha and interleukin-2 cancer medications, amiodarone heart medication and lithium for bipolar disorder.
If you have any of the aforementioned symptoms or if you’ve had previous thyroid problems or notice a lump in the base of your neck, ask your doctor to check your thyroid levels. The TSH (thyroid-stimulating hormone) blood test is used to diagnosis thyroid disorders. Thyroid disease is easily treated once you’ve been diagnosed. Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid and others), which is an oral medication that restores adequate hormone levels. And treatments for hyperthyroidism may include an anti-thyroid medication such as methimazole (Tapazole), which blocks the production of thyroid hormones. Another option is radioactive iodine, which is taken orally and destroys the overactive thyroid cells and causes the gland to shrink. But this can leave the thyroid unable to produce any hormone and it’s likely that you’ll eventually become hypothyroid and need to start taking thyroid medication. For more information on thyroid disorders, visit the American Thyroid Association at Thyroid.org. 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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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Health News Twiggy Eure now in charge of diversity at Crouse Crouse Health has appointed Twiggy Eure to the position of diversity, equity and inclusion recruitment/retention coordinator for the organization. She will coordinate and guide efforts to define, assess, foster and cultivate diversity and inclusion at the hospital. Eure will Eure also develop and oversee programs, services and initiatives designed to promote diversity and inclusion throughout the Crouse Health system. She will work closely with the hospital’s recruitment coordinators and management team to support their efforts in attracting more candidates of a diverse background to Crouse. Eure will also support Pomeroy College of Nursing in its efforts to attract diverse applicants to the college. Additionally, she will mentor and assist staff members with opportunities to advance within the Crouse organization. Eure most recently served as talent management coordinator/ personnel analyst for the Syracuse City School District. She has also held the positions of practice manager/ human resources manager for St. Joseph’s Physician Health, PC, and executive team member for Destiny USA. A recipient of the 2014 YWCA Diversity Achiever’s Award and graduate of Leadership Greater Syracuse, Eure holds a master’s degree in instructional design, development and evaluation from Syracuse University. “Crouse should be known in our community as an organization that treats and serves all people without bias or judgment. That is the basis of our mission and supports our long-standing commitment and responsibility not only to our patients and their families, but also to those who work here,” said Crouse CEO Kimberly Boynton. According to Boynton, the position reflects Crouse’s strategic commitment to enhancing the organization’s culture by focusing on the important issues of diversity and inclusion. “This is not a ‘training’ initiative; rather, it is a vital part of who we are as an organization, and how we position Crouse for success in the future. We’re excited to have Twiggy join us to help develop a structure that supports this element of the Crouse culture.”
Audiologist Devlin Lighty join Oswego Health Oswego Health welcomes audiologist Devlin Lighty to the Oswego practice. The new audiologist is Page 20
providing hearing and balance services for clients of all ages using the newest technology available. Lighty earned her Doctor of Audiology degree from Towson University in Maryland. She earned her Bachelor of Science degree in communication sciences and disorders from Howard University in Washington, D.C. Lighty arrives at the Oswego practice after working several years in the Maryland and Washington, D.C. area. “I like working in a practice of this size. It allows me to really get to know my patients and meet their clinical needs.” Equipped with an AudioStarPro audiomLighty eter, TympStar middle ear system and a sound proof-booth, Lighty can test clients comfortably while obtaining accurate test results. She also treats young children. Lighty’s office is located adjacent to Oswego Hospital.
NP joins Nephrology Associates of Syracuse Nurse practitioner Jessica Arcuri has recently joined Nephrology Associates of Syracuse, PC. She is a certified family health nurse practitioner with a master’s degree in nursing from SUNY Upstate Medical University. She is a member of the American Academy of Nurse Practitioners. Arcuri Arcuri also holds a Master of Science degree in nursing, summa cum laude, and was the class valedictorian from SUNY Upstate Medical University in 2016. She graduated from St. Joseph’s Hospital Health Center College of Nursing and previously worked for five years as a charge nurse on a per diem basis for St. Joseph’s Hospital Health Center in Syracuse.
HCR Home Care names three new directors HCR Home Care has named a director of patient services in Central New York and hired two directors of nursing in the North Country and Finger Lakes regions. • Jason Woodsome, director of patient services in Central New York, oversees HCR’s clinical staff members who provide home care visits to people across the region, including care visits from registered nurses; home health aides; physical, occu-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
Breast Cancer Center at Crouse Renamed to Honor Dr. Hadley Falk New name follows largest donation in Crouse Hospital’s history The Crouse Hospital’s Breast Health Center has recently been renamed. The center’s new name is Dr. Hadley J. Falk Breast Health Center to honor physician Hadley Falk, who died Oct. 12 at age 65. Falk had spent virtually his entire career at Crouse as a plastic and reconstructive surgeon, specializing in surgery for breast cancer patients. Hadley Reflecting Falk’s years of deep concern for the well-being of Crouse patients, particularly those having breast cancer, his final act of caring was a bequest — the largest received in Crouse history — that will benefit breast cancer center. “With such a generous gift comes great responsibility for Crouse,” said CEO Kimberly Boynton, “and we have committed to using these funds for endeavors that are consistent with Dr. Falk’s commitment to the best in patient care and Crouse’s strategic initiatives. We sought input from Dr. Falk’s friends and professional colleagues on how best to perpetuate his work pational and speech therapists; and medical social workers. He previously served as HCR’s director of nursing in the Central New York region. Woodsome, a registered nurse, resides in Constantia, southern Oswego County. • Bobbie Biesenbach is director of nursing in the North Country region. PreviWoodsome ously managing the continuing care team for six counties at Lifetime Care, Biesenbach has experience with paraprofessionals and with working with DSS agencies and managed Medicaid plans. She is a registered nurse and resides in Morrisonville, Clinton County. • Jennifer Ruffell, RN, is director of nursing in the Finger Lakes region. Ruffell has 14 years of experience in health care administration, most recently as director of nursing services
with Crouse breast care patients.” According to Crouse Health Foundation President Carrie Berse, monies received to date have funded a new ultrasound machine and other upgrades to equipment and software used in the facility; education for staff; an endowment fund in his name that will help underwrite future Falk Breast Health Center needs; the purchase of instrumentation for plastic surgery procedures in the Madison-Irving Surgery Center, where Falk frequently did his plastics cases; and support for the construction of the first patient care unit at Crouse featuring all private rooms, which is scheduled to open later this year. “Hal Falk was respected by his fellow physicians and loved by his patients for his caring and expertise. His skills made a tremendous difference in the lives of those who entrusted him with their care,” said Berse. For more information about the Falk Breast Health Center’s bequest, contact the Crouse Health foundation’s president, Carrie Berse, at 315/470-7004 or carrieberse@crouse. org. Women seeking mammograms or breast cancer patients seeking assistance may call the Falk Breast Health Care Center at 315-470-5880 for an appointment.
at Penfield Place Nursing Facility. She resides in Webster, Monroe County.
Anne Zaccheo achieves fellowship status Anne E. Zaccheo, practice director at Nephrology Associates of Syracuse, PC, has become a fellow in the American College of Medical Practice Executives (ACMPE). ACMPE is the certification entity of the Medical Group Management Association (MGMA). Fellowship in ACMPE’s industry-leading program demonstrates mastery and expertise in the profession of medical practice management. To achieve fellowship, Zaccheo first earned the certified medical practice executive (CMPE) designation by passing rigorous essay and objective examinations that assess knowledge of the broad scope of medical practice management, as outlined in the body of knowledge for medical practice management. This includes business operations,
Health News financial management, human resources management, information management, organizational governance, patient care systems, quality management and risk management. In addition, Zaccheo completZaccheo ed a minimum of 50 continuing education credit hours to achieve CMPE status. To earn the fellowship, Zaccheo submitted a professional paper titled, “Survival of the Small Medical Practice in the Evolving American Health Care System,” documenting the objectives and results of an investigation into a health-care management topic. Zaccheo has worked at Nephrology Associates of Syracuse, PC since May 2013 and is an active member in both the national, state and local MGMA groups, as well as the Central New York Health Business Alliance.
St. Joseph’s CPEP team welcomes psychiatrists St. Joseph’s Health recently welcomed two psychiatrists to its comprehensive psychiatric emergency program (CPEP), which provides evaluation and treatment for individuals of all ages who are suffering from an acute mental health crisis. • Archana Kathpal earned her Doctor of Medicine degree from Government Medical College, Patiala, India, and a Master of Science degree in clinical psychology from California State Polytechnic University in Pomona, Calif. She Kathpal completed her residency in adult psychiatry at Mt. Sinai School of Medicine — Elmhurst
Hospital in Elmhurst, and completed fellowships in child/adolescent psychiatry and forensic psychiatry at SUNY Upstate Medical University in Syracuse and Rutgers University’s Robert Wood Johnson Medical School in New Brunswick, N.J., respectively. Prior to joining St. Joseph’s Health, Kathpal worked as a psychiatrist at Samaritan Medical Center in Watertown, where she provided clinical psychiatric services to adult and child/adolescent patients in the outpatient clinic. She has been published in the Asian Journal of Psychiatry, Apollo Medicine and Journal of Correctional Health. Kathpal is a member of American Psychiatric Association, and the American Academy of Psychiatry and the Law; and is fluent in English, Hindi, Punjabi and Urdu. • Tarun Kumar earned his Doctor of Medicine degree from Kasturba Medical College, Mangalore (Manipal University) in India. He completed his adult psychiatry residency at Mt. Sinai School of Medicine — Elmhurst Hospital in Elmhurst.; and a fellowship in child/adolescent psychiatry at SUNY Upstate Medical University in Syracuse. Kathpal also completed a fellowship in forensic psychiatry at Rutgers University’s Robert Wood Johnson Medical School in New Brunswick, New Jersey. Prior to joining St. Joseph’s Health, Kumar worked as a psychiatrist providing outpatient adult and child/adolescent psychiatric services at Carthage Behavioral Health in Carthage and Samaritan Medical Center in Watertown. Kumar is currently working as the medical director at Behavioral Health & Wellness Center (an entity of Transitional Living Services) in Lowville. Kumar contributed to the development of substance abuse guidelines, which are now being used as the University Correctional Healthcare (UCHC) Guideline for Substance Use Disorder Treatment in New Jersey Department of Corrections (NJDOC). His other research projects have been published in various journals, including Asian Journal of
Psychiatry, Apollo Medicine, South Med Journal and Hong Kong Journal of Psychiatry among others. Kumar is a member of American Psychiatric Association and the American Academy of Psychiatry and the Law; and is fluent in English, Hindi and Punjabi.
Crouse, ESF partner to provide care to students The SUNY College of Environmental Science and Forestry (ESF) and Crouse Health have teamed up to provide access to health and wellness services for ESF’s 2,000 students. Working through Crouse Medical Practice (CMP) — a multispecialty physician practice with multiple locations and more than 70 providers — ESF students will have access to care for all non-emergency, non-life threatening illnesses, such as coughs, fever, sore throat, upper respiratory infections, lacerations and sprains/ strains, as well as immunizations and physicals. As the preferred provider for ESF students, Crouse will provide medical services weekdays from 8 a.m. to 5 p.m. at CMP’s main location in the CNY Medical Center, across the street from Crouse Hospital. After-hours and weekend care will be available to students through Crouse PromptCare and the hospital’s main ER. As part of the program, CMP is currently working with Kinney Drugs to develop a customized prescription delivery system for on-campus delivery. According to CMP medical director, physician Carl Butch, Crouse will maintain all pertinent medical records for students who receive services through the program, including health histories and immunizations. CMP will also offer financial aid options to uninsured students and those who cannot afford services. “This partnership is a great way for Crouse to extend its mission of community-focused care to one of our major neighbor institutions on the Hill and we look forward to growing the program with ESF,” says
Butch, who adds that CMP will participate in ESF student orientations and student advisory committee meetings. Crouse is also providing dedicated clinical staff to the program, including a nurse practitioner, LPN and appointment scheduler. According to Anne Lombard, vice provost and dean for student affairs at ESF, more than 1,600 student appointments are expected during the academic year.
Podiatrist joins SOS as first female physician Podiatrist Stephanie Hook has recently joined the foot and ankle team at Syracuse Orthopedic Specialists (SOS). Hook is board-certified by the American Board of Podiatric Medicine and is skilled in rheumatologic conditions, pediatrics podiaHook try and diabetic foot care. “SOS looks forward to welcoming Dr. Hook to our foot and ankle team,” said physician John F. Fatti, president of SOS. “She brings a unique podiatric perspective to the team. As the first female physician to join SOS, Dr. Hook can also provide great insight to our practice.” Prior to joining SOS, Hook spent eight years providing podiatry services in Central New York. She received her Doctor of Podiatric Medicine degree from Ohio College of Podiatric Medicine in Cleveland, and was a resident at Catholic Health System in Buffalo from 2004 to 2006, then served as chief podiatry resident there from 2006 to 2007. “I am thrilled to be joining SOS,” she said. “I’ve long been impressed with their community involvement, and, personally, I’m looking forward to bringing my podiatric skill to complement their foot and ankle team, and apply my knowledge in diabetic and rheumatologic concerns.”
VNA Executive Gets ‘Advocate of the Year’ Award Cheryl Manna, chief operating officer at VNA Homecare, was recently presented with the Community Partner/Advocate of the Year Award at the 5th Annual Excellence in Health Care Awards. Presented by Bankers Healthcare Group, Inc., the Business Journal News Network and BizEventz, the Excellence in Health Care Awards recognize Central New York health care industry leaders, innovators and companies who have made a significant impact on the quality of health care and services throughout the community. Specifically, the Community Partner/Advocate of the Year Award honors an
organization or individual who has successfully implemented a program that has addressed and acknowledged problems in health care administration or in the delivery of health care. With more than 25 years of home care management experience, Manna was appointed director of operations for VNA Homecare’s MLTC program in 2013 and was promoted to her current position as the system’s chief operating officer in 2015. She earned her Bachelor of Science degree in health services management from SUNY Polytechnic Institute (formerly SUNYIT) and was the 2006 recipient of the Outstanding Health Services Management Student Award.
Manna is also an active member of several community organizations, including the National Association of Home Care and Hospice, the Home Care Association of New York State, the Health Friends Board of Directors and the LeadingAge New York MLTC/PACE Cabinet. Prior to joining VNA Homecare, she served as regional director of Network Development for the Visiting Nurse Service of New York. “It’s both an honor and a privilege to be recognized for doing what I’m passionate about,” Manna said. “I consider myself lucky to be in a position where I can work to make a real difference in our community’s health care environment.” December 2016 •
Cheryl Manna, chief operating officer, VNA Homecare, and recipient of the 2016 Community Partner/Advocate of the Year Award (left) poses with Kate Rolf, president and chief executive officer, VNA Homecare at the 2016 Excellence in Health Care Awards.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Want to Raise a Puppy?
Guide Dog Organizations Need Help Puppy raisers needed to provide the first training for dogs that will serve as guide dogs By Deborah Jeanne Sergeant
uiding Eyes for the Blind, an organization that trains service animals, estimates that about 2 percent of people in the U.S. with visual impairment use guide dogs, amounting to about 10,000 guide dogs. Numerous regional and national organizations train guide dogs, but before dogs qualify for guide dog training, they need a foster home. That’s where puppy raisers come in. Everyday people may be good candidates for providing a potential guide dog’s first home. Most organizations don’t enforce many parameters about a puppy raiser’s age, occupation or marital status; however, a few traits help make a puppy raising experience successful. “It has to be someone who’s willing to devote the time to it,” said Alison Sinnott, puppy placement specialist for Freedom Guide Dogs in Cassville in Oneida County. “It’s more dedicated than pet raising. You have to take the dog to restaurants, stores, bus stations, train stations. Many home-school or work from home and they’re there a lot of the time.” Perpetual homebodies don’t help puppies socialize, which is a big part of the puppy raiser’s job. The dogs require sensory input of all sorts to help them cope with any situation they may encounter with their eventual handler. “We have all age ranges of puppy raisers,” Sinnott said. “Some are retired and quite active. Most of our puppy raisers are snowbirds so they travel a lot. Some are just young couples with small children and everything in between.” Without adult help, children likely cannot raise a puppy themselves, but many families enjoy raising guide dog candidates together. Puppy raisers should have plenty of time to spend with a puppy. People who travel for work frequently to places where puppies can’t go, or spend numerous hours away from home may not be ideal puppy raisers. Retirees, at-home parents, small business owners, and those with accommodating workplaces possess the flexibility to tend to day-to-day puppy care, attend training meetings and take the puppy to plenty of places for socialization. Puppy raisers must keep in mind the long-term goal for their new charge: placement as a guide dog. That means following the directions of the guide dog organization, such as teaching good manners, enforcing housebreaking, and preparing to return the dog. “It’s extremely difficult to raise a puppy and give it up,” Sinnott said. “You have to have a strong sense of what you’re doing this for.” At about 18 months of age, the
IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2016
Paula Weronski of Gowanda, puppy raiser for Guiding Eyes for the Blind, holds her new puppy, Pat. Photos Courtesy Guiding Eyes for the Blind.
Linda DeTuy, retired letter carrier and a puppy raiser in Macedon, heard about Guiding Eyes on her mail route in 1987. A man with visual impairment asked if she would raise a puppy for Guiding Eyes. She’s currently raising her 18th puppy for the organization. Her biggest surprise has been the variety of personalities each dog exhibits, and also how much training each dog can absorb. “We had one dog that graduated with a gentleman who was blind, deaf and mute,” DeTuy recalled. “The dog had to learn the number of taps on his leg because he could not call his name.” Her puppy adventures have taken her to venues such as Portugal and Brazil where her dogs have been placed. “We have had one dog in Brooklyn and the gentleman comes up every year for Thanksgiving,” she said. “We’re close to all of them.”
dog is usually ready for further training as a guide dog if it passes muster. Depending upon the organization, dogs that don’t “pass” guide dog training may be passed along to a different branch of their organization or to a different service organization for another type of service. Some return the animals first to the puppy raiser for optional adoption, and, if refused, to another good home. Guide dog training organizations source dogs through breeding, rescue or donation. The animals are expected to learn good manners and balance obedience with the moxie to contradict their handlers if that’s what it takes to guide them away from danger. Linda Damato, director of the puppy program for Guiding Eyes for the Blind in Yorktown Heights, NY, said that the organization has about 440 puppies in foster homes. Guiding Eyes serves the area from Ohio eastward and from Maine to North Carolina. Though it’s a lot of work to socialize and care for a puppy, she said that “most of the puppy raisers say when they hand in the dog that they get out of it more than they give. There’s a connection with the community they build.” Mekalea Chambliss, Central New York co-coordinator for Guiding Eyes for the Blind, started as a puppy raiser in 2002. “We get a lot of ‘poor dog has to work all the time’ from people, but in reality, they work when they have their jacket on,” Chambliss said. “We do fun pet stuff as well, but out-ofjacket, out of work. They’re not on the job 24/7. They relax and play.” She takes along brochures with her to help educate the public on service animals and training service animals, but most businesses accommodate her once the manager realizes what she is doing. She starts out young pups with limited exposure to new places until the dogs’ confidence builds to the point where they can handle larger, noisier, busier places. “There’s a lot of work behind it” Chambliss said. “You have to be able to read your own dog.” Planning an exit strategy for when a dog has reached its limit helps Chambliss reduce the animal’s stress level if it’s experiencing an off day. She works at a dog daycare and grooming facility as a supervisor, which makes it easy to take her furry charges with her nearly all the time. The dogs in her program learn through temporary “puppy swaps” that they need to obey every human handling them. “It’s a huge commitment, but it is completely worth it,” Chambliss said. “The dogs give you a whole lot more than you give them.”
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