In Good Health: CNY #279 - March 2023

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CANCER CARE The State of Drug Addiction. How Bad is the Problem in the Central New York?P18 FREE CNYHEALTH.COM MARCH 2023 • ISSUE 279 New CEO of St. Joseph’s Health Still Finds Time to Treat Patients in the ER P.15 Meet Dr. Steven Hanks One of the jobs of HematologyOncology Associates’ physician Steven Duffy is to bring cancer clinical trials to CNY. He talks about this and his career and why he changed his major from computer science to medicine. 5 THINGS TO KNOW ABOUT YOUR KIDNEYS

Cutting Calories May Slow Aging in Healthy Adults

The key to living longer could be eating less.

In a new study published in the journal Nature Aging, researchers found that a calorie-restricted diet had substantial health benefits, including delayed aging.

“The main take-home of our study is that it is possible to slow the pace of biological aging and that it may be possible to achieve that slowing through modification of lifestyle and behavior,” said senior study author, physician Dan Belsky, an assistant professor of epidemiology at Columbia University's Mailman School of Public Health in New York City.

The phase 2 clinical trial included 220 adults who either made a 25% calorie cut to their diet or no changes at all. The body mass index (BMI) for participants ranged from 22 to 27 (a BMI of 30 is the threshold for obesity).

In the first month, those in the calorie-restricted group were given three prepared meals each day so they would be familiar with portion sizes. They were counseled about their diet for the first 24 weeks of the two-year study.

The other group had no counseling or restrictions.

Despite the plan to cut about 500 calories in a 2,000-calorie daily diet, most cut only half that, said physician Evan Hadley, director of the geriatrics and clinical gerontology division at the National Institute of Aging (NIA), which funded the study.

“But that 12% was enough to have significant changes,” Hadley told NBC News.

Researchers used an algorithm based on past data for 1,000 people who were followed for 20 years, to see how certain DNA biomarkers changed in the study group.

The algorithm was like a “speedometer,” Belsky explained, to help gauge the pace at which participants aged.

Those who cut their calories slowed their aging by 2% to 3%, reducing the likelihood of dying early by 10% to 15%.

"We all have the power to change the trajectories of aging," Belsky contends.

Researchers plan to follow those on the calorie-restricted diet for 10 years.

It's not clear why eating less would slow aging, though it may prompt cellular changes, Belsky said.

"It may induce sort of mecha-

nisms of survival responses in the body that have the effect of cleaning up intracellular garbage," Belsky explained. “It's a signal to the body, saying, 'Hey, pay attention. There are resource stresses in the environment. We need to make sure that we are using all of the resources available to us most efficiently.'”

Still, long-term limits on calories have been shown in animals to be harmful, including reduced muscle strength, slower metabolism and an impaired immune system, Valter Longo, director of the Longevity Institute at the University of Southern California, told NBC News. Longo

was not involved in this study.

“It may cause powerful anti-aging effects, but also probably some degree of frailty or other issues that may not be so beneficial,” Longo said.

People should not starve themselves, Pankaj Kapahi, a researcher at the Buck Institute for Research on Aging, told NBC News. He was not involved in the study.

Kapahi noted that exercise and balanced eating are important for aging.

"Calorie restriction has to be done at a marginal level," he said.

Page 2 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
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Meet Your Doctor

Steven Duffy, MD

Director of research at Hematology-Oncology

Associates:One of the jobs of HematologyOncology Associates’ physician is to bring cancer clinical trials to CNY. He talks about this and his career and why he changed his major from computer science to medicine.

Q: Give us an overview of your work with Hematology-Oncology Associates of CNY.

A: I’m a general hematologist and medical oncologist here at the practice. I’ve been here for three years, but I’ve been practicing for more than 10 years. One of the things I do is see patients with a variety of blood disorders and cancers. I’m also the director of our research department, and am working to bring clinical trials to people in this community.

I really enjoyed my time training in hematology and oncology with hospitalized patients. And, ultimately, started doing a lot of rotations in clinics. I just really enjoyed it. I liked that I got to deal with a variety of medical problems and organ systems within the body. And I became very interested in the science of cancer medicine.

Q: Have you found there to be any transferable skills from computer science to medicine?

things that attracted me to research was finding new mechanisms to treat cancer.

Q: Did the pandemic cause issues so far as diagnosing cancer in a timely manner? Have you seen changes in the rates of cancer diagnoses?

A: I think there are a few trends overall. One of those trends is we’re seeing malignancies in younger people. The big example there is colorectal cancer. For the past 20 years we’ve seen a 2% increase each year in people under the age of 50, which is one of the reasons we start screening for colorectal cancer at a younger age. So it feels like we’re seeing more cancer in younger people. In the context of the pandemic, I feel like it’s caused a lot of delays. It’s harder to get things done quickly. So, where something took maybe a week to setup before the pandemic, things are now taking longer due to staffing issues. And, of course, during the pandemic people pushed back a lot of screening. So we’re seeing more people presenting at later stages of disease. If they’d been screened sooner, or presented to get their symptoms looked at sooner, they waited and showed up with more advanced diseases. That was certainly a concern during the pandemic and it seems to be panning out with what we’re seeing in our practice.

to a Western society, their incidences increase. When you see this kind of immigrant effect, it strongly implies that it’s exposure-related.

Q: When it comes to fiber, is there a difference between natural fiber and refined fiber so far as colorectal cancer risk goes?

A: I think it’s mainly whole fiber from plant-based foods. You can get fiber in highly processed foods, but I think it’s better to get it from the food itself. We get a bit fixated on getting certain nutrients through pills. “This vitamin is in an apple, so let’s make a pill that isolates the vitamin.” But that vitamin doesn’t always pan out as well as just eating an apple.

Q: Do you find screenings are effective as a mitigation for these increased incidences?

A: Absolutely. These screenings can prevent the cancer. So, for example, doesn’t just grow out of anywhere. Colon cancer starts with an abnormal polyp in the mucous membranes of the colon and that polyp starts to grow more and more mutations over time, and that polyp starts to form more and more mutations and turn into invasive cancer, which can become life-threatening. So if you have a colonoscopy and you find this polyp, and you remove this polyp, then the cancer never had a chance to start. So colorectal screenings are extremely effective. The same goes for mammograms, which detect lesions before they turn into invasive cancer. Even when I see patients for non-cancer related issues, I still harp on them about getting their screenings because it’s just so important. We’re happy to take care of people with cancer, but we’d rather not have to see them in the first place. We’d rather they never develop cancer.

Q: What brought you back to Syracuse?

A: Family. I moved to Syracuse originally in 1989 and it became home. I’ve left a couple times, but it keeps drawing me back. Sometimes moving from Virginia to Syracuse sounds like a counterintuitive move, but I think it’s a great place to raise kids.

Lifelines

Name: Steven Duffy

Q: When it comes to the increase in colorectal cancers specifically, what do you think is going on there?

A: That’s a great question. In my personal opinion, without being too controversial, is that the standard American diet is a big factor. In certain other countries we don’t see as much of this. It could also be due to other exposures that we’re seeing in society. A lot of people worry it could be diet related, though. Some think it’s due to a decrease in fiber intake, others an increase in animal protein intake. One of the things that we see across the world is that people who eat diets rich in fruits, vegetables, legumes have lower incidences than people who eat diets high in processed foods and processed meats in particular. There are even studies that show if you take people from one part of the world and then move them

Position:Hematologist-oncologist and director of research at Hematology-Oncology Associates of CNY

Hometown: Syracuse

Early Life: Moved with his mom from Dublin, Ireland, to Syracuse at age 11

Education: Medical degree from SUNY Upstate Medical University; residency in internal medicine at SUNY Upstate; fellowship in hematology-oncology, SUNY Upstate

Career: Worked at busy practice in Richmond, Virginia, where he was involved in cancer research, teaching and the development of multidisciplinary cancer care teams

Affiliations: Crouse Hospital; St. Joseph’s Hospital

Organizations: American Society of Clinical Oncology; American Society of Hematology

Family: Wife (Michelle), son (Ian), daughter (Lily) expecting another soon

Hobbies: Hiking, snow activities, exercising

Page 4 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
‘One of the things I enjoyed most about computer science was problem solving. In computer science it’s fixing a broken machine or debugging code. In medicine, your patients come to you with a problem and you try to figure out how everything ties together. Their symptoms, new developments. So it’s also a lot of problem-solving, which is something that attracted me to this field.’

Hundreds of U.S. Doctors Lost Their Lives During Pandemic

Many of America's doctors who were heroes on the front lines of the pandemic paid the ultimate price for their efforts, a new analysis shows.

An estimated 622 extra deaths occurred among U.S. doctors aged 45 and over from the pandemic's onset in March 2020 through December 2021, researchers say.

Older doctors who provided direct care to patients battling COVID-19 were at especially high risk.

These excess deaths to physicians didn't subside until April 2021, soon after the introduction of COVID-19 vaccines, concluded a team led by Mathew Kiang, an epidemiologist at Stanford University's School of Medicine in California.

The findings were published Feb. 6 in the journal JAMA Internal Medicine.

The only good news coming out of the new study: Despite the tragic loss of so many doctors' lives, death rates among physicians were still lower than that observed among the general population.

That suggests "personal protective equipment use, vaccine requirements, infection prevention protocols, adequate staffing and other workplace-based protective measures were effective" in preventing more deaths among doctors, the authors wrote.

They conducted the study by comparing pre-pandemic data on deaths to older (aged 45 and above) physicians from 2016 through Febru-

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ary 2020 to data collected during the pandemic itself.

Almost 800,000 physicians were included in the analysis. The team excluded younger physicians from their analysis because deaths among that group were very low (fewer than five deaths per month).

Deaths to U.S. doctors peaked in December 2020, the study found, with 70 excess fatalities occurring that month. Deaths began to decline through 2021.

Among the 622 excess deaths recorded during the pandemic, certain factors seemed to raise the risk that a doctor might die, the study found. Men made up about two-thirds (65.3%) of those who passed away, and the odds that a doctor might die during the pandemic rose with his or her age, the report found.

Older doctors who cared for COVID-19 patients appeared to be at especially high risk, suggesting that hospital "workplace policies should prioritize mitigating risks in this group" in the future, Kiang and colleagues wrote.

Of course, the deaths of working physicians may have exacerbated a wider tragedy: more deaths to patients as hospitals faced staffing shortages caused (at least in part) by the loss of these valuable crew members.

That's why "preventing excess deaths among physicians is an important component of mitigating excess deaths in the general population," the study authors concluded.

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March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 5
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Nearly 1 in 5 American Adults Takes Sleep Meds

Nearly 20% of American adults use a drug to help them sleep, either occasionally or regularly, health officials recently reported.

Sleep medications, sold both over-the-counter and by prescription, are a common treatment for sleep problems, said senior report author Lindsey Black, a health statistician at the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

"Our report details patterns of use of medication to inform patterns of use among subgroups of the U.S. population," Black said. "We do hope

by dissemination of this report it can lay the groundwork for more work in this area and our understanding of sleep health among adults."

Using data from the 2020 National Health Interview Survey, Black and colleagues found that among adults ages 18 and older, 8.4% used medication to help them fall or stay asleep on most nights or every night. Another 10% said they used medication on some nights.

Women were more likely than men to take medication for sleep and the percentage doing it generally increased with increasing age.

Specifically, 10% of women used sleep medication, compared with 6.6% of men. White adults were more likely to use sleep medications, and Asian adults were least likely to do so. Also, the percentage of men who used medication for sleep dropped as family income increased, Black's team found.

The findings were published Jan. 25 as an NCHS Data Brief.

One expert wasn't at all surprised by the number of Americans who rely on sleep medications.

"I work in a sleep center. And you know, I certainly see a lot of sleep medication use," said Lauren Broch, a clinical sleep psychologist at the Northwell Health Sleep Disorders Center in Great Neck.

Broch thinks not only are sleep medications (both prescription and over-the-counter) overused but also

poorly used.

Prescription drugs like temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), eszopiclone (Lunesta) and zolpidem (Ambien, Edluar, ZolpiMist) were designed to be used in the short term, not as a long-term crutch.

The same is true for over-thecounter sleep aids, many of which contain the antihistamine diphenhydramine, the active ingredient in Benadryl.

People who use these medications habitually come to rely on them, Broch said.

"Many people start believing that the sleep medication is what is making them sleep," she said. "There's a dependence on them, and sometimes tolerance, and they believe that they must use it or they won't sleep. That's never a good thing."

HealthcareinaMinute

The Pandemic Is Over!

Well, not really. The administration has declared an end to the public health epidemic as of this May. The government is not saying the clinical pandemic is over, although it is on the decline. The declaration officially puts an end to the PHE originally declared by the previous administration in 2020 in response to COVID-19. The PHE has been extended several times since 2020. Among other things, it authorized expanded telehealth services and improved payment for providing services (paid same as in-person visit). The PHE also expanded Medic-

2022 Bad for Hospitals

Last year was the worst year for financially ravaged hospitals since the onslaught of the pandemic.

A study published by industry advisory group Kaufman Hall revealed the average hospital started off the year with operating margins hovering around minus 3.5%. Hospitals gradually dug their way out negative operating margins by December 2022, but about half of the nation’s 7,000 hospitals finished in the red for the year in total. Analysts predict some improvement or relief in 2023 due to better management of staffing issues, improvement in the supply chain, continuing leveraging of outpatient services, increased alliances or ventures with physicians and stronger commercial payer negotiations. Related to the bad year fiscally: 50% of hospital-based physicians and nurses reported job-related distress and 25% reported depression.

Private Equity in Rural Hospitals

Desperate for capital, rural hospitals are easy pickings for aggressive profit- at- all- costs private equity

aid eligibility to cover more of the indigent. So, the end of the PHE in May will at least create confusion, if not chaos. States will be forced to reconsider and reconfigure Medicaid eligibility. Physicians and hospitals may lose improved payment for telehealth services. (As of this writing, Medicare is extending behavioral telehealth for seniors through 2024.) While PHE declarations only impact Medicare and Medicaid, commercial insurers typically follow suit. Late night TV comedians have tongue in cheek made light of “government declares pandemic over!” Funny, but not.

(PE) companies. They approach financially vulnerable hospitals with management and consulting contracts with no investment or assuming any risk. PE firms own or manage about 130 rural hospitals mostly in southern states like Texas, Kentucky and North Carolina. The purely forprofit firms typically strip out many needed services, close beds, slash staffing and all but eliminate charity care. They quickly turn around the profit and loss statement, grab their fees and get out. This has put additional pressure on surrounding urban and suburban facilities that end up providing the care discontinued at the rural hospital. Medicare, state Medicaid agencies and provider organizations are investigating the negative impact of PE on their rural providers.

Long COVID-19 Decreasing

good news is the number of individuals suffering with long COVID-19 declined from 19% in June of last year to 11% this year. In addition, 17% of those who had long COVID-19 no longer have symptoms. The Kaiser Family Foundation report was based on analyzing CDC

data. The issue, however, remains a serious concern. The bad news is the best practices to treat long COVID-19 have yet to be finalized. There is no singular test to definitively determine if long COVID-19 is caused by covid alone. Post COVID-19 conditions are NOT due to just one illness. Your health history plays an important factor. It is estimated that 500,000 to 4 million individuals in the workforce have long COVID-19.

Behavioral Health Crisis Among Our Young

Behavioral healthcare has long been besieged by the opioid epidemic (suicides, addiction, depression). Then COVID-19 struck three years ago, further highlighting the shortcomings of our behavioral health system.

COVID-19 (along with social media) has had the most negative impact on our young. A survey of parents, conducted The Pew Research Center, revealed they now rank their children’s mental health status as a primary concern (anxiety, depression, suicide). The study also revealed what many employers are experiencing: the mental health of children directly impacts the well-being and productivity of their parents. All agree that government and commercial insurers must expand the access to, quality of, and affordability of behavioral health. Regulatory barriers must be removed, including anachronistic–redundant state licensing requirements that make it unnecessarily complicated for professionals to provide telehealth services across state lines. The nonprofit National Alliance of Healthcare Purchasers Coalition, which represents 12,000 employers and purchasers covering more than 45 million employees, is dedicated to promoting effective programs and strategies to improve our behavioral healthcare system for all and especially for the young.

CVS–Aetna Expand Mental Health

This alliance and similar commercial ventures and alliances, continue to distance themselves from traditional hospital and provider-based delivery systems by pio-

neering innovative, consume-friendly delivery systems. CVS–Aetna has been offering basic virtual and in person primary care services since May of 2022. Effective spring 2023, CVS–Aetna will be expanding telehealth behavioral health services to Aetna members, including appointments with licensed therapists and psychiatrists (MDs). Currently, the average appointment for a virtual, in person or at home primary care visit is out 24 days. The average appointment for an in person behavioral health service, before telehealth is introduced, is out 48 days. Time will tell how popular and effective these corporate healthcare delivery systems are.

US Healthcare Again Fares Poorly

The recent report from the Commonwealth Fund once again illustrates how poorly we are doing when compared to 37 other wealthy countries. Here are some of the low points. As of 2020, our average life expectancy was 77. The average life expectancy among our 37 counterparts was three years more at 80. We have the highest rate per 100,000 of avoidable deaths, infant and maternal deaths and gun related deaths. The latter being 7.4–100,000 versus 2.7–100,000 average in the other 37 countries. We spend, by far, more than any of our counterparts. The US spends close to 18% of its GDP on healthcare. That’s just over TWICE the average of the other 37 countries. The closest to our 18% of GDP were Germany at 13% and France at 12%. The major difference? Most of the 37 countries that clearly outperformed us in just about every category have single-payer healthcare systems.

Page 6 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
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.
– CNY’s Healthcare Newspaper • Page 7 M E E T T H E U P STAT E U RO LO GY T E A M FO R A N A P P O I N T M E N T, C A L L 315.464.1500 Female and reconstruc tive urology, urinar y incontinence in women, pelvic oor treatment and neurourology MATTHEW D MASON, MD, FAAP DMITRIY NIKOLAVSKY, MD RYAN SIDEBOTTOM, DO General urology, male health urologic oncology, enlarged prostate kidney stones At Upstate Urology of Auburn TIMOTHY K. BYLER, MD MRI fusion male health prostate cancer and kidney stones ZAHI N MAKHULI, MD Genera urology, andrology JC TRUSSELL, MD Male infer tility erec tile dysfunc tion andrology general urology prosthetics and Peyronies OLEG SHAPIRO, MD Urolog c oncology and endourology robotic and laparoscopic surger y of prostate kidney bladder and adrenal; kidney stones SCOTT WIENER, MD Kidney Stones, Minimal y Invasive Kidney Surger y, Enlarged Prostate HANAN GOLDBERG, MD, MSc Urologic oncology; robotic and laparoscopic surger y of prostate kidney b adder and adrenal ANTHONY J TRACEY, MD, MPH , FAAP Pediatr c urology, treatment of hern as and hydroceles, robotic surger y, urinar y trac t infec tions, pen le abnormalities NATASHA GINZBURG, MD IMAD NSOULI, MD GENNADY BRATSLAVSKY, MD Chairman Urologic oncology; robotic and laparoscopic surger y of prostate kidney, bladder and adrenal STEPHEN BLAKELY, MD ELIZABETH FERRY, MD General urology ROBERT FLEISCHER, MD General urology SEETHARAM BHAT, MD, MBBS Urologic oncology; robot c and laparoscopic surger y of prostate, kidney, bladder, and adrenal Reconstruc tive uro ogy incontinence, prosthetics urinar y stula, neurogenic bladder, urinar y diversion Robot c surger y General urology, female and reconstruc tive urology Ped atric urology treatment of hern as and hydroceles robot c surger y ur nar y trac t infec t ons penile abnormal ties Incontinence urethral stric ture disease vesicovagina stu a reconstruc tive surger y transgender care JOSEPH JACOB, MD, MCR Urologic oncology; robotic and aparoscopic surger y of prostate, kidney, bladder and adrena MAHMOUD CHEHAB, MD General urology, ma e health, urologic oncology, enlarged prostate, k dney stones , and robotic surger y GARRETT SMITH, MD General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn. NICK LIU, MD Urologic oncology; robotic and laparoscopic surger y of prostate, k dney, bladder and adrenal EDWARD IOFFE, MD General Urology Endourology and Laporoscopic Surger y JEFF VILLANUEVA, MD Pediatric urology treatment of hernias and hydroceles robotic surger y urinar y trac t infec tions penile abnormalit es

Practical tips, advice and hope for those who live alone

The Power of Faith: One Woman’s Spiritual Journey

Life after a divorce or the death of a spouse can leave you reeling and wondering about practically everything — your judgment, your future, your fears, and your faith.

Below is an interview I conducted with one of the most thoughtful and inspiring women I've met through my “Alone and Content” workshops.

Caroline (not her real name) was divorced when I met her and has since remarried, “happily,” she added with a smile.

Her faith lifted her up and carried her through the hardest times following her separation. It is my hope that her journey will inspire yours.

• Would you care to share a little bit about your faith?

I’m a Christian... I've looked at other religions and have made a conscious decision to remain a Christian, even though I don’t understand it all. I am learning to embrace the mystery.

• What role did your personal faith play in your adjustment to living alone?

My Christian beliefs hold to the tenet that I am never alone — that Christ is with me wherever I am. I’ve prayed a lot and have found indescribable peace in that praying.

• What was the biggest challenge you faced living alone and how did your faith help you heal?

Grieving the end of my marriage caused me the most pain while

alone. All the 'if onlys' and 'why me?' really tore at my heart. The Bible was my constant companion. I was also inspired by “The Purpose Driven Life,” by Rick Warren, and other Christian books and radio programs, which helped me put things into perspective.

Talking with others in my congregation was also a huge part of my healing. I get emotional when I think about the support and caring that surrounded me, rescued me.

• Is there a particular experience you had that captures the power of your faith?

My youngest son was 7 at the time. After dinner he brought me his homework book to sign, as was his teacher’s daily requirement. He’d been at his dad’s house the previous three days and I saw his dad’s girlfriend’s signature on the parent line in the book. My heart stopped.

Then, something in me snapped — all the times my precious children were away from me ... all the awfulness ... all the anger and injustice and fear. I sucked it up and forced my shaking hand to sign my name next to hers. I made my way outside,

stumbling, and collapsing under the maple tree in my back yard.

I laid on my back clutching my chest, my heart. No tears. Just intense pain. I did not, could not, make a sound or move. But after a while, my mind prayed a lament, begging God for relief from this excruciating pain.

In that instant, a 'peace that passes all understanding' moved over me and I felt my golden retriever appear and quietly curl up next to my body.

• Did you ever lose faith or struggle to regain your faith?

I did not lose my faith but, boy, did I ever have a few words with God! One morning during breakfast with my two boys, I ran to the garage and grabbed my bike after learning of the girlfriend’s ongoing involvement my boys’ lives.

I needed to get out of the house so the boys wouldn’t hear my rant at their father. I tore down the road, enraged and screaming at God, 'How could you let this happen?!'

About a half mile from home, I saw a doe quietly standing by the side of the road. I calmed down immediately and just sobbed. I turned the bike around just as the sun burst over the horizon, washing the sky, the quiet country road, and me in the warm morning light. I was reminded again 'You are never alone.'

• What advice would you give to those whose suffering has challenged their faith?

Remember a time when you risked it, trusted God, and felt a measure of serenity after you did. Remember that, 'This, too, shall pass.' Remember that there are things we can only learn when in solitude. That God has a bigger plan than our plan.

• What role does prayer play in your life?

Prayer is the great wireless communication connection to God. God speaks to us in three ways, through the Bible; through people, which in-

cludes books people write and teachers like you; and through prayer, which may encompass comforting things embodied in nature, dogs, deer, sunrises, and so much more.

• How can those who live alone activate their faith more fully?

It’s like exercise and eating right. You get out of it what you put into it. You prepare yourself for the years ahead by continuing to move and by putting good things into your body.

You prepare your heart and soul for the times ahead by studying your faith of choice and by nourishing your mind and actions with uplifting words and passages, helpful deeds, gratitude, and inspirational music and images.

• Was there a favorite scripture passage that lifted you up during your challenging times that you'd like to share with my readers?

"Do not be anxious about anything, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus." — Philippians 4:6-7

I hope you have found this interview helpful and supportive. While I find my spiritual bearings in nature, meditation, love and a humanist philosophy, I am inspired by the words and wisdom expressed by Caroline. We can all be strengthened by a spiritual life, wherever that path leads us. Embrace it.

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 her to speak, visit www. aloneandcontent.com

Page 8 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
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My Turn The Cancer Wife

I’m writing something a little different for this column — a book review.

It’s not a best seller, it’s not a scientific work, but the book is straight from the heart.

My husband’s cousin’s daughter, Courtney Jensen-Krzykowski, recently wrote “The Cancer Wife: I Do.” It is part memoir and part support guidebook for cancer caretakers. I met my husband and his large clan of siblings and cousins when I was a teenager and I feel like I’ve known them forever.

Courtney wrote this book to share her experiences and aid caregivers for a loved one battling cancer. She has even gone on to form a nonprofit called When Life Gets Krzy, Inc. to support cancer caregivers. You can find it on Facebook. All profits from her book go to the nonprofit to purchase gift cards and other things to support self-care for cancer caregivers.

Her cancer story started two years ago.

She was eight months into a difficult pregnancy. She and her husband Matt were looking forward to the birth of their second daughter. Their first daughter had just turned 4.

Her husband, age 35, had been feeling vaguely ill for a few months

and losing weight. One day he developed severe abdominal pain and went to a local urgent care. There they saw that he was very sick. Suspecting appendicitis, they sent him to the hospi tal by ambu lance. Scans revealed cancer obstructing his bowel. He underwent emergency surgery. They hoped the procedure would avoid a colostomy and stabilize him to start cancer treatment. Complications on the day after surgery sent him back to the operating room. He un-

derwent a second major surgery, and wound up not only with a colostomy, but also with a 10-inch wound that required packing for months to come. The next month their second little girl was born. Fortunately, mother and baby were fine. But the whole process was an ordeal.

Courtney writes about getting up to tend to Matt’s colostomy and to pack his surgical wound between contractions. He was too sick and weak to do it himself. He was barely able to muster the strength to get out of a chair to cut the baby’s cord. For those of us fortunate enough to have never been the caregiver for a very sick cancer patient, this book gives an idea of the stresses involved.

Courtney gives good advice for coping with the stresses of navigating endless doctor appointments, laboratory and imaging studies, chemotherapy and radiation side effects, all while balancing parenting two young children and holding down a full-time She writes that when friends asked how she did it, she replied the reality is that there is no other choice.

As Courtney writes, “Don’t lose sight of your strength, or the warrior

you’re behind. Acknowledge the battle you’ve been through. There is no shame in taking care of yourself. Take a break.”

It may not be the most literary book out there, but it is worth a read. Hopefully it will help cancer caregivers to realize that they are not alone.

“The

Page 10 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.
Lisa Clemmons, RN, BSN, OCN
ongoing relationships I am able to build with my patients at HOA are very special to me. Our patients and dedicated team members keep me coming back to work each day!” What’s so special aboutcancer care nursing? Shadow us & we’ll show you! Scan the code to learn why you’ll love joining the HOA nursing team!
“My husband’s cousin’s daughter, Courtney JensenKrzykowski, recently wrote ‘The Cancer Wife: I Do.’ It is part memoir and part support guidebook for cancer caretakers.”

Nearly 2 Million New Cases of Cancer Expected in 2023

In January, the American Cancer Society published its annual cancer outlook statistics.

Among the findings, the society stated that in 2023, 1,958,310 new cancer cases and 609,820 cancer deaths are projected to occur in the United States.

Other findings include:

• Prostate cancer increased by 3% annually from 2014-2019 after declining for two decades, which means 99,000 new cases.

• Lung cancer in women decreased at one-half the pace of men, 1.1% vs. 2.6% annually between 2015 and 2019.

• Cancers of the breast, uterine, liver and melanoma increased.

• Cervical cancer decreased by 65% between 2012 and 2019 among women in their early 20s.

• The death rate of cancer declined by 1.5% between 2019 and 2020, contributing to an overall 33% reduction since 1991, an estimated 3.8 million deaths averted.

• Cancer is still the second-leading cause of death in the US.

Heredity plays a role in 5%-10% of all cancers, according to the National Cancer Institute. Health habits can reduce the risk of many kinds of cancer.

“Fundamentally, according to the American Cancer Society, at least 18% of all cancers and 16% of cancer deaths are related to sub-optimal nutrition, alcohol, inactivity and excess body weight,” said physician Kaushal B. Nanavati, assistant dean of wellness and director of integrative medicine and survivorship at Upstate Cancer Center.

He believes that minimizing risk for chronic disease helps reduce risk for cancer and that means reducing inflammation and promoting gut health. One important area related to both of these is improving the diet.

“A study showed seven-plus servings of vegetables a day helps prevent the onset of cancer,” Nanavati said.

By covering half the plate with vegetables at lunch and dinner, a person would consume about five to

six servings. Snacking on vegetables and folding a cup of vegetables into a breakfast omelet would amount to the recommended seven-plus servings.

“At the cellular level, oxidative stress can damage the cell wall or structure,” Nanavati said. “Vegetables, especially ones that are cruciferous vegetables and those rich in carotenoids, have been shown to benefit preventing certain types of cancer by stabilizing cell and reducing oxidative stress.”

These including broccoli, cabbage, cauliflower, asparagus, spinach, kale and Brussels sprouts.

“When eating fish, go with cold water, wild caught fish,” Nanavati said. “Salmon, tuna and mackerel are excellent examples of fish to eat.”

He cautioned to limit consumption of red meat and especially processed meats, and foods high in sugar, saturated fat, trans-fat and sodium.

“Any consumption of alcohol can increase risk of certain cancers,” Nanavati said. “If you don’t drink, don’t start. If you do, the key is moderation: one serving daily for females or up to two for males is moderate, but more research is showing one for men or women on any given day is better. You can’t save them all up for Saturday night. Fundamentally, if you don’t drink, don’t start.”

Another important factor is bodyweight. Obesity contributes to the risk for pancreatic, liver, colorectal, esophageal, endometrial, kidney and post-menopausal breast cancer. In addition, the extra weight is associated with hormone release, which can spur cancer growth. To help control both weight and hormone levels, Nanavati said to engage in 150 to 300 minutes of moderate to vigorous physical activity per week, plus strength training.

Moderate activity could include walking, dancing, gardening or biking. Jogging, running, aerobic dance, swimming laps or shoveling snow all represent vigorous activity. Strength training could include bodyweight exercise, lifting kettlebells or dumb-

bells or using weight machines.

“People don’t have to spend thousands of dollars for gym memberships,” Nanavati said. “We can work with our own bodies and there are many online resources. Cato has a community center that has a lot of free programming.”

Many high schools provide free community gym time as well.

Although a few minutes of sun exposure weekly and vitamin D supplementation can help ensure sufficient vitamin D levels, excessive sun exposure raises risk for skin cancer.

“Avoid too much sun and wear skin protection when in the sun to reduce skin cancer,” said Kara Verbanic, public health educator with Onondaga County Health Department.

Wearing broad-brimmed hats, sunglasses and SPF protective clothing helps.

Cancer screenings represent an important tool for both prevention— such as in the cast of colon cancer— and early detection, when cancer is most often easier to treat. Self-exams can also catch cancer early.

“Know your body,” Verbanic said. “If something doesn’t seem right, call your doctor and get checked. Cancer doesn’t always

show symptoms early on which makes regular screening key. You may feel fine and not like you need to see a doctor until it’s a problem and by then it can be too late.”

She wants people to talk with their physician about when to start screening, as some people with family history of cancer may be advised to start early. Cancer screenings are available for breast cancer, cervical cancer, lung cancer, colorectal cancer and prostate cancer among others.

William Dahut, chief scientific officer with the American Cancer Society, said that 42% of cancers are preventable.

“If this was a new drug, it would be truly incredible,” Dahut said.

In addition to seeking appropriate screening, exercising, minimizing alcohol and maintaining a healthy weight, he encourages people to eschew tobacco. Tobacco use contributes to risk of many kinds of cancer—not only lung cancer.

“Tobacco is made of thousands of chemicals, including at least 70 that cause cancer,” Dahut said.

The website nysmokefree.com and most healthcare providers offer free tools and resources to support smoking cessation for those who want to quit.

March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 11
American Cancer Society states we will likely see about 609,820 deaths as a result of cancer. Local experts discuss ways to keep cancer at bay
Physician Kaushal B. Nanavati, assistant dean of wellness and director of integrative medicine and survivorship at Upstate Cancer Center. William Dahut, chief scientific officer with the American Cancer Society.

Things You Need to Know About Kidney Disease

It’s a condition that arises gradually but can cause tremendous pain and affect quality of life. Chronic kidney disease, also called chronic kidney failure, involves a measured loss of kidney function. A kidney’s function involves filtering wastes and excess fluids from the blood, which are then removed in your urine. Advanced chronic kidney disease causes dangerous levels of fluid, electrolytes and wastes to build up in your body.

Physician Antoine Azar, who is part of the Nephrology Associates of Syracuse, a private kidney specialist medical practice that has been serving the community for more than 44 years, discusses five aspects of kidney disease.

1.Kidney issues for youth and adults

Some common kidney issues that affect children and adults are kidney stones, kidney infections, acute kidney injury and chronic kidney disease. Chronic kidney disease is especially important because more than one in seven US adults — and as many as nine in 10 adults — have the condition.

“Common kidney issues in the early stages of the disease are typically not noticed by patients. As the disease progresses, individuals may notice foamy urine and they wake up at night more often to go to the bathroom,” said Azar. “Other common kidney issues may include anemia and blood pressure-related issues including headache, dizziness and

kidney stones.”

2.Misconceptions

There are various misconceptions when it comes to the condition. Sometimes people consider the word chronic and believe it means severe. In actuality, it means longterm. Chronic kidney disease processes slowly and people may not notice for some time until their kidneys are seriously damaged.

“People say kidney disease is symptomatic, meaning that you will know if you have kidney disease. This is false and unfortunate,” said Azar. “Many people are unaware of kidney disease. Chronic kidney disease has been called the silent disease because most people experience no symptoms in the early stages of the disease. That is why it is important to be aware of your risk factors.”

Another myth about kidney disease is that if you are at risk there is nothing you can do about it.

“The earlier a person is assessed for kidney disease, the sooner an individualized care plan can be implemented to quickly take action

Be a Savvy Health Care Consumer M

anaging your health care, or the care of a loved one, can be overwhelming, especially if complex medical conditions are involved, or the list of providers and prescriptions is long. Here are easy ways to keep it all under control.

Get organized

“Create a health care binder with the names and contact information for your health insurer, each provider you see, and the pharmacy and lab you use,” says physician Nicholas Massa, vice president, medical affairs at Excellus BlueCross BlueShield. He recommends a three-ring binder so you can add and remove pages. Pick one that is brightly colored, and label it clearly so it stands out from your other important documents. Include a calendar and extra pages so you can keep a running log of office visits and topics covered.

If you have a family member or trusted friend who assists with health care paperwork or transportation to appointments, show them your binder and explain your record keeping system. It’s good to have backup.

Get connected

Create a member login for your insurer’s website and download the mobile app if it has one. Establish accounts with each of your providers’ online patient portals. These tools provide easy two-way communication with your care team and allow you to receive email and text reminders about appointments, screenings, and even lab results. Store the usernames and passwords in your binder.

“Make sure your providers are connected with each other by consenting to HealtheConnections, Central New York’s secure clinical information exchange,” says Massa. “Ask

to slow the progression of the disease and prevent further damage as much as possible,” he said.

3.Kidney disease signs

There are very few signs of early or moderate chronic kidney disease that only blood or urine testing will show. In very advanced cases, people may experience the symptoms of toxin buildup, which may include confusion, loss of appetite or foul taste, nausea and vomiting, or itching. They may also notice the effects of fluid accumulation, including swelling of the legs and shortness of breath.

“There are mostly no signs or symptoms in the early stages of kidney disease. Common early symptoms of kidney issues include urinating more or less than usual, fatigue and weakness, sleep problems, loss of appetite, muscle cramps, nausea, and vomiting, which happens at advanced stages,” said Azar. “Chronic kidney disease slowly damages the kidney over time which means that the kidneys’ ability to filter wastes from the body worsens. Some other common kidney issues may include kidney stones.”

4.Family history

Some kinds of kidney disease are directly inherited on a single gene, like polycystic kidney disease. Other kidney diseases come about as a combination of many genes in addition to environmental factors, which also tend to run in families.

“Two of the main causes of chronic kidney disease are diabetes and high blood pressure, which are two conditions that can be inherited. A family history of kidney disease, such as a family member being on dialysis may indicate that an individual

your provider to supply you with the form.” HealtheConnections supports more than 12,000 physicians and millions of patients across 26 New York state counties in the Central, Northern, Southern Tier, and Hudson Valley regions, and surrounding states. Consenting allows your medical care team to securely share records across connected institutions and practices, making your patient information available wherever and whenever needed for your care.

Get support

Anyone, at any time, could need someone they trust to get involved in their care.

Add a family member or friend to your caregiver team by signing HIPAA authorization forms allowing your providers to share information with them. “Having that extra set of ears will help ensure that you clearly understand your provider’s instructions,” says Massa. He also recommends patients select a health care agent to make decisions on their behalf if they are unable to speak for themselves. This is done by completing a health care proxy

will have a predisposition to possibly develop kidney disease,” said Azar. “Some cystic kidney diseases can be hereditary. It is extremely important for people who have diabetes, high blood pressure, heart disease, obesity or a family history of kidney disease to know their risk of developing kidney disease.”

5.How does dialysis work

Dialysis is a procedure that replaces kidney function in people with kidney failure. It doesn’t fix the kidneys themselves. Dialysis gets rid of the extra fluid. You can get dialysis treatments in a number of different ways: blood dialysis or belly dialysis (peritoneal dialysis), in a dialysis center or at home. They all serve the same purpose and work equally well.

“When an individual’s kidneys no longer function, this is referred to as end-stage renal disease or kidney failure. Dialysis is one treatment option for kidney failure whereby an access point in the person’s body is established to allow the person’s blood to be removed, filtered to take away waste and excess fluids and then the clean blood travels back into the person’s body. Dialysis does not improve kidney function; it is a procedure to clean the person’s blood when their own kidneys are not able to do it,” he said.

form, available from any health care provider. Keep a copy in your binder and share copies with family members.

“Managing your health care can be so much easier if you follow these simple suggestions,” encourages Massa. “You can do this!”

For more health and wellness information visit ExcellusBCBS.com.

Page 12 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
5
Nephrologist Antoine Azar, who is part of the Nephrology Associates of Syracuse. Massa

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Dental Work for Less

‘Turkey teeth’ and other dental tourism may cost less but present risks, say local providers

The desire for a perfectly symmetrical, snowy-white smile seems to have become even greater in recent years, giving rise to “dental tourism,” in which Americans travel to other countries for cosmetic dental work, like whitening and veneers. Typically not covered by dental insurance, these procedures are much less expensive in some other countries.

Turkey has become a particular destination, offering procedures at 50% to 70% off the cost of US-based providers. One procedure in particular has become widely reported on social media, known as “Turkey teeth,” in which patients have entire rows of teeth treated to result in an instant Hollywood-worthy smile. Local dental experts warn that non-domestic work can lead to unwanted outcomes.

“The issue when going to another country, like a Latin American country, is the regulation and the schooling a dentist has to do is far less stringent than here,” said An-

thony J. Tabone, a dentist operating an eponymous practice in Auburn.

“You have to be concerned with the quality. The materials and labs are not regulated.”

American dentists must be licensed to practice and complete a specified level of education. Tabone said that even in England, the requirements are not as stringent as in the US.

“In England, dentists aren’t considered ‘doctors’ as a professional title,” he said. “It seems there’s a certain respect of the title because we’ve gone through an extensive amount of training. In my sophomore year of dental school, I took 32 classes — more than 40 credit hours. It’s a pretty standard sort of training dentists have in the US.”

He trained alongside students who were practicing dentists in other countries but came to America and had to start their education all over to become credentialed here.

Tabone said a friend of his traveling in India observed dentistry

Massachusetts Bill Would Let Prisoners Donate Organs in Exchange for Shorter Sentence

Massachusetts legislators have proposed a bill that would allow prison inmates to donate their organs or bone marrow as a way to trim the length of their sentence.

While some experts wonder about the ethics of such a law and whether it would even be allowed under federal law, a Democratic sponsor of the bill, state Rep. Judith Garcia, told the Associated Press it could reduce health inequities from “the vicious cycle of unjust incarceration and over-policing of Black and Brown communities.”

While Black and Hispanic people tend to have a higher need for organ

donation because of certain health conditions, discriminatory incarceration rates limit matches and lead to long waitlists for Black people, Garcia explained.

Not all experts agree with the tenets of the bill and it faces an uphill battle to passage, however.

“The bill reads like something from a dystopian novel,” Kevin Ring, president of Families Against Mandatory Minimums, a Washington, D.C.based criminal justice reform advocacy group, told the AP. “Promoting organ donation is good. Reducing excessive prison terms is also good. Tying the two together is perverse.”

Federal law bans selling human

practice on the side of the street.

Some dental procedures in other countries are not part of how US dentist practice. In particular, the “Turkey teeth” procedure is not advisable. It may involve shaving off a thin layer of enamel to fit a veneer to the teeth—the typical method for applying veneers—but some Turkish providers remove up to 70% of the enamel to completely crown the teeth. The provider grinds down the patient’s natural teeth to tiny nubs before the crowns are applied.

“It goes to regulations,” Tabone said. “They’re not held to the same standards as this country.”

He encourages anyone considering cosmetic dentistry to completely understand the procedure, know the provider, obtain references and seek a few different opinions before proceeding. These steps would be very difficult when seeking cosmetic dentistry abroad.

Veneers and crowns need replacing over time, losing so much enamel as in the case of Turkey teeth can shorten the natural teeth’s longevity.

Paul Sussman, dentist and co-owner of Center for Cosmetic Dentistry in Rochester, said that the lifespan of a crown may be as short as seven years.

“Once this has to be replaced, there will be very little to work with,” Sussman said.

Because a Turkey teeth procedure may leave little enamel, it can damage the nerve of the tooth, causing extreme pain and increase the risk of extraction shortly after the procedure.

Sussman said that there’s also the danger that shoddy work can allow saliva, bacteria and food to leak under the restorations, which can break down the natural teeth.

Sussman has treated patients who have received treatment overseas and without knowing what material was used, correcting or repairing their teeth may be more challenging.

“I’ve had patients go to Mexico,” he said. “Maybe they get it done quickly. When we do treatments, we want it to look natural, not like Chiclets. We don’t want people to know you’ve had anything done to your teeth like it’s artificial. Typically,

So why are dental procedures so inexpensive in Turkey? According to www.dentalhubatalya.com, a Turkish website about dental care:

“The currency: Lira, Turkey’s currency has a lower value than the pounds, euro, or dollars. This ensures those with strong currencies obtain dental care at a very cheap price due to the exchange rate.

Cost of living: Owing to the low value of the country’s currency, living in Turkey is more affordable than in most European countries. There’s the low cost of material, low cost of labor and cheap structures, all of which impacts the overall cost of getting a dental veneer, making it cheap.

Government incentives: Turkey has recognized the potential of medical tourism and is tapping into it, investing heavily in the development of the sector. To help boost the sector, the government offers incentives such as monetary aid, loans, tax reductions and so on.

High competition: There are a lot of dental clinics in Turkey. The competition keeps the prices lower. And with the number of foreign patients always coming in, most clinics can afford to maintain the standard while lowering the price.”

when patients go out of the country, they come back with white, Chiclet-looking things that don’t look natural. Natural teeth have surface texture and slight variations of color, so it looks natural.”

Sussman encourages patients who want to improve their smile to talk with their dentists about affordable options, such as replacing a silver filling with a natural-looking one, whitening, or recontouring. A combination of procedures can dramatically improve appearance. Sussman also sometimes applies veneers a few at a time to help patients spread out the cost.

Most dentists and orthodontists provide installment plans to help patients better afford care.

organs. George Annas, director of the Center for Health Law, Ethics & Human Rights at Boston University’s School of Public Health, told the AP that reducing a prison sentence in exchange for organ donation is the equivalent of a payment.

“You can’t buy an organ. That should end the discussion,” Annas said. “It’s compensation for services. We don’t exploit prisoners enough?”

On the other side, bill co-sponsor Democratic state Rep. Carlos Gonzalez, said the program was voluntary and that he would be open to an organ donation program that wasn’t

paired with sentence reduction.

“It’s not quid pro quo. We are open to setting policy without incentives,” Gonzalez said, adding that it is “crucial to respect prisoners’ human dignity and agency by respecting their choice to donate bone marrow or an organ.”

Under the proposal, the program would allow inmates to receive sentence reductions of 60 days to one year after donating organs or bone marrow. A committee would decide how much would need to be donated for a sentence reduction.

Page 14 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023

New CEO of St. Joseph’s Health Still Helps Out in the ER

When the clock struck midnight this past New Year’s Eve, Steven D. Hanks officially became the new president and chief executive officer of St. Joseph’s Health, Syracuse and St. Peter’s Health Partners, Albany.

In those early morning hours, however, he wasn’t in the office.

As he had done many times in the past, Hanks had taken a shift at the St. Peter’s Hospital, Albany, to work side-by-side with other physicians and nursing staff caring for patients in the emergency department.

Since he started the transition to physician executive in 1998, Hanks has held various healthcare leadership positions throughout the country, most recently at St. Peter’s Health Partners. He joined the organization in 2016 as vice president and chief medical officer, and has served as chief clinical officer, chief operating officer and for five months last year, as interim president and CEO.

While Hanks has been primarily focused on the administrative side of medicine, he doesn’t shy away from donning his scrubs to work per diem hospital shifts, often in short-staffed emergency departments.

“It keeps my clinical skills sharp and intact, and I love doing it,” he said. “I enjoy spending that time with my colleagues and the patients.”

Hanks’ skills as a physician became even more in demand when the COVID-19 pandemic hit in March 2020, causing large numbers of sick patients to flood hospital emergency departments. During the crisis, he worked many hours as a hospitalist in the special COVID-19 units set up at St. Peter’s Hospital.

When cases began to decline in New York state, he traveled to a hospital in Boise, Idaho, to help out there after COVID-19 began surging

in the West.

Trinity Health, which owns both St. Joseph’s Health and St. Peter’s Health Partners, consolidated the two healthcare systems into a single regional operation last year in response to the financial challenges brought on by the COVID-19 pandemic.

The newly integrated health care organization was established to create a more efficient and cost-effective system with one management team (St. Peter’s Health Partners) oversee-

“I don’t think we were anticipating how severe it would still be post pandemic,” he said. “It’s unbelievable.”

Hanks, who worked with management to bring the Albany and Syracuse operations together, noted that staffing shortages, a shift in patient volumes and the increasing cost of medical supplies have contributed to the unprecedented financial challenges being faced by hospitals nationwide.

“Last July we brought together the two healthcare systems under Trinity Health New York to consolidate administrative expenses and reduce costs, without impacting patient care,” Hanks said.

their test results and treatment sooner and opens the doors to refer more patients for specialized care throughout the network.

The consolidation of St. Joseph’s Health and St. Peter’s Health Partners puts both organizations in a better position to adapt to the changing health care landscape, Hanks said. Many hospitals nationwide have needed to temporarily close some of their operating rooms because of staff shortages, while keeping the remaining ones open for emergency procedures.

“We see the future of hospitals in outpatient spaces,” Hanks said.

It’s expected the demand for acute inpatient-level care will become the main focus of hospitals, while less intensive types of medical care will continue to shift toward outpatient settings, such as clinics and ambulatory surgery centers.

For example, there is already a trend nationwide for total joint surgeries, such as knee and hip replacements, to be done on an outpatient basis. In the past, these types of surgeries were routinely done as inpatient procedures, but “orthopedic surgeons have worked to advance the science of care, so the majority of these procedures can be safely done” at ambulatory surgery centers, Hanks said.

A major advantage of outpatient surgeries is that medical staff “don’t have to worry about operating room schedules being interrupted in emergency cases. They are working in a safer, more controlled environment,” he noted.

Patients undergoing outpatient surgeries don’t typically require an overnight hospital stay because much of the preparation for a successful outcome is done in advance, Hanks said. Most physicians will discuss with their patients the important steps they should take to ensure a successful recovery, such as managing weight and blood pressure, and stopping smoking, in a month or two prior to the scheduled procedure.

ing the operation.

St. Peter’s Health Partners primarily operates in the Capital Region. It has five hospitals: St. Peter’s in Albany, three Samaritan Hospital campuses (two in Troy and one in Albany), and the Sunnyview Rehabilitation Hospital in Schenectady. Hanks maintains offices in both Albany and Syracuse, spending about one week each month at the St. Joseph’s Hospital.

As one of the largest, nonprofit Catholic healthcare systems in the United States, Trinity Health operates hospitals and other healthcare facilities in 26 states. St. Joseph’s had been acquired by Trinity Health in 2015.

While it’s been three years since the first COVID-19 cases were confirmed in the United States, “all hospitals are still struggling,” including large medical centers throughout the country, said Hanks.

Many of the “back-office functions” such as legal services, human resources, information systems and compliance have been consolidated within the larger Trinity Health network. “A single executive team running the Trinity Health operations in New York state will result in significant savings,” he added.

In many ways, the arrangement will also enhance patient care. Because Trinity Health is a nationwide system, “we have the ability to leverage shared electronic health records, and to share the most current science-based and evidence-based care, which will lead to innovative and best practices for all patients,” Hanks explained.

Patients will benefit from the latest health care research and information shared in the larger system of care, regardless of which Trinity Health building they enter, he said.

“We are a regional network, integrated with hospitals, nursing homes, assisted living, rehabilitation centers, and home health care services,” he said.

The shared electronic medical records system allows patients to get

“These steps have been shown to improve outcomes of surgical procedures and the patients recover more quickly,” while the overall medical expenses are less than an inpatient stay, he said.

Prior to joining St. Peter’s Health Partners, Hanks served as physician executive with the Cerner Corporation, a global health care information technology company in Kansas City, Missouri. He had earlier spent more than a decade with Hartford HealthCare in Connecticut. During his tenure in Hartford, he also held the position of assistant dean for graduate medical education at the University of Connecticut.

Hanks holds a Bachelor of Science in neurosciences from the University of Rochester, where he also received his medical degree with distinction in research. He completed his internship and residency in internal medicine at the University of Rochester’s Strong Memorial Hospital.

During his early years in practice, he earned a certificate in medical management from the American College of Physician Executives before completing his master’s in medical management from Carnegie Mellon University’s Heinz School of Public Policy in Pittsburgh. He is board certified in internal medicine and is a fellow of the American College of Physicians and the Federation of State Medical Boards.

March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 15
Physician Steven Hanks next to a DaVinci robotic surgery equipment. He became the CEO of St. Joseph Health in Syracuse Jan. 1.
While physician Steven Hanks has been primarily focused on the administrative side of medicine, he doesn’t shy away from donning his scrubs to work per diem hospital shifts, often in shortstaffed emergency departments. “It keeps my clinical skills sharp and intact, and I love doing it,” he says.

SmartBites

The skinny on healthy eating

How Avocados Improve the Health of Your Skin

At this time of year, when my skin is as dry as dust, as flaky as shredded wheat, and as supple as wood, I’m always on the lookout for foods that boost skin health. Lucky for me, a standout food that promotes healthy skin is also one of my favorite fruits: avocado.

In a recent study at UCLA Center for Human Nutrition, researchers concluded that daily avocado consumption could lead to improved elasticity and firmness in the facial skin of healthy individuals.

According to Zhaoping Li, Ph.D., chief of clinical nutrition at UCLA, the study showed that the best approach to young and vibrant skin is not just topicals, but improving your whole diet with foods such as avocados. “When you take care of your entire body with proper nutrition, then your skin is going to reflect that,” Li said.

So what makes this buttery, creamy fruit your skin’s best friend?

As its taste and texture suggest, avocados are rich in fat. But, thankfully, the majority is monounsaturated fat, the good kind that doesn’t increase blood cholesterol. This healthy fat

helps to moisturize and soften skin, as well as increase elasticity and reduce the appearance of wrinkles. One study of over 700 women concluded that a high intake of fat—especially monounsaturated fat—was linked to more supple, springy skin.

Avocados teem with two skin-preserving vitamins: vitamin C and vitamin E. Both are powerful antioxidants that help protect skin cells from damage caused by environmental stressors, like sunlight, air pollution, and cigarette smoke. What this could mean for us avocado-aficionados—in the best-case scenario— is skin that defies aging and disease. Go, avo!

Lastly, this “alligator pear” contains lutein, another kind of antioxidant that protects against UV damage. Studies have shown that, when present in sufficient quantities in the skin, lutein helps to filter high-energy wavelengths of light. The result may be protection against sunburn, signs of aging, and skin cancer.

One cup of sliced avocado has 230 calories, 10 grams of fiber, 21 grams of fat, (15 grams is monounsaturated), and impressive amounts of vitamin K and folate, two more vitamins with anti-aging benefits.

How Many Calories a Day Can Safely Spur Weight Loss?

The key to losing weight sounds simple — eat less.

Regardless of the diet you follow, dropping the pounds means burning more calories than you eat.

That begs the question, how many calories should I eat to lose weight?

According to the U.S. National Library of Medicine, for most people, cutting about 500 calories a day is a good place to start. If you can eat 500 fewer calories every day, you should lose about a pound a week.

Another easy way to figure out how many calories you should eat is to multiply your weight by 15, Harvard Health advises. That number will give you the number of calories you need to maintain your current weight. To lose weight, simply cut that number.

But counting calories isn't enough, says Samantha Heller, a nutritionist at NYU Langone Health

in New York City.

"Everyone wants a quick fix, but weight loss is not an overnight proposition. We do not gain weight nor will we lose weight quickly," she said.

"If you want to lose 10 pounds, one important tool is keeping a food diary," Heller said. Keep track of everything you eat for five to seven days. Then review your food record.

See where you can cut back on sweets, snacks, large portions and alcohol. Let those discoveries help you make a plan for losing weight.

How to cut calories in a healthy way

"Many of us need support and structure to help us on our journey, so programs like Weight Watchers or seeing a registered dietitian may be helpful," Heller said.

You can lose weight by eating

Adapted from wellplated.com

Serves 6

For the salad:

1 large English cucumber, sliced or diced

½ small red onion, thinly sliced

1 pint cherry tomatoes, halved

2 medium avocados, sliced or diced

½ cup crumbled feta cheese, divided

¼ cup chopped fresh cilantro (or dill)

Helpful tips

Ready-to-eat avocados should dent when slightly squeezed. If hard, place in direct sunlight or in a sealed paper bag to speed ripening. Once ripe, they can be refrigerated for up to a week. Avocados quickly turn brown once exposed to air. Although unappetizing to see, the brown flesh is perfectly safe to eat. To slow or reduce browning, try these tips: cover the flesh with lemon or lime juice or wrap tightly with plastic wrap and store in the refrigerator.

For the dressing:

3 tablespoons fresh lime juice (2 small limes)

2 tablespoons olive oil

2 teaspoons honey

2 cloves garlic, minced

½ teaspoon kosher salt

½ teaspoon black pepper

In a small bowl, whisk together the dressing ingredients: lime juice, olive oil, honey, garlic, salt, and pepper.

In a large bowl, place the cucumbers, onions, tomatoes, avocado, half of the feta, and cilantro. Pour the dressing over the top, then gently stir to combine. Sprinkle the remaining feta over the top. Enjoy immediately or cover the bowl with plastic wrap and refrigerate for up to 4 hours (stir just before serving).

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

anything as long as you are consuming fewer calories or burning more calories than you were previously.

"But it is far more important to be healthy, not skinny, and to find a sustainable lifestyle," Heller said.

How to eat healthy?

Eat more vegetables such as car-

rots, tomatoes, broccoli, spinach, lettuces, peppers and kale; add legumes such as kidney, pinto, white beans, lentils, split peas and edamame; use whole grains including whole wheat, oats, farro, quinoa and brown rice; and include some daily fruits and nuts, Heller said.

Replace high-calorie foods with low-calorie, healthier alternatives.

Page 16 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
Avocado Cucumber Tomato Salad

New CEO Leads Lab Alliance Into Its 25th Year

“The large impact in the health of the community that we serve, it really is exciting.” This is according to Rita Romano, who was named as the chief executive officer of Laboratory Alliance of Central New York late last year. She is leading the company into its 25th year.

“Large” might be an understatement considering the scope of the organization’s work.

During the COVID-19 pandemic, the public has become keenly aware of the critical role that testing can play, but Laboratory Alliance’s work goes well beyond COVID-19 testing.

Romano oversees a staff of 360 — a number that is growing, she pointed out — who conduct more than 10 million tests each year in the company’s three test sites, providing 1,500 tests and test combinations across a variety of laboratory medicine, such as hematology, cytology, histology, microbiology, immunology, chemistry and transfusion medicine.

Laboratory Alliance’s main facility is in Liverpool, with smaller labs at St. Joseph’s Health Hospital and Crouse Hospital, where inpatient and outpatient clinical and anatomic pathology testing is done.

Moreover, its 55 couriers covered more than 1.5 million miles last year, servicing regional hospitals, longterm care facilities and healthcare practices in a 16-county region in Central New York. They travel as far west as Aurora, east as Utica, north to Carthage and south to Ithaca. Many of their employees have been with the company since it was founded in 1988, with some having 40-plus years of experience at other sites before joining Laboratory Alliance.

As the company marks its quarter-century, Romano said she plans to continue to grow the operation, forge partnerships with other health systems in the community and guar-

antee that those who need access to laboratory testing has it available to them.

“We want to be the laboratory of choice, we want to be the employer of choice,” she said. “I think we have a beautiful culture here.”

She believes that developing these partnerships helps to keep the work in the community, as opposed to tests being sent to other places. Keeping it local is important to her.

“This is the community that I grew up in, the community I stayed in. I raised my children here,” she said.

The daughter of Italian immigrants, Romano graduated from Syracuse’s Henninger High School and St. Bonaventure University. She joined Laboratory Alliance in 2011, and over the years moved up through the company.

In 2013, she became the director of its operations center, where she was responsible for the oversight and management of clinical and anatomic pathology laboratory services in accordance with the accreditation authorities, physicians’ orders, policies, procedures, established standards and administrative policies.

She ran Quadrant Laboratories, LLC, beginning in March 2021, overseeing the establishment of 43 community-based testing sites for COVID-19 across New York state. She returned to Laboratory Alliance this past fall.

With her experience and work ethic, she is a very hands-on leader, and is not one to simply sit in her office.

“I walk the talk, I do rounds. I’m a licensed tech, so I’ve worked in the trenches, if you will. I know what they’re challenged with. So, I’m supporting those challenges. We really work as a team,” she said. “I’m really blessed with my talent here.”

AT AUBURN COMMUNITY HOSPITAL, WE HAVE FOUND MORE WAYS TO SPECIALIZE IN YOU.

We are partnering with Upstate Cancer Center to provide cancer care in the comfort of our community.

Right here at ACH, our new Cancer Center is ready to provide individualized treatment options from some of the brightest experts in the country. Every care plan ensures the comfort and convenience for patients and families.

Hours of Operation: Monday - Friday 8:30am-4:30pm Call 315-253-1818 to schedule an appointment.

YOU CAN ALSO VISIT OUR WEBSITE AT: auburnhospital.org/cancercare

March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 17
Rita Romano became the CEO of Laboratory Alliance of Central New York in December 2022. She is a her. Office in Liverpool.

The State of Opioid Abuse — How Bad Is It?

Deaths by overdose still going up year after year

Three years ago, area experts could only guess the effects of the pandemic on area’s opioid abuse problem.

As it turns out, the isolation and disruption contributed to higher use. However, the trend may soon slow.

“Over the last few years, we have been affected by the pandemic,” said Mariah Senecal-Reilly, coordinator of the mental health and substance use initiatives program with Onondaga County Health Department. “We’ve seen some increases in overdose fatalities and occurrences related to a number of factors like disruption of treatment, financial downturn and feelings of despair. We do have some tentative good news: this year, if we continue on the same path that we have been, it looks like our fatalities will have decreased for the first time in years.”

The uptick in overdose deaths in recent years is largely because those using drugs are unaware of the presence of fentanyl in any given dose. Its extreme potency contributes to accidental overdoses.

“Most everything has fentanyl in it,” Senecal-Reilly said. “We’re seeing it laced in methamphetamines, cocaine and counterfeit pills. About a month ago, spike, synthetic marijuana, was laced in that as well. Fentanyl is 100 times stronger than heroin and 50 times stronger than morphine. When someone’s not expecting, it they’re at a significant increased risk for an overdose.”

The department’s emphasis on prevention includes education in several school districts, teaching self-regulation and developing resiliency, which are proven to reduce substance abuse. Reducing harm represents another strategy, including case management for people at risk for overdosing and reducing barriers to accessing naloxone, which counteracts the effects of opioids during an overdose episode and fentanyl test strips. Peer services support those pursuing recovery.

“We’re planning on doing

a real-time as possible overdose response,” Senecal-Reilly said. “We’re thinking this will be helpful to the vulnerable population. We’re expanding our funding to evidence-based prevention in schools.”

She views telemedicine as another tool for aiding in substance use recovery, especially for people with limited ability to participate in traditional settings. Oftentimes, stigma, transportation and employment and child or elder care obligations hamper patients’ ability to pursue treatment.

Eric A. Bresee, licensed mental health counselor and executive director of Farnham Family Services in Oswego, said that a greater emphasis on a medical model and education— and a shift away from scare tactics— has proven more effective in his field.

“The educational approach is a lot more respectful of people and where they’re at,” he said. “We’re treating people with respect and dignity and support them for achieving their true goals.”

He said that in Oswego County, opioid use has continued its steady increase since 2011, less changed by the pandemic then elsewhere. However, “alcohol use disorder rose significantly,” he said.

Access, legality and social norms all likely contribute to the increase in alcohol use compared with other substances.

Among the pandemic-influenced changes at work, home and society, “there were a lot of stressors involved and some folks turned to alcohol, and that’s why we saw those rates rise,” Bresee said.

Like Senecal-Reilly, he views telehealth as another tool for providers, but not a replacement for face-to-face care.

“We continue to experience the worst overdose crisis in the history of the nation, which is devastating individuals, families and communities,” said Evan Frost, assistant director of Communications & Public Information for the New York State Office

of Addiction Services and Supports in Albany. “Fentanyl continues to be a major factor in overdoses and deaths in New York state. In 2021, the vast majority of overdoses involved synthetic opioids like fentanyl. The main danger from fentanyl is that it is often added to a substance without the user’s knowledge, which can substantially raise the risk of an overdose since the person using the substance has not built up a tolerance.”

Administering naloxone (such as Narcan) to counter the effects of an opioid overdose is saving lives. In 2020, emergency medical services in Monroe County administered naloxone 695 times, 623 in 2021 and through the third quarter of 2022 (the most recent data available), 409 times.

Law enforcement personnel also administered naloxone 71 times through the same time period and the Registered Community Opioid Overdose Prevention program reported 393 events. Actual numbers may be higher, as not all events are reported.

Statewide, the introduction of telehealth and mobile treatment in recent years has helped reach people who may otherwise not have accessed services.

“These initiatives have allowed us to meet people where they are and deliver individualized, person-centered services to meet their needs,” Frost said. “We are also collaborating with the office of Mental Health on efforts to treat co-occurring substance use and mental health disorders, including through certified community behavioral health clinics, which provide an array of coordinated services to address substance use or mental health, and crisis stabilization centers, which provide support, assistance and urgent access to care for individuals experiencing a crisis situation related to substance use and/or a mental health condition. We plan to build on these efforts in the coming year.”

In 2021, there were 6,037 overdose deaths in New York State. This is an increase of approximately 101% since 2015.

Frost said that OASAS will continue with Street Level Outreach Teams, Outreach and Engagement Services, Shelter In-reach Programs and ensuring providers have access to naloxone and fentanyl test strips. The strips can help a person using opioids know if fentanyl is present.

“Other Harm Reduction programming is included in these efforts,” he added.

OASAS also plans to “improve treatment equity. Historically, addiction treatment has not been as available to minority communities,” Frost said.

On Feb. 8 this year, New York state announced it will make available to 18 providers statewide $8.6 million to develop integrated outpatient treatment initiatives targeting opioid use. The money comes from a more than $2 billion fund received from settlements with opioid manufacturers. Some of the fund will be distributed to municipalities and the rest to support opioid programs.

The New York State Department of Health recently reported that in 2021 statewide:

• 4,766 overdose deaths involving opioids, a 14% increase over 2020.

• 10,430 outpatient emergency department visits due to opioid overdoses, a 12.6% increase over 2020.

• 19,139 instances of naloxone being administered by Emergency Medical Services, an 11.8% increase over 2020.

Anyone struggling with addiction can call the HOPEline 24/7 at 1-877-8-HOPENY (1-877-846-7369) or text HOPENY (Short Code 467369).

Family members may also use these services.

NYS OASAS Treatment Availability Dashboard at FindAddictionTreatment.ny.gov or through the NYS OASAS website, www.oasasd. ny.gov, lists treatment options.

Anyone struggling to file a claim or who has been denied a claim can contact the CHAMP helpline at 888614-5400 or ombuds@oasas.ny.gov.

Page 18 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
Number of Opioid-Related Deaths in Oswego County 2016 23 2017 18 2018 14 2019 31 2020 27 2021 35 Number of Opioid-Related Deaths in Onondaga County 2016 128 2017 79 2018 78 2019 98 2020 134 2021 160
Through June 2022
Number
Number
Deaths Year Year Addiction
of Deaths
of

Fighting Addiction

On the Forefront of Prevention and Treatment: Eric Bresee and Mariah Senecal-Reilly

An early interest and educational background in psychology prepared Eric A. Bresee for his role as executive director at Farnham Family Services in Oswego. A Hannibal native, Bresee became interested in psychology during his senior year of high school when a presentation at his school about the topic intrigued him.

“I was interested in understanding how people work and that aligned with psychology,” he said.

He studied psychology at SUNY Oswego and hoped to help people someday. After graduation, he worked at Oswego County Opportunities with people with developmental disabilities. There he met someone who encouraged him to obtain his master’s degree at Oswego. He did so and in 2015, he became executive director at Farnham, where he had already served on the board for a few years.

Through his experiences on the board at Farnham, “I developed compassion for people struggling with substance use disorder,” he said. “I saw a growing need, especially with

opiates. I wanted to get involved and make a difference.”

Over the years, Bresee has seen the model of care develop from one of abstinence-only to one that includes personalized, person-focused harm reduction for those who use substances.

Although challenges in his work include staffing and finding ways to help patients achieve their goals, he appreciates how his role at Farnham has helped him grow as a leader and continues to delight him as patients become healthier.

“When I see individuals getting their lives back and families relieved that their loved one is healthy again, that’s inspiring,” he said. “It makes this work very rewarding.”

Seeing a family member struggle with substance use inspired Mariah Senecal-Reilly to become interested in the field. She serves as coordinator of the Mental Health and Substance Use Initiatives Program for Onondaga County Health Department.

She earned a degree in social work with a psychology minor from LeMoyne College and her master’s in

public administration from Syracuse University. She initially worked for Oswego County as a program coordinator in 2014 but changed jobs three years later to work in Onondaga County for a shorter commute.

“We have made a great deal of progress in stigma reduction from when I started to now,” Senecal-Reilly said. “Now the public is more aware as is society. We are more accepting.”

But other changes are not so happy.

“We have been heavily impacted by overdose fatalities,” she said. “I’m hopeful we’re turning it around. That’s been hard.”

Her program has grown over the past year with new positions. Since

she began at Onondaga County, she has helped develop strategies such as syringe exchange to reduce harm, providing naloxone to counteract opioid overdose and an overall patient-centered response to substance use.

“It’s unique to be developing the program,” she said.

Although most people doing this kind of work develop empathy for those they serve, Senecal-Reilly’s work feels very personal.

“I think of everything I do could affect my family member who uses,” Senecal-Reilly said. “It’s easy for me to think of everyone we serve as someone’s family member. Having that connection makes it more than a job for me.”

A New Era in Addiction Treatment

Addiction affects all, regardless of background, race, ethnicity, gender, religion or socio-economic status. In recent years, communities across our nation — including Central New York — have experienced alarming increases in the number of people needing addiction treatment services.

As the longest running treatment program in the region, Crouse Health’s Addiction Treatment Services remains committed to our mission to expand access to care and ensure delivery of high-quality addiction and mental health treatment in our community.

We are proud of our facility that matches the caliber of our staff and provides a nurturing, safe and uplifting environment that is already greatly enhancing our focus on holistic patient care: The Bill & Sandra Pomeroy Treatment Center at Crouse Health.

If you, a loved one, friend or colleague is in need of treatment for substance use disorder, please contact us at 315-470-8304 or visit crouse.org/addiction.

Bill & Sandra Pomeroy Treatment Center in Syracuse. The two-story, 42,000 square-foot facility at 2775 Erie Blvd., East, replaces the 100-year-old former location of Crouse’s outpatient treatment services at 410 South Crouse Avenue.

March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 19
Addiction
Mariah Senecal-Reilly Eric Bresee

Mark Cuban Pharmacy Could Save Billions on Prostate Cancer, Bladder Drugs

A new drug company founded by entrepreneur Mark Cuban could save patients $1.29 billion a year based on 2020 Medicare Part D expenditures on just the nine most popular urological drugs, according to a study published in the Journal of Urology.

The study, led by Vanderbilt University Medical Center (VUMC) researchers, examined the potential savings if Medicare prices for generic drugs were as low as those offered under the Mark Cuban Cost Plus Drug Company, which provides a standard template pricing of the cost of manufacturing the drug plus a 15% markup, plus standard $5 fees for dispensing and $3 fees for shipping.

“We found that if the U.S. government used Mark Cuban’s cost-plus drug pricing model to supply urological drugs to Medicare patients, they would save taxpayers an estimated $1.29 billion,” said lead author physician Ruchika Talwar, a fellow in urologic oncology at VUMC.

“It means that patients would be able to get their drugs more affordably, but also means that taxpayer funds could go toward other important issues and hopefully save us all some money in general.”

The nine commonly-prescribed urological drugs that were studied — tamsulosin, finasteride, oxybutynin, alfuzosin, solifenacin, tolterodine, sildenafil, tadalafil, and abiraterone — are used to treat conditions including prostate cancer, overactive bladder and prostate enlargement.

For the 90-day prescription prices, all drugs generated cost savings for Medicare, ranging from 48.7% to 99.2%. The savings for abiraterone alone amounted to $656 million, or nearly 52% of all potential Medicare savings for urological drugs in both 30-day and 90-day prescription models. Abiraterone is used to treat prostate cancer that has spread to other parts of the body by blocking testosterone, which is the hormone that drives prostate cancer growth.

“Just by changing the way one commonly prescribed drug (abiraterone) was purchased, we could convey a benefit of more than $650 million in cost savings to taxpayers,” Talwar said. “The impact of this could be astronomical across all cancers … any sort of oral, generic drug available through Mark Cuban’s company can be a lot cheaper for many patients, not just Medicare patients, through this program. And taxpayers are the ones who fund Medicare drug spending.”

Addiction

Q & A with Kathleen Gaffney-Babb

New Helio Health interim president and CEO says organization serves 17,000 people annually with a budget that will surpass $100 million this year.

‘We’re large because the needs in the communities have expanded,’ she says

Q: Can you give us an overview of Helio Health?

A: Helio Health provides substance use and mental health disorder treatment. We provide it in four regions, mainly Syracuse, Utica, Rochester and Binghamton, and we provide services for approximately 17,000 people a year. We do that in various treatment modalities. We have inpatient, outpatient, residential and in-community services and housing services.

Q: How many employees does Helio Health have and how big is your budget?

A: We have more than 1,000 employees and contractors. Some are contracted employees and some are specific employees of Helio Health. Our budget in 2023 is going to surpass $100 million.

Q: When did you become interim president and CEO, and what was it about the position that appealed to you?

A: I started effective Jan. 1, 2023. I started with this agency a long time ago as a counselor in our outpatient division, and shortly after that, I was asked to be the director of our outpatient. A few years after that, I was asked to be the director of our inpatient, and then following that, I became the director of quality assur-

ance, training and compliance. Most recently, I served as the executive vice president and chief operating officer. Most of my adult professional life has been spent at this organization. [These positions have been at Helio Health, formerly Syracuse Behavioral Healthcare.] When we learned of our former president and CEO accepting a position in Chicago at a large national nonprofit, I was the exact candidate to be able to fulfill the shoes of the interim president and CEO and potentially the permanent president and CEO. I know this organization better than most and my heart and my personal dedication have been to serve the mission of this organization as long as I can remember.

Q: What are some of your goals for Helio Health for the future?

A: Our goals for Helio Health continue to be to serve the needs of the community where we provide services. We’re large because the needs in the communities have expanded. We’ve expanded our services in all those different areas to be able to meet those needs. I see us continuing to assess what the needs in the communities are, to be able to provide access to services and quality. We also have a training institute.

Q: Do you have a leadership style or philosophy?

A: I think my leadership style is two-fold. I believe very strongly in servant leadership. I’m here to serve Helio Health. That’s because of the work that we do. I think that in order to do the work appropriately and with respect, you have to be mission-focused. I’m going to lead them, supporting them and supporting their work at Helio Health. The other part of my leadership style — and it is really more of an integrated approach — is trying to help people grow in their own development. In some ways it’s taking any kind of shade off of their lamp and letting their light shine on their own skills and their own expertise, so that they can grow professionally at Helio Health as I have.

Q: You mentioned that you have now 17,000 clients. Have those numbers grown within the last five years?

A: There’s been significant growth in the last five years. Some of that is because we’ve grown significantly in the last five years. Part of that is there was a community need. It was identified; we were approached to fill that need and we expanded our services accordingly. In the last five years, from 2017 to 2022, we started providing opiate treatment programs, in-community services; we expanded our reach in Binghamton and Utica. We merged with a couple of other behavioral health companies. The need in the communities both for mental health treatment and substance use disorder treatment and housing, has expanded.

Q: You alluded to the mental health crisis. What kind of progress are we making?

A: I guess the answer is how you define progress. The progress that I see is that we are having this conversation about mental health. We’re recognizing that it is a need. In Onondaga County we are in 18 different schools. We’ve been asked to provide mental health and substance use counseling in the school setting. We are doing mental health first aid training. We’re doing teen mental health training — specific trainings geared toward helping in a preventative way, helping people before they reach a mental health crisis. That people have issues that they’re dealing with as it relates to their mental health and that they’re open to having themselves and their family members receive treatment is progress. Are we making progress as it relates to the number of crises, the number of suicides? Our statistics would tell you “no.” Because of that, there’s attention being paid to it. It says something needs to be done. It means we will have more treatment programs. Helio Health is going to be the regional intensive crisis stabilization center, where people can come 24/7 and be evaluated and referred to the appropriate level of care. It isn’t going to take the place, nor should it, of an emergency room or a psychiatric emergency room, but it’s the window of opportunity when people say “I need help.” Being able to be available in a 24/7 setting is critically important.

To learn more about Helio Health, visit https://www.helio.health or call 315-471-1564.

Page 20 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023

Tranq Making Inroads in Central New York

Drug used as horse tranquilizer increasingly seen in cases of opioid overdose deaths

Since 2021, a newcomer to substance abuse disorder has been making inroads in the area: xylazine. Known as “tranq” on the street, the horse tranquilizer is not FDA approved for use in humans and is not under the jurisdiction of the Controlled Substance Act. It is available as a veterinary sedative under the brand names of Rompun, Sedazine and AnaSed.

“Tranq or xylazine is not routinely tested for in toxicology testing or by medical examiners, so we are not able to speak to its overall prevalence in New York state,” said Evan Frost, assistant director of Communications and public information with the New York State Office of Addiction Services and Supports in Albany. “We do now that it has been found in testing conducted in New York City and there have been instances of wounds/skin

ulcers related to xylazine in other regions of the state, so we know it is also outside of New York City in some capacity.”

Xylazine is most often used as a “cutting agent” for illegal fentanyl mixes. A cutting agent is a cheap and readily available drug—xylazine in this case—mixed with the more expensive and harder to obtain drug such as fentanyl.

Sometimes cutting agents heighten the effect of the more expensive drug. With xylazine, the unintended effects can include bradycardia (slow heart rate), blurry vision, central nervous system depression, unsteady gait, slowed or stopped breathing, low blood pressure, hypothermia, high blood glucose levels, severe withdrawal, pinpoint pupils, necrotic skin ulcerations (may occur at other areas beside injection site with repeated exposure), coma and death.

Because xylazine is a sedative, it is sometimes combined with stimulants like methamphetamine and cocaine to counteract the sedative effects.

“There were some cases in Syracuse, but I haven’t heard of any in Oswego County yet,” said Eric A. Bresee, licensed mental health counselor and executive director of Farnham Family Services in Oswego.

Mariah Senecal-Reilly, co ordinator of the Mental Health and Substance Use Initiatives Program with the ga County Health Depart ment, said that the first discovery of xylazine in the county’s illicit drug supply occurred in No vember.

“We have been monitoring it pretty closely and haven’t found similar situations since November,” she added. “I’m not going to say we won’t see it again because it’s been very prevalent in Philadelphia.”

Recent reports in dicate that more than 90% of illicit drugs in Philadelphia contain xylazine and in New York City, it’s 25%, which appears to indicate that xylazine is making inroads into New York. Because of the many equine businesses and farms in Oswego

and Onondaga counties, it may be easier to access xylazine. However it is speculative at this point to assume that it will become more widespread in rural areas.

“It’s particularly insidious because it causes terrible skin infections, not just at the injection location but throughout a person’s body,” Senecal-Reilly said. “They have some really harmful abscesses. It complicates things further for someone who’s using Xylazine reduces blood flow to the skin.

Since xylazine is often used to cut fentanyl and other drugs, it may be even more dangerous than a single, known drug in case of an overdose.

Healthcare providers in these cases have little idea of what the patient has taken. Xylazine is not an opioid drug.

“Narcan works on opioid reversal, but doesn’t work on the xylazine tranquilizer part of what the person has consumed,” Senecal-Reilly said. “Narcan won’t do anything for xylazine. It’s important to perform rescue breathing for these patients because there’s lack of oxygen.”

March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 21
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Top 10 Things for Kids’ Long-term Health

All parents want their children to enjoy lifelong health. To promote a better chance of lifelong health, parents can do a few things now.

1 – Establish Dental Visits

Anthony J. Tabone, a dentist operating an eponymous practice in Auburn, encourages parents to bring in their children starting at age 2 to establish home care, educate “and if nothing else, make sure there’s nothing else going on,” he said. “Early visits can rein in any habits the parents might not be aware of that can affect their child’s oral and overall health.”

Dental professionals can screen for issues like obstructive sleep apnea, for example.

2 – Establish Healthcare Visits

Pre-natal and post-natal care from a provider can help give babies the best start by helping parents learn the right steps to take.

“If the mom is planning to become pregnant in the next year or so, taking folic acid, stopping drinking, substances and getting healthy nutrition and exercise helps them be strong and healthy for pregnancy,” said Beth Machan coordinator of the perinatal and infant community health collaboratives initiative for Onondaga County Health Department. “Once the mom becomes pregnant, we talk about early and consistent prenatal care: a chance to

identify any problems, discuss with the doctor how to have a healthy pregnancy. We can advise them about WIC which can help them obtain nutrition food if their budget doesn’t allow.”

Check-ups with medical providers help track development, stay on schedule for vaccines and detect and monitor any small issues before they become big issues. Providers can also educate the family on good health habits.

3 – Get Childhood Immunizations

The advisory committee on immunization practices sets the recommended ages for routine vaccines, many of which occur during the first year of a child’s life, with boosters later in childhood.

“At pediatric visits as recommended, parents can stay up to date on immunizations,” Machan said. “These will protect them from illnesses.”

Parents should address with their child’s pediatrician any concerns about childhood immunizations’ safety. However, nearly every child without allergies to vaccines’ ingredients can safely receive immunizations. These vaccines can protect children against 20 potentially life-threatening diseases. Generally, vaccines work by mimicking an illness, which stimulates the body’s immune system to mount a very strong response against its next exposure to that illness.

Free clinics can help families without insurance.

4 – Provide breastmilk. “We do believe that breastfed is best,” Machan said. “Breastfed babies have a lower risk of asthma, diabetes, obesity, ear infections and stomach bugs. It supports a strong immune system.”

5 – Limit screen time. Avoid making screen time a go-to means for occupying children. Engaging learning toys and games and spending time reading and playing together “helps kids expand their vocabulary and helps them be readier for school,” Machan said. “Parents are their children’s best teacher.”

6 – Establish Active Habits. Engaging children in regular physical activity they enjoy can help form a lifelong habit of movement.

“Kids should be active each day,” Machan said. Children need about 60 minutes of physical activity daily, which can include sports, games and free play.

7

– Establish Healthful Nutrition Habits

“Start and model positive eating habits young,” Machan said. “This starts with sitting down and having healthful dinners together. Offer fruit and vegetables, not just what they want to eat.”

The My Plate guide can offer an easy way to ensure balanced meals.

8 – Establish and Model Good Sleeping Habits.

“Keep a regular bedtime when you can and develop a routine before bed, like reading,” Machan said. “Generally, your children should be in bed before you.”

Avoiding electronics before bed can also help promote better sleep. Most children need nine to 12 hours of sleep per night, depending on their age and other factors.

9 – Test for Lead.

Lead exposure can cause permanent brain damage, nervous system, kidney and liver damage, infertility, seizures and death. Homes built before 1978 likely have lead paint in them unless remodeled since then.

“Test your home for lead if there are concerns,” Machan said. “At ages 1 and 2, have the children tested.”

Old painted baby furniture and toys, cheap imported jewelry and some imported toys are known for containing lead.

10– Model and Teach About Mental Health.

Good mental health can help children stay resilient when faced with challenges. Grace Puchalski, licensed clinical social worker and owner of Walk with Grace in Liverpool, said that protective factors include positive discipline, recognizing each child’s needs, teaching children to regulate their emotions and clearly communicating.

“Parents need to listen and help children work through things, not say, ‘Don’t worry about it’ or ‘You don’t feel that way,’” Puchalski said.

She added that children need to feel that their parents will be there for them and that they can rely on their parents for help. Validating children’s feelings helps them feel that they are safe expressing themselves to their parents. Consistency in meeting their basic physical and emotional needs builds trust and helps them build self-esteem. Children should be able to access mental healthcare as needed.

Page 22 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023 Kids Health
Grace Puchalski, licensed clinical social worker and owner of Walk with Grace in Liverpool.

Parenting

When It’s All Too Much, Set Boundaries

Some days, I wish I had an off switch.

As a parent, I often find myself feeling like my life is a never-ending to-do list (on which I’m constantly losing ground).

With so much to do, it’s really hard to give myself what I need, which is to relax and find space to breathe.

That’s because, like a lot of other parents, I’m not very good at setting boundaries.

A boundary is defined as a limit of something, whether that something is physical or mental. But, when the demands of life are many, it’s difficult to limit how much time I’m willing to give to all of the things.

Present-day parenting certainly doesn’t encourage setting boundaries. I’m expected to keep my children educated, nurtured, well-rounded and engaged. I’m also expected to keep my job, nurture my interests, be informed on current events, keep myself healthy and juggle all the balls. And, maybe it’s not an expectation, but I also want to give back to my children’s schools and my own community. There is always so much to do. My fear is, if I slow down and leave too many things undone, the patchwork of my life will unravel.

But will my life really unravel if I don’t get everything done? Would setting some personal boundaries give me more satisfaction than getting all of the things done would give me? Could boundaries be the magical equalizer in my overstuffed life?

Maybe they are. Perhaps, I need to learn to set limits when I’m feeling overwhelmed. It can’t hurt to try and see what happens. If you’re a parent who is also struggling to set boundaries, here are some places I am going to start.

• Time to set a boundary: When I’m feeling overwhelmed and my children have nothing to do with it

On any given day, there are a lot of things that can weigh on me. Small issues can really add up to big challenges. When that feeling comes along, I think it’s ok to tell my kids, “Mom had a challenging day today. You kids had nothing to do with it, but I’m short on patience right now. Perhaps we can take it easy tonight and watch a nature show so I can decompress.”

All the other stuff can wait. It’s good to set boundaries.

• Time to set a boundary: When I’m feeling overwhelmed by my children

The more we love someone, the easier it is for them to push our buttons. Some days, my kids really frustrate me. When they have tough

days, I think it’s OK to set boundaries. When my kids are being unkind to me, I can put a small wall up. I can tell them it’s OK to be upset, angry or hurt. However, they can’t keep being unkind to others. If they can’t turn it around, I can tell them to go to their rooms and draw, pick up a good book or go outside and vent. I can also offer to help them through their difficulties. As a parent, it’s my responsibility to teach them to embrace and own their emotions. However, they need to do that for themselves and regroup. When someone needs a break, let them have it. It’s good to set boundaries.

• Time to set a boundary: When I’m not feeling well physically

If I feel sick, I should be able to take care of myself. That may mean sending everyone to bed early for a night or two. It may mean easing up on restrictions for my kids’ screen time. It may mean telling my husband that he needs to pick up my tasks for a short time. By powering through every illness, I’m not being a good role model. I’m teaching them their health should take a back seat to the demands of life.

It’s OK to rest and recuperate. It’s good to set boundaries.

• Time to set a boundary: When I don’t want to be touched

Moms with younger kids likely know about being touched out. When I am touched out, I think it’s good parenting to set boundaries with my kids. If I don’t like the way they are touching me, I should kindly tell them that. When I set this boundary, I can remind them how much I love them. This communication is widely important. It teaches my kids to set their own boundaries for their bodies. It teaches them to respect the boundaries of others.

We are all in command of our own bodies. It’s good to set boundaries.

• Time to set a boundary: When I need me time

When I need time for me, I should be able to take it. Whether I want to go for a run, get a workout in, read a book or talk to a friend, I should be able to set up a boundary that says, “I’m important too. I deserve to be nurtured.” My purpose in life is not to do everything for everybody else. If I need to recharge, it’s OK to build a wall between myself and my to-do list.

The tasks can wait; life can’t. It’s good to set boundaries.

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Childhood Emotional Abuse Can Have Lasting Effect

In 2020, 618,000 children in unique incidents were victims of abuse and neglect, according to The National Children’s Alliance. Of these cases, 65% included sexual abuse, 20% physical abuse, 8% neglect, 8% witness to violence, 3% drug endangerment and 8% were other types of abuse or neglect.

Emotional abuse overlaps each of these categories, can occur in the absence of other kinds of abuse and often goes unreported. These factors make it difficult to estimate how many children experience emotional abuse. But researchers estimate that about 40% of children at some point suffer from it.

Emotionally abusive parents differ from those who exhibit an occasional moment of poor reaction and apologize afterwards.

“It is psychological violence,” said Grace Puchalski, licensed clinical social worker and owner of Walk with Grace in Liverpool, quoting from a recent definition from the American Psychiatric Association. “It is non-accidental, verbal or symbolic

act by a child’s parent or caregiver that results in or have reasonable potential to result in significant psychological harm to the child.”

These acts may include manipulation, maligning, belittling accomplishments, gaslighting, taunting and degrading. It is earmarked by yelling, screaming, name calling, cursing and swearing and put-downs.

“People underestimate the damage because people can’t see it like physical abuse,” Puchalski said. “It injures the child’s self-esteem and wellbeing.”

These can include health problems, difficulty in reaching age-appropriate developmental milestones, relationship problems and socioeconomic challenges, to name a few.

Puchalski said that some children may bully others.

As adults, “they would be prey to other people who target those who are vulnerable,” she added. “They have trouble with relationships at work and romantic relationships. They may experience substance abuse, criminal behavior and as the

most extreme examples, homicide or suicide.”

Parents who habitually engage in abusive behaviors teach their children that relationships are dangerous and result in confusion and emotional pain.

Other trusted adults may inflict emotional abuse. However, the closer the person is to the children, the more damage the abuse inflicts. In the case of an adult outside the family, the children’s resiliency factors can make a difference as to how much damage the emotional abuse causes.

For example, parents who stick up for their children and support them in a conflict with caustic teacher can help their children learn how to deal with treacherous people and reinforce their own caring relationships.

Helping children find ways to express their thoughts and feelings without judgment is one way that parents can help children feel supported when an emotional trauma occurs.

“Children need safe, stable environments to help them mitigate these effects,” said Laura Maggiulli, director of research at Hillside in Rochester. “A youth without those factors —that’s where more often we’ll see lasting impacts of trauma. They don’t have the supports to help them process the trauma.”

Lacking this environment can result in what, Maggiulli calls “toxic stress,” when the brain becomes so conditioned to respond to stress and danger that it becomes stuck in the fight or flight mode for long periods.

“This leads to disruption in development,” she said. “This endures into long-term consequences that basically follow you into adulthood. These lasting impacts can be linked to things like health problems. Some of the biggest are cancer, diabetes, asthma and kidney disease. They can oftentimes be linked back to mental illness and risky behavior like substance abuse. They have a higher risk of unemployment.”

For some families, emotional abuse becomes a multi-generational issue as the following generations mimic the behavior they saw in their

parents as children. From childhood, their brains have been hardwired to automatically resort to fight or flight mode in the face of conflict instead of extending compassion and understanding. Their understanding of relationships has been skewed into one of competition instead of cooperation.

Breaking the cycle of childhood emotional abuse relies upon the adults addressing their own issues first before changing how they relate and behave with their children.

“Being able to recognize and become aware of the deficiencies is important,” said Samantha G. Stringer, licensed mental health counselor in private practice in Rochester. “At some point in life, we do see our deficits, whether it’s by someone sharing what they see in us or by the emotional hole that’s evident. I believe that everyone has it in us to get to that point where we realize something’s going on. Something doesn’t seem right; I need some help.”

She has treated clients who as young adults do not understand why they act the way they do, but once they begin talking about their childhood, a pattern of abuse emerges: yelling, cursing, emotional or physical abuse.

At that point, they begin to better understand that this behavior is unwarranted and they can work towards changing themselves because they do not want to follow that pattern.

Stringer recommends psychotherapy and talk therapy for unpacking and healing childhood trauma, whether as a child or adult.

“They can do better, think better, live better, have better physical and mental health,” Stringer said. “There is a slew of things we can do. I think about the spiritual aspect of it as well, knowing that spiritual side of yourself and looking at life for what it is.”

She also emphasizes developing purpose and engaging in regular self-care.

“We’re often compassionate with our feelings to friends and family and having that same self-compassion can go a long way,” Stringer added.

Page 24 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023 Kids
Health

Could You Have a Thyroid Problem and Not Know It?

If your thyroid is out of whack, it can cause a number of health issues that can be tricky to detect because the symptoms often resemble other age-related health problems. In fact, as many as 30 million Americans have some form of thyroid disorder, but more than half aren’t aware of it.

What to Know

The thyroid is a small butterfly-shaped gland located at the base of your neck that has a huge job. It produces hormones (called T3 and T4) that help regulate the rate of many of your body’s activities, from how quickly you burn calories to how fast your heart beats. It also influences the function of the brain, liver, kidneys and skin.

If the gland is underactive and doesn’t produce enough thyroid hormones, it causes body systems to slow down. If it’s overactive, and churns out too much thyroid, it has the opposite effect, speeding up the body’s processes.

The symptoms for an underactive thyroid (also known as hypothyroidism) — the most common thyroid disorder in older adults — will vary but may include fatigue and weakness, unexplained weight gain, increased sensitivity to cold, constipation, joint pain, a puffy face, hoarseness, thinning hair, muscle stiffness, dry skin and depression.

Some patients may even develop an enlarged thyroid (goiter) at the base of the neck. However, in older adults, it can cause other symptoms like memory impairment, loss of appetite, weight loss, falls or even incontinence.

And the symptoms of an overactive thyroid (or hyperthyroidism) may include a rapid heart rate, anxiety, irritability, fatigue, insomnia, increased appetite, weight loss, tremors of the hand, frequent bowel movements, sweating, as well as an enlarged thyroid gland. Too much thyroid can also cause atrial fibrillation, affect blood pressure and decrease bone density, which increases the risk of osteoporosis.

Those with the greatest risk of developing thyroid disorders are women who have a family history of the disease. Other factors that can trigger thyroid problems include: autoimmune diseases like Hashimoto’s or Graves disease; thyroid surgery; radiation treatments to the neck or upper chest; and certain medications including interferon alpha and interleukin-2 cancer medications, amiodarone heart medication and lithium for bipolar disorder.

Get Tested

If you have any of the aforementioned symptoms, or if you’ve had previous thyroid problems or notice a lump in the base of your neck, ask your doctor to check your thyroid levels. The TSH (thyroid-stimulating hormone) blood test is used to diagnosis thyroid disorders but depending on what they find, additional blood tests may be necessary.

If you are diagnosed with a thyroid problem, it’s easily treated. Standard treatment for hypothyroid-

ism involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid and others), which is an oral medication that restores adequate hormone levels. And treatments for hyperthyroidism may include an anti-thyroid medication such as methimazole and propylthioracil, which blocks the production of thyroid hormones. Another option is radioactive iodine, which is taken orally and destroys the overactive thyroid cells and causes the gland to shrink. But this can leave the thyroid unable to produce any hormone and it’s likely that you’ll eventually become hypothyroid and need to start taking thyroid medication.

For more information on thyroid disorders, visit the American Thyroid Association at Thyroid.org.

Jim Miller is the author of Savvy Senior, a column that is published every issue of In Good Health.

March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 25
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My First Colonoscopy

Three people who I knew died last year from colon cancer. In one instance, it was less than three months between diagnosis and death for a man who was just 54 when he died. That type of heartache and shock is something I wouldn’t wish on my worst enemy.

The horrible and untimely deaths of those three individuals coupled with the urging of my own physician during a recent physical prompted me to make a commitment to secure an appointment with a gastroenterologist for my first-ever colonoscopy.

At 46 and with concerns about my family history of cancer, I recognized the importance of having the procedure done as one of the best preventive measures for my personal health.

Prepped and ready to go

I had heard from family members and friends terrible tales of doom-and-gloom surrounding “the prep.” The moaning and whining revolved around having to be on a clear liquid diet the day before the procedure, a process which includes the consumption of a stool softener cocktail that lacks anything in the form of taste.

That being said, I stuck to the game plan and only consumed water and green tea throughout the day before I began drinking the powdered laxative at the prescribed times until all 64 ounces were in my system.

I then sat back and waited… and waited… and waited.

It was one of the most mundane and mind-numbing evenings of my life, with hunger pains, downright boredom and frequent flatulence the only highlights after what would be my normal “dinner time” until I went to bed.

I then tossed and turned for quite some time, continuously wondering

if I would set some sort of unofficial world record as the first person in modern history to win the battle against what I creatively labeled as my “pesky poop punch.” I even began to worry that maybe I wouldn’t be eligible for the procedure and my one-day fast and scheduled day off from work would all be in vain.

Nature called — with a vengeance

It was around 3:30 a.m. when nature called. To be quite honest, it wasn’t a call. It was instead an outright pillage-and-burn-invasion of my insides. All of my worries about frustration about a lack of “action” quickly flowed down the toilet thanks to my frequent trips to the bathroom. I felt a sense of relief and a bizarre level of achievement that the prep had worked through my system as planned and that my previous concerns about the magic not happening were nothing more than a distant memory.

For anyone who has yet to undergo a colonoscopy but plans to have the procedure scheduled sometime in the future, I offer some simple advice for “prep day” so that you are mentally prepared.

• Closely follow the doctor’s instructions

• Be prepared for some discomfort

• Use mind over matter to ignore any hunger pains

• Be patient, as good things come to those who wait

Show time

Once I was in the office of my gastroenterologist everything moved along without any real issues or concerns. I was given a gown, told to undress and make myself comfortable on a bed located in an area separated by curtains from other

areas which also had beds occupied by other patients.

I was then wheeled into another room by a very nice woman who explained exactly what would take place over the next few hours. After further instruction and a brief conversation with my doctor, I was “given the gas” and began counting down from 100. And that was that.

Seriously. The next thing I remembered was looking around the room and wondering when my procedure would begin. I didn’t see anyone and was trying to focus and figure out exactly where my doctor and nurse were, at which point the nurse appeared, loudly chuckled and said “It’s all over. You did great. Congratulations!”

I was quite groggy, but had no pain and felt nothing else out of the ordinary. The nurse then told me to take my time and not get up until I felt ready to chat with the doctor, who eventually arrived to tell me that everything went well. He did remove one adenomatous polyp, which was biopsied and found not to be cancerous. He also recommended that I focus on a high fiber diet to avoid any potential problem in the future with diverticulosis, a condition where small pouches form in the wall of the colon.

He then thanked me for taking the time to get checked and learn that I had a happy and healthy colon.

HOA Achieves Accreditation for Radiation Oncology Services from ASTRO’s APEx

Hematology-Oncology Asso-

ciates of CNY (HOA) successfully attained accreditation from the American Society for Radiation Oncology (ASTRO) APEx (Accreditation Program for Excellence).

APEx provides external validation that a radiation oncology facility is delivering high-quality patient care. HOA’s accreditation is effective through November 2026.

“HOA is pleased to receive APEx accreditation from ASTRO, the

largest radiation oncology society in the world,” said Maryann Roefaro, HOA’s chief executive officer. “Our radiation oncology team is invested in evaluating our processes to meet ASTRO’s high standards for safety and quality. Achieving APEx accreditation shows our local community that we are dedicated to delivering consistently safe patient-centered cancer care.”

APEx, the fastest-growing radiation oncology practice accreditation program in the United States, is a voluntary, objective and rigorous multi-step process during which a radiation oncology practice is evaluated using consensus-based standards. The practice must demonstrate its safety and quality processes and show that it adheres to patient-centered care by promoting effective communication, coordinated treatments and strong patient engagement.

“ASTRO commends HOA for achieving APEx accreditation,” said

Post procedure paperwork and final thoughts

About a week after my procedure I received documentation in the mail that the colonoscopy was a success. Included was the recommendation that I return for another colonoscopy in seven years. I later shared that information with my primary doctor, who promptly responded to my email correspondence by updating my personal information charts and thanking me for following through on her recommendation to have the procedure done.

I also did my own research the following day on the difference between hyperplastic polyps and adenomatous polyps and the benefits a high fiber diet has for anyone with diverticulosis.

While colonoscopies are certainly not something to plan a festive gathering around, the entire ordeal was pretty simple. The peace of mind I now have was well worth the trouble and minor inconveniences I experienced.

Note: The American Cancer Society recommends that men and women should be screened for colorectal cancer starting at age 50, with people who are defined by their medical expert as being “average risk” to start regular screening at age 45.

physician Geraldine M. Jacobson, chairwoman of the ASTRO board of directors. “By undergoing this comprehensive review, the facility demonstrated their strong commitment to delivering safe, high-quality radiation oncology services to their patients.”

APEx is the only radiation oncology accreditation program that includes a self-assessment, which allows practices to internally assess compliance with quality improvement standards. The practice then proceeds to a facility review by an external surveyor team that includes a radiation oncologist and a medical physicist. The program reflects the recommendations endorsed in the ASTRO publication Safety is No Accident: A Framework for Quality Radiation Oncology and Care. To date, more than 250 U.S. facilities have earned APEx accreditation. Learn more about APEx at www. astro.org/APEx.

Page 26 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023

How to Cover Dental Care in Retirement

Dear Savvy Senior, I had dental insurance through my work for many years but lost it when I retired and joined Medicare. Where can retirees find affordable dental care?

Uninsured Al

Dear Al,

Unfortunately, about two-thirds of U.S. retirees don’t have dental insurance today. Without coverage from traditional Medicare, and with private dental insurance typically costing too much to be feasible, most seniors are stuck paying full out-ofpocket prices every time they visit a dentist. While there’s no one simple solution to affordable dental care there are a variety of options that can help cut your costs. Here’s where to look.

• Medicare Advantage: While dental services are mostly excluded under original Medicare, many Medicare Advantage plans do provide coverage for dental care, but it’s usually very limited. Medicare Advantage plans are government approved health plans (usually HMOs and PPOs) sold by private insurance companies that you can choose in place of original Medicare. To shop and research Advantage plans in your area visit Medicare.gov/plan-compare or call 800-633-4227.

• Dental insurance: If you have gum problems and need extensive dental care, a dental insurance plan may be worth the costs versus paying for care yourself. Monthly premiums for individual plans range from about $20 to $80. A typical plan includes two or three cleanings and checkups per year, but these plans will likely have a waiting period — anywhere from a few months to a few years — before coverage for more expensive procedures kicks in. To find dental plans in your area, see eHealthInsurance.com.

• Dental savings plans: While savings plans aren’t as comprehensive as insurance, they are a good option for those who don’t have dental insurance. How this works is you pay an annual membership fee — around $80 to $200 a year — in exchange for 10% to 60% discounts on service and treatments from participating dentists. To find a savings plan, go to DentalPlans.com (or 888-632-5353) where you can search for plans and participating dentists, as well as get a breakdown of the discounts offered.

• Veterans’ benefits: If you’re a veteran enrolled in the VA health care program or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA offers a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost. The VA also provides free dental care to vets who have dental problems resulting from service. To learn more about these options, visit VA.gov/dental or call 877-222-8387.

• Cheaper dental care: Because prices can vary by dentist, one way to ensure you get a good deal on your dental care is to call multiple provides and compare prices. To get an idea of what different dental procedures cost in your area, see FairHealthConsumer.org. If you’re paying cash, it’s also perfectly reasonable to ask your dentist for a discount.

There are also a number health centers and clinics that provide low-cost dental care to those in need. And all university dental schools and college dental hygiene programs offer dental care and cleanings for less than half of what you would pay at a dentist’s office. Students who are supervised by their professors provide the care. See TeethWisdom.org to search for a center, clinic or school near you.

March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 27
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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The Social Security Office

From the Social Security District Office

Social Security Launches Redesigned Website at SSA.gov

Have you visited the redesigned SSA.gov yet? In December 2022, we updated our homepage with a new design to help you find what you need more easily.

SSA.gov is visited by over 180 million people per year and it is one of our most important tools for providing efficient and equitable access to service. Whether providing service in person or online, our goal is to help people understand what they may qualify for and seamlessly transition them to an application process.

Now, with improved self-service accessibility to online services, you might not have to call or visit an office to get what you need. This helps our staff focus on serving customers who need in-person assistance.

• Reimagined website prioritizes customer experience

The redesign is intended to provide a clear path to the tasks you need to accomplish. Many of the most visited sections of SSA.gov are now live with a more user-friendly and task-based approach. New pages and improvements based on public feedback will continue to be unveiled in the coming months, as part of our ongoing efforts to improve how the public can do business with us.

When you visit SSA.gov, you can use interactive tools to:

• Check eligibility for benefits

The new benefit eligibility screener is a convenient and simple way for you to learn if you might be eligible for benefits.

• Save time on Social Security number (SSN) and card online services

DRIVERS WANTED

To distribute copies of In Good Health, CNY’s Healthcare Newspaper, in offices and other high traffic locations in Onondaga and Oswego counties. Great for active retirees or at-home moms in need of some extra cash. Not a regular job. Work only one or two days a month during office hours (9 to 5). Compensation: $14.20 /h plus 30 cents per mile. It amounts to about $150 - $200 per month. No heavy lifting. Drivers are required to have a dependable vehicle, be courteous and reliable. We audit all areas of distribution. Call 315-342-1182 and ask for Loni for more information.

If you lose your SSN card, you may not need a replacement. In most cases, simply knowing your SSN is enough. If you do need a replace-

Q&A

Q.: Why is it so important that my baby have a Social Security number?

A.: Your child may need a Social Security number if you are planning to open a bank account, buy savings bonds, obtain medical coverage, or apply for government services for the child. Your child will also need a Social Security number if you are going to declare him or her on your taxes. Getting a Social Security number for your newborn is voluntary, but it is a

ment card, you may be able to request it online by visiting our Social Security Number and Card page at www.ssa.gov/ssnumber.

You can also start an application for an updated card or request an SSN for the first time. You may never need to go to an office, but if you do need to visit an office to complete the application then you can save a lot of time by starting online.

• Start an application for Supplemental Security Income (SSI)

You can start the application process online and request an appointment to apply for SSI benefits by answering a few questions on our SSI page at www.ssa.gov/ssi.

• Apply for Social Security benefits and other online services

For most benefits, you can apply online or start an application online. In many cases, there are no forms to sign. We will review the application and contact you with any questions or if we need more information. Visit our online services page at www. ssa.gov/onlineservices to apply for retirement, disability or Medicare.

Many Social Security services do not require an office visit. If you have a personal My Social Security account, you can start or change direct deposit, request a replacement SSA1099, or print or download a current benefit verification letter if you need proof of your benefits.

If you’re not yet receiving benefits, you can use your online account to get a personalized Social Security statement, which provides your earnings information as well as estimates of future benefits. The portal also includes a retirement estimator tool and links to information about other online services. We encourage people without a personal My Social Security account to create one today at www.ssa.gov/myaccount.

Please share this with your loved ones and post it on social media.

good idea to apply when your child is born. You can apply for a Social Security number for your baby when you apply for your baby’s birth certificate. The state agency that issues birth certificates will give us your child’s information and we will mail you a Social Security card with the child’s Social Security number. Visit www.ssa.gov/ssnumber for more information.

Page 28 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023
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800-858-8109

Forbes names Excellus as second best midsize employer

Excellus BlueCross BlueShield is

ranked No. 2 on the Forbes 2023 list of America’s Best Midsize Employers.

“We’re a top employer in America thanks to our employees, who take great pride in our culture of passionately serving our customers and fulfilling our mission of improving access, affordability and the quality of healthcare in the communities we serve,” said Excellus BCBS President and CEO Jim Reed.

“We’re proud of this recognition and are committed to supporting our employees with our inclusive culture, comprehensive employee benefits, flexible work environment and more,” Reed added.

This award is presented by Forbes and Statista Inc., a world-leading statistics portal and industry-ranking provider.

Forbes and Statista selected the America’s Best Employers 2023 through an independent survey applied to a vast sample of about 45,000 American employees working for companies with more than 1,000 employees. Across 25 industry sectors, 1,000 employers have been awarded, 500 large employers and 500 midsize employers. Midsize employers are companies with 1,000 to 5,000 employees.

The evaluation was based on direct and indirect recommendations from employees who were asked to rate their willingness to recommend their own employers to friends and family. Employee evaluations also included other employers in their

respective industries that stood out either positively or negatively.

St. Joseph’s Health adds a new cardiac surgeon

St. Joseph’s Health announced

committee on quality of care. He is also a contributing author of several research publications.

Oswego Health has new director of corporate marketing

Oswego Health. I look forward to transforming local healthcare with her.”

Oswego Health recently

promoted long-time employee

Martin earned her Master of Science in sports management in 2014 from Texas A&M University and her Bachelor of Science in 2001 from Louisiana State University. In addition, she recently completed an online credential program in strategic planning in healthcare offered by the Society for Health Care Strategy & Market Development (SHSMD).

Krishna

cardiologist Krishna Patel has joined its cardiac surgery team at St. Joseph’s Health Cardiovascular Institute. A highly skilled surgeon, Patel returns to Central New York following a three-year cardiothoracic surgery residency at Texas Heart Institute, Baylor College of Medicine in Houston, Texas.

“I am excited to be a part of the cardiovascular team at St. Joseph’s Health,” said Patel. “I’m looking forward to contributing to St. Joseph’s tradition of cardiac excellence.”

“St. Joseph’s Health has a long-standing reputation as a national leader in cardiac services,” said physician Philip Falcone, chief medical officer at St. Joseph’s Health.

“Having Dr. Patel as a part of our team further contributes to the high level of safe care our heart patients have come to expect from us.”

Patel earned his medical degree from Rutgers-New Jersey Medical School in Newark, New Jersey, and his undergraduate degree in biology from the College of New Jersey. He completed a fellowship in immunotherapy and surgical oncology at the surgery branch of the National Cancer Institute in Bethesda, Maryland, and a categorical surgery residency at the University of Rochester Medical Center in Rochester.

During his time in Rochester, Patel served on the graduate medical education committee and joint

ARISE adds staff to its leadership team

Martin

Jennifer Martin to director of corporate marketing strategy. Marketing professional Martin started at Oswego Health in 2015 and for the past eight years has been the director of marketing and has assisted with the development of communication strategies for the organization and its affiliates. In addition, she was responsible for online reputation management and community engagement.

In this new role, Martin will lead the operational execution of marketing campaigns developed at the system level and oversee measurement and performance. She will be responsible for analyzing patient behavior and developing brand reputation across the health system as this is critical and central to a consumerism strategy aimed at differentiating Oswego Health in the marketplace.

“There is probably not a more deserving and suitable person for this role, than Jenn,” said Senior Vice President of Communications and Chief Brand Officer Jamie Leszczynski. “She is one of the biggest advocates for the organization and an amazing champion for local healthcare. She continually demonstrates the ability to design effective communication strategies, and has such a skill for identifying marketing channels that meet the strategic needs of

ARISE, a Syracuse-based nonprofit organization that provides services that promote the social, educational, economic and individual interest of people with disabilities, recently announced the hiring of new staff.

Beth Hurny-Fricano has joined as the director of clinical services. Prior to joining ARISE, Inc, she served as the executive director for the Onondaga Council on Alcoholism & Addictions, Inc. doing business as Prevention Network. She is an adjunct professor in the Master of Social Work (MSW) program at Syracuse University, the College of Nursing at Upstate Medical University, and the Human Services Department at Onondaga Community College. Hurny-Fricano received a bachelor’s degree in human services from Cornell University, a master’s degree in social work from Syracuse University, and an Ed.D. in executive

Oswego Health Welcomes Emily Crandell, PA-C, CDCES to Oswego PrimeCare

Oswego Health welcomes

certified physician associate Emily Crandell to the healthcare system as a new provider at Oswego PrimeCare.

Crandell earned her physician assistant’s degree in 2016 from Upstate Medical University and her bachelor’s degree in Biology in 2013 from SUNY Oswego.

Crandell previously worked in Oswego at a private practice where she gained extensive primary care and outpatient experience. She is also a certified diabetes educator, an important skillset that Oswego Health will look to tap into as they expand programs for the community.

The team at Oswego PrimeCare offers the highest quality of primary care including health promotion, disease prevention, health maintenance, counseling, patient education, and diagnosis and treatment of acute and chronic illnesses.

leadership from St. John Fisher University. She is a licensed master social worker, a master credentialed alcohol and substance abuse counselor, and a credentialed prevention professional.

• Kristi McClusky has joined the organization’s executive leadership team as the director of quality improvement and corporate compliance. McClusky brings a wealth of experience as the former director of quality assurance at Liberty Resources and LIFEPlan Care Coordination Organization. She is a graduate of Nazareth College of Rochester.

• Amy Ellingworth, CPA, has joined as executive leadership team as chief financial officer. She has worked in the nonprofit sector hospital and healthcare industry for over 15 years, most recently at the Syracuse Community Health Center. She is a graduate of Binghamton University having earned a Bachelor of Science from its School of Management.

March 2023 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 29
News
Health
Jim Reed LEFT TO RIGHT: Beth Hurny, Kristi McClusky, Amy Ellingworth

Upstate Medical University to Offer Doctor of

Optometry

Program

Partnership with SUNY College of Optometry in Manhattan to

eye

SUNY Upstate Medical University

and SUNY College of Optometry will join forces to improve access to health care through growing the number of eye doctors in Central and Western New York.

The partnership between the two SUNY campuses leverages the strengths of both institutions through creating an optometry campus extension program offering a doctorate of optometry degree, collaborative vision research, access to eye care and economic opportunities in the region.

According to SUNY Upstate, this partnership addresses the critical need for more eye doctors in the region and provides a more affordable option for aspiring eye care professionals, especially those who live in New York state.

“We are addressing several critical issues through this partnership — the future of health care delivery with an interdisciplinary focus, collaborative research opportunities to improve eye and vision care, and

the regional workforce shortage,” said David A. Heath, president for SUNY College of Optometry. “Being part of the SUNY system provides unique opportunities to participate in solving challenges and we are looking forward to partnering with Dr. [Mantosh] Dewan and his team to provide a greater resource for the upstate region.”

Reports from area optometrists and ophthalmologists indicate that many eye care positions remain vacant putting pressure on an already lean workforce and leaving some communities without ready access to eye and vision care.

Further, a recent survey conducted by SUNY College of Optometry found that 25% of optometrists practicing in the region anticipate retiring within the next five years, an increase over the previous survey conducted in 2010.

As the only school of optometry in New York state, with its Manhattan campus, located 250 miles from

Syracuse, this partnership offers an alternate environment and a potentially more affordable option for students, especially those who already live in New York state, and wish to train at a top institution outside of a metropolitan area.

“We are delighted to bring the world-class expertise of SUNY Optometry to enrich Upstate’s internationally-recognized department of ophthalmology and center for vision research. By serving as their extension campus, we will increase the number of eye care professionals available to serve our communities,”

said physician Mantosh Dewan, president of Upstate Medical University. “This also fulfills Upstate’s goal to deepen partnerships with other SUNY schools and to increase the breadth of health professional programs offered by Upstate Medical University.”

The program will parallel the doctor of optometry program currently offered by SUNY College of Optometry. The first class is anticipated to start in the fall of 2025 with an estimated 30 students pending successful completion of all state and accrediting body approvals.

Auburn Community Hospital to Develop Cardiac Care Institute

$21 million grant from NYS will fund the creation of an outpatient Cardiac Care Institute and to expand and modernize its operating rooms and surgical services

Auburn Community Hospital (ACH) has been awarded a $21 million Statewide Health Care Facility Transformation Grant. ACH applied for $21 million to fund two major projects that address significant community health care needs. Auburn will use the funding to develop an outpatient Cardiac Care Institute on its campus and to expand and modernize its operating rooms and surgical services.

The ACH Cardiology Institute will include a hospital wide multidisciplinary team of health professionals linking admissions, the emergency department, the cardiac catheterization team, intensive cardiac care unit, inpatient telemetry, outpatient testing, the laboratory, imaging services and cardiovascular rehabilitation.

This will allow ACH to provide outpatient cardiac services which is a significant need in Cayuga County, according to the hospital. Cayuga County has an increasingly elderly population with the inherent cardiac issues that accompany aging, as well as its emergent and long-term cardiac repercussions for patients who suffered from COVID-19.

In addition, this funding will allow ACH to modernize the OR rooms and expand its surgical services. ACH will expand the size and capacity of its operating area, including three new state-of-theart operating rooms and one new procedure room. These ORs and procedure room will allow ACH to

increase the number of surgeries and interventional radiology procedures. The volume increase encompasses hip and knee surgery, orthopedic sports surgeries, ENT and bariatric surgeries, and is directly related to new surgeons and specialists ACH has hired. This also complements ACH’s collaboration with the SUNY Upstate faculty practice to permit their surgeons to schedule additional surgeries at ACH. The additional OR capacity will also allow ACH to dedicate certain rooms for ambulatory surgery versus inpatient or emergency surgeries and allows for interventional radiology procedures in partnership with the University of Rochester Medical Center.

“We are delighted to receive this news from the state of New York,” said Scott Berlucchi, CEO. “A great deal of support has been provided by Gov. Hochul and the NYS Health Department for ACH and its transformation. We are also thankful to our NYS legislators and community leaders for their support of our hospital. The creation of our cardiac institute, combined with the new cancer center, and the OR expansion will provide the essential care that our community needs and that today they may have to travel long distances to receive these services. These services will now be accessible in our own backyard by our worldclass doctors, nurses, and health care professionals.” said Berlucchi.

Page 30 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2023 Health News
Upstate Medical University President Mantosh Dewan, left, and SUNY Optometry President David Heath.The first optometry class at Upstate Medical University is anticipated to start in the fall of 2025 with an estimated 30 students.
‘addresses the critical need for more
doctors in the region’
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