IGH - CNY #260, AUGUST 2021 by In Good Health: CNY's Healthcare Newspaper

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CNYHEALTH.COM

AUGUST 2021 • ISSUE 260

BACK TO SCHOOL SPECIAL ISSUE ✓ REMOTE LEARNING is hurting students academically and emotionally ✓ BULLYING IS BACK as in-person school returns; we discuss what to do about it ✓ BACK-TO-SCHOOL ANXIETY has skyrocketed. What can parents do to help their kids? ✓ AUTISM: Back to school for kids on the autism spectrum brings challenges

Starts on P. 19

MEET YOUR DOCTOR Medical oncologist Santosh Kumar talks about career, new cancer treatments. P. 4

PRIVATE PRACTICES Fewer doctors are choosing to go into private medical practices. P. 18

DENTAL CARE Millions of American adults haven’t seen a dentist in at least a year. P. 7

‘My Second Act’

Molly English-Bowers, a former editor-in-chief of the Syracuse New Times, discusses transitioning from journalism to nursing. “My biggest regret? I didn’t become a nurse 38 years ago,” she says. P. 14

Living to Age 130: New Study Projects It Could Happen H ow long can a human live? New research predicts there’s a chance that someone in the world will celebrate a 130th birthday in this century. There’s been a steady rise in the number of people living beyond 100

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years in recent decades, with up to nearly half a million worldwide, researchers noted. The world’s oldest known person was Jeanne Calment of France, who was 122 when she died in 1997. Currently, the world’s oldest person is

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

118-year-old Kane Tanaka of Japan. Some experts believe that disease and basic cell deterioration limit human life span, but others believe there is no ceiling. University of Washington researchers used statistical modeling

to determine potential maximum life spans this century. “People are fascinated by the extremes of humanity, whether it’s going to the moon, how fast someone can run in the Olympics, or even how long someone can live,” said study author Michael Pearce, a doctoral student in statistics. “With this work, we quantify how likely we believe it is that some individual will reach various extreme ages this century,” he said in a university news release. Pearce and his colleagues concluded that by 2100, it’s nearly 100% likely that the current known record of 122 years will be broken. There’s a 99% probability that someone will live to 124, a 68% chance of someone making it to 127, and a 13% likelihood that a person will reach 130. It’s extremely unlikely that a person will live to 135 this century, according to the study published June 30 in the journal Demographic Research. While there are increasing numbers of long-lived people, the authors noted that the death rate flattens after a certain age, which means that a 110-year-old and a 114-year-old have about the same chances of living another year. “It doesn’t matter how old they are, once they reach 110, they still die at the same rate,” said study co-author Adrian Raftery, a professor of sociology and of statistics. “They’ve gotten past all the various things life throws at you, such as disease. They die for reasons that are somewhat independent of what affects younger people,” he explained in the release. “This is a very select group of very robust people.”

From left to right: Dr. Tanya Paul (OBGYN), Marilyn Degiovine (Patient), Scott Berlucchi (President & CEO), Dr. Ranjna Sharma Medical Director of Breast Cancer Program, Dr. Amy MacDonald, (OBGYN)

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Meet

Suicide Prevention Walk Scheduled in Madison County County has one of the highest rates of suicide in NYS

he Suicide Prevention Coalition of Madison County will host the annual STEPtember for Suicide Prevention Walk at 10 a.m. Saturday, Sept. 11 at the Great Swamp Conservancy in Canastota. While this is the first year the walk will be held at the Great Swamp, Sept. 11 will also mark the second annual STEPtember for Suicide Prevention Walk. Prior to 2020, the coalition had partnered with the American Foundation for Suicide Prevention to host Out of Darkness Walk at Jim Marshall Farms in Chittenango. This annual event takes place in September, which is National Suicide Prevention Awareness Month. Community members are encouraged to donate to support these efforts. All donations benefit local suicide prevention (education and awareness), intervention, and postvention efforts in Madison County. Madison County, a predominantly rural area, has one of the highest rates of suicide among NYS counties. Compared to the NYS rate of 8.5 deaths for every 100,000 people, the suicide mortality rate in Madison County is 14.1. A single suicide loss is estimated to impact 115 people, according to NYS Department of Health data, 2009-2018). These statistics reflect a tragic loss of life and the need for prevention and postvention efforts in our community. The STEPtember for Suicide Prevention Walk is open to anyone and everyone. Registration is open throughout the month of August. Although the coalition is inviting those in Madison County to walk in-person, the participants are still encouraged to log their activity and donate throughout the entire month of STEPtember. Participants can register as individuals or as members of a team and log their movement each day throughout the month. Kathleen Liedka, member of the Suicide Prevention Coalition of Madison County stated, “Step to it and join us on September 11, 2021 for the 2nd annual STEPtember for Suicide Prevention Walk.” To learn more, register, or donate, visit bridgesorvirtualsuicideprevent.godaddysites.com and visit our Facebook page at www. facebook.com/STEPtemberWalk.

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Your Doctor

By Steve Yablonski

Santosh Kumar, M.D.

Doctor with Hematology-Oncology Associates of CNY specializes in the treatment of gastrointestinal, colon, pancreatic cancers. “There has been a lot of exciting treatment options,” he says about new cancer treatments. Q: What is your hometown? A: Jacobabad, a city in Sindh, Pakistan. Q: Why did you decide to become a physician? A: At a very early age, whenever I went to see my family physician for a fever or any other illness, I saw his dedication and how other patients loved him. I felt it would be a very noble profession to help take care of patients at difficult times of their lives and make them feel better. So, I also decided to become a physician. Q: Where did you get your training? A: I did my medical school in Pakistan and after completing medical school, I decided to move to the United States in 2004, for further education and training. After three years of internal medicine residency, I joined Dartmouth Hitchcock in New Hampshire as an attending physician for inpatient care. Q: Where else have you studied? A: I went to the University of Vermont for a post-doctoral research fellowship in hematology and oncology. There I participated in various research projects in gastrointestinal cancers and symptom management. For my fellowship in hematology and oncology, I joined the University of Rochester Medical Center. I feel fortunate to have learned from some of the best mentors in the field. Q: Why did you enter the field of hematology/oncology? A: During my hospitalist physician years, I developed a love for hematology-oncology. The science behind each disease and discovery of new treatment options captured my attention. Despite passing through difficult times, I witnessed the strength of my patients. There was always a true connection between the patient and the oncologist. Q: What is the most common type of cancer you see? A: I see all types of cancer and blood disorders. I have particular interest in gastrointestinal cancer,

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

colon cancer, pancreatic cancer, stomach cancers. Things like that. Q: How did you come to be a part of Hematology-Oncology Associates of CNY? A: I joined Hematology-Oncology Associates of CNY because I saw a team-based approach utilizing the best available medicine and advanced technology to provide the highest quality of care. I think what makes us unique is the ability to treat the whole patient and develop individualized treatment plans. I treat patients with cancers and blood disorders. I have been here four years now. We have three locations. Q: Cancer treatments are constantly evolving. Has there been any recent medical breakthrough that may be good news for cancer patients? A: There has been a lot of exciting treatment options. More options have become available over the last 10 years, which has significantly changed the way we treat the patient, today, 2021. There are a lot of offices, which is a good thing; patients have a lot of options and can choose where they go to get the best care for themselves. The incidences of cancer are increasing and I think we need more providers in our Syracuse area to take care of all the patients. Q: In what way did the pandemic most affect your work and your patients? Did you notice many patients putting off treatment or cancer screenings?

A: We were open, but patients were cautious due to the pandemic. They were afraid of going out and becoming infected. We started seeing some patients virtually. Now, they are starting to come back to our office. Q: How do you handle patients asking what their life expectancy is? A: Obviously, it is a delicate question and no one really knows those answers. Based on their stage and any other underlying medical problem … we can give them an approximate idea of how long the patients usually live. But, everybody’s different. It is also how they respond to their treatments. Q: I understand you work with a nurse navigator regarding gastrointestinal cancer. Can you tell me more about that? How does that benefit your patients and your practice? A: Oncology nurse navigators offer individualized assistance to our patients throughout the cancer care continuum, prevention, screening, diagnosis, treatment, survivorship and end of life. They are also very helpful bridging the communication between patient and doctor; there is a lot going on with a patient with a diagnosis of cancer. The navigator makes sure the patient is kept informed about things, even if the doctor isn’t available. Q: How often do you see a patient? A: It depends on the patient, once a week, once every two weeks. Every different cancer, every different patient receives different care; depending on their symptoms, the type of treatment they are receiving, they need to be seen at different intervals. We monitor them all to ensure they are receiving treatment in a safe and effective manner. Q: How important is early detection of cancer? A: Early detection is very important in all of the cancers. Treatment depends on the stage at diagnosis. So if a cancer is found at an early stage it is much more treatable. But if a patient is diagnosised with an advanced stage, there are treatment options, but they may not be as successful. We have seen some patients with advanced cancers now because they didn’t come for a checkup during the pandemic. Q: You’re in a stressful line of work. What do you do to relax? A: During my time away from work, I spend time with my family, visit parks and enjoy food at different restaurants. I enjoy trying different foods; my favorite is Italian.

Lifelines

Name: Santosh Kumar, MD Position: Medical oncologist at Hematology-Oncology Associates of CNY, which has offices in Auburn, East Syracuse and Onondaga Hill (Syracuse) Hometown: Jacobabad, Pakistan Education: Board-certified in internal medicine, medical oncology and hematology Affiliations: Crouse Hospital, St. Joseph’s Hospital, Auburn Community Hospital Family: Married, with two children Hobbies: Spending time with family, visiting parks and enjoying meals at different restaurants

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August 2021 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

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Even Before Pandemic, OneThird of U.S. Adults Went Without Dental Care Millions of American adults haven’t seen a dentist in at least a year, a new U.S. government health survey reveals

n 2019, before the coronavirus pandemic made dental visits difficult, a third of adults under 65 hadn’t had a dental exam or cleaning in the past 12 months, according to the report from the U.S. Centers for Disease Control and Prevention. And the problem was worse in rural America, the National Health Interview Survey showed. The authors suspect the reason is easy to explain. “It was beyond the scope of study, but we kind of assumed there are fewer health care providers in the rural areas, compared to urban areas, so there’s less access to dental care in rural areas,” said study co-author Robin Cohen, a statistician at CDC’s National Center for Health Statistics. Income and race also underpin the results, Cohen said. The survey found: • In 2019, 65.5% of U.S. adults saw a dentist in the past 12 months. • More adults in urban areas than rural areas saw a dentist (67% versus 58%). • In both cities and rural areas, women were more likely than men to have visited a dentist in the past 12 months. • In urban areas, white adults (70%) were more likely than Hispanic

adults (59%) or Black adults (62%) to have seen a dentist. • In rural areas, white adults (59%) were more likely than Hispanic adults (46%) to have had a dental visit. As income increased, so did the odds of seeing a dentist. And that was true in both rural and urban areas. Jane Grover is director of the Council on Advocacy for Access and Prevention at the American Dental Association in Chicago. She said staffing shortages are a key contributor to access issues in rural America. “They may not have the staffing that many urban areas have — I’m talking about the number of dental assistants and dental hygienists,” Grover said. Cost is another barrier to care, Grover said. Low-cost clinics can help in urban settings, and some clinics charge on a sliding scale based on patients’ ability to pay. In rural areas, these clinics can be few and far between. Grover said more needs to be done to make dental care available to folks who can’t afford it, no matter where they live. This includes involving dental students who can help provide services at little or no cost.

ONONDAGA, OSWEGO, CAYUGA & MADISON COUNTIES A monthly newspaper published by Local News, Inc. 33,500 copies distributed throughout more than 1,000 high-trafﬁc locations, including all Wegmans stores.

In Good Health is published 12 times a year by Local News, Inc. © 2021 by Local News, Inc. All rights reserved. P.O. Box 276, Oswego, NY 13126 Phone: 315-342-1182 • Fax: 315-342-7776 • Email: editor@cnyhealth.com Editor & Publisher: Wagner Dotto • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Deborah Banikowski, Anne Palumbo, Chris Motola, George W. Chapman, Melissa Stefanec, Chris Motola, Eva Briggs (MD), Mary Beth Roach, Barbara Pierce • Advertising: Cassandra Lawson, Amy Gagliano Layout & Design: Joey Sweener • Office Manager: Nancy Nitz

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Create an inviting ‘Table for One’ this Summer

ith the worse of the pandemic behind us and with summer in full swing, restaurant traffic is booming. And it’s no wonder. After being cooped up for so long, people are ready to hang up their aprons, get out of the house and enjoy dining out – like ol’ times. I know I am! It’s great to spend time with friends in a new place, soaking up the atmosphere, and trying new foods. But a steady diet of eating out is not possible for me, nor would it be my preference. Among other things, it would gobble up my budget! I enjoy preparing simple, healthy meals at home and taking myself “out" to eat at my kitchen counter, dining room table, or back patio. But this hasn’t always been the case. After my divorce, I found dining alone at home to be one of my biggest challenges. While living alone gives you the freedom to dine as you please (one of its many benefits!), I don’t recommend eating breakfast for dinner or munching through a bag of Cheetos as a substitute for a healthy, well-bal-

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anced meal. When it comes to eating alone at home, treat yourself as you would treat a good friend you are having over for dinner. Why? Because you are worth it. When you prepare and enjoy a good meal on your own, you’ll be sending yourself a valuable message: It’s important to take good care of myself and to treat myself with respect. I matter enough to nurture—and feed—myself with care. Eating well and right has all kinds of benefits. And what better way to start enjoying those benefits than by creating an inviting table for one in your own home. Below are a few tips to help you get started: • Stock your kitchen with healthy food. It’s so much easier to put a healthy meal on the table when the good stuff is plentiful and the junk food is in short supply. I’m fully aware of my own downfalls (ice cream, nuts, cookies, chips) and don’t regularly stock these items in my kitchen. Instead, I have on hand a good supply of frozen and fresh vegeta-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

bles, prepackaged salad greens, fruits in season, and single-serve portions of frozen meat and fish. You’ll also find plenty of grab-and-go power bars in my pantry for when I’m on the run. • Indulge your senses. Stimulate your appetite by preparing something that produces a wonderful, delicious aroma. My go-to appetite stimulant? I love the scent of sautéed garlic and jump-start many a solo dining experience with a little butter and garlic in my stove-top skillet. The aroma invites me into the cooking process and in no time, I’m focused on cutting and chopping instead of the worries and stresses of my day. To keep things interesting, I also try to incorporate colorful fruits and vegetables into each meal, which is recommended by nutrition experts. The colors often correspond with important nutrients that may provide health benefits. • Select the best seat in the house. While eating in front of the TV may be the perfect choice on some occasions, I encourage you to find dining spaces inside or outside your home that may offer more inspiration. Chances are, you’ll appreciate the change of scenery. Consider that special nook where the sun filters in or that table by the window with the great view. Mix it up, experiment with different settings, and discover what feels best in the moment. • Set the stage. Create a

pleasing table setting and mood that feels comfortable for you. I like to put down a placemat, use a cloth napkin, turn on some enjoyable music and position a good book, magazine, or iPad within reach. You might even light a candle. I do, especially in the evening. Its warm glow gives me a good, comfy feeling. If you’ve never set the stage like this before, it can feel contrived at first, but stay with it. Over time, I’m confident you’ll find it as enjoyable and relaxing as I have. • Enjoy your own company. When you eat alone, you’re in the company of someone special − yourself! You are with someone who approves of your meal choices and cooking techniques, appreciates the candle you lit and knows that life and good food are to be savored and enjoyed. Creating a pleasant “table for one” is a great opportunity to focus on yourself and to nourish your body and spirit at the same time. So, pull up a chair, say a few words of gratitude and enjoy your meal. Bon appétit! Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite Voelckers to speak, visit www.aloneandcontent.com

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Healthcare in a Minute By George W. Chapman

Hospital Pricing: Uninsured Charged a Lot More for Same Services

he recent requirement for hospitals to post their prices for 300 “shoppable” services, discussed here in earlier columns, has revealed uninsured consumers are charged far more than insured consumers. (They always have been). A recent survey of 1,550 hospitals by the Wall Street Journal revealed that uninsured patients were billed 3.6 times the negotiated rate with Medicare Advantage plans. Using their purchasing power, insurance companies typically negotiate volume based discounted prices with hospitals. In the past, the largest carriers in a market would often insert “favored nation” claus-

es in their contracts, which meant should the hospital offer a deeper discount to a competitor; the favored carriers would automatically get the same discount. Clearly an individual cannot negotiate a volume-based discount like carriers do, but it doesn’t necessarily mean they have to be charged the highest price. In the past, hospitals feared that if they offered a deep discount to an uninsured indigent patient, it would trigger the favored nation clause. That no longer being an issue. Hospitals today are far more willing to discuss and negotiate fees in advance.

Impact of Vaccines: 279,000 Lives Saved

to negotiate prices with drug manufacturers. The ubiquitous drug lobby has long argued or threatened that lower prices will negatively impact research and development. A recent report from the House Oversight committee reveals 14 of the largest manufacturers spent an outrageous $577 billion on stock buybacks and dividends from 2016 to 2020. That is $56 billion more than they spent on research and development those years. The argument that lower prices curtail R&D is totally debunked. There is no valid reason preventing Medicare from negotiating drug prices, especially considering Medicare sets prices for physicians and hospitals. This is one of the most obvious tools available to Medicare to finally lower drug prices.

A study by the Commonwealth Fund and the Yale Center for Infectious Disease Modeling and Analysis estimates the vaccine rollout has prevented around 1.25 million hospitalizations and 279,000 deaths. The study looked at what would have happened without the 328 million doses being delivered. An Aetna Foundation study found healthier communities tend to have far less vaccine hesitancy among residents. Traditionally less healthy states, clustered in the southeast part of the country, also have the lowest vaccination rates and highest hesitancy rates. In June, unvaccinated people accounted for 99% of deaths due to the virus. The CDC wants to get more vaccines to family medicine practices as they are highly trusted by the vaccine hesitant.

Drug Prices Once again, congress is pushing a bill that would allow Medicare to use its enormous purchasing power

Where Should We Invest? An article by Judith Graham in Kaiser Health News questioned our healthcare spending versus benefits. The recent approval of the Alzheimer’s drug Aduhelm by the FDA inspired the article. $56 billion was invested in the drug with question-

able efficacy. It may help one to two million people diagnosed with Alzheimer’s. Not to cast aspersions on the drug, is that prudent spending, mostly by Medicare, when looking at bang for the buck for seniors? Graham queried several physicians asking where they would invest $56 billion to improve care for our seniors and to get the best bang for the buck. The priorities in no particular order are: 1. Make Medicare more affordable. In 2017, the average senior spent $5,800 out of pocket or a staggering 36% of the average Social Security check. 2. Pay for vision, hearing aids and dental. (It should be noted several Advantage plans do offer some coverage here. 3. Support family care givers. 4. Strengthen long-term care. 5. Help people age in place. 6. ASK seniors what they need. 7. Focus on prevention, no matter how old someone is. 8. Study and invest in social determinants of health.

Ban on Surprise ED bills Part of the Affordable Care Act is a “no surprise” provision. It prohibits insurers from retroactively denying emergency department claims for services considered not emergent. These denials virtually stick an ED with unexpected collection issues and the consumer with unexpected out of pocket bills. Insurers claim retroactive denials serve as incentives for their members to receive, what they deem to be primary or urgent care, in less costly settings like a physician office, health center or urgent care facility. Most EDs do triage non-emergent patients to their “fast tracks,” but the bills are still much higher than they would be if care was delivered at a physician’s office or urgent care facility. The rapid expansion of urgent care facilities with their extended hours of operation has drastically reduced unnecessary ED use. However, in many rural areas, the hospital ED is often the ONLY alternative for non-emergent care after 5 o’clock, on weekends and holidays.

Demand to Decrease Healthcare analytics firm Trillant is predicting demand for healthcare services will flatten out or even August 2021 •

decline post pandemic. That coupled with an increase in suppliers of services from industry upstarts like Amazon, Walmart and various drug chains means that an industry that has avoided the inevitability of supply and demand, is in for a rude awakening. Does this mean there will actually be real price competition? Trillant is basing their predictions on 70 billion claims for 309 million visits. Telehealth is already down 37% from pandemic highs. Annual surgical services growth, hospital bread and butter, is now projected to be in the 1% to 2% range versus historical 3% range. Overall, demand will be down. Population shifts to states with lower taxes like Texas, Florida and Idaho will cause demand to increase there but be offset by demand decreases in states losing population like New York, California and Pennsylvania.

Push for Home Dialysis Reform Thirty-seven million Americans suffer from kidney disease; 550,000 of them require dialysis. Having to travel to a kidney dialysis center three times a week is a tremendous emotional, logistical, time, transportation, access and quality of life burden, especially is rural areas. Several industry players including home dialysis machine manufacturers, the National Kidney Foundation and the American Society for Nephrology are lobbying congress to remove antiquated or outmoded federal regulations that make it hard for patients to get home dialysis. The coalition’s goals are to modernize conditions for coverage, empower patients and provide a better quality of life. 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 gwc@gwchapmanconsulting.com.

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My Turn

By Eva Briggs, MD

Is Fungal Disease the Next Potential Cause of a Pandemic?

ecently, I read an article about the emergence of fungal disease as the next potential cause of a pandemic. The article mentioned Candida auris, a type of yeast capable of invading the lungs of patients weakened by COVID-19 and killing many of those infected. The article also mentioned Aspergillus fumigatus, another fungus that can invade COVID-19-damaged lungs and kill patients. The very next day, National Public Radio aired a story about Mucormycosis, a fungus ravaging COVID-19 patients in India. So, while we often think of viruses and bacteria as infectious disease scourges, we shouldn’t forget about fungi. Fungi have cell walls rather than cell membranes like animal cells. They cannot manufacture their own

food like plants. They have nuclei, unlike bacteria. They are ubiquitous, with more than six million different species. Many fungi are beneficial. They produce fermented foods such as bread, beer and cheese. Mycorrhizal fungi assist plant growth. Fungi produce commercial enzymes such as lipase used in laundry detergent. Many mushrooms are tasty delicacies. The antibiotic penicillin was discovered because it is produced by fungi. Fungi are everywhere. Each of us inhales more than 1,000 fungal spores every day. For a long time, scientists thought that fungi were not important pathogens because mammals have a core temperature higher than that preferred by fungi. Sure, the cooler outer surfaces of our body were at risk for fungal infections such as athlete’s foot, ringworm and yeast infections. But invasive infections

seemed rare. Prior to the mid-20th century people with impaired immune systems didn’t live very long. Improved medical therapies enable people with immune systems damaged by illness, cancer treatment and age to survive. Medicines can suppress the immune system in patients with autoimmune disorders as well as in transplant recipients. Many more people now live with compromised immune systems, rendering them potentially vulnerable to fungal infections. Here’s a little more information about the three fungal infections I mentioned at the start of this article. Candida auris was first identified as a disease-causing organism in 2009. Because it’s frequently resistant to most antifungal drugs, it is hard to eradicate not only from patients but from their environment. Once it invades a facility, it may survive on almost every surface: floors, walls, ceilings hospital beds, telephones, etc. Aspergillus is a mold found almost everywhere both indoors and outdoors. Typically, it infects people whose lungs are weakened by illness such as cystic fibrosis and other lung diseases including COVID-19. It can also attack people that have impaired immune systems. It may invade into the blood vessels and beyond. Mucormycosis, the disease starting to run rampant in India (and some other places) attacks COVID-19 patients with diabetes. It’s also called black fungus. Steroids, powerful anti-inflammatory drugs sometimes used to treat COVID-19 patients, also increase vulnerability to mucormy-

cosis. The mortality rate is 50%. The fungus infects the lungs, and also the nose and sinuses. From the sinuses it can spread to the brain and the eyes. To attempt to treat the disease, sometimes surgery is necessary to remove the patient’s eye(s). Other well-known invasive fungal diseases include pneumocystis pneumonia (the infection that tipped scientists into the discovery of HIV), blastomycosis and coccidiomycosis (valley fever). One approach to combating fungal disease is the development of a vaccine. So far there has not been a vaccine against any fungal disease. But early research for a Valley fever vaccine is promising. Because dogs always have their nose in the dirt and therefore frequently inhale “Coccidiodes” spores, scientists are developing a new vaccine formula that might reach the market for use in dogs as early as next year. Canine vaccines are overseen by the US Department of Agriculture. Any future human vaccines require clinical trials overseen by the U.S. Food and Drug Administration, a process that normally takes years. Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.

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Page 10

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

Things You Should Know About Good Skin Care By Ernst Lamothe Jr.

ow with the summer in full swing and people outside for longer periods of time, there is a strong possibility that you could be enjoying yourself without regard to your skin health. “Sun protection is our first line of defense against skin cancer, sunburns and signs of aging like dark spots and wrinkles,” said Virignia Tracey, a board-certified dermatologist and fellow of the American Academy of Dermatology. Tracey, who works at Empire Dermatology in East Syracuse, talks about five skin care tips.

Tanning beds are a no-no Everyone has their own personal view about skin care, and the kind of sunscreen you should put on, while others believe the natural rays of the sun should glisten your skin without sunscreen, especially on cloudy days. But a harmful thing sometimes happens indoors when it comes to sun safety. Many people want an even tan so they believe in the idea of getting a base tan from a tanning bed, which experts caution against. While we used to think UVA light mostly just caused skin aging, medical officials know that the longer the wavelength that penetrates the skin more deeply, the stronger it is linked to melanoma. “Tanning beds are classified by the World Health Organization as a carcinogen or cancer-causing prod-

uct,” said Tracey “Each tanning bed use increases the risk of melanoma skin cancer, and using tanning beds before age 35 can increase that by almost 60%.”

Sunscreen for babies The American Academy of Dermatology recommends that babies younger than 6 months old do not wear sunscreen. Instead, they should wear sun protective clothing with a UPF of 50 or higher, avoid the peak hours of sunlight exposure between 10 a.m. and 2 p.m. and also seek shade when outside. “For kids, I like a sunscreen that is SPF 30 or more, broad spectrum, water resistant, that ideally contains a physical blocker like zinc oxide. It’s also important to find a product they like enough to let you put on and re-apply,” said Tracy.

Vitamin C serum Vitamin C is an antioxidant and protects your skin from free radical damage and oxidative stress caused by UV exposure and pollution. This can lead to skin aging and wrinkling in addition to the development of solar lentigines or sun spots. The antioxidant properties of vitamin C help fight free radicals and damage caused by UV radiation. “Vitamin C serum is one of my favorite additions to a skin care routine. A few drops should be applied under sunscreen each morning. It is

You Can Save Three Lives, in Eight Minutes It’s as easy as contacting the Red Cross By Mary Beth Roach

t takes eight minutes to save three lives. This is the length of time it takes to donate blood at one of the

area American Red Cross drives. That blood can, in turn, save three lives, according to Lisa Smith, the executive director of the Central

Lisa Smith, the executive director of the Central and Northern New York Chapter of the American Red Cross

an antioxidant that protects against environmental damage and also can help with fine lines and even skin tone,” said Tracey.

Wear hats Hats are an essential part of protecting your skin from the sun. A wide-brimmed hat is preferable because oftentimes we will see skin cancers develop on the top of ears, tip of nose and back of the neck where a regular baseball cap would not cover. “Hats, especially with wide brims provide excellent UV protection. Avoid mesh fabric. Hats are especially important for our patients with hair thinning,” said Tracey.

Virignia Tracey is a board-certified dermatologist who works at Empire Dermatology in East Syracuse. “Sun protection is our first line of defense against skin cancer, sunburns and signs of aging like dark spots and wrinkles,” she says.

Regular skin care maintenance Skin care regimen recommendations will vary based on skin type, age and specific concerns such as acne, dry skin, and aging skin. In general, a solid skin regimen will consist of a vitamin C serum in the morning paired with sunscreen (SPF 30 or higher) and a retinoid or retinol cream at night which helps promote cell turnover leading to increased collagen production and clear pores. If you are in your 20s, Tracey recommends washing at least once daily with a gentle cleanser and applying an antioxidant serum to prevent free radical damage from sun and pollution. In your 30s, add a cleanser with

AHA/glycolic acid to gently exfoliate two to three times weekly and continue a daily antioxidant serum. In your 40s, use a rich moisture cream at all times containing lipids and ceramides to restore moisture barriers, which is lost with age and choose an eye cream with peptides and growth factors. In your 50s, cleanser or cream with an AHA like glycolic acid once or twice a week, antioxidant serum and eye and neck cream. “I recommend a gentle face wash followed by facial moisturizer with sunscreen daily,” said Tracey. “Patients with various skin concerns like rosacea, melisma, or acne may need personalization to their skin care routine. For anti-aging skin care I like to add a vitamin C serum under SPF in the morning and a retinol at night.”

and Northern New York Chapter of the American Red Cross. There have been numerous blood drives held in July and the response has been good. Several blood drives are scheduled for August throughout Central New York. To check a site near you, go to www.redcross.org and click on “Give Blood” tab. “The blood drives are doing well. We have a very committed community here,” she said. Yet, the need is still great. The organization nationwide needs an extra 1,000 units every day, in addition to the average 12,000 to 12,500 units that are donated daily through the country, she pointed out. Several factors are triggering this urgent need. Surgeries that had been cancelled during the pandemic are being rescheduled, people are out and about more and the country has seen some of the worst disasters in years. “Last year was worse than we’ve had in years — the wildfires, the hurricanes, the flooding, the tornadoes. We’re headed into another season that is projected as being as severe,” she said. And the Red Cross needs to remain prepared. If the local Red Cross can meet its goals now, she said, their supply will carry them through the remainder of the summer. While there is always a need, the urgency is now, she said. The process for signing up to donate blood is easy and much of the preliminary paperwork can be

done online, shortening the time one is actually at the donation site. Visit www.redcross.org and click on “Donate blood.” A dropdown menu will appear, from which you can find a convenient location and fill out an electronic RapidPass registration form, which will save you some time at the donation site. There is also a lot more information on the menu about the process and the benefits of donating. While much of the blood stays within the eight counties served by the local chapter, it will be shipped to other locations to meet the demand, especially if specific matches are needed. “There are no boundaries,” Smith said. “We don’t want there to be. We need other communities to help us just as we help them.” In addition to donating blood, there is also a need for volunteers to assist the Red Cross in its work, whether it’s in disaster relief; the biomedical area; or in blood drives, from greeting donors to helping them afterward to driving the blood to the processing centers and to hospitals. With the New York State Fair returning this year, the Red Cross will need at least 700 volunteers to help not only with a blood drive inside the Fairgrounds, but also at a nearby parking lot it will operate for the entire 18-day run. Crucible Steel donates the lot to the agency, which then charges fairgoers a fee to park. All proceeds support the mission and services of the Red Cross, Smith said.

August 2021 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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St. Joe’s Named ‘Best Regional Hospital’ St. Joseph’s Health has been recognized as a best regional hospital for 2021-22 by U.S. News & World Report for the seventh consecutive year. It was also ranked No. 1 in Syracuse and No. 17 in New York state. This recognition comes just shortly after St. Joseph’s Health Hospital was designated the only hospital in Central New York to earn the highest “A” rating for patient safety by Leapfrog Hospital Safety Grades for the fifth consecutive rating period, was named a Blue Distinction Center for Maternity Care designation from Excellus BlueCross Blue Shield, and earned the Mitral Valve Repair Reference Center Award from the American Heart Association. The annual Best Hospitals rankings and ratings, now in their 32nd year, are designed to assist patients and their doctors in making informed decisions about where to receive care for challenging health conditions or

for common elective procedures. St. Joseph’s Health Hospital was recognized as high performing in the following 11 procedures and conditions: abdominal aortic aneurysm repair, aortic valve surgery, heart bypass surgery, heart failure, heart attack, colon cancer surgery, chronic obstructive “As the pandemic continues and as St. Joseph’s Health continues to focus on caring for patients with and without COVID-19, we are honored to be recognized by U.S. News & World Report for the seventh straight year,” said Les Luke, president and CEO at St. Joseph’s Health. “Our teams have truly shined this past year, truly devoted to caring for our patients and their families in new and different ways and we are committed to providing the safest and best care to all members of our community.” For the 2021-22 rankings and rat-

ings, U.S. News evaluated more than 4,750 medical centers nationwide in 15 specialties and 17 procedures and conditions. In the 15 specialty areas, 175 hospitals were ranked in at least one specialty. In rankings by state and metro area, U.S. News recognized hospitals as high performing across multiple areas of care. “This year’s expanded report from U.S. News includes new ratings for important procedures and conditions to help each patient pick the right hospital for the type of care they need,” said Ben Harder, managing editor and chief of health analysis at U.S. News. “Hospitals faced incredible challenges this past year, and the best of them have provided great care throughout the pandemic and continue to offer excellent care today.” The U.S. News Best Hospitals methodologies in most areas of care are based largely on objective measures such as risk-adjusted survival and discharge-to-home rates, volume, and quality of nursing, among other care-related indicators. Best Hospitals was produced by U.S. News with RTI International, a leading research organization based in Research Triangle Park, N.C.

The Case for Minimally Invasive Surgical Treatment of BPH By Hanan Goldberg, M.D.

he prostate is a walnut-sized gland situated underneath the bladder and in front of the rectum. The urethra, which is the channel transporting urine from the bladder through the penis, runs through the prostate center. The prostate secretes fluid that nourishes and protects the sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and it’s expelled with sperm as semen. Benign prostatic hyperplasia (BPH) — which is also called prostate gland enlargement — is a common condition among aging men, in which the prostate enlarges and can cause obstruction of the urinary stream (Figure 1). It commonly affects the quality of life in approximately one-third of men older than 50 years, and it is one of the top 10 diseases of men above 50. As many as 14 million men in the United States have symptoms of BPH. The severity of symptoms in men with BPH varies, but symptoms tend to worsen over time gradually. Common signs and symptoms include frequent or urgent need to urinate, increased frequency of urination at night, weak stream with difficulty starting the urination and

Figure 1: Benign prostatic enlargement Page 12

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emptying the bladder. Additional signs and symptoms include blood in the urine, urinary tract infections and even stone formation. Aside from causing obstruction and impairment of the urinary stream, BPH can cause irreversible damage to the bladder and hamper its ability to contract and empty. With time, if left untreated and with no dis-obstruction, bladder damage may become irreversible and result in urinary tract infections, kidney problems, and more. There are a plethora of management strategies for PBH, including surgical and minimally invasive treatment options. These include pharmacological treatment, resection, vaporization, and enucleation of obstructing prostatic tissue. The surgical treatments can be administered using various modalities. Out of the 14 million US men with known BPH, approximately 64% are treated with medications, 34% with observation, and only 2-3% undergo some surgical treatment. The gold standard surgical treatment option is the transurethral resection of the prostate (TURP), an endoscopic minimally invasive technique, with no external incisions that enable the surgeon to resect, evaporate or enucleate the obstructing prostate tissue and create an open clear channel. Although the success rates of TURP are quite high, one of its main adverse effects is retrograde ejaculation (dry orgasm) that can occur in as many as 90% of cases. Retrograde ejaculation occurs when semen enters the bladder instead of emerging through

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

Figure 2: Retrograde ejaculation

Figure 3: Urolift procedure concept: the penis during orgasm. Patients would be able to reach sexual climax but might ejaculate very little or no semen. Although it is not harmful, it can potentially cause male infertility. It is caused by damage to the nerves or muscles surrounding the bladder neck (Figure 2). Additionally, up to 10% of men who undergo a TURP can experience a temporary or permanent difficulty in achieving and maintaining an erection (erectile dysfunction) afterward. Aside from the numerous surgical modalities being offered by many centers across the nation, including minimally invasive techniques utilizing advanced laser systems, a relatively novel minimally invasive modality, the prostatic urethral lift (Urolift) is also an established treatment option. The Urolift represents a minimally invasive approach, which can be done under local or general anesthesia. In this procedure, obstructing lateral prostate lobes are compressed by small permanent suture-based implants delivered under endoscopic guidance (Urolift), opening the prostatic urethra and leaving a continuous anterior channel allowing a good urinary stream (Figure 3). Randomized studies have assessed the benefit of the Urolift

Les Luke is president and CEO at St. Joseph’s Health. procedure, demonstrating significant efficacy in all standard parameters. Although not as effective as TURP, its superior procedural simplicity, ability to be done under local anesthesia, not requiring tissue removal, short duration (10-20 minutes), and essentially lack of consequent retrograde ejaculation and erectile dysfunction as an adverse effect, make it a very attractive minimally invasive approach. This procedure is offered throughout Central New York by the Upstate Urology doctors at various offices including Syracuse, Courtland, Binghamton, Utica, and more. Ultimately, the choice of surgical modality depends on several factors, including prostate size, patient comorbidities, patient preferences, willingness to accept specific side-effects, availability of the surgical armamentarium, and experience of the surgeon with these surgical techniques. Regardless of the treatment option that is finally chosen, men above the age of 50 with urinary symptoms should be examined and assessed by a urologist. `

Physician Hanan Goldberg works at the department of urology, Upstate Medical University.

MEET THE UPSTATE UROLOGY TEAM Chairman Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

General urology, andrology

GENNADY BRATSLAVSKY, MD ZAHI N. MAKHULI, MD

Male infertility, erectile dysfunction, andrology, general urology, prosthetics, and Peyronies

OLEG SHAPIRO, MD

Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities

MATTHEW D. MASON, MD

JC TRUSSELL, MD

General urology, female and reconstructive urology

ELIZABETH FERRY, MD

General Urology, Endourology and Laporoscopic Surgery

EDWARD IOFFE, MD

Urologic oncology and endourology, robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal; kidney stones

General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn.

RYAN SIDEBOTTOM, DO

Reconstructive urology; incontinence, prosthetics, urinary fistula, neurogenic bladder, urinary diversion. Robotic surgery.

Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

RUBEN PINKHASOV, MD, MPH Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities

ANTHONY J. TRACEY, MD, MPH, FAAP

DMITRIY NIKOLAVSKY, MD

IMAD NSOULI, MD

MAHMOUD CHEHAB, MD

Female and reconstructive urology, urinary incontinence in women, pelvic floor treatment and neurourology

NATASHA GINZBURG, MD Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

NICK LIU, MD Urologic Oncology; robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal

Urologic oncology; robotic surgery of prostate, kidney, bladder

TOM SANFORD, MD

Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities

JEFF VILLANUEVA, MD

TIMOTHY K. BYLER, MD

General urology, male health, urologic oncology, enlarged prostate, kidney stones , and robotic surgery

Kidney Stones, Minimally Invasive Kidney Surgery, Enlarged Prostate

SCOTT WIENER, MD

MRI fusion, male health, prostate cancer and kidney stones

General urology

Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

JOSEPH JACOB, MD

STEPHEN BLAKELY, MD

Incontinence, urethral stricture disease, vesicovaginal fistula, reconstructive surgery, transgender care

HANAN GOLDBERG, MD, MSc

General urology

ROBERT FLEISCHER, MD

UROLOGY

FOR QUESTIONS OR TO MAK MAKE KE A REFERRAL, CALL 315.464.1500 August 2021 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Molly English-Bowers: ‘My Second Act’ Nursing turned out to be the best career decision I ever made, nearly 40 years after graduating from college By Molly English-Bowers

t wasn’t easy, deciding what to do with the rest of my working life when I was ‘let go’ from an occupation I studied for, excelled at, and enjoyed for 25 years. Not only was my ego wounded (not to mention the humiliation of being fired), but it was daunting figuring out, at 51, what to do when retirement is at least 14 years away. Within weeks of losing my job as editor-in-chief of the Syracuse New Times, I landed a job as communications director at a public employee union. But, like the newspaper industry, labor unions have been contracting for decades and there simply wasn’t enough work for me. After 18 months I was laid off. I continued freelance writing, created my own website, began training at Prudential Financial, trying to find a new direction. I applied for unemployment, which helped close the budget gap, but the entire process brought with it a set of, frankly, silly workshops. I didn’t need help writing an effective resume; I had interviewed and hired dozens of staff and interns. I didn’t need help with interview skills (as a journalist I had interviewed Graham Nash, Hillary Clinton, Jim Boeheim and so many more). I needed help rallying my self-confidence, looking at continuing education options and figuring out how to pay for it. Once I had decided upon applying to OCM BOCES’ licensed practical nursing program, CNY Works, which facilitates the state unemployment insurance program from its offices on James Street in Syracuse, was extremely helpful. An adviser at CNY Works told me about a grant from the federal Workforce Innovation and Opportunity Act to help pay the bill. I drafted a letter requesting the grant. Meanwhile, I applied to the LPN program, writing a letter of intent, taking the appropriate entrance exams and being interviewed by staff at BOCES. Within weeks I received an acceptance letter from BOCES as well as a letter from CNY Works informing me that I had been awarded a $5,000 grant. The cost for pursuing this second career was approximately $12,000 for a 12-month program. That included books, supplies to learn clinical skills and instruction from experienced nurses. Even if I hadn’t gotten that grant, it seems to me that $1,000 a month is not a lot of money to spend depending upon where you wind up working; you can recoup that money pretty quickly. Classes began on April 11, 2015, my 54th birthday. I continued to receive unemployment benefits, which allowed me to study full time. I remain in awe of my classmates who worked full time, tended to their children and attended class from 4 to 10:30 p.m. Their struggle was real, but most made it through the program and work as nurses today. Graduation day was March 30, 2016; I was chosen to be class speakPage 14

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Molly English-Bowers, the former, editor-in-chief of the Syracuse New Times, went back to school to become a nurse on April 11, 2015, her 54th birthday. She has been working in healthcare right after her graduation, the following year. Her regret? Not starting her second career sooner. er, I was named valedictorian, and I earned the excellence in clinical award. Not a bad start to a second career. All that remained was to take and pass the NCLEX (National Council Licensure Examination), and then secure employment. One of the beauties of choosing a career in nursing is the impressive range of places to work. I knew where I didn’t want to work, a hospital. My first job was at a local family practice as a graduate nurse, meaning that you earn valuable experience, as well as a salary, before you take the exam. Working at a hectic practice that serves all ages and all conditions proved overwhelming for me and I moved on. Next stop was enhanced assisted living, for those who need help with personal care and medication administration but who do not have dementia or Alzheimer’s as a diagnosis. These facilities cannot admit residents that need 24-hour care. Again, this was not an ideal fit. So, I applied to Syracuse Home in Baldwinsville on a per-diem basis, not wanting to commit to a full-time position there until I was certain it was the place for me. It didn’t take long for me to realize I had found a work home. I informed the director of nursing that I was interested in full-time employment and within a few months, a position opened up. And what a wonderful decision it has been. The job is challenging but not overwhelming. I learn something nearly every day. It’s easy to fall in love with the residents, most of whom have dementia as a diagnosis. Syracuse Home also has a rehab unit, admitting patients recovering

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

from any variety of surgeries. The goal is to rehabilitate them so they can return home. I work as a float nurse, meaning I am assigned to any of the three units and working on unit 3 (rehabilitation) provided a mental break from the challenges on the long-term units. As an aside, I did begin pursuing an RN, taking prerequisites at Onondaga Community College. As much as I enjoy sitting in a classroom and as well as I did academically, I didn’t want to pause my working life again, this time to become an RN. Sure, it’s the next step on the nursing career (and salary) ladder, but I am content where I am. I don’t need to be an RN to feel any more valuable to my co-workers and to the facility. Most importantly, Syracuse Home management and staff value my contributions, my work ethic, and my love of the residents. I have found a happy ending to my professional life. Now, at age 60, I can keep working as long as I want to, in whatever capacity my license allows, wherever I may be living and as little or as much as I choose. My biggest regret? I didn’t become a nurse 38 years ago.

Career opportunities First and foremost, nurses must enjoy caring for people. Sure, the profession is growing and job opportunities abound. But, if you aren’t compassionate, the challenges can be overwhelming. Being a nurse is stressful enough and if you hate what you do, trust me, it will show. Top reasons for choosing nursing as my second career:

Former editor-inchief of the Syracuse New Times discusses transitioning from journalism to nursing • The options: LPNs can work in doctor offices, hospitals, assisted living and long-term care facilities (commonly known as nursing homes), public schools and colleges, as traveling nurses or in-home. The license is, for the most part, portable. Reciprocity exists with most every other state, according to practicalnursing.org. Nurses can work full time, part-time, or per diem (choosing your days and shifts). Furthermore, most facilities offer differentials over the day shift base pay for working evening and night shifts. I work evenings for several reasons and the extra pay per hour is just one. • Demand: A growing emphasis on preventive care, rising rates of chronic conditions and an aging population add up to an increased need for LPNs and RNs. In 2018, there were more than four million jobs in five nurse occupations, according to the U.S. Bureau of Labor Statistics. Employment growth isn’t the only source of job openings, either. Most of the openings for nurses are expected to result from the need to replace those who leave the occupation permanently. Moreover, employment of nurses is projected to grow much faster than all other occupations through 2028. And, it appears, I am not alone. According to the National Sample Survey of Registered Nurses, 45% of RNs are 50 years or older. And, according to the same survey, the average age of all licensed registered nurses is currently 47 and this average is increasing every year, indicating that more and more students are entering the field after having pursued another career.

Different nurses, different roles Nurses have a special role in providing healthcare to patients. The job descriptions vary but the goal remains the same: to give the best care possible. Here are the general tasks for each specific license, although tasks can vary depending on worksite: • Licensed practical and licensed vocational nurses give patients basic care and monitor and record their health, such as by checking their vital signs. They may be supervised by a registered nurse. • Registered nurses evaluate patients’ health, provide and coordinate patient care and educate patients about health conditions. • Nurse anesthetists administer anesthesia and any related care before, during and after medical procedures. • Nurse midwives assist in labor and delivery and provide gynecological exams, family planning services and prenatal care to women. • Nurse practitioners work as primary and specialty care providers. They may make diagnoses, order medical tests, and prescribe medications.

MOBOCES LeadwPartnerwInnovatewExcel

From left, Robyn Smith, community investments and partnership manager, CNY Region Excellus BlueCross BlueShield; and Oswego Health’s Director of Business and Community Development Michele Hourigan.

Oswego Health Foundation Announces ‘For Your Health 5K’ Oswego Health Foundation’s sixth annual For Your Health 5K will be held Saturday, Aug. 14. Runners and walkers of all ages and levels are encouraged to participate. The event will feature a kids fun run at 8 a.m. and the For Your Health 5K run/walk will start at 8:30 a.m. at the scenic course on the Seneca Hill campus, between Fulton and Oswego, off Route 481 on Route 45A. Last year’s event was held virtually and raised over $24,000 with 134 participants. Awards will be presented to the top three overall male and female 5K finishers in both the walking and running divisions of the Oswego Health race. Community members can register online at www.raceroster. com/events/2021/46134/for-yourhealth-5K. This year’s presenting sponsor is Excellus BlueCross BlueShield. “We are excited to have the continued support of Excellus BlueCross BlueShield and we appreciate their dedication to local healthcare services,” said Oswego Health’s Director of Business and Community Development Michele Hourigan. “This event

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Responsible for instruction (theory and clinical skills) in a full-time Practical Nurse Program following NYS Education Department regulations. Duties include, but not limited to: • curriculum development in collaboration with nursing faculty; • coordination of clinical & lab experience; • evaluation of programs outcomes and student performance. Bachelor of Nursing degree required. Work experience in a hospital setting and/ or long-term care setting preferred. Teaching experience, organizational and communication skills desired. Excellent beneﬁts. Location of position: BOCES Utica ACCESS Site, 508 Second Street, Utica, NY 13501. Please submit a cover letter and resume to:

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not only promotes being healthy but is a great way for the community to come out and support the initiatives of their community healthcare system.” “Excellus BlueCross BlueShield’s sponsorship of the sixth annual “For Your Health 5K” is an example of our commitment in supporting local organizations like Oswego Health that share our mission as a nonprofit health plan,” said Mark Muthumbi, regional president, Excellus BlueCross BlueShield. “The funds raised during this community event, will provide patient room updates at the Oswego Hospital, and ensure patients, families and providers are able to work together with the highest level of quality care. We are proud to be a part of that!” Local businesses or organizations can also enter a team. For more information please call Hourigan at 315-326-3788. The For Your Health 5K is part of the Make it Happen 20K Race Series. Oswego Health’s race is the third race in the series. The series concludes with the Go Bucs 5K Run/ Walk on Oct. 10.

Free Diabetes Prevention Program in Madison County Local residents are invited to join a Prevent T2 Lifestyle Change Program, part of the National Diabetes Prevention Program, led by the Centers for Disease Control and Prevention (CDC). This CDC-recognized lifestyle change program is a research-based program focusing on healthy eating and physical activity. It has shown that people with prediabetes who take part in a structured lifestyle change program, lose 5-7% body mass and increase their physical activity to 150 minutes per week can cut their risk of developing Type 2 diabetes by 58% (71% for people over 60 years old)! Participants in this program get a full year of support from a trained lifestyle coach and learn how to eat healthier, add physical activity into their routine, manage stress, stay motivated and solve problems that can get in the way of meeting their goals. The program’s group setting provides a supportive environment with people who are facing similar challenges and trying to make the same changes. Together participants celebrate their successes and find ways to overcome obstacles.

Two Prevent T2 Lifestyle Change programs are scheduled to start on Wednesday, Sept. 15. An in-person class will be held from 11 a.m. to noon at the Madison County Office for Aging office building at 138 Dominic Bruno Blvd. Canastota. A virtual class will be held on Zoom from 6:30 to 7:30 p.m. Both groups meet for a year — weekly for the first 16 sessions, then once or twice a month for the remainder of the year to help maintain healthy lifestyle changes. If you have been diagnosed with prediabetes, sign up today! If you are unsure if you have prediabetes, take a quick prediabetes risk test at https://doihaveprediabetes.org/ to determine if you are at risk for Type 2 diabetes. To join one of the free upcoming Prevent T2 Lifestyle Change Programs or for any questions about the program, contact Stephanie Henry, program coordinator, by phone at 315-313-4399 or via email at henry.s@ mcruralhealthcouncil.org. You can also register on at www.mcruralhealthcouncil.org. Click on “Contact Us” to complete the registration form. August 2021 •

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Page 15

SmartBites By Anne Palumbo

The skinny on healthy eating

4 Reasons to Eat More Blueberries

hen it comes to superfoods—foods that abound with compounds considered especially beneficial to a person’s health—blueberries always make the top 10 list. What gives blueberries this nutritional edge? And why should we eat more of this powerhouse fruit? Let’s take a look at four good reasons.

1. Longevity Promoters Research shows that blueberries may have one of the highest antioxidant levels of all common fruits and vegetables. Antioxidants protect your body by neutralizing free radicals, which are unstable molecules that can damage cells and contribute to aging and diseases, such as Alzheimer’s, cancer, and diabetes. Although free radicals are naturally produced by the body, lifestyle factors—such as smoking, alcohol, fried foods—can accelerate their production, resulting in an unhealthy balance.

2. Brain Boosters Blueberries, which teem with flavonoids, a particular plant compound with powerful antioxidant and anti-inflammatory properties,

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appear to reduce cognitive decline in the elderly, according to research published in Annals of Neurology. The study suggests that cognitive aging could be delayed by up to 2.5 years in older adults who consumed greater amounts of this nutrient-dense berry. Studies have also found that blueberries may improve a person’s short-term memory and motor coordination.

3. Blood Pressure Reducers Concerned about high blood pressure? Eating just one cup of blueberries a week may cut your risk of developing hypertension, a major risk factor for heart disease. Anthocyanins—the pigments that give red, purple and blue fruits and vegetables their rich coloring—seem to protect against high blood pressure, says a recent study published in the American Journal of Clinical Nutrition. While there is no cure for hypertension, making lifestyle changes—such as eating more berries—may lower your risk of heart disease, stroke, kidney disease and more.

4. Bone Builders Blueberries contain a unique mix

of minerals and vitamins that contribute to bone health, most notably vitamins C and K and the mineral manganese. While vitamin C is essential to the formation of collagen (the foundation that bone mineralization relies on), vitamin K helps to make various proteins that are needed for the building of bones. Manganese may help promote strong, dense bones when combined with calcium and vitamin D.

Healthy Blueberry Parfait with Granola 1 cup blueberries, washed and dried 1 cup plain Greek yogurt (or yogurt of choice) ½ cup granola Spoon ½ cup yogurt in the bottom of a glass and smooth the top. Add ¼ cup granola and ½ cup blueberries. Repeat the layers and eat right away, or chill in fridge until ready to eat.

Helpful tips Shake the blueberry container before purchase, noticing whether the berries move freely: if they do not, this may indicate that they are old, soft, or spoiled. Before storing, remove any crushed or moldy berries to prevent the rest from spoiling. Place in covered container and store in refrigerator for five to seven days. Don’t wash blueberries until right before eating as washing removes the bloom that protects the berries’ skin from degradation.

Anne Palumbo is a lifestyle colum-

nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Whole Grains Every Day: Key to Your Health and Waistline

hole grains can help older adults maintain a thinner waist, lower blood pressure and lower blood sugar, new research suggests. Just three servings a day may do the trick, the authors said. One serving is a slice of wholegrain bread, a half-cup of rolled oat cereal, or a half-cup of brown rice. Researchers noted that their study — partially funded by the General Mills Bell Institute of Health and Nutrition — doesn’t prove that whole grains are protective, only that there appears to be a link between them and waist size, blood pressure and blood sugar. “These are all risk factors that can contribute to the development of heart disease if not maintained at healthy levels,” said study co-author Nicola McKeown of the nutritional epidemiology team at Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging in Boston. The researchers used data from a health study of residents in Framingham, Massachusetts, which started in 1948. They looked at health outcomes linked to whole and refined grains in the diets of more than 3,100 participants. Data was collected every four years over a median follow-up of 18 years. (Median means half were followed longer, half for less time.) The new study compared chang-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

es in five heart disease risk factors — blood pressure, blood sugar, cholesterol, triglycerides and waist size — with reported intake of whole grains. Researchers examined effects of eating less than a half-serving to three or more a day. The upshot: People who ate few whole gains gained an inch around the waist every four years — compared to a half-inch among those who ate the most whole grains. Participants who ate fewer whole grains also saw bigger increases in blood pressure and blood sugar than those who ate the most whole grains. While whole grain intake was also associated with improvements in blood levels of HDL, or good, cholesterol, as well as triglycerides, the findings were not significant, researchers added. For waist size, blood pressure and blood sugar, the greatest benefit came from having three to four servings of whole grains a day. Most whole grains came from whole wheat breads and ready-to-eat cereals. Refined grains were mostly pasta and white bread. McKeon said whole grains probably

help prevent adverse changes in risk factors studied in several ways, but the mechanisms aren’t yet known. “For instance, in terms of helping prevent gain in body fat, the benefits may be related to the fiber in whole grains, which can help to prevent post-meal blood sugar spikes, help us to feel full so that we might eat a little less, or even feed our healthy gut microbes," she said. Other nutrients found in whole grains, such as magnesium, may help with maintaining healthy blood sugar levels and blood pressure. “And then we have the many phytochemicals found in whole grains that may act alone or in synergy with other nutrients to help maintain our health as we age,” McKeon said. “This is still a very active area of research.”

Health Career

Medical Scheduler

The job can offer a means of getting into the administrative side of healthcare. Mean wage in Syracuse area is $37,390 By Deborah Jeanne Sergeant

he medical scheduler is a non-clinical role that includes direct contact with both patients and providers, forming a vital link between those giving and receiving healthcare. While not requiring any education beyond a high school diploma, this job can offer a means of getting into the administrative side of healthcare. Schedulers do more than make

appointments. Schedulers also help the office’s providers and other personnel function better. These offices can be busy places. “Every physician needs to have an excellent scheduler,” said Kathleen E. Dyman, executive vice president of the medical society that includes Madison, Oswego and Cayuga counties. “Their role is very important. The front office is critical.

If that’s not doing well, the patients won’t go in to see the doctor.” In a competitive healthcare industry, providing top-quality service from the first phone call to the patient’s check out makes a difference. Unsatisfied patients tell their friends and can post negatively online about the doctor’s office, even if the physician’s care is exemplary. “Medical schedulers play an integral role to keep patient flow on track and the practice running efficiently,” said Maureen Bisaccio, director of Adecco Medical & Science for Upstate New York. “By relieving doctors and nursing staff from certain responsibilities, it allows them to focus on providing more hands-on patient care.” Schedulers may also schedule home visits from some types of providers and schedule transportation to visits. This happens over the phone and sometimes in person, so a good candidate for a medical scheduler position should have good people skills and phone skills. Since medical offices use technology to keep all their visits organized, a medical scheduler should also possess proficiency in Microsoft Office and be capable of learning any practice-specific software. “Medical schedulers often work in a fast-paced environment,” Bisaccio said. “An ideal candidate will be detail-oriented, organized and have the ability to multi-task in a busy practice. Other soft skills include someone who has excellent communication skills and is professional and personable. As in any medical environment, there’s also an element of compassion and patience necessary to provide best in class service to patients.” A medical facility can be a stress-

ful and busy environment. For this reason, a good medical scheduler should have organizational skills and the ability to troubleshoot and prioritize. They may need to talk with patients on the phone while keeping people in the office content to wait to check in, for example. Smaller practices may require a medical scheduler to perform more secretarial duties, such as filing, reception, and managing the office. Larger facilities may use the worker as only a scheduler. A successful medical scheduler may have a number of opportunities for advancement in a few different environments. “The world is your oyster if you’re a clerical support person in the medical world,” said Colleen Ester medical team lead for TES Staffing in Rochester. “Be very open-minded to the environment and the challenges you’re facing. It could include working as a practice manger, office manager, or in compliance.” Working as a medical scheduler can offer exposure to many facets of the medical office. While some medical offices have added online scheduling, Ester does not see medical scheduling as an endangered career choice. Some people prefer making their medical appointments with a person rather than an online calendar. Some people have questions that require a phone conversation. Many medical offices believe that the customer service offered by a medical scheduler cannot be replicated through a website. The Bureau of Labor Statistics states that the annual mean wage for a medical scheduler in the Syracuse area is $37,390.

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Page 17

Fewer Doctors Go Into Private Medical Practices Experts say some don’t want the hassle of running a private practice, prefer a steady paycheck By Deborah Jeanne Sergeant

n American Medical Association survey shows more doctors are now working in larger health systems, such as hospitals, than in private practice. Of 3,500 physicians who responded to the survey, only 49% reported working in private practices. This is the first time the number has fallen below 50% and the trend will most likely continue, according to the medical association. A few different factors play into this shift from the physician working at a privately owned and operated practice to working at a facility owned by a hospital system, national chain such as CVS or Walmart or federally-funded clinic. One reason is that fewer newly minted doctors can or want to operate their own facility. “They owe a lot of money in medical school debt and can’t afford to open their own practices,” said Kathleen E. Dyman, executive vice president of the medical society that covers Oswego County. As the cost of entrepreneurship has increased in many ways, including labor, real estate and supplies, the cost of medical malpractice insurance has also increased. Dyman said that many new physicians are joining hospital systems to work as a hospitalist or at another facility to avoid footing this expense. According to Arthur J. Gallagher & Co., a medical malpractice insurance brokerage in Houston, the average annual cost of the malpractice insurance is $75,000 for a family practice physician in New York state. Although medical malpractice insurance is not required, most physicians want it to avoid financial ruin in case of litigation. For mid-career independent doctors, the additional rules added by changes such as the institution of

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electronic medical records has proven too onerous. Instead of spending most of their time caring for patients, they find that recordkeeping and documentation devours much of their day. “They’re tired of the federal rules and the cost of federal rules,” Dyman said. “They want to get rid of all the paperwork.” She added that independent physicians must rely heavily on a good manager and administrative staff to ease these burdens. At a hospital, documentation, billing and collections are all handled by the health system. A doctor may enjoy better quality of life since the system may be able to better staff than an independent practice. Providers may face financial instability while establishing a new practice, along with long hours. The “business” side also challenges many new physicians. According to the Harvard Business Review, “most doctors in the U.S. aren’t taught management skills in medical school. And they receive little on-the-job training to develop skills such as how to allocate short- and long-term resources, how to provide developmental feedback, or how to effectively handle conflict leadership skills needed to run a vibrant business.” These educational shortfalls can make starting an independent practice very challenging. “There’s an economic certainty getting a paycheck every two weeks that’s attractive,” said Ken Schoetz, vice president of Health Care Association of Western and Central New York, (HAWCNY), which includes member hospitals Oswego Health, Auburn Community Hospital, Upstate University Hospital and St. Joseph’s Health are among its members.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

One of the challenges of working independently is the difficulty in negotiating sufficient reimbursement from payors. Larger organizations’ volume enables them to obtain better reimbursement from drug manufacturers and insurers, just as a big box store orders goods from manufacturers at a much higher volume than a small store and can receive volume discounts on the items. “It’s more beneficial to the physician than the hospital as scale moves the entire economy, including health care,” Schoetz said. “Better pricing benefits the provider and the patient.” The physician has a few personal “costs” by working for a larger health system, including the sacrifice of some freedom. Unlike the entrepreneurial model of the independent practice, the physician is not the boss. “You’re not running your practice the way you might want to,” Schoetz said. “You have to follow the hospital’s rules and use their technology, which you might not like. They may say to start the day at 8, not 10.” Physicians also have less say over who works under them. They also cannot determine their own salary, compared with if they start a practice and manage it well. Patients may also experience a few drawbacks. Perception is a big one. “Sometimes, I think that anything that’s big, whether it’s AT&T or Wegmans or Ford Motor Company, there can be some impersonality,” Schoetz said. “People still like the idea of a provider knowing who they are. They want a close, personal relationship. Doctors who go into these arrangements try to keep these relationships.” But the health care system may be able to provide a better level of care with the additional physicians

Kathleen E. Dyman, executive vice president of the medical society that covers Oswego County: “[New doctors] owe a lot of money in medical school debt and can’t afford to open their own practices,” she says. on staff than without them. With more physicians, they can expand capacity to treat more patients, which can improve their finances and offer more specialized care. Patients needing multiple specialists may also enjoy a “one-stopshop” experience versus traveling from office to office. “Anytime a provider can reduce costs and by having the economic scale of a larger facility, patients benefit in terms of cost and the care they would receive,” Schoetz said. He added that this is a trend he does not foresee going away in the short-term or long-term. “There will be differences from what it used to be,” he said. “The hope is, you will get better care and make hospitals better able to withstand the challenges. The ultimate outcome will be better patient care.”

BACK TO SCHOOL

Remote Learning Hurt High School Students Academically, Emotionally

here were academic, social and emotional consequences for U.S. high school students who attended classes remotely during

the COVID-19 pandemic, new research shows. The study included more than 6,500 students in Orange County

Back to School Anxiety in Kids: How Parents Can Help Prepare your kids for what it will be like going back to school By Deborah Jeanne Sergeant

ost children feel excitement and perhaps nervousness about their first day back at school after summer break. For the 2021-22 school year, COVID-19 may bring more changes—and, for some, concerns. But what indicates garden-variety jitters compared with anxiety that warrants help? Area experts weighed in. The effect that the pandemic has had for the past year and a half has only added to the difficulty of returning to school for some children. “Any time children go through a transition or period of major change there is a normal sense of anticipation and potential stress,” said Jennifer Rapke, licensed clinical psychologist and chief of Child Psychiatry Consultation Liaison Service at Upstate Golisano Children’s Hospital. “Since routines and structure has changed so much over the last year, we expect that a return to a more typical-looking school year may be difficult for some. This year we may also see some specific anxieties surrounding social distance, mask wearing and hygiene as well since they have been taught so heavily to be cautious about these issues for the last one and a half years.” Young children may dream up outlandish reasons that they cannot return to school. Older children may say they do not want to go back or excessively plan their return. Striking

a good balance between planning and obsessing can help children feel prepared, yet flexible if things go differently than they anticipated. “Anxiety is often based on fear of the unknown, so anything a caregiver can do to increase awareness or give information about their areas of concern will likely help some,” Rapke said. “There are books about going to school you could purchase or borrow from the library. You could arrange for a meet and greet with school staff or for a tour of the classroom or school. You could send a comfort, transition or stress-fidget item with them to school.” Most importantly, she encourages parents to try to talk about their children’s anxiety with them. “We want children to know that they are supported, loved and not alone, so regularly check in and have set aside time to touch base with them,” Rapke said. Take the time to listen, not just jump in to fix what’s wrong. Summertime often represents for children a period of greater freedom, relaxed schedules and more time to play. While this much-needed break can help them recharge for learning in September, it also means that they are out of synch for the schooltime schedule. To combat this effect, Doug McCaffer, special education K-sixth teacher at Liverpool Central School District, wants parents to get back to

Public Schools in Florida, who were surveyed in October 2020, when twothirds were attending school remotely and one-third were attending in person. On a 100-point scale, in-person students scored higher than remote students on social well-being (77.2 vs 74.8), emotional well-being (57.4 vs 55.7) and academic well-being (78.4 vs 77.3). This “thriving gap” was consistent across gender, race/ethnicity and socioeconomic status, according to the study published online July 13 in the journal Educational Researcher. “Notably, the thriving gap was larger among students in 10th through 12th grades than it was among ninth graders,” study co-author Laurence Steinberg, a professor at Temple University in Philadelphia, said in a journal news release. While the differences between the two groups of students aren’t large, even small effects are significant when they impact millions of people, the researchers explained. “Many news stories have reported on individual stories of teenagers who have suffered from anxiety, depression and other mental health challenges during the pandemic,” said study author Angela Duckworth, a professor at the

University of Pennsylvania and the founder and CEO of Character Lab. “This study gives some of the first empirical evidence of how learning remotely has affected adolescent well-being,” Duckworth added. Social well-being was assessed by asking the students about fitting in at school, whether there was an adult in their school who could offer support or advice, and whether there was an adult in their school who always wanted them to do their best. For emotional well-being, the teens were asked how often they felt happy, relaxed and sad, and how they felt overall about their life. For academic well-being, the students were asked how interesting they found their classes, how important they felt it was for them to do well in their classes, and how confident they were that they could succeed in their classes if they tried. “As policymakers gear up for national tutoring and remediation programs — which we agree are urgent priorities — we must recognize that our nation’s students are not just lagging as performers, they are suffering as people,” Duckworth said. “Meeting their intrinsic psychological needs — for social connection, for positive emotion, and authentic intellectual engagement — is a challenge that cannot wait,” she added.

about school or are they their children’s sleeping spending hours rumiand eating schedules at nating on these worries least two weeks before to where they won’t eat school starts. dinner or go out and play “Start getting them up with friends? Does it at the time they’re norcause them to lose mulmally get up and having tiple nights of sleep? Do breakfast when they’ll eat they spend hours asking during the school year,” questions or talking about McCaffer said. their worries?” Figure out when they She added that even will need to get up by a day of “protest” about contacting the bus garage William Sullivan going to school is normal; to learn when they should but hours of crying or refusing to go expect the bus. at all should concern parents. McCaffer also recommends Anxiety that prevents the child working with children on some “light academics” a few weeks before from eating, sleeping or other routine school starts, such as reading or com- daily activities for a period of time may indicate that professional help pleting a few easy math problems is warranted, as well as an inability together as a review. to calm down with distractions or “Do basic stuff you can work comforting supports. with them on,” McCaffer said. “Returning to school is a big Knowing what their surroundtransition that can be difficult for ings and teachers will look like any child,” said William E. Sullivan, comforts children apprehensive Ph.D., licensed psychologist and asabout starting school. Children may sistant professor in the department of feel more at ease after reviewing the pediatrics at Golisano Center for Speschool website to view photos of the cial Needs at SUNY Upstate Medical teachers, grounds and the school’s University. “Every child is unique theme for the year. If possible, visitand there is no one-size-fits-all strateing the school for an open house can gy to facilitate an easy transition back help them feel more comfortable. to school. It is a big change that can These measures should put most children at ease, unless they feel truly be quite stressful.” He encourages parents to “be anxious. patient and responsive to your “The key difference between child’s individual needs. Get back these normal jitters and a concerning level of anxiety is the level of intensi- into a comfortable routine as soon as you can—the smaller the change, the ty and persistence of these thoughts easier the transition will be.” and feelings,” Rapke said. “Are they just momentarily tense while talking

“Any time children go through a transition or period of major change there is a normal sense of anticipation and potential stress.”

Jennifer Rapke, licensed clinical psychologist and chief of child psychiatry consultation liaison service at Upstate Golisano Children’s Hospital. August 2021 •

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Page 19

BACK TO SCHOOL

School Is Back, and So Is Bullying Responding like the bully only makes two bullies By Deborah Jeanne Sergeant

he National Education Association estimates that 160,000 children miss school each day because they fear bullying from other students. Beginning in 2012, the New York State Education Department has required all public schools to file reports on incidents of bullying, harassment, intimidation or menacing. The state defines bullying and harassment as creating “hostile environments through threats, intimidation or abuse, including cyberbullying.” One obvious way children indicate bullying is through conversation about what’s going on at school. Mara Sapon-Shevin, Ph.D., director of Creating Safe and Peaceful Schools Project and professor at Syracuse University, said that asking “How was your day?” after school “is worthless.” Instead, she encourages parents to ask deeper questions about things like whom they sat with at lunch or played with at recess. “Really listen and pay attention,” Sapon-Shevin said. It may also help to casually offer books in which bullying happens, such as “Chrysanthemum” by Kevin Kenkes (Green Willow Books: 2011) or “Say Something” by Peggy Moss (Tilbury House Publishers: 2013). Sapon-Shevin warned to be careful about didactic books about bullying. Reading about bullying or watching a TV show about it can help children recognize it better. “Talk about the dynamics in the classroom,” Sapon-Shevin said. Children may also try to explain injuries, lack of interest in activities or missing or damaged possessions as bullying progresses. Bullying behavior commonly stems from issues the bully experiences at home because of parental neglect, abuse or mistreatment. Children often bully as a means of acting out to get attention or as a misguided attempt at building their ego. By attempting to understand the bully, the victim can respond in a

way that won’t exacerbate the situation. But victims should never feel they are to blame for bullying. “No one deserves to be bullied,” Sapon-Shevin said. She added that parents should not minimize their children’s hurt feelings but offer support, such as, “I’m sorry that happened; you don’t deserve that.” Parents should teach their children to not feed into bullying and to use words to express that they do not like what the bully is saying or doing. Responding like the bully only doubles the bad behavior. Bullies need to learn to solve problems in a way that is not aggressive. Social skills like taking turns, losing a game or making friends may be lacking. While other children cannot be expected to fill in these gaps, becoming aware of why the bully may act out can be helpful in responding in more constructive ways. Some children bully because they are anxious about social settings. It is easier to assure a dominant social status by force than to risk it by playing nice. Extending friendship to these children may cause their tough kid facade to crumble. Doug McCaffer instructs at Anaconda Brazilian Jiu Jitsu in Syracuse and is a special education teacher at Liverpool Central School District in K-sixth grades. At Anaconda, children learn how to be prepared for bullying. “We do this through building confidence and we talk about scenarios, do role play and talk about managing fear and get them comfortable dealing with things,” McCaffer said. He also works with children about how to address bullies when no grown-ups are around—the usual scenario when bullying happens. “We teach them de-escalation and how to be safe with their body language such as holding their hands in a manner that’s defensive but not threatening,” McCaffer said. “They can’t be knocked over or hit easily. They’re in a manner that says ‘I don’t want to fight’ but they’re prepared if

something does happen to them.” Of course, telling an adult is the next step. However, if the confrontation escalates into violence or begins with violence, McCaffer wants to make sure the children know what to do: use self- defense to escape and survive. A martial art based in grappling and leverage, Jiu Jitsu can help smaller, weaker people defend themselves against larger ones. “We talk about scenarios where there are no adults available,” McCaffer said. “One of the things we teach is how to get away in a defensive way so you’re not turning your back. Managing distance is another thing we talk about. Most attacks happen in the two to three feet distance. We talk about more than one bully as well. Sometimes, kids gang up on another.” Unfortunately, many children lack the confidence and knowledge

to speak up to bullies in a way that deescalates the confrontation. Freezing up, answering in kind or going on the attack only worsens the situation. McCaffer also teaches children how to carry themselves in a way that they do not look like an easy target. “Overall, it’s about preparation,” he said. “If you’re confident in handling yourself physically, then you will feel more confident in being able to get to out of a bullying situation and handle fear. Even if you’re prepared, it’s natural to be afraid.” Many children feel uncomfortable sharing about bullying outside their home. However, telling a school official about the bullying is usually necessary to resolve it. If this does not help the situation and it continues for a long time, children may need mental health treatment because of the stress and anxiety it causes.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

BACK TO SCHOOL

Back to School for Kids on the Autism Spectrum Be patient and realistic. It could get overwhelming for the parents and the child By Deborah Jeanne Sergeant

any children feel excited about going back to school — but for some children on the autism spectrum, the thought of returning to school feels overwhelming. “It’s reasonable to conclude that a significant proportion of children with autism and other neurodevelopmental disorders have struggled immensely over the past year and a half,” said Andy Lopez-Williams, Ph.D., founder and clinical director with ADHD & Autism Psychological Services and Advocacy/CNY Quest in Syracuse and Utica. “These struggles aren’t limited to academics as many children with autism missed out on therapies such as occupational, speech/language, physical, and psychological therapies.” That is why he believes that

schools, families, and providers should work together to form the best plan for addressing each child’s needs. For example, Lopez-Williams wants parents to share with the school as much information as they can about how each child is doing academically and developmentally. Otherwise, children can fall behind even more. Lopez-Williams also thinks the school and parents should remain in communication to help prepare children for returning to school for both the sake of safety but also for helping the children feel less apprehensive about going back to school. Doug McCaffer, special education teacher at Liverpool Central School District, said it is important for the children to know that their parents have spoken with the school.

Energy Drink Dangers By Deborah Jeanne Sergeant

hugging energy drinks seems like an easy way for children and teens to get a quick burst of zip to power through a busy school day and perform well in their activities. Area experts warn that energy drinks are not healthful pickme-up beverages. “Generally speaking, energy drinks are made of caffeine, sugar and supplements to provide a quick boost of short-term energy,” said Lacey Roy, owner of Full Bodied Health in Fayetteville. “I don’t recommend children under 18 consume energy drinks.” While they boast vitamin and mineral content—derived from supplements—energy drinks also contain unhealthful ingredients. Supplements are not regulated by the Food and Drug Administration. The various supplements in energy drinks may not be helpful at all or could be so high as to cause harm, es-

pecially when consumed by children. Since energy drinks are sold as “supplements” and not as beverages, the label claims can remain unverified. In addition to a lack of benefit, energy drinks cause harm. “Many studies have shown damage to the heart, liver and kidneys when children consume these types of drinks regularly, not to mention the addictive nature of caffeine,” Roy said. “These drinks often replace healthy eating and hydration habits which at that age are a couple underlying causes of low energy.” Children tend to overdo things they believe are helpful. If one drink is good, two or three must be even better! This line of thought can lead them to consume many times the intended amount for their size. Some energy drinks, known as “shots,” are already much smaller than a 12-ounce can of soda. Others are sold in containers similar to soda.

“You can tell your child, ‘I talked with your teacher and we’re on the same page,’” he said. “It eases all of their concerns and fears.” In addition to their children’s individualized education program, parents should ask about the daily schedule, any modifications and accommodations the child will need and when any therapy will happen. Discussing all of these with children can make their return to school smoother. “When they come to school, they’ll be prepared for what to expect, even little things like snack time and lunch,” McCaffer said. “If it’s a new teacher, you want to talk about the child’s strengths and weaknesses. They may be able to work in a reward system to motivate the child. You could talk about what works when the child is resistant to learning something.” He also recommends setting up a means of communication such as texts, emails, a time to call or journal. This kind of rapport can help educators and parents work out what best aids the child. Meeting in person with the children along can also help. “Prior to school starting, perhaps it could be arranged to tour the school and meet the teachers,” said Jean Leiker director of the local chapter of The Central New York Chapter of the Autism Society of America in Dewitt. “Get a schedule, understanding that things can change.” Parents can use the schedule to create an illustrated social story to help the children better visualize how their day will go. Photographs may cause disappointment in children who are very literal, such as a meltdown for being assigned a blue desk instead of the green one in the photo. Using cartoon illustrations may be better for conveying the concept of a random desk and not one specific desk. “A lot of families get lax on our summer routines,” Leiker said.

Since many children on the autism spectrum thrive with routine, it is helpful to get back on a school schedule at least two weeks before school starts again. Leiker also thinks it is a good idea to establish rapport with the educators and school counselors before school starts. “Make sure the flow of communication is easy,” Leiker said. “That helps us help our kids to know what to expect. Families should share what’s going on at home and tips and strategies to make everyone have the best day possible.” The change of going back to school should include positive changes that the child can control. William E. Sullivan, Ph.D., licensed psychologist, and assistant professor of the department of pediatrics at Golisano Center for Special Needs at SUNY Upstate Medical University, suggested incorporating fun in backto-school shopping. “Allow your child to pick out their own school supplies,” he said. “Perhaps incorporate sensory-friendly items that they can bring with them to ease the transition. Make sure new clothes and shoes are comfortable and give your child time to get used to them.” Breaking out the new supplies, pants and shoes on the first day back to school may contribute to the child’s stress if these items don’t “feel right.” Sullivan encourages providing teachers with any information that will help them make the child feel comfortable in class. Though teachers are experts at educating, “you, mom and dad, are the experts on your own child,” Sullivan said. “It is important that you share your knowledge with your child’s school team. Make sure that all of your child’s resources and supports are in place prior to their arrival. For example, you want to ensure that your child’s individualized education plan has been discussed and agreed upon before the school year begins.”

Drinking several energy shots in a sitting would not challenge most children. Teens who consume alcohol and energy drinks together place themselves at higher risk for alcohol poisoning. Because the energy drinks can keep them awake longer, teens are not as prone to pass out from drinking. This denies their bodies the opportunity to get rid of the excess alcohol. Since the energy drinks keep teens awake, they can drink to the point of alcohol poisoning, all while not realizing how intoxicated they have become. In 2011, American Academy of Pediatrics stated that no child should consume energy drinks. Two years later, the American Medical Association stated that no advertisements for energy drinks should target children. Names like Red Bull, Monster and 5-hour Energy make them appealing for children and teens. Many stores stock them near the gum, candy and snacks at the registers—exactly where children look for a treat while shopping with their parents or where teens look to grab a snack after practice. Energy drinks’ ubiquity at convenience stores makes it easy for children to find, buy and consume

them. Nutritionally, energy drinks offer lots of empty calories. One 16-ounce energy drink can contain as much as 62 grams of sugar, far beyond the maximum allowance for a day. These calories replace calories from nutritious foods and the sugar content contributes to tooth decay. Energy drinks’ boost also comes from a high concentration of caffeine. Children should not drink any caffeinated beverages. Because most children find coffee too bitter, energy drinks seem a more appealing stimulant alternative. Unlike coffee, which does contain some naturally occurring antioxidants, energy drinks provide nothing proven beneficial. “The best way for kids to feel energized is to get into a good sleep routine, get daily exercise, stay hydrated—with preferably water—eat complex carbs such as fruit, vegetables, whole grains, healthy fats (nuts, seeds, vegetable oils and avocado) and lean protein (eggs, chicken, meat, fish, and beans),” said Julie Mellen, registered dietitian with Upstate Health Care Center. “These things help with feeling satiated, they take longer to digest and provide a slow steady source of energy.”

August 2021 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

Parenting

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

nd just like that, pandemic restrictions are fading in the rearview mirror. Life is starting to look more like it did in 2019. However, with all the good re-opening brings, there is one negative aspect I can’t stop thinking about—the busyness. Going back to normal means a return to busyness. I’m not sure I’m mentally ready for it.

Busyness

It’s the state or condition of having a great deal to do. It’s the expectation of professional and personal life. It’s the new American way. When it comes to work, everyone is busy. My professional calendar looks like a three-year-old playing Nintendo’s Tetris for the first time. My job is demanding (and I love it), but busy is status quo. When I shut my laptop for the day, the madness doesn’t end there. My family’s schedule is just as demanding as my work schedule. Evenings and weekends are full of sports, lessons, doctors’ appointments, school events, birthday parties, barbecues, getaways, grocery shopping, meal planning, errands, vet appointments, volunteering, cleaning, meal preparation and the like. My schedule just doesn’t let up. At work, there is always another meeting or an extra hour or two to work. After work, there is always a backlog of things to tackle. In short, free time is harder to find than my son’s favorite stuffed animal when we are 15 minutes late for wherever it is we’re going.

Free time

According to the U.S. Bureau of Labor Statistics, free time is loosely defined as having time for any leisure activity, such as watching TV, socializing, or exercising. According to BLS’s American Time Use Survey, in 2019, people aged 20 to 54 had approximately four hours of leisure time per day. As a parent, I’m skeptical of that figure. That much free time sounds like unimaginable decadence. I know I’m not alone. For many parents, leisure time is a mirage. On any given weekday, I’m lucky to fit in 20 minutes of reading or texting with friends (and most of that happens while I’m hiding in the bathroom). At this point, I don’t even know if I would know how to leisure if I could magically find the time.

Current mindset: ﬁnding time

So how does one fix the busyness? How does one find the time to stop and engage in leisure? The phrase “finding time” is such a strange idiom. It implies time is hiding somewhere (perhaps with my son’s favorite stuffed animal?). This idiom insinuates that if we only

looked harder, we would find all the time we needed. The concept of finding time is ludicrous. As a parent, spouse, family member, friend, employee and citizen, I have certain responsibilities; I am going to be busy. And, although I accept that some amount of busyness is part of a beautiful life, I simultaneously recognize that too much busyness turns that beauty into exhaustion. And striking that balance between being busy and being exhausted is an art I’ve yet to master. For all my trying, I haven’t found a way to get it all done and still feel good. Perhaps, I’ve been going about things the wrong way. I view life’s obligations as taking time from my day and that’s not going to make me feel like I have more time. It puts me in a depletion mindset. So, how do I find time to do all of the “life stuff” and feel whole? Perhaps, the only way to find time is to give it.

New mindset: giving time

Maybe time, like love, doesn’t obey the laws of science. Love is one of the few tangible things in life where the more you give away, the more you get in return. What if, despite all our efforts to make time, what we really needed to do all along was give time away? I may not have much time, but I can pause my work for 30 seconds to give my son a meaningful hug. When my daughter needs a cuddle, I can stop doing the dishes and curl up with her on the couch. When my husband wants to sit on the porch and listen to the rain, I can give him my companionship. When I need a workout to clear my mind, I can give myself the opportunity to do just that. If I change my perception from taking time to giving time, maybe I can change the physics of my life. Expending time on important things doesn’t take time away from my day. When I give someone I love my time, they give me their time in return. You get what you give. With the proper outlook, these activities turn into non-zero-sum expenditures. Giving my time to others doesn’t deplete my bank, it lets both of us walk away with more than we came with. Given to the right people, time is reciprocal. It’s no longer taken. It’s given and received.

Back to the busyness

As I head back into the madness of post-pandemic work and life, I’m going to try to give my time more prudently. I know I will never be able to add hours to my day. However, I’m almost certain that a change in my outlook will add more life to my years. And, somehow, that simple fact takes the edge off the busyness. So, bring it on.

Aduhelm: the New Alzheimer’s Disease Medicine SUNY Upstate geriatrician: drug requires further studies

By Steve Yablonski slowed the disease’s progression. Three scientists resigned from the committee in protest after the approval, because the evidence wasn’t there. They thought the drug needed more study.

Q: Can you tell us about your background? A: I am the chair of geriatrics and the director of Upstate University Hospital’s Center of Excellence for Alzheimer’s disease. Because of my work in geriatrics and the fact that Alzheimer’s disease and other dementias are a disease that are more prevalent as we get older, I have been doing a lot of work with Alzheimer’s disease.

Q: How long would that study have to be? A: That is a good question. They approved this drug under “accelerated approval” which means the drug has a chance of helping people, but the company has to do more research to see if it really helps. So they have up to nine more years to come up with studies to see if the drug helps. So, yes, this is still a research question. There are other companies that have similar molecules and they have on-going studies that are happening right now. It’s possible that we will have more information from those studies. Right now, we just don’t have enough information about Aduhelm to know how well it works.

Q: What is Alzheimer’s disease? A: Alzheimer’s is a brain disease where the brain cells die and the neurons that help with memory no longer work. It destroys memory as well as other important mental functions. It changes the way people’s brains work in the sense of making decisions, how they physically function and get through the day. When people think of Alzheimer’s, they immediately think of a memory problem and that is a part of it. But it really is a generalized brain disease that begins to change everything about a person including their personality, their daily function.

Q: Why does it cost so much? A: We are waiting to hear from Medicare to see what they are going to cover. The drug itself is expensive; the scans that you have to get are expensive. This drug is given by an IV infusion, that means you have a copay for every time you go to the infusion center, usually once a month. You would have a co-pay every time you get a brain scan. And, to determine whether you have a buildup of amyloid, you have to have a special brain scan.

Q: Can it be cured? A: It is an incurable, progressive brain disease. It primarily affects people over 65. Q: Is what is commonly referred to as a “senior moment” a red flag? A: No, not necessarily. As we get older, there are changes in the ways our brains process various information. Memory loss is not a normal part of aging. But as we get older it may take a little longer to process information. If those senior moments begin to interfere with your daily function, that’s when we get concerned that it could be something more. I usually encourage anyone who is concerned about their memory to get an evaluation, because not everything is dementia. Q: How is it treated? A: Right now we do not have any medication that cures or reverses the process that triggers Alzheimer’s. The current medications, which have been out for more than 20 years, manage some of the symptoms but they don’t change the underlying disease. As of this time, Alzheimer’s disease does not have a cure. It gets worse with time. Q: The FDA recently approved Aduhelm, the first new drug to treat the disease in many years. What is it and how does it work? A: It is an antibody, which is a drug that targets amyloid plaque, a type of protein, in people’s brains. There is an association between this abnormal build up of this protein in the brain and the development of Alzheimer’s disease. That doesn’t mean that everyone who has amyloid in their brain will get Alzheimer’s. And, it also means that if you don’t have amyloid you can’t get Alzheimer’s. The question is, does remov-

‘The FDA approved the drug even though its outside panel of experts said there wasn’t enough evidence to show the medication slowed the disease’s progression.’ Geriatrician Sharon Brangman, chairwoman of Upstate University Hospital’s Center of Excellence for Alzheimer’s Disease. ing this amyloid help the brain maintain or regain any of its functions? This new drug removes the amyloid very efficiently. But the question is, after the amyloid is gone, is it helping? Is it making the symptoms of Alzheimer’s disease better, is it keeping someone stable? Is it restoring any of their brain functions? Those are the questions that we don’t have an answer for right now. It requires more data. Q: Are there side effects? A: Yes, it increases small bleeds in the brain and swelling in the brain. You have to take brain scans at a regular basis when you are on this medication. According to some trials, these side effects do go away after a period of time. Some people do get more severe symptoms than others; that’s based on some other factors that we have to take into consideration at the time of treatment. So, right now there are a lot of questions

about who should actually take this medication. And, does this medication really help? Q: You are concerned the drug might not work as well as advertised? A: With a disease as devastating as Alzheimer’s, you can imagine, people are clamoring to try this drug. They are so desperate for anything that they hope will fight this disease. Q: So, would you feel comfortable prescribing it to someone who requested it? A: We’re working very hard to figure out what is best for our patients. We’ll gather all the information that we can so that they can make a good choice. Q: More research is required? A: The FDA approved the drug even though its outside panel of experts said there wasn’t enough evidence to show the medication August 2021 •

Q: Is the decision up to the patient? A: So we have a lot of things to sort out so we can help our patients make a good decision. It’s been approved by the FDA. Some people want it, they are willing to take that risk; a drug that may have side effects but may help them. So what I’m trying to do is figure out as much information as possible so I can help patients make the best decisions for their care. The drug is legal and it’s available and I just want to make sure that we are informing people so that they understand it. There are some people who have a higher chance of getting those brain bleeds or brain swelling. But they may also have a higher chance of getting a benefit. So we have to be able to help people weigh their risks. Everyone has the right to weigh their risk. It’s not my job to say absolutely not if the drug is legal. My job is to make sure people have got the information they need so they can make the best decision. Q: How busy does this make your office? A: Our office is very busy; has been for a number of years. Since this announcement we’ve had numerous patients and families calling asking if they are eligible to take this medication. So an already busy clinical office has gotten even busier.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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A Place Where Peace of Mind Has a Home Address Matthew House in Auburn is celebrating its 20th year anniversary with some special events this year By Steve Yablonski

ocated in a quiet residential neighborhood in Auburn is Matthew House, a two-bed, nonprofit, nondenominational home for people who are terminally ill and who, for a variety of reasons, can no longer remain in their own homes. Inside there are two windowed suites overlooking the backyard. Each suite creates a comfortable, private space for the resident and visiting loved ones. Its mission, provide a home where people who are terminally ill can die with dignity and in comfort. The house is named after a young man who had cancer and a lot of family to care for him. One of his final concerns before he died was to have a home for people with terminal illness and without family resources to die and be cared for as he was… not in a hospital. “Under the guidance of a community-based board of directors, we open our hearts and our home to provide a loving space where we can support the residents and their loved ones as they journey toward a dignified death,” according to their website. They provide services free of charge and rely solely on donations, memorials, fundraisers and grants to carry out their mission. The executive director, Angela Ryan, manages the day-to-day operations of Matthew House. She is assisted by the manager of resident services, Shelly McBain. Along with these two full-time positions, 12 per diem staff and trained volunteers contribute their skills in direct resident care, housework, gardening, maintenance, grocery shopping and a variety of other activities. “Since our opening in 2002, Matthew House has welcomed more than 460 residents,” Ryan said. “Some are with us for weeks or months, others for only days. Even though small in size, we have touched countless lives in our community.” Matthew House serves residents of Cayuga County and surrounding areas. They may be referred by hospice, hospitals, private physicians or family members. The environment produced at Matthew House is most often positive, caring, happy and compassion-

Matthew House’s executive director, Angela Ryan (left) and Shelly McBain, manager of resident services. “Everyone that is here wants to be here and are special individuals with big hearts,” says the executive director. ate.

“Everyone that is here wants to be here and are special individuals with big hearts. We also have a very large team so if individuals need to step back or take a short break, there is enough coverage to help out. Most of the direct care volunteers do one shift a week which is four hours long so the care and responsibility is spread out,” the executive director said. “I firmly believe it is important to celebrate and honor end-of-life just as we do with birth. It is about finding quality and getting back to the little individual things in life that bring us joy. Most days here are filled with laughter, jokes and big smiles… and then we have a few days here with loss, sadness; but that is all apart of the end-of-life journey.”

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Anniversary Celebration

his year’s 20th anniversary kick-off event will be held on Friday, Aug. 6. The event will be a dinner dance, which will be Matthew House’s largest fundraiser for the year. It will be held at the Springside Inn in Auburn. It will be an evening of dinner and dancing, featuring the band Mere Mortals. In addition to this event, there will be a variety of opportunities throughout the coming year to spotlight and celebrate Matthew House. To learn more, call 315-2522052 or visit www.matthewhouse.org.

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provides the medical management services to residents as if they were in their own home. Matthew House and Hospice of the Finger Lakes are separate entities with a working affiliation. Residents must have a diagnosed progressive disease with a limited life expectancy of three months or less and accept the philosophy of comfort care. Matthew House is not a medical facility but rather a private nonprofit home. Primary care is provided by Matthew House staff and volunteers under the supervision of the executive director and at the direction of hospice. Resident selection is made based upon the person or situation presenting the most significant and immediate need. Potential residents must also have no extensive medical care needs beyond the staff’s ability to handle and must be able to be managed safely in a home setting.

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Ilion Resident Happy to Celebrate 102 Years of Age Secret to long life? Put family ﬁrst, enjoy life By Jessica Arsenault Rivenburg

hen Ellen Ball came into the world, Woodrow Wilson was president, there were 48 states in the U.S. and gasoline cost 30 cents per gallon. World War I ended less than six months prior and the Spanish Influenza pandemic was still in full swing. Ball lived through the roaring ‘20s, the Great Depression and WWII, the civil rights movement, the moon landing and JFK’s assassination. Ellen Ball turned 102 in May. Ball was born May 7, 1919, to Richard and Grace Dutton in Natural Bridge, in Jefferson County. While still young, Ball’s parents moved to Litchfield. It was there that Ball grew up and met Stanley Ball. The two married on Aug. 9, 1940. In 1943 the couple bought the Ball family’s dairy farm in Litchfield, from Stanley’s grandfather. Ellen and Stanley raised four children on that farm — three girls and one boy — all working together as a family to keep things running. “I didn’t like milking those cows,” Ball says now with a laugh. “I never could get the hang of it.” She was thankful for the college

kids Stanley hired to help out during the summer months, and later on, for the milking machine the family installed. “Those cows did keep me busy,” she mused. “I did a lot of running and walking all over that farm chasing after cows.” At 102, Ball is part of a very elite group of people known as centenarians, the title bestowed upon those who live to be 100 and older. According to the 2010 census (2020 results are not yet available), only 0.0173% of the population makes it to 100. In 2012, the United Nations estimated there were 316,600 centenarians worldwide — out of a population of 7.086 billion. Scientists and laypeople alike have long sought the secret to living so long. According to Ball, the answer is fairly simple: Enjoy life. “Enjoy your family,” Ball said. “Have parties. Don’t waste time arguing and fighting. Put family first. And dance. Enjoy life.” Ball has loved dancing all her life. Square dancing, waltzing or slow-dancing, anything would do. She frequented school dances and

Ellen Ball, who lives at The Grand Rehabilitation and Nursing at Mohawk Valley in Ilion, turned 102 in May. “Enjoy your family. Have parties. Don’t waste time arguing and fighting. Put family first. And dance. Enjoy life,” she says. church dances with Stanley and friends. Now that her legs don’t move quite like they used to, Ball says she enjoys watching others dance. Deb Farr, director of activities at The Grand Rehabilitation and Nurs-

ing of The Mohawk Valley in Ilion, where Ball resides now, says Ball is known to be a happy person. “She’s been known to say her longevity is due to being a good dancer and a good kisser,” Farr said. “She’s a very happy lady.”

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The Hidden Dangers of Sleep Apnea Dear Savvy Senior, How can you know when someone has sleep apnea? My husband has become such a terrible snorer that he wakes himself up at night, and he keeps me up too. Tired Teri

Dear Teri, If your husband is a loud snorer who wakes himself up during sleep, he probably needs to be tested for sleep apnea, a dangerous disorder that affects more than 22 million Americans, but often goes undiagnosed. Sleep apnea is a disorder that causes a person to stop breathing during sleep, hundreds of times during the night, for 10 seconds or more at a time. Left untreated, it can cause extreme daytime sleepiness, as well as a host of serious health conditions like high blood pressure, heart attack, stroke, diabetes and dementia. In fact, it’s estimated that every year, around 38,000 Americans die in their sleep from a heart attack or stroke because of sleep apnea. But the good new s is that sleep apnea is very treatable and most insurance companies, including Medicare, cover it.

Who Has It?

There are three types of sleep apnea: obstructive, central and mixed. Of the three, obstructive sleep apnea (or OSA) is by far the most common and occurs when the throat muscles relax during sleep, blocking the airway. While anyone can have it, sleep apnea is most common in people who are overweight, male, middle-aged and older. For women, the risk increases after menopause. The symptoms include loud snoring (however not everyone who snores has apnea), long pauses of breathing, gasping or choking during sleep and daytime drowsiness. But because most of these symptoms happen during sleep, most people don’t recognize them. It’s usually the person they’re sleeping with who notices it.

Diagnosing Sleep Apnea

To help you get a handle on your husband’s problem, the American Sleep Apnea Association has

several diagnostic tests he can take at SleepApnea.org/treat — click on “Test Yourself.” If the screening indicates that he may have sleep apnea, make an appointment with his doctor or a sleep specialist who will probably recommend an overnight diagnostic sleep test called polysomnography, which can take place at a sleep center lab (see SleepEducation.com), or at home using a portable device.

Treatment Options

Your husband is at greater risk for sleep apnea if he’s overweight, smokes or consumes excessive amounts of alcohol. Excess weight, especially around the neck, puts pressure on the airway, which can cause it to collapse. Smoking can increase the amount of inflammation and fluid retention in the upper airway. And alcohol and sleeping pills can relax the muscles in the back of his throat, interfering with breathing. Addressing these issues, if necessary, is usually the first line of treatment. If that doesn’t do the trick, mild cases of sleep apnea may respond to oral devices that fit into the mouth like a removable mouth guard or retainer. These devices work by positioning the lower jaw slightly forward to keep the airway open during sleep. Another noninvasive treatment option to consider is the new FDA approved eXciteOSA device (eXciteOSA.com). This treats sleep apnea and snoring by improving tongue muscle function by delivering electrical stimulation to the tongue through a mouthpiece that’s worn for just 20 minutes during the day. If none of these options work, the most effective and commonly prescribed treatment for OBA is a continuous positive airway pressure (CPAP) device. This involves sleeping with a snorkel-like mask that’s hooked up to a machine that gently blows air up the nose to keep the passages open.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

What Did You Earn at Your First Job?

ver wonder what you earned the year you worked your first job? Or perhaps any other year you worked? We can tell you. Your earnings history is a record of your progress toward your future Social Security benefits. We keep track of your earnings so we can pay you the benefits you’ve earned over your lifetime. This is why reviewing your Social Security earnings record is so important. While it’s your employer’s responsibility to provide accurate earnings information to us, you should still review your earnings history and inform us of any errors or omissions. This is so you get credit for the contributions you’ve made through payroll taxes. You’re the only person who can look at your lifetime earnings record and verify that it’s complete and correct. If an employer didn’t properly report even just one year of your earnings to us, your future benefit payments could

Q&A

Q: I got an email that says it’s from Social Security, but I’m not so sure. They want me to reply with my Social Security number, date of birth, and mother’s maiden name for “verification.” Did it really come from Social Security? A: No. Social Security will not send you an email asking you to share your personal information, such as your Social Security number, date of birth or other private information. Beware of such scams — they’re after your information so they can use it for their own benefit. When in doubt, or if you have any questions about correspondence you receive from Social Security, contact your local Social Security office or call us at 1-800-772-1213 (TTY 1-800325-0778) to see whether we really need any information from you. 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

be less than they should be. Over the course of a lifetime, that could cost you tens of thousands of dollars in retirement or other benefits to which you are entitled. It’s important to identify and report errors as soon as possible. As time passes, you may no longer have easy access to past tax documents. Also, some employers may no longer exist or be able to provide past payroll information. The easiest way to verify your earnings record is to visit www.ssa. gov/myaccount and set up or sign in to your personal my Social Security account. You should review each year of listed earnings carefully and confirm them using your own records, such as W-2s and tax returns. You can find out how to correct your Social Security earnings record by reading our publication How to Correct Your Social Security Earnings Record at www.ssa.gov/pubs/EN05-10081.pdf. Let your friends and family know they can access important information like this any time at www. ssa.gov and do much of their business with us online.

benefits. You can apply safely and securely at www.ssa.gov/applyonline. Learn more about Social Security for same-sex couples by visiting www. ssa.gov/same-sexcouples. Q: I heard there is a Social Security video available in American Sign Language (ASL). Where can I find it? A: Yes, it’s true. The video is called “Social Security, SSI and Medicare: What You Need to Know About These Vital Programs.” The video is available in ASL and it presents important information about our programs. You can watch the video now at www.ssa.gov/multimedia/video/ asl. The video is a part of our larger collection of on-demand videos and webinars available at www.ssa.gov/ webinars and at www.YouTube.com. Q: I run a bed and breakfast. By this time every year, I am tired of all the paperwork involved with filing taxes. Is there an easier way for small businesses to file W-2s for their employees? A: Absolutely. If you are a small business owner or entrepreneur, you should check out Social Security’s Business Services Online (BSO) website. There, you can file your employees’ W-2s and W-2cs electronically and print out the W-2s to provide paper copies to your employees. You also can verify the Social Security numbers of your employees. Our online services are easy to use, fast, and secure. Visit our BSO page at www. ssa.gov/bso.

Health News Head of Upstate Concussion Center recognized Brian Rieger, Ph.D., the director of the Upstate Concussion Center, has been given an award from the Brain Injury Association of New York State (BIANYS) for his ongoing work advocating for concussion awareness Brian Rieger, Ph.D. and improved care for those suffering from the injury. In addition to his work with the Concussion Center, Rieger is chief psychologist in the department of physical medicine and rehabilitation at Upstate. Rieger was recently awarded the Ted Weiss Consumer Advocacy Award from BIANYS, which is a statewide nonprofit that provides advocacy and support to people living with brain injuries. The Ted Weiss Consumer Advocacy Award “recognizes a fellow citizen whose actions have demonstrated unfailing commitment to the highest standards of truth, justice and accountability while striving to ensure the rights, safety and an improved quality of life for all people impacted by brain injury,” according to BIANYS. The award was presented to Rieger on June 9 during the organization’s annual meeting, which was held virtually for the second year in a row. “When we started the Concussion Center at Upstate many years

ago, it quickly became apparent to me that while we could help people in the clinic there was a lot of work that needed to be done to help people out in the world in their lives that we couldn’t do in the clinic,” Rieger said. “We needed to educate people about how to better recognize and manage concussion as well as making sure that there are supports in place to help people get back to school or work and other activities. Community outreach is something that I’ve always done because it’s what’s needed with concussion, but it’s certainly nice to be recognized for that.” The award is named after former U.S. Congressman Ted Weiss, of Manhattan. Weiss was chairman of the human resources and intergovernmental relations subcommittee when he led an investigation into fraud and patient abuse in the brain injury rehabilitation industry, which was largely unregulated. This investigation led to major changes and regulation in brain injury care and rehabilitation. Rieger has worked with BIANYS for many years. He has served as co-chairman of the BIANYS Concussion Initiative and previously received a public policy award from the organization as well. The Concussion Initiative advocates for broader understanding of concussion and improved care for those suffering from the injury. “It’s comprised of providers and others throughout the state who form a leadership and advisory committee,” he said. “We work to try to improve the understanding and management of concussion, as well as trying to improve access to proper care. I have always been interested in helping educators understand how to best support students returning

to school after concussion, and have recently been focusing more on the issue of returning to work as well.”

The Center for Wound Healing at Oswego receives award Oswego Health physicians, leaders and clinicians recently celebrated the President’s Circle award, which was given to The Center for Wound Healing. The center along with only 15 others around the country were awarded this prestigious honor by Healogics, the nation’s largest provider of advanced wound care services. The Center for Wound Healing at Oswego Health achieved outstanding clinical outcomes for 12 consecutive months, including patient satisfaction higher than 92%, and a minimum wound healing rate of at least 92% within 28 median days to heal. The Center for Wound Healing is a member of the Healogics network of over 600 wound care centers and offers highly specialized wound care to patients suffering from diabetic

foot ulcers, pressure ulcers, infections, and other chronic wounds which have not healed in a reasonable amount of time. Advanced wound care modalities provided by wound care experts on staff include negative pressure wound therapy, total contact casting, bio-engineered tissues, biosynthetic dressings and growth factor therapies. The center also offers hyperbaric oxygen therapy, which works by surrounding the patient with 100% oxygen to help progress the healing of the wound. “Like every other award the center has earned, this award signifies the passion our staff has in providing care for our community,” said Oswego Health Medical Director Carlos Dator, Jr. Upstate opens second outpatient pharmacy near Community Hospital After overwhelming success with its downtown outpatient pharmacy, Upstate Medical University has opened a new, additional outpatient pharmacy across from Upstate Community Hospital on Onondaga Hill that will serve more patients and be open to the public. The new SUNY Upstate Outpatient Pharmacy is located at 5000 W. Seneca Turnpike at the intersection of Broad Road, in the building previously occupied by Syracuse Orthopedic Specialists (SOS). Upstate began leasing the 4,200-square-foot space late last year and has invested more than $2 million in renovations and equipment, and celebrated its grand opening with a ribbon-cutting July 15. The new pharmacy will support the Meds to Beds program at Up-

Continued on pg. 30

New Independent Senior Living Community Opening in Baldwinsville A local family-owned and operated business recently announced the opening of Red Mill Manor, a boutique-style senior independent living community in the heart of the village of Baldwinsville. The 32-unit senior community is located on Paper Mill Island, offering waterfront living on the Seneca River and views of Lock 24, one of the busiest locks on the historic Erie Canal. Red Mill Manor is rich in character and history. The three-story building operated as a gristmill for over 200 years until it was redeveloped as a boutique-style waterfront hotel. During the last year, Red Mill Manor was repurposed for independent senior living with modern finishes and amenities while still preserving the historic post, beam, and timber structure with mission-style oak finishes throughout. All residences are equipped with granite countertops, kitchenettes, new appliances, ample storage, and cozy living spaces. Red Mill Manor offers active seniors chef-prepared meals, regular housekeeping, a vibrant schedule of on and off-site activities, and transportation for errands and appointments. The community provides

Red Mill Manor in Baldwinsville. well-appointed residences with historical character, a waterfront, a Stickley-furnished gathering room, a river-view dining room, a library, an exercise room, the Lockside Pub for happy hour, a community kitchen for private family celebrations as well as a waterfront deck and canal-view patio. A variety of room styles are available for different budgets. The

fixed monthly fee includes dining, housekeeping, activities, transportation and all utilities (including gas, electric, phone, cable TV, and internet). “Our CNY seniors are looking for an active and engaged community that provides safety, security, and all the comforts of home,” said Red Mill Manor partner Paul Cappuccilli. “Red Mill Manor offers worry-free, August 2021 •

waterfront living with freedom from home maintenance and all the costs of homeownership. Just like the Village of Baldwinsville, Red Mill Manor is a historic and vibrant community offering warmth and friendship for our senior community.” To learn more about the Red Mill Manor and schedule a tour, visit www.redmillmanor.com or call 315-303-0406.

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Health News continued from pg. 29 state Community Hospital, it will handle all of Upstate’s mail order prescriptions and will specialize in compounding, which is the mixing of complex pharmaceuticals in specialized dosages and forms. About 15 people will work in the new facility, which includes a walk-up counter for employees and patients. The new pharmacy is also home to Upstate’s new pill packaging machine, which produces individualized pill packs based on dosing time (morning, noon, evening and bedtime) that are proving popular and effective for patients. Every hour, the machine can produce 1,200 pouches, which are portioned and labeled for different times of the day. Many patients require four pouches per day meaning the machine can produce monthly packs for about 10 patients per hour. Another new machine provides a high level of quality control by checking up to 2,400 medications per hour to ensure the patient is receiving the correct medication, said Eric Balotin, RPh, director of retail and specialty pharmacy services. “The pill packs, the Meds to Beds program and many of the other things we’re doing significantly reduce hospital readmission rates related to adverse medication problems,” Balotin said. “We’re hoping to get 300 to 400 patients using the pill packs, which can be mailed directly to our patients. We are trying to keep people out of the hospital and trying to keep them safe from medication

adverse effects.” Balotin noted that the pill packs use symbols and images as instructions, which is helpful in cutting across language barriers. Upstate opened its first outpatient pharmacy downtown in June 2018. The pharmacy created a highly utilized and efficient Meds to Beds program that ensures patients leave the hospital with critical medications in hand. Today, Upstate’s outpatient pharmacy mails about 2,000 prescriptions per month, personally delivers 600 packages a month and has a staff of 12 insurance authorization specialists and two medication assistance coordinators. “We have saved patients more than a million dollars on their prescription costs in the last year,” he said. “And we’re on track to do more than that this year.”

Excellus named to the Best Places to Work for Disability Inclusion Excellus BlueCross BlueShield has been named to the Best Places to Work for Disability Inclusion after receiving a top score of 100% on the 2021 Disability Equality Index (DEI), a national benchmarking survey by Disability:IN and the American Association of People with Disabilities. The Disability Equality Index (DEI) is a comprehensive benchmarking tool that helps companies build

a roadmap of measurable, tangible actions that they can take to achieve disability inclusion and equality. Each company receives a score, on a scale of zero (0) to 100, with those earning 80 and Sady Fischer above recognized as a “Best Place to Work for Disability Inclusion.” “We are excited about this significant ‘first’ for our company as a Best Place to Work for Disability Inclusion. This top score is a testament to the culture of inclusion we are building collectively. We also recognize that that our effort towards advancing inclusion for people with disabilities is not finished. We have been taking intentional actions toward inclusion for years and this is simply another step toward improving as a company. When it comes to DEI, our work is never done,” said Sady Fischer, corporate director of Diversity, Equity & Inclusion for Excellus BlueCross BlueShield.

John Romancik promoted at Excellus BCBS Excellus BlueCross BlueShield has announced the promotion of John V. Romancik to regional direc-

Crouse Named Antimicrobial Stewardship Center of Excellence

ConnextCare Receives NCQA Recognition for Distinction in Behavioral Health Integration ConnextCare has recently been recognized by the National Committee for Quality Assurance (NCQA) for Distinction in Behavioral Health Integration. The NCQA is a private, nonprofit organization that strives to improve the quality of health care. The NCQA Distinction in Behavioral Health Integration is awarded to NCQA-recognized patient-centered medical homes (PCMHs) who excel in integrating behavioral health services into primary care settings. Practices that earn NCQA’s Behavioral Health Integration Distinction have the appropriate resources and quality measures in place to care for the needs of patients with behavioral health disorders. This Page 30

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breaks down barriers to behavioral health care for patients and leads to improved clinical outcomes and patient satisfaction. “Our medical and behavioral health teams have worked together to develop processes that support coordination of care for our patients,” said Senior Vice President and Chief Nursing and Quality Officer Nancy Deavers. “We are pleased to have received this distinction which recognizes our staff’s dedication to improving our care delivery.” Deavers said ConnextCare is honored to receive the recognition and will continue its efforts in providing high-quality behavioral health services to the community. ConnextCare operates health centers in Fulton, Mexico, Oswego, Parish, Phoenix, and Pulaski. It also operates seven school-based health centers located in APW, Mexico, Pulaski, Fulton and Sandy Creek School Districts.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021

tor of sales in the company’s Central New York and Utica/North Country regions. His responsibilities in this new role include managing mid-segment commercial sales and retention efforts. Romancik has been in the insurance industry more than 15 years. He began his career at Excellus BCBS in 2014 as a small group account consultant and most recently served as regional sales manager for the company’s eastern region, where he managed community-rated commercial sales and retention. Previously, he was an account executive specializing in employee benefits with a Central New York broker agency. Romancik is a volunteer and supporter John Romancik of Clear Path for Veterans. He received a Bachelor of Science degree in finance from Canisius College in Buffalo. Romancik and his family currently reside in Central New York.

The Infectious Diseases Society of America (IDSA) has named Crouse Health an Antimicrobial Stewardship Center of Excellence. Crouse joins an elite group of designated institutions across the United States that are dedicated to raising standards that define excellence in the practice and implementation of antimicrobial stewardship, which is a global public health priority as established by the World Health Organization (WHO) and the U.S. government. “The IDSA certification affirms Crouse’s mission to provide the best in patient care and promote community health,” said Chief Operating Officer/Chief Medical Officer Seth Kronenberg. “This significant quality achievement reflects the commitment our providers demonstrate toward helping both our patients and this national and global health challenge.” Antibiotics, antivirals and other antimicrobial medications have saved millions of lives worldwide, but these drugs are losing their effectiveness because of antimicrobial resistance (AMR), which occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines. AMR makes infections harder to treat and increases the risk of disease spread, severe illness and death. Some of this is inevitable, but over-prescription and improper use

of antimicrobials play a big role. Up to half of antibiotic use is unnecessary or inappropriate. For common bacterial infections, including urinary tract infections, sepsis, sexually transmitted infections, and some forms of diarrhea, high rates of resistance against antibiotics frequently used to treat these infections have been observed world-wide, indicating that we are running out of effective antibiotics, according to WHO. AMR also affects the treatment of mycobacterium tuberculosis, malaria and fungal infections. Drug-resistant infections can strike anyone — young or old, healthy or sick. Each year more than 70,000 individuals die due to antimicrobial resistance (AMR) infections. Treating resistant infections costs the U.S. health care system an estimated $21 to $34 billion annually. “The Crouse stewardship team works in a highly collaborative manner to improve our institution’s use of antibiotics. I think we all make a difference in the quality of our patient care and it is encouraging to be recognized by the IDSA,” said physician Stephen J. Thomas, clinical director, Crouse antimicrobial stewardship program. Said pharmacist Andrea Call, clinical pharmacy coordinator and Crouse Antimicrobial Stewardship Program (ASP). “The IDSA certification for the Crouse Health ASP reflects dedication and skill among our healthcare professionals, hospital administration and staff to collaborate with the ASP and optimize antimicrobial therapy for Crouse patients while conserving use when possible.”

Excellus BCBS, Camping World Collaborate On Make-A-Wish Reveal Event Camping wishes come true for ﬁve young dreamers

xcellus BlueCross BlueShield participated in a special MakeA-Wish reveal held June 25 at Camping World in Syracuse. This event was supported by Camping World and Excellus BCBS. The reveal gave five critically ill children 2021 Gulf Stream Enlighten 25BH campers to fulfill their camping dreams. This event was supported by Excellus BlueCross BlueShield’s Central New York, Southern Tier and Utica regions, marking the first time these regions have collaborated on a MakeA-Wish event. “Excellus BlueCross BlueShield is super excited to participate in this wish reveal. It is incredibly special to be able to participate in a wish that will not only impact one wish child but five wish kids all at one time,” said Lisa A. White, senior vice president and chief compliance and risk officer at Excellus BlueCross

BlueShield. White has been volunteering for Make-A-Wish for the past four years and currently serves as the vice-chairwoman on its board of trustees. “It is so rewarding to be able to give a child dealing with a critical illness the hope and strength to continue the fight by giving them something to look forward to,” she said. “It not only impacts the wish child, but their entire family.”

Recipients The Central New York recipients were (photos from left-to-right): • Angeliese Parrilla, 16, of Syracuse. She was born with congenital heart disease. Throughout her young life she has endured many doctor visits, exams, and procedures, including a heart catheterization in 2018. While treatment for the condition is ongo-

NOT JUST COVERAGE.

ing, Parrilla is strong and determined to live life as it comes. This quiet girl loves science, nature and animals and one day wants to be a veterinarian. She is looking forward to traveling and exploring in her new camper. • Delanie Zimmer, 14, of Liverpool. She loves animals, especially her horses Zeus and Cooper. For the most part, she’s a typical teenager who enjoys playing clarinet, learning about earth science in school, and eating her favorite meal—spicy chicken wings and pizza. But as an infant, Zimmer was diagnosed with a rare disorder called tuberous sclerosis. The condition caused numerous tumors throughout her body, triggered seizures, and led to heart, skin, brain, eye, and kidney issues. Zimmer has to make annual trips to Boston to receive treatment from a specialist, who has fortunately found a combination of medicines to keep her seizures under control. While

there’s no cure for her condition, Zimmer is active and focused on her passion for horses. She especially enjoys traveling to and competing in horse shows, where her specialty areas are English and Western riding, and Hunter Jumper and Barrel Racing competitions. Delanie wished for a camper to make traveling to the shows easier. She’s looking forward to more road trips and competitions, and being able to hang out with friends afterward! • Callin Mack, 6, of Sterling. He is a kind, happy boy with a big sense of humor. He enjoys playing with LEGOs and magnet toys, and loves being with his family. In August 2018, Mack went to the eye doctor for a routine checkup. During the appointment, his doctor discovered he had no vision in his left eye. Scans were recommended and a diagnosis was delivered: Mack had a rare, benign brain tumor called a craniopharyngioma. Following diagnosis, Callin underwent radiation and multiple procedures, including surgery. The location of the tumor has caused some physical problems, and Mack will have to continue to be monitored by his physicians indefinitely. Despite the challenges, however, this joyful boy is undaunted. Mack asked for a camper so he could go on camping trips with his family. He’s especially looking forward to playing on the beach and making s’mores by the campfire. “Callin is a remarkable little boy,” said his mom, Brittany. “To think of all the battles he has fought at such a young age and still remain hopeful, thoughtful, and positive is honestly more than we would ever have expected of him. There is nothing that can take his smile and joy for life away.”

CONFIDENCE.

At a time when great coverage seems more important than ever, you can count on Excellus BlueCross BlueShield. Connect with us today and explore plans with: A card that gets you into the doctors you know and trust Affordable options to help you save on premiums and copays Resources for mental health and emotional well-being Find more answers and support at

ExcellusBCBS.com

A nonprofit independent licensee of the Blue Cross Blue Shield Association

August 2021 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2021