IGH CNY #205 Jan 2017

in good January 2017 •

Run for Life Maryann Roefaro, CEO of Hematology Oncology Associates, tests her endurance at NYC marathon while supporting Hospice of CNY

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Issue 205

cnyhealth.com

CNY’s Healthcare Newspaper

SMOKING ‘How I Quit After 40 Years’ ‘Trying to quit as a senior citizen turned out to be quite different from all those attempts in my younger years’. page 11

Top 10 ways women can improve their health

OB-GYN ISSUES Five things you need to know to about

The ‘Angelina Jolie’ Effect

Tests for the breast cancer BRCA gene shot up by 64 percent following Jolie’s 2013 decision to have preventive mastectomy

Cheaper Hearing Aids Coming onto the Market

Fighting Blindness page 14 Caused by Glaucoma Robert Fechtner, M.D.: A life working to make sure people don’t lose their vision to glaucoma

Haddock

‘My family’s go-to fish in January is haddock. Mildtasting and reasonably priced, this flaky white fish teems with good things.

It’s a great choice after the end of the eating season’

Excellus: Telemedicine to Surge This Year page 7

Upstate New Yorkers will embrace telemedicine this year, expects Excellus BlueCross BlueShield page 11

Pizza Trends Pizzas are trending toward thinner crusts and half of consumers prefer to go thin. Find out the top 10 habits Americans have when it comes to pizza page XX

U.S. Doctors Still OverPrescribing Drugs: Survey

More than one in four say antibiotics are given when the drugs will likely do no good

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espite evidence that certain drugs aren’t always necessary, doctors are still prescribing these treatments, a new survey of doctors reveals. Antibiotics are by far the drugs most frequently used in situations where they’ll provide no value for patients. The survey found that more than a quarter of doctors surveyed (27 percent) said that antibiotics are often administered to patients when the drugs will do no good.

In most cases, the antibiotics are prescribed to treat upper respiratory infections even though these are most often caused by viruses unaffected by the medication, said Amir Qaseem.

He’s vice president of clinical policy for the American College of Physicians (ACP) and chairman of the ACP’s High Value Care Task Force.

Other treatments that doctors use frequently despite their questionable value include aggressive treatments for terminally ill patients (9 percent), drugs prescribed for chronic pain (7 percent), and dietary supplements such fish oil and multivitamins (5 percent), the survey revealed.

“There is a lot of waste in our health care system, and we need to acknowledge that,” Qaseem said.

The results are from a random

Worldwide Cancer Rates Up More Than One-Third in Past Decade Researchers cite population aging and growth

survey of 5,000 ACP member physicians. The survey asked doctors to identify two treatments frequently used by internists that were unlikely to provide high value care to patients.

The CDC itself estimates that as much as one-half of antibiotic use in humans is either unnecessary or inappropriate. An estimated 47 million unnecessary antibiotic prescriptions are handed out in the United States each year, the agency said.

Pressure to fulfill patients’ expectations might be driving some doctors to prescribe antibiotics, Qaseem said.

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ancer cases rose 33 percent worldwide in the past 10 years, a new study shows. In 2015, there were 17.5 million diagnoses and 8.7 million deaths in the world from the disease, the researchers found. The rise in cancer cases was mainly due to population aging and growth, along with changes in age-specific cancer rates, according to the Global Burden of Disease Cancer Collaboration study.

The lifetime risk of developing cancer was one in three for men and one in four for women, the researchers said.

Prostate cancer was the most common type of cancer in men (1.6 million cases), and tracheal, bronchus and lung cancer was the leading

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

cause of cancer death in men. Breast cancer was the most common cancer for women (2.4 million cases), and the leading cause of cancer death in women.

The most common cancers in children were leukemia, other neoplasms, non-Hodgkin lymphoma, and brain and nervous system cancers, said researcher Christina Fitzmaurice, from the University of Washington in Seattle.

The study was published online Dec. 3 in the journal JAMA Oncology.

Cancer is the second leading cause of death worldwide, and statistics such as these play an important role in cancer control planning, the researchers said in a journal news release.

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Teacher Loses 33 pounds, Learns to Love Retirement Many Americans Skip the Dentist Due to Cost Researchers say finding highlights need to overhaul dental insurance

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mericans are more likely to skip needed dental care because of cost than any other type of health care, researchers report.

Working-age adults are particularly vulnerable, the study found.

Some 13 percent reported forgoing dental care because of cost.

That’s nearly double the proportion of seniors and triple the percentage of children for whom cost poses a barrier to dental care, the study showed.

Cost was the main impediment to dental care even for adults with private insurance.

“It seems like medical insurance is doing a better job at protecting consumers from financial hardship than dental insurance,” said study

author Marko Vujicic.

Typically, private dental insurance includes annual maximum benefit limits and significant “coinsurance” — the patient’s share of costs on covered services, Vujicic explained.

He is chief economist and vice president of the American Dental Association’s (ADA) Health Policy Institute in Chicago.

“Anything beyond checkups, like getting a cavity filled or a root canal and a crown, you’re looking right away at 20 to 50 percent coinsurance,” Vujicic said.

Typical fees for fillings range from $86 to $606, according to a 2013 ADA Health Policy Institute survey.

Root canals go for $511 to $1,274. For a crown, the range is $309 to $1,450.

I’m Peg Markham, and I’m retired from the Baldwinsville Schools.

I WORE A SACK For my retirement party, I had to wear a sack. I had thought I looked better than I did in the pictures of the event. I was never able to wear the bathing suit I wanted, never the dress I wanted.

NAGGING PROBLEM I always thought, “My life is perfect, but I’d like to lose 35 pounds.” I exercised daily, but couldn’t control my eating.

PAIN I started getting problems. I had knee and heel problems. High cholesterol. I felt less pretty, less sexy.

I TRIED MANY TIMES I wondered, “What’s wrong with me? I’d give anything to lose weight!”

I tried commercial programs and counting calories. I often lost weight, but it always came back.

DOCTOR-APPROVED I asked my physician. He said he had many patients who had success with Alternative Hypnosis.

I WAS SKEPTICAL I thought I couldn’t be hypnotized. I thought people would

control me. It’s not like that at all.

FREE NO-PRESSURE SCREENING I got in right away for my free screening. I was impressed at how thorough and no-pressure it was. I decided that very day that Alternative Hypnosis was right for me. There was no pressure and everything was explained.

I’VE KEPT 33 POUNDS OFF My heel and knee problems went away. I can bend over again. It’s much easier to do things: housework, walking, shoveling.

My cholesterol came down.

This time, I’ve stayed at my goal weight. After Alternative Hypnosis, I know I’ll never have a weight problem again, guaranteed.

HYPNOSIS HELPED ME DO WHAT I KNEW I NEEDED TO DO Hypnosis helped me to get control of food and increase my exercise. When I need to eat, it’s usually healthy.

REASONABLE FEES To be healthy and the size you want to be the rest of your life is almost priceless.

CALL THEM NOW! I give Alternative Hypnosis all the credit and recommend them all the time. It’s like I’m on a soap box. I never lost weight for good until I went there!

MORE RESULTS….

CONGRATULATIONS

FIRST TO OUR TEAM for putting patients & safety

Thanks to you, Oswego Hospital earned the nation’s top distinction for patient safety with an “A” grade from the Leapfrog Hospital Safety Score. The “A” recognizes our high standards in patient safety.

This honor belongs to every one of our 1200 team members, who work every day for our patients.

Congratulations and thank you.

Oswego Health oswegohealth.org/safety

“So far, I have lost 77 pounds. I recommend this program very highly.” Ella Mae – Machine Operator “I have lost over 90 pounds and changed my life.” Michael Poirier – Customer Service, Clay “After three weeks, I lost 12 pounds and blew my physician away with my lowered blood pressure.” Don McMaster – IT Manager “This time I know I can maintain the weight loss permanently” Melody Mariani – Educator, Syracuse

“Now I’m eating apples again.”

Kathleen Veri - Retired LPNPhlebotomist, Syracuse “I had gastric bypass, and I was sabotaging the surgery. Hypnosis helped achieve the things I wanted with my weight.” Jean Ferguson Retired, Auburn

QUIT NICOTINE, TOO! “I don’t crave cigarettes. Quitting has been so easy, I don’t need their free rehypnosis.” Alexandra – Fitness Provider, Syracuse

The Leapfrog Hospital Safety Grade is an elite designation from the Leapfrog Group, an independent nonprofit that sets the highest national standards for patient safety, quality and transparency in health care.

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315-349-5500

Lose Weight AlternativeHypnosisNY.com January 2017 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 3

CALENDAR of

HEALTH EVENTS

Weight Loss Surgery?

It’s Life Changing…

Jan. 10

Free healthy living classes at Oswego Hospital As the New Year begins, community members who suffer from a chronic disease can learn how to improve their health status. Oswego Health will offer another session of its free healthy living classes at Oswego Hospital. The six-week class will be held from 4 to 6:30 p.m., on Tuesdays, starting Jan. 10 in the hospital’s cafeteria conference room. The program ends Feb. 14th. The program, developed by Stanford University, is designed to help those with any chronic disease, such as arthritis, heart disease, osteoporosis or diabetes to improve their health status. The workshops will cover nutrition and exercise, as well as how to get support, deal with pain and fatigue and talk with your physician and family members about your condition. Participants will learn goal-setting techniques and establish a step-by-step plan to improve their health.

Those taking part in the program will be provided a free workbook and healthy snacks at each class session.

To register, or if you have questions, call 349-5513.

Jan. 11, Feb. 7, March 6

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315-255-7036

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17 Lansing Street • Auburn, NY 13021 Page 4

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? The Cayuga County Office for the Aging will offer complimentary monthly classes to help you make sense of Medicare. You will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches.

You’ll learn about how Part D drug plans work and whether EPIC co-pay assistance is an option for you. If your income is limited, you will receive information about programs to help pay for your insurance coverage, as well as a listing of the free and low cost preventive care under Medicare.

All classes will be held in the basement training room of the Cayuga County Office Building. Classes are scheduled for 2 to 4 p.m. Wednesday,

Jan. 11; from 3 to 5 p.m., Tuesday, Feb. 7; and from 10 a.m. to noon March 6.

Registration is required and all classes are open for enrollment now.

For more information or to register, call the Cayuga County Office for the Aging at 315-253-1226, or visit www.cayugacounty.us/aging under the News & Activities section.

Alzheimer’s group announces new programs Following months of planning and training, the Alzheimer’s Association, Central New York Chapter has launched a number of new support groups in the region. These include traditional caregiver support groups, as well as specialized groups for individuals with early-stage Alzheimer’s disease or other dementia and a Spanish language group.

“We have seen an increase in need for emotional support among Alzheimer’s caregivers in our community,” said Katrina Skeval, chief program officer for the chapter. “What we have also heard is a need for individuals in the disease’s earliest stages to come together in a forum that is mutually supportive.”

New groups in Vestal and Whitesboro will join a group in DeWitt as monthly gatherings for both people with the disease and their caregivers.

These groups, facilitated by trained staff and volunteers of the Alzheimer’s Association, are structured so that individuals with dementia and their caregivers meet in separate groups following a larger group discussion at the beginning of each meeting.

Advance-screening is recommended for the person with dementia prior to attending an early-stage support group by calling 315-472-4201.

The chapter has also partnered with the Spanish Action League in Syracuse, or La Liga de Acción Hispaña, to provide a support group for Spanish-speaking caregivers. The group will meet at the Spanish Action League’s Syracuse office, 700 Oswego St., on the first Wednesday of each month at 6 p.m.

All support groups are free of charge and facilitated by trained individuals. For more information about dates and locations, call 1-800-2723900 or email cny-programs@alz.org.

Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by

Health CNY’s Healthcare Newspaper

Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.

In Good Health is published 12 times a year by Local News, Inc. © 2017 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.) Suzanne M. Ellis • 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.

Cheaper Hearing Aids Coming onto the Market FDA to ease up on hearing aid rules

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etting a hearing aid should be less of a hassle — and eventually less expensive — under new rules introduced by the U.S. Food and Drug Administration.

The FDA said early in December it will no longer enforce a requirement that people aged 18 and older receive a medical evaluation or sign a waiver before buying most hearing aids.

The agency said it will also consider creating a category of overthe-counter hearing aids that could provide innovative and lower-cost devices to millions of Americans.

Currently, a pair of hearing aids typically costs $4,000 or more, putting them out of reach for the majority of older Americans who need them, according to the President’s Council of Advisors on Science and Technology.

“Today’s actions are an exam-

ple of the FDA considering flexible approaches to regulation that encourage innovation in areas of rapid scientific progress,” FDA Commissioner Robert Califf said in an agency news release.

The President’s advisory council and other critics had argued that existing FDA rules were a potential barrier to people getting hearing aids, and provided little to no benefit to patients.

“Untreated hearing loss, especially in older Americans, is a substantial national problem,” the council said in a recent report. Hard-of-hearing seniors face significantly impaired communication, social participation and overall health and quality of life, the report noted.

Changes to the FDA rules, which take effect immediately, could lead to technological breakthroughs that result in less-expensive hearing-aid

options, according to the council.

Although some 30 million people in the United States suffer from hearing loss, only about one-fifth who could benefit from a hearing aid seek help.

The FDA said it will continue to enforce the medical evaluation requirement for prospective hearing

aid users younger than 18.

The agency will also continue to require that hearing aid labels include information about medical conditions that should be evaluated by a doctor. Also, licensed hearing aid dispensers must still give consumers information and instructions about hearing aids before purchase.

Healthcare in a Minute

By George W. Chapman

Merger Mania to Intensify

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he trend will continue at an accelerated pace in 2017 as both hospital systems and commercial insurers engage in “bigger is better” business strategy. As the chess pieces move around, the ultimate impact on consumers will most likely differ from market to market. On one hand, bigger really is better for consumers if consolidation results in improved services, access, outcomes and lower prices due to standardization and economies of scale. On the other hand, bigger is worse for consumers if consolidation results in no improvement in services, access, outcomes or prices due to lack of competition and choice. The Department of Justice looks at all mergers and remains vigilant on behalf of consumers. When bigger is better, rural consumer areas tend to benefit the most, but suffer disproportionality when bigger is worse.

Trump Health Appointees

Tom Price, former orthopedic surgeon turned congressman from Georgia, will head Health and Human Services. He has been an outspoken critic of the ACA and advocates its repeal. The American Medical Association has been guarded about its approval/endorsement of Price as physicians seem split 50/50 over the ACA and are frankly tired of all the volatility and wrangling. For inexplicable reasons, Price is in favor of privatizing Medicare, which works well and increased only 1.7 percent in 2015. Seema Verma, former CEO of Seema Verma Consultants, will head CMS. Interestingly, Verma was instrumental in the implementation of Indiana’s expanded Medicaid pro-

gram (ACA) while Mike Pence was governor.

ACA Repeal and Hospitals

Proving there is far more at stake to repealing the ACA, the American Hospital Association projects a collective loss of $166 billion on net income should the ACA be repealed without an adequate replacement due to the loss of insurance coverage by the 20 million people who receive coverage via the ACA.

Healthcare Ads

If it seems like every other ad on TV is either for a drug, hospital or insurance plan, you’re not far off.

The healthcare industry is solidly entrenched among the top 10 industries when it comes to advertising, according to Kantar Media. Advertising in healthcare totaled almost $10 billion in 2015, which was an 11 percent increase over 2014 spending. Drug advertising accounted for $6.6 billion, hospitals and healthcare systems $2.3 billion and insurance $1.1 billion. The favorite medium was TV where the industry spent over half of the $10 billion. Other media like magazines, digital, newspapers, billboards and radio combined for the remainder of ad spending. So, when pressed, where does the average person turn to for health information? The Internet. According to a survey by Kantar media, three out of four of us research health issues on the Internet.

How Washington Works

Just how things get done (or not) in Washington is exemplified by how the “21st Century Cares Act” (TCCA) became law. Most agree the current heroine epidemic was created largely

by drug manufacturers spending billions to get the medical community to prescribe their opioids. Four of five heroin addicts started out on an opioid like OxyContin. The TCCA commits billions of tax dollars to medical research and $1 billion to states to combat heroin and pain killer addiction, which all sounds good enough. But a bill this size would never see the light day without the blessing of the various lobbyists on the hill, most notably the drug lobby.

A total of 1,455 lobbyists representing more than 400 companies made their client’s views known. As a result, the bill includes reductions in regulations and protocols which the drug industry found too restrictive and costly. While there was broad support for the bill on both sides of the aisle, and from the president, critics see the “compromise” with the drug industry as a blow to consumers who are protected by the protocols and regulations. The FDA will be allowed to expand the use of a previously approved drug, known as going off label, based solely on anecdotal rather than scientific evidence.

Life Expectancy

A recent article in the Wall Street Journal summarized a report by the Centers for Disease Control and Prevention. There was no change in the average life expectancy of all Americans born in 2014 vs 2013. There was a very slight decline in the life expectancy of a white males born in 2014 (78.8) vs 2013 (78.9). Life expectancy is based on the year you were born. The report noted that since 2000, white middle-aged Americans are dying at a rising rate largely due to suicide, drug/alcohol abuse and chronic liver disease. The US ranks only 53rd out of the top 100 countries in life expectancy. Monaco leads the way at 89. We are behind just about January 2017 •

every economically developed country like Italy, Canada, Spain, Sweden, Germany, United Kingdom, France, etc. The good news? We have come a long way. World-wide life expectancy in the Bronze Age, around 3000 BC was 26. In classic Rome times, around 400 AD, it was 20-30. In medieval times, around 1500, it was 35. Just 116 years ago, in 1900, life expectancy world-wide was 31. It has more than doubled to 67 in 2010.

See Your Doctor

The citizens in those 52 countries that rank higher than the US in life expectancy have more contacts with their physician’s practice per year than the average American does. In Japan, for example, they average 13 contacts a year. A “contact” can be through a face to face visit, a phone call, social media, patient portal, telemedicine. In the US, we average only 4 contacts a year. While there can be plenty of reasons why, many feel the biggest reason is simply cost. As premiums spiral upwards, so do deductibles and out of pocket expenses which makes most people think twice about contacting their physician and even put needed treatment off. The grave consequences of being out of touch with your physician are obvious. Make increased “contact” with your physician a resolution for 2017 and live longer.

George W. Chapman is a healthcare consultant who works with hospitals and medical groups.

He operates GW Chapman Consulting based in Syracuse.

Email him at gwc@ gwchapmanconsulting.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

Americans’ Cholesterol Levels

Keep Falling

Meet

Your Doctor

By Chris Motola

Nedim Ruhotina, M.D. New Crouse urologist talks about career, shortage of urologists and the importance of shared decisions when it comes to prostate screening

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liminating trans fats from the U.S. diet may be one factor in this healthy trend, CDC researchers say Healthier diets may be a factor in the ongoing decline in levels of unhealthy blood fats for Americans, new research suggests. According to the report from the U.S. Centers for Disease Control and Prevention, blood levels of total cholesterol, LDL (“bad”) cholesterol, and the blood fats known as triglycerides have continued to fall among adults through 2014.

All of that may be adding up to improved heart health nationwide, with death rates from heart disease also on the decline, the CDC noted.

“Removal of trans-fatty acids in foods has been suggested as an explanation for the observed trends of triglycerides, LDL-cholesterol levels, and [total cholesterol] levels,” wrote a team led by CDC researcher Asher Rosinger.

These trends “may be contributing to declining death rates owing to coronary heart disease since 1999,” the study authors suggested.

One cardiovascular specialist was heartened by the news.

“Although heart disease remains the No. 1 cause of death, we have made tremendous strides in lowering the number of people at risk,” said physician Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York City.

“As this study shows, through prevention and education we have helped lower cholesterol; a key risk factor in heart disease,” he said.

Average total cholesterol fell from 204 milligrams per deciliter (mg/dL) of blood in 1999-2000 to 189 mg/dL in 2013-2014. Between the relatively short span of 20112012 to 2013-2014, average total cholesterol levels plummeted by 6 mg/dL, the authors noted.

Average triglyceride levels also decreased — from 123 mg/ dL in 1999-2000 to 97 mg/dL in 2013-2014, with a 13 mg/dL drop since 2011-2012.

Average LDL “bad” cholesterol levels fell from 126 mg/dL to 111 mg/dL during the study period, with a 4 mg/dL drop between 2011-2012 and 2013-2014, the CDC reported.

The study was published online Nov. 30 in the journal JAMA Cardiology.

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Q: Give me an overview of your specialty and the patients you see.

A: I’m a urologist. I see patients with benign and malignant urological conditions, both men and women. I specialize in minimally invasive methods. So I do robotic and laparoscopic surgery on prostate cancer, kidney cancer and bladder cancer. I also see men with malehealth related issues like testosterone, erectile function, BPH issue. So I see a pretty wide range of issues. I deal with kidney stones as well.

Q: It seems like urology is the closest thing men have to an OB/GYN specialty.

A: Yeah, urologists do see men and women since kidney and bladder issues affect both genders.

We do see more men, though, since we also deal with a lot of prostate issues, as well as erectile dysfunction and male infertility. We do develop a very close, long-term relationship with our patients. So we do get viewed as men’s health doctors fairly often. The important thing about men’s health is that we evaluate overall health since general health issues often have an effect on urological health issues.

Q: Is there an element of primary care in your specialty?

A: Most of

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

our patients are referred to us by primary care, but there is an element of screening — prostate cancer screening — to our specialty.

Q: There was a lot of debate recently as to the value of prostate cancer screening. Has there been much movement on that?

A: Prostate cancer screening has evolved over the last few years, certainly. We as urologists feel the patients should have as much information as possible as to whether or not prostate cancer screening is appropriate for them.

We do recommend shared decisionmaking between the patients and their physicians in patients who are at average risk between the ages of 55 and 70, and in higher-risk patients who have a family history, or are African American men. So we recommend engaging in a screening discussion earlier than that.

It can save lives with the right patient, but that process should between discussed.

Q: You’re relatively new to Crouse.

What brought you to Syracuse?

A: I had a great opportunity after training with AMP [Associated Medical Professionals], a large urology group practice based in Syracuse, so I was already here. The opportunity combined with my wife being from the area made it good for both job and family reasons. Crouse

has a large minimally invasive program, so it’s a great place for me to transition into a practice.

Q: As I understand it, urologists are pretty rare. Did you have more offers than you knew what to do with?

A: In general, I think you’re right. Around only 300 urologists are trained every year. Overall the number of urologists per capita in the U.S. is lower than what we need ideally. With the aging baby boomer population, the demand is increasing, especially outside of major metropolitan areas. In smaller, more rural areas, the need can be really high. In Central New York, there’s definitely a need overall. I saw a lot of demand in the Midwest and the South as well.

Q: Do you think it’s more a matter of there being a limited number of slots available, or that it’s not that popular with medical students?

A: It’s not so much that there aren’t people interested in going into it. I think the average number of medical students interested in urology is increasing, but the chances of matching in your urology specialty is becoming more competitive. The issue is that the number of spots is limited hasn’t really increased over the last 10-15 years. It takes at least five years to become a practicing urologist, so there’s going to be a delay in meeting the demand. So there are a lot of nurse practitioners and physicians assistants with urology training who are helping meet some of the demand in the meantime for outpatient urology care.

Q: Do you tend to deal with kidney stones from more of an interventional or preventive perspective?

A: We have guidelines on preventive management of kidney stones. They’re pretty common.

Between one in 10 and one in 15 Americans will develop a kidney stone in their lifetime. One thing we recommend is that patients stay well hydrated. To drink two to three liters of water a day. Minimize your salt intake. Minimize the amount of animal protein you eat, increase fruit and vegetable intake. We always tell patients that lemonade is shown to help. If you have kidney stones, you should talk to a physician to see if you might have any stone-forming risk factors. So we really do try to focus on lifestyle factors initially.

Lifelines Name: Nedim Ruhotina, M.D. Position: Attending urologist at Crouse Hometown: Burlington, Mass Education: Cornell University (undergrad); Vanderbilt University School of Medicine (medical); Brigham and Women’s Hospital (internship); Harvard Program in Urology (residency) Affiliations: St. Joseph’s; Community General Campus Organizations: American Urological Association Personal: Fluent in Serbo-Croatian, German. Working knowledge of Danish and medical Spanish Family: Married (to an internal medicine physician at Upstate) Hobbies: Skiing, basketball, golf, biking, running, tennis

Virtual doctor working remotely to check patient’s blood pressure and X-rays.

Scenes like this will likely be more common starting this year. Excellus BlueCross BlueShield and other insures are introducing platforms that will allow virtually anyone to consult with a doctor remotely.

Telemedicine Visits in Upstate NY Likely to Surge This Year

Excellus BCBS predicts a rapid rise in the use of telemedicine starting this year

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pstate New Yorkers will embrace telemedicine as an alternative to getting care for minor conditions this year and it’s expected to use that option more than 50,000 times by the year 2018, Excellus BlueCross BlueShield officials recently predicted.

Relying on national studies, local projections and preliminary results from a pilot program of its own employees’ use of telemedicine, the health plan said a surge in the use of telemedicine is likely to begin in 2017 and grow rapidly every year through the remainder of this decade and beyond.

“Ideal medical care is when a patient sees his or her physician face-to-face, and both know and trust each other, but in our rapidly changing and fast-paced world, some of those face-to-face visits can’t always take place,” said physician Richard Lockwood, vice president and chief medical officer of Excellus BlueCross BlueShield’s Central New York region.

“Telemedicine is an alternative that is in place and will gain popularity across the country,” Lockwood said. “It allows people in rural areas to see specialists in urban settings. It serves the needs of patients who find it difficult to get out of work to see their doctor when they need to address a problem for themselves or their children. And, it’s a speedy alternative to going to an urgent care center or even the hospital emergency room for minor medical conditions.”

Wil-Care

Historical advances in clinical decision-making; the evolution of customer-friendly technology applications for smartphones, tablets and computers; and more people having high-deductible health policies are the most frequently cited reasons driving the trend. Remote medical care, known as telemedicine, is when the patient and the provider are in two different locations, but are linked by telephone or a secure twoway video connection.

While telemedicine services are available to anyone with or without health insurance, easy-to-use platforms are being built into most health insurance offerings throughout upstate New York. Starting Jan. 1, MDLIVE will be the platform offered

by Excellus BlueCross BlueShield to all privately insured and Medicare Advantage members as their new enrollment or re-enrollment begins.

“There’s an old adage that you should be skeptical of chefs who don’t taste their own cooking,” Lockwood said. “With that in mind, Excellus BlueCross BlueShield ran a pilot program that encouraged our employees to register themselves and family members with MDLIVE. The responses we received for getting this benefit and using it were overwhelmingly positive.”

Among registered employee users, about 8 percent made use of the telemedicine option. More than half said they would have gone to an urgent care center or the emergency room for a minor condition if the telemedicine option hadn’t been available.

Medicaid Eligible for Free Taxi for all your Medical: Doctors, Therapy, Counseling, Labs, X-rays & MRI

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Upstate's program was assessed in a number of areas including the quality of orthopedic surgery and surgical outcomes, post-surgical follow-up, and shared decision-making between a patient and their health care team. Additionally, Upstate was recognized for its exceptional patient education and speciality joint anesthesia program, designed to provide maximum patient comfort during the recovery process.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

GMO Labeling Law to allow labeling GMO food doesn’t please critics or supporters

By Deborah Jeanne Sergeant

I

n August, President Obama signed into law a requirement for labeling designating foods containing genetically engineered ingredients, often referred to as genetically modified organisms (GMOs). But it seems that the measure doesn’t please either those who support or denounce the use of GMOs. Many critics of GMOs believe the labeling is inadequate since food packers and manufacturers need only include wording about the GMO ingredients, a QR code or a toll-free phone number to access more facts.

In the latter two labeling types, consumers must seek the information themselves.

Foods that are processed from genetically modified crops and contain only traces of genetically modified material may bypass the labeling.

A part of the American diet since 1996, genetically modified foods are from plants that have been grown from seeds with altered DNA. The changes help plants resist pests, promote positive traits (such as non-browning apples) and resist herbicides used around crops.

Since they appeared in U.S. markets, “we have not seen any specific pattern of GMO-related diseases,â€? said physician Maxime BĂŠrubĂŠ facility medical director at St. Joseph’s Health. “There are, however, some studies suggesting that some of the GMO toxins pass from the mother to the fetus. “As you can see, the issue is very complex. While it is too early to form a valid scientific answer, I would err on the side of caution. Whenever possible, try shopping at local farmers markets for organic produce and buy meats from local sources, as

well.�

Some opponents of GMOs blame over-use of Roundup, a commonly used herbicide, as one reason they believe genetically engineered crops harm people, since crops that can resist Roundup may be freely treated with the herbicide.

Steve Ammerman, representative of New York Farm Bureau in Albany, contests this viewpoint.

Roundup is “is one of the most mild herbicides. You can buy it at Wal-Mart and put it on your driveway.�

But as for over-using herbicide or engaging in off-label use, Ammerman said that’s unlikely since farmers try to reduce their overhead as much as possible and herbicide costs them money.

He believes that genetical engineering is a safe way to grow food. “There have been more than 2,000 studies that have shown there’s no greater risk to human health to crops grown with genetic engineering than those traditionally bred,� he said. “The National Academies of Science has released a study. It was a very wide reaching analysis of the information and it supported what an overwhelming number of scientists believe. It spoke a lot to the safety of GMO crops.�

Available at https://nas-sites. org/ge-crops, the study stated that only about 12 percent of the world’s farmland is planted with genetically engineered crops. Few crops are predominately available and widely planted as genetically engineered.

They include soybeans, cotton, corn, and canola. Sugar beets, summer squash, and papaya aren’t as widespread. A few other crops, such as non-browning apples and potatoes,

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“Complete avoidance of these [GMO] foods can become a difficult and expensive endeavor, and there is limited evidence to support either position regarding whether they are safe or not.�

Physician Maxime BÊrubÊ, St. Joseph’s Health are still pretty rare as genetically modified types.

Ammerman said that labeling foods as containing or not containing genetically engineered ingredients can lead consumer to think that “GMO� means “unsafe.� “That’s been a concern of agriculture for quite some time,� Ammerman said. “A mandatory GMO label is seen as a skull and crossbones.

There has been a lot of misinformation. There has been fear bred in consumers.�

He added that some foods that have never been available as genetically engineered is now being billed as “GMO-free� which he believes is misleading.

“It’s marketing and trying to take advantage of the trend of the moment and some consumer bias one way or another,� Ammerman said. “It’s like ‘fat-free’ or ‘natural’ or ‘gluten-free.’�

A statement on Farm Bureau’s webpage about GMOs reads, “Technology allows farmers to produce more food, using less land and few chemicals, while conserving soil, water, and on-farm energy.�

But farmers can choose nonGMO seeds if they wish. “Farmers have a choice,� Ammerman said. “Most corn grown is GMO, but there is non-GMO corn available that you can plant for organic or conventional use.�

He views genetically engineered seed as helping farmers cope with environmental fluctuations and challenges of areas stricken with drought or other problems. “A GMO seed has an average of 13 years of testing before it goes into the market,� Ammerman said. “There’s more testing on seeds than pharmaceuticals.�

While the viewpoints on genetically engineered foods vary, BĂŠrubĂŠ said that science doesn’t clearly associate them with any health dangers. “Complete avoidance of these foods can become a difficult and expensive endeavor, and there is limited evidence to support either position regarding whether they are safe or not,â€? BĂŠrubĂŠ said.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

WANDERERS’ REST HUMANE ASSOCIATION NEEDS YOUR HELP

Linda Jackson, president of the Cicero American Legion’s Auxiliary.

LIVES SAVED THROUGH GENEROSITY OF OTHERS

Every day the flood of orphaned and homeless animals arrive needing help. Some are abused, neglected or abandoned. Your support is critical because without it we could not accomplish the responsibility that comes with preparing these homeless sweet souls for a new life and a better chance.

Please do not wait to send your financial support. Please do it NOW, for every day another one awaits.

We will continue to provide each one with the love, care and opportunity they deserve.

But we need every one who care enough to help us do exactly that.

Bundles for Babies Brings Joy to Service Member Families

By Matthew Liptak

B

undles for Babies is a program to support service members’ families with baby clothes and other items made possible by the American Legion chapter in Cicero.

The effort has been going on for the last 15 years.

In the last three years the legion has given away about 1,000 items to families in need, according to Linda Jackson, president of the Cicero American Legion’s Auxiliary.

“Bundles for Babies is where people will knit or crochet,” she said. “We’ve had people make baby quilts, sweater sets. We also accept donations like onesies, high chairs and strollers. We take them up to Fort Drum. We take them to the ninth floor of the VA women’s clinic. They have gone to Korea also.”

Those donating need not be a member of the auxiliary or even the legion to participate. Jackson has been trying to grow the program — soliciting donations far and wide.

Not so long ago the group received 70 baby quilts from a women’s group from Rochester. The group became aware of the effort through social media.

Jackson said moms who receive the clothes and other items are very appreciative. They are living on something of a fixed income, she said. When their spouses go overseas they do not have access to their hus-

bands paychecks in many cases.

That’s especially the case at Fort Drum.

“Up there they have the family unit,” Jackson said. “The woman [an auxiliary member], goes once a week to the hospital there. Sometimes they could have 20 women. Their husbands are deployed and they have no family.”

The program is so vital that Jackson hopes the headquarters of the American Legion will spread it nationally. There’s definitely a need beyond this area’s fifth district of the Legion, she said.

“Right now they have a hold on it,” she said. “I have sent [letters] in, but our state president is in fifth district. She’s trying to push it. I really do think it’s a good idea.”

Although the auxiliary, made up all of women, has 293 members, the program is always looking for help in gathering and making items for the service families.

As for her, she said she’s going to keep plugging away at helping those who serve us. Her father was a WW2 and Korean War veteran.

“I was always taught to pay it forward or pay it back,” she said.

“That’s why I got involved in the auxiliary.”

For more information about the Bundles for Babies, call Jackson at 315-699-2748.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

Change Two Lives...

Yours and a Child’s

Live Alone & Thrive

Practical tips, advice and hope for those who live alone Become a Foster Parent Create an Inviting Today ‘Table for One’ in 2017

By Gwenn Voelckers

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ith the hustle-bustle of the holidays behind us, January can bring a welcome respite and some nice, quiet time to yourself.

Until, of course, all that desirable alone time becomes, well, less desirable.

For those who live alone, dining solo can present one of the biggest challenges.

And it’s no wonder.

For most of humanity dining is a social activity.

We enjoy sharing our meals with loved ones, friends and colleagues.

So when we find ourselves alone at the dinner hour, it can feel a little uncomfortable, even lonely. It’s not unusual to fill in the awkward silence with distractions: the company of TV, the comfort of a good book or the diversion of a favorite magazine.

Believe me, I’ve been there. I can’t tell you how many of my favorite books contain food crumbs. But I’m not complaining. Good reading material can be a great dining companion. But it represents just one ingredient of the solo dining experience.

While living alone gives us the freedom to dine as we please (one of its many benefits), I don’t recommend eating breakfast for dinner or munching through a bag of Cheetos as a substitute for a healthy, well-balanced meal.

When it comes to eating alone at home, treat yourself as you would treat a good friend you are having over for dinner. Why? Because you are worth it. Because you will feel better about yourself, both physically and emotionally.

When you prepare and enjoy a good meal on your own, you’ll be sending yourself a valuable message: It’s important to take good care of myself and to treat myself with respect. I matter enough to treat — and feed — myself well.

Eating well and right has all kinds of benefits. And what better way to start enjoying those benefits than by creating an inviting “table for one” in your own home. In fact, why not consider the tips below and give it a try today?

n Stock your kitchen with healthy food. It’s so much easier

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Page 10

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

to put a healthy meal on the table when the good stuff is plentiful and the junk food is in short supply. I’m fully aware of my own downfalls (ice cream, nuts, sweets, chips) and do not regularly stock these items in my kitchen.

Instead, I have on hand a good supply of frozen and fresh vegetables, prepackaged salad greens, fruits in season, and single-serve portions of frozen meat and fish. You’ll also

find plenty of grab-and-go “power” bars in my pantry for when I’m on the run.

n Indulge your senses.

Stimulate your appetite by preparing an item or meal that produces a wonderful, delicious aroma. My secret? I love the scent of sautéed garlic, and jumpstart many a solo dining experience with a little butter and garlic in my stove-top skillet.

The aroma invites me into the cooking process and within minutes the worries and stresses of my day start to melt away.

I also try to incorporate foods with a variety of textures and color — soft, chewy, crisp, and firm — into each meal. These touches serve to make the dining experience more interesting and pleasant.

n Select the best seat in the house. While eating in front of the

TV may be the perfect choice on some occasions, I encourage you to find dining spaces inside or outside your home that may offer more inspiration.

Chances are, you’ll appreciate the change of scenery. Consider that special nook where the sun filters in or that table by the window with the great view. Mix it up, experiment with different settings, and see how much better it feels. n Set the stage. Create a pleasing table setting and mood: put down a placemat, use a cloth napkin, turn on some enjoyable music, and position a good book, magazine or tablet computer within reach. You might even light a candle. I do.

If you’ve never set the stage like this before, it can feel contrived at first, but stay with it. Over time, I’m

confident you’ll find it as enjoyable and relaxing as I have.

n Enjoy your own company.

When you eat alone, you’re in the company of someone special — yourself! You are with someone who approves of your meal choices and cooking techniques, appreciates the candle you lit, and knows that life and good food are to be enjoyed.

Cherish this quality time with yourself.

Creating a pleasant “table for one” is a great opportunity to focus on yourself and to nourish your body and spirit at the same time. So, pull up a chair, say a few words of gratitude, and enjoy!

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

How I Quit Smoking After 40 Years ‘Trying to quit as a senior citizen turned out to be quite different from all those attempts in my younger years’

By Suzanne M. Ellis

D

o you think that because you’re in your 50s, 60s, 70s — or beyond — that it’s too late to quit smoking? Have you tried and failed so many times over the years that you believe it’s a hopeless venture? Do you tell yourself you’ve smoked so long it won’t make any difference?

Over the past few decades as a smoker, I’ve felt all of those things and then some. I’ve rationalized many times all the excuses why I shouldn’t even bother attempting to quit. But three and a half years ago, I decided to try one more time, and I’ve been a non-smoker ever since.

I realize now that all that rationalizing was just more excuses. And, believe me, I know all about excuses because I smoked for the better part of 40 years and gave myself every reason in the book why I couldn’t or wouldn’t or shouldn’t stop.

Even the on-again, off-again health scares weren’t enough to convince me: Not the annual bouts of pneumonia or bronchitis that became ever more debilitating as I aged. Not the chest X-ray six years ago showing “dark spots” on my lungs, and not the eventual diagnosis of early-stage emphysema. Not even the untimely (and most likely preventable) death of my beloved mother, who smoked for 60-plus years and suffered with chronic obstructive pulmonary disease, could convince me to stop.

I thought constantly about quitting (don’t we all?), especially in 2013 when I plopped $9.70 on a store counter for my daily fix of Marlboro Lights in a box.

When I reached my 60s, I also began to think a lot about my mortality and the time I had left. I knew that smoking a pack a day, or sometimes more, wasn’t going to help me live longer, and I often played that public service announcement in my head, the one that ends with, “It’s never too late to stop.”

The encouraging news I’d like to share is that trying to quit as a senior citizen turned out to be quite different from all those attempts in my younger years. For starters, I was retired. Although I still work from home and my retirement is an active one, when push comes to shove, I’m pretty much the one who controls the content of my days.

Unlike in the past, if the cravings got to be too much I could close the blinds, lock the doors and spend the day in bed or on the couch watching television. If I needed to get away from my regular routine — some-

thing that’s extremely important when you’re trying to quit — I could go to the movies at 11 o›clock in the morning. I could lose myself in a museum or the shelves of a library or bookstore until the madness passed.

I could walk around the block anytime I needed to get out. I could do whatever it took to survive the desperate pangs of withdrawal, especially during those first seven days, which are so crucial to success. When we are working full-time, those options are not generally available to us and it’s easy to fall prey to the stresses of confinement.

Another thing that was different this time is that I had a prescription for Chantix, a relatively new drug that helps significantly with cravings. Yes, I read all the warnings about the possibility of nightmares and other uncomfortable or dangerous side effects. But if you read the fine print on just about any effective drug these days, those warnings are equally frightening. I was fortunate; I used Chantix faithfully for six months and suffered no ill effects.

The only change in my dreams was that I began to dream in color, which was a rather pleasant experience.

I was also helped by using Nicorette gum, starting with 4 mg pieces and eventually reducing the dosage to 2 mg. That, too, was a different experience from years past. The original (and the only nicotine gum available at the time) was quite distasteful. Today, the flavors include White Ice Mint, Fruit Chill, Cinnamon Surge and Fresh Mint, to name a few. All are far more palatable than the original, and they are also a great help with cravings.

Those things, combined with the best tricks I learned over the years to fight the urges, have resulted in more than three smoke-free years.

Drink lots of water, treat yourself in some way every day, change up your routine, avoid the “triggers,” those activities you associate with smoking. If you always have a cup of coffee at the kitchen table with your first cigarette of the day, take your coffee elsewhere.

If you always smoke when you’re sitting at the computer, use a library’s computers for a few weeks. Shake

things up; it really helps to break the grip of nicotine.

I recently saw a pulmonary specialist and underwent a series of tests, and I was told there are no longer signs of chronic obstructive pulmonary disease. The shortness of breath I was experiencing has lessened, and I am sleeping better than I have in years. While I still take medication for high blood pressure, it is now consistently lower than it has been in many years. I’m also saving more than$ 3,500 a year by not buying those Marlboro Lights every day, and that’s a big help when you’re living on a modest fixed income.

Sure, there are times I miss smoking, and I probably always will.

But those thoughts are just thoughts, not cravings, and they pass quickly as I remind myself how much healthier I’ve become in just a few, short years.

Let’s face it, being a smoker these days is embarrassing, not to mention it has become almost impossible to find public places where it’s legal to smoke.

So why not give quitting one more try? Now that you’re older, I think you’ll be pleasantly surprised at the difference. And what a difference it will make in your life.

Suzanne Ellis is a freelance writer who retired after more than 30 years as a professional journalist. She lives in Baldwinsville, N.Y. January 2017 •

Never Too Late to Stop Smoking Even quitting in your 60s can add years to your life, researchers find You’re never too old to reap the health benefits of quitting smoking, a new study finds.

“Even participants who quit smoking as recently as in their 60s were 23 percent less likely to die during follow-up than those who continued to smoke into their 70s,” said lead researcher Sarah Nash, who conducted the study while at the U.S. National Cancer Institute.

In addition, the age at which you start smoking can have an impact on longevity, the researchers found.

“This study confirms that age at smoking initiation and cessation, both key components of smoking duration, continue to be important predictors of mortality in U.S. adults over age 70,” Nash said.

“It also underscores the importance of measures to prevent initiation, as well as encourage cessation, for all smokers,” she added. Nash is currently with the Alaska Native Epidemiology Center at the Alaska Native Tribal Health Consortium in Anchorage.

Nash’s team found that smoking, which is known to be an important predictor of early death among middle-aged smokers, was also strongly related to early death from smoking-related causes among those aged 70 and older.

Compared with those who had never smoked, people who still smoked when they were 70 and older were three times more likely to die during the six-year study period, Nash said.

In addition, among current smokers, the age at which they started smoking was linked to an increased risk of smoking-related death, Nash said.

“Smokers who started smoking earlier in life were at increased risk of death, as were those who smoked more cigarettes per day over the age of 70,” she said.

“Regardless of their age, all smokers benefit from quitting,” Nash added. “Also, smoking patterns early in life may still affect mortality even 50 to 60 years later. So, it is important to support efforts to prevent adolescent smoking initiation.”

The study findings were published Nov. 30 in the American Journal of Preventive Medicine.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

SmartBites

The skinny on healthy eating

Why Haddock is a Nutritious Catch

E

very fish has its hook and…its sinker. Some, like shrimp, are high in muscle-building protein, but then also potentially high in contaminants if farm-raised in undesirable conditions. Others, like white tuna, keep our bodies humming with energizing B vitamins, but then also give us pause with high mercury levels. Still others, like salmon, are omega-3 superstars, but then not such bigwigs on the fat and calorie front.

It’s all relative, especially when it comes to your individual needs.

Come January, with the eating season officially over and resolutions on the upswing, many of us desire to cut back on calories and feel more fit.

Eating lean protein, such as fish, is universally recommended by nutritionists and leading institutions alike.

My family’s go-to fish in January (and throughout the year) is haddock.

Mild-tasting and reasonably priced, this flaky white fish teems with good things. An average 3.5-oz serving has only 112 calories, scant fat, a whopping 24 grams of protein and healthy doses of three B vitamins: niacin, B6, and B12. All together, these B vitamins strengthen our immune system, convert food to energy, keep our nerves in tiptop shape and help make red blood cells.

Another nutritious hook? Haddock rocks with impressive amounts of two essential minerals: phosphorous, which helps form and maintain healthy teeth and bones; and selenium, a powerful antioxidant that helps prevent cell damage and that may also prevent certain cancers.

As for mercury levels, haddock routinely makes the “lowest levels” list, according to the Natural Resources Defense Council. Mercury can impair the neurological brain development in fetuses, infants and children, which is why children and women of childbearing age are advised to limit their exposure to “high mercury” fish.

Wondering if haddock has any “sinkers”? Well, much like sole, snapper and flounder, haddock is no great catch when it comes to the almighty heart-healthy omega-3s. Alternating haddock with a fish that’s high in this fatty acid, like salmon, works for our family.

Helpful tips:

Fresh fish should be cooked within two days, up to three at most, from the time it was purchased (it’s best though to cook it the day you buy it).

Once cooked, any leftover fish remains good for three to four days.

Frozen haddock, like other lean white fish, typically lasts between six to

Top Eight American Pizza Habits

eight months. The key to keeping haddock’s calorie and fat content low is in its preparation: grilled, broiled or baked versus breaded and fried.

Italian-Style Baked Haddock Adapted from Bon Appetit; serves 4 2 tablespoons olive oil 1 small onion, chopped 2 cloves garlic, minced 1 8-oz. pkg. sliced mushrooms, hard stems removed 1 yellow or orange bell pepper, chopped 1 teaspoon dried basil or 1 Dorot basil cube* 1 14.5 oz. can petite diced tomatoes, drained ¼ teaspoon red pepper flakes (optional) Salt and pepper to taste 1½ pounds haddock fillets 1 cup shredded mozzarella or cheese of choice Preheat oven to 350°F. Lightly oil a nine-inch glass baking dish. Heat olive oil in large skillet over medium-high heat. Add onion, garlic,

A

mericans consume 350 slices of pizza every second, and 15 percent deem it their top comfort food. In the November issue of Food Technology magazine associate editor Melanie Zanoza Bartelme outlines eight American pizza trends, preferences and consumption habits.

1

Over half (58 percent) of U.S. pizza eaters say they would buy more frozen pizza if it had more premium or gourmet ingredients.

2

Pizza consumption in restaurants is trending at its highest level in the past four years . Seventy-six percent of consumers have eaten at a pizza restaurant in the past 12 months.

3

Pizzas are trending toward thinner crusts and half of consumers prefer to go thin. Hand-tossed, however, is the No. 1 crust type found on restaurant menus, preferred by 57 percent of consumers.

4

Another trend in pizza crust centers on gluten-free. Gluten-free launches increased 58 percent between 2012 and 2015.

5

Tomato-based red sauce remains the most common topping on pizzas, but nontraditional sauces such as Page 12

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

mushrooms, bell pepper and basil and sauté until vegetables are tender, about 10 minutes. Stir in tomatoes and red pepper flakes. Season with salt and pepper, and cook for five to eight minutes more, stirring constantly, until slightly thickened. Arrange fish in prepared dish. Pour sauce over.

Sprinkle mozzarella on top. Bake until fish is cooked through, about 25 minutes. Pair with rice or linguine. *Dorot basil cubes are a convenient, economical way to add the taste of fresh basil to dishes. They come 16 to a tray and can be found in the frozen section of most major grocery stores.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com. ranch, alfredo and white sauce are also appearing.

6

Mozzarella is the most commonly used pizza cheese, with 71 percent, with ricotta and Parmesan at a distant two and three (35 percent and 32 percent, respectively), but alternate cheeses are on the rise. These include goat, gorgonzola, fontina, Romano, asiago, provolone, feta, and even pepper jack gaining traction. In addition, preference for gouda is increasing, and it is among the fastest-growing cheeses on restaurant menus.

7

Sausage and pepperoni are still the top meats, being featured on 73 percent of restaurant menus, but bacon is also widely available, and chicken breast is up 22 percent, likely due to its perception as a healthier meat. Prosciutto is growing, up 27 percent since 2010. Other emerging meat toppings include meatballs, salami and anchovies (Packaged Facts 2015).

8

Onion, tomato, mushroom and peppers are featured as pizza toppings on at least 73 percent of restaurant menus.

Meet Your Provider

Health Navigation of CNY Agency helps patients and their families find their way during a critical illness

Q. What is a private patient advocate?

A. A private patient advocate works for YOU. The medical delivery system is fast-paced and complex, and is largely driven by insurance procedure codes. An advocate can help you navigate the system to ensure that your needs are addressed and that you are comfortable communicating with your healthcare providers and making treatment decisions. An advocate will help you to understand your diagnosis and treatment options and empower you with confidence as you go through your healthcare journey.

Private patient advocacy is a fastHealth Navigation of growing profession CNY is a private patient throughout the advocate consulting country. I am one practice established by of 650 members Carrie Scholz. of the Alliance of

Professional Health Advocates, an organization for professional, independent patient advocates throughout the country.

Q. Does insurance cover this service?

A. Insurance does not cover the services of private patient advocates. A private advocate works for you and is an out-of-pocket expense.

There are also advocates who work for hospital systems or health agencies. These advocates can be very helpful. They are however, working for their employers and thus are limited in their scope and range of resources.

Q. What qualifies you to be a patient advocate?

A. Currently there is no recognized set of Q. How do you help your clients? credentials to be an advocate. The Patient AdvoA. I help my clients navigate their way cate Certification Board is developing a national through the healthcare system and become better standard for a “Board Certified Patient Advocate” informed and proactive healthcare consumers. and expects to implement this in 2017.

Some activities include: I am a licensed master social worker with • Researching diagnoses and treatment opmore than 30 years of experience practicing as tions to help understand choices and decisions. a medical social worker and patient advocate • Preparing for medical appointments by in hospital, home care and agency settings. I formulating goals and questions for the healthhave experienced the healthcare system as a care team. professional, a family member/caregiver and • Accompanying clients to appointments for as a patient. These experiences have fueled my support, providing a “second set of ears” and passion to help individuals gain a sense of control offering assurance that questions are answered. through their own healthcare journey.

Making sure they understand the diagnoses and that they know the plan and the next steps.

Q. How does someone know if working with a • Facilitating access to services and benefits. private patient advocate is right for them?

• Supporting clients and their loved ones.

A. The best thing to do is to contact me to • Helping access relevant resources during discuss your individual situation. I typically contreatment. sult with potential clients by phone to get a sense • Exploring clinical trials when applicable. of their circumstances and provide information • Helping clients feel more in control of their about how I might help. The phone consultation healthcare futures. is free and generally takes about 30 minutes.

Carrie@HealthNavigationofCNY.com • 315-436-3526 • www.HealthNavigationofCNY.com

My Turn Have You Walked Over Shards of Glass?

That’s How a Person with Gout Feels Like

By Eva Briggs

O

uch! Imagine walking on shards of glass with every step. That’s what happens in gout. It’s a form of arthritis where sharp crystals form in the fluid that is supposed to lubricate your joints so they can glide smoothly.

Uric acid, the chemical in those painful crystals, forms as part of the normal breakdown of purine, a protein building block. Some people are genetically predisposed to accumulate high levels of uric acid in their blood. Environmental factors such as diet, male sex and increased age also contribute to the risk of gout.

Gout attacks usually develop rapidly. The pain typically starts at night and becomes severe over two to four hours time. The affected joint turns red, hot, painful and exquisitely tender. The most common location is the first metatarsal pha-

langeal joint, where the big toe meets up with the foot. Even the pressure of a blanket at night can be too much.

There are three mainstays of treatment for acute gout episodes.

Steroids such as prednisone can combat the inflammation and pain.

NSAIDs (non steroidal anti-inflammatory drugs) are also effective. A prescription NSAID called indomethacin is one popular gout remedy, but often over-the-counter NSAIDs such as ibuprofen or naproxen work as well. A third option is the drug colchicine. In the past doctors prescribed high doses that caused diarrhea but we now know that much lower doses are effective. At one time colchicine was a relatively inexpensive generic but now it is available only as the costly brand-name drug Colcrys.

There is no one simple test to confirm or rule out gout. The gold standard is to put a needle into the inflamed joint and remove fluid for

microscopic examination for uric acid crystals. But it’s not always easy to aspirate fluid from a small joint.

And it’s painful for the patient. Blood work can show an elevated uric acid level. Sometimes uric acid falls to the normal level during an attack, so a repeat test after recovery may be needed. One new technique is to perform ultrasound on the inflamed joint. It’s not perfect but can identify about 3/4 of patients with gout.

It’s important not only to treat gout attacks, but to lower the uric acid level in the blood between attacks. Untreated longstanding gout can lead to permanent joint damage.

And urate crystals may be deposited into the skin forming tophi — hard nodules filled with a chalky material.

Uric acid can also form kidney stones which are painful and potentially damage kidney function.

Since uric acid is formed from purine produced by protein metabolism, a low purine diet is the first step. Organ meats (liver, kidney, sweetbreads) and certain kinds of seafood are out. Alcohol, especially beer, also seems to promote gout attacks.

The Mayo Clinic has a good online resource about diet in gout: www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/ in-depth/gout-diet/art-20048524.

January 2017 •

Several types of medicine can lower uric acid levels. Usually these medicines aren’t started until a patient has had more than one gout attack. The goal is to bring the urate level to less than 5-6 mg/dL. Although recently the American College of Physicians came out with new guidelines suggesting that physicians only need to treat until gout attacks disappear. That’s directly at odds of the recommendation of the American College of Rheumatology whose guidelines endorse lowering the uric acid level to the goal level.

Gout has been around for a long time. It was first described in Egypt in 2,600 B.C. The name gout was first used in 1200 A.D. It derives from the latin word gutta, meaning drop. Allegedly this is because gout was ascribed to “the notion of the ‘dropping’ of a morbid material from the blood in and around the joints.”

Since a picture is worth 1,000 words, check out the drawing from 1799 by James Gillray, who illustrated gout as a demon gnawing at his foot: https://commons.wikimedia.org/ wiki/File:The_gout_james_gillray.jpg

Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated

by Oswego Health.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 13

Fighting Against Blindness Caused

by Glaucoma

By Matthew Liptak

U

pstate’s Ophthalmology chairman, physician Robert Fechtner, 59, has spent his career working to make sure people in Central New York and around the world don’t lose their vision to glaucoma.

Fechtner, who lives in Fayetteville, has also been the executive vice president for the World Glaucoma Association for the last five years. He recently received the lifetime achievement award by the American Academy of Ophthalmology, primarily for his work in education and clinical research.

Those are lofty achievements, but the doctor has a driving passion that is just as ambitious.

“I’m passionate about glaucoma because there is so much more we need to understand to be able to eliminate visual disability around the world from glaucoma,” he said.

The ophthalmologist seemed to be shepherded to his line of work by fate.

“Life always has its coincidences,” Fechtner said. “When I was a medical student I met our chairman of ophthalmology at the University of Michigan who was a glaucoma specialist. He later helped steer me toward one of the pioneers in computer imaging of the eye — Bernard Schwartz. Schwartz was using stereo photographs like you would see in a Viewmaster, taking pictures of the optic nerve and then using military map-making computers to measure them. It was a really innovative approach to understanding changes to the optic nerve over time.”

Many people might think that glaucoma is a dangerously high pressure in the eye itself, but it is actually damage to the optic nerve. The optic nerve brings the images you see from your eye to your brain for interpretation. The high eye pressure can be more of a symptom.

“You can have glaucoma with high, normal or even low eye pres-

Fechtner

“A diagnosis of glaucoma provides an opportunity to preserve vision. It is not at all a sentence of progressing into darkness. Most people with glaucoma — if they get the care they need — live their life with good, useful, independent vision.”

Physician Robert Fechtner

sure,” Fechtner said. “The only way we can find glaucoma is not with an eye-pressure test, but by actually examining the eye. Everyone aged 40 and over should have a comprehensive eye examination.”

That regular eye exam is key to discovering glaucoma early. There is no cure to the damage that glaucoma causes, but there is a way to arrest the damage and prevent the vision from getting worse.

The problem is, many people don’t notice glaucoma-related vision loss until the disease is more advanced.

Fechtner says there is no reason to panic if you do get a diagnosis of the disease. Many cases can be treated successfully with as little as one eye drop once a day.

“A diagnosis of glaucoma provides an opportunity to preserve vision. It is not at all a sentence of progressing into darkness. Most people with glaucoma — if they get the care they need — live their life with good, useful, independent vision.”

Have you been overwhelmed by a diagnosis?

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Global fight

The doctor is also working to allow people living in undeveloped

countries — where resources are scarce — to have the same chance to save their vision as people in developed countries.

The World Glaucoma Association is the international umbrella for national and international glaucoma societies — more than 80 member societies representing 10,000 doctors.

This year Fechtner is organizing the June 2017 World Glaucoma Congress in Helsinki, Finland.

“We have a particular initiative right now in sub-Saharan Africa,” he said. “The economic resources and the educational resources there are greatly varied, but are limited. We will be bringing some of the young ophthalmologists from sub-Saharan Africa to the meeting and then providing them with fellowships to get additional training in glaucoma.”

Those who have a family member with glaucoma should be sure to see an ophthalmologist, because there is a genetic factor in some cases of glaucoma, the doctor said. But modern science hasn’t discovered yet what the real cause of the disease is. There is some thought that it might be an aging-related phenomena, Fechtner said.

The future is likely to provide more and better treatments. Eye implants just a fraction of a millimeter in size will soon be able to be inserted in the eye to relieve pressure. And new medications and sustained drop delivery methods are on the horizon.

Some of the drops will be needed every three to six months as opposed to daily or weekly.

Locally, Fechtner has hopes that Upstate will do more outreach for eye disease. That means incorporating eye diagnostic equipment with a mobile breast-imaging bus or having a standalone vehicle.

“You can put a complete eye exam suite in a not-so-very-large van,” Fechtner said. “That’s future-reaching and we’re going to need to raise the funds for efforts like that, but I think they’re really worth while.”

Ultimately, though, the passion driving Fechtner and many other doctors around the globe is pushing them to find an answer to the vision loss that can accompany glaucoma. He believes it is within reach if regenerative drugs can be found to restore the damaged optic nerve.

Across the globe, blindness from glaucoma may become a thing of the past.

“Restoring vision with glaucoma I believe is possible in our lifetime,” Fechtner said.

Get support navigating a critical illness Carrie Scholz is a patient advocate with more than 30 years of professional social work experience in patient advocacy and medical social work.

Carrie@HealthNavigationofCNY.com

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

Run for Life

By Maryann Roefaro

Maryann Roefaro, CEO of Hematology Oncology Associates, tests her endurance at NYC marathon while supporting Hospice of CNY

O

n Nov. 6, 2016, the sunrise cast a beautiful light on the Statue of Liberty, illuminating a precious reminder of our freedom while welcoming and warming the hearts of 50,000 runners on Staten Island as they prepared to run the largest marathon in the world — the 2016 TCS New York City Marathon.

More than 1 million spectators that day warmly welcomed runners from all over the world in extraordinary New York fashion.

The cheering, shouting, well wishes, excitement, motivation, crazy costumes, the funny and motivating signs — it was all the craziness that one can expect from this awesome event that lined every inch of the 26.2 miles, with the exception of the bridges that didn’t allow for such.

It was a race that included all five boroughs of NYC, starting on Staten Island, running through Brooklyn, Queens, the Bronx and ending in Central Park in Manhattan. Pure passion and determination flooded the streets, while people gave it all they had — running 26.2 miles, cascading over five bridges and making 26 turns along the way. It was a spectacular day with perfect weather for running

a marathon through my favorite city in the world!

There were so many reasons for me to be thrilled and grateful to be at this race. Among them is the fact I had spent 20 weeks pushing my training to prepare my 57-year-old body to make it, knowing how much my husband, daughters and even my dog supported me and sacrificed time without me throughout my training.

I was grateful for having special friends who provided motivation and encouragement to instill confidence that I could and would seize the challenge. Most importantly, I was grateful for the 96 individuals that donated to my Hospice of CNY “It’s not how you start, it’s how you finish” fundraiser.

St. Jude’s gifted me space in its charity tent that provided added warmth during my wait if needed after Hospice of CNY provided notification of my fundraising efforts.

I left my hotel for Staten Island at 5 a.m. for a race start of 10:40 a.m.

I was given an orange bracelet at the expo that allowed me to enter the charity village where I met two wonderful women who became my best pals for the next four hours.

Inspirational force

The bracelet, however, on my right wrist served as a symbol for me throughout the race. I looked at it whenever I needed strength or motivation to keep moving. I looked at it when I was in euphoria and when I was in pain. It represented a lot to me — how generous people had been to donate to “Mare’s Marathon” and more importantly the journey that individuals make with hospice and the intended use of the funds.

The patients who utilize their services at the end of life and the family members that gather hope, love and courage to walk that final human road with their loved ones are journeys far more difficult and testing of the human spirit than a marathon.

It’s hard for me to believe I raised $11,011 for one of my favorite organizations and group of leaders and employees. Hospice is so precious and needed in our community. The generosity was overwhelming and I’m eternally grateful to all those who donated.

The whole day is one that I will never forget. From start to finish, it offered the gamut of life’s emotions for me. Just waiting in my corral to January 2017 •

start and hearing directions in several languages gave me chills.

The beautiful singing of “God Bless America” brought tears to my eyes and I’ll never forgot how special I felt to be there to hear the roar of the cannon signifying the start of the third wave.

I had made it to the start line and onto the Verrazano Bridge with Frank Sinatra’s “New York, New York” blasting — memories burned in my heart and soul forever.

This was my third marathon and all of them have left me with treasured memories. There’s nothing like your first and there’s nothing like the largest marathon in the world — NYC! Some ask, “Why run and why a marathon?”

I think George Sheehan, a runner and author, said it best when he said, “The obsession with running is really an obsession with the potential for more and more life.”

Why a marathon? “It’s the current distance that maximally tests my body, mind and spirit complete with tears of astonishment, accomplishment and joy!” he said.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 15

Women’s HEALTH

5

Things You Need to Know to About Common OB-GYN issues

By Ernst Lamothe Jr.

P

hysician James E. Brown is the medical director for the women and children’s service line at St. Joseph’s Hospital Health Center in Syracuse. Brown is board certified in obstetrics and gynecology and is a fellow in the American College of Obstetrics and Gynecology in addition to being a member in several professional societies and associations. He has a special interest in high-risk obstetrics and infertility, minimally invasive laparoscopic gynecological surgery, as well as office-based minimally invasive surgeries. He talks about five familiar OB/GYN issues women come to his office asking about.

1.

Abnormal periods

Most women have menstrual periods that last four to seven days. A woman’s period usually occurs every 28 days, but normal menstrual cycles can range from 21 days to 35 days. Some discomfort during the cycle is normal for most women. Abnormal uterine bleeding may apply to a variety of menstrual irregularities, including: a heavier menstrual flow; a period that lasts longer than seven days; or bleeding or spotting between periods, after sex, or after menopause.

“Abnormal periods are very common and that is one of the reasons why patients come to my office. They ask questions about whether their periods are too long or heavy and there are a number of things we can do to help,” said Brown.

2.

Bladder health

Bladder health can be a delicate subject that many people are too embarrassed to talk about but that can affect someone’s everyday life. Millions of Americans suffer too often in silence and fear telling family members or even physicians.

Your bladder — a hollow organ that holds urine from your kidneys — is one of those body parts that you probably don’t think about until it stops working properly. Poor bladder health problems can lead to issues such as urinary incontinence, overactive bladder, urinary tract infections.

“This can especially become an issue after pregnancy,” said Brown. “It is normal and something that women deal with especially as they get older.

The hardest part is getting people to discuss the issue and understand that they are not the only one.”

3.

Importance of Kegel exercises

Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. You can do Kegel exercises, also known as pelvic floor muscle training, just about anytime.

Many factors can weaken your pelvic floor muscles, including pregnancy, childbirth, surgery, aging, excessive straining from constipation or chronic coughing, and being overweight.

For Kegel exercises, identify the pelvic floor muscles by stopping urination in midstream. If you succeed,

you’ve got the right muscles. Once you’ve identified your pelvic floor muscles you can do the exercises in any position, although you might find it easiest to do them lying down at first. Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds.

Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.

“It truly is something that I recommend to women because it can be quite successful,” said Brown.

“Women should attempt to do those exercises several times a day. This can especially be the case if women are dealing with bladder leakage.”

4.

How should I prepare for pregnancy

Brown said people ask a lot of questions when they finally decide to try for kids. They ask how often they should be having sex and if there are certain things they should be doing to have a higher success rate.

While there are several answers to those questions, he gives every patient this one advice.

“One of the first things I tell people is not to put too much pressure on themselves,” said Brown. “If you are both healthy and virile, then most times it is simply a matter of time.

It takes about 50 percent of couples at least six months before they are pregnant and the remaining another six months. They should focus on relaxing and of course focus on the

The ‘Angelina Jolie’ Effect Tests for the breast cancer BRCA gene shot up by 64 percent following Jolie’s 2013 New York Times op-ed about her decision to have preventive mastectomy

P

op culture icons can influence our fashion choices, dietary habits and brand preferences, but can celebrities also influence our medical decisions?

The answer is a resounding yes, according to a new Harvard Medical School study analyzing the rates of genetic testing for breast cancer in the aftermath of Angelina Jolie’s 2013 oped piece in The New York Times.

The findings, published Dec. 14

Page 16

•

in The BMJ, revealed a large spike in genetic tests for a gene known to increase breast cancer risk following Jolie’s op-ed, but no corresponding uptick in mastectomy rates, suggesting the tests did not lead to increased breast cancer diagnoses. The results illustrate that celebrity endorsements can fuel the use of health care services but may not effectively target the populations in greatest need of such services, the researchers said.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

“Our findings underscore celebrity endorsements as a powerful influence on health-related behaviors, but they also show that such endorsements do not necessarily target those most at risk for developing a disease,” said investigator Sunita Desai, a Seidman Fellow in health care policy and economics and a researcher in the department of health care policy at Harvard Medical School.

In other words, Jolie’s testimonial

frequency.”

Another tip is starting to take vitamins months before you start trying.

“You want your prenatal vitamins to be in your system before you achieve pregnancy,” Brown added.

5.

Mammograms

Over the past several years, there has been a push to decrease the amount of mammograms and pap smears that a woman receives. Medical officials often worry about over-treating conditions.

“The Center for Medicaid and Medicare Services has essentially come out and said it is OK for us to decrease the frequency of screenings.

They have said that going every other year for women in their 40s and every three years to five years for women after 50,” said Brown. “We accept that as reasonable but we also understand that not every individual falls into that category.”

Brown stressed that if a woman has family issue of breast or cervical cancer, they should speak with their physician about the best timetable for testing.

“We never want a one-size-fits-all philosophy,” he added. “There are women that should go and get their mammograms every year to make sure that everything continues to be fine, especially if you are at a higher risk.”

raised the visibility of genetic testing for breast cancer mutations, and it may also have inadvertently fueled overtesting among low-risk groups, the study suggests.

Many women seem to have heeded her call. Examining an insurance database containing the records of more than 9 million women age 18 to 64, the researchers found a 64-percent uptick in the rates of genetic testing for breast cancer in the two weeks following Jolie’s commentary. By comparison, there was no such spike during the same period in the previous year, researchers noted.

At $3,000 each, the cost of the BRCA test is also significant. Researchers estimated that in the span of two weeks the op-ed may have precipitated 4,500 more BRCA tests than would have normally occurred during that time period nationally at a price tag of $13.5 million.

urologyIGH.10.25x6.75.qxp_Layout 1 8/19/16 1:12 PM Page 1

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 17

Women’s HEALTH What to Do with Dark Circles Around the Eye

Do people constantly ask if you’re tired because of dark circles under your eyes?

By Deborah Jeanne Sergeant

I

t’s a fairly common condition, but lack of sleep isn’t the real culprit.

Getting enough sleep certainly supports good health and looking healthy; however, even well-rested people can have dark circles.

“The main cause has to do with your collagen in that area around the eyes,” said Ramsay Farah, dermatologist and chief of dermatology and associate professor of pathology at Upstate Medical University. “The skin is really thin. Some have more collagen than others. If yours is quite thin, the blood vessels in the skin can show up more. Some people have more blood vessels than others. The physiology dictated by genetics will dictate if you have a propensity for these or not”.

Mild cases of dark circles may be adequately covered with cosmetics.

Finding the correct color at a drugstore make-up display isn’t easy. A professional make-up artist can assist in finding the right make-up primer, foundation, and concealing products.

But not everyone finds that make-up provides adequate coverage, especially if the area is saggy, wrinkled and

discolored. Make-up tends to creep into lines around the eyes, which draws more attention to the dark circles instead of concealing them.

For longer-lasting results, Farah recommends radiofrequency treatments that increase the collagen around the eyes. Injections of fillers can also lessen the appearance of dark circles.

“It’s similar to what you inject to minimize laugh lines around the mouth,” Farah said. “Injecting fillers often lessens the appearance of dark circles.”

Both of these procedures lasts about a year or more.

Injecting platelet-rich plasma can also help reduce the appearance of dark circles. Farah described the process, as “you draw someone’s blood and thin it down to separate the cells from the clear part of the blood, the plasma. It has lots of things in it like platelets. You can inject that under the eyes and that has a very nice effect.”

Injecting platelet-rich plasma takes a couple of sessions, but the results last several months.

Brian Raphael, board-certified

dermatologist with Empire Dermatology in East Syracuse, said that working with lasers can be tricky, but they can lessen purple pigmentation around the eyes.

Blood vessels near the surface of the skin cause this kind of discoloration. Treating under eye circles by laser works by strategically shutting down superfluous blood vessels around the eye.

“It doesn’t damage all the blood vessels,” Raphael said. “The ones we

see on the surface of the skin aren’t important for the skin to stay healthy.

The laser can do it at a certain depth of the skin and target only certain size of blood vessels.”

By reducing the number of blood vessels that are visible through the thin skin below the eyes, the laser reduces the appearance of dark circles.

The treatment may cause temporary bruising and redness, but its results last indefinitely.

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Page 18

•

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

Women’s HEALTH

Top 10 Ways Women Can Improve Their Health Want to be fitter and healthier in 2017? Here are the top tips from local experts.

By Deborah Jeanne Sergeant

1.

Manage your stress.

“Stress is a major killer, particularly for peri-menopausal and menopausal women. It’s very draining on the adrenals. The adrenal glands make hormones. If called on to make a lot of adrenaline, hormone production can go by the wayside. That makes cholesterol go up. We are ‘stress-aholics.’ It’s very difficult for us to let ourselves off the hook. Learn to evaluate what you can so ‘no’ to instead of taking on all things.

2.

3.

4.

Get sufficient rest.

“We recover adrenal energy while sleeping. We need to make sure we get well rested.

Perform meaningful work.

“We’re given examples of women who can do it all. If you do what you love, you’ll never work a day in your life.

Check your vitamin D levels.

“With waning sunlight, vitamin D becomes important to monitor. In this neck of the woods, it’s tough to get enough sunlight.

Blood work can indicate if you need more vitamin D so you can supplement.

5.

Load up on produce.

“Make sure we have a diet rich in vitamin C to support the immune system and adrenal system. We’re more prone to desire comfort foods, the siren song of carbohydrates. We need to eat wonderfully abundant green and orange stuff.

• Karen Fisk, wellness educator at Natur-Tyme in Syracuse

8.

6.

• Mary F. LaRussa, nurse practitioner, Women Veterans Program manager, Maternity Care coordinator, Syracuse Veterans Administration Medical Center, Women’s Wellness Center in Syracuse

Know your heart disease risk.

“The No. 1 killer of women in the US is heart disease, so to improve health is to address prevention as well as treatment. Risk factors include obesity, hypertension (high blood pressure), smoking, poor nutrition, sedentary lifestyle, genetics, excessive alcohol consumption, diabetes.

7.

Recognize signs of a heart attack.

“I make a big deal about our Go Red campaign because women don’t know about heart disease.

Nearly half the US women do not recognize heart disease and its symptoms. Call 911 if in doubt. Women’s symptoms include fluttering in chest, shortness of breath, lightheadedness,

Parenting

By Melissa Stefanec

F

Drop Resolution, Adopt ‘Slogans’ for 2017

or the past few years, I’ve been dedicating my January column to New Year’s resolutions for parenting. Out of fear of repeated and egregious failure, I am not going to read 2016’s resolutions.

I probably put some nonsense in there about being more present in the moment, taking time for myself, doing more hands-on activities with my kids, exercising more, working less and cutting myself some slack. If these were indeed the themes of my resolutions, I am going to give myself an 18 out of 100.

I wanted to be present more. I wanted to live in the moment with my kids. I wanted to be more present at the gym. I wanted to yell less. I wanted to go easier on myself. I wanted to have reasonable expectations of myself and everyone around me.

So, this year, instead of making

dizziness, fainting, pain in neck, jaw, throat or upper abdomen or back.

One in four women will die from heart disease. It’s a little known fact that heart disease is the No. 1 killer of women.

a bunch of resolutions I can hardly recall — let alone adhere to — I am going to come up with some slogans for 2017. May I also add that I am setting the bar pretty low, because I want to give myself a high-five when I look back on 2017. n Away go germies down the

drain

I seriously deserve a parenting citation for forgetting to wash my son’s hands before meals. Being that he is only 2, I can’t send him to wash up by himself like I can my daughter.

Unfortunately, this means my son sometimes starts cramming dinner into his mouth with hands that have an inch worth of invisible daycare grime on them. I can do better. n When I’m sick, I take a sick day

Know your vital signs.

“Get weighed, blood pressure taken, cholesterol checked regularly and, if obese, screened for diabetes.

9.

Balance meals.

“Fiber helps slow the release of nutrients in the bloodstream so the blood sugar is more stable. If it’s more stable, then you’re not going to have highs and lows and weight won’t be an issue typically. Fiber helps with satiation.

Snack on more things like egg, seeds, nuts, mozzarella cheese stick, avocado on a salad, sunflower seeds, pumpkin seeds, chia in almond milk, humus with veggies, tuna fish with veggies, apple slices with walnuts. Try peanut butter or almond butter with apples.”

When I inevitably forget to wash the germies down the drain, and the whole family ends up with some general grossness, I am going to take some time off from work. My company isn’t going to come to a screeching halt in my absence. If it does, I need to come up with a slogan for asking for a big-time raise. n Food first, stuff second I will feel accomplished if I get dinner on the table, especially after a long day of work, commuting and running errands. This is no small feat. I will not worry about laundry or picking up. Food will be first. The same goes for meals at work. I don’t care how busy I am, the company can do without me during my lunch break. If not, I need to revisit that raise jingle. n When I feel so mad I want to

roar, I will take a deep breath and count to four

OK, there may be a little Daniel Tiger’s Neighborhood copyright infringement here, but I needed at least one catchy slogan in my lineup.

Besides, it’s some of the best advice I’ve heard. I tell it to my kids a lot, but I should be telling it to myself threefold. When I want to yell, I need to take a step back. If I still want to yell after four, the kids better already be heading to time out.

January 2017 •

• Laurel Sterling, registered dietitian practicing in Canastota

10

. Protect your skin.

“We recommend SPF 30-plus. The key is it lasts two to three hours so you should reapply throughout the day. It’s good that it’s in make-up, but it’s usually only 15 SPF. By lunch, it’s as if you have nothing on your skin. Micro-beads of zinc oxide and titanium dioxide in products are great so you don’t look like a lifeguard with a zinc sunscreen. It blends in well and has a better feeling and smell. Pick something you like because it won’t work in the bottle; you have to put it on. Reapply, reapply, reapply. Most people don’t put on enough at one time. Use at least one shot glass of sunscreen every application to cover your arms, legs, and anywhere a bathing suit isn’t covering. It breaks down easily on warm days. Leaving it in your glove box isn’t advised. it won’t last as long. It has an expiration date and you should follow that. Wear a wide-brimmed hat. Wear long-sleeved shirts. Many fashionable items are now sun protective. Parasols are now becoming popular in the US.” • Brian Raphael, board-certified dermatologist, Empire Dermatology, East Syracuse

n I love listening, ‘cause listening is love

When you hear “Mommy !”every 20 seconds or so, it’s easy to go on autopilot and stop really listening. Kids know when you are truly engaged with them, and although it’s not realistic to be earnestly engaged with young ones at all times, I need to do it more and make my kids feel important. Maybe (huge pipe-dream here), doing this will encourage my kids to listen more intently to me and others. n Stress the small stuff, pay the

price

We are all only human. Sometimes the stress of the small stuff is all we feel. When I start stressing the small stuff, I am going to pay the price. However, this year, instead of that price being constant stress, I am going to make myself think of something beautiful when the details and perfunctory things get me down. I can’t magically make stress stop, but I can always redirect myself. n I am Superwoman Seriously. The amount of stuff I pull off in one day is astounding. The fact I do (and have some semblance of sanity) is a true testament to my spirit and hard work. I am Superwoman, no asterisks, buts or footnotes required.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 19

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

By Deborah Banikowski District Manager, Syracuse

Social Security Is Always Evolving

S

ocial Security is always evolving to meet the needs of the American public. We’re optimistic about the future and the limitless possibilities for progress.

Much of the progress we’ve made together, as a nation, is through the shared responsibility of paying Federal Insurance Contributions Act (FICA) tax. This federal payroll tax funds Social Security — programs that provide benefits for retirees, the disabled, and children of deceased workers. You help us keep millions of hard-working Americans out of poverty.

Without your contribution, wounded warriors wouldn’t receive the benefits they deserve. Children who have lost parents would have no social safety net. Millions of elderly people would be destitute. In the same way that we take great pride in helping people who need it, you should take pride in making this country stronger. You can see the many ways our retirement benefits help your loved ones and neighbors at www.socialsecurity.gov/retire.

Q&A

Q: I’m trying to figure out how much I need to save for my retirement. Does the government offer any help with financial education?

A: Yes. For starters, you may want to find out what you can expect from Social Security with a visit to Social Security’s Retirement Estimator at www.socialsecurity.gov/ estimator. The Financial Literacy and Education Commission has a website that can help you with the basics of financial education: www.mymoney. gov. Finally, you’ll want to check out the Consumer Financial Protection Bureau, which offers educational information on a number of financial matters, including mortgages, credit cards, retirement, and other big decisions. Visit the Consumer Financial Protection Bureau at www.consumerfinance.gov.

Q: I got married and I need to change my name in Social Security’s records. What do I do?

A: If you change your name due to marriage, or for any other reason, you’ll need to report the change and get a corrected Social Security card with your new name. You will need to fill out form SS-5. You can get a copy of this form by visiting www. socialsecurity.gov/ss5doc or by calling our toll-free number 1-800-7721213 (TTY 1-800-325-0778). You’ll also need to provide the original marriage certificate showing your new and old

The strength of our nation relies on cooperation and the empathy to understand each other’s unique struggles. Similarly, Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards.

“Compassionate allowances” offer a way of quickly identifying diseases and other medical conditions that invariably qualify under the listing of impairments based on minimal objective medical information. This also lets Social Security target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly.

You can view the list of compassionate allowances at www.socialsecurity.gov/compassionateallowances.

Our diversity is an asset that can bring us together, making us stronger as a nation. Visit www.socialSecurity.gov to empower your future, for today and tomorrow.

names. You can mail or take the documentation to your local Social Security office. In some cases, we may need other forms of documentation as well. For more information, visit www.socialsecurity.gov/ssnumber.

Q: I’m planning to retire next year. I served in the Navy back in the 1960s and need to make sure I get credit for my military service. What do I need to do?

A: You don’t need to do anything to apply for the special credit for your military service — it is added automatically. For service between 1957 and 1967, we will add the extra credits to your record at the time you apply for Social Security benefits. For service between 1968 and 2001, those extra military service credits have already been added to your record.

So you can rest assured that we have you covered.

Q: How do I report a change of address if I’m getting Supplemental Security Income (SSI)?

A: A person receiving SSI must report any change of address by calling our toll-free number, 1-800772-1213 (TTY 1-800-325-0778), or by visiting a local office within 10 days after the month the change occurs.

You cannot complete a change of address online. You should report your new address to Social Security so you can continue to get mail from Social Security when necessary, even if you get your benefits electronically by direct deposit or direct express. Learn more about SSI at www.socialsecurity.gov/ssi.

SEEKING COMPANION SEEKING COMPANION

By Jim Miller

How Much You’ll Pay for Medicare in 2017 Dear Savvy Senior, I know there won’t be much of a cost-of-living increase in Social Security benefits next year but what about Medicare?

How will the 0.3 percent Social Security raise affect our Part B monthly premiums in 2017?

Inquiring Beneficiary Dear Inquiring, Considering the rising cost of health care coverage, the news regarding your Medicare costs for 2017 is not too bad. Here’s what you can expect.

Part B Premiums Because the Social Security Administration is giving out a measly 0.3 percent cost of living increase starting in January — that equates to about a $4 to $5 monthly increase on average — the 2017 Part B monthly premium for about 70 percent of Medicare recipients will increase only about $4 to $5.

Thanks to the Social Security Act’s “hold harmless” provision, Medicare cannot pass along premium increases greater than the dollar increase in their Social Security checks.

So, if your Medicare Part B monthly premium is currently $104.90, you can expect it to be around $109 (on average) in 2017.

Or, if you signed up for Part B for the first time in 2016, your $121.80 monthly premium will rise to around $127 (on average) next year.

Some Will Pay More Unfortunately, the hold harmless provision does not protect all Medicare recipients. New Medicare enrollees (those who will enroll in 2017), beneficiaries who are directly billed for their Part B premium, and current beneficiaries who have deferred claiming their Social Security will pay more.

If you fit into any of these categories, your Medicare Part B premium will be $134 per month in 2017, up from $121.80.

The hold harmless rule also does not protect high-income Medicare

beneficiaries who already pay higher Part B premiums because their annual incomes are above $85,000 for an individual or $170,000 for a couple. If you fit into this category, here’s what you’ll pay for your Part B premium next year, based on your 2015 tax returns.

• Individuals with incomes of $85,000 to $107,000, or married couples filing joint tax returns with incomes of $170,000 to $214,000, will pay $187.50 per month.

• Individuals earning $107,000 to $160,000 (couples $214,000 to $320,000) will pay $267.90.

• Individuals with incomes of $160,000 to $214,000 (couples $320,000 to $428,000) will pay $348.30.

• Individuals with incomes over $214,000 or couples above $428,000 will pay $428.60.

Another increase high-income beneficiaries (those with incomes over $85,000, or $170,000 for joint filers) need to be aware of is the surcharge on Part D premiums. Affluent seniors that have a Medicare Part D prescription drug plan will pay an additional $13.30 to $76.20 per month, depending on their income, on top of their regular Part D premiums.

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Deductibles and Co-Pays Other changes that will affect all Medicare beneficiaries include the Part B deductible, which will increase to $183 in 2017 from $166 in 2016. The Part A (hospital insurance) annual deductible will also go up to $1,316 in 2017 (it’s currently $1,288) for hospital stays up to 60 days. That increases to $329 per day for days 61-90, and to $658 a day for days 91 and beyond. And the skilled nursing facility coinsurance for days 21-100 will also increase to $164.50 per day, up from $161 in 2016.

For more information on all the Medicare costs for 2016 visit Medicare.gov and click on “Find out how much Medicare costs in 2017,” or call 800-633-4227.

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.

January 2017 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

Health News Certified PA joins Oswego County OB-GYN, P.C.

CrouseCares campaign leadership: Front Row, left to right: Sandra Pomeroy, Paul Kronenberg, MD, Trish Hopkins and Diane Miron. Back row, left to right: Kimberly Boynton, Bill Pomeroy, Mike Hopkins and Bob Miron.

Crouse Health Foundation Announces Comprehensive Campaign For Crouse Health

C

rouse Health Foundation has announced the most ambitious campaign in its history — a $20 million effort over the next five years.

Of that goal, $17.5 million of the campaign target is earmarked for capital improvements to the Pomeroy Emergency Services Department and the Baker Regional Neonatal Intensive Care Unit.

Another $2.5 million is annual unrestricted giving to the foundation to provide ongoing support for other Crouse programs and services.

Additionally, the campaign will focus on increasing gifts to its endowment with both current and planned gifts.

In late September, community chairs Trish and Mike Hopkins announced that more than $10,273,000 had been raised toward the $20 million goal during the quiet initial phase of the campaign.

Crouse Health President and CEO Kimberly Boynton is optimistic about the community’s support for the CrouseCares campaign.

“Today’s Crouse Health reflects a rich history of innovation, visionary leadership and strong community support. Crouse’s heritage as a trusted health and wellness regional resource — and major economic anchor in Central New York — mirrors the growth and development of our community over the past 129 years,” she said. “Never before in the history of Crouse has there been a more opportune time to

Page 22

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build on and strengthen that promise for generations to come. Crouse is truly our community’s hospital. “ The CrouseCares leadership has begun its work to achieve the campaign’s financial goals. In addition to Trish and Mike Hopkins, those involved with the effort are honorary chairs Kimberly Boynton, Paul Kronenberg, MD, Bob and Diane Miron, and Bill and Sandra Pomeroy; individual campaign leaders are Mary Cotter and Paul Solomon; annual giving committee leader is Tim Atseff; planned giving committee leader is Betsy Hartnett; corporations leader is Mel Stith; foundations leaders are David Ridings and Peggy Ogden; medical staff leaders are physicians David Landsberg, Ellen Bifano and David Mason; Crouse Health employee leaders are Kelly Maher, Brad Hellwig, Mary Flood and Peaches Edwards; and organized labor leaders are Greg Lancette and Don Morgan.

Crouse Health Foundation President Carrie Berse invites members of the Central New York community to invest in the future of healthcare in the region. “Whether you have experienced the exceptional care at Crouse Health first hand or want to support an important community asset, your gift makes all the difference,” says Berse.

If you have any questions about the CrouseCares campaign, please contact Director of Philanthropy Jeff Comanici at 315/4707054 or jeffrycomanici@crouse.org.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017

Certified physician assistant Megan Irland has returned to Central New York. She has joined the professional staff at Oswego County OB-GYN, P.C. and the medical staff at Oswego HospiIrland tal.

Irland, originally from Martville, earned her master’s degree in physician assistant studies from LeMoyne College in 2011 and a bachelor’s degree in biology and pre-med from Hartwick College in 2006. She is certified by the National Commission on Certification of Physician Assistants.

Prior to coming to Oswego County OB-GYN, P.C., Irland was employed in a neuro critical care intensive care unit in New Orleans for four years. Irland also worked at Oswego County Opportunities in its family planning division in 2012.

Among other things, Irland provides well women’s care, gynecological and obstetrical services to the women of Oswego County.

CNYCC has new chief Medical officer Physician Joseph Maldonado Jr. has been appointed chief medical officer at Central New York Care Collaborative (CNYCC).

Maldonado brings more than 25 years Maldonado of healthcare experience and extensive work in the areas of health policy and advocacy at the regional, state and national levels.

Previously, Maldonado served on the staff of Carthage Area Hospital, Rome Memorial Hospital and Faxton/St. Luke’s Hospital.

Maldonado has worked in leadership roles for several healthcare organizations including Healtheconnections (CNY RHIO), MLMIC, New York State Urological Society (past president), Medical Educational Scientific Foundation of NY (president) and Rome Area Physician Organization (president) and delegate to the American Medical Association.

Maldonado also served as the immediate past-president of the Medical Society of the State of New York. In addition, he has worked as part of the NYS DOH integrate care workgroup, basic health plan and healthcare exchanges workgroups.

A graduate of the Albert Einstein College of Medicine of Yeshiva University, Maldonado also holds

three graduate degrees from University of Oxford: an MBA, diploma in evidence based healthcare and MSc in major program management.

Maldonado serves as an assistant clinical professor at Touro College of Osteopathic Medicine where he previously held the post of assistant clinical dean.

In addition to these accomplishments, Maldonado is president of the Mohawk Glen Urgent Care PLLC in Rome, NY. CNYCC is a partnership that connects more than 1,400 healthcare and community based service providers in six counties across Central New York — Cayuga, Lewis, Madison, Oneida, Onondaga and Oswego.

The primary goal of the collaborative is to serve the population by improving the coordination of healthcare services, enhancing the quality of performance outcomes, and creating an overall better system of care for patients.

St. Joseph’s leaders honored for service Two members of St. Joseph’s Health were recently recognized with St. Joseph’s Leadership in the Franciscan Tradition award. It recognizes and honors the leaders within the St. Joseph’s Health organization who follow St. Francis of Assisi as servant leaders. As a Catholic organization in the Franciscan tradition, St. Joseph’s Health calls on its leaders to strive to lead and serve the way St. Francis did.

The awardees are: • Deborah Welch, St. Joseph’s vice president for people and mission integration. Welch has been a part of St. Joseph’s for half of her lifetime.

She began her career as a member of the Welch behavioral health team, where she developed critical perspective to help her understand the challenges of the patient population as well as the challenges and the work of the staff that serves the needs of that population. She has been a leader in much of St. Joseph’s groundbreaking work in the development of behavioral health programs, is a respected community leader, and consistently demonstrates her compassionate focus on employee and patient advocacy. Under her guidance, St. Joseph’s internal communications has improved, patient satisfaction scores have improved, and patient advocacy has improved.

• Jessica Caruso, clinical director for emergency and observation services with St. Joseph’s Inpatient behavioral health. Caruso has been a nurse with St. Joseph’s Health for several years, and was promoted to the position of clinical director in

Health News January 2016. She was nominated for this award by her team who described that, even in the short time since becoming clinical director, Caruso has demonstrated that she is a strong leader who is empathetic and kind, compassionate and fair — giving the staff and patients her full attention and respect. She also strives toward Caruso continual improvement with new programs, staff initiatives, and patient care, gathering input from everyone involved and empowering her team.

Oswego imaging facilities in earn designation Oswego Health’s new computed tomography (CT)s have been designated as Lung Cancer Screening Centers by the American College of Radiology (ACR).

Oswego Heath recently installed low-dose CTs at the Oswego Hospital, the Central Square Medical Center and the Fulton Medical Center.

The ACR Lung Cancer Screening Center designation is a voluntary program that recognizes facilities that have committed to practice safe, effective diagnostic care for individuals at the highest risk for lung cancer.

In order to receive this elite distinction, facilities must be accredited by the ACR in computed tomography in the chest module, as well as undergo a rigorous assessment of its lung cancer screening protocol and infrastructure. Also required are procedures in place for follow-up patient care, such as counseling and smoking cessation programs.

Along with screening for lung cancer, a CT scan is one of the fastest and most accurate tools for examining the chest, abdomen and pelvis because it provides detailed, cross-sectional views of all types of tissue. It is also used to examine patients with injuries from trauma, such as a motor vehicle accident, as well as patients with acute symptoms such as chest pain, abdominal pain or difficulty breathing. It is also often the best method for detecting many different cancers.

St. Joseph’s Health wins Consumer Choice Award St. Joseph’s Health was named a 2016/2017 Consumer Choice Award by National Research Corporation. The annual award identifies hospitals across the United States that healthcare consumers choose as having the highest quality and image.

“For each of the past 21 years, winning hospitals have provided outstanding experiences that have transcended their four walls to drive consumer preference, trust, and loyalty in their markets. We are honored to congratulate this year’s winners on a job well done,” said Brian Wynne, Market Insights general manager at National Research Corporation, which coordinates the award.

Winners are determined by consumer perceptions on multiple quality and image ratings collected in the company’s Market Insights survey, the largest online consumer healthcare survey in the country. National Research surveys more than 300,000 households in the contiguous 48 states and the District of Columbia.

Hospitals named by consumers are analyzed and ranked based on Core Based Statistical Areas defined by the U.S. Census Bureau, with winning

Upstate Nurse to Head Regional Stroke Center Jennifer Schleier, stroke program manager for Upstate University Hospital’s Level 1 Comprehensive Stroke Center, has been elected chairwoman-elect of the board of Central and Western New York Stroke Coordinators Consortium.

In succeeding years, she will also serve as president and past president.

The Central and Western New York Stroke Coordinators Consortium supports members and their organizations, through mentorship, by sharing best practices and strategies that promote community health and aid in the implementation of quality stroke initiatives throughout the region. The Central and Western New York Stroke Coordinators Consortium supports hospitals in Buffalo, Rochester, Syracuse and the surrounding region.

Schleier is no stranger to the region’s stroke teams. As stroke program manager for Upstate, she has been instrumental in building telestroke relationships with hospitals in Carthage, Ogdensburg, Cortland, Alexandria Bay and Wa-

Crouse Medical Practice welcomes new physicians

Auburn’s MRI System Accredited The American College of Radiology recently announced that Auburn Community Hospital’s state-of-the-art MRI — magnetic resonance imaging system — has been granted accreditation.

“Most community hospitals use a smaller 1.5 Tesla magnet with their MRI systems,” said physician David Waldman, chairman of the University of Rochester (URMC) imaging department. “With ACH’s 3-Tesla

Jennifer Schleier

model, the images that radiologists get are of superior quality.”

Having partnered with the URMC imaging department, acquiring the best MRI system available, and now having received national accreditation by the American College of Radiology, the hospital is now able to provide patients and physicians, “the very, very best our region has to offer,” said Scott Berlucchi. ACH president and CEO.

Crouse Medical Practice, affiliated with Crouse Health, welcomes the following physicians to its practice; all are seeing new patients: • Shradha Pant: A native of Nepal specializing in family medicine, Pant received her medical degree from the University of Science and Technology in Chittagong, Bangladesh. She completed her Tomy residency at the UND Center for Family Medicine in Minot, N.D. January 2017 •

tertown.

Schleier also brings to the group, the knowledge of care provided by one of only two DNV-certified comprehensive stroke centers in New York.

Schleier has been in the nursing profession for more than two decades, with most of that time being spent in critical care.

She joined Upstate in 2001 and was promoted to patient service leader in the neurosurgical ICU, where she helped train and mentor new staff members. In 2004, she joined a special team of nurses at Upstate, who comprise a rapid response team across the hospital that coordinates care for patients in multiple specialized units requiring advanced knowledge and skill.

A nursing excellence award winner, Schleier holds a bachelor’s degree in nursing from Keuka College. She is a member of the American Association of Critical-Care Nurses and holds certifications in adult critical care nursing (C.C.R.N.) advanced cardiovascular life support and has advanced training in trauma nursing.

• Mercy Tomy: From New Hartford, NY, Tomy specializes in internal medicine. She received her medical degree from St. George’s University School of Medicine in Grenada and completed her residency at the Overlook Medical Center in Summit, N.J. • Anthony Rotella: A native of Liverpool, Rotella specializes in family medicine and received his medical degree from New York Institute of Technology College of Osteopathic Rotella Medicine. He completed his residency at Aria Health in Philadelphia.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 23

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2017