Baldness Treatments Find out about the newest treatment for hair loss available in the area, including microtattooing. Men’s Health Issue inside
June 2017 • Issue 210
CNY’s Healthcare Newspaper
SUMMER FOOD New Crouse ER Taking Shape Years in the making, Crouse Hospital’s new 20,000 sq. ft. emergency department set to open in July
Coming This Summer
Now that the warm weather is here (finally), a wonderful feeling comes across us: we want to eat lighter and fresher. See inside a guide to what to eat and what to stay away from (or eat in moderation). Inside
Cancer Navigator Elizabeth Fuertes-Binder is the breast cancer patient navigator at Upstate Cancer Center, a new program that offers free mammograms. Her job: get women to test for breast cancer
Expect more ticks and a deadly new tick-borne disease. Find out why
Hepatitis C Should all baby boomers get tested for it?
How can such a sweet li’l thing be so nutritious? Who does it think it is having more vitamin C than an orange? Enough antioxidants to rival a raspberry? Half the calories of a banana? And as much fiber as an apple? See SmartBites inside
America Really Loves Fast Food Eight in 10 eat it at least once a week, surveys find
Longevity in the U.S.
Location, Location, Location Study found life expectancy differed by as much as 20 years in different counties, states
ow long you will live depends a lot on where you live in the United States, a new study of federal health data reveals. Overall, life expectancy increased for American men and women by slightly more than five years between 1980 and 2014, researchers report. But life span can differ by as much as two decades between various U.S. counties, said lead researcher Ali Mokdad, a professor of global health with the University of Washington’s Institute for Health Metrics and Evaluation, in Seattle. “You have people here in this country that are living longer than the life expectancy of the best country in the world, and you have people here in certain counties who have a life expectancy similar to some developing countries in the Middle East or South America or Cuba, for example,” Mokdad said. Economic and lifestyle factors appear to account for much of the gap, Mokdad added. A group of counties in central Colorado — which includes affluent cities like Aspen and Breckenridge — have the nation’s highest life expectancy, the re-
searchers found. Summit County, Colo., topped the list at 86.8 years, followed by Pitkin County (86.5 years) and Eagle County (85.9 years). That’s better than the principality of Andorra, a tiny country wedged between France and Spain that has the world’s longest life expectancy at 84.8 years, the researchers said. Iceland has the next highest life expectancy among countries, at 83.3 years. On the other hand, several counties in North and South Dakota containing Native American reservations had the lowest life expectancy in the United States, the research-
ers found. And Southern counties along the lower half of the Mississippi, in eastern Kentucky, and in southwestern West Virginia also had very low life expectancy. Oglala Lakota County, S.D., which includes the Pine Ridge Native American reservation, had the lowest life expectancy in the country in 2014 at 66.8 years — comparable to countries like Sudan (67.2 years), India (66.9 years) and Iraq (67.7 years), the researchers said. Overall, life expectancy in the United States increased for men and women a combined 5.3 years, from 73.8 years to 79.1 years. For men, life expectancy rose from 70 to 76.7 years, while for women it rose from 77.5 to 81.5 years. But this average increase was fueled by large increases in
A Celebration of Life!
will honor those in our community who are living with and beyond cancer, and those who have supported them along the way.
Come celebrate the wondrous gift of life with our community’s cancer survivors at
Throop Fire House
Beech Tree Rd, Town of Throop
on June 4, 2017 from 12:00 pm until 3:00 pm Our celebration will include: •Inspirational Messages from Cancer Survivors •Music •Food •Raffles & Door Prizes •Games •Exhibits A Special Thanks for Community Support Lowe’s, Throop Fire Department, Aldi’s, and Vitale’s Farm Market Music by “Your Generation” DJ Service - Joe Szakalski
Please include location you will be attending (Auburn or Liverpool) and survivor’s t-shirt size.
Please RSVP to: email@example.com Or (315)472-7504 ext 1312 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
NATIONAL CANCER SURVIVORS DAY
NATIONAL CANCER SURVIVORS DAY
Hematology Oncology Associates of CNY
RSVP email must include “RSVP" in the subject line.
The courage and determination of cancer survivors is an inspiration to all!
On National Cancer Survivors Day® Sunday, June 4, 2017
life expectancy in certain parts of the country, such as central Colorado, western California and along the East Coast. In other parts of the country — most notably eastern Kentucky, central Alabama and southwestern Oklahoma — there were some counties where life expectancy actually fell by one to two years. These numbers show that an environment that promotes healthy living has more of an impact on how long you’ll live than the kind of health care available to you, Mokdad said. “We’re not going to get out of this investing solely in the medical system,” Mokdad stressed. “We have to invest in prevention.” The findings were published May 8 in the journal JAMA Internal Medicine.
On National Cancer Survivors Day® .
Sunday, June 4, 2017 Hematology Oncology Associates of CNY will honor those in our community who are living with and beyond cancer, and those who have supported them along the way.
Come celebrate life at Longbranch Park, Liverpool, NY on June 4, 2017 from 10:30 am until 1:30 pm.
HOPE GROWS HERE Our celebration will include: •Speakers • Fun Activities • Entertainment •Door Prizes • Picnic Lunch The event is free for survivors, family and guests. *RSVP email must include "RSVP" in the subject line.
Please include location you will be attending (Liverpool or Auburn) and survivor's t-shirt size.
Please RSVP to: firstname.lastname@example.org or (315) 472-7504 ext 1312
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Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. You must continue to pay your Medicare Part B premium. The Part B premium is covered for fulldual members. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other pharmacies, physicians and/or providers are available in our network. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Aetna complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, free language assistance services are available. Visit our website at www.aetnamedicare.com or call the phone number listed in this material. ESPAÑOL (SPANISH): ATENCIÓN: Si usted habla español, se encuentran disponibles servicios gratuitos de asistencia de idiomas. Visite nuestro sitio web en www.aetnamedicare.com o llame al número de teléfono que se indica en este material. 繁體中文 (CHINESE): 請注意：如果您說中文，您可以獲得免費的語言協助服務。請造訪我們的網站 www.aetnamedicare.com 或致電本材料中所列的電話號碼。 Y0001_4002_9196_FINAL_1 Accepted 01/2017
©2017 Aetna Inc.
June 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Multi-organ blood analysis to be held in Fulton Oswego Health’s annual Fulton multi-organ blood analysis will be held Saturday, June 3, in the cafeteria of G. Ray Bodley High School. Oswego Health and the Fulton Kiwanis Club are teaming up once again to offer the community this important screening. This full battery of tests can help prevent potential health problems. The cost of the analysis is $40. Typically these tests can cost more than $340. In addition, there are two optional tests that each cost an additional $20. They include a vitamin D screening and the prostate specific antigen (PSA) test, which is recommended to men older than age 50. Appointments can be made online 24 hours a day at oswegohealth/ blood analysis. They can also be made by calling 315-349-5914 weekdays from 8 a.m. to 4 p.m. The screening will be offered from 6:30 to 9:30 a.m. A 12-hour fast is required. Checks to cover the cost of the screenings should be made out to “Oswego Health.” The analysis screens individuals for various conditions such as anemia, diabetes, and others, as well as for coronary, kidney, and liver dis-
eases. The most popular screening at the event is the portion of the analysis that assesses LDL and HDL cholesterol along with triglycerides. Lab technicians from Oswego Hospital will be on hand to conduct the blood draw.
Cancer Survivors Day events in L’pool, Throop Hematology-Oncology Associates of CNY (HOA) is sponsoring its second annual Celebrations of Life for National Cancer Survivors Day, which will take place at two locations: from 10:30 a.m. - 1:30 p.m., Sunday, June 4 at Long Branch Park in Liverpool; and from noon to 3 p.m. at the Throop Fire House on Beech Tree Road in Throop. “These events honor the members of our community who are living with and beyond cancer — the survivors — as well as their loved ones who have supported their journey,” said Maryann Roefaro, HOA CEO. “We are inspired by these individuals every day and privileged to share this day with them.” At each location guests will be treated to lunch, inspirational speakers, musical entertainment, fun activities/games, door prizes and exhibits The events are free for survivors
CELEBRATING 50 YEARS Grasta's Beauty and Wig Studio • We specialize in professional, personal, and confidential service. • We enjoy making clients feel beautiful from the inside out. “TO WHOM IT MAY CONCERN: This letter is to verify that Sharon Grasts was a self-employed outstanding beautician, utilized by the Genesee Hospital. She worked right by the side of doctors and all of the nurses on staff for these services to our in-patients. Sharon’s end product was very satisfactory, as was her interactions with patients, families and staff.” Sincerely, Shirley Reber, RN Senior Vice Presient, Nursing.
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hile hernias are more common in men, women can also develop them. Patients can experience groin pain, nausea or a bulge in the affected area. However, some patients have no symptoms, which is why screening is so important.
with their family and guests. However, reservations are requested by emailing email@example.com or calling 315-472-7504 ext. 1312. Emails need to include RSVP in the subject line, note the number attending at which location, as well as the name and the T-shirt size of the cancer survivor.
736 Irving Ave. | Free parking in Crouse garage | Continental breakfast available Page 4
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
Live Alone and Thrive: New one-day workshop
AIDS Walk/Run held at Beaver Lake The public is invited to join ACR Health’s AIDS Walk/Run on Sunday, June 4, at Beaver Lake Nature Center near Baldwinsville. It is the largest event in all of Central New York that supports programs and services to fight HIV and AIDS. This year, the event is celebrating 25 years. Supported by Empower Federal Credit Union, it starts at 10 a.m., rain or shine. Registration begins at 8:30 a.m. on event day. The AIDS Walk/Run benefits ACR Health and features a 5K fundraising walk, 5K timed run, and a 10K certified run. The event is known for its generous supplies of free food, drinks and fundraising incentives. Participants are encouraged to fundraise a minimum of $25. All proceeds stay in Central New York to benefit ACR Health’s youth HIV/ STD prevention programs and emergency client needs. Register online at ACRHealth. org/events or call AIDS Walk/Run headquarters at 315-475-2430.
Oswego Lions Club hosts River’s Edge Craft Show The Oswego Lions Club with host its sixth annual River’s Edge “handmade” Craft Show from 10 a.m. to 5 p.m. Sunday, June 11, at Breitbeck Park in Oswego. This year’s event is already larger than last year with many more vendors and a larger children’s area with the book mobile, karate demonstrations by Performance Fitness, robotic demonstrations by “Freezing Code,” finger printing by the Oswego County Sheriff’s department and the Oswego City Police Department, face painting and much more. Along with the crafts there will once again be wine tasting from some of the finest New York State wineries. Musical entertainment by Double V’s will be playing all afternoon, and there will be more food vendors to satisfy the hungry. For more information, contact
Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own” is a one-day workshop offered for women who want to rediscover joy, find more contentment and gain the know-how to forge a meaningful life on their own. Participants will meet others in similar circumstances and learn practical strategies to overcome loneliness, rediscover your true self, socialize in a couples’ world and make the best of this opportunity on your own. The workshop takes place from 9:30 a.m. to 4 p.m., Saturday, June 24, at House Content Bed & Breakfast in Mendon. The fee of $135 includes information and resources you can trust, empowerment exercises, and a Living Alone binder. Breakfast refreshments and lunch are included. To learn more, contact Gwenn Voelckers at 585-624-7887 or email firstname.lastname@example.org.
Aug. 9, Sept. 28
LGBTQ group presents SafeZone training The LGBTQ Academy SafeZone Training is a four-hour, dynamic, interactive workshop that includes activities and discussion about issues facing the LGBTQ community. Some of the topics to be discussed are LGBTQ inclusive and respectful language, the process of coming out, understanding sex, gender and sexuality, taking action, respectful communication in the face of resistance, where to go for help and much more. This session will give participants the skills they need to provide support and to create environments that are safe and inclusive so that all people are empowered to reach their full potential. Registration fee is $75 and includes a SafeZone manual, SafeZone sticker, SafeZone lapel pin and breakfast. The training will take place from 9 a.m. to 1 p.m., Aug. 9 and the same time on Sept. 28. Both events will take place at the LGBTQ Academy’s Education Center, 100 College Ave. Rochester. For more information and to register, send an email to email@example.com.
Crouse Institute for Robotic Surgery Presents Presented by three of the region’s leading robotic surgeons: Brian Anderson, MD
Jeffrey DeSimone, MD
Ben Sadowitz, MD
This screening is free, but pre-registration is required. Call 315-470-7701 or visit
• Watch a demonstration of our robotic-assisted technology • Free screening available following the presentation
Crouse Hospital – Conference Room A
Join our surgical experts to learn about this common but poorly understood condition, the importance of early detection and the latest minimally invasive procedure for repair available at Crouse.
Saturday, May 20 | 9-11 a.m.
Chris Pelton at 315-529-6414 or Becky O’Kane at 315-343-3997 or visit www. facebook.com/oswegolionsriversedgecraftshow.
The Chris J. and Marshia K.
crouse.org/hernia | RSVP May 17
Witting Surgical Center at Crouse Hospital
Presented in partnership with CNY Surgical Physicians
For me it’s personal! Upstate legacies: lifesaving and life-changing In 1993, my son David was on top of the world! He had graduated from a prestigious culinary institution and was building his reputation as an executive chef. Then David suffered a career-ending and life-altering spinal injury in a skiing accident. After months of outstanding care and physical therapy David is able to live an independent and productive life, BUT that’s not all! today, groundbreaking research is taking place at Upstate Medical University that we hope will one day restore all of David’s functions and reverse spinal cord injuries for thousands of others in Central New York and beyond. Through The Upstate Foundation, I have established A New Beginning Fund for spinal cord research, and I have remembered Upstate with an estate gift to fund this research and benefit many in our community for years to come. it’s also personal for you since every Upstate legacy dollar stays right here in Central New York to help assure happy, healthy and longer lives for your loved ones, friends and neighbors.
I invite you to join me in creating a legacy gift through your will or financial plans. Together we can do great things for Central New York. Ruth Schwartz Charitable Giving Planner, The Upstate Foundation
For free and confidential information on how to make a low cost, high impact legacy gift contact, or have your professional advisor contact, John Gleason at 315-464-4416 or email us today at FDN@Upstate.edu Our legal name is THE UPSTATE FOUNDATION INC.
www.UpstateFoundation.org June 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Joselito Ouano, M.D. New primary care physician in Fulton: “If you talk to them, listen to them and make it a two-way street, you’ll have more success in getting the patient involved in maintaining their health’ Q: Give us an overview of your position and the types of patients you see. A: I’m working for Oswego Health. I’m a primary care physician and I’m doing outpatient medicine at their Fulton satellite office called Primecare. It’s one of the offices they’ve established to take care of the community here in Fulton and the surrounding communities. Q: It seems like recent changes to health care law are looking heavily at primary care as a way of controlling costs. Have you felt that in your practice? A: I agree with that. Where I used to work, near Allentown, Pa., a lot of larger hospitals established what are called medical homes. It’s basically primary care offices that have been certified by the government to coordinate care for that community for disease management, as far as making for the patients have the proper care from specialists, from social services. So it’s kind of a one-stop shop for the community’s health. We’re creating a situation where patients can go see their primary care physician and start managing all their health care needs, from treating the acute illness, treating chronic illness, educating patients and making sure preventive care is something in the forefront. From I’ve seen, it’s becoming pretty common on the East Coast for primary care to be centralized in guiding care in their
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
community. Q: You mentioned educating patients. How much of your practice is dedicated to “training” patients, so to speak? A: It’s always part of the visits. We always talk to them about their health, whether it’s about controlling their weight, avoiding cigarettes, safety issues like seat belts, texting while driving. We try to talk to patients about things that will keep them healthy. It doesn’t take long to discuss most of these things during a visit. If you’re just lecturing them, though, it will go in one ear and out the other. But if you talk to them, listen to them and make it a two-way street, you’ll have more success in getting the patient involved in maintaining their health. Q: Syracuse is a bit like Allentown, but Fulton is a lot smaller. What made you want to change from practicing in a midsized city to a small one? A: In the Allentown area, I was used to working in large hospital health systems. One of the things I noticed is that when a health system becomes too big, it’s starts to become more business-like. You start feeling like you don’t have as much interaction with your patients. It becomes this fast-paced, get-themin, get-them-out thing. I knew of this area for quite some time. When I was in high school in Hazelton, Pa., I used to come up to go fishing in Pulaski and passed through Oswego and Fulton on my way to Pulaski. When the opportunity came, I researched the area to see what had changed,
and saw that it still had the small community feel, lots of outdoor activities. And it has a health care system where you still have some control over the amount of time you have with your patient without being micromanaged. Q: Have you noticed much difference in the types of issues that patients present with in Fulton compared to Allentown? A: Pretty much still seeing the same type of people in Fulton. The only population I’m not seeing much here that I saw there were the Amish. Q: Is that difficult? Are there certain things you can’t do for them? A: No. They don’t have insurance, so they’re all cash-paying. They would generally wait until there were health issues that they couldn’t handle. They’re a population that are stoic and you generally won’t see them for annual check-ups. We were usually more of a last resort for them. Q: What kind of impact would you like to have on the Oswego Health system? A: Certainly the goal here is to let the community know that we’re here, we’re available and they shouldn’t have to wait long to be seen. The population can have someone locally now to go to. A lot of the local practices were overbooked and having a hard time accepting new patients. So hopefully we can alleviate that congestion and help keep the community as healthy as possible. Q: Back when A. L .Lee Memorial Hospital was still a hospital, one of the arguments for keeping it intact was that, during the worst of lake effect season, the 10-mile distance between Oswego and Fulton might as well be 80 miles. To what degree are you able to provide comprehensive care to Fultonites who can’t easily make it to Oswego or Syracuse? A: Our practice is outpatient, so we provide chronic care — diabetes, high-blood pressure, common injuries. We do preventive medicine, education and screenings. We have support of the facility next to us, which does blood work, mammograms, MRIs, so we can get studies done right here. In the office we’re in right now, we’re getting some specialists, so patients can follow-up with a surgeon here if, say, they got their surgery in Oswego. Our hope is to get additional sub-specialists here regularly to save patients some time. We’d like to get as much as we can done here. It’s a nice, modern facility that can serve the majority of the community’s needs. Now, complicated illnesses and major surgeries may still need to be referred to Oswego or Syracuse, but we can still help guide them to where they need to be.
Lifelines Name: Joselito Ouano, M.D. Position: Family medicine physician at Primecare Hometown: Hazelton, Pa. Education: Cebu Institute of Medicine; The Reading Hospital of Pennsylvania; Pennsylvania State University Affiliations: Oswego Health Organizations: American Academy of Family Physicians Family: Wife (Vivian); son (Justin); daughter (Sydney) Hobbies: Gardening, hiking, fishing, target shooting, tennis, reading
Coming This Summer: More Ticks and a Deadly New Tick-Borne Disease People need to be extra cautious when outdoors, with more of the critters after a mild winter
cientists have a double-shot of bad news about ticks: There’s a new, and potentially fatal, tick-borne illness called Powassan, and this summer looks like it might be one of the worst on record for an increase in the tick population. “Tick-borne diseases are on the rise, and prevention should be on everyone’s mind, particularly during the spring and summer, and early fall when ticks are most active,” said Rebecca Eisen. She is a research biologist in the U.S. Centers for Disease Control and Prevention’s division of vector-borne diseases. Laura Goodman, a senior research associate in population medicine and diagnostic sciences at Cornell University, concurred. “It’s going to be a bad season,” she said. Approximately 75 cases of Powassan disease were reported
in the United States over the past 10 years. Most cases have occurred in the Northeast and Great Lakes region, according to the CDC. Powassan is a virus that can be transmitted through a tick bite. Although rare, Powassan has been spreading, and more cases are likely this year, Goodman said. Signs and symptoms of Powassan can include fever, headache, vomiting, weakness, confusion, seizures and memory loss. Long-term neurological damage also may occur, according to the CDC. There’s currently no specific treatment for the disease. People with severe Powassan often need to be hospitalized to receive respiratory support, intravenous fluids or medications to reduce swelling in the brain. If inflammation of the brain
(encephalitis) occurs, the fatality rate is approximately 10 percent, the CDC warns. There’s no vaccine to prevent Powassan. The best prevention is avoiding ticks. And that may be harder to do this year, experts at Cornell University explained. Because of a milder winter in the Northeast, a dramatic increase in the tick population is expected in that region and possibly across the northern United States. Ticks carry not only bacterial diseases such as Lyme, but also viral illnesses like Powassan and parasitic diseases like babesiosis. To protect yourself from a tickborne infection, the CDC recommends: • Learning which tick-borne diseases are common in your area. • Avoiding places with thick veg-
etation, high grass and leaf litter. • Walking in the center of trails when hiking. • Using repellent that contains 20 percent or more DEET on exposed skin for protection that lasts several hours. • Using products that contain permethrin to treat clothing and gear — such as boots, pants, socks and tents — or wearing clothing pre-treated with permethrin. • Bathing or showering as soon as possible after potential exposure, to wash off ticks before they bite. • Removing all attached ticks as soon as possible. • Treating dogs with products that kill and/or repel ticks. • Examining gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats and day packs. • Drying clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended. • If the clothes can’t be washed in hot water, tumble dry on low heat for 90 minutes or high heat for 60 minutes. The clothes should be warm and completely dry.
Healthcare in a Minute By George W. Chapman
Understanding Trumpcare It took over seven years, but the House finally managed to get enough votes, barely, to repeal the Affordable Care Act (Obamacare) and replace it with the American Health Care Act (AHCA or Trumpcare). The fate of the bill now is in the hands of a much more moderate Senate. Once enough votes were pledged, the bill was intentionally sent to the floor for a House vote before the Congressional Budget Office could take a look at the bill and figure out what the financial and coverage consequences would be. If you recall, the CBO estimated that the original version of the AHCA would cause 24 million people to lose coverage. The revised bill sets aside $8 billion for pre-existing conditions or for high-risk pools. That sounds like a lot, but it is only $1.6 billion per five years. According to industry experts, about 226,000 people had pre-existing conditions covered by the ACA at a cost of $2.5 billion in 2011.
AHCA pre-existing conditions
The list is far more extensive and pervasive (ridiculous?) than you think. The AHCA would allow all commercial insurers to charge more all their customers for the following: cancer, chronic obstructive pulmonary disease, Crohn’s disease, cystic fibrosis, depression, diabetes, Down syndrome, eating disorders, epilepsy, glaucoma, gout, heart diseases, heartburn, high cholesterol, hypertension, kidney problems, mental health issues, sleep disorders, TB and tooth disease, among others. This issue, along with cost sharing reductions, will get the most attention when the Senate takes a look.
So the $8 billion proposed by the AHCA would only cover about half the 226,000 people with pre-existing conditions. Employer plans could be impacted by the AHCA by a provision that could jeopardize the current cap on out-of-pocket expenses. The bottom line is sicker people will pay a lot more for their insurance or go without. The latter option means hospitals and physicians will once again be faced with providing uncompensated care to the people who are the sickest and most vulnerable. Almost all of the industry’s major trade associations have expressed their concerns over potential reductions in insurance subsidies (cost-sharing reductions) including American Medical Association, American Nurses Association, American Hospital Association, and American Health Insurance Plans. The CBO analysis of the AHCA sent to the Senate should be out by the time you read this.
The healthcare industry has added a lot of jobs to the economy over the last 10 years and most of the jobs are good-paying jobs. The increase in hospital staffing has been in response to an aging population, increased regulatory burdens and increased demand for services as more people are insured. Reimbursements that have not kept up with increasing costs and the uncertainty over the AHCA (Trumpcare) have caused even the largest hospital systems to reduce staff. Brigham and Women’s Hospital in Boston announced plans to offer buyouts to 1,600 employees. Catholic Health Initiatives will cut 900 positions through layoffs and buyouts.
The Anderson Cancer Care Center in Texas plans to cut 1,000 jobs. NYC Health & Hospitals announced organizational restructuring that would eliminate 600 positions across its system. Before the ACA was repealed, the Urban Institute estimated even a partial repeal of the ACA, let alone a full replacement, would increase uncompensated care to providers by about $1 trillion a year for the next 10 years. Many hospitals will face credit downgrades if the AHCA causes millions to lose their insurance. To make matters worse, as staffing cuts are made, hospitals must deal with increasing physician and nurse burnout.
Americans use more drugs per capita than any other country. We also pay more for drugs than other country. Drugs now account for 10 percent of total healthcare spending. Recent accounts of price gouging by drug companies has brought the issue to the forefront. Even drugs made right here in the USA are cheaper in most other countries. The simple solution is already on the books. The FDA is empowered by the 2003 Medicare Modernization Act to allow drug imports to the USA, if they are deemed safe and less expensive. The drug lobby has been very effective at preventing anyone in the FDA or HHS from employing this provision. It is ultimately up to the president, who oversees HHS and the FDA, with one executive order.
The VA is contemplating closing more than 1,100 vacant and underutilized facilities in order to save $25 million a year and to shift more care to the private sector. President Trump recently signed a bill extending the period in which vets can seek medical care from private physicians and hospitals. The move toward priJune 2017 •
vatization was recently accelerated by reports of long, often fatal, waits for care at certain VA facilities.
We’re No. 37
The World Health Organization ranks the healthcare systems in 190 countries. The rankings are based upon several factors including the overall health of the population; health disparities within the population (poor vs. rich; public insurance vs. private insurance); system responsiveness/patient satisfaction; distribution of responsiveness within the population (uninsured vs. insured; urban vs. rural); distribution of financial burden (who pays: government, employer, self). All things considered, the WHO ranks the U.S. No. 37. The top five countries are: France, Italy, San Marino, (an independent sovereign country within Italy); Andorra, (an independent sovereign country between Spain and France) and Malta. Other notables are: UK, No.18; Germany, No. 25; Canada, No. 30; Russia, No. 130; China, No. 144. In last place at No. 190 is Myanmar. The U.S. remains firmly entrenched as the No. 1 country for highest cost per capita at about $10,500 and percentage of GDP at about 18 percent. In the 1960s, healthcare was 5 percent of the U.S. GDP George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at firstname.lastname@example.org.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Why You May Need a Health Care Advocate By Deborah Jeanne Sergeant
ou receive a stunning medical diagnosis that will require a long, arduous treatment and recovery. Your elderly father lives in another state. He functions well overall, but seems confused about his myriad of doctor’s appointments and medications. Your child’s health falters and you cannot find the right specialist to give you solid answers and treatment options. Any of these scenarios Torrey — and more — could indicate that a health care advocate could help you and your family. While health insurance typically does not cover the cost of retaining a health care advocate, Trisha Torrey, head of The Alliance of Professional Health Advocates in Florida, said that a health care advocate can help patients save money in some cases, such as finding a better price on medication or guiding patients toward the right specialist instead of paying for care that doesn’t help. “What Americans have Scholz learned is the health care system is only set up to help patients if they can make money off patients,”
Torrey said. “The money has gotten in the way.” The many changes in the health care and health insurance industries in recent years have left patients reeling. Torrey compares health care advocates to attorneys, as few people would represent themselves in court on an important or highly complex case. Lowered reimbursements have forced physicians to cram more patients into their case load to ensure they can stay solvent. Torrey said that doctors used to see 20 patients daily, but now try to see up to double that amount. As a result, the patient experience suffers. Health care advocates can help care providers by ensuring that the patient asks all the questions he needs to ask, understands the doctor’s orders and adheres to the orders, too. Torrey added that these steps are hard to do for patients who are in pain or taking some medication. Torrey said that at first, physicians thought advocates would take up valuable visit time; however, many more providers are realizing that advocates actually save them
time. Torrey said that the demand for advocates is growing. She has about 250 to 300 independent advocates in the US and Canada. Many come from clinical or social services backgrounds. “You can’t understand the health care system,” Torrey said. “It’s intentionally set up to be obscure. The only way to get through the system with the health care you deserve is to have a patient advocate by your side.” Carrie Scholz, patient advocate and owner of Health Navigation of CNY in Syracuse, would agree. “The health care system has gotten so fast-paced and complex,” she said. “It’s really driven by diagnostic codes and payer sources.” Because visits, by necessity, are shorter, providers have less time to discuss patient health. That’s where advocates come in. Initially, she felt concerned that providers would view
advocates’ presence as adversarial; however, most respond positively. Scholz feels that advocates fill a complementary role to help facilitate communication and better care coordination. Many older people see multiple providers. Since the electronic medical records in different health systems don’t always communicate, health advocates can help ensure that each provider is on the same page. Clients of Health Navigation of CNY pay for the service out-of-pocket, as with any other health advocate. But Scholz said that the service “gives people the ability to feel confident in their health care decisions. They can mitigate their side effects and do their best to achieve a quality outcome.” After an initial assessment, navigators with Health Navigation of CNY work with clients as little or as much as needed and bill at an hourly rate. Health Navigation of CNY offers phone coaching as well.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
Is New York the Worst Place for Doctors? Yes, according to a national survey; local experts: Upstate hurt in survey when lumped with Downstate
Have you youbeen beenoverwhelmed overwhelmed Ge G Have byaadiagnosis? diagnosis? by Health Navigation of Central New York youororaaloved lovedone oneisisfacing facinga a Health Navigation of Central New York IfIfyou can help you: complexhealthcare healthcarecrisis crisisyou youmay mayfeel feel can help you: complex confusedand andfrightened. frightened.A Apatient patient confused research your diagnosis • •research your diagnosis andand advocatecan canhelp helpyou younavigate navigatethe the advocate treatment options treatment options healthcaresystem systemtotoinsure insurethat thatyour your healthcare • •prepare forfor appointments by by prepare appointments needs needsare areaddressed, addressed,and andthat thatyou you prioritizing your goals andand questions prioritizing your goals questions are comfortable making treatment are comfortable making treatment • connect with resources and benefits • connect with resources and benefits decisions decisionsand andcommunicating communicatingwith with • support you and your family members your health care providers. • support you and your family members your health care providers.
Have support navigating Have you you been been overwhelmed overwhelmed Get Get support navigating by aa diagnosis? aa critical illness by diagnosis? critical illness N By Deborah Jeanne Sergeant
ew York ranks dead last as the most desirable place for doctors to practice, according If you orto a loved one2017 is facing a a March, WalletHub report.Health Navigation of Central New York 315.436.3526 Carrie@HealthNavig HealthNavigationofCNY.com 315.436.3526 HealthNavigationofCNY.com Carrie Scholz is a patient advocateCarrie@HealthNa with The study helpNavigation you: complex you may feel can Health of Central New York If you or healthcare a loved onecrisis isincluded facing a14 metrics, more than 30 years professional social work Carrie Scholz is aofpatient advocate with such wage, punitive tendency of confused andasfrightened. patient complex healthcare crisisAyou may feel can help you: the state medical board and annual • research your diagnosis and experience in patient advocacy and medical more than 30 years of professional social work advocate can you navigate the rates, • treatment confused andhelp frightened. Ainsurance patient options research your diagnosis and malpractice liability social work. in patient advocacy and medical experience healthcare system toyou insure that your advocate can help navigate the among other factors. treatment • prepare for options appointments by social work. needs are addressed, and that you study healthcare The system to drew insureinformation that your goals and questions • prioritizing prepare foryour appointments by from the U.S. Census Bureau, Buare comfortable making treatment needs are addressed, and that you prioritizing goals and withyour resources andquestions benefits reau Labor Statistics, Council for • connect decisions andofcommunicating with are comfortable making treatment Community and Economic Research, connectyou withand resources and members benefits your family your healthand carecommunicating providers. decisions with Admin-•• support Health Resources & Services “The report does show trends, you and your family members your health careWebMD providers. istration, and other sources. • support but may not be as bleak,” he added. 315.436.3526 Carrie@HealthNavigationofCNY.com HealthNavigationofCNY.com Jim Coulthart, executive Factors affecting New York’s vice-president of the Onondaga ranking include the state’s high cost 315.436.3526 Carrie@HealthNavigationofCNY.com HealthNavigationofCNY.com HealthNavigationofCNY.com County Medical Society, said that of medical malpractice insurance; our society’s tendency to sue and, 315-436-3526 however as with other factors, the specifically, New York’s many insurcity’s cost of living skews the statisCarrie@HealthNavigationofCNY.com ance regulations, make the state less tic. hospitable to doctors. While the cost of medical mal“Any one of these stressors or ag- practice insurance in Upstate ranges gravating factors by itself is probably between $25,356 and $36,357 annualnot a big deal,” Coulthart said. “A ly according to the Medical Liability cumulative effect is what we’re expe- Monitor’s 2015 survey, the higher riencing. That’s what puts New York rates in Downstate, topping $136,398 state toward the bottom of the list.” in Long Island, skews the statistics. It’s important to look at the “Lumping everything in New listing in context, since many of the York state isn’t fair because we have lower-ranking states, including New Upstate that’s cost effective and York, include large metropolitan Downstate that’s costly,” Gilbert said. Health of Central or a loved onethat is facing a areas have higher costs of livingNavigation Gilbert believesNew that York salary alone Carrie Scholz is a patient advocate with and denser ex healthcare crisisconcentration. you may feel can help you: doesn’t reflect the financial effects more than 30 years of professional social work They include Maine, Connectiof living in Upstate.and He said that sed and frightened. A patient • research your diagnosis cut, Massachusetts, Rhode Island, experience in patient advocacy and medical Upstate offers physicians less costly ate can help you navigate the treatment options Maryland, New Jersey and District of housing, a good public education social work. care system to insure that your Columbia. • preparesystem for appointments by and a higher quality of life. are addressed, and that you New York ranks as the fourthprioritizing“When someone’s looking at a your goals and questions most populated state behind three mfortable making treatment job in one state versus another, do • connect with resources andcost benefits states, California, Texas, they look at the total and total ons and larger-sized communicating with and Florida (according to the 2010 benefit?” Gilbert asked. “I counseled • support you and your family members ealth care providers. US Census). The census also states several residents and made sure they that 11,323,961 live in either New understand the differences.” York City or Long Island and only In a state with a poor public 8,422,266 live Upstate, meaning that education, physicians may have the the majority of the state’s populaadded expense of paying for a prition lives in New York City, which is vate school education, for example. culturally and environmentally much “Maybe we’re just doing a poor different from Upstate. job of ‘selling’ New York to physiNew York’s ranking has to do cians,” Gilbert said. with many different factors, accordCoulthart said that Upstate offers ing to Mark W. Gilbert, practice a great quality of life, such as close administrator at University OB GYN access to nature, community life and Associates, Inc. at Upstate Medical a good environment for raising a University. family.
ave you been overwhelmed Get support navigating by a diagnosis? a critical illness pathways to independence
Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by
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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.) • 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.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
New One-Day ‘Live Alone and Thrive’ Workshop: Registration Now Open Forging a new life on your own. Need some help?
or some women, living alone in mid-life is a welcome change, especially if they are coming out of an unhappy marriage. But for many others, the change is not welcome, and the prospect of living alone can appear on the horizon as a daunting challenge. The ending of my own marriage years ago fell into the latter category; it was not a welcome change. But it was a change nonetheless and one I had no choice but to accept and ultimately to embrace. It took some time and some hard-knock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to offer support to other women in similar circumstances. “Living Alone: How to Survive and Thrive on Your Own” is a workshop I developed to help women discover the know how to create a satisfying and enriching life on their own. I’ve been leading the workshop for over 12 years now, and often get questions from In Good Health readers about what the workshop covers and how it is organized. In this month’s column, I am pleased to answer the most frequently asked questions:
Q. What is the purpose of the workshop — and what do you cover? A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude, and my workshop will help you think differently about living alone. Specifically, I cover how to overcome loneliness and other emotional pitfalls, banish negative thinking, rediscover your true self and socialize in a couples’ world. The goal is to embrace what may be a once-in-a-lifetime opportunity to get to know yourself again and create a rewarding life on your own. Feeling comfortable with your independence will improve your chances of finding happiness, and it will improve your chances of finding a new healthy relationship, if that’s what you desire. When you feel better about yourself — more self-assured and resourceful — life on your own or with a special someone can be richer and more satisfying. Getting good at living alone takes practice. here’s no magic pill and it doesn’t happen overnight. But it can happen, and good things can result. Q. Who attends the workshop?
A. Most of the women who attend the workshop are in mid-life and have come out of long marriages or relationships. Some are on their own for the first time in their lives. All have one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist and/or their congregation. Q. I’m still grieving the loss of my marriage/spouse. Is this workshop right for me? A. Good question. My Living Alone workshop is a “nuts and bolts” practical workshop to help women feel more whole and complete on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend grief counseling or the help of a professional counselor. Q. What are your credentials? A. I am not a licensed professional. My expertise is born out of real-life experience. I’ve “been there.” I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of living alone. After some hits and misses, I found my way and now thoroughly enjoy the freedom and independence that comes with living alone. My time-tested experience, resources, tips and techniques have inspired and helped many workshop participants. My workshop has been the jump-start they needed to reclaim their lives. Q. How large are the workshops?
A. Ideally, I like to have eight women in each workshop, although, on occasion, I have led workshops with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly gives way to a comfortable camaraderie and it’s not unusual for nice friendships to develop among participants. Q. Where are the workshops held? A. At House Content Bed & Breakfast in Mendon, N.Y. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshop. Q. I’d like to sign up for the workshop. What’s my next step? A. I like to speak with potential participants by phone, as a first step. That way, I can answer your questions and you’ll know better whether this workshop is right for you. Just call me at 585-624-7887 or email me at email@example.com, and we’ll schedule a time to talk. You will find information about my upcoming one-day workshop 9:30 a.m. to 4 p.m., Saturday, June 24, in the Calendar of Health Events included in this issue. 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 or to contact Voelckers, call 585-6247887 or email: gvoelckers@rochester. rr.com.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Crouse’s new emergency department will feature 29 private rooms along with one semi-private room.
The Modern ER: Crouse’s New Emergency Department to Go Live in July Years in the making, Crouse Hospital’s new 20,000 sq. ft. emergency department to feature latest equipment, to shorten door-to-provider time By Matthew Liptak
t has been years in the making, but Crouse’s new Pomeroy Emergency Services Department is about to be open and it is creating excitement. “This is tremendous,” said physician David Mason, chief of the new department. “In terms of the give-and-take that we had I think we designed it really well. It’s going to be such a huge upgrade from what we have now. It’s really going to be awesome.” Crouse’s emergency department was built in 1974. It was due for some updating, but officials didn’t rush things, they said. They took as much time as was needed to try to get things right and bring Syracuse its latest 21st century ED. “What goes into it?” Mason mused. “Lots of blood, sweat and tears. Basically lots of research.” The heads of the new department worked with all other departments connected to the ED to get their input. They also worked with an architect firm to get the most out of the space they had to work with. “[We] tried to take the best things we could from what other people had done, learn from their struggles,” Mason said, “It’s been probably three to four years at the design level, planning the last two. It was about two years of weekly meetings getting down to the nitty gritty.” The hard work resulted in a 30room ED. That includes 29 private rooms along with one semi-private room. The upgrade is a substantial one over the old department that had only a few private rooms, but used multiple bays as well as hallways to house patients. “Basically the same amount of stretchers; it’s just taking care of patients in the way that they want to be taken care of,” Mason said. “There’s a huge gain in that. People don’t par-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
ticularly want to be in the hall when they’re not feeling well.” Crouse’s new ED will include all new medical equipment, according to Mason. The new rooms will improve patient flow because procedures can be done quicker. Much of Crouse’s improvements over the last few years, even before construction, has had to do with improving patient flow and cutting the time to see a provider. “We changed our model and put a physician in triage for 12 hours a day,” Mason said. “In 2011 we started with that model. That brought our door to provider time down from 75 minutes into the mid 20-minute range, which is a huge change. We got the provider to see the patient much, much quicker. A couple years after that, we looked at a rapid evaluation model. That’s what we designed our new ED on. Instead of a one bed, or two-room triage intake area, you have a whole intake unit. The providers and nurses ideally see the patient at the same time. We try to get everyone in at the same time and tag team as best we can. Our door-to-doctor time came down more with that model. We saw gains in our throughput times of getting people home sooner with the same level of care.” As of the writing of this story, Crouse’s door-to-doctor time was in the low 20 minutes. It’s door-to-discharge time for the main ED was 184 minutes. Crouse officials hope to shave those times even further. The ED is monitored for its times and some of its reimbursement is based on them, Mason said. The ED is moving from 8,000 square feet of space to 20,000-plus square feet. Although this is a vast improvement, designers were still
limited by the available area. The long and numerous meetings to prepare for the new ED allowed those involved to make the most of the space. “We, unfortunately, had lots of physical constraints because the shelf space was already built. It wasn’t like we had a blank slate. It did make the project more challenging. We fought for every square inch of medical space we could get. We want to be able to give as much patient care as efficiently as possible,” said Mason. In the spirit of maximizing space, the ED will have all valet parking in the future. The old ED space will be converted for additional uses by 2018. Mason said Crouse focuses most on emergencies related to heart attacks and neuroscience, like strokes. It does have a prompt care unit, however, which specializes in low-severity emergencies. That does 40 percent of the volume and the doorto-discharge time is 95 minutes. A short stay in the ED may beat over-nighting at the hospital for the patient, but it does offer more of a challenge to the staff. Crouse’s new emergency department will have two nurses and a tech caring for every six patients and two providers caring for every 15 patients. As the 21st century progresses, Mason said he is happy that Crouse will have a modern emergency department to meet patient’s needs. “I’ve been here now seven years,” he said. “It’s been a running joke that it was promised five years ago. The fact that we’re a month from opening the doors is amazing. It’s coming down to weeks now as opposed to next year or months from now. The excitement is there.”
Program Offers Free Mammograms
A New Spirit Aesthetics For All Your Skin Care Needs
By Matthew Liptak
pstate Cancer Center has instituted a new program to make sure women can get screened for breast cancer with as little hassle as possible. “It’s an initiative from Gov. Cuomo to really get women to have mammograms,” said Elizabeth Fuertes-Binder, 49, who was hired as patient navigator for the program. The program, called the National Accreditation Program for Breast Centers Patient Navigator Project, has the goal of increasing breast cancer screenings by 10 percent over the next five years. The five-year grant Upstate received was about $75,000, Fuertes-Binder said. Upstate works with two provider — Community Health and FamilyCare Medical Group — to identify those patients who have fallen behind in scheduling a regular mammogram. “The goal is really to work collaboratively with other organizations, offices in the community to [identify] people who have not done the mammogram or women who are behind on their mammograms,” Fuertes-Binder said. “My job is to reach out to them, and give them some information, and help them.” Fuertes-Binder will work with women to schedule a free appointment at a convenient location, discuss what to expect during the exam, navigate any insurance requirements,
How to Get Screened
Those interested in scheduling a mammogram through a free Upstate Cancer Center program, should call 315-464-5267 or send an email to firstname.lastname@example.org. help arrange child or elder care and see that any transportation needs in getting to the appointment are met. “At Upstate, they’re targeting a diverse population and women who normally wouldn’t go [for the test],” she said. The new navigator said she is motivated in her work of helping women get checked. She is not a nurse, but has an administrative background in the medical field. She hopes that grant, which began in the fall of 2016. is extended, so she can help more people. “It’s nice that you can interact with people and make a difference,” she said. “I think people feel it can be complicated. My job is to streamline it and make it pretty simple...so it takes the stress away.” Before joining Upstate, Fuertes-Binder served as program coordinator for Enable, a local agency that serves individuals with developmental or physical disabilities, and as a director with Menorah Park Group Residences, which provides a variety of independent living options in the Syracuse area.
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June 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
What to Eat This Season Surprising sources of summer weight gain (and what to do!) By Anne Palumbo
ow that the warm weather is here, a wonderful feeling comes across us: we want to eat lighter and fresher. An abundance of fresh summer produce certainly supports that desire. So hats off to farmers and farmers markets everywhere! But summertime does not automatically equal healthier eating and living. Although people may wish to eat healthier during the summer months, there are “seasonal temptations” that can derail even the best intentions. These warm-weather temptations, many of them caloric to boot, are typically found at festivals, state and county fairs, barbecues and the occasional picnic. Here are some summer foods you want to avoid (or else consume in sincere moderation) and some healthier options for you to consider. Fried dough: Consider roasted nuts or popcorn. Nothing kicks off the festival season quite like a big greasy plate of fried dough. Unbeknownst to many, these caloric bombs weigh
in with about 800 calories and 44 grams of fat, some of which could be the dreaded trans fats. Rumor has it, fried dough’s evil twin, funnel cake, is just as bad. Sure, they’re often divvied up, but still! Figuring you left those carrot sticks at home, opt for sharing some protein-packed roasted nuts or fiber-rich popcorn (minus all the butter and salt, of course). Frappuccino topped with whipped cream: Consider plain iced coffee. Oh, those frozen coffee drinks garnished with oodles of whipped cream: What would summer be without them? A lot less caloric, that’s what. Got a favorite? I did. But after discovering the sweet li’l thing had a waist-expanding 420 calories, 15 grams of fat and 66 grams of sugar, I switched over to plain iced coffee with some skim milk. On those occasions when only a frozen coffee drink will do, go for one made with nonfat milk and ditch the whipped cream: you’ll save hundreds of calories. Creamy potato or pasta salads:
Consider whole-grain salads. Stick-toyour-ribs foods like potatoes and pasta give us the slow-burning energy we need to stay warm in the winter. Come summer, however, we want to stay cool and light on our feet, which is why whole-grain salads are a good choice. Grains like farro, quinoa, buckwheat and brown rice can be prepared ahead of time and made into delicious, nutritious side salads. Still yearning to bring a potato or pasta salad to the family picnic? Dress it with a zesty vinaigrette versus a heavy mayo and add some veggies. Premium ice cream and custard: Consider sherbets, sorbets and low-fat yogurt blends. Ice cream consumption goes up in the summer and it’s no wonder: it’s cool, creamy, and delicious. The problem is — and it’s a biggie if you’re monitoring your intake — many of these premium ice creams (a.k.a. gourmet, artisanal, scratchmade) are loaded with fat, calories and cholesterol. Check the ice cream carton’s nutrition label for some eye-opening stats; and then, if you’re like most people who eat more than a meager ½ cup, multiply the amounts by 2. A cup of chocolate custard, for example, has about 500 calories and 28 grams of fat. Orange sherbet, on the other hand, has about 200 calories and only 3 grams of fat. Jumbo hot dogs with the “works”: Consider normal-sized hot dogs with fewer toppings. The average hot dog is not all that caloric, especially these days with so many lower-calorie and lower-fat versions available. And while hot dogs are not exactly a nutritionist’s favorite food, they can often be a better choice at the barbecue over a hamburger blanketed with cheese
Eight in 10 Eat Fast Food at Least Once a Week: Survey
mericans love fast food — even if they can afford meals that aren’t prepackaged in grease-resistant wrappers, according to a new study. The study found that Americans of all economic classes eat fast food. Middle-income Americans are the most likely to eat fast food, but only by a slight margin from other income groups. Even the wealthiest Americans admit to eating fast food, trailing other groups by just a bit, the researchers said. “It’s not mostly poor people eating fast food in America,” said study co-author Jay Zagorsky, a research scientist at Ohio State University’s Center for Human Resource Research.
“Rich people may have more eating options, but that’s not stopping them from going to places like McDonald’s or KFC,” he said in a university news release. The study included information from a national survey. The researchers zeroed in on roughly 8,000 people who were questioned about their weekly fast food intake in 2008, 2010 and 2012. The participants, who were all middle-aged, were asked how many times they had eaten food from a fast food restaurant, such as McDonald’s, KFC or Taco Bell, in the past seven days. The answers were then compared to questions about their wealth and
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
income. The study found that the fondness for fast food transcends economic classes and is shared by rich and poor alike. Overall, the researchers found that 79 percent of the participants ate fast food at least once a week. Twenty-three percent ate fast food three or more times during any one of the weeks examined in the study. The researchers noted that people whose income fluctuated dramatically in either direction didn’t change their eating habits. “If you became richer or poorer, it didn’t change how much fast food you ate,” Zagorsky said. The study was published online in Economics & Human Biology.
or Italian sausage. The calories begin to add up, however, with larger sizes (jumbo, stadium, bun-length), heaps of toppings, and the inclination to eat more than just one. Some bruisers with chili sauce pack a whopping 400 calories. So, choose your dogs and toppings wisely. Scour labels and opt for varieties that are uncured (nitrate/nitrite free) and lower in fat, calories, and sodium. Consider alternatives to beef — chicken, turkey, veggie — and pair it with a whole grain bun. Lastly, swap some of the traditional toppings for lower-calorie salsa. My favorite? Trader Joe’s uncured chicken hot dogs. Yum. Barbecued pork ribs: Consider leaner meats sans sauce. Pork ribs, while delectable, have more calories and fat, including saturated fat, than most meats. A half rack of barbecued pork ribs (about 6), for example, has anywhere from 500 to 600 calories and 30 to 40 grams of fat, a third of which are saturated. Saturated fat, as many know, has been linked to high cholesterol and heart disease. The slathered-on barbecue sauce only adds more calories. Select leaner, healthier meats — like skinless chicken or turkey, pork loin or sirloin steak — and use dry rubs for flavor over sauces. Final suggestion: Summer bursts with fresh produce in stores and at farmers markets, so take advantage of the seasonal, healthful bounty. What’s more, freezing produce is easy and preserves most of the fruit or vegetable’s nutritional content. Anne Palumbo is the author SmartBites, a food-related column published every month in In Good Health.
The skinny on healthy eating
The Audacity of Strawberries H ow can such a sweet li’l thing be so nutritious? Who does it think it is having more vitamin C than an orange? Enough antioxidants to rival a raspberry? Half the calories of a banana? And as much fiber as an apple? The nerve of this good-for-you goldmine! Let’s start with vitamin C and why it’s so important to our health. An essential nutrient, vitamin C — which is integral to collagen synthesis — works hard to keep bones, muscles and tissues in tip-top shape. Current research suggests it may even protect against skin wrinkling. And even though this immune-boosting vitamin may not be the cure for the common cold, it has been shown to reduce the length and severity of some colds. A cup of strawberry halves delivers a confident dose: 150 percent of our daily needs. Strawberries are antioxidant superstars, boasting enough of these magical molecules to rank among the top 10 fruits and vegetables for antioxidant content. Antioxidants are important compounds that protect our body from disease and accelerated aging by gobbling up harmful free radicals — byproducts of the oxida-
tion process that have been linked to cancer, heart disease, Alzheimer’s disease and more. Strawberries, already crazy-high in vitamin C (a powerful antioxidant!), are boldly loaded with the Michael Jordan of the antioxidant world: phytochemicals. Moving briskly to fiber: Strawberries are a darn good source of both soluble and insoluble fiber, delivering about 3 grams per sliced cup. While soluble fiber helps to stabilize blood sugar levels and lower cholesterol, insoluble fiber promotes regularity. Both contribute to a full feeling that helps curb snacking between meals, a boon for weight watchers. Think we’re all done with this heart-shaped hotshot? Hardly! This sassy superfruit flaunts an arsenal of “lows”: low in calories (only 50 per cup), fat, sodium and cholesterol; and, also, according to the American Diabetes Association, on the “low end” of the glycemic index. On top of everything, strawberries strut out an impressive amount of manganese, a mineral that’s good for bones and energy production.
Healthy Strawberry Smoothie
Strawberries, once picked, do not ripen further, so choose berries that are firm, plump, and deep red with their caps attached. Medium-sized strawberries are often the most flavorful. Buy organic if possible and consume within a few days of purchase. Place unwashed berries in refrigerator until ready to use. Do not leave berries at room temperature or exposed to sunlight for too long, as this will cause spoilage and possible loss of nutrients.
2 cups ripe strawberries, washed, hulled and sliced 1 cup low-fat plain Greek yogurt ¾ to 1 cup orange juice, almond milk or low-fat milk ¼ teaspoon vanilla 1 teaspoon sweetener of choice 1 tablespoon ground flaxseeds Anne Palumbo is a lifestyle colum (optional) nist, food guru, and seasoned cook, who Add the ingredients to a food has perfected the art of processor or blender. Process until a preparing nutritious, well-blended puree forms, about 15 calorie-conscious seconds, stopping to scrape down the dishes. She is hungry sides of the container once or twice. for your questions Taste the mixture and adjust sweetenand comments about er, if needed. If smoothie is too thick, SmartBites, so be in add water, juice or milk. If smoothie touch with Anne at is too thin, add more fruit. email@example.com.
June 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
By Eva Briggs
All About Polycystic Ovarian Syndrome
olycystic ovarian syndrome (PCOS) is the most common endocrine problem in reproductive age women in the United States. About 7 percent of women have PCOS. The disorder causes three key features: First, too much of the hormone androgen (hyperandrogenism). Second, infrequent, irregular menstrual periods (oligomenorrhea). Third, polycystic ovaries. The diagnosis of PCOS requires two out of those three symptoms. There isnâ€™t a single definitive test available to diagnose PCOS. Hyperandrogenism causes excessive acne, hair loss in a male-pattern baldness distribution and increased hair growth in a male pattern. Blood tests for elevated androgen levels arenâ€™t usually needed unless the hyperandrogenism symptoms are ex-
cessive or if they start suddenly and progress rapidly. In that case, blood tests help rule out the possibility of a tumor secreting male hormones. Menstrual problems include oligomenorrhea (infrequent cycles more than 35 days apart) or amenorrhea (no menstrual periods for six to 12 months after a regular cyclic pattern has been established). Adolescents often have irregular periods at first, so this symptom shouldnâ€™t be diagnosed until two years after a woman begins menstruating. Polycystic ovaries are defined as 12 or more follicles in a single ovary. The number could be 25 or more follicles when using newer and more sensitive technology. If a woman has both hyperandrogenism and menstrual abnormalities, then an ultrasound might not be needed for diagnosis.
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Women with PCOS are at increased risk of diabetes and metabolic syndrome (high blood sugar, high blood pressure, and abnormal cholesterol levels). PCOS patients also may have infertility issues. The exact cause of PCOS is uncertain. It likely results from a genetic redisposition coupled with environmental factors. Treatment depends on whether a woman desires pregnancy and which symptoms are most troublesome. For women desiring pregnancy, the medications clomiphene (Clomid) or letrozole (Femara) induce ovulation. Women who want to control menstrual irregularities but donâ€™t desire pregnancy can use hormone-containing contraception such as birth control pills, patch, vaginal ring or the levonorgestrol containing IUD (Mirena). Sometimes surgery is used to restore ovulation in women resistant to clomiphene. Lasers or electrosurgical needles make multiple punctures of the ovary via a laparoscopic approach. This lowers male hormone levels and increases a hormone called follicular stimulating hormone (FSH). Itâ€™s less likely to cause multiples babies (twins or triplets) than fertility drugs. Potential complications are scarring, as well as possible impairment of future infertility by decreasing ovarian reserve. Insulin resistance may lead to pre-diabetes or diabetes, and the first line of treatment is metformin. Women who wish to become pregnant can
take it. Diet, exercise and weight loss are also beneficial. The first line of treatment for hirsutism (excessive hair growth) is the birth control pill. But it may take as long as six months for improvement to begin. Other ways to treat hirsutism are the medicine eflornithine (Vaniqa), electrolysis and lasers. The medicines spironolactone and flutamide have been used but there isnâ€™t a lot of data for their effectiveness. Acne is common and the first line of treatment is hormonal contraception. It can be combined with typical topical acne medicines such as benzoyl peroxide, retinoids and antibiotics. Women with PCOS should be followed by their physicians due to the long-term increased risk for diabetes, metabolic syndrome and endometrial cancer. Pregnant women with PCOS are at increased risk of gestational diabetes, preeclampsia, cesarean delivery and delivering early or late. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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IN GOOD HEALTH â€“ CNYâ€™s Healthcare Newspaper â€˘ June 2017
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Parenting By Melissa Stefanec
Playing the Blame Game, Mom Style
ow would my kids be if they had different lives? Lately, the hyper-analytical side of me has been unrelenting on this topic. I’ve been thinking a lot about the classic nature vs. nurture and, as one of the main nurturers of my children, I’ve been introspective about the less-desirable facets of my children’s personalities. To put it plainly, I’ve been blaming myself for my children’s shortcomings and wondering how I should have done things differently. Unfortunately, I think a lot of parents do this (and then do it some more). Every time our kids fall short of our expectations, we wonder what we did wrong. It’s silly and irrational, but seeing as children are both of those things, it makes perfect sense. Two problems have been plaguing my thoughts as of late. The first step in solving a problem is to identify it. So, here they are (with a proposed solution that I will have to repeat as a daily affirmation). Problem No. 1 — Beating myself up for not having myself or my hus-
band stay home with the kids. My husband and I work outside of the home. My son spends the bulk of each day with a small group of children at an in-home daycare. My daughter splits her time between kindergarten and the same daycare. They are very well cared for and very much loved by my daycare provider. They also have a core group of daycare friends whom they have spent most of their young lives around. Of late, one of my most nagging questions is how my children would be if one of us stayed home. One thing I especially dwell on is my son. He has very much become a stereotypical little boy. He loves horseplay, trucks and dinosaurs. He acts how little boys are supposed to act because he spends time at daycare with little boys who act like quintessential little boys. I am intrigued by how much different my son might be if he wasn’t exposed to that. Maybe he would be very close to the same; maybe he would be drastically different. The thing is, I will never know, and that drives me batty.
Solution — Although I don’t think it’s uncommon to ask how our children would be different if they had different experiences, there is nothing to be gained from such thinking. I think it’s all right to look back at our mistakes or missteps and learn from them so we can be better parents in the future, but anything more than self-reflection is just indulgent and dangerous. To put it another way, I need to stop looking back and start looking forward. I need to drop the guilt about my kids spending most of their waking hours at daycare. That’s my family’s reality. It’s worked out well for us; I need to stop contemplating how I could’ve possibly painted a rosier past. All decisions result in consequences, and I will never know if I made the right decisions for my kids. So, I just need to keep on keepin’ on and make all of my parenting decisions with equal amounts of love and prudence. Problem No. 2 – Taking responsibility for my kid’s shortcomings. I think a lot of parents blame themselves for everything. We look at our children’s undesirable traits and wonder what we did or didn’t do to bring them out in our children. We blame ourselves for the nature, and we blame ourselves for the nurture. When my children bicker with each other, I wonder if my husband and I bicker too much. When my children fail to exercise self-control, I think about all the times they’ve pushed me to the brink and made me lose control. Have I taught them to do the same when things get really tough? (Which, let’s face it, is about every five minutes for young chil-
Solution — I am going to look into the mirror each morning and I remind myself that I am not perfect, I shouldn’t expect myself to be, and my children don’t want me to be. We are all hopelessly flawed, and no amount of effort will change that. It isn’t really a matter of whether or not we are going negatively impact our children; it’s more a question of how. When my daughter displays her inherited sass, I will remind myself of how much sassy women are needed in this world. When my son wants to be independent to his detriment, another passed-on affliction, I will imagine him doing his own laundry when he is 9 and taking control of his life. When my kids bicker with each other, I will remind myself how great it is that neither of them stand down easily. When they display a trait that I just can’t put a positive spin on (e.g., whacking one another for stealing a toy), I will chalk it up to kids being kids, issue an appropriate consequence, and remind myself they are their own beings. So, next time you want to blame yourself for every toddler or teenage rebellion, cut yourself a little slack. Although parents undoubtedly contribute genetic and environmental influence, our children are still their own people. We are not solely responsible for their actions. I will console myself with the fact my kids got my good habits and my bad habits. And, sometimes, it’s our bad habits that make us strong, resilient, amusing, humble and, most importantly, human.
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We participate with most insurance plans including Fidelis June 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Two out of three American men manifest noticeable hair loss by age 35. By 50, the number jumps to 85 percent and the hair loss is significant. Figures are from the American Hair Loss Association based Calabasas, Calif.
Answers to Men’s Hair Loss
results. PRP also is applied directly es the client’s natural color. Since to the scalp to reduce further hair the ink contains no metals, it cannot loss. change color significantly. Because Quatela explained the two the needle doesn’t go deep like regtransplantation methods his office ular tattoos, most clients experience offers. Follicular unit transplantation little pain. is often called the “strip method” Going too deep makes the ink because it involves the removal of spread. The rest of the client’s hair a strip of hair-bearing skin from the should stay cut within one millimeter back of the scalp. long to blend with the tiny tattoos. The doctor separates the strip Eric Taylor of Rochester respondBy Deborah Jeanne Sergeant treatments along with laser treatinto micro-follicular unit grafts to be ed to an ad for Scalp Aesthetics to ments that re-grow hair. Clients come transplanted in the same direction of solve his hair woes. He had the proin twice per week for a month, then the patient’s natural hair growth so it cedure done in 2013 and couldn’t be wo out of three American men weekly, every other week and, finally, looks natural. happier with his look. Now he works show noticeable hair loss by every three weeks for maintenance. Neograft follicular unit exas the company’s global sales and opage 35, according to the AmerWithin three months, she said, fine traction also uses the patient’s own erations manager. ican Hair Loss Association, based in fuzz appears and within a year, hair but extracts them in multiple He said that many people have Calabasas, Calif. By 50, the number clients grow thick, visible strands to tiny circular areas containing foltold him he should grow out his hair, jumps to 85 percent and the hair loss licular units. This method prevents not realizing that his “full head of is significant. A whopping 25 percent help fill in their hair. “We never recommend to comdamaging the grafts by pulling or hair” was mostly tattooed. begin the process of male pattern pletely stop treatment, but they’re twisting them. For most top-of-the-head procebalding by age 21. on a maintenance routine at home,” For both procedures, it will dures, the client receives 15,000 tiny Men who want to do something Fragale said. take about four to six months to see hair replicated dots. Taylor chose a about their hair loss have more In addition, Profiles offers new growth. The final result can be slightly receded hairline which he options available than ever. But, first, assessed at one year. felt appears more realistic for his age. they should know the reason for their supplements that contain vitamin B, biotin and a complex formulated by a Quatela also offers topical prodTaylor said that he likes the hair loss by discussing it with their doctor to support hair health. ucts among its hair loss treatment permanency of his hair loss solution, primary care provider. Thyroid disProfiles also fits custom hair sysoptions. and the fact that he doesn’t have to ease or stress can cause hair to thin, tems that bond directly to the scalp. Some men buzz or completely worry about swimming, wind or for example. Nutrition, stress and Hair transplants are still quite in shave their heads to minimize the sweating as with hairpieces. His only medication could play a role. demand. contrast between balding areas and maintenance is shaving his remainSome topical treatments can Order Proposal# Vito C. Quatela,MP board-certified intact areas. But shaved guys lose the ing hair every 48 to 72 hours and a reduce the appearance of thinning he classification of: facial plastic surgeon, serves clients definition that a hairline provides. Ad touch up of the tattoos every seven by bolstering the remaining hair and from all over Upstate New York at Some feel that shaving detracts from Letterto eight years, as the ink can fade reduce the amount of hair shed. their facial features. slightly over time. Vanessa Roming, sales consultant the Quatela Center for Hair Restoration in Rochester. His practice That’s where Scalp Aesthetics “It works well with the graying at CosmoProf in Syracuse, recom2014 mended Gibs products, which she offers platelet rich plasma (PRP), a may help. Founded in Rochester, the process,” Taylor said. “If someone advance in hair loss. Ad Id: company has spread to 160 locations has it done in their 30s, he can come said help prevent hair loss.” Acct# A1ZGFE Sales Rep: GRIMALDI,recent JENNIFER L treating Size: HCN6 AMZHMA1 Contract# 5544766 PRP treatment begins by drawing the worldwide, including Syracuse. back two or three times before they For re-growing hair, she said to patient’s blood. When platelets from Technicians use an extremely thin can let it go along with the graying try topical Nioxin. To retain the new the blood are activated, their growth needle to perform micro tattoos on process of the natural hair.” hair, the user must continue to apply factors “trick” cells into thinking a man’s balding areas to mimic the The typical procedure costs it daily. they’re in a younger growth phase. appearance of a short buzz cut. $3,000 to $5,000. At Profiles by Kristin in SyraPRP is injected into the scalp to The technician goes only one laycuse, representative Nichole Fragale help hair transplants achieve better er deep with organic ink that matchsaid the office offers scalp therapy
New treatments for baldness range from platelet rich plasma to micro tattoos that mimic the appearance of a short buzz cut
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
A.M.P. is a multi-specialty medical practice located throughout CNY with services that include:
A.M.P. is a multi-specialty medical practice located throughout CNY with services that include: -
1226 East Water Street, Syracuse NY 13210 (315) 478-4185 - North Medical Center 5100 West Taft Road, Suite 4D, Liverpool NY 13088 (315) 458-6669 1226 East4211 Water Street, Syracuse NY211, 13210 (315) 478-4185 Northeast Medical Center Medical Center Drive, Suite Fayetteville NY 13066 (315) 329-0210 Medical 5700 Street, West Genesee Street, Suite Camillus NY 13031 (315) 478-4185 1226Center EastWest Water Syracuse NY124, 13210 (315) 478-4185 NorthStreet, Medical 5100 West(315) Taft363-8862 Road, Suite 4D, Liverpool NYHartford 13088NY (315) 458-6669 357 Genesee SuiteCenter 1, Oneida NY 13421 ♦ 2 Ellinwood Drive, New 13413 (315) 724-1012 North Medical Center 5100 West Taft Road, Suite 4D, Liverpool NY 13088 (315) 458-6669 1617 North James Street, Suite 700, Rome NY 13440 (315) 337-2204 ♦ 6 Euclid Avenue, Building 2, Cortland NY 13045 (607) 753-9076 Northeast Medical Center 4211Medical Medical Center Drive, Suite 211,West Fayetteville NY 13066 (315) 329-0210 Northeast Medical Center Center Drive, Suite Fayetteville 13066 329-0210 192 Genesee Street, Auburn NY4211 13021 (315) 258-5253 ♦ Fulton Commons 806211, Broadway, Fulton NY NY 13069 (315)(315) 297-4700
Medical Center West 5700 Street, Suite Camillus NY 13031 (315) 478-4185 Medical Center West 5700West WestGenesee Genesee Street, Suite 124,124, Camillus NY 13031 (315) 478-4185 Genesee Street, Suite 1, Oneida NY 13421 (315) 363-8862 ♦ 2 Ellinwood Drive, New Hartford NY 13413 (315) 72 357 Genesee Street, Suite 1, Oneida NY 13421 (315) 363-8862 ♦ h James Street, Suite 700, Rome NY 13440 (315) 337-2204 ♦ 6 Euclid Avenue, Building 2, Cortland NY 13045 (6 Ellinwood Drive, New Hartford NY 13413 806 (315)West 724-1012 enesee Street, Auburn NY 130212 (315) 258-5253 ♦ Fulton Commons Broadway, Fulton NY 13069 (315) 1617 North James Street, Suite 700, Rome NY 13440 (315) 337-2204
6 Euclid Avenue, Building 2, Cortland NY 13045 (607) 753-9076
♦ 192 Genesee Street, Auburn NY 13021 (315) 258-5253 A.M.P. is a multi-specialty medical practice located throughout CNY with services that include:
Fulton- Commons 806 West Broadway, Fulton NY 13069 (315) 297-4700 1226 East Water Street, Syracuse NY 13210 (315) 478-4185 North Medical Center 5100 West Taft Road, Suite 4D, Liverpool NY 13088 (315) 458-6669 Northeast Medical Center 4211 Medical Center Drive, Suite 211, Fayetteville NY 13066 (315) 329-0210 Medical Center West 5700 West Genesee Street, Suite 124, Camillus NY 13031 (315) 478-4185 357 Genesee Street, Suite 1, Oneida NY 13421 (315) 363-8862 ♦ 2 Ellinwood Drive, New Hartford NY 13413 (315) 724-1012 1617 North James Street, Suite 700, Rome NY 13440 (315) 337-2204 ♦ 6 Euclid Avenue, Building 2, Cortland NY 13045 (607) 753-9076 192 Genesee Street, Auburn NY 13021 (315) 258-5253 ♦ Fulton Commons 806 West Broadway, Fulton NY 13069 (315) 297-4700
A.M.P. is holding our 4th annual ZERO Prostate Cancer Run/Walk! We hope to see you! Saturday, June 24th @ 9:00am at Clay Central Park 4821 Wetzel Road, Liverpool, NY 13090 Register today! www.zeroprostatecancerrun.org/syracuse
June 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Low-skill Jobs May Raise Suicide Risk Among Men Suicide among low-skilled workers 44 percent higher than national average
By Deborah Jeanne Sergeant
en employed in low-skill jobs are 44 percent more likely to commit suicide than the national average, as reported by the U.S. Office of National Statistics. The figures don’t surprise Alice Honig, PhD, professor emeritus at Syracuse University in private practice. She sees two primary issues at work: a skewed perspective on manliness and lack of knowledge about what could help. She said that most women feel fulfilled through the several roles available to them such as career, mother, aunt and grandmother. But some men tend to hang their selfworth mostly upon their workplace successes — or lack thereof. “If you have shame about not being the top breadwinner, it’s a toxic and idea of being an ‘OK’ man if you don’t make a lot of money to take out feeling,” Honig said. “If you’re a low-educated male whose whole idea a woman and have a good time? Or provide for a family?” of being a male is being sexually asWhile sertive and having a good job, what’s urologyIGH.10.25x6.75.qxp_Layout 1 8/19/16 1:12 PM Page 1 professional mental health care can help, many men won’t seek going to happen to your self esteem
help. Honig said that mental health care can seem unattainable to many men. Many working poor don’t qualify for income-based insurance
programs, and some find premiums, co-pays and deductibles unaffordable if they work for an employer who does not have to provide health insurance coverage. They may not be aware of sliding scale fees or low-cost clinics some colleges offer. While seeking higher education seems an obvious step toward a more fulfilling life, a man working to support his family on a low income won’t have much time or energy to pursue training. The cost of education has risen exponentially in recent years and even free education costs time. For middle-aged and older men, seeking education for better employment can be even more difficult because they may have more responsibilities than younger, single people. Some have not engaged with technology and their employable skills lag behind because of it. Honig said that many women who didn’t pursue education after high school feel less inhibited than other men about later seeking more education. “Some men just give up,” she said. “They think they’re worthless and want to give up.” Christine Matteson, licensed mental health counselor in private practice in Syracuse, thinks that a counselor or therapist can help men discuss potential opportunities. “People can get stuck in their thinking if they don’t know other options,” she said. She also wants men to discuss any previous mental health issues, which can contribute to risk for suicidal ideation or death by suicide. Maintaining a close support system can also help; however, Matteson said that men don’t tend to do this as much as women.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
Men’sHealth Identifying Aggressive Prostate Cancers Roswell researchers developing genetic testing to establish if prostate cancer is slow-growing or fast-growing. Test to help patients, doctors to determine cancer treatment By Deborah Jeanne Sergeant
rostate cancer is one tricky cancer. Men with prostate cancer may have a tumor that doesn’t grow or spread quickly. In this case, a waitand-see option may be favorable over prostatectomy, which can cause side effects like incontinence and impotence. But other men have aggressive tumors that spread to other areas of the body rapidly. Surgery or follow-up cancer treatments can give them the best chance to save their lives. Telling the difference between slow-growing and fast-growing and recurring tumors has relied mostly on prostate-specific antigen (PSA) testing. But soon, genetic testing may lend a hand. Factors other than prostate cancer can elevate the PSA level. Obesity and other factors can abnormally lower PSA levels. Various factors can skew PSA testing, resulting in false negatives or false positives. Researchers with Roswell Park Cancer Institute in Buffalo, led by Irwin H. Gelman, Ph.D., have identified the 11-gene signature linked to advanced, recurrent prostate cancer. Once they establish the gene signature’s predictive value, they can perform a biopsy to give men and their doctors more information to make what is often a life-altering decision. Gelman directs Research Integration and serves as a distinguished professor of oncology, along with chairing the Cell & Molecular Biology academic program. He also directs shRNA Core Resource at Roswell Park Cancer Institute. “The signature is based upon trying to predict early on whose cancer might recur,” Gelman said. “The research is to look at tumors, or human cell lines which recapitulate this recurrence type of disease and then trying to find out genetic gene signatures that align with a recurrence versus a primary disease.” Men with family history of prostate cancer are more likely to have a more aggressive prostate cancer, which makes such testing even more meaningful. Gelman and his team hope to start a clinical trial to confirm that the gene signature can accurately predict which tumors will spread and recur
and which ones won’t. For those with recurring tumors, treating with drugs that attack the gene signature can disrupt the cancer’s mechanism and “decrease significantly the recurrence of the disease,” Gelman said. “Hopefully, it will become a predictive marker to figure out who’s at higher risk and develop and test to decrease the incidences of occurrence.” The team has a few ideas of drugs that could be useful in preventing recurring prostate cancer, and hope to complete a trial in a few years. William Phelps, PhD, works with American Cancer Society-funded researchers as vice president of Extramural Research in Atlanta, Ga. He said that the question of whether a tumor is slow growing or fast growing “is certainly one of the critical questions that physicians don’t have a tool to answer. “People’s perception of cancer can be, ‘Just get it out of me.’ But if they want to wait and see, it is absolutely a critical question if their cancer will grow quickly and the field needs this as a prognostic and diagnostic tool.” David Albala, chief of urology at Crouse Hospital and a partner at Associated Medical Professionals of NY, compared identifying aggressive prostate cancer with genetic testing to determining risk of breast cancer. “Currently, there are a number of commercially available genetic profile tests to help us make decisions in prostate cancer,” Albala said. “Many with low-risk prostate cancers, we can do active surveillance on.” “If the risk was high you might want to look at other treatment. Comorbidity and age play into it.” For example, a tumor that’s growing slowly in a man who’s 89 and has experienced two strokes is treated much differently than a slow-growing tumor in a man who’s 50 and in otherwise good health. “I think the future is in the next type of marker, phenotypic marker,” Albala said. “Understanding genomic markers is like taking a picture of a certain number of genes and understand how they related to prostate cancers. It’s how the tumor reacts in the environment. We’ve been doing cutting-edge research.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Treatments for Andropause, the ‘Male Menopause’ By Deborah Jeanne Sergeant
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2017
omen aren’t the only ones to experience “the change” later in life. “Andropause” is often used to describe symptoms affecting mature men such as decreased libido, lowered vitality, weight gain, erectile dysfunction, decreased muscle mass and bone density, anemia, pre-diabetes, depression and increased irritability. These symptoms correlate with older age because that’s when levels of testosterone begin to dip for many men. About four out of 10 men over the age of 45 have low testosterone and that number increases as men get older, according to the Urology Care Foundation in Linthicum, Md. Some of the symptoms of andropause can indicate other issues, so it’s important to seek a medical exam. A blood test can measure testosterone levels. If a medical provider identifies low testosterone as the reason for the symptoms, the provider and patient discuss options and weigh the risks and benefits of various treatments, if that’s what the patient wants. If the symptoms are minor and can be addressed through non-medical means, that’s a good first step. Bashar Omarbasha, urologist with Associated Medical Professionals based in Syracuse, said that men diagnosed with low testosterone may benefit from losing weight and that’s the initial response he recommends. “The most common reason for low testosterone in the US is male obesity,” Omarbasha said. “Belly fat suppresses the production of testosterone. Once they lose the weight, the testosterone levels start to go up, but you have to convince them of that.” He said that metabolic syndrome ties in with high cholesterol, diabetes,
and low testosterone. Eating better, exercising and losing weight can improve his testosterone levels to within a normal range. Omarbasha said that men diagnosed with low testosterone usually respond well to testosterone replacement therapy. Within a short time period of using testosterone gel, implants or intramuscular injections, the symptoms subside. “They come to the office very happy and they feel like a young kid now,” he said. A contraindication for testosterone replacement therapy is the presence of prostate cancer. Omarbasha Though replacement therapy cannot cause prostate cancer, if the patient already has prostate cancer, testosterone replacement therapy can accelerate it. That’s why patients receiving testosterone replacement therapy are regularly screened for prostate cancer. Omarbasha said that many men do not see their doctor about the symptoms related to low testosterone and he wishes more men would. “It is highly treatable and men can find relief,” he said. Christie Mason, gym manager and personal trainer at Stability Fitness in Oswego, said that an improved diet and weight lifting can improve testosterone levels some, but popping off a few reps of light weights won’t do much. “They need to work the legs because they have bigger muscles,” she said. “That will help increase their testosterone.”
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I’ve recently read that all baby boomers should get tested for hepatitis C. Is this really necessary, and if so, what are the testing and treatment procedures? Healthy Boomer Dear Healthy,
see your primary care doctor for a basic blood test to determine whether you have ever been infected with hepatitis C. This is a relatively inexpensive test and typically covered by health insurance under routine medical care. If the test is negative, no further tests are needed. But, if the test is positive, you’ll need another test called HCV RNA, which will show whether the virus is still active. If you test positive, you have chronic hepatitis C and will need to talk to your doctor about treatment options. If you’re infected, but have no liver damage, your doctor should monitor your liver at your annual physical. The main treatments for chronic hepatitis C today are several new FDA-approved antiviral medications that have a 95 percent cure rate. Compared to older treatments, these new medications have minimal side effects. Unfortunately, all the new drugs are very expensive — a 12-week treatment course can cost anywhere from $50,000 to $90,000. Not all health insurance plans, including Medicare Part D plans, cover all prescribed medications for hepatitis C. And due to the expensive nature of these medications, most insurance plans require that you meet several requirements in order to get coverage. If your insurance provider doesn’t cover the antiviral therapy your doctor recommends, there are financial assistance options available. To look for help, visit HEPC.liverfoundation.org and put your cursor on “Resources” and click on “What if I Need Financial Assistance to Pay for Treatment?” And for more hepatitis C information, along with a quick online quiz you can take to determine your risks, see CDC.gov/knowmorehepatitis. You can also get information over the phone by calling the national toll-free HELP-4-HEP helpline at 877-435-7443.
It’s true. Both the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention (CDC) recommend that all baby boomers — people born from 1945 through 1965 — get a hepatitis C test. The reason is because baby boomers account for 75 percent of the 3 million or so hepatitis C cases in the U.S. Those that are infected are at very high risk of eventually developing liver cancer, cirrhosis or other fatal liver diseases. Most hepatitis C infections occurred in the 1970s and 1980s, before there were tests to detect them and before the nation’s blood supply was routinely screened for the virus. Hepatitis C is transmitted only through blood, so anyone who received either a blood transfusion or an organ transplant prior to 1992 is at increased risk too. So are healthcare workers exposed to blood, and people who injected drugs through shared needles. The virus can also be spread through microscopic amounts of infected blood that could occur during sex, from sharing a razor or toothbrush, or getting a tattoo or body piercing at an unsterile shop. Most people that have hepatitis C don’t know they’re infected because there are no symptoms until their liver becomes severely damaged. It can actually take 30 years for people to show any signs of the virus, but by then, it may be too late to treat. But if it’s detected in time, newBugow’s treatmentsDriver are now available that can cureRehab it. email@example.com
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Social Security Supports National Cancer Survivors Day In 2017, more than a million people will be diagnosed with cancer around the world. This alarming statistic affects people and families everywhere. Chances are, you know someone who has been affected by this terrible disease. On June 4, we observe National Cancer Survivors Day in the United States. In support of this day, Social Security encourages getting checkups to provide early detection, raise awareness through education and recognize the survivors who have gone through this battle or are still living with the disease. Social Security stands strong in our support of the fight against cancer. We offer services to patients dealing with this disease through our disability insurance program and our compassionate allowances program. Compassionate allowances are cases with medical conditions so severe they obviously meet Social Security’s disability standards, allowing us to process the cases quickly with minimal medical information. Many
Q: My same-sex partner and I recently married. Will we qualify for Social Security benefits? A: You may be eligible to apply for Social Security benefits. Many factors affect your eligibility for benefits, including how long you worked and your age. Social Security is now processing more claims in which entitlement or eligibility is affected by a same-sex relationship. We encourage you to apply for benefits right away, even if you aren’t sure you’re eligible. Applying now will protect you against the loss of any potential benefits. You can apply safely and securely at www.socialsecurity. gov/applyonline. Learn more about Social Security for same-sex couples by visiting www.socialsecurity.gov/ same-sexcouples. Q: I worked the first half of the year, but plan to retire this month. Will Social Security count the amount I earn for this year when I retire? A: Yes. If you retire mid-year, we count your earnings for the entire year. We have a special “earnings test” rule we apply to annual earnings, usually in the first year of retirement. Under this rule, you get a full payment for any whole month we consider you retired regardless of your yearly earnings. We consider you retired during any month your earnings are below the monthly earnings limit, or if you have not performed substantial services in self-employment. We do not consider income earned, beginning with the month you reach full retirement age.
cancers are part of our compassionate allowances list. There’s no special application or form you need to submit for compassionate allowances. Simply apply for disability benefits online, in-person or over the phone. Once we identify you as having a compassionate allowances condition, we’ll expedite your disability application. Social Security establishes compassionate allowances conditions using information received at public outreach hearings, from our employees, who review millions of disability cases each year, from medical and scientific experts, and from data based on our research. For more information about Compassionate Allowances, including the list of eligible conditions, visit www. socialsecurity.gov/compassionateallowances. Social Security is with you throughout life’s journey, through good times and bad. If you think you qualify for disability benefits based on a Compassionate Allowances condition, please visit www.socialsecurity.gov to apply for benefits. Learn more about the earnings test rule at www.socialsecurity.gov/retire2/rule.htm. Q: How do I know if I have worked long enough to qualify for Social Security disability benefits? A: You must have worked long enough — and recently enough — under Social Security to qualify for disability benefits. Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. The amount needed for a credit changes from year to year. The number of work credits you need to qualify for disability benefits depends on your age when you become disabled. Generally, you need 40 credits, 20 of which you earned in the last 10 years, ending with the year you become disabled. However, younger workers may qualify with fewer credits. To learn more, see our Disability Planner at www.socialsecurity.gov/dibplan/dqualify3.htm. Q: I’m applying for disability benefits, and I read about “substantial gainful activity.” What is that? A: The term “substantial gainful activity,” or SGA, is used to describe a level of work activity and earnings. Work is “substantial” if it involves doing significant physical or mental activities or a combination of both. If you are working and earn more than a certain amount, we generally consider that you are engaging in substantial gainful activity. In this case, you wouldn’t be eligible for disability benefits. You can read more about how we define substantial gainful activity at www.socialsecurity.gov/OACT/COLA/sga.html.
H ealth News MVP Health promotes Kelly Smith to VP, sales MVP Health Care has promoted Kelly Smith to vice president, sales. She will be responsible for identifying and growing MVP’s new commercial business opportunities. Smith joined MVP in August 2015 as director, new sales and exchange solutions. In her time at MVP she has implemented sales strategies for commercial products in East New York, Hudson Valley and Vermont. She also has worked with national and regional consultants, brokers and employers as MVP takes a lead role in developing private insurance exchanges. Prior to joining MVP, Smith was a senior member of the New York Health Benefit Exchange, publicly known at N.Y. State of Health. Smith is a member of the National Association of Health Underwriters and is a graduate of the Leadership Institute Smith through the Rensselaer County Regional Chamber of Commerce. A graduate of SUNY Oswego, Smith has a bachelor of science degree in biology.
Rattmann elected Excellus BCBS board chairman Thomas E. Rattmann has been elected chairman of the board of directors of Excellus BlueCross BlueShield and its parent company. He succeeds Thomas A. Hildebrandt. Rattmann is chairman of the board of Columbian FiRattmann nancial Group, a life insurance organization based in Binghamton,
which is primarily focused on the issuance of small-face life insurance products. He retired as Columbian’s chief executive officer in December 2016. Rattmann has been a member of company’s governing board since 2010. He continues as chairman of the regional advisory board of Excellus BlueCross BlueShield Southern Tier region. In his career Rattmann has served on boards of directors of leading life insurance industry trade organizations, including as past chairman of the Life Insurance Council of New York and as a director of the American Council of Life Insurers. He also has served on the boards of directors of various community organizations in the greater Binghamton area.
Upstate has new director for ambulatory services Physician Amy L. Tucker has been named medical director for adult ambulatory services at Upstate Medical University. “We are thrilled to have a physician of Dr. Tucker’s caliber join our organization, to help lead our efforts within the ambulatory care space,” said physician Tucker Anthony Weiss, chief medical officer for Upstate University Hospital. “We see continued shifts in care to the outpatient side, particularly as part of our work within delivery system reform incentive payment program (known as DSRIP). Dr. Tucker’s expertise will be critical in our organization’s evolution in that direction.” As medical director of adult ambulatory services, Tucker is responsible for the overall management of the adult ambulatory operations at Upstate, excluding the Upstate Cancer Center, including clinical practice operations, medical affairs and quality. Upstate offers a large network of outpatient clinical sites to serve patients from both hospital campuses and in the community. Ambulatory services include primary and specialty care, encompassing nearly 80
specialty clinics. A practicing cardiologist, Tucker has served on the faculty at the University of Virginia (UVA) since 1994, most recently as an associate professor of medicine. While at Virginia, Tucker held various administrative roles including founder and director of the club red women’s cardiovascular prevention clinic, associate chairwoman of medicine for undergraduate medical education, and director of the cardiovascular fellowship training program. Tucker also served as the director of ambulatory and consultative cardiology services. In 2014, Tucker was appointed chief medical officer for Locus Health, LLC (previously Broad Axe Care Coordination), a company providing comprehensive care coordination, remote patient monitoring, and performance optimization using advanced data analytics. Through its partnership with Locus Health, UVA significantly reduced hospital readmission rates. Tucker is a fellow of the American College of Cardiology and the American College of Physicians. Tucker earned a master’s degree in health care management from the Harvard School of Public Health (2012) and earned her MD (1986) and undergraduate degrees at the University of North Carolina-Chapel Hill.
Faatz-Crofut Home longtime director retires After 25 years working as administrator for the Faatz-Crofut Home for the Elderly in Auburn, Christina Cummings-Shattuck retired at the end of April. Cummings-Shattuck joined the nonprofit in 1988 as activities director. She rose to administrator in 1992 and has guided the organization through many major renovation projects, including additions of Cummings private restrooms, total makeovers of the dining room and activities room and new flooring for the second and third floor of the facility. During her
tenure, each annual New York state inspection resulted in positive outcomes leading to a better quality of life for the residents. “I have devoted 29 years to this grand facility”, said Cummings-Shattuck. “Enjoying each day; meeting people from all walks of life; listening to their stories; giving them a shoulder to cry upon; sharing a good laugh. Helping not only the resident, but their loved ones go through this next phase of their life and sometimes even into the last phase. The residents became and are my family.” “Working with Christina has been a true pleasure,” said Maryjane Benson, president of the board of managers. “Christina is resourceful, encouraging and has always put the interest of the residents first. We will miss her sense of humor and wish her the best always.” The Faatz-Crofut Home for the Elderly is an adult residence offering affordable quality care and supervised living assistance to its residents. “The Home for the Friendless” was organized in 1865 for dependents of the Civil War veterans and for women of limited resources. The mellowing brick building on Grant Avenue has operated without interruption since that time.
Louis Papa appointed to board of Excellus BCBS
Physician Louis J. Papa has been appointed to the board of directors of Excellus BlueCross BlueShield and its parent company. Papa has been a member of the regional advisory board of Excellus BlueCross BlueShield Rochester Region since 2008 and will continue to serve on that board. A resident of Rochester, Papa Papa is board certified in internal medicine and is a primary care physician with the Center for Primary Care and Olsan Medical Group. He also is an attending physician at Strong Memorial Hospital and Professor of Clinical Medicine at the University of Rochester.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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