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Bariatric Surgery 101


MAY 2019 • ISSUE 233


Chief of bariatric surgery at Upstate University Hospital, physician Flavia Soto, discusses quality of life of patients after bariatric surgery, and how surgery helps with other conditions such as diabetes and sleep apnea

New report from the CDC shows a sharp rise in elder abuse in the U.S. — family members commit most of the violence, the report states Inside Find out how many cases of abuse have been registered in Central New York P. 22


Caregivers urged to hit the pause button to avoid burnout


Tips to Get Through Your Midday Slump

Marijuana and its effect on male fertility

P. 12

CROUSE NORTH North Country Affiliate Partners and Crouse Health establish entity to provide locally-based planning and increased access to clinical care in the North County

Why You Should Eat More Broccoli P. 15

High Rate of Sex Before Age 13 Among Boys P. 10

Pelvic Health... Woman to Woman Pelvic health is nothing to whisper about. But that’s what many women do when it comes to talking openly and honestly about an important part of the female anatomy. Leading the discussion locally is Hadley Narins, MD, a fellowship-trained urologist dedicated to making women feel comfortable about bringing up problems — and treating them. Specializing in urinary incontinence and managing pelvic organ prolapse, she has the skill and sensitivity to make women’s lives healthier and happier. Welcoming new patients! Call 315-478-4185. Learn more at


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Women’s services at Crouse. As individual as you are. No two women are alike. At Crouse, we believe you want — and need — healthcare that puts a continual focus on what matters most — you. Our hospital was founded by women — and more than a century later, services for infants and women of allages remain at the heart of Crouse Health. Partner with women’s wellness providers who discover your individual needs by listening more closely and caring more deeply — and treating you with the respect and dignity you deserve. That’s Carepassion.TM Page 2

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

Gun Deaths Up Sharply Among America’s Schoolkids Deaths of school students surpass number of deaths among police officers or active duty military personnel


un-related deaths among school-aged children in the United States are increasing at alarming rates, researchers report. In 2017, gun violence claimed more 5- to 18-year-olds than it did police officers or active-duty members of the U.S. military, according to a chilling new study led by investigators from Florida Atlantic University. “It is sobering that in 2017, there were 144 police officers who died in the line of duty and about 1,000 active duty military throughout the world who died, whereas 2,462 school-age children were killed by firearms,” study senior author, physician Charles Hennekens said in a news release. He’s a professor of medicine at the University’s Schmidt College of Medicine. The nationwide study found nearly 39,000 gun-related deaths among 5-to-18-year-olds between 1999 and 2017. That included almost 6,500 deaths among kids between 5 and 14 years of age, and more than 32,400 among older teens. Significant increases began in 2009, with a wave of shootings among 5- to 14-year-olds, followed by a similar wave among teens

starting in 2014. Both waves — which researchers described as epidemics — continued through 2017, the most recent year for which data are available. Gun-related deaths over the period accounted for 5.6% of deaths in the younger group and nearly 20% among older kids. Researchers also found statistically significant increases in gun-related deaths among black children aged 5-14, starting in 2013. Hennekens likened attempts to halt the epidemic without gun control to trying to curb lung cancer deaths due to cigarettes without reducing tobacco use. The analysis of data from the U.S. National Center for Health Statistics also looked at causes of death among school-aged children. It said 61% were the result of assault; 32% were from suicide; 5% were accidental; and 2% undetermined. Blacks accounted for 41% of all deaths, and 86% were boys. The authors said the findings, published March 21 in the American Journal of Medicine, reveal significant public health and policy challenges.


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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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May 4

Freedom from Fear: Choosing Life Over Fright Imagine waking up each morning feeling peaceful, calm, happy, and safe in your own skin. Imagine having the courage to fulfill your dreams.  What’s getting in your way? Fear of failure? Fear of not being enough? Fear can thwart your life purpose, to experience peace and joy, and to attain your dreams.  In this workshop, educator and expert on fear and anxiety Monica Gullotta will help you navigate through fear and become who you long to be.  Gullotta founder of “Educating with Monica” and numerous workshops on anxiety and depression, gives you tools and techniques to become free of fear and fear-based thoughts and actions. The workshop will take place from 10 to 11:30 a.m. Saturday, May 4, at Cafe 407, 407 Tulip St., Liverpool.  Registration is required.  Call 315-622-5596.  Fee is $25 and all attendants will receive a workbook along with the workshop.

May 7, June 11

Medicare questions answered in Auburn Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? Cayuga County Office for the Aging offers complimentary monthly classes to help you make sense of Medicare. Here you will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches. You’ll learn about how Part D drug plans

work and whether EPIC co-pay assistance is an option for you. If your income is limited, classes will provide information about programs to help pay for your insurance coverage, as well as a listing of the free and lowcost preventive care under Medicare. All classes will be held in the basement training room of the Cayuga County Office Building. The current schedule is from 2 to 4 p.m. May 7 and from 5 to 7 p.m. on June 11. Please bring ID for a security check at the front door. Registration is required. For more information or to register, please call the Cayuga County Office for the Aging at 315-253-1226, or visit www.cayugacounty.us/aging under the News & Activities section.

May 16

Onondaga County honors senior for their services Pete Headd, deputy commissioner and executive director, Onondaga County Office for Aging, recently announced the older Americans month honorees for 2019. They will be recognized at the annual Celebration Luncheon for Onondaga County Seniors, which will take place at noon Thursday, May 16, at Drumlins Country Club, 800 Nottingham Road, Syracuse.  This event celebrates National Older Americans Month, which is every May. The following residents will be honored: • Ann Hoadley, Senior Citizen of the Year -  • Michael Messina-Yauchzy, Westcott Community, Center, Serving Seniors Honorees of the Year • Annette Adams Brown, Flan-

ders Memorial Caregiver of the Year -  Event Chairwoman JoAnne Spoto Decker, director of community services and long-term care, said, “The mission of the Office for Aging is to improve and enrich the quality of life of all seniors and caregivers in Onondaga County by providing programs and services they need to live independently. Our seniors are vital members of our community, helping others with their knowledge and their time. The theme of Older American’s Month this year is Connect, Create, Contribute and we believe that statement accurately describes those we are honored to serve each day, and also celebrate at this annual event.”  Seniors, aged 60 or older, and their guests, must register by Friday May 3. The meal cost is $5 for seniors and $20 for guests under age 60. For more information, call 315435-2362 Ext. 4942.

ingful life on their own. In this workshop, you’ll meet others in similar circumstances and learn practical strategies to rewrite the next chapter of your life, whether it be to get unstuck, to cope better or to thrive. The program covers how to overcome loneliness, find contentment within yourself, and socialize in a couples’ world. The workshop takes place from 9:30 a.m. to 4 p.m. Friday, May 31, at House Content Bed & Breakfast in Mendon. Breakfast, snacks, coffee, tea and a healthy lunch will be provided. The workshop fee of $165 includes interactive discussions, empowerment exercises, and helpful resources you can trust. To register, contact Gwenn Voelckers at 585-6247887, email gvoelckers@rochester. rr.com, or visit www.aloneandcontent.com.

May 27

Lustgarten Foundation holds Onondaga Lake walk

Memorial Day benefit for LaFayette Outreach The Columbian Presbyterian Church, corner of routes 11 and 20 in LaFayette, will host its annual Memorial Day benefit for LaFayette Outreach from 8 a.m. to noon, Monday, May 27. All of the proceeds will be donated directly to LaFayette Outreach, which is the local food pantry and service-referral agency. The event consists of a silent auction, bake sale, plant sale, “Red, White & Blue ice cream sundaes, and a free kids’ craft area.  Questions or donations, call 315-677-3293 or send an email to cpresbyt@twcny.rr.com.

May 31

One-day boot camp for women who live alone Do you live alone? Do you find it challenging? “Alone and Content” is a one-day boot camp offered for divorced and widowed women who want to rediscover contentment and gain the know-how to forge a mean-

June 8

The local chapter of Lustgarten Foundation is organizing the Syracuse Pancreatic Cancer Research Walk starting at 9 a.m. June 8 at Onondaga Lake Park, Willow Bay picnic area at 3850 Longbranch Road, Liverpool. The walk begins at 10:30. Participants will walk a 1.5-mile or 3-mile route and are encouraged to bring friends and family out for a day of awareness, raffles, and food. There are also several sponsorship opportunities available by contacting Lisa Crowley, event coordinator at 516-737-1561 Participants can register or create teams at www.lustgartenwalksyracuse.org  or by calling 1-866-789-1000. Participants who preregister online or by phone will receive a T-shirt on the day of the walk. All the proceeds from the event will go directly toward pancreatic cancer research, according to the organization.

Join us for the Lustgarten Foundation Pancreatic Cancer Research Walk!

Saturday , June 8th Onondaga Lake Park Willow Bay Picnic Area Liverpool, NY

Check in starts at 9:00 am Walk starts at 10:30 am Sign up at lustgartenwalksyracuse.org or Call 866-789-1000

100% of Every Dollar You Raise Goes Directly to Pancreatic Cancer Research Page 4

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.

Partner with Your Provider To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.

Be Heart Smart A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure

New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com

Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.


WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015

May 2019 •

©WellCare 2015 NA_03_15_WC IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 5


Your Doctor

By Chris Motola

Flavia C. Soto, M.D. Study Shows Dogs Can Accurately Sniff Out Cancer in Blood


ogs have smell receptors 10,000 times more accurate than humans’, making them highly sensitive to odors we can’t perceive. A new study has shown that dogs can use their highly evolved sense of smell to pick out blood samples from people with cancer with almost 97% accuracy. The results could lead to new cancer-screening approaches that are inexpensive and accurate without being invasive. “Although there is currently no cure for cancer, early detection offers the best hope of survival,” said Heather Junqueira, who is lead researcher at BioScentDx and performed the study. “A highly sensitive test for detecting cancer could potentially save thousands of lives and change the way the disease is treated.” Junqueira presented this research in April at the American Society for Biochemistry and Molecular Biology annual meeting in Orlando. For the new study, Junqueira and her colleagues used a form of clicker training to teach four beagles to distinguish between normal blood serum and samples from patients with malignant lung cancer. Although one beagle — aptly named Snuggles — was unmotivated to perform, the other three dogs correctly identified lung cancer samples 96.7 % of the time and normal samples 97.5 %t of the time. “This work is very exciting because it paves the way for further research along two paths, both of which could lead to new cancer-detection tools,” said Junqueira. “One is using canine scent detection as a screening method for cancers, and the other would be to determine the biologic compounds the dogs detect and then design cancer-screening tests based on those compounds.” BioScentDx plans to use canine scent detection to develop a non-invasive way of screening for cancer and other life-threatening diseases. As a next step, the company launched a breast cancer study in November in which participants donate samples of their breath for screening by trained cancer-sniffing dogs. The researchers also plan to separate the samples into their chemical components and present these to the dogs to isolate the substances causing the odor that the dogs detect.

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SUNY Upstate doctor discusses quality of life of patients after bariatric surgery, and how surgery helps with other conditions such as diabetes and sleep apnea Q: You have a lot of experience doing bariatric surgery and now serve as chief of bariatric surgery at Upstate University Hospital. What made you want to practice in Central New York? A: The opportunity to work in academic environment and advancing my career in minimally invasive bariatric surgery as well. Q: Bariatric surgery has been around for a while at this point. What have we learned about its long-term efficacy and risks? A: There’s no question that it’s the most efficient in terms of helping patients the most with long-term weight loss and maintaining their weight. With non-surgical weight loss, the rates are still very low in terms of efficacy and keeping that weight off. Q: What surprised me in talking to physicians about bariatric surgery is that the effect isn’t mechanical, but there’s a big hormonal effect as well. A: Correct. We call our surgeries “bariatric and metabolic surgeries” because it’s not just about the weight loss but the changes we provoke in the gastrointestinal hormones of the patients and the way they interact with the brain. Those changes are favorable for the resolution of medical problems as well as weight loss. Q: What is the quality of life like for patients after the surgery? You hear a lot rumors about

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

only being able to eat a spoonful at a time. A: In terms of evidence we have, the quality of life is very high for those patients. They are able to have less disease, less morbidity and many of their medical problems disappear when they lose weight. We give them the possibility of having a better life. We coach patients through the process. We have a comprehensive practice with nutrition services. We try to help them understand that lifestyle changes are important for their long-term success. Q: Aside from obesity, what other conditions are helped by the surgery? A: In terms of the patient population we treat, patients often come with other medical conditions associated with obesity like diabetes, high blood pressure, sleep apnea, sometimes acid reflux disease, as well as joint pain. So those are the most common. If you see the evidence we have of the effect obesity has in every single system and organ in the body, it’s a broad spectrum. Bariatric surgery can improve most of that. Q: When you say obesity has an effect on every system and organ, can you give me some examples outside of the ones we more directly associate with obesity like diabetes. A: [Obesity] increases the chances of developing cancer. Longevity decreases when you have obesity as well. We’re able to reverse that. Q: How long is the recovery time? A: We try to get patients up and running close to their normal lives almost as soon as they wake up from anesthesia, but we do want them to take some time off from work. We want them to adjust to the new way of eating with portion sizes. And, of course, they’re going to lose weight very quickly. So we recommend they take time off, not because of complications, but because we want them to be successful

during this period. We’ve found that patients who aren’t given some time to adapt tend to struggle a bit more. Q: I understand you were the only woman in your program back home. What was that like? A: When I was training in Argentina, I was the only lady in a group of 20 guys. I think I was the second woman in five years in that program at the time. When I came to the U.S. it was a little different. But things have changed dramatically back home since then. It makes me feel old. Q: Did you feel like a pioneer at the time? Or did you just not really think about it? A: I didn’t. For me, I was a doing what I wanted to do. I still have a great relationship with some of my partners from that time. Q: America has a reputation for having a particularly bad obesity problem. Is it a major issue in Argentina? A: If you see the numbers, America has a little higher prevalence of obesity, but unfortunately it’s a global issue. The increase all over the world is alarming. It’s really more of a pandemic than a local epidemic. Q: Since we can’t blame it, at least not entirely, on culture, what do we think is behind the obesity pandemic? A: It’s multifactorial. If you see the most current information from the Obesity Medical Association, there are many reasons why we’re becoming obese. It’s not only about the fat deposit, it’s how it affects organs. It’s about how fat tissue produces hormones. It’s more than one thing. It can sometimes be genetically related. It’s not just about how much you eat and how much you don’t exercise. It can be chronic and relapsing. Even with bariatric surgery, if we don’t maintain lifestyle changes, it can come back. Q: Other than diet and exercise, what are some of the issues at play? A: The first approach for any patient with obesity, we have to try a plan of diet and exercise first. Patients, in terms of candidacy, are recommended to have tried several other approaches before trying surgery. Candidates also have to have a BMI of 35 and have associated medical conditions, or have a BMI of 40 without those conditions. We also have do to risk assessment to make sure they’re good candidates.


Name: Flavia C. Soto, M.D. Position: Chief of bariatric surgery at

Upstate University Hospital Hometown: La Plata, Argentina Education: Universidad Nacional de La Plata; post-doctoral fellowship at the Cleveland Clinic Florida; general surgery internship and residency at New York Medical College, St. Vincent’s Hospital, New York City Affiliations: Upstate University Hospital Membership: American Board of Bariatric Surgery; American Society of Metabolic and Bariatric Surgery; Fellow of the American College of Surgery Family: Husband, two children (5 years old, and 7 months old) Hobbies: Running, volleyball, crosscountry skiing

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By George W. Chapman

Large Employers Limiting Choices to Providers


aced with continually rising healthcare premiums and costs, many large employers like Walmart are receiving a lot of press for selecting approving and limiting the physicians and hospitals their employees can use. This “narrowing” of the panel of providers to control costs and raise quality is not new. The concept has been around since the 1970s when staff model HMOs and Preferred Provider Organizations (PPOs) were established and members were limited to a select panel or network of providers. What is new is that the impetus to limit the panel or network is coming from the employer versus the HMO or insurer. In the past, some HMOs and PPOs actually failed because consumers were overly wary of limited networks and demanded almost unlimited choices. To attract business, commercial insurance companies

Hospital Ratings Challenged

The American Hospital Association is lobbying CMS to either improve its five-star hospital rating system (Hospital Compare) or take it off line. The AHA believes the 14-year-old rating system does not accurately portray hospital performance. Critics claim the star ratings, from one to five, are misleading and harmful oversimplifications of how a particular hospital performs. They suggest working with CMS on developing hospital peer groups (teaching, urban, rural, large, small, regional, etc.) for better and fairer comparisons. Currently, larger teaching hospitals that admit the sickest patients, often transferred from other

would tout their huge networks of physicians and hospitals, basically guaranteeing the consumer that their physician and their hospital were in the network. The problem is, it is difficult, if not impossible, to effectively contain costs and maximize quality with so many disparate providers. Taking matters into their own hands, employers are aggressively seeking out the most cost-effective physicians and hospitals with the best results. Walmart reports employees spend less time in the hospital, need less expensive follow-up care and avoid unnecessary procedures including surgeries. Walmart’s plan is administered by the Pacific Business Group on Health. In order to lower costs and improve outcomes, consumers must be willing to forego unlimited choices for smaller panels and networks.

of the confusion with HSAs is over what products are eligible for purchase. Amazon will end the confusion by listing eligible products or items on your screen. HSAs are the best tool for saving money because of the multiple tax advantages. You contribute pre-tax dollars to a taxfree account, paying for eligible items tax free. There is no “use or lose it“ requirement. Unspent dollars earn interest.

A Nation in Pain

An analysis funded by the National Institutes of Health estimated nearly 40 million of us experience severe levels of pain. An estimated 126 million reported some type of pain in the 90 days prior to being surveyed. It is hoped the study will help shape future research and development, target more effective pain relievers and complementary health approaches. The latter refers to non-prescription drug relief from yoga, massage and meditation. The study has attracted more attention as the opioid epidemic has worsened.

Battling Drug Prices

hospitals, tend to fare worse in the current rating system.

Amazon Accepting HSA Cards

As part of its aggressive foray into healthcare, Amazon announced it will be accepting health savings account cards for the purchase of medical supplies online. More than half of US employees are enrolled in high deductible, HSA-eligible, plans which means high out-of-pocket expenses. Out of pocket spending for healthcare was about $370 billion last year. By offering consumers an affordable and convenient option for medical supplies, Amazon hopes consumers will fund their HSAs and take advantage of the savings. A lot

Scott Gottleib recently resigned his position as FDA commissioner. Frustrated by the dirty tactics of drug manufactures to delay or prevent the entry of biosimilar drugs into the market produced by competitors, he is taking his fight to lower drug prices to The American Enterprise Institute think tank. He said his primary focus with AEI will be discovering affordable solutions to innovative treatments, including gene therapies. Bringing in substitutable generic drugs to the market under the “conventional drug pathway” (controlled by the pharmaceutical industry) is fraught with roadblocks and politics. The biosimilar pathway should bring about much-needed competition and lower prices. May 2019 •

Primary Care 2.0

It’s been proven that outcomes are better when your care is managed by a personal primary care physician who provides cost-effective treatment and preventive services and acts as your quarterback for access to specialists and the healthcare system in general. Unfortunately, with the shortage of primary care physicians, people are seeking more short term, episodic and expensive alternatives like urgent care and emergency departments. Continuity of care is critical to better outcomes and lower costs. Those without a primary care provider or manager are finding that navigating our confusing healthcare system alone is a nightmare. Primary Care “1.0” must be updated to PC “2.0” to accommodate today’s reality. There must be increased incentives like free medical school tuition, higher residency pay and tax breaks for medical students selecting a primary care career. Empowered nurse practitioners and physician assistants, working in tandem with physicians, can help alleviate the shortage and provide increased access to quality care. But the real panacea will be the evolution of telemedicine as an accepted method of delivering coordinated, low cost, high outcome primary care.

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.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 7

Bryony Grealish of Syracuse was born with just one finger in each hand and foot, a rare genetic disorder known as ectrodactyly-ectodermal dysplasia.

No Fingers, No Problem Bryony Grealish of Syracuse thrives as a cooking coach despite being born with just one finger in each hand (and one toe in each foot). She owns The Fingerless Kitchen By Mary Beth Roach


ryony Grealish was born with only one digit on each hand. But she hasn’t let this slow her down. Anything but. Instead it has fueled her innovative spirit. “Your limitation is an opportunity to do something different and amazing. We all know, as with a disability, you know what you can’t do, but then the world’s open to you for what you can,” she said. With this positive attitude, Grealish is working to create an opportunity for herself that she hopes will open the door of opportunities for others. Grealish, 40, has a severe form of ectrodactyly-ectodermal dysplasia. It is a syndrome usually characterized by deformities of one’s hands or feet and commonly includes missing or irregular fingers or toes, according to the U.S. Department of Health and Human Services’ National Institute of Health. In Grealish’s case, there is only bone structures for one finger on each hand, and she walks on one bone in each foot, she said. She compared it to walking on ice skates with a single blade or inline skates with just one line of wheels, and she is constantly balancing and shifting weight. From her home on Syracuse’s northside, this wife and mother of two has begun a cooking program called The Fingerless Kitchen, LLC, through which she provides cooking lessons to teach people with disabilities how to cook. The logo for The Fingerless Kitchen is actually a graphic of Page 8

Grealish’s hand. Her husband, Elias Liquori, photographed her hand and used the picture to develop the design. She’s done YouTube videos, speaking engagements and spots on at least one local television show. She’ll cook with the show’s hosts, who’ll have their fingers taped up, or just use their pinky finger, in order to better understand the challenges that she, and others like her, face. Grealish’s received a degree from Syracuse University in social work, and had been affiliated with Aids Community Resources, Inc. (now ACR Health) and later with the Huntington Family Center. It was during her time with Huntington, she said, that she came up with the idea to write a cookbook to teach people with disabilities how to cook. She said that she let self-doubt deter her — but only for a while.

Changing people’s lives Grealish’s upbringing wouldn’t allow her to completely give up on her idea. She, along with her nine siblings, were all adopted by Charles Grealish and Mary Jane Von Braunsberger, both psychologists, and raised in the Westcott neighborhood, a short distance from Syracuse University. The children were of different races and there was a large age range, she said. Calling her parents her heroes, she attributes everything to them. “They were the ones that really kept pushing me to go for it and be

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

who I am and don’t let anyone tell you otherwise.,” she said. The parents also taught their children to help their community. Initially, she thought that her community was her hometown of Syracuse. However, her viewpoint changed over time. “I realized that my community was people like myself.,” she said. It got her thinking about not just teaching people with disabilities to cook but also inspiring them to start their own businesses. She left her job at Huntington a little more than two years ago, and started a catering company. That idea didn’t work the way she had hoped, she said, yet she saw a silver lining. “We take our little failures and we change it,” she said. The big change for her would come in the spring and summer of 2018. She had been working with staff from the Women Igniting the Spirit Entrepreneurship program (WISE) and had attended one of its seminars, which featured Rick Tamlyn, a thought leader and an experiential keynote speaker. Grealish would later attend a two-day program, hosted by Tamlyn, that would be a turning point for her. While she always felt that she was supposed to do something special, she said, she never could figure out what it was — until this workshop. “I knew that I was supposed to do something, that I have these hands for a reason, and that I was going to change people, and I was going to change their lives for the

better, but I didn’t know how it was going to happen,” she remarked. She knew she was going to do a cooking show; to fill a void since, as she said, no one was doing anything about showing people with disabilities how to cook. “We all have to eat. There’s community around food. It’s a basic life skill. People always gather around food,” she said. As families and friends gather for holidays, they often gather in the kitchen, with everyone cooking. Grealish pointed out that oftentimes, people with disabilities are not in the kitchen, they’re not part of the process. “While everybody’s here, laughing and having a good time, you have people who are set aside from it all. They’re not a part of the process, they’re not engaging with their loved ones or their friends. They’re left to the side, which doesn’t do them any good all the way around,” she explained. Grealish has been interested in cooking since she was about 8 years old. She watched her dad, who was wheelchair-bound as a result of a car accident when he was 20, cook, and without the help of any adaptive devices. She would help him in the kitchen, prepare meals for their family. “We’re always gathering around the dining room table for every meal,” she said. She still has that dining room set in the home she shares with her husband, Elias, and her two sons, Aidan, 12, and Ethan, 4. Over the years, she has continued to learn and try new things, although she said that not all attempts have been successful. “Sometimes it’s a massive disaster and it’s OK,” she said, laughing. “There’s lessons in the kitchen. If I can bring people with different disabilities into the kitchen to learn — there are life lessons here. You can learn how to cook and feed yourself. You can learn to be part of a community, to grow friendships around your cooking and build confidence.” Grealish knows from personal experience the importance of building that confidence. As a child, she had been bullied, and she said that sometimes would question why she was born with such a disability. Even now, she’s had experiences when children have run from her in fear, “terrified of my hands,” she said. And while their parents are embarrassed, she encouraged them to use it as a learning moment. “Tell them it’s OK. Meet that person, see that they’re a human, that they’re a person with feelings and emotions, just like you,” she said. She now sees her hands as a gift, by which she can cook up ways to help. She will continue to work on her cookbook and look for a publisher, schedule more speaking engagements, strive to create a television cooking show, and seek out a company that she can partner with to create products in the kitchen for people with disabilities. “My hands, these are now my superpower. I can do what I love and take what I love to help people in my community, and use my hands to do good,” she said.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone & Content Workshop: A One-Day Boot Camp Forging a New Life on Your Own


or some women, living alone in mid-to-later life is a welcome change, especially if they have chosen to step away from an unhappy marriage. But for others, the change is often sudden and not welcome. The prospect of living alone can appear on the horizon as a daunting challenge. The ending of my own marriage years ago fell into the latter category; it was not a welcome change. But it was a change nonetheless and I chose to accept it and ultimately to embrace what would become a defining chapter in my life. It took some time and some hard-knock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to offer support to other women in similar circumstances. “Alone & Content: Forging a New Life on Your Own” is a one-day boot camp I developed to help women discover the know how to create a more satisfying and enriching life on their own terms and timetable. I’ve been leading the workshop for over 14 years now, and often get questions from In Good Health readers about what the boot camp covers

and how it is organized: Q. What is the purpose of the boot camp and what do you cover?

A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude and perspective. At the end of our day together, it’s my hope you will feel a few steps closer to finding your way forward, whether it be to get unstuck, to cope better or to thrive. We’ll talk about how to overcome loneliness and other emotional pitfalls, rediscover your true self, socialize in a couples’ world, and let go of self-limiting beliefs or obstacles that get in the way of personal growth. The goal is to embrace what may be a once-in-a-lifetime opportunity to get to know yourself all over again and to create a rewarding life on your own, whether it be for a year or two or for the rest of your life. Feeling comfortable with your independence will improve your chances of finding happiness, and it will improve your chances of finding a new healthy relationship, if that’s what you desire.

s d i K Corner

High Rate of Sex Before Age 13 Among Boys


sing information from two national surveys, researchers from Johns Hopkins Medicine and the Guttmacher Institute have found that in some metropolitan areas, more than a quarter of young, African American men reported having sexual intercourse before age 13, and for about 45 percent of them, the sex was either unwanted or experienced with “mixed feelings.” The researchers caution that while self-reporting surveys have limitations, they say similar results drawn from multiple data sources suggest that rates of underage male Page 10

sex in metropolitan areas are substantially higher than previously estimated using only national data. They also find that race, ethnicity and location play a larger-than-appreciated role. The researchers say their study, described in the April 8 issue of JAMA Pediatrics, points to the need for better and much earlier access not only to sex education, but also sexual health clinics, family planning and parenting services, and mental health counseling services for inner city male youth, particularly if they have experienced unwanted sex.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

When you feel better about yourself — more self-assured and resourceful — life on your own or with a special someone can be richer and more satisfying. Q. Who attends the boot camp?

A. Most of the women who attend the workshop are in mid-to later life, around my age. I am 64 years young. Almost all have come out of a long marriage or relationship, and some are on their own for the first time in their lives. While their circumstances may differ, they share one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist, and/or their congregation.

Q. I’m still grieving the loss of my marriage/spouse. Is this boot camp right for me?

A. Good question. The Alone & Content boot camp is a “nuts and bolts” practical workshop to help women feel more whole and complete on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend attending a grief support group (check out Lifetime Care) or the help of a professional counselor. Q. What are your credentials?

A. I am not a licensed professional. My expertise is born out of real-life experience. I’ve been there. I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of living alone. After some hits and misses, I found my way and now thoroughly enjoy the freedom, independence and peace that come with living alone. My time-tested experience, resources, tips and techniques have inspired and helped many participants. My boot camp has been the jump-start they needed to rewrite this chapter in their lives. “Young men having sex before age 13 usually haven’t received the appropriate sex education and services, and we need a better system to respond to their needs,” said physician Arik Marcell, senior author of the study and associate professor of pediatrics at the Johns Hopkins University School of Medicine and Johns Hopkins Children’s Center. “The cultural double standard about sexual behavior in the United States, in which it is OK for young boys, but not girls, to be sexually active, has prevented us from effectively addressing male adolescents’ vulnerabilities and their healthy sexual development,” Marcell adds. Currently, 24 states and the District of Columbia mandate sex education at some level. Although most adolescents receive some form of sex education between grades six and 12, with some as early as grades four or five, the researchers say what they learn is highly dependent on their region, school and parents’ decisions to allow them in the classes. In 2014, fewer than half of high schools and only 20 percent of middle schools delivered sex education covering all 16 critical sexual education topics identified by the CDC, according to the Guttmacher Institute. “I have heard boys and adolescents talking about their first sex

Q. How large is the boot camp?

A. Ideally, I like to have eight women in each boot camp, although, on occasion, I have led the workshop with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly evolves into a comfortable camaraderie and it’s not uncommon for warm friendships to develop among participants that carry on long after the boot camp has ended. Q. Where is the Alone & Content boot

camp held?

A. The boot camp takes place at House Content Bed & Breakfast in Mendon, a few minutes south of Rochester. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the boot camp. What’s my next step?

A. Let’s talk by phone as a next step. That way, I can your answer your questions and you’ll know better whether this boot camp is right for you. Just call me at 585-624-7887 or email me at gvoelckers@rochester. rr.com, and we’ll schedule a time to chat. You’ll also find information about my upcoming boot camp in the Calendar of Health Events included in this issue.

Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon. She is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about her boot camp, to purchase her book, or invite her to speak call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com

encounters in a way that suggests they didn’t anticipate, understand or know what was happening or what’s appropriate and what’s not,” says Marcell, “I was concerned that such early sex experiences happening to boys could be unwanted and influence their future health. We used the data available to us in these surveys to attempt a better look at the scale and pattern of this problem across the nation.” Young men who reported in the national family growth survey that they first had sex before age 13 described a range of attitudes about this experience. Only 55 percent said that their first sexual experience was wanted, while 8 percent said it was unwanted and 37 percent said they had mixed feelings about it. The investigators underscored the importance of recognizing young people’s perspectives, and also noted that reports of whether a first sexual experience was wanted may be influenced by gender and race expectations, stereotypes, peer pressure and coercion. “Too often, the sexual health needs of young men are overlooked,” says Guttmacher Institute researcher Laura Lindberg. “Outdated attitudes and harmful gender stereotypes leave many young men without needed information and services.”

Say hello to healthy.

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Learn more at connextcare.org — or better yet, stop in to one of our six sites Located in Fulton, Mexico, Oswego, Parish, Phoenix, Pulaski and say hello.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Tips to Get Through Your Midday Slump

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CNY’s Healthcare Newspaper

A monthly newspaper published by Local News, Inc. 35,000 copies distributed throughout more than 1,000 high trafďŹ c locations, including all Wegmans stores.

In Good Health is published 12 times a year by Local News, Inc. Š 2019 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Chris Motola, Ernst Lamoth Jr., Eva Briggs (MD), Eudene Harry (MD), JC Trussell (MD) • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

Page 12


IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019


e have all felt it. After lunchtime, you’re lethargic, tired and constantly checking the clock waiting for the day to be over. But fear not! Your day will no longer be ruined by the afternoon lull. Here are some quick tips to avoid the midday slump and allow you to end your day rejuvenated!

Spend Five Minutes in Nature According to a study published in the Journal of Positive Psychology in 2019, just five minutes sitting in nature improves moods, decreases negative feelings and increases your sense of being awe and wonder at being a part of something bigger than yourself. If you have more time, combine being in nature with exercise. This can include hiking of simply taking a walk through the park lined with trees. This can reduce your heart rate and improve your ability to recover from stressful events.

Bring the Outdoors In Feeling overwhelmed and can’t leave the building? Hang paintings of nature scenes on the walls, look out a window or a nature scene on your video device. It seems that even the picture of nature had the potential to reduce feelings of stress.

Break Out That Adult Coloring Book Can’t absorb any new information? Take a break and take out the adult coloring book you have not taken the time to use. This distraction gives the brain the space it needs to tackle the problem while you focus on the joys of choosing the colors that make you feel better. Pro tip: Choose yellow and other bright colors if you need a pick-me-up.

Incorporate Natural Mid-Afternoon Boosts Grab some green tea, it is high in antioxidants, contains a small amount of caffeine and also has an ingredient that can help create a sense of calmness. If you combine this with a little aromatherapy, either peppermint or lemon to quick lift or lavender to keep the calm going,

you might find yourself feeling better after a quick 10-minute break.

Quick Desk Exercises Here are two quick exercises that helps to release stress, restore a sense of calm while improving moods. Do any exercise that helps bring the heart rate up a little bit to get blood pumping while also releasing the energy of frustration. First, do some quick tricep extensions using a chair. Then follow with a stretch that helps to relieve the tension. Shrug shoulders up to the ear and gently rotate forward then backward. Follow this with an open stance, arms open wide and slightly raised as if to open up to receive warmth, love and support, then simply cross your arms around your shoulders and give yourself a hug. Cross your arms until you feel the muscles in the upper back gentle stretch and start relieving some of that built up tension. After all, we do tend to carry a lot of stress in the upper back and neck. Bonus, hugs help to relieve stress and improve moods.

Laugh & Breathe It is as simple as laughing. It decreases cortisol levels and improves moods. A simple way to watch a funny clip or even more simple, record a baby’s laughter and listen to it. That sound of pure joy and wonder can bring a smile back to your face and do wonders for your mood. Lastly, practice stopping and breathing. Four counts in, hold for four and release for four. Do this about four times and feel the stress slowly ebb away.

Eudene Harry is the medical director for Oasis Wellness and Rejuvenation Center in Orlando, a wellness practice devoted to integrative holistic care. She is a veteran physician with more than 20 years of experience. She earned her medical degree and performed her residency at Thomas Jefferson University in Philadelphia. Her most recent book, “Be Iconic: How to be Healthy and Sexy at Any Age� is now available on Amazon. She regularly contributes to television and radio shows nationwide.

For all the ways you make a big difference: thank you. You are the front line. You’re there when you’re needed most, paying attention to the small details. You solve problems and take time to be kindhearted. You understand and show genuine empathy and care. You work hard because it’s hard work, yet you do it with grace. You’re a nurse, and patients’ lives are better because of you. At Nascentia, we’re especially proud of our 178 nurses (and growing), who give their all for their patients and our mission. In celebration of National Nurses Week, we say “thank you” for your compassion and dedication.



May 2019 •

nascentiahealth.org • Page 13

IN GOOD HEALTH – CNY’s Healthcare Newspaper



Marijuana and its effect on male fertility

By JC Trussell, MD


arijuana (cannabis) is the most commonly used drug in the world, with an estimated annual prevalence of 3.8% of the adult population. Overall, there has been a trend toward laxity in cannabis regulations as is evident by the recent passage of laws allowing recreational use in several states in the U.S. Since cannabis use tends to be more prevalent among those of reproductive age, the effect of cannabis on male reproduction must be evaluated. Research looking at the effect of cannabis on becoming a dad, is at best, confusing.

First the bad news.


Most research indicates that marijuana has a negative effect on sperm and therefore on male fertility. A 2015 study of 1,215 young Danish men (aged 18 to 28 years) who regularly used marijuana —more than once per week — was associated with a 28% lower sperm count. This was in contrast to other men who did not use marijuana or, used it less than weekly. Making matters worse, the combined use of marijuana (more than once per week) and other recreational drugs reduced the sperm count by 52%. Secondly, a 2011 study reported that chronic exposure to THC — the main psychoactive constituent of marijuana — impaired both sperm count and motility. Lastly, a 2014 study reported that the use of cannabis among young men, within three months of a semen analysis, was a

risk factor for poor sperm quality. Even older studies have demonstrated similar findings. For instance, a 1985 study reported that chronic marijuana users (“chronic” was not defined) had a decline in sperm volume, count and motility.

Now the good news.

A survey of U.S. couples attempting to conceive demonstrated no association between never-smokers and the marijuana users and time to conception.

The takeaway.

Clinicians should not advise that marijuana is safe while trying to conceive. Use of marijuana appears to have a negative effect on male fertility: worsening sperm count, motility and shape. On the other hand, the good news is that the effects do not seem to be permanent and may not affect most couples’ time to pregnancy.

■ See story “Medical Marijuana: A Boon for Older Adults?” on page 21. J C Trussell is a urologist at SUNY Urology and a SUNY Upstate. His specializes in andrology, erectile dysfunction, peyronie’s disease and male infertility.

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SmartBites Bites

Helpful tips:

By Anne Palumbo

The skinny on healthy eating

Why We Should Eat More Broccoli


eat a lot of broccoli, probably more than your average Jane. When I was younger, I ate it for the taste. But now that I’m older, I make a concerted effort to eat broccoli for its comprehensive nutrition benefits — benefits, in particular, that help my aging body. Ever since I was diagnosed with osteopenia (low bone mass) a few years ago, I’ve been on a mission to slow further bone loss by eating foods that support bone health. While broccoli doesn’t provide much calcium or any vitamin D, it does provide a phenomenal amount of bone-strengthening vitamin K: over 100% of our daily needs in an average serving. Vitamin K improves bone health by helping our body absorb calcium and by keeping it in our bones. My concerns about cancer have intensified with age, especially since age alone is the No. 1 risk factor. Aware also that cancer-causing

substances are a top risk, I can’t help but shudder every time I recall running behind the DDT mosquito trucks when I was a kid. So I look to broccoli, a cruciferous vegetable, for its high concentration of sulforaphane — a powerful phytonutrient that has demonstrated an ability to prevent cancer or slow its progression in multiple studies. Thinning skin and the resulting tears also plague me, prompting me to consume foods that are high in vitamin C. Did you know that an average serving of broccoli serves up well over 100% of our daily needs? An essential nutrient, vitamin C plays a vital role in the formation of collagen and has even been linked with wrinkle reduction. Plus, this powerful antioxidant, which protects cells from free-radical damage, may also reduce our risk of certain cancers. Dogged by LDL (bad) cholesterol that has risen with age, I also seek foods that provide the kind of fiber that helps whisk cholesterol out of the body: soluble fiber. One cup of cooked broccoli has about 5 grams of fiber, of which more than half is soluble. I’m equally grateful for broccoli’s insoluble fiber, as it helps with digestion and promotes regularity. You know what else buoys me about broccoli? It’s super low in fat, cholesterol, and calories (only 60 per cooked cup!). Now, ready to eat more broccoli?

Choose broccoli heads with tight, deep green florets and firm stalks. The broccoli should feel heavy for its size, and the cut ends should be fresh looking. Avoid broccoli with browning stem ends or yellowing florets. Refrigerate unwashed broccoli in a loose plastic bag and wash just before using.

Broccoli-Cheddar Quiche with Quinoa Crust Crust:

Serves 6

2/3 cup dry quinoa, cooked and chilled 1 large egg, beaten ¼ cup grated Parmesan cheese ¼ teaspoon coarse black pepper Filling: 2 teaspoons olive oil 1 small onion, chopped 2-1/2 cups chopped broccoli florets 2 cloves garlic, minced ½ cup fat-reduced milk 4 large eggs 2 large egg whites ¾ teaspoon kosher salt ¼ teaspoon coarse black pepper ¼ teaspoon crushed red pepper (optional) 1 cup grated fat-reduced cheddar cheese

Preheat oven to 375 F. Lightly oil a 9-inch pie dish. Rinse quinoa in a fine-mesh sieve and transfer to a medium pot. Add 1-1/3 cups water and bring to a boil. Cover, reduce heat to low and simmer until water is absorbed, 15-20 minutes. Set aside off the heat for 5 minutes; uncover, fluff with fork, then chill in fridge for 10 minutes. Combine chilled quinoa, beaten egg, Parmesan cheese and black pepper in a bowl; stir well. Press mixture into bottom and up sides of pie dish. (Dust your hands with flour if mixture starts to stick.) Bake in preheated oven for 20 minutes; cool. In a large sauté pan, heat oil over medium heat. Add onions and

broccoli and cook slowly, stirring frequently until vegetables are soft (about 8-10 minutes). Add garlic and cook 1 minute more. Remove from heat; cool. Combine milk and next 5 ingredients; stir with a whisk. Arrange broccoli mixture over crust; top with grated cheese. Pour egg mixture into the dish and bake at 375 F for 35-40 minutes, until center is set. Let stand 5 minutes; cut into 6 wedges. Note: Prefer no crust? Skip the crust steps and head straight to spreading the broccoli mixture in the lightly oiled pie dish.

Anne Palumbo is a lifestyle colum-

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

Foods to Lower Your Cholesterol Count Oat bran is among foods that experts believe can lower cholesterol


t’s not always possible to lower cholesterol through diet alone — sometimes there’s no way to override your DNA, and medication becomes a must. But certain foods can be part of the plan to improve your numbers, to both lower low-density lipoprotein (LDL) cholesterol, the bad one, and raise your high-density lipoprotein (HDL), the good one. First, choose foods with soluble fiber. Think of this type of fiber as a magnet, drawing cholesterol out of your body. Good sources are oats, oat bran and barley, along with beans, eggplant and okra. When used in recipes, these foods tend to take on the flavors of other ingredients, so be adventurous with recipe planning — and generous with herbs and spices. Apples, grapes, strawberries and citrus fruits are good

choices because of their pectin, a type of soluble fiber. Next, go for foods with polyunsaturated fats. These include vegetable oils like canola, sunflower and safflower, as well as fatty fish

like salmon, rich with omega-3 fatty acids, and most types of seeds and nuts. Plant-based foods also contain substances called plant sterols and stanols, which help keep the body

May 2019 •

from absorbing cholesterol. Particularly good sources are Brussel sprouts, wheat germ and wheat bran, peanuts and almonds, and olive, sesame and canola oils. In terms of foods to limit, talk to your doctor about your unique needs. High-cholesterol foods like shellfish and eggs aren’t as dangerous as once thought. The verdict is still out on the saturated fat found in meat, but some research has found that full-fat yogurt, milk and even cheese may be good for you. The one type of fat to completely avoid is trans fat. The U.S. Food and Drug Administration banned its addition to foods in 2018, but because of extensions granted to some manufacturers, certain items could be on store shelves until January 2021. So keep checking the ingredients on any packaged foods you’re considering.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 15

My Turn

By Eva Briggs

Mitral Valve Regurgitation: It Can Affect Dogs, and People, Too


ast week I brought my dog to the vet for his annual checkup. Boomer is in great shape for a 12-year-old dog, so I was surprised to learn that he had a new heart murmur due to a disorder called mitral valve regurgitation. I took out my stethoscope and was startled by how loud his murmur was. It’s a problem that occurs in people, too. First, a reminder that the term heart murmur refers to an abnormal sound caused by turbulent blood flow. Often murmurs happen because the heart’s structure is abnormal. But some murmurs, especially in kids where the heart’s plumbing is smaller, are innocent. Innocent murmurs occur in a structurally normal heart and don’t indicate heart disease. The mitral valve separates the left atrium of the heart from the left ventricle. During diastole, the relaxation phase of the heart, blood returning from the lungs fills the left atrium. When the heart contracts, the left atrium squeezes sending blood through the mitral valve to fill the larger left ventricle. Next the mitral valve closes and the left ventricle contracts, delivering blood to the body. In mitral regurgitation, the mitral valve doesn’t close all the way. Blood leaks backwards into the left atrium. So the body receives less blood and the left ventricle has to work harder.

Page 16

It can stretch, enlarging the heart. Often mitral regurgitation has no symptoms initially. It may take months or years to progress to symptoms. When mitral regurgitation becomes symptomatic, it causes heart failure. The overworked weakened heart muscle can’t keep up. At first exercise becomes difficult. Exertion causes fatigue or shortness of breath. The shortness of breath can worsen, especially when lying down. Fluid in the lungs leads to cough, and fluid in the body causes leg swelling. The stretched heart muscle can develop abnormal rhythms, causing palpitations and sometimes atrial fibrillation. What causes mitral regurgitation? In my dog’s case, and for many people, it arises from age-related degeneration. Another cause is mitral valve prolapse. In this common disorder, the mitral valve bulges backward when the ventricle contracts. Most of the time there is no associated leak. Over time some people develop mitral regurgitation. Another cause is damage to the chordae tendinae, tendons that tether the two segments (leaflets) of the valve to prevent the leaflets from bulging backward. Rheumatic fever, a complication of untreated strep throat, can damage the mitral valve. It’s now rare in the U.S. but not uncommon in developing countries. Infection of the

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

heart valve, endocarditis, is another potential cause. One way the heart valve can become infected in otherwise healthy young people is by injection of drugs under nonsterile conditions. Heart attacks that affect the heart muscle supporting the mitral valve can cause mitral regurgitation that is potentially sudden and severe. Myocarditis, inflamed or damaged heart muscle, is another cause. Chest trauma can damage the mitral valve, sometimes rupturing the chordae tendinae and producing sudden severe symptoms. Other causes include congenital heart disease, atrial fibrillation, radiation therapy to the chest, and medicines containing ergotamine. If your doctor suspects mitral regurgitation, a variety of tests help determine the diagnosis and severity. An echocardiogram uses sound waves to image the heart and the blood flow through the heart. An EKG evaluates the electrical system of the heart. A chest X-ray is another way to evaluate heart size and look for fluid in the lungs. Other tests that a cardiologist might order include a cardiac CT, cardiac MRI, exercise or other stress test, or cardiac catheterization. Once the diagnosis is made, how is it treated? Patients with mild disease may need no treatment other than close monitoring. As the disease progresses, medications might be needed. Diuretics, often called “water pills” relieve excess fluid in the lungs or legs. Blood thinners may be needed if there is associated atrial fibrillation. Since elevated blood pressure worsens mitral regurgitation, antihypertensive drugs are prescribed if blood pressure is high. Many patients eventually require

Boomer, the author’s 12-year-old dog was diagnosed with heart murmur due to a disorder called mitral valve regurgitation. This is a problem that can affect people, too. surgery to repair or replace the mitral valve. Some types of repair can even be done via a catheter inserted in the groin. Lifestyle changes can also help. Exercise regularly (within any limits set by your doctor), eat a heart healthy diet, quit smoking, cut back on alcohol, prevent infective endocarditis, and follow up regularly with your doctor. As for Boomer, he has no heart symptoms, so my vet is recommending watchful waiting. I like to hope he has several more years of romping through the woods with me. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

Second New MS Drug Secures FDA Approval


he U.S. Food and Drug Administration has approved another new multiple sclerosis drug the second in one week. Mavenclad (cladribine) pills can be used to treat relapsing forms of MS in adults, including relapsing-remitting disease and active secondary progressive disease. The drug is not recommended for MS patients with a course of the disease known as clinically isolated syndrome. Due to safety concerns, Mavenclad is generally recommended for patients who have not responded to or can’t tolerate other MS drugs, the FDA said. The drug is from EMD Serono, Inc. “The approval of Mavenclad represents an additional option for patients who have tried another treatment without success,” physician Billy Dunn said in an agency news release. Dunn is director of neurology products in the FDA’s Center for Drug Evaluation and Research. Earlier in April, the FDA approved Mayzent (siponimod) pills, also for relapsing forms of MS. Patients with relapsing MS have periods of worsening symptoms followed by recovery periods. The Mavenclad trial involved more than 1,300 patients with relapsing forms of MS who had at least one relapse in the previous 12 months. Those who took Mavenclad had a significant decrease in the number of relapses and slower progression to disability, according to the FDA. But Mavenclad has a boxed warning for an increased risk of cancer and fetal harm. The drug should not be used in patients with current cancer. In patients who’ve had cancer or have an increased risk of cancer, doctors should weigh the benefits and risks of Mavenclad, the FDA said. Because of the potential for fetal harm, Mavenclad should be avoided in pregnancy. And it should not be taken by women and men who do not plan to use effective contraception during treatment or for six months after treatment ends. If a woman becomes pregnant, she should stop taking Mavenclad, the FDA noted. Other warnings include the risk of decreased white blood cell counts, increased risk of infections, and liver injury. The most common side effects among patients taking the drug were upper respiratory tract infections, headache and a decrease in white blood cells. MS is an autoimmune disorder targeting the central nervous system. It is one of the most common causes of neurological disability in young adults. It occurs more often in women than in men.

YO U R I N N ER CH I LD IS AGELE S S. Imagine if your joints were, too. We perform more knee replacement, hip replacement and spine surgeries than any other hospital in our region.* More experience leads to better clinical outcomes — just ask the thousands of orthopedic patients who’ve trusted us to help them keep playing. *HANYS Market Report, 2016


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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 17

Nursing Career: Lifelong Dream for Two CNY Women By Deborah Jeanne Sergeant


or many children, their desired career changes on a whim. These two women always felt a strong pull towards nursing.

Donna Lynch Upstate Family Medicine


ince girlhood, Lynch felt she wanted to become a nurse. “I played nurse from when I was 3,” she recalled. Right out of high school, she began attending St. Joseph’s School of Nursing and then obtained her Bachelor of Science in Nursing from Syracuse University. She worked at St. Joseph’s Hospital for about 18 months. “I did a float pool to go to all the different departments to decide what I liked,” Lynch said. She settled on coronary care, emergency, and intensive care. For the next decade, she worked in Crouse Hospital’s coronary care, and later the emergency room. But motherhood changed things for Lynch. “Working 10- to 12-hour shifts was difficult,” she recalled. She transitioned to outpatient

services at Upstate Family Medicine in 2008 and has worked there ever since, eventually achieving her current position of clinical leader, the charge nurse of the clinic. “I love the communication with patients and the interaction,” Lynch said. “I love talking with them all day.” Though getting back with all her patients in a timely fashion challenges her some days, she enjoys helping them maintain good health. She said that in her 22 years of nursing, the way nurses see their patients has changed the most. “Now, everything is geared like a business, toward customer service,” Lynch said. “Everyone is looking at patients as a whole. We see our patients from birth until they pass away.” Why patients come in is also shifting. “Now, we are looking at more aspects of the entire family,” Lynch said. “Ten to 20 years ago, we didn’t have as many children with anxiety and depression. It’s more open now. We’re seeing a lot of that, not only in kids but in most of our patients. I think it’s being more recognized and talked about, even post-partum depression. There’s new medications to treat it. There’s more counselors now to help people. We have social workers and therapists to work with families and therapists.” She advises anyone interested in nursing to volunteer at a hospital to see how nurses work with patients and doctors. Lynch also thinks it’s important to research nursing schools by attending nursing program open houses. “Nursing is one of the best fields to go into because you can do anything: traveling nurse, in the home, for agencies. It’s not just hospital work,” Lynch said. “You’re not stuck in one place.” Lynch and her late husband had

one son, who is now a freshman in college. She enjoys working out, running, hiking, fishing and cooking.

Emery House Upstate University Hospital


ouse always loved science and taking care of people. Those interests dovetailed in the field of nursing. She attended Cayuga Community College in Auburn and earned her bachelor’s degree and master’s from Keuka College so she could work in critical care. “I like knowing more about my patients and having more autonomy in their care,” she said. “I can make a recognizable difference in people’s lives.” She has worked at Upstate’s Downtown and Community campuses as a resource pool nurse. That means that a month in advance, she is assigned to whichever intensive

It’s Nurses Week: A Career with Diverse Range of Options


Registered nurse Meredith Boss is the assistant director of nursing for Loretto’s restorative care unit. Page 18

ational Nurses Week is celebrated May 6-12 and recognizes and elevates the nursing profession. When many people think about nursing, they think of a doctor’s office or hospital. But this week is intended to elevate the entire spectrum of nursing: from LPNs and RNs, to specialty nurses in doctors’ offices and long-term care facilities, to home health nurses, nurse educators and more. In our own backyard, for example, Loretto’s 20-plus programs across its 19 locations include at least 10 different types of nursing positions. The levels of nursing range from home health aides and certified

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

nurses aides to registered nurses and directors of nursing units. Work environments range from day programs to home care, rehabilitation, telemedicine, and acute skilled nursing — some with traditional schedules and some with very flexible schedules. Registered nurse Meredith Boss is the assistant director of nursing for Loretto’s restorative care unit which uses telemedicine technology to deliver real-time care via electronic communication. Any given day in a tele-medicine unit can be very different from traditional nursing care. Boss was intrigued by this cutting-edge approach and jumped when the opportunity to learn a new modernized form of care came to Loretto.

In 1993, the American Nurses Association declared May 6-12 as the national week to celebrate and elevate the nursing profession. National Nurses Week is a time for everyone — individuals, employers, other health care professionals, community leaders and nurses — to recognize the vast contributions and positive impact of America’s 4 million registered nurses. Each year, the celebration ends on May 12, Florence Nightingale’s birthday. Nightingale, the founder of modern nursing. care unit needs a nurse. “I constantly get new learning experiences,” House said. “I love that. I love the variety and diversity. My particular role is to orient the nurses coming into this department through on-the-job training.” One of her daily challenges includes facing ethical and social situations many find uncomfortable. It can relate to family dynamics and the family of patients making life-altering decisions for them if they cannot speak for themselves and have not appointed a health care proxy. Sometimes, the family does not agree with the health care proxy. “We always try to do the best for the patient,” House said. “We carry out whatever wishes are identified by the patient or the health care proxy, but we have to set aside our own feelings so we can show we’re doing the best for what the patient wants.” House never realized in nursing school the enormous responsibility of working as a nurse. She also didn’t anticipate the “many hats” nurses wear, such as conflict management, social work or housekeeping. “We have good teamwork professionally with our patients and physicians and more,” House said, “but I wish more families were in touch with the greater good for the patient.” She thinks that anyone with deep compassion, critical thinking skills and a willingness to learn can become a nurse. But it’s not easy. “Nursing school is one of the hardest things I’ve ever done, but it doesn’t stop there,” House said. “Even going through a very challenging educational journey, once you’re in your work environment, you’re learning the extra things to do your job effectively.” House likes to go out to lunch with other nurses on their days off, as well as spend time with her boyfriend and her dog. “The technology is not difficult to learn and offers so much real-time information on a patient. We also have such an amazing team. Our motto is ‘RCU-crew: Our hearts beat for you,’” she said. For anyone considering a career in nursing, not only are the options near limitless, but the need for nurses in our community and across the country is dire. Because of this, Loretto welcomes nurses at any level and provides both encouragement and financial support to help employees advance their nursing careers. These opportunities aren’t limited to individuals who are still early in their careers. Part-time work in any of these nursing positions can also be a rewarding option for those who are recently retired or semi-retired. Submitted by Loretto

Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

What’s in a Toy?


ecently, I came across an interesting toy advertisement. It showed a little girl happily tinkering with a 14-piece carpenter’s set. The set contained everything she would need to build herself something — a small saw, a level, a vice, a hammer and some nails. If it weren’t for some out-of-date typeface and an unfashionable bowl-cut on the little lady, the advertisement might have given me hope. You see, this ad wasn’t in an online banner or a digital flyer. It was actually from a 1970 Sears’ catalogue. If I tried to find a similar advertisement in mainstream media, I would be sorely disappointed. Today’s toys are ridiculously gendered. Believe it or not, there was a time when toys were less gendered. A look back at the 1970s reveals toy makers rarely marketed toys based on gender. Elizabeth Sweet, a postdoctoral scholar at the University of California at Davis, recently studied and reported on this phenomenon (check out her findings; they are enlightening). If you flipped through the pages of toy catalogue from the 1970s or 1980s, you weren’t smacked in the face with hot pink and dark blue. It wasn’t all princesses and ultra-jacked robot superheroes. You saw little boys playing with toy groceries and refrigerators and girls playing with toy hammers and nails (just like us grownups do). Women are closing gender-related societal gaps, but a look at toys would never indicate that. Despite the contrary credos I recite to my children, we are living in an age of boy’s and girl’s toys. Ask any child, and they can regale you with this plight. Walk down the aisle of any store, or scroll through any online listing, and it becomes very apparent what toys are intended for which gender. It’s not just the color coding. Boy’s toys are typically geared toward activities, confrontations, grossness and domination. Girl’s toys are geared toward gentility, helping, caregiving and mild ambitions. It’s 2019 — haven’t we all decided people are complex and that our complexities and associated preferences extend past our genders? Our everyday lives say “yes”, while the toys our kids plead for say “no”. It doesn’t have to be like this. Public outcry has changed a great many things. If you are one of those people who think this isn’t a big deal or can’t see a better way to do it, consider these things:

There are other demographics If toys aren’t broken down by gender, what can they possibly be

broken down by? Here are some ideas: age and interest. Imagine browsing online, searching for the word ‘dinosaur’ and being met with a page full of dinosaur toys. Not just gnashing T-rexes with razor-sharp claws, but also parent T-rexes with baby dinosaurs. Imagine searching for the word ‘doll’ and being met with a picture of a boy playing with a boy doll, and a host of polo shirts and baseball caps to accessorize his doll. Imagine both things being OK, because some girls like dinosaurs and some boys like little people.

There will still be plenty of choice There are people out there who worry that taking gender bias out of the toy market will mean everyone will have to play with the same thing. That is a fallacy. I know plenty of little girls who love to level block buildings with toy robots. I know plenty of little boys who love pushing around a stuffed cat in a baby carriage. The hang-up isn’t with our children. They are pushed by society to think these inclinations are wrong. We are simply stifling their natural urges. We just need to reach a point where a boy feels equally empowered to play with a toy kitchen as he does a foam dart gun. Everything won’t be beige and androgonous.

These new norms hold our kids back When I wonder what is holding our society back from categorizing its toy offerings by something other than gender, I come back to the same idea. It’s fear. Fear that boys who play with dolls will grow up to be lesser men and turn into sissies. Fear that girls who play doctor will learn to call the shots and somehow be less desirable than their more demure counterparts. Fear that things are working well enough, and shaking them up will result in some sort of societal net loss. The thing is, that doesn’t pass the sniff test. The age-old gender roles don’t do most of us any good. They certainly don’t give kids much of a choice. At their best, these unrealistic expectations instill guilt and insecurity in anyone brave enough to buck the norm. At their worst, they hold kids back from becoming their best selves. Don’t we want a world where our kids thrive because of their passions, not despite them? We won’t change the system overnight, but we can start with leading our sons and daughters down the “wrong” toy aisle and encouraging them to dream of a world where unicorns and robots are for whomever wants to have fun with them.

QUALITY CARE AND EXCELLENT PATIENT OUTCOMES START WITH THE NURSES AT ACH Auburn Community Hospital Honors Our Nurses Auburn Community Hospital recognizes and honors the over 400 nurses that work in our Hospital network. Chances are the first encounter you will have when you come to Auburn Community Hospital or a physician’s office will be with one of our nurses. We want our community to know that no matter what brings you in, no matter which of our providers, offices, or medical services you may need, we’re all connected by more than just our name. We’re connected by our commitment to your health and our community. The impact our nurses have on our community is enormous. Our nurses are moms and dads, family members, friends and neighbors. You will see them at school events, local restaurants, grocery stores, churches and various other events throughout the area. They work in our community because it is extremely rewarding to take care of people who are friends and neighbors. Our nurses are part of a team that work tirelessly every day to achieve our mission of compassionate, quality care. The individuals on this talented team are not only our colleagues, but our friends, neighbors, and fellow community members. We are a team, and all of us share the goal of making sure a patient visit is the most positive experience we can deliver, together. Our message to our patients, friends and community leaders is that Auburn Community Hospital provides remarkable care every single day—24/7 and it all starts with our nurses.

May 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Golden Years


Things You Need to Know About Hearing Loss By Ernst Lamothe Jr.


osing your hearing can be a scary experience. The unknown or panic of decreasing hearing ability can send many people into depression or nervousness and even cause them to withdraw from important social interactions. Hearing loss can be so gradual that some people don’t notice the effects until it is too late. There are many things about hearing and hearing loss that people don’t know and hearing specialists are available to help people navigate this information which can reduce many of their fears and concerns. “The main effect of hearing loss is a person’s inability to participate in many social situations,” said Douglas Brown, audiologist at dB Audiology Associates, PC in Syracuse. “They have greater difficulty understanding words in noisy situations whether you are in a restaurant, party or any large group setting. People who are experiencing hearing loss are not enjoying their activities as much as they could be.” Brown, a New York state licensed audiologist who has been providing services in Central New York since 1973, discusses five pieces of information about hearing loss.


Over time people will experience hearing loss Our lives are very noisy as a whole let alone if you work in a factory or in construction. It doesn’t have to be incredibly loud for damage to happen to your ears; even lower level noise for extended exposure times can cause permanent issues with our hearing. Many people use power tools and partic-

ipate in recreational activities that produce harmful sound levels, such as attending loud sporting events, music concerts. When these activities are repeated over time, the risk of hearing loss increases. “People are losing their hearing faster than they should because many of our recreational activities are noisy,” said Brown. “It could be powerboats, the music we listen to, lawn mowers, motorcycles and other loud sounds in our lives. We are seeing an increase in younger people who are experiencing hearing loss. We advise people to either limit their exposure to these loud sounds or wear protective ear plugs.”


Hearing loss can strain a relationship Some situations where an individual won’t be able to hear others can produce irritation for the speaker and listener. “When you have to ask someone to repeat something several times, it can be a frustrating issue for all involved,” said Brown. “Nobody wants to repeat themselves or have to ask to have anything repeated. It prevents people from feeling like they are truly engaged and connected to any activity because they are only hearing bits and pieces. This could cause them not to want to interact with others and isolate themselves.”


There are many different types of hearing loss. The job of an audiologist is to determine the appropriate treatments for hearing loss once you receive an official diagnosis. There are various causes of hearing

loss from natural to genetic to allergies. “Not every condition can be easily treated or resolved. Some occur because of genetic disorders and can be corrected with surgery, other times the problem is based on blood flow issues in the inner ear or you can have infections or tumors in the ear,” added Brown.


Hearing aids are advance In the 21st century, there have been significant advances in hearing aids. Manufacturers have made improvements by developing hearing aids that are more effective for various types of hearing loss. That includes those specifically made for high frequency hearing loss, along with better feedback, noise reduction, rechargeable batteries, and connectivity to Bluetooth technology. Digital hearing aids, with the aid of computer programming by the audiologist and a computer processing chip in the device help convert incoming sound so that it can be amplified to an individual’s specific needs. They also analyze the listening environment every couple milliseconds to determine if noise reduction assistance is needed. They are quite complex. “People are wearing computers for hearing aids,” said Brown. ”They have become more sophisticated. They do an incredible job at keeping the background noise to a minimum while enhancing speech volumes. They really are adjustable to each person’s desire.”

Who Will Speak for You?


early nine out of 10 Upstate New York adults are aware of the term, “health care proxy,” according to a survey commissioned by Excellus BlueCross BlueShield. Among respondents who had heard the term, 89 percent know that it is a way to legally designate someone as your health care agent to represent you during a medical crisis if you can’t speak for yourself. Despite high awareness and knowledge of the health care proxy term, the survey also revealed that only about four out of 10 Upstate New York adults have completed a health care proxy form to designate a spokesperson who will represent them if they can’t represent themselves. “That’s disappointing because so many people have had the experience of making gut-wrenching medical decisions for loved ones who were unable to communicate,” said physician Patricia Bomba, vice presiPage 20

dent of geriatrics at Excellus BCBS. According to Bomba, advance care planning can make those decisions easier. “Conversations change lives. It always seems too early, until it’s too late,” she said. ”Advance care planning lets you authorize someone you trust to make your health care decisions if or when you can’t make them yourself.” Excellus BCBS encourages all adults ages 18 and older to start conversations with their health care providers and then extend them to family members and trusted friends. The goal is for all adults to have conversations and complete a health care proxy to choose and formally name a health care agent who is aware of their values, beliefs and goals for care and treatment and is willing to speak on their behalf. “It’s not just for older adults or for people with a serious illness,” said Bomba. “Anyone can suddenly lose the ability to make his/her own

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

medical decisions about the treatment they wish to receive, and what they would like to avoid.” Bomba breaks advance care planning down into five easy steps: 1. Learn about advance directives (New York state health care proxy and living will). 2. Remove barriers to completing advance directives. 3. Motivate yourself by watching testimonial videos at CompassionAndSupport.org. 4. Complete your health care proxy and living will. Talk to your family and physician or nurse practitioner about what matters to you. 5. Periodically review and update your advance directives. Excellus BCBS led the development of a free community website, CompassionAndSupport.org, that includes information on advance care planning, free downloadable forms and instructional videos. The health plan also actively pro-

Douglas Brown, audiologist at dB Audiology Associates, PC in Syracuse.


Pay attention to symptoms There are those who have the most common type of high frequency hearing loss and they are able to hear deep loud voices, but struggle to hear birds tweeting and consonant sounds like “s” “f” and “th.” These high frequency losses make it so you can hear the speaker talking but can’t always make out what is being said because of an inability to hear certain speech sounds. When someone first begins to experience decreased hearing, certain symptoms come to the forefront. That includes muffling of speech and other sounds, difficulty understanding words especially when in in background noise and crowds, trouble hearing consonants, and frequently asking others to speak slower, clearer or louder. “By the time most people come to see an audiologist they have been dealing with the problem anywhere from seven to 10 years.” said Brown. “Hearing loss is gradual and most people don’t notice it right away. But pay attention to some of the symptoms and get your hearing check just to make sure.”

motes National Healthcare Decisions Day, observed on April 16, to encourage family discussions and advance care planning. “Your family, friends and physicians need to know your preferences for medical care,” said Bomba. “Advance care planning gives you peace of mind in knowing that your wishes for care will be represented, and the conversations it stimulates also give your loved ones the confidence they’ll need to be able to speak for you.” Excellus BlueCross BlueShield’s infographic titled “Who Will Speak for You?” prompts advance care planning conversations between adults and their physicians or nurse practitioners. The infographic is being made available to doctor’s offices throughout upstate New York. To start your own conversations, download the infographic, Who Will Speak for You? at https://bit. ly/2XRpeni. Additional advance care planning resources are www.CompassionAndSupport.org www.nhdd.org

Golden Years

Specialists in Integrative Oncology, Gastroenterology, Acute Tick Bites & Treatment of Lyme Disease Amy Lazzarini, MD, MSHS

Integrative Gastroenterology Integrative Lyme Disease Treatment Mold Related Illness (CIRS)

Medical Marijuana: A Boon for Older Adults? By Deborah Jeanne Sergeant


he incidence of pain affecting older adults is considerable: half of this population who live independently and about 80% of those who live in long-term care facilities suffer from chronic pain, according to the National Institutes of Health. As medical marijuana gains traction across the US, should older adults seek its use? That depends upon whom one asks. Physician Az Tahir, who practices holistic integrative medicine at High Point Wellness in Syracuse, said that many of his older patients have “reported beneficial effects of medical marijuana and canabidoil.” To take medical marijuana, patients must have physician approval to obtain it at a legal dispensary. Cannabidiol , also known as CBD, is a supplement from the hemp plant which contains only minute traces of THC, the compound inherent to marijuana that causes hallucinogenic effects. It’s available over the counter since it’s a supplement and therefore not regulated by the Food & Drug

Administration. “A lot of chronic pain patients had spoken about this,” Tahir said. “It’s very, very beneficial. I don’t see much risk involved with CBD or medical marijuana for chronic pain.” He added that conferring with a doctor about taking either is a good idea to avoid any negative prescription interactions. For a generation that took recreational marijuana, taking prescribed marijuana may seem a more natural course than conventional pain medication; however, physician Sharon Brangman, who serves as chief of the Department of Geriatrics at Upstate University Hospital, offered a word of caution. “It’s an area where we don’t have a lot of science, where we don’t know how it affects older adults,” Brangman said. She added that many patients ask about medical marijuana or CBD, but with few studies as to their safety and efficacy for older adults, these are not something easily recommended. If medical marijuana isn’t smoked but taken orally or topically,

the experience may be quite different for those who experimented with it recreationally in the past, since its effects take more time to begin and last longer. Part of that may be because medical marijuana is more of a nutrac eutical containing many different compounds than a lab-derived pain medication. Consistency in the product can be hard to achieve. “Using CBD oil topically probably has little problem,” Brangman said. “TCH and CBD taken orally can interfere with the metabolism and breakdown of some medications, like some used for acid indigestion, anxiety and depression. It interferes with anti-psychotics, caffeine absorption and blood pressure medicine. People should not think THC and CBD are completely side-effect free. We don’t know the long-term side effects, either.” The age of the patients involved also can make a difference. In their 20s, their faster moving metabolism handled marijuana differently than now, when a slower metabolism, other medication and age-related disease processes can impact how marijuana

dB Audiology Associates, PC 5992 East Molloy Road Syracuse, NY 13211


Hearing Measurement services and advice provided by a NY State Licensed audiologist who has been providing professional hearing care to Central NY for over 40 years.

affects the body. Brangman said that further research could help physicians know whether medical marijuana could help older adults; however, like any medication, it’s a tough age group to study because most have several health conditions and other prescriptions. Long-term studies are difficult because their health status can change over the years, which complicates the study. “As a result, many medications are tested on younger people who are healthy and we have to see if they make sense for older people,” Brangman said. “There are many things we have to build into these studies to accommodate the needs of older people.” She foresees many years’ research before physicians can have the answers they need to recommend medical marijuana or CBD oil for older adults. In the meantime, anyone interested in these items should discuss contraindications with their doctor. n See story “Marijuana and its

effect on male fertility” on page 14.

Services / Products Available:

n Baseline and monitoring testing for chemotherapy and other hearing – harmful medications n Hearing measurements for personal (medical, communication) or occupational (OSHA, DOT, law enforcement) purposes. n Hearing protection counseling and devices for loud recreational (music listening, hunting, motor sports, landscaping) and occupational (professional musicians, fire and police personnel) activities. n Hearing aid selection, fittings and repairs n Tinnitus evaluations and treatment. n If you have any questions or concerns regarding your hearing or how to protect it.

Give Doug Brown a Call!

315-410-1295 By Appointment

May 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 21

Golden Years

Elder Abuse On the Rise in America

CDC: Family members commit most of the violence


s the American population ages, elder abuse rates are increasing, particularly among men, federal health officials reported in April. Between 2002 and 2016, the rate of assaults among men 60 and older jumped 75%, while it rose 35% among women between 2007 and 2016. Among older men, the homicide rate increased 7% between 2010 and 2016, according to the U.S. Centers for Disease Control and Prevention. “We are still examining the circumstances that appear to be associated with the increase in violence against this age demographic,” said lead researcher Joseph Logan, from the CDC’s National Center for Injury Prevention and Control. “We have identified that many of the assailants were known to the victims and in a position of trust,” Logan noted. Physician Ronan Factora, chairman of the Special Interest Group on Elder Abuse and Mistreatment at the American Geriatrics Society, thinks the problem is probably even worse than the report suggests. “These data underestimate the extent of elder abuse in America,” he said. “We probably underestimate the amount of physical violence, because this study only used records from emergency departments.” Many more cases of abuse were

probably seen by private doctors or not reported at all, said Factora, who had no part in the study. “This is really a small fraction that represents a larger problem that has been growing,” he added. The biggest issue is that most elder abuse isn’t recognized, Factora said. That’s because there isn’t a standard way to screen for it or recognize it. Factora believes, however, that elder abuse is gaining more visibility, which may be part of why it’s seen as increasing. “As the years have gone by, elder abuse has become more highlighted and thus better detected,” he said. “But the increase is not just a demographic issue.” Factora said that much of the abuse among people who are physically or mentally impaired is perpetrated by caregivers who are stressed out by the demands of caring for a loved one. Still, “abuse can have lasting effects that aren’t reversible after a certain point,” he said. “People who need help with transportation, finances and medication put a lot of burden on caregivers,” Factora said. According to the CDC report, it’s family members who commit most of the violence. “A lot of this

is because of the demands placed on them for care, which really puts a stress on them,” Factora said. Unfortunately, many seniors are in jeopardy because of their physical or mental condition, and can’t defend themselves, he said. Abuse is really related to dependency, Factora explained. Help in finding ways to cope with the burden of caring for someone is available. Perhaps if more people took advantage of programs for family caregivers, a lot of elder abuse could be stopped before it starts, he suggested. “The resources are there. The problem is connecting the caregivers who are burned out with the resources that can help them,” Factora said. The best way to deal with elder abuse is through awareness of all its forms. This study deals with physical abuse and murder, he pointed out, but abuse also includes neglect and financial exploitation. Often a person is the victim of several kinds of abuse. Someone who is physically abused can also be neglected

Hundreds of Cases of Elder Abuse Registered in CNY


lder abuse in Central New York is more prevalent than many people may realize. According to the New York State Committee for the Coordination of Police Services to the Elderly 2014 Annual Report, Onondaga County registered 156 cases of domestic abuse committed against those 65 and older. Oswego County saw 97 incidents, Cayuga had 36 and Madison had 30 cases. The report further determined that only one in 24 cases of elder physical abuse in the community is ever reported to authorities, indicating the problem is far more widespread. The report provides the most recent local information available. Stacie France, community response coordinator for Oswego County Opportunities, Inc. in Os-

Page 22

wego, said that seniors don’t speak up for many reasons, including “fear of retaliation for reporting the abuse and fear the abuse will get worse after they report,” she said. Abusers typically cut off the senior from the use of the phone, transportation and anyone outside. In cases where the abusers provide most or all of the care, they use that responsibility as leverage. Many people find it much easier to report when the perpetrator is a stranger than to see a loved one get in trouble. “A lot of elderly victims want to maintain a relationship with the abuser,” France said. “They just want the abuse to end.” Many also fear they’ll have no place to go and will lose their possessions if their family member won’t care for them anymore. France added

IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

that moving seems unimaginable and unaffordable to many at this age. “Many victims of abuse are isolated from friends, family, social support networks,” France said. “The abuser may be all that they have.” The extent of control and abuse may have increased gradually and kept so quiet that victims think no one will believe them. Elderly victims may be marginalized by those who hear their story, as the caregiver rationalizes signs of abuse “by saying the person fell, they’re frail, bruise easily, it happened while trying to bathe or change the person or move them, the victim has Alzheimer’s or dementia and they can’t be believed, etc,” France said. While some elderly persons receiving care may face cognitive challenges, they could still accurately relate what happened to them.

and financially exploited. Factora believes that if you see or suspect someone is a victim of elder abuse, you should report it to adult protective services. “We need to find these cases, and once we find how big this epidemic is, that may be a push to identify the abuse we don’t see,” he said. “What we are seeing is the tip of the iceberg.” For the study, researchers used data from the U.S. National Electronic Injury Surveillance System -- All Injury Program and National Vital Statistics System to look for trends in assaults and murders among men and women aged 60 and older. The report was published April 5 in the CDC’s Morbidity and Mortality Weekly Report.

Where to Get Help For help, call:

• Onondaga County Adult & LongTerm Care Services: 315-435-3355 • Onondaga County Office for Aging: 315-435-2362 • Oswego County Office for the Aging: 315-349-3484 • Oswego County Opportunities’ Services to Aid Families 24-Hour Crisis Hotline: 315-342-1600 • Cayuga County Office for the Aging: 315-253-1226 • Madison County Office for the Aging: 315-697-5700 • Adult Protective Services: 315-435-2815 • New York State Office for the Aging Information Line: 1-800-342-9871 • New York State Crime Victims Hotline: 1-800-771-7755

“Ageisim is still very prevalent,” France said. “Our society tends to regard older individuals as debilitated, incompetent, unworthy of attention and autonomy.”

By Deborah Jeanne Sergeant

Golden Years

R-E-S-P-I-T-E Caregivers urged to get frequent breaks to avoid burnout

By Deborah Jeanne Sergeant


f you care for an elderly loved one at home, particularly one with memory issues, you should consider respite care. “Care giving is very, very challenging,” said physician Sharon Brangman, who serves as chief of the department of geriatrics at Upstate University Hospital. “Most of the caregivers we work with want to participate in the care but that doesn’t miniBragman mize how challenging it is to give that care.” She said that many times caregivers lack the perspective to realize their own stress level. Many caregivers feel guilty about leaving their loved one in someone else’s care; however, Brangman said that respite care often gives them the ability to provide better care, since people who feel burned out end up giving less-than-optimal care. “They’re exhausted but they can’t stop,” Brangman said. “Or they think they have a physical ability to change the course of a disease if they try hard enough. They have unrealistic goals in their role in the disease process. The hardest part may be reaching out to get help. Then it should get easier.” Respite services may be offered at a day program, at home for shortterm or long-term periods, or at nursing homes for long-term, such as for a vacation. The types of care for the elderly can include companion care, where meal preparation may be provided, but no personal care. The next level is a personal aide who might help with chores like bathing or toileting and reminders to take medication. The highest level of care is medical care, which includes assistance with taking medication. Changing the mindset about respite involves helping caregivers realize that respite is both good for them and their loved one. Many frail, elderly adults can’t get out much. Seeing a fresh face or visiting a senior center with activities can provide a pleasant diversion from chronic pain and boredom. Sara Sunday, aging services administrator with Oswego County Office for the Aging, said that some feel they can’t afford respite, not realizing the free, contribution-suggested and income-based options available. Caregivers can start with people

Finding Respite To locate respite services near you, contact New York Connects and at 800-342-9871 or www.nyconnects.ny.gov. Also, visit www.ongov.net/aging/ documents/AdultDayPrograms. pdf for Onondaga County or search for respite in all of Central New York at https://211cny.com. they know. When trusted neighbors, friends or family members ask what they can do to help, see if they can sit with your loved one for a few hours once or twice a month. Enlisting several helpers can offer you regular time away. Sunday said that volunteers can be very helpful. “It comes down to the trust of the person to leave their loved one in the trust of someone else,” she said. “We’re trying to work with the churches in the community in Oswego County to see if that’s something they wanted to bring to the community. It’s needed.” Free day programs are usually staffed by trained volSunday unteers. They usually offer programs certain days of the week or just a few days per month. Paid services can also help provide respite. Professional care giving facilities can include senior centers, which typically don’t provide personal care, senior daycare, which may provide personal care, and medical day care. Respite workers can also come overnight so caregivers can sleep better. Veterans enrolled for benefits with the Veteran’s Administration (VA) can receive in-home care or up to 30 days per year outside their home. The VA provides a caregiver support line and hosts special events in the community to help caregivers. The organization also counsels caregivers about the help available in the community. “To be the best caregiver, you need self care,” Sunday said. “You can get caregiver burnout. To be the best caregiver, you have to step back, take a breather, and go back refreshed with a clean frame of reference.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 23

Golden Years

End-of-Life Plans Baby boomers reflect the ‘I did it my way’ anthem of their generation even in funeral pre-planning By Deborah Jeanne Sergeant


ewer people are choosing the traditional embalming and casket burial in a cemetery, according to the area’s funeral industry experts. Though still a popular option, more people create their own fitting tribute. Baby boomers reflect the “I did it my way” anthem of their generation even in funeral pre-planning. “Funerals today are less formal, less religious and more personalized than in the past,” said Adrian Dowdle, director at Dowdle Funeral Home in Oswego. Over the past 60-plus years, his business has seen enormous changes, from the elaborate, four-day events commonplace in the 1960s, to simple, one-hour memorials favored in current times. Few want home funerals, but ask for more offbeat venues, like the family’s bar/restaurant, and more custom touches. Dowdle recalled a funeral of an Irishman who wished his pallbearers to wear green plaid sport coats. Other funerals have included a honor guard of golfers who in military fashion raise a club to cross instead of swords for the casket to pass under. Before another golfer’s funeral, a surviving son asked if he could place a golf ball in his mother’s casket. Dowdle laid a box of brand-new balls near the casket and thought nothing else of it until the pallbearers were carrying the casket down the church’s steep steps. “Tearful silence was broken by the sound of 24 golf balls tumbling from the top to the bottom of the solid wooden casket,” Dowdle recalled. Apparently, he had placed all of the balls inside. “I thought the noise would never end,” Dowdle said. “Each occurrence sounded like Mickey Mantle had just hit a homerun.”

Dowdle said that the son quipped, “I think Mom has enough golf balls to last her.” “The mourners exploded in laughter followed by applause,” Dowdle added. A moment of appropriate levity like this never would have happened decades ago, when funerals were typically more rigid, ritualistic affairs choreographed by clergy and funeral directors to the last detail. Donna Whitbeck, funeral director at New Comer Cremations and Funerals in Syracuse, also said that in recent years, fewer people follow the lead of clergy members for planning memorials or services, and even when they’re involved, they are not as in charge. “We’ve moved away from a traditional church-based spirituality,” Whitbeck said. “The way families think of spirituality determines how they think of death and what it means for them.” Some wish to display items related to their loved one’s interests and hobbies at a memorial service or funeral. Whitbeck recalled services that included an ATV, motorcycle and wearing a favorite team’s jerseys. “Then you’re celebrating their life and the things that are meaningful,” Whitbeck said. “That means more than going to church if they weren’t church-attending people.” Some choose to use video and technology to tell a story about the person’s life by creating a photo slideshow set to music. Some ask for a release of balloons, butterflies or doves after the service. Whitbeck said that cremation has been on the rise because of finances, desire for simplicity and the family’s environmental values. Families can choose biodegradable containers to bury under a planting. Some choose


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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

Balloons have been used in a number of funeral ceremonies recently. More families choose offbeat ways to to say goodbye to their loved ones. to bury immediately; others wait to bury them with a spouse, or spread them at a meaningful location, such as at a family camp. “They want their service and a celebration of life to be indicative of their life, not the traditional going to the cemetery,” Whitbeck said. Those who consider having no gathering at all, Whitbeck cautions that may not be the best way to go, as the opportunity to grieve can represent the first step in the healing process, as well as helping the community become aware of the loss so they can extend their support to the bereaved. Green burials align with the values of the environmentally conscientious. Usually, the body is buried within a couple of days, unless environmentally-friendly embalming methods are used. A simple, biodegradable coffin or shroud takes the place of an elaborate coffin. The body returns to the earth more readily and there’s no concrete vault involved. Usually, that means a “green” cemetery or green section of a standard cemetery. Some families have jewelry made from the cremated remains, such as diamonds (www.lifeGem.com, www. heart-in-diamond.com and www. lonite.com are three such vendors). The process can take months to complete, but processors use only a small amount of hair or ashes for lab-created gems. Some people choose to leave their body as a means of helping others. While indicating organ donation on the driver’s license is a simple way to leave a legacy, donating one’s entire body to scientific study can help medical schools train the next generation of physicians. In addition

to helping science, “there are some who may do it for financial reasons,” said Daniel A. Jaeger, licensed funeral director and technical director of the Anatomical Gift Program at SUNY Upstate Medical University. The organization hosts an annual memorial service for the families to honor their gifts and show how beneficial they are to medical students. “The families are happy to find out how their loved one help our students,” said physician Donna Mihaila, director of the program. Anatomical gifts are accepted only from those 18 and older and those of sound mind. The only disqualifying conditions include infectious or contagious disease, obesity and autopsy. The whole body must be surrendered, with the exception of the eyes if they are donated separately. Sixteen medical schools in New York maintain a donor program, including University of Rochester Medical Center. In addition to pre-registering, their loved ones know about their choice so the medical school is made aware of the donor’s death right away. Bodies must be accepted within 24 hours. Bodies remain with the medical school for about two years, after which time they’re cremated at the school’s expense. The cremated remains may be returned to the family or buried, if they wish. Upstate receives an average of 225 anatomical gifts annually. For more information, visit www. upstate.edu and search “anatomical gift program.”

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contact a broker or agent to assist you. See LocalHelp.HealthCare. gov to locate someone in your area. Short-Term Health Insurance If you can’t find an affordable ACA plan, you may want to consider short-term health insurance, which is much cheaper. These plans, which are not available in every state, are bare-bones health plans that provide coverage for three, six or 12 months – depending on state/federal rules. But be aware that short-term plans don’t comply with the ACA so they can deny sick people coverage, they don’t cover preexisting conditions and they can exclude coverage essentials like prescription drugs. To shop for short-term health insurance, visit eHealthInsurance. com or contact a local broker or agent via LocalHelp.HealthCare.gov.

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COBRA If you need health insurance coverage for less than 18 months, another option you may want to consider is COBRA, which allows you to remain on your former employer’s group health plan, but not every employer plan is COBRAeligible. Contact your employer benefits administrator to find out if yours is. In most cases COBRA is expensive, requiring you to pay the full monthly premium yourself. But, if you’ve already met or nearly met your employer plan’s deductible and/or out-of-pocket maximum for the year, and don’t want to start over with a new plan; or if you find your employer’s health plan to be better or more affordable that the other options, it makes sense to keep your current coverage under COBRA. 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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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 25

As we celebrate National Nurses Week, HCR Home Care thanks our dedicated nurses for their exceptional patient care!

The Social Ask Security Office By Deborah Banikowski District Manager, Syracuse

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it’s probably a good time to evaluate some financial “best practices” for the rest of the year. A good spring-cleaning can clear out the clutter to let you see a clear path for your future. Social Security is always here to help. Even if you just started working, now is the time to start preparing for retirement. Achieving the dream of a secure, comfortable retirement is much easier with a strong financial plan. Tip 1: Start Early Our online retirement planning resources are helpful to people at any stage of their career. Our many calculators, Benefit Eligibility Screening Tool, and disability resources are all available at www.socialsecurity. gov/planners. From here, you can read and download publications and also email and share with colleagues, friends and family. Remember, the earlier you start, the better chance you have at saving what you need. Tip 2: Be Informed We’re often asked, “What’s the best age to start receiving retirement benefits?” The answer is that there’s

and, ultimately, it’s your choice. The most important thing is to make an informed decision, based on your individual and family circumstances. To help you make that decision, see our retirement publications at www. socialsecurity.gov/pubs/?topic=Retirement. Tip 3: Estimate the Benefits You Might Get Knowing the amount of money you could get is pivotal in planning your finances. With the Retirement Estimator, you can plug in some basic information to get an instant, personalized estimate of your future benefits. Try out different scenarios, such as higher or lower future earnings amounts and various retirement dates to see the various potential effects on your future benefit amounts. Visit www.socialsecurity.gov/benefits/retirement/estimator.html. Social Security can help you spring into action and take control of your future with the proper planning tools. Share these online resources with friends and family so they, too, will have the tools.



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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 27

Crouse Announces the Creation of Crouse North North Country Affiliate Partners and Crouse Health establish entity to provide locally-based planning and increased access to clinical care in the North County


n December 2017, the boards of directors of Carthage Area Hospital, Claxton-Hepburn Medical Center in Ogdensburg, River Hospital in Alexandria Bay and Crouse Health in Syracuse announced a clinical affiliation to enhance healthcare quality and access in Central and Northern New York. As communicated at the time, the North Country affiliation with Crouse Health does not represent a merger or acquisition, but instead is providing the foundation to allow each institution to strengthen patient services in their respective communities while sharing best practices and expertise. Crouse North to Coordinate Centralized System Planning Since the four organizations announced the partnership, significant planning, sharing and collaboration has occurred, including the recent establishment of Crouse North. This new regional entity, which includes representatives from the leadership

and board of directors of each hospital, is overseeing the coordination of clinical and physician services in the North Country region. In addition to his role as CEO of Carthage Area Hospital, Rich Duvall has been named interim regional director of Crouse North until a permanent director can be recruited. “Crouse North provides the structure and strategic support to enable coordinated planning and provider recruitment moving forward,” says Duvall. “Our goal is to enhance access and care delivery for the communities we serve by developing an integrated, system approach to strengthen and grow clinical and operational services among the affiliated partners.” “With our strong focus on keeping healthcare local, this structure will allow us to identify clinical programs and services that may not currently be available to North Country residents, improve coordination of care between the partner hospitals and take advantage of Crouse’s affil-




THAN THE NATIONAL AVERAGE In 2017, the uninsured rate across upstate New York averaged just 4.0 percent. This maintains our region’s historically low uninsured rate. It compares with a New York state average of 5.7 percent and a national average of 8.7 percent. Our 2018 and 2019 rate increases in the small group and individual markets were among the lowest in upstate New York, which helped keep our local health insurance affordable and uninsured rate low.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

iation with Northwell Health,” adds Duvall. As part of the collaborative planning process, physician Walter Fink, has been named chief medical officer for Claxton-Hepburn Medical Center, further reinforcing and supporting current and future efforts to achieve enhanced integration of clinical services in the region. Fink also continues in his role as Carthage Area Hospital chief medical officer. Clinical Progress: Access to Care From a clinical standpoint, the affiliate partners have been working to develop a system of clinical care delivery that will enhance access to health services in a number of specialty areas. Planning discussions have involved numerous North Country-based physicians and board and medical staff leadership from each of the affiliate partners. Clinical areas currently being evaluated include urology, cardiology, neurosurgery/spine care and

Physician Seth Kronenberg, Crouse Health chief operating officer and chief medical officer. OB/GYN services, among others. “The model we are putting in place will have numerous North Country-based specialists sharing clinical services as needed at the partner hospitals,” said Crouse Health Chief Operating Officer and Chief Medical Officer Seth Kronenberg. The three North Country affiliate partners and Crouse Health continue to work together to implement current initiatives and to identify future opportunities to provide accessible, coordinated clinical care for North Country residents, including telehealth in the areas of endocrinology, cardiology and neurology/stroke care. “Working collaboratively, we have made solid progress in a relatively short period of time and through the establishment of Crouse North we look forward to building on and advancing the strategic goals that brought our organizations together,” states Kronenberg.

H ealth News

Roswell, Oneida Healthcare announce major gift

Roswell Park Comprehensive Cancer Center and Oneida Healthcare announced they have received a $1 million gift from an anonymous donor to their joint capital campaign. Along with other donations, this generous philanthropic gift will assist in the completion of a three-phase project that will provide expanded access to Roswell Park’s National Cancer Institute (NCI) level cancer care to residents of Central New York. As the first phase of the campaign, Oneida Healthcare and Roswell Park opened a new infusion center in Madison County in the fall of 2017, as part of a medical oncology affiliation with Roswell Park, which includes 12 infusion suites, four clinical exam rooms, a telemedicine conference center, and a consultation room. In June of this year the second phase, the Dorothy G. Griffin Radiation Oncology Center, will be completed as a joint effort between the two healthcare providers. The final phase will be the expansion of Oneida Healthcare’s imaging services with the installation of a new state-of-the-art 3 Tesla MRI, PET/ CT and a second 3-D mammography unit at the Alice M. Gorman Imaging Center. All three services will be conveniently located on the Oneida Healthcare campus. “The support of our generous donors continues to play a vital role in providing access to the highest quality of care, close to home,” said Gene Morreale, president and CEO of Oneida Healthcare. “With the continued growth of our oncology program and the expansion of our outpatient imaging services, we will be able to provide patients with stateof-the-art diagnostics, local access to NCI cancer care guidelines, and to the latest treatment options from a comprehensive cancer center ranked among the top 3% nationwide. Without our generous donors, this would not be possible.” The anonymous donation follows a $250,000 gift made to the campaign by Community Bank N.A. and Oneida Savings Bank Charitable Foundation in late 2018, to be given across five years and help cover renovations, construction and leading-edge technology in the new facilities. $100,000 will come from Community Bank N.A., and $150,000 from Oneida Savings Bank Charitable Foundation. Together with the gift from the banks, other philanthropic contributions and a $6.75 million grant awarded by the New York State Department of Health in 2016, this generous $1 million gift brings the total raised for the campaign to more than $10 million of the $12 million goal for the three-phase project.

St. Joe’s Cardiovascular Institute opens in Rome

Nationally-ranked St. Joseph’s Health Cardiovascular Institute has

opened an office in the Dorothy G. Griffin Cardiovascular Center at Rome Memorial Hospital in Rome. The practice will be staffed by seven St. Joseph’s cardiologists: Russell Silverman, medical cardiologist and director of St. Joseph’s Physicians Cardiology; Nishith Amin, interventional cardiologist; Michael Fischi, interventional cardiologist; Paul Hanna, medical cardiologist; Gangadhara Kabbli, medical cardiologist; Barbara Kircher, medical cardiologist; and Alan Simons, interventional cardiologist. St. Joseph’s Health is leasing office space in the Dorothy G. Griffin Cardiovascular Center at Rome Memorial Hospital for its new cardiology practice and plans to expand coverage over the coming months. Patients will have access to Rome Memorial Hospital’s state-of-the-art diagnostic cardiac testing, including nuclear cardiology studies, CT angiograms, exercise stress tests, electrocardiograms (EKGs), echocardiograms, Holter cardiac monitoring and vascular ultrasound. “Delivering high quality care in home communities is best for the patient, and we are bringing expertise from one of the top 15 cardiac care hospitals in the nation directly to patients in Rome,” said physician Joseph Spinale, chief medical officer at St. Joseph’s Health. “When open heart surgery or tertiary care is needed, patients from Rome will have a direct connection to the leading heart hospital in the region.” “When we affiliated with St. Joseph’s Health, it was with the primary goal of expanding patient access to needed services in the community,” said RMH President/Chief Executive Officer David Lundquist. “The statistics related to the impact of heart disease are staggering and the needs for cardiac care increase every year. “Providing quality cardiovascular care in our community is a critical component to a healthy community. St. Joseph’s Health shares our commitment to providing patients with high-quality, patient-centered care that is coordinated and easily accessible.” St. Joseph’s Health Hospital was recently named one of America’s 50 Best Hospitals for Cardiac Surgery according to a national study by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals.

Behavioral health systems announce merge Two of the region’s largest nonprofit behavioral health systems — Helio Health and Central New York Services — formally announced their affiliation and planned merger as Helio Health. With Central New York Services’ annual operating budget of $17 million and 248 staff, the combined companies will operate under a $70 million budget with 729 combined employees. John Warren, executive director of Central New York Services, will assume the position of vice president of residential construction and development and Jeremy Klemanski, president and CEO of Helio Health,

will serve as president and CEO. The combined resources include dozens of clinics and residential care centers, almost 800 employees, 10,000 people served, millions of dollars in charity care, community benefits and government program services. Helio Health has facilities in Syracuse, Rochester, Utica and Binghamton. “We are excited about building a more integrated behavioral healthcare network for our region,” said Klemanski. “We want people in our region to have access to the best behavioral health services available, and this merger helps us build toward that goal.” “The chance to join Helio Health in developing an integrated continuum of care for our most vulnerable citizens is a great opportunity,” said Warren. “Bringing our agencies together solidifies and enhances critical community services. Central New York Services is delighted to be part of this important step in enhancing the quality of community behavioral healthcare in our region.”

Hutchinson named community engagement manager Martha Hutchinson has been

named community engagement manager at Alzheimer’s Association, Central New York Chapter, a newly created position on its programs and services team. In this role, Hutchinson will oversee the chapter’s Hutchinson volunteer program, grassroots outreach and engagement of diverse and underserved communities. She will also direct Alztogether, the chapter’s social engagement program for individuals living with Alzheimer’s disease or other dementia. Alztogether facilitates museum visits, cultural experiences and hands-on activities intended to create meaningful connections between the individual living with the disease and their caregiver. She joined the chapter in 2016 as its volunteer and outreach coordinator. Previously, she was the youth and community programs manager for the Peninsula School of Art in Door County, Wisc. Hutchinson, a native of Ellison Bay, Wisc., earned a bachelor’s degree from the University of Minnesota-Twin Cities.

Sign for the Crouse Health’s Pomeroy Emergency Services at Crouse.


Crouse ER Recognized for High Care Standards for Older Adults

he American College of Emergency Physicians (ACEP) has awarded Crouse Health’s Pomeroy Emergency Services its Bronze Standard – Level 3 designation, which recognizes emergency departments in the U.S. that provide excellent care for older adults. The award is provided in partnership with the national Geriatric Emergency Department Accreditation (GEDA) program. Crouse’s emergency department accreditation signals to the public that the hospital is focused on the highest standards of care for the communities’ older adults. The GEDA program is the culmination of years of progress in emergency care of older adults. In 2014, ACEP, along with Society for Academic Emergency Medicine, Emergency Nurses Association, and American Geriatrics Society, developed and released geriatric ED guidelines, recommending measures ranging from adding geriatMay 2019 •

ric-friendly equipment to specialized staff to more routine screening for delirium, dementia and fall risk, among other vulnerabilities. The voluntary GEDA program provides specific criteria and goals for emergency clinicians and administrators to target. The accreditation process provides more than two dozen best practices for geriatric care. The level of GEDA accreditation achieved depends upon how many of these best practices an emergency department is able to meet. A Level 3 emergency department must incorporate many of these best practices, along with providing inter-disciplinary geriatric education, and having geriatric appropriate equipment and supplies available. Led by physician David Mason, Crouse’s Pomeroy Emergency Services is the newest ER facility in Central New York, providing care for some 80,000 patients annually.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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H ealth News

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St. Joe’s recognized for infant sleep education

St. Joseph’s Health was recently recognized by the National Safe Sleep Hospital Certification Program as a “Silver Safe Sleep Leader,” for its commitment to best practices and education on infant safe sleep. It’s one of the first hospitals in New York state to receive the title. “We are proud to receive this designation,” said Jonathan Chai, neonatologist at St. Joseph’s Health. “It proves our commitment to reducing sleep-related deaths in our community by utilizing a robust infant safe sleep environment policy and modeling safe sleep practices in our hospital.” According to the New York State Department of Health, the infant mortality rate in Onondaga County is 5.9 per 1,000 live births, and the rate in the Central New York region is 6.5

per 1,000 live births. “Sleep-related death results in the loss of more than 3,500 infants every year in the U.S.,” said Michael H. Goodstein, neonatologist and medical director of research at Cribs for Kids. “We know that consistent education can have a profound effect on infant mortality, and this program is designed to encourage safe sleep education and to recognize those hospitals that are taking an active role in reducing these preventable deaths.” “Providing the very best care for mothers and their babies is a top priority at St. Joseph’s Health,” said Chai. “We are already recognized as a baby-friendly hospital by WHO and UNICEF, which represents the gold standard of care for infant feeding. With this newest distinction, there’s no question St. Joseph’s is the best choice for expectant mothers.”

Harbor Lights Honors Retiring Dr. Jay Chapman


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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

arbor Lights Chemical Dependency Service recently honored physician Jay Chapman who retired as the organization’s medical director. Chapman served in that position since 2010 and received a plaque from Harbor Lights’ director Stanley Long. Chapman, who is an avid bird photographer, presented Harbor Lights with one of his prized photographs picturing a dove which he indicated is an image signifying the work done at Harbor Lights. The Mexico-based nonprofit provides outpatient clinic services to people with alcohol and substance abuse problems. It has provided these services for more than 25 years. Physician Amanda Ray has been appointed as new medical director for Harbor Lights.

Crouse Nurse Receives DAISYAward

Registered nurse Catherine Braudrick from Crouse Health Cardiac Care Center’s electrophysiology lab received in March the DAISY Award from Megan McCabe, cardiac services administrator, left, and Lynne Shopiro, interim chief nursing officer. In November 1999, the family of J. Patrick Barnes formed the DAISY Foundation as a way to express their profound gratitude to nurses for the work they do for patients and their families every day. DAISY is an acronym for Diseases Attacking the Immune System. Barnes died at age 33 of complications of idiopathic thrombocytopenic purpura (ITP), a little known but not uncommon auto-immune disease. In 2015, Crouse became a DAISY-affiliated hospital, and presents an award to a deserving nurse, selected by a committee, regularly throughout the year. The DAISY Award program at Crouse has been made possible through a donation from the Crouse Hospital medical staff.

“It’s difficult to isolate one specific event during which Catherine did not go above and beyond,” wrote the team that nominated Braudrick. “She exceeds even the highest expectations of care on a daily basis to every patient that she comes in contact with.”

For Jack it’s personal!

“She and I were one. What they did for her, they did for me.”

UPSTATE LEGACIES The appreciation is evident in Jack Gorham’s voice when he talks about the way Upstate University Hospital physicians, nurses, physician assistants and staff treated his wife Colleen throughout her 17-year journey with cancer.

Have you or your family experienced Upstate’s heart and


Jack wants to help maintain this level of care and compassion for future cancer patients. That is why he has remembered the Upstate Foundation in his will. That is his heart and hope.

Understanding firsthand how charitable gifts impact the lives of others can change the lives of those who give and those who receive. Your gifts have an immediate impact on the programs and services you care most deeply about. Thoughtful gift planning can help to minimize costs and maximize future impact of those gifts, helping to ensure your personal legacy continues long into the future. Would you like to learn more about high-impact, low-cost Legacy Gift opportunities that can help you meet your personal and philanthropic goals? For free and confidential information contact, or have your professional advisor contact, our planned giving professionals at 315-464-6490 or email HamiltoL@upstate.edu.

Impacting patient care, education, research, and community health and well-being through charitable giving.

www.UpstateFoundation.org May 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2019

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