PRICELESS

Furry Friends This Thanksgiving: A good time to be grateful for our furry friends. See “Live Alone & Thrive” column on page 8

n Related: Dog ownership associated with longer life Page 27 Physician Cristian Andrade started at St. Joe’s as a resident in 2003. He was recently named VP for medical affairs at the hospital.

CNYHEALTH.COM

November 2019 • ISSUE 239

Food for a Healthy Brain What types of food may benefit our brain the most? See page 16

Tying the Knot Tied to Longer Life Span, New Data Shows

Special Inside: 100 pieces of parenting advice. Page 10

Thank a Caregiver

Research also shows widowed have the highest death rate of all the categories Page 19

November is National Family Caregiver Month. Three caregivers share their experiences

Special Issue

INSIDE

Golden Years

ConnextCare Expanding in Oswego County

Starts on page 20

Parsnip, Anyone? Pity the poor parsnip. Often overlooked in favor of its more attractive cousin, the carrot, it begs for us to wake up to its distinct taste, versatility and rich nutritional profile. Page 17

5 Things You Should Know About Hypnosis National board-certified clinical hypnotherapist in Syracuse talks about how people can benefit from hypnosis, hypnotherapy. Page 14

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

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November 2019 •

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hen you have the flu, it may seem like nothing can make you feel better (or worse). However, relief may come from an unexpected place. Oddly enough, some foods may make your flu symptoms worse — or better — without you ever realizing it. The flu often makes consuming food difficult, as flu symptoms can cause nausea or stomach symptoms. Nausea can decrease the desire to eat, and gastrointestinal symptoms like vomiting and diarrhea can be triggered if food is consumed too soon. Eating nutrient-dense foods is useful no matter what kind of sickness you have. In fact, it’s especially important when you have a fever. But not all food is created equal. While comfort foods may be what you want when you’re not feeling your best, they’re not necessarily going to make you feel better. In fact, I’d suggest avoiding your go-to comfort foods, as you may end up developing a distaste for them if you consume them when nauseated. I’d suggest avoiding these four foods when you have the flu:

Caffeinated drinks and alcohol

Between elevated temperatures and increased sweating, dehydration is something to be cautious of when you have a fever. Caffeine and alcohol can make your symptoms worse (especially stomach-related symptoms), so I’d recommend sipping on water and other clear liquids throughout the day to stay hydrated.

Greasy foods

You’ll want to avoid foods that are difficult to break down and hard on your gastrointestinal system. Foods high in saturated fat should be avoided or limited, as well as fried,

greasy foods.

Hard to digest grains

The flu occasionally causes you to have an upset stomach, so sticking with foods that are easy to digest like simple/refined carbohydrates is recommended. Foods like dry saltine crackers, toast and pretzels are easy on your stomach and are most likely to be tolerated when you have the flu. That being said, foods that are higher in fiber are also harder to digest, so I’d recommend avoiding them at first.

Sugary food or drinks

You may think vitamin C rich fruit juices are the best things to drink when you’re sick, but most of these options aren’t nutritionally dense and can inflame your immune system. Again, I’d recommend sipping on water and other clear liquids to stay hydrated.

What should I eat instead?

Broth-based soups are a good choice when you’re sick, as they’re easily tolerated but will also help to replace any fluids and sodium that may have been lost. If you’re losing a lot of fluids from stomach issues (vomiting or diarrhea), drinks with electrolytes like sports drinks or Pedialyte will help keep you hydrated better than water. Once you’re able to tolerate liquids, try slowly moving to soft, bland foods that are less likely to trigger nausea. I’d also recommend consuming small, frequent meals once you’re able to eat, as an empty stomach can also worsen nausea in some people. Kasey Vavrek is a registered dietitian at The Ohio State University Wexner Medical Center.

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

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November 2019 •

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Meet

Your Doctor

By Chris Motola

Cristian Andrade, M.D. Research: Sleeping Less Than 6 Hours May Raise Risk of Cancer, Even Death

ot getting enough sleep may put some people at risk for much more than being drowsy the next day, a new study says. Middle-aged people with high blood pressure, Type 2 diabetes, heart disease or stroke could be at increased risk for cancer and early death if they get less than six hours of sleep a night, researchers reported early in October in the Journal of the American Heart Association. Specifically, those with high blood pressure or diabetes who slept less than six hours had twice the risk of dying from heart disease or stroke compared with people who slept six or more hours. Sleep-deprived people with a history of heart disease or stroke had three times the increased risk of dying from cancer during the study that spanned three decades. “Our study suggests that achieving normal sleep may be protective for some people with these health conditions and risks,” the study’s lead author Julio Fernandez-Mendoza said in a news release. He’s an associate professor at Pennsylvania State College of Medicine and sleep psychologist at Penn State Health Milton S. Hershey Medical Center in Hershey. But more research will be needed to determine whether increasing sleep through medical or behavioral therapies could reduce risk of early death, Fernandez-Mendoza said. The study looked at more than 1,600 adults who were categorized into two groups. One had stage 2 high blood pressure or Type 2 diabetes. The other had heart disease or stroke. Participants were studied in a sleep lab for one night between 1991 and 1998. Researchers then tracked their cause of death up to the end of 2016. In that period, 512 people died — one-third of them from heart disease or stroke and one-fourth from cancer. Fernandez-Mendoza said better identification of people with specific sleep issues would potentially lead to better treatment. “Short sleep duration should be included as a useful risk factor to predict the long-term outcomes of people with these health conditions,” he said.

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Started as resident and rose to the position of top doctor at St. Joseph’s Health. The Brooklyn native discusses his goals and why he chose to stay in Syracuse Q: You’ve been with St. Joe’s for a long time. How did you work your way up the ladder? A: I started with St. Joseph’s as a resident. I really liked it here. Being from New York City, I had assumed that I was eventually going to return there, but the culture here, which I really enjoyed, made it hard to want to pack up and go home. I really enjoyed being here. I ended up joining the hospitalist team here in 2006 as an attending [physician]. Worked as a full-time hospitalist for several years. I was asked to be a coordinating member of the team. I was the assistant medical director for about two years. Shortly after that I was asked to be chief of hospitalist services, overseeing both teams in the hospital and some of our regional programs. I did that for about five years, and was recently asked to step into the role of vice president of medical affairs. Q: Is your position entirely administrative? A: The position is mostly administrative, I’d say about 80% administrative, 20% clinical. Mainly because I do want to keep my clinical skills sharp. I’m not quite ready to give that part up. Plus, I think being clinical and visible on the floor keeps you in touch with the medical staff and a little more down to earth. So I don’t want to lose that part, for sure. Q: One of your main goals is to shorten hospital stays, correct? A: It’s a little complex because certainly I want to help us not just reach the efficiencies we need in today’s healthcare climate. And, of course, a big portion of that is decreasing the cost in care to the patient. But really more importantly it’s transforming the care that occurs in the hospital to be more patient-centric. When a patient stays longer than they should,

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

they are at risk of picking up infections or ending up severely deconditioned from not moving around. I think it’s a big patient quality and satisfaction issue. I think if you improve the quality of care, then the finances will fall into place and length of stay will decrease as well. Q: How can you reduce the deconditioning problem? A: When you’re ill, you feel wiped out and tired, and it’s good to let someone rest for a little bit. But once you start recovering from an acute illness, it’s really important to get mobile again. It improves your immune system. It keeps your lungs open. It keeps you from deconditioning further, which can actually make you sicker. So, mobility is a really key issue past the acute care phase of their treatment. We do focus on keeping people as mobile as possible. We have physical therapists for those who need a little bit more intervention if they can’t fully get out of bed, to help them regain some of the strength they lost during that acute illness. The more you incorporate that into your care, the better the patient does and the shorter the hospital stay usually is. Q: There’s been a big push toward using outpatient care where possible over the last decade or two. What role does inpatient care pay in that environment? A: The inpatient care setting has changed drastically since I started practicing, and I hear from my more mature colleagues that it’s changed even more drastically since they started. The focus over the years has really been to take care of the patient at home and in the community whenever possible. And even in the case of inpatient care, we’re trying to get the patient home and back into the community as soon as possible.

In the News Physician Cristian Andrade has recently been appointed St. Joseph’s Health’s new vice president of medical affairs (VPMA). Andrade has been with St. Joseph’s for 16 years. Family medicine-trained, he joined St. Joseph’s as a resident in 2003 and has served as a St. Joseph’s hospitalist since 2006. During that time, Andrade has assumed progressive administrative responsibilities, most recently as the regional medical director and chief of hospitalist services. Q: St. Joe’s has a well-known reputation for cardiac care. What’s another area in which St. Joe’s could reach that level of care with a little effort? A: I would say our ENT [ear, nose and throat] program is something we’ve been ramping up over the years. We’ve hired some ENT specialists practicing at our outpatient centers and some care at the hospital as well. I think we still have some opportunity there to serve our patients with expanded ENT services. In addition, over the last couple years, we’ve become a designated stroke center. It’s taken off very well, but there are still opportunities there as well. It’s a tougher market in this town, because we aren’t the only designated stroke center. Q: Cities like Syracuse have put a lot of effort into developing their medical industries. Coming from New York City, do you see smaller cities able to offer a similar level of care these days? A: I’m actually very impressed with the level of care we’re able to provide here in Central New York. Of course, cities like Boston and New York have big academic centers that we might lack here, but if you compare our cardiology and cardiac surgery and grades, the care you can receive here is sometimes even better than you can receive in those regions. We are able to attract some pretty talented physicians. Q: Beyond shortening hospital stays, what kind of impression do you want to leave on St. Joe’s? A: Just to reiterate, I get the sense that patients are more informed about the care they receive, just like any other product. So, I want to play a central role in making care more patient-focused. I also want to be a vote for the medical staff, who see drastic changes happening all around them. We need to keep them in mind as we’re making changes to the health care industry.

Lifelines

Name: Cristian Andrade, M.D. Position: Vice president of medical affairs at St. Joseph’s Medical Center Hometown: Brooklyn Education: University of Medicine and Dentistry of New Jersey in Newark; Wagner College, Staten Island; Advanced Executive Leadership for Physicians, Cornell University-HANYS Affiliations: St. Joseph’s Medical Center; Oneida Healthcare; Rome Memorial Hospital; Bishop Rehabilitation and Nursing Center Organizations: Society of Hospital Medicine Family: Married, four children Hobbies: Fishing, maintaining salt water aquariums, outdoor activities

Syracuse Has the Highest Multiple Sclerosis Diagnosis Rate in the Country

he multiple sclerosis diagnosis rate in the Syracuse area is higher than anywhere else in the country, according to a new study of medical claims by the BlueCross BlueShield Association. In examining medical claims from more than 41 million commercially insured members of BlueCross BlueShield companies, the study found that the national multiple sclerosis diagnosis rate was 24 per 10,000 commercially insured Americans in 2017. That same year, the multiple sclerosis diagnosis rate was 45 per 10,000 commercially insured people in Syracuse, the highest rate among the metropolitan statistical areas examined in the study. The New York state rate was 31 per 10,000 of those who were commercially insured. “It’s startling to see such high multiple sclerosis diagnosis rates in Syracuse and New York state, compared with rates in the nation as a whole,” said Excellus BlueCross BlueShield Vice President and Chief Medical Officer Richard Lockwood,

of the body. While multiple sclerosis symptoms vary, they often include progressive physical and cognitive decline. The cause of multiple sclerosis is not known, and there is no cure yet. Food and Drug Administration-approved medications can work to slow the course of the disease and its progression. More than 520,000 commercially insured Americans were living with multiple sclerosis in 2017, according to the report. This is the 27th study of the Blue Cross Blue Shield “The Health of America Report®” series. For more information, visit www.bcbs.com/ the-health-of-america.

M.D. “Other eye-opening facts in the community must continue its search report are that 75% of those diagfor a cure, along with its focus on nosed with multiple sclerosis are diagnosis, symptom management women, and that the average age of and treatment so that people who are someone living with multiple scleroaffected can lead a healthy, producsis is 47.” tive and fulfilling life.” The report also Multiple found that Sclerosis Diagnosis Multiple sclerosis lifelong Rates,is a2017 compared to the overall population, disease of the central nervous system (metropolitan statistical area data) commercially insured Americans that disrupts the body’s ability to with multiple sclerosis are: send neurological signals within and • Three times more likely to between the brain and other parts have behavioral health conditions, including major Source: BlueCross BlueShield Association. Multiple Sclerosis depression and substance Diagnosis Rate (per use disorder. • Two to three times 10,000), 2017 Region more likely to experience Albany-Schenectady-Troy, NY 28.2 chronic health conditions, such as hypertension and Buffalo-Cheektowaga-Niagara Falls, NY 36.4 high cholesterol. “With about half of New York-Newark-Jersey City, NY-NJ-PA 24.9 the people living with multiple sclerosis also Rochester, NY 33.0 battling at least one other Syracuse, NY 44.9 chronic health condition, it’s not surprising that on New York state 31.3 average, they lose 14.8 years of healthy life,” said National 23.9 Lockwood. “The medical

Variation from National Average Diagnosis Rate: 4.3 12.4 0.9 9.1 20.9 7.4 N/A

Healthcare in a Minute

By George W. Chapman

NYS Lags When it Comes to Vaccines

he personal finance website WalletHub tracked 18 key metrics to determine state vaccination rates among children and adults. The states with the best vaccination rates are: 1, Massachusetts; 2,

ACA Continues to Perform

While everyone running for president is espousing what they would do about healthcare, the ACA keeps chugging along. The designers and proponents of the ACA predicted that once insurers became more comfortable with their new markets, premiums would stabilize. They were right. According to BlueCross BlueShield Association, the median preliminary premium increase across 23 exchanges so far, for 2020, is an impressive 2.3%. This continues a trend of minimal (relatively) premium increases for the ACA over the past few years. A recent survey conducted by eHealth revealed a majority of commercial insurers plan to increase the number of plans they offer on the exchanges. All of this has occurred while Washington continues to dismantle and attack the ACA by eliminating the mandatory insurance requirement and reducing marketing support. As a result, the rate of uninsured Americans is now increasing. Over the last two years, 2017 and 2018, 2.5 million people decided to drop insurance. The ACA requires all insurers to rebate any

Vermont; 3, Rhode Island; 4, North Dakota; 5, New Hampshire; 6, Nebraska; 7, Delaware; 8, South Dakota; 9, West Virginia; 10, Washington. New York state ranks in the bottom 10 at No. 43. profits/surpluses over 20% of total premiums collected. Consequently, insurers owe a record $1.3 billion to consumers this year. The rebate is further evidence that insurers are doing well and that the market has stabilized. Most of the rebates will go to individuals insured via the exchanges versus those covered by large employer-sponsored plans.

Pre-existing Conditions

According to the Kaiser Family Foundation, about 54 million of us have a pre-existing condition that could have been declined (not covered) if not for the ACA. The fate of the ACA awaits a constitutional challenge in federal courts. Any “replacement plan” suggested by Washington or any presidential candidate would certainly have to include the ACA’s crucial provision covering pre-existing conditions.

Drug Information

Years ago, most physicians would get information on new drugs from a drug “detailer” or drug rep. They were employed by a drug man-

ufacturer and typically were paid a commission based on the volume of prescriptions filled in their market. Drug detailers would show up at a busy practice and get valuable time with the medical staff in exchange for drug samples, pizza, doughnuts, pens and coffee cups. Detailers would also sell several physicians at once by providing drinks and dinner at a local restaurant. Kickback regulations have severely limited the gifts detailers can give to physicians. Consequently, busy practices have reduced the access and time they allow detailers. Thanks to technology, more and more physicians are getting their drug information online. Only 54% of physicians say they see drug reps in person. About 40% of physicians do not give any time to drug reps. Physicians say drug companies are doing a better job of providing effective, non-promotional, educational information online. Busy physicians do not want to be “sold” on a drug. They want access to clinical information that helps them treat their patients.

Walmart University

Walmart’s 1.5 million employees can now further their education by obtaining a bachelor’s degree from “Live Better U.” The degrees are offered through Purdue University Global, Southern New Hampshire University, Bellevue University and Wilmington University. Employees will pay just $1 a day while pursuing degrees in health science, healthcare management, pharmacy technology, and optical care. Walmart will homegrow the professionals they will need to staff their 5,000 pharmacies, 3,000 vision centers and 400 hearing centers. Walmart is also trialing a full-service standalone clinic in Dallas, Georgia. The giant retailer plans to provide home healthcare in the future as well. November 2019 •

Future of Medicine

Large corporations, like Walmart, are sensing lots of opportunity in the healthcare industry. They are reacting to: fewer and fewer medical residents specializing in primary care every year; the predicted shortage of physicians growing to 122,000 by 2032; the fact that traditional providers of care are cash-strapped and slow to adapt; consumers are not getting what they want; and the overall cost of health is high. New players CVS and Aetna merged about a year ago. Still in the planning stages, they are committed to providing a high-tech healthcare experience utilizing artificial intelligence, virtual care (telehealth) along with their physical brick and mortar clinics. CVS plans to turn 1,500 of their stores into “HealthHUBs” which will focus on providing a variety of health services.

Healthcare Waste

According to a joint study from Humana insurance and the University of Pittsburg School of Medicine, a quarter of all annual healthcare spending — between $760 and $935 billion — is wasted. The study, published in the recent edition of the Journal of American Medicine, estimates that $266 billion of all waste is due to administrative costs associated with ever-changing billing, coding and quality reporting requirements. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

This Thanksgiving: A Good Time to Be Grateful for Our Furry Friends

s Thanksgiving approaches, we are reminded to slow down and set aside time to remember, reflect and be thankful. To be grateful. And to count our many blessings. This year, in addition to being thankful for my good health, my dear friends and family, and some new opportunities to learn and grow, I am filled with a deep appreciation for Scout, my 3-year-old English springer spaniel. I named her after the feisty little girl in “To Kill a Mockingbird.” Scout has enriched my life in immeasurable ways, and I can speak with enthusiasm about the joys of sharing my life and home with her. In doing so, I hope to inspire you — especially those of you who live alone — to give pet ownership serious consideration. Thanks to Scout ... I look forward to coming home and walking through my front door. No matter how stressful my day or how tired I might feel, I am filled with eager anticipation as I approach the entryway. My heart practically skips a beat. When I step inside, I am greeted by a full-body wag and some cheerful yapping that always make me smile. After I take off my coat, Scout and I enter into our welcome-home ritual: she pokes her head through my knees and I rub her ears until her hunger kicks in (which takes less than two seconds). It’s so good to be home! Thanks to Scout ... I get to experience — really experience — the outdoors and all the beauty, mystery

and drama that the weather and our four seasons hold. Scout insists we walk, run or play outside multiple times a day — rain or shine (or snow!). I consider her my personal trainer par excellence. While exercising Scout, I’ve witnessed breathtaking sunrises and sunsets. I’ve been soothed by the soft sound of raindrops on my umbrella. I’ve felt victorious against Nor’easters that threaten to rob me of my coat. And on crisp November days, I’ve been transported back to halcyon fall days in Ohio, where I grew up. Would I, on my own, spend this much time outdoors? Not a chance. In the dark of night or in bad weather, the comforts of home and a warm bed would prevail. Think of how much I would miss! Thanks to Scout ... I know the nearly indescribable feelings of contentment and peace when she is snuggled up against me during my morning meditation. At my side, with her chin resting on my lap, our breathing begins to synchronize, in and out, in and out. In these relaxed, mindful moments, I have no cares. No one can reach me. For a few precious minutes each day, the world has stopped, and it’s just me and my dog in blissful tranquility. Thanks to Scout ... I’ve met a wonderful and interesting assortment of dog lovers and their “best friends.” On our afternoon walks along the Erie Canal, Scout and I regularly meet and greet fellow two- and fourlegged walkers. Over the years, these

30+ years of experience Specializing in:

Gwenn Voelckers and her dog Scout enjoying some leaf peeping at Harriet Hollister Park at the end of Canandaigua Lake. acquaintances, some of whom have become friends, have turned our daily walking routine into a spirited and meaningful “canal connection.” When our paths cross, we exchange more than just passing pleasantries; we stop, chat and, mostly, laugh while our dogs get reacquainted and tangled in each other’s leash. I leave these encounters with a warm heart, so happy to be part of a community of devoted animal lovers. Thanks to Scout ... I’ve discovered my “inner parent” and am proud of her. Having no children, I used to wonder if I would have been a good mother and role model. Would I have been patient? Nurturing? Firm when needed? Calm in a crisis? Sacrificial? Scout has given me a chance to explore and express my maternal side, and to cultivate my caretaking skills. My relationship with Scout has led to increased self-awareness. She has helped me discover and develop some essential, as well as some elusive, parts of myself. Thanks to Scout ... I now have a deeper appreciation for the messiness of life, and how much joy and humor can be generated by the chaos and clutter of a lovable pooch. Scout reminds me that I’m not really in control, and that life can

march along just fine, thank you, despite the disarray and dog hair that blows like tumbleweed through my home. It’s a good life lesson. Thanks to Scout ... I am happier living alone. She’s a second heartbeat in my home, a loving companion and a source of never-ending amusement. Even listening to her chew her food makes me chuckle! We share a human-animal bond anchored in mutual adoration and unconditional love. For that special bond and blessing, I am grateful. If you, too, enjoy the companionship of a dog or cat, let’s be thankful for the countless ways our furry friends expand and enhance our lives. In their presence, every day can be Thanksgiving! 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

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Say hello to healthy.

59 dedicated physicians and healthcare providers. Say hello to a more convenient way to stay healthy in Oswego County. Formerly known as NOCHSI, ConnextCare offers a comprehensive set of services family and internal medicine, pediatrics, dentistry, psychiatry, social work under one medical group. Patients within our network can now visit any of the six locations at any time. And because we’re seamlessly connected, our staff can access your medical records at the touch of a button. It’s a faster, more convenient and easier way to keep yourself and your family healthy.

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.

November 2019 •

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Page 9

Parenting By Melissa Stefanec

MelissaStefanec@yahoo.com

100 Pieces of Decent Parenting Advice

little more than eight years ago, I became a mother. In the years since then, I have given my readers in a window into the madness and beauty I’ve encountered on my journey. Mothering is unique, in the truest sense of the word, in that no other job requires so much of you starting on Day 1. With those larger-than-life expectations comes a desperation to learn as much as you can. That’s why parenting-advice articles are so popular; we’re all a little lost and in need of consultation. In the 99 parenting columns preceding this one, I gave advice, shared successes and revealed failures; however, I often try to focus on what parenthood has taught me. Besides filling my life with love, being a mom has taught me more about myself, my marriage and my life than any other relationship or experience. My children have been catalysts of great change and my greatest teachers. It’s painfully corny but wildly accurate. So, to celebrate making it this far, I want to share 100 pieces of parenting advice. Some of these things are truisms that I couldn’t actually realize without the experience being a parent. Said another way, some of these things are so simple that only children could make me understand them. 1. Celebrate the small wins 2. Move past small annoyances 3. Pick your battles 4. Pick your battles (redundancy intended) 5. Save your energy for the people that matter 6. Value experience above things 7. A child’s laughter is healing 8. Encourage laughter from others 9. Don’t take yourself too seriously (seriously) 10. The best things in life are derived from hard work 11. Define success by how you make others feel 12. Good moods are contagious (so are bad moods)

13. When someone falls, help them up 14. Love heals wounds 15. People hear what you do, not what you say 16. Coach free will, don’t squash it 17. Don’t miss an opportunity to show love 18. Strong people say I’m sorry 19. Say I’m sorry with the same conviction you say I love you 20. Make more time to play 21. Too much screen time makes for monsters (of any age) 22. Memories are formed by quality time, not quality gifts 23. Give people your undivided attention 24. Allow yourself time to wonder at the world around you 25. Make time for books 26. When you mess up, own up 27. After owning up, try to do better next time 28. Make others feel how you want to feel 29. Choose your friends wisely 30. Overscheduling leads to madness 31. Be ready to leave 10 minutes early 32. Remind the people in your life how much they matter 33. Make a sane schedule and stick to it 34. Wear your heart on your sleeve and others will reveal their hearts 35. Don’t tell jokes at another’s expense 36. But do tell lots of jokes 37. Go to bed early 38. Everyone has their own struggles 39. Everyone is a natural at something 40. Silliness is invaluable 41. Forgiveness is freeing 42. You can only play with so many toys 43. Double check your work 44. A good night’s sleep is great emotional medicine 45. Ask before you touch someone 46. Read body language, not words 47. Physical contact isn’t owed 48. Life is more fun when you share 49. When things get hard, love harder 50. Sometimes, you will yell; apologize 51. Don’t ask more of others than you’re willing to give 52. Be the bigger person and others will grow 53. Host dance parties in your living room 54. Matching is overrated

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55. Take lots of pictures, but don’t lose the moment 56. When traveling, pack a change of clothes and some snacks 57. 75% of problems can be solved by sleep and food. 58. Tackle problems with a clear and open mind 59. Celebrate all of your birthdays 60. Most misdeeds are forgivable 61. Learning is an opportunity like no other 62. Keep asking questions 63. Respect others’ boundaries 64. When you see something beautiful, call attention to it 65. When you hurt someone, quickly say “I’m sorry” 66. Dress for the weather 67. Make lists; your memory will fail you 68. Value and employ organization 69. When someone is struggling, ask how you can help 70. Say thank you 71. Show your gratitude 72. Don’t force your hang-ups on others 73. Let parenting make you a better person 74. Sometimes, it’s ok to act like a wild animal 75. Be popular with the right people for the right reasons 76. Physical activity is integral to health 77. No one likes a tyrant, no matter the tyrant’s age 78. It’s better to laugh than get mad 79. But get mad about the right things 80. Plan for the worst; assume the best 81. Praise the good in people 82. Discipline from a place of kindness 83. Correct people to grow people not to belittle them 84. Take breaks when you need them 85. Taking deep breaths and counting to 10 actually is calming 86. Stay home when you’re sick 87. When someone says “stop,” stop 88. Smile at strangers 89. Smile at loved ones 90. Make people feel like they are worth coming home to 91. Taste buds change, so keep trying new things 92. Volunteer early in life, and it will be normal 93. Pets make for best friends 94. Make time to create things 95. Music and art are important (on so many levels) 96. Being outdoors fills up your soul 97. Speak to each other with respect and kind ness, even if you don’t agree 98. As annoying as it can be, keep asking why 99. Life is painfully and beautifully short, so don’t take it too seriously (see #9) 100. Be kind to each other, to yourself, to other creatures and the planet you call home To view Melissa Stefanec’s most recent columns, go to cnyhealth.com and select “Parenting” under the “Columnist” tab.

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Upstate Foundation to Establish Golisano Center for Special Needs By Deborah Jeanne Sergeant that welcome people with sensory related issues such as a multisensory area for children on the autism spectrum. “We’re trying to design it from the perspective of addressing the needs these kids have, as opposed to a doctor’s office that we’ll fit kids into it,” Roane said. “The primary focus will be pediatric, though we’ll see the occasional adult.” The center will need to hire additional nurse practitioners and physician assistants, plus around eight at the M.D. or Ph.D. level. Some of the administrative staff will come on board from other clinics within Upstate that are being rolled into the new center. Some of the services offered at Developmental Evaluation Center, Margaret L. Williams Developmental Evaluation Center and Family Behavior Analysis Clinic will be provided at the new center. Those organizations will continue operation. The Golisano Center for Special Needs will significantly increase the number of children with intellectual and developmental disabilities served by Upstate Golisano Children’s Hospital. “The center will enable us to increase capacity to 7,600 children per year, which is a 167% increase in unique numbers served compared to 2018,” said physician Gregory Conners, executive director of the children’s hospital. Roane said that the goal is to open the facility sometime in the first quarter of 2020. “Tom is a true philanthropist who gives for all the right reasons,” said Eileen Pezzi, vice president for development at Upstate Medical University. “We are proud to have Tom Golisano’s name on buildings throughout our campuses.”

From age 3 through fifth grade, there were no differences in emotional and behavioral health between children who had time-outs and those who did not, the investigators found. Rachel Knight, an assistant professor of clinical psychology at University of Michigan C.S. Mott Children’s Hospital in Ann Arbor, led the study, which was published online recently in the Journal of Developmental & Behavioral Pediatrics. “No differences were found with respect to child internalizing problems, including anxiety and depression, externalizing problems, including aggression and rule-breaking behavior, or self-control,” Knight’s team reported. The authors noted that time-out is one of the only child discipline The study included the children strategies recommended by the of nearly 1,400 U.S. parents. Of those American Academy of Pediatrics. Even though extensive research parents, 28% said they used timehas shown it to be effective, some outs when their child was 3 years online information and media reports old.

have claimed time-outs increase the risk of behavioral problems and damage parent-child relationships, the study authors explained. “Parents often resort to the internet and social media for guidance, but the internet provides inaccurate information for families regarding the use of time-out,” Knight and her colleagues warned. Research findings on the topic need to be offered in a “readily accessible and easily digestible format … to assuage possible parental concerns and promote the use of this highly effective child discipline strategy,” the study authors urged. However, as with previous research, the new study linked physical punishment to externalizing behaviors in kids. “We hope our findings will be helpful to parents who see confusing and at times alarming claims of negative side effects of time-out,” Knight said in a journal news release.

3 Sexually Transmitted Diseases Surging in U.S.

he number of people with chlamydia, gonorrhea, and syphilis is rising, according to a report by the Centers for Disease Control and Prevention, The information is part of CDC’s annual “Sexually Transmitted Disease Surveillance Report,” containing data from 2018. It was released early in October. In a companion press release, physician Gail Bolan, director of the division of sexually transmitted disease prevention, writes that this is the “fifth consecutive year of increases” for the three STDs.

STDs in numbers

Between 2017 and 2018, the number of gonorrhea cases increased by 5% to a total of 580,000 cases; this is the highest number of cases since 1991. As for chlamydia, cases hit the highest numbers ever recorded by the CDC. Compared with 2017, they were 3% higher, making a total of 1.7 million cases. The number of primary and secondary syphilis cases, which are the most infectious stages of syphilis, increased by 14% to 35,000 cases; this is also the highest level since 1991. Syphilis can pass between a mother and her unborn child, which doctors refer to as congenital syphilis. In 2018, there were 1,300 cases of syphilis in newborns, an increase of 40%. In all, 70% of congenital syphilis cases occurred in five states: California, Florida, Texas, Arizona, and Lou-

gift from Paychex founder and philanthropist Tom Golisano will enable the Upstate Foundation to establish Golisano Center for Special Needs at Upstate Golisano Children’s Hospital. The center is slated to provide comprehensive and coordinated medical and behavioral care for children and adolescents with a variety of intellectual and developmental disabilities. “It gives me great pleasure to contribute $3 million to Upstate Golisano Children’s Hospital to help create the Center for Special Needs, and improve and expand services for children with intellectual and developmental disabilities and their families,” Golisano said. “The number of children needing services and the number currently on the wait list is staggering. The expansion and co-location will help meet the growing demand for services and expedite patients’ progress toward healthy, productive lives.” Henry S. Roane, Ph.D., chief of development, behavior and genetics at the department of pediatrics, Upstate Golisano Children’s Hospital, said that the center will offer better care for these patients because it brings the services they need under one roof. “Syracuse and Upstate has had a number of disjointed programs serving the same general population for years,” Roane said. “One of the most frustrating things is there’s very little collaboration across these programs. By introducing a structure under a more uniform brand is a way to help bring that together. It gets people in the mindset of work together in the center.” The gift will enable Upstate to develop and renovate more than 10,000 square feet of existing space. It will offer more patient exam rooms and space for children to receive evaluations and therapy. The center will include accessibility and features

isiana. Congenital syphilis increases the risk of stillbirth, miscarriage, newborn death, and lifelong medical issues. Antibiotics can effectively treat all three of the above STDs. However, if they are left untreated, they can lead to infertility and ectopic pregnancies. STDs can also increase the risk of contracting HIV. These increases are particularly striking given that STDs had, seemingly, been on the ropes. As the CDC report states in the foreword written by D. Bolan, “not that long ago, gonorrhea rates were at historic lows, and syphilis was close to elimination.”

Why the increase?

Several factors are likely to play a part in the increase in STDs. According to the CDC press release, these factors include poverty, drug use and unstable housing, all of which “reduce access to STD prevention and care.” The CDC also noted a reduction in condom use among some at risk demographics, such as young people, and gay and bisexual men. Added to this, the CDC explain in the press release how certain financial restraints have played a part: “[I]n recent years, more than half of local programs have experienced budget cuts, resulting in clinic closures, reduced screening, staff loss, and reduced patient follow-up and linkage to care services.”

s d i K Corner

Giving Your Child a Time-Out Won’t Cause Long-Term Damage: Study

ime-outs don’t increase kids’ risk of emotional or behavioral problems, according to a new study that researchers say dispels misleading information.

November 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

My Turn

By Eva Briggs

Dog Bites

CDC: 4.7 million dog bites each year in the U.S.; about 800,000 of those require medical attention

magine that you’re taking a walk and pass someone holding onto a large dog that is lunging, barking and has its hackles up. The owner calls out, “Don’t worry, he’s just enthusiastic.” Should you believe them? My answer: no! Use your common sense and keep your distance to reduce that chance that you become a dog bite victim. You can quibble over whether the dog is enthusiastic, aggressive or fearful. But in any case, believe the signals that it is highly aroused, because a highly aroused dog is a bite risk. The CDC estimates that there are 4.7 million dog bites each year in the United States, and about 800,000 of those require medical attention. Dog bites account for about one-third of the dollars paid out by homeowners insurance. The average claim was a whopping $37,000 in 2017 —undoubtedly it’s even more now. As with most injuries, prevention is better than treatment. That includes supervising young children around dogs and teaching children how to behave around dogs. Chil-

dren suffer a significant proportion of dog bite injures. Their injuries are often severe because they’re low to the ground (easier for a dog to reach their faces) and small (easier to injure with a well-placed chomp.) Always ask before approaching or petting a dog. If the owner says no, believe them, no matter how friendly the dog seems to you. And if the owner says yes, but the dog’s behavior says no, believe the dog and don’t touch. Warning signs dogs may give before biting include: • Yawning, licking their lips and turning away to avoid eye contact — all signs of stress. • Baring the teeth, growling and snapping. • Tail wagging. This can be confusing. A happy dog wags their tail and wriggles the whole body. An uncomfortable dog may stand stiffly with a raised, slowly wagging tail. • Rigid body. • Fur standing up. • Seeing the whites of their eyes. Don’t run away, and don’t make loud squealing noises. That can trigger a dog’s prey drive, making it irresistible for the dog to chase and catch you.

There are certain situations that increase the risk that a dog will bite. Don’t disturb a dog that is sleeping, sick, injured, frightened or caring from puppies. A dog that is tied up, or in a car, may consider the area personal space to be defended. Permit a dog to sniff you before touching or petting it. Let the dog approach you. About half of dog bite injuries involve the family dog. Don’t assume a familiar dog won’t bite. Dog training and socialization, starting from puppyhood, is a good idea but beyond the scope of this article. What should you do if approached by an unfamiliar dog that you don’t want to interact with? First stop, stay still and don’t panic. Avoid eye contact. In a firm deep voice tell the dog “no,” “stop” or “go home.” Stand with the side of your body toward the dog. Directly facing the dog or making eye contact can be perceived as a threat. Slowly raise your hands to your neck, with your elbows in. Wait for the dog to pass, or back slowly away. If the dog does attack, place an object such as a purse, backpack, umbrella, or whatever you have between

you and the dog. If you are knocked down, curl into a ball with your head tucked in. Cover your ears and neck with your hands. If you are bitten, wash your wounds with soap and water, apply an antibiotic ointment, and cover with a bandage. Try to get contact information for the owner to determine whether the dog’s rabies vaccination is up to date. All animal bites should be reported to the health department. I recommended seeking medical attention for all bites. And definitely watch for signs of infection such as worsening redness, pain, red streaks, fever or pus. I love dogs, but stay safe out there. Eva Briggs is a medical doctor who works at two urgent care centers in the Syracuse region.

Be the priority:

MoreSchedule Women inyour Upstate Getting Screened for Breast Cancer mammogram TODAY Breast Among cancer women screening dataYork show thatbreast Upstate New York women make getting a in New state, cancer is the most common mammogram a priority cancer and the second-leading cause of cancer-related death.

pstate New York women between the ages of 50 and 74 are beating the national breast cancer screening goal, but two in 10 still do not get their recommended mammograms, according to a review of data issued in October by Excellus BlueCross BlueShield. The breast cancer screening rate in Upstate New York (82.2%) exceeds the national Healthy People 2020 goal (81.1%) established in December 2010 by the U.S. Department of Health and Human Services. In 2010, the overall breast cancer screening rate in the U.S. was 72.4%. “I’m pleased to see the high breast cancer screening rate among women in Upstate New York,” said physician LouAnne Giangreco, Excellus BlueCross BlueShield vice president and chief medical officer. “It shows that the message regarding the importance of screening is getting through.” The U.S. Preventive Services Task Force recommends that all women ages 50 to 74 be screened for breast cancer every two years. Some women may need to be screened earlier or more frequently. Drilling down into the latest

Page 12

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MAMMOGRAM

2 years An X-ray of the breast

that can detect suspicious areas that could be signs of cancer, even when they are too small to feel.

The U.S. Preventive Services Task Force recommends women ages 50-74 have a mammogram every two years.

Some women need to start getting mammograms earlier or have them done more often.

screening data, Excellus BlueCross detection is key, and mammograBlueShield found that some parts of phy is the most important screening Upstate New York are doing better test for the disease. A mammogram than others. Since the health insurer can detect a tumor up to two years last reviewed the data in 2014, breast before it can be felt by the patient or IS IT DANGEROUS? The potential benefits of early cancer screening rates increased in a doctor. cancer detection outweigh the risks of a small amount of the Finger Lakes, Southern Tier, and “Considering the effectiveness of radiation exposure. Utica/Rome/North Country regions, mammograms, we want to do everybut dropped in Western Central It can thing can to reduce obstacles WILL and IT HURT? be we uncomfortable forany some, New York. that prevent women from getting but the test only takes a few minutes and can save your life. Among women in New York screened,” said Giangreco. “New state, breast cancer is the most comdata from U.S. Census Bureau WHAT IF MY RESULTS AREthe ABNORMAL? About mon cancer and the second- of leading show that 96.5% the Upstate New 10 percent women are called back for of further evaluation. cause of cancer-related deaths. Early York population has health insur-

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

SCREENING SAVES LIVES

ance, so coverage isn’t likely to be as much of an issue as other barriers to care may be.” “The test only takes a few minutes and can possibly save a life,” said Giangreco. “The potential benefits of early cancer detection outweigh any perceived or potential risk.” A woman’s risk factors determine when she should begin getting screened. • All women ages 50 to 74 should be screened for breast cancer every two years. • At age 40, women at average risk should discuss with their doctor when to start screening. • Women at high risk or with a family history of breast cancer should talk with their doctor about the right age and frequency of screening. For tips on making breast cancer screening a priority, view a downloadable Excellus BlueCross BlueShield poster at https://tinyurl.com/ EXmammo. Learn more about breast cancer risk factors and screenings by talking with your doctor, or by visiting the U.S. Preventive Services Task Force website at http://tinyurl.com/ USPSTFbc.

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Study: Hospital Patients Benefit from Presence of Flowers Local professionals agree: Plants, flowers have positive effect on hospital patients By Deborah Jeanne Sergeant

o you know someone who’s ill or injured? If you’re going for a visit, chances are you’ll likely bring along a gift as good manners. But taking a bouquet or plant to a friend admitted to the hospital or recuperating at home is more than just a thoughtful gesture. A gift of flowers may actually help the patient get better. A study by the American Society for Horticultural Science indicates that post-surgery patients between ages 19 and 60 recovering in 40 hospital rooms with 12 plants and flowers had measurably lower blood pressure and heart rates than the 40 patients in control rooms with no plants or flowers. Patients with foliage also reported less pain, reduced need for pain relievers and lower levels anxiety, plus greater patient satisfaction rates than the control rooms that were identical in every way, including the rooms’ views, except for the lack of plants. The patients were aware that the study provided the plants and flowers. “People feel more comfortable in an environment where there’s a sense of life,” said Scott Mooney, Ph.D., co-founder of Beacon Psychological Services, PLLC in Oswego. “People feel grounded by nature and plants. Signs of life are helpful to someone’s recovery. It can help their Mooney immune system. Anything that can help patients to feel more relaxed may positively affect the body’s ability to heal.” Many studies indicate access to nature as beneficial to patients, such as a hospital window facing a park, photos of peaceful nature scenes or even viewing the color green. Flowers in a hospital room could provide another means for patients to

connect with nature since going for a walk won’t work for most patients. “This piece of research builds on prior research that shows a view of nature through the hospital window versus a brick wall results in significantly shorter length of stays in the hospital, less use of pain reliever and fewer negative comments from the patients to the nursing staff,” said Richard O’Neill, Ph.D., professor in the department of psychiatry at Upstate Medical University. “I think this seems like a relatively easy way to help people feel less anxious and recover faster in the hospital. The intuition of people who bring plants in a hospital is correct. It helps to make people feel better.” Plants and flowers also offer a distraction from pain. The study’s abstract said that the flowers provided “effective positive distraction, which may provide ample involuntary attention, increase positive feelings, block or reduce worrisome thoughts and promote restoration from stress.” O’Neill said that he has also read that a study of patients with a view of nature in an office setting versus no view of nature achieved similar findings with patients feeling less anxious, less nervous and less distressed. O’Neill thinks part of the “green” effect is that the plants improve indoor air quality. But the feeling that their room was special also improved their outlook. A room decorated with stuffed animals or balloons might have a similar effect since gifts make a room look more personal and less clinical. Any gift from a friend would provide an emotional lift and some physical benefits. “The most important thing in terms of happiness is a sense of having good relationships with other people,” O’Neill said. “This study didn’t raise this issue about how many people came to visit, but one of the most important things is going to visit so you feel connected to those who care about you. You’re not all by yourself suffering. People would interpret the plants like someone cares.”

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Page 13

Things You Should Know About Hypnotherapy By Ernst Lamothe Jr

ith people seeking various non-medical, non-invasive treatments to heal various issues in their lives, hypnotherapy has slowly gained traction as an option. Hypnotherapy is a type of guided hypnosis used among psychological and medical treatments. Treating anxiety, depression, addictions and facing fears, hypnotherapy can improve sleep and quality of life. “Hypnotherapy can help improve and resolve relationships, address grief issues, resolve issues with anger management and, most importantly, boost self-confidence and assertiveness,” said Karen Schwartz, a national board-certified clinical hypnotherapist at Transformative Services in Syracuse. Throughout her experience, Schwartz gives some insight and describes her field of work and why she continues her work in hypnotherapy. Here are five things to know about hypnotherapy.

background in different therapies in order to master the techniques of hypnotherapy.”

Counseling

Hypnotherapy is more than just hypnosis, but it offers beneficial services such as counseling. Counseling addresses several problems such as marital issues, behaviors, self-esteem, eating disorders and many more. “Each situation is handled differently, depending on what the patient is looking to resolve within themselves,” explains Schwartz, who has a master’s degree in psychology. “It is important to get an understanding of how a person ended up in the situation they are in and other leading factors that may be affecting them.” Once the therapist grasps a better understanding of the situation, then the effects of hypnosis can begin to alter the mind.

Pain management tool

Many people do not consider hypnotherapy as a medAlthough patients want ical treatment, but it is an effective immediate relief of their symp- tool for pain management, addictoms or illnesses, they mentally have tions, injuries and depression, said to put it in their heads that they want Schwartz. Hypnosis is also a great to heal and that they will get better. tool for removing emotional pain in “It’s not just the therapy methods which many people suffer from on a and experience that work to help daily basis. Prenatal hypnosis is anease these symptoms, but it is rather other common form of therapy that the willingness of the patient that more pregnant women are starting to they heal over time,” said Swartz.” consider. 18.XXX_Urology_MeetTheTeam_Horiz.qxp_Layout 1 11/14/18 9:28 AM Page 1 It is crucial for therapists to have a The main area in the body that

Mind over Matter

hypnotherapy targets is the brain. The brain controls all of our sensory integration, and with hypnosis it allows the body to feel sensory sensation causing the body to feel more calm and worry-free.

You might need multiple sessions

Anyone expecting a quick one session fix for their specific issues must understand that is not how hypnotherapy works. “Each person enters the office with different worries or issues they would like to resolve within themselves, and they have to understand that it can take many sessions to resolve,” said Schwartz. “Everyone heals differently, so someone can feel better with just one session and with others it takes several sessions to see results. Many people suffer from multiple things rather than just one or two, and in this case, Schwartz mentions that each session will work on healing one part of the body at a time rather than focusing on healing everything altogether. In reality, healing takes time whether that is one week to a whole year, so it is important to always listen to your body.

Triggering different emotions

Like regular therapy, many of our bad habits, experiences or phobias will come up in the sessions. While fear is natural and a healthy response to danger, espe-

Karen Schwartz is a national boardcertified clinical hypnotherapist at Transformative Services in Syracuse. cially in a survival instinct mode, phobias are different. They are more intense than fears and can lead to anxiety and panic attacks. The main goal of hypnotherapy is to push those bad habits away and to place positive reinforcement as our main focus. This then builds a clearer foundation of how we want to continue to live our lives. “Hypnosis is an important factor to triggering the subconscious,” said Schwartz. “Triggering the subconscious releases tension and unwanted emotions that may be weighing down the person emotionally.” In addition, the best result with hypnotherapy is when patients are willing to make it work, she sad.

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Lab Techs: Behind the Scenes Yet Vital to Healthcare Workers in this field receive an annual mean starting wage of $51,840 in the Central New York area By Deborah Jeanne Sergeant

f you like science, health and technology, working as a lab tech might be right for you. The path to employment in this career is much shorter than you might think. While many medical careers necessitate lengthy education, the clinical laboratory technician and clinical laboratory technologist require only two and four years’ worth of schooling, respectively. Workers in this field receive an annual mean starting wage of $51,840 in the Central New York area, according to the Bureau of Labor Statistics, which combined both titles into its salary figure. Technologists make significantly more than technicians. After successful completion of their education, candidates for lab tech positions must pass a certification exam, which licenses them to work nationwide and take 12 continuing education credit hours annually thereafter. “It is very much in demand,” said Patricia A. Main, laboratory administrative director for Oswego Health. “It’s getting stronger and stronger.” The Bureau of Labor Statistics projects 11% job growth, considered “much faster than average” than all other careers. Older lab techs are retiring and leaving vacancies, just in time for the baby boomers to increase demand for lab services. Since fewer schools offer lab tech programs, graduates have many opportunities for work. Main said that these roles usually attract people who like helping others through the medical field, but not necessarily as nurses or doctors at that point in their lives. “You need a love of science, math and being analytical,” Main said. “It’s like solving a puzzle a lot of times. You need attention to detail. You have to be very disciplined to be able to do the same things in the same steps reliably.” Lab techs can do far more than

handle samples. Their analysis plays a major role in physician diagnoses. In fact, about 75% of decisions made in hospitals rely upon the lab. “It’s an excellent opportunity,” said John W. Bagenski, associate administrator, corporate compliance officer and technical director laboratory at Auburn Community Hospital. “The techs in the hospital must know what quality control is. All the results must be correct and what results mean and how to explain it to nurses and doctors. They have to know how to repair the analyzers and trouble-shoot and maintain it. They have the responsibility of getting the most correct answer possible in the shortest time. They work as a team.” Lab techs who work outside of a medical setting, such as in research, a veterinary clinic, food research and development, may not be required to have a license, but these positions don’t pay as well and aren’t as readily available. Lab technologists have more room to advance than lab technicians. Technologists can take on supervisory roles, managing, quality researching or infection control. Or, they could work for companies that manufacture medical analyzers or repairing equipment. They can work in a genetics lab, which are not usually associated with a hospital. Or a testing lab for soil or water, forensics, drug testing or food industry. Some students in laboratory technologist programs go on to become physicians, but for those who don’t get into medical school, they can still work in a medical position with a good salary without taking more education. Those who major in biology or pre-med may not have that option. “It’s a career path to go as far as you want to go,” Bagenski said. “They people working in it are satisfied. I don’t know many people who have left this field.”

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Top Foods For Your Brain Studies point to several types of food linked to better brain power

oes what we eat affect the health of our brain? I ponder this question frequently now that I’m older and losing or forgetting things on a regular basis: glasses, keys, appointments, book titles, people’s names…you get the fuzzy picture. Since our brain is always “on” — working hard 24/7 and requiring fuel even while we sleep — why shouldn’t what we eat directly affect the structure and function of our brain? Many experts strongly believe it does, acknowledging that while there is no single almighty brain food that can ensure a sharp brain as we age, there are certain foods that are particularly rich in healthful components that support brain health. Research has shown that foods with certain nutrients that are touted to be healthy — omega-3s, choline, B vitamins and antioxidants, among others — actually correlated not only to cognitive function but also to how the brain itself functions. Many of the best brain foods are the same ones that protect our heart and blood vessels. Can the same benefits be obtained from consuming the same nutrients through supplements? Unfortunately, studies say “not entirely.” While the reasons aren’t completely understood, experts believe it has something to do with how our bodies metabolize pills versus food. If there’s any merit to that old adage “you are what you eat,” then perhaps eating a healthy, balanced diet that includes these top brain-boosting foods may help to keep our memory, concentration, and focus as sharp as it can be.

Leafy greens Dark leafy greens such as kale, spinach, collards and arugula stand out as an especially important category. A study from two acclaimed universities, recently published in the journal Neurology, found that a diet containing approximately one serving of green leafy vegetables a day is associated with slower age-related cognitive decline. Just one! The research suggested that the rich concentration of brain-healthy nutrients — vitamins A, E and K, lutein and folate — packed within the greens were likely contributors to the slower decline. Folate, in particular, may protect the brain by lowering the level of an amino acid (homocysteine) that, when elevated, may trigger the death of brain nerve cells.

Berries While all fruits do a body good, only berries seem to command attention when it comes to brain health. Experts credit the flavonoid anPage 16

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By Anne Palumbo

the only nut that contain significant amounts of omega-3s.

Dark chocolate For chocolate-lovers, news doesn’t get much better than this: Numerous studies strongly suggest that the right kinds of chocolate, consumed regularly, can help keep our mind sharp and alert, and our mood calm and happy. Cocoa beans are an excellent source of flavonoid antioxidants, which gather in the areas of the brain that deal with learning and memory. The benefit of such “gathering”? Researchers say these compounds may enhance memory and help slow down age-related decline. Even more good news? Two new studies have found that some of chocolate’s benefits may also occur at fairly doable doses: one-half ounce to one ounce a day. Generally, the darker the chocolate (70% or more), the greater the benefits.

Eggs

tioxidants in berries, especially the anthocyanins that give berries their brilliant hues, for protecting our gray matter. These antioxidants help by reducing inflammation and oxidative stress, two processes that may accelerate the onset of age-related conditions such as Alzheimer’s and dementia. Researchers at Harvard’s Brigham and Women’s Hospital found that women who ate one or two half-cup servings of blueberries and strawberries per week delayed memory decline by up to two and a half years. Studies have also suggested that berries may improve communication between brain cells and that blueberries in particular may delay short-term memory loss.

Fatty Fish When people talk about brain foods, fatty fish swim to the top of the list because they teem with a nutrient that’s a major building block of the brain: omega-3 fatty acids. Omega-3s, which help build cell membranes throughout our body and brain, play an important role in sharpening memory, improving mood, and protecting our brain against decline. Studies

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

have found that people with high levels of omega-3s had increased blood flow in the brain, as well as more gray matter. Gray matter contains most of the nerve cells that control decision-making, memory and emotion. These healthy (unsaturated!) fats have also been linked to lower levels of beta-amyloid — the protein that forms damaging clumps in the brains of people with Alzheimer’s disease. Examples of fatty fish that contain high levels of omega-3s include salmon, mackerel, tuna, herring and sardines.

Nuts and Seeds Experts say we should all go a little nuts for nuts and seeds for this key benefit: nuts and seeds are especially rich in vitamin E. A potent antioxidant, vitamin E shields cell membranes from damage associated with oxidative stress, a disturbance that increases with age and is considered a major contributor to cognitive decline. According to a Harvard University study, women aged 70 or older who ate five or more servings of nuts per week scored higher on cognitive tests than women who didn’t eat nuts at all. Nuts and seeds also contain a host of other brain-boosting nutrients, including omega-3 fatty acids. Those with the highest amount of vitamin E include sunflower seeds, almonds, and hazelnuts. Walnuts are

While eggs provide a variety of nutrients, it’s their connection to choline that gives them their brainy edge. An essential nutrient that research says may protect against cognitive decline as we age, choline helps brain cells communicate with each other and keep memories intact. According to studies at Boston University and Harvard, adults with more choline in their diet scored higher on memory tests and experienced healthier aging of the brain. In fact, some experts believe that choline may hold promise in the war against Alzheimer’s. Given that egg yolks are among the most concentrated sources of this nutrient, we reap the most benefits by eating the whole egg (if your diet permits). Does eating eggs, which are also rich in brain-boosting B vitamins, help delay brain shrinkage, a natural loss linked to age-related cognitive decline? Current research suggests they may.

Whole Grains Nutrient-rich whole grains are an integral part of the Mediterranean diet — a diet linked to a reduced risk of memo-

decline in older adults, according to a study published in the Journal of the American Geriatrics Society. Whole grains contain soluble fiber, which ferries cholesterol from the body and prevents plaque from forming in arteries. Clear arteries promote good blood flow to the brain and may help reduce the risk of developing dementia and stroke. Healthy-carb whole grains also provide a steady supply of energy to the brain by releasing glucose slowly into the bloodstream. Our brain, which uses a whopping 20% of the energy we consume, benefits from whole grains by remaining more mentally alert throughout the day. Keys? Why, they’re right here!

Coffee If coffee is the highlight of your morning, you’ll be thrilled to hear it’s good for your brain. Beyond boosting alertness and potentially enhancing short-term memory, coffee may also protect the brain against cognitive impairments and heighten thinking skills. According to physician Donald Weaver of Krembil Brain Institute, “Coffee consumption does seem to have some correlation to a decreased risk of developing Alzheimer’s disease and Parkinson’s disease.” What’s more, in a recent study published in The Journal of Nutrition, participants with higher caffeine consumption scored higher on tests of mental function. Coffee is also an excellent source of powerful antioxidants, which may offer some protection against progressive cognitive decline.

Turmeric Could a curry a day keep the forgetfulness at bay? Numerous studies suggest it may. Turmeric, the spice that gives curry its bright yellow color, has been the focus of research lately due to its concentration of curcumin. A powerful antioxidant and anti-inflammatory, curcumin has been shown to improve memory and mood in people with mild, age-related memory loss, according to a study by UCLA. The latest research on turmeric has also shown that because curcumin can cross the blood-brain barrier, it may have the potential to help clear the amyloid plaques that are a hallmark of Alzheimer’s disease. In India, where turmeric is a regular staple in curry dishes, senior citizens traditionally have a lower risk of Alzheimer’s disease. More research is needed however to assess the impact of turmeric on this progressive brain disorder, as India’s low meat consumption may also contribute to the population’s reduced risk. Anne Palumbo is the author of SmartBites column, which appears in In Good Health every month.

SmartBites

By Anne Palumbo

The skinny on healthy eating

Humble Parsnip Asserts Plenty of Nutrients

ity the poor parsnip. Often overlooked in favor of its more attractive cousin, the carrot, it yearns for our attention. Pale, anemic and rather awkwardly shaped, it begs for us to wake up to its distinct taste, versatility and rich nutritional profile. Let’s begin with what makes this particular root vegetable so nutritious. Parsnips, like many vegetables, are a great source of soluble and insoluble fiber, with one cooked cup providing nearly 25% of our daily fiber needs. While insoluble fiber promotes regularity, soluble fiber helps keep our tickers in tip-top shape by ferrying cholesterol out. Worried about Type 2 diabetes? Fiber may lower your risk of developing this chronic disease because it helps slow down the rate of glucose absorption after a meal. Despite its pale exterior, parsnips dish up a surprisingly healthy dose of vitamin C: about 25% of our daily needs in just one serving. Essential for the growth and repair of tissue all over the body, vitamin C also helps to increase the production of infection-fighting white blood cells, which is why many of us turn to vitamin C during cold and flu season. Though it may not keep you from catching a cold, there is some evidence that vitamin C may shorten the duration and intensity of a cold. Parsnips are a decent source of folate, a B vitamin especially important to woman of childbearing age because it reduces the risk of birth defects. Folate benefits the rest of us in three outstanding ways: by ridding the blood of an amino acid that has been linked to narrowing and hardening of the arteries; by regulating our moods due to its role in the production of serotonin (a.k.a. the “happy chemical”); and by helping to prevent gum disease by reducing inflammation. Rich in health-promoting antioxidants — with vitamin C and manganese leading the list — parsnips may provide protection against cell-dam-

aging free radicals that contribute to many chronic diseases, such as cancer, heart disease, Alzheimer’s and vision loss. As for its distinct taste and versatility, parsnips possess a sweet, nutty flavor unlike any other vegetable, lend themselves to a variety of cooking methods (roasted, sautéed, braised or boiled), and are a welcome addition to many dishes.

Helpful tips

Select parsnips that are firm, smooth and free of blemishes. In terms of size, small to medium offer the best flavor (fatter ones can be woody). Although parsnip’s peel can be eaten, many recommend peeling it to improve texture as well as taste (it can be bitter). Parsnips, stored in a plastic bag and placed in your refrigerator’s vegetable drawer, should last about two weeks. Wash just before use.

Parsnip-Pumpkin Soup with Coconut and Curry Adapted from Epicurious Serves 4-6

3 medium parsnips, peeled and cut into 1-inch chunks 1½ tablespoons olive oil, divided 1 medium onion, chopped 3 cloves garlic, minced 1 tablespoon Thai red curry paste (more, if desired) ¼ cup warm water 1 tablespoon ginger, peeled and minced 1 cup canned pumpkin 3 cups chicken broth 1 cup lite coconut milk Lime-Yogurt Drizzle 1 to 2 tablespoons fresh 3/4 cup raw shelled pumpkin seeds, roasted Heat oven to 400 degrees. Place parsnip chunks in a large bowl and toss with ½ tablespoon olive oil and a sprinkling of salt. Spread out on large baking sheet in a single layer and roast, stirring once or twice, for 25 minutes. Meanwhile, in a large soup pot, heat remaining 1 tablespoon olive oil over medium heat and sauté onion and garlic for about 5 minutes until soft. Add roasted parsnips to this pot, along with broth, and bring to a slow boil. Once soup is boiling, reduce heat to low, and add pumpkin and ginger. Before adding red curry paste, blend it with ¼ cup warm water in a small bowl. This makes it easier to incor-

porate into soup. Cover and simmer for about 15 minutes. Puree the soup with handheld immersion blender, stir in coconut milk, season with salt and pepper. Add more broth or coconut milk if soup seems too thick. Garnish with lime-yogurt drizzle and roasted pumpkin seeds. To make lime-yogurt drizzle: Whisk yogurt and lime juice (to taste) in a small bowl until well blended. Note: If you’re skipping the drizzle, you can add fresh lime juice directly to the soup when you stir in the coconut milk. To roast pumpkin seeds: Heat oven to 350 degrees. Spread the raw, shelled pumpkin seeds flat on a cookie sheet and bake for about 10 minutes, until lightly golden. Correction: October’s chia seed pudding recipe forgot the most important ingredient of all: 1/4 cup chia seeds. Clearly, I need to eat more brain foods!

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.

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What Happened to Urine Samples?

Bladder Health for Life Like many other tissues of the body, bladder muscles get weaker and less stretchy with age, causing a series of problems By Deborah Jeanne Sergeant

he aging process is unkind to most of the body. The bladder is no exception. To support bladder health, you can take steps to mitigate the effects of aging. Like many other tissues of the body, the bladder’s tissue gets weaker and less stretchy with age. That means that the bladder won’t hold as much and that the bladder won’t completely empty during urination. Some older adults purposefully hold their urine in an attempt to “strengthen” it. “When adults go to the bathroom, they should try to empty their bladders the best they can,” said physician David Albala, affiliated with AMP Urology. To avoid exacerbating the issue, he advises attempting to completely empty the bladder at least every three to four hours. Men may experience decrease force of stream, urgency and increased frequency, which could indicate enlarged prostate or another issue.

“If you have those types of symptoms, see a urologist to get your prostate examined,” Albala said. “In the middle of that work-up, they may do testing to see how well the bladder is emptying.” Women often experience urinary leaking and incontinence, since childbearing weakens the pelvic floor muscles, which support the bladder. The effect can manifest years later. Albala said that women should consider performing Kegel exercises to strengthen the pelvic muscles. Consulting with a physical therapist that specializes in incontinence may also help. Lifestyle changes can help maintain better bladder health. Albala recommends drinking six servings of eight ounces of fluids per day, preferably water. He also said that staying active and eating a balanced diet should help. Alcohol and coffee and other sources of caffeine can irritate the bladder, so reducing intake can improve bladder function.

“Bladder cancer’s biggest risk is smoking,” Albala said. “It’s not the most common cancer. It’s about 5% of all cancer — a very low number — but it can be hard to cure. There are gene mutations that can contribute, but smoking, workplace exposure to industrial chemicals, and some medicines increase risk. Clearly, smoking increases the risk by two to three times.” Caught early, bladder cancer has an 80% five-year survival rate. Albala recommends weight loss, which he said can help with incontinence in obese women. Lifestyle changes can also reduce risk of urinary tract infections (UTIs). Physician Joseph Jacob, assistant professor of urology with SUNY Upstate Medical University, said that for women, hygiene, wiping front to back and urinating after intercourse, can decrease UTIs. “Constipation can actually cause bad urinary problems,” Jacob said. “The bowel and bladder are related. Constipation can cause incomplete

Upstate’s New Imaging Technology Improves Bladder Cancer Detection By Payne Horning

pstate University Hospital has introduced a new way to discover bladder cancer that officials hope will light the way to improved results for patients. Blue light cystoscopy is a technology that involves the use of a special fluorescing agent, which is directly injected into a patient’s bladder ahead of an operation. Cancer tumors soak up this material, causing them to emit a bright pink glow. Doctors can then better spot where the tumors are thanks to the pink color’s sharp contrast with the blue-screen lens. Physician Joseph Jacob, a fellowship-trained urologic oncologist who directs the bladder cancer program at Upstate, says this new technology is

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a game-changer. “It makes it much easier for us to see — especially small tumors — the ones that are flat and may not be obvious,” Jacob said. “If you can pick these up, you can clean up the bladder, you can be more confident that you’re doing a better job for the patient, and what that means is we’re not missing tumors that could lead to dangerous effects for the patient.” Jacob says the technology is so easy to use that finding where the cancerous cells is obvious, something even a layperson with no medical training could find. “It’s not even really a subtle thing — it lights up,” he says “I use it on all of my bladder cancer patients. We’re picking up more instances than

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

before. It’s helping me tremendously.” Jacob says there are no side effects from the fluorescing agent either apart from very rare allergic reactions. The key to the success of this new approach, according to Jacob, is that cancerous cells in the bladder don’t function like their healthy counterparts. The normal lining of the bladder is built to not absorb any fluids. The tumors, on the other hand, are growing and have more blood flow through them — opening the door to the fluorescing agent. Blue light cystoscopy has seen great success in national trials as well, Jacob says. Doctors are finding more cancers, keeping patients out

Routine urine samples? Not anymore. As new research emerges on the lack of benefits of regularly sampling urine, fewer providers request urine samples for patients lacking symptoms. “A lot of people think that whenever you have bacteria in the urine or if it has a strong odor or if it’s cloudy there’s an infection,” said geriatrician Sharon Brangman, professor of medicine and head of the geriatric department at SUNY Upstate Medical University. “We know now that if you have an infection that needs treatment, you need to have 102 fever or significant pain when you urinate and any of the following: going to the bathroom a lot, urgency, pain in the lower part of the belly, any blood in the urine, a sudden onset of incontinence and any pain in the lower back area.” She added that odor could reflect a change in diet or medication and color may change depending upon the amount of fluids consumed. Over-prescribing antibiotics for urinary issues — or any other reason — has led to the rise of antibiotic resistant “super bugs” that become very difficult for physicians to treat. “We have to be very careful about using antibiotics,” Brangman said. “It’s common to have bacteria in the urine, especially if you have diabetes. As physicians, we realize now we should not routinely check urine if there are no symptoms.” elimination of urine.” Maintain regular bowel movements by eating more foods rich in fiber such as whole grains and whole fruits and vegetables or adding a fiber supplement to the diet. Other medical conditions can exacerbate bladder problems, such as diabetes, which can affect the nerves that control the bladder and alter the sensation that the bladder is full. Some medications can make a difference in bladder health and urination, too.

of the operating room longer, and preventing cancers from returning as frequently as they were before. The American Urological Association and the Society of Urologic Oncology recommended the technology in its 2016 guidelines because it can improve detection of cancerous cells. Jacob says most of the major cancer centers in the country now offer Blue light cystoscopy, but its reach elsewhere is limited. “It’s money. Money talks,” Jacob says. “We [at Upstate] are academics and so we’re always trying to think of what we can do that’s evidence-based that can improve care for patients. That’s something we’re always trying to do. This is evidence-based — it’s been shown to help patients and so we just made it a priority.” According to Upstate, bladder cancer affects more men than women and the likelihood of bladder cancer increases with age. About nine out of 10 people with bladder cancer are older than 55, while the average age of diagnosis is 73.

Tying the Knot Is Tied to Longer Life Span, New Data Shows Research also shows widowed have the highest death rate of all the categories

arried folks not only live longer than singles, but the longevity gap between the two groups is growing, U.S. government health statisticians report. The age-adjusted death rate for the married declined by 7% between 2010 and 2017, according to a new study from the National Center for Health Statistics (NCHS), part of the U.S. Centers for Disease Control and Prevention. “Not only is the rate for married lower, but it’s declining more than

any other group,” said lead author Sally Curtin, an NCHS statistician. Statistically, death rate is the annual number of deaths for every 100,000 people. It’s adjusted so that a 26-year-old and an 80-year-old married or widowed or divorced are on equal footing. The new study reported that the death rate for never-marrieds declined only 2%, while that for divorced people hasn’t changed at all. Worst off were the widowed, for whom the death rate rose 6%. They

have the highest death rate of all the categories, researchers said. Married men in 2017 had an age-adjusted death rate of 943 per 100,000, compared to 2,239 for widowers. The death rate was 1,735 per 100,000 for lifelong bachelors and 1,773 for divorced men. Married women had a death rate of 569 per 100,000, two-and-a-half times lower than the 1,482 rate for widows. The death rate was 1,096 for divorcees and 1,166 for never-married women.

Part of the marriage benefit could be explained by the fact that people in good health are more likely to marry, said Katherine Ornstein, an associate professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City. Once you’re in a marriage, there are a host of tangible and intangible benefits that give you a health advantage, experts said. Married people are more likely to have health insurance, Ornstein said, and therefore, have better access to health care. Being married also means you have someone looking out for you and reinforcing healthy behaviors, said Michael Rendall, director of the Maryland Population Research Center at the University of Maryland. “Having somebody there who’s your spouse will tend to promote positive health behaviors — going to the doctor, eating better, getting screened,” he said. This is particularly true of men, who previous studies have shown derive more health benefits from marriage than women. “Men tend to have fewer skills than women in terms of looking after themselves,” Rendall said. Finally, the companionship of marriage staves off health problems associated with loneliness and isolation, Ornstein said. “Social support and the social engagement that comes with being married is a huge benefit for mental health and physical health,” she said. All these benefits also explain why widowed people tend to do so badly after the death of their spouse, Ornstein said.

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Golden Years

Say Thanks to a Caregiver

November is National Family Caregiver Month. Three CNY women share the stories of their journeys as caregivers By Mary Beth Roach

ovember is National Family Caregivers Month, a time dedicated to remembering the millions of family members who tend to the physical and emotional needs of their loved ones. According to statistics for 2015 provided by the National Alliance for Caregiving and AARP, 34.2 million

Americans provided unpaid care to an adult age 50 or older, and 15.7 million Americans care for family members with Alzheimer’s or other forms of dementia. Three Central New York women recently shared the stories of their journeys as caregivers. Two women who are caregivers

for their husbands and one who is a single mother with a child with a myriad of health needs discussed the challenges that come with that role, the range of emotions, their support systems and their unique perspectives that enable them to carry on. Parents who are caregivers for children with special needs can also

Barbara Shelly ‘We just did what families do’ Barbara Shelly, 76, has tended to her son before his death from cancer in 1981. She’s been a caregiver for her husband’s aunt, for her sister, for her mother and now her husband, Dan, 78. “We just did what families do. When you look back on it, you’re like ‘oh my gosh,’ but you don’t think about how you’re going to do it, you just respond,” Barbara said. Barbara and Dan have been married for 53 years. But when Dan had a stroke the day after Christmas in 2014, while they were at their winter home in Florida, her life as she had known it began to unravel. Dan had suffered what doctors call multi-infarct vascular dementia, which is brought on by a stroke, or mini strokes, that causes a loss of brain function. Dan’s situation was made worse by several other health issues he had. After returning to Syracuse, Barbara, Dan and their daughter, Robin, began the arduous task of visits with specialists, trips back and forth to the University of Rochester Medical Center for a diagnosis that would allow them to seek further treatment and therapy. The diagnosis of the multi-infarct vascular dementia prompted Barbara and Robin to begin to do a lot of research and talk to people. “What we decided to do instead of reacting to things was to be proactive,” Barbara said. “Until then we were reacting. Every new thing that comes up, we’d either try it, check it out.” One of their searches led them to the local chapter of the Alzheimer’s Association, which Barbara said, has been very helpful and opened the door to a wealth of resources. She also found great resources through the Onondaga County Department of Adult & Long-Term Care Services. “While this person is reducing their world, because of their dementia, you have to expand your world to include resources for the person that’s losing their presence in the world,” Barbara noted. She also tried various programs that she thought Dan might enjoy — and they would work for a while — but life at home became increasingly challenging. Eventually the family Page 20

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Barbara Shelly her husband, Dan. He had a stroke the day after Christmas in 2014, while they were at their winter home in Florida. After that episode, Barbara’s life as she had known it began to unravel. She is her husband’s primary caregiver. decided that the best option for Dan was to move him to a residential care facility. He has since moved into a facility in the eastern suburbs of Syracuse with a specific memory care unit. Like so many caregivers, her emotions over time have run the gamut — anger, feeling cheated, depression, loneliness. But she has a strong network of people, including her daughter and one of her best friends. Having been a caregiver for so many of her family members, she has learned some valuable lessons. “When you’re starting to make decisions, you need to be proactive. Being in denial only hurts you and your loved one. So, find a resource for yourself first,” she pointed out.

side, including his ability to eat and swallow. The third has affected his peripheral vision. Ralph’s memory has been compromised to some degree as well, and sometimes he’ll drift back in time, she said. Each hospitalization was followed by intensive therapy, and although people have suggested to Donna that she place Ralph in a nursing home, she said she couldn’t. She remarked to them that she wasn’t ready to put him there. “He’s my husband. I married

feel isolation and anxiety, constantly waiting for the other shoe to drop, and the stress of the situation can often cause divorce, according to Kate Houck, executive director of David’s Refuge, a local organization established to provide respite weekends for parents.

him for the good and the bad times,” she said. So over time, she learned to puree food, and although he’s progressed to whole foods, she makes sure that everything is cut up to a size he can manage. She gets him up every morning, bathes him, dresses him, checks his blood sugar since he’s on insulin, and then determines what their breakfast will be. They then do some simple stretching exercises. Ralph is a registrant at the Adult Day Health Center at St. Camillus, and on the three days he goes to that facility, Donna will help out at her parish, Our Lady of Hope in Syracuse, have lunch with a friend, or catch up on her sleep. On the other days, Donna might take him to Home Depot, the grocery store or the Destiny USA. While helping him in and out of his wheelchair and in and out of the car to take these rides can be physically difficult for Donna, she said that it makes him feel like he’s part of life and not just sitting home. “I try to keep things as normal as possible,” she said. For a while, she found herself completely waiting on him, but soon realized, she said, it wasn’t fair to either of them. So now, Ralph helps her with little household chores, like folding the towels, watering the plants or dusting. While these may

Donna Rawson “He’s my husband. I married him for the good and the bad times” Donna and Ralph Rawson had dreamed of going on an Alaskan cruise when she retired. It is not to be. Today, at the age of 64, Donna said her dream is to make life as realistic for her husband, age 73, who suffered his third stroke this past January. Ralph’s first stroke, in 1995, affected his left side; his second, in 2016, impacted his entire right

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

Donna Rawon, right, is the primary caregiver for her husband, Ralph Rawson. In 2016, he had his second stroke, which impacted his entire right side, including his ability to eat and swallow. Last January, he had another stroke (his third) that affected his peripheral vision. Next to them is Sara Spinner, program director, The Adult Day Center at St. Camillus, where Ralph is a registrant. Photo courtesy of Deborah Christiansen, The Centers at St. Camillus.

be small things, the smile on his face when he accomplishes these tasks is so encouraging for her. “He can feel good about doing things,” she said. Donna realizes that she is fortunate to have a strong support system around her, something critical for caregivers. Their daughter, Michele Day, and son, Father Matthew Rawson, are in the Syracuse area and visit when they can. She has a cluster of friends who have been a source of strength, too. “If I feel myself getting down, all I have to do is text somebody, and I get an immediate response.” Her parish community and her strong faith have also sustained her. “I think my faith and my religion have become very strong throughout this. Because if I didn’t have that, I think I would have been lost,” she said. She gets up each morning about 90 minutes prior to Ralph’s in order to pray to help her through the day, she said. And while the days and nights can be exhausting — and Donna admitted to feelings of being tired, depressed, and frustrated — there are times when a simple gesture or remark can lift that weight for a bit. She related one of those moments that she and Ralph shared one evening not too long ago. He had wheeled himself over to Donna and said to her, “‘if it wasn’t for you, I don’t know what I would be or where I would be because I love you so much.’” Donna said, “I have always loved my husband, and I always will. And I think the strength that I get from my own faith and hope carries me through quite a bit. I’ve learned to care for him, not because I have to, but because I want to.”

Golden Years

primary caregiver for her 11-year-old daughter, Addison Gridley, whose myriad of health issues began at birth. Her elderly mother, who has a number of health needs, moved in with them a little over a year ago. Julie holds a full-time job and she says life can get pretty taxing at times. Addison has cerebral palsy; arthrogryposis multiplex congenita (AMC or often just called arthrogryposis, which consists of joint contractures that affect her from the hips down); brain anomalies; and epilepsy, which has been brought under control with medications. She’s non-verbal and in a wheelchair. Yet, Julie said, her daughter is very bright, curious and engaged. Addison needs to be transitioned from her bed to her wheelchair, and to the stair gliders in their home. And when she wants to get out of her chair, which Julie said is often, she will crawl around, using her upper body. However, Julie needs to lift her daughter from the chair to the floor and back each time.

“She’s a really active kid. She’s really curious. She wants to be doing different things,” she added. But because her legs can get twisted or bent, she needs continual supervision. Julie also needs to assist Addison with dressing and some personal hygiene routines. While she has aides to help her with Addison and her mother, it’s still Julie who takes on the majority of the work — and the emotions and the concerns. Being a single mom, Julie said, “I have no one to pass the baton to on a regular basis.” There’s the added concern of what would become of Addison if something were to happen to Julie. Now, at the age of 55, she is planning to take an early retirement in the very near future, leaving SUNY Upstate, where she’s worked for 37 years because she feels she needs to be home. “I’m having really conflicting

Julie Gridley Crosby ‘My daughter’s just taught me we’re all OK. She is so happy. The littlest things make her joyful’

Julie Gridley Crosby, a single parent who is the primary caregiver for her 11-yearold daughter, Addison Gridley. Addison has cerebral palsy, arthrogryposis multiplex congenita, which consists of joint contractures that affect her from the hips down; brain anomalies and epilepsy.

Julie Gridley Crosby’s life is a balancing act. As a single parent, she is the

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feelings about that,” she said. “I’m looking forward to having less to juggle, but at the same time, that’s a loss in and of itself for me.” When Addison was younger, Julie had family members nearby — a sister and some grown nieces — who could offer some assistance, but over time, they’ve all moved away. She also explained that when she became a mom, her friends were also becoming mothers or already had young children. But there “came a fork in the road,” she said. “They’re living a very different experience than me.” That feeling of isolation is common for parents of a child with special needs. She has been able to find emotional support from David’s Refuge, a Manlius-based nonprofit that provide respite, resources and support to parents and guardians of children with special needs or life threatening medical conditions “I’m very close to people I’ve met through David’s Refuge. Every time I’m with them, I feel strengthened. I get an email or a text or I can reach out and say ‘I’m having a real hard day today,’ and they get it. That support means an awful lot,” Julie said. As the first single parent in the organization, she would go on to establish a single parent’s group there. She helps to host the respite weekends at different B&Bs in the area, showing them to their rooms and facilitating the group meeting. Through her experiences, Julie has come to learn a great deal about herself. “My daughter’s just taught me we’re all OK,” she said. “She is so happy. The littlest things make her joyful. I actually legally changed her middle name to Joy. She’s full of joy. And that’s one of the lessons — to be happy. We’re together. We’re happy. We love each other.”

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Page 21

SURGERY AND RADIATION FOR BREAST CANCER IN AS LITTLE AS ONE DAY

Key Questions Seniors Should Ask Their Doctors

With doctor visits getting shorter and shorter, knowing what to ask the doctor is crucial By Deborah Jeanne Sergeant

ith electronic medical records, tighter margins for medical practices and a shortage of providers, most doctors cannot offer their patients much time to talk during visits. To get the most out of your visit, plan ahead the questions you should ask. Local experts offered a few ideas.

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• “Write those questions down. It’s easy to forget in the moment. Give the list to the nurse before the physician even comes in. The nurse may ask, ‘What’s going on?’ so that is a good time to present that list. Don’t assume that if you have 10 to 15 questions they’ll have time, so pick your top few. • “Ask about medications and side effects of what you’re currently taking or how a new medication may interact. • “A lot of seniors experience things they think are part of old age but don’t necessarily fall into normal aging, whether memory, balance or what they think is a side effect of a medication.” — Diane Oldenburg, senior public health educator, Oswego County Public Health • “In men, it’s prostate health and erectile dysfunction. There are a lot of urologic conditions that can indicate other things, so it’s important to mention these. Some men with erectile dysfunction may come in and there’s also cardiac issues going on that are related. • “Let your doctor know exactly the truth. Don’t be ashamed of anything. By doing that, it’s going to make the physician’s job much easier.” — Urologist David Albala, AMP Urology • “’This is what I want to do’ or ‘This is what I’d like’ or “This is what is important to me.’ The physician should know that. • “They should talk about their family history. Have their parents passed from a rare condition or something that’s common? A lot of conditions and diseases run in families. If your mother and father had heart attacks, it means you’re at increased risk.

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

• “People don’t tend to bring up infectious diseases. Back in the ‘80s when HIV was identified, it was a death sentence. Now it can be treated and you’ll most likely die of something else. • “Talk about alcohol use or drug use. Drinking a fifth of vodka every other day can play a factor into other medications or condition. — Physician William Jorgenson, medical director of Donald J. Mitchell VA Outpatient Clinic, Rome • “If my patients are having any trouble getting through the day — grocery shopping, cooking or driving — people are reluctant to talk about it. If we discuss it earlier, we can set up a care plan to help that person stay as independent as possible. People get scared and then we reach a crisis point. • “If they have any changes in their mood. A lot of older adults don’t want people to know if they’re feeling down or lonely. These changes are very manageable. We have resources to put into play that would help that person. If we address it early, we can help them. • “So many worry if they have problems with their memory it’s that they have Alzheimer’s and there are many other things that can be impacting their memory that we can address. If it is Alzheimer’s, it’s important to address it early to avert any crisis. • “If you don’t like any of your medications, or their side effects, let your doctor know. don’t just stop taking them. Or if you take supplements you got from a nutrition store or bought online, it’s important for the doctor to know. A lot of people think if they get it without a prescription and it’s ‘natural’ it’s OK, but it can interfere with anything else they’re taking or other health concerns. • “We try really hard to communicate so patients understand what’s going on. If there’s something you don’t understand, don’t just nod. If the doctor isn’t able to answer all your questions, maybe the nurse can. And there are organizations that can help. We often refer patients to other local resources where they can get their questions answered.” — Geriatrician Sharon Brangman, professor of medicine and head of the geriatric department at SUNY Upstate Medical University

Golden Years

Even Age 80 Is Not Too Late to Begin Exercising: Study

E say.

ven seniors who never exercised regularly can benefit from a workout program, researchers

A new study found that men in their 70s and 80s who had never followed an exercise regimen could build muscle mass as well as “master athletes” — those of the same age who had worked out throughout their lives and still competed at the top levels of their sports. The U.K. researchers took muscle biopsies from both groups in the 48 hours before and after a single weight-training session on an exercise machine. The men were also given an isotope tracer before the workout in order to track how proteins were developing in their muscles. It was expected that the master athletes would be better able to build muscle during exercise, but both groups had an equal capacity to do so, the University of Birmingham team found. The study was published Aug. 30 in the journal Frontiers in Physiology. “Our study clearly shows that it doesn’t matter if you haven’t been a regular exerciser throughout your life, you can still derive benefit from exercise whenever you start,” lead researcher Leigh Breen said in a university news release. He’s a senior lecturer in exercise physiology and metabolism.

“Obviously a long-term commitment to good health and exercise is the best approach to achieve wholebody health, but even starting later on in life will help delay age-related frailty and muscle weakness,” Breen said.

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Current public health advice about strength training for older people tends to be “quite vague,” he noted. “What’s needed is more specific guidance on how individuals can improve their muscle strength, even

outside of a gym setting through activities undertaken in their homes activities such as gardening, walking up and down stairs, or lifting up a shopping bag can all help if undertaken as part of a regular exercise regimen,” Breen said.

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Golden Years

Finding a Cure for Alzheimer’s Disease Local chapter of Alzheimer’s Association raises top dollars destined to find a cure for Alzheimer’s disease and to help fund programs for those affected By Deborah Jeanne Sergeant

oes it seem like many organizations and individuals you know are taking part in some sort of fundraiser for the Alzheimer’s Association? It’s just not an impression. The Central New York chapter offers numerous opportunities for the community to become involved. Since dementia is the fifth leading cause of death in the U.S., it’s vital to both fund research and provide help for those affected and their families. The Alzheimer’s Association represents the largest nonprofit funder of dementia research. Its main two fundraisers are The Longest Day and The Walk to End Alzheimer’s. “These events bring together communities to honor those living with the disease and their caregivers, as well as those who have died from it,” said Jared Paventi, chief communications officer with the Central New York chapter. The walk is the world’s largest event to raise awareness and funds for dementia care, support and research. It has been held annually for 30 years. More than 600 communities nationwide participate. The Central New York chapter holds five Walk to End Alzheimer’s events: Binghamton, Ithaca/Cortland, Syracuse, Utica/Rome and Watertown. “We remember all of these reasons why we participate with

our Promise Garden Ceremony, an emotional, inspirational part of the opening where we renew our commitment to the fight against Alzheimer’s,” Paventi said. The Walk to End Alzheimer’s raises $500,000 annually for the chapter, which supports the care, support and research programs. “This year saw tremendous response from the region, as we attracted record numbers of walkers in Utica/Rome [nearly 600] and Watertown [400],” Paventi said. A couple regions received alltime high amounts: $73,314 in Utica/ Rome and $72,247 in Watertown. “Our walk in Syracuse remains our largest event, attracting more than 1,500 people and raising in excess of $225,000,” Paventi said. The Longest Day event is named for the “long days” caregivers put in with their loved ones with dementia and because it used to be held only on the longest day of the year in midJune. Paventi said that the name also holds symbolism as it is the day with the most light. “On June 20, thousands of participants from across the world come together to fight the darkness of Alzheimer’s through an activity of their choice,” he said. Participants can host a Longest Day event any time of the year now, and can raise funds doing any activity they choose. Whether it’s a

Recent Walk to End Alzheimer’s in Syracuse raised more than $225,000. karate school kicking for the cause, a knitting club making a scarf in a day or a baking company baking for a cure, the events put the “fun” in fundraisers. Participating groups can choose to seek pledges and/or sell items to raise funds. “The Longest Day is part of an emerging style of event in the nonprofit sphere,” Paventi said. “Rather than hold a walkathon or a bikeathon on a particular day, The Longest Day gives participants the opportunity to select an activity they enjoy and use it to raise money and awareness for the Alzheimer’s Association.” In 2019, 62 different events took place in Central New York, including bake sales, fitness classes, yogathons, and more. The Alzheimer’s Association Central New York chapter serves the cities of Binghamton, Ithaca, Syracuse, Utica and Watertown and their surrounding counties. Its services include 24/7 helpline, care consultations for families affected by dementia, support groups for caregivers, social activities for individuals with dementia and their care partners, and educational programs. The Alzheimer’s Association’s free multilingual helpline provides reliable information and support to those in need of assistance 24 hours a day, 7 days a week: 1-800-272-3900.

Clarity Clinical Research in E. Syracuse Developing Research on Alzheimer’s Syracuse’s only private Alzheimer’s research clinic explores different causes of Alzheimer’s disease, and investigational treatments for those suffering from dementia

or years, clinical trials have evaluated treatments aimed at slowing or stopping Alzheimer’s disease by focusing on amyloid, a sticky plaque that deposits in the brain and has been thought to contribute to impairment in memory functioning. As clinical trials have continued to fail in this area, researchers are

now beginning to focus their efforts elsewhere in hopes of finding a cure for one of the world’s most devastating illnesses. As of late, the link between Alzheimer’s disease and diabetes has continued to gain the attention of researchers, and has even led to the creation of investigational treatments aimed at slowing or stopping the

disease. Currently, Clarity Clinical Research is testing an investigational treatment aimed at slowing or stopping the progression of memory loss for those diagnosed with both Alzheimer’s disease and Type 2 diabetes. “The more we learn about this disease, the more we are under-

Every 65 Seconds Someone Develops Alzheimer’s Dementia in the U.S. The Alzheimer’s Association shares facts on the disease: • Alzheimer’s is the most common type of dementia, which accounts for about 80 percent of dementia cases. • Dementia refers to a decline in mental ability severe enough to interfere with daily life. • According to the Alzheimer’s Association 2019 Alzheimer’s Disease Facts and Figures Report, every 65 seconds someone in the United States develops Alzheimer’s dementia. • One in 10 people aged 65 and older lives with dementia and the percentage of people with dementia increases with age. • More than 400,000 individuals live with Alzheimer’s dementia in New York state. This number does not include individuals with other types of dementia. • More than 1.6 million New Yorkers provide unpaid care to their loved ones who live with dementia.

standing that early diagnosis and treatment will be key,” said Lisa Sonneborn, site director at Clarity. “Many of the clinical trials currently attempting to slow or stop the disease are focused on treatment at the earlier stages of Alzheimer’s.” As clinical trials continue searching for a cure, it is crucial that patients and caregivers understand that their participation at any point in the disease process is key to moving medicine forward, said Sonneborn. As the global epidemic continues, it will be the willingness and efforts of patients and families affected by this disease that can truly make an impact in the fight against Alzheimer’s. Clarity Clinical Research is an Alzheimer’s disease research clinic located in East Syracuse with several clinical trials in the works.

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

Stoneleigh Apartments Stoneleigh Apartments 400 Lamb Ave, Canastota • 697-2847 400 Lamb Ave, Canastota • 697-2847

By Jim Miller

Cremation:

An Affordable Way to Go

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Because prices can vary sharply by provider, the best way to get a good price on a simple “no frills” cremation is to call several funeral homes in your area (most funeral homes provide cremation services) and compare prices. When you call, ask them specifically how much they charge for a “direct cremation,” which is the basic option and the least expensive. With direct cremation, there’s no embalming, formal viewing or funeral. It only includes the essentials: picking up the body, completing the required paperwork, the cremation itself and providing ashes to the family. If your family wants to have a memorial service, they can have it at home or your place of worship after the cremation, in the presence of your remains. If you want additional services beyond what a direct cremation offers, ask the funeral home for an itemized price list that covers the other service costs, so you know exactly what you’re getting. All providers are required by law to provide this. To locate nearby funeral homes, look in your local yellow pages or Google “cremation” or “funeral” followed by your city and state. You can also get good information online at parting.com, which lets you compare prices from funeral providers in your area based on what you want. Or, if you need more help, contact your nearby funeral consumer alliance program (see Funerals.org/ local-fca or call 802-865-8300 for contact information). These are volunteer groups located in most regions around the country that offer a wide range of information and prices on local funeral and cremation providers.

InvitingInviting one bedroom apartments essential services one bedroom apartments close close totoessential services and stores, as well as emergency and health services for and stores, as well as emergency and health services for Seniors (over 62) or receiving SS with a permanent mobility Seniorsimpairment (over 62) or receiving SS with a guidelines permanent mobility within income

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How much does cremation cost and how can I find a good deal in my area? I would like to get a simple, basic cremation that doesn’t cost me, or my family, a lot of money.

Cremation costs can vary widely. Depending on your location, the provider and the services you request, cremation can range anywhere from $500 to $7,500 or more. But that’s a lot cheaper than a full-service funeral and cemetery burial that averages nearly $11,000 today. Here are some tips to help you get a good deal.

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Pricey Urns

The urn is an item you need to be aware of that can drive up cremation costs. Funeral home urns usually cost around $100 to $300, but you aren’t required to get one. Most funeral homes initially place ashes in a plastic bag that is inserted into a thick cardboard box. The box is all you need if you intend to have your ashes scattered. But if you want something to display, you can probably find a nice urn or comparable container online. Walmart. com and Amazon.com for example, sell urns for under $50. Or, you may want to use an old cookie jar or container you have around the house instead of a traditional urn.

Free Cremation

Another option you may want to consider that provides free cremation is to donate your body to a university medical facility. After using your body for research, they will cremate your remains for free (some programs may charge a small fee to transport your body to their facility), and either bury or scatter your ashes in a local cemetery or return them to your family, usually within a year or two. To find a medical school near you that accepts body donations, the University of Florida maintains a directory at Anatbd.acb.med.ufl.edu/ usprograms. 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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CANCER BEWARE TOGETHERWEFIGHT hoacny.com November 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Emplyoees at Loretto.

Meeting Workforce Challenges in Healthcare Submitted by Loretto

he senior care workforce is diminishing, which means we need to get creative with attracting and retaining employees. Almost 70% of new hires in senior care are millennials, and they are looking for different benefits than generations before them. According to a survey by Glassdoor, 79% of U.S. employees would prefer new or additional perks over a pay raise. Among the top listed are performance rewards, financial wellness and healthy lifestyle initiatives, professional development, and schedule flexibility. According to the Society for Human Resource Management, four

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out of five employees say personal financial issues affect their job performance, leading to an increase in stress, an inability to focus, absenteeism and tardiness. At Loretto, we talked with staff members and discovered financial stress is a concern for our employees. To create a support system for our employees, we listened to the causes of their financial stress and implemented a few programs to support them. We have started a diaper bank that provides diapers to those who need them for their children to attend daycare, on-site urgent care for employees who can’t afford copays, and education and training through partnerships with philanthropic groups and community organizers. As a result, we’ve seen an increase in our employee retention and improved job satisfaction. We can’t do it alone. Workforce development was the theme of this year’s Loretto Foundation Heroes and Hope Luncheon Oct. 10, and we celebrated two individuals who have helped us meet the needs of our employees — Congressman John Katko and CenterState CEO President Rob Simpson. At Loretto, we are proud of the perks we’ve been able to offer, but we still need to fill many more positions. So, we are constantly evolving and thinking creatively about how we can continue to enrich the lives of the 2,500 exceptional people who work here every day — and how we can attract more.

Making the best of the time that’s left

We offer comfort to our patients. We console family and friends. We care about the quality of life.

315-634-1100 www.hospicecny.org Serving Onondaga, Cayuga, Oswego & Madison Counties Page 26

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

Certain Disability Payments and Workers’ Compensation May Affect Your Social Security Benefits

any people working nowadays have more than one job. This means they have several sources of income. It’s important to keep in mind that having multiple sources of income can sometimes affect your Social Security benefits; but, it depends on the source. Disability payments from private sources, such as private pensions or insurance benefits, don’t affect your Social Security disability benefits. Workers’ compensation and other public disability benefits, however, may reduce what you receive from Social Security. Workers’ compensation benefits are paid to a worker because of a job-related injury or illness. These benefits may be paid by federal or state workers’ compensation agencies, employers, or by insurance companies on behalf of employers. Public disability payments that may affect your Social Security benefits are those paid from a federal, state or local government for disabling medical conditions that are not job-related. Examples of these are civil service disability benefits, state temporary disability benefits, and state or local government retirement benefits that are based on disability. Some public benefits don’t affect your Social Security disability ben-

Q&A

Q: How much will I receive if I qualify for Supplemental Security Income (SSI) benefits? A: The amount of your SSI benefit depends on where you live and how much income you have. The maximum SSI payment varies nationwide. For 2019, the maximum federal SSI payment for an eligible individual is $771 a month and $1,157 a month for an eligible couple. However, many states add money to the basic payment. For more information, go to www.socialsecurity.gov/ssi. Q: Can I use the metal or plastic versions of Social Security cards that some companies make? A: We don’t recommend it. There is no need to have a replica of your card. In most cases, the only time you may need to produce your Social Security card is when you apply for employment. At other times, we strongly recommend that you keep anything with your Social Security number on it with your other important papers. Do not carry your Social Security card with you. Also, we strongly advise against laminating your card. Your Social Security card has many security features, which are not detectable if

efits. If you receive Social Security disability benefits, and one of the following types of public benefits, your Social Security benefits will not be reduced: • Veterans Administration benefits; • State and local government benefits, if Social Security taxes were deducted from your earnings; or • Supplemental Security Income (SSI). You can read more about the possible ways your benefits might be reduced at www.socialsecurity.gov/ pubs/EN-05-10018.pdf. Please be sure to report changes. If there is a change in the amount of your other disability payment, or if those benefits stop, please notify us right away. Tell us if the amount of your workers’ compensation or public disability payment increases or decreases. Any change in the amount or frequency of these benefits is likely to affect the amount of your Social Security benefits. An unexpected change in benefits can have unintended consequences. You can be better prepared if you’re informed and have financially prepared yourself. Visit our benefits planner webpage at www.socialsecurity.gov/planners for information about your options for securing your future.

laminated. Those features include latent images you can only see at an angle and color-shifting ink. You should question anyone else other than your employer who asks for your Social Security number or your card. Not everyone you do business with needs it. Learn more at www.socialsecurity. gov/ssnumber. Q: I’m not sure when I’m going to retire so I want to estimate my retirement benefit at several different ages. What’s the easiest way to do that? A: Using our Retirement Estimator is easy at www.socialsecurity. gov/estimator, and it’s the best way for you to get a good idea of what your monthly benefit payment may be after you retire. The Estimator gives estimates based on your actual Social Security earnings record. Keep in mind, these are estimates and we can’t provide your actual benefit amount until you apply for benefits. You can use the Estimator if you have enough work to qualify for benefits and aren’t currently receiving benefits. If you are currently receiving only Medicare benefits, you can still get an estimate. You can learn about this subject by reading our publication, “Retirement Information For Medicare Beneficiaries,” available at www. socialsecurity.gov/pubs.

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Dog Ownership Associated with Longer Life Research shows more evidence your dog might lengthen your life

etting your health go to the dogs might turn out to be a great idea: New research bolsters the association between dog ownership and longer life, especially for people who have had heart attacks or strokes. Earlier studies have shown dog ownership alleviates social isolation, improves physical activity and lowers blood pressure. The new work builds on that, said physician Glenn N. Levine, who led a committee that wrote a 2013 report about pet ownership for the American Heart Association. “While these non-randomized studies cannot prove that adopting or owning a dog directly leads to reduced mortality, these robust findings are certainly at least suggestive of this,” he said in a news release. The two new studies were published recently in “Circulation: Cardiovascular Quality and Outcomes.” One study, from Sweden, compared dog owners and non-owners after a heart attack or stroke. Records of nearly 182,000 people who’d had heart attacks and nearly 155,000 people who’d had strokes were examined. Dog ownership was confirmed with data from the Swedish Board of Agriculture, where registration of dog ownership has been mandatory since 2001, and the Swedish Kennel Club, where pedigreed dogs have been registered since 1889. When compared with people who didn’t own dogs, owners who lived alone had a 33% lower risk of dying after being hospitalized for a heart attack. For dog owners who lived with a partner or child, the risk was 15% lower. Dog-owning stroke survivors saw a similar benefit. The risk of death after hospitalization for those who lived alone was 27% lower. It was 12% lower if they lived with a partner or child.

What’s behind the canine advantage? “We know that social isolation is a strong risk factor for worse health outcomes and premature death,” said study co-author Tove Fall, a doctor of veterinary medicine and a professor at Uppsala University in Sweden. “Previous studies have indicated that dog owners experience less social isolation and have more interaction with other people. Furthermore, keeping a dog is a good motivation for physical activity, which is an important factor in rehabilitation and mental health.” The second set of researchers reviewed patient data from more than 3.8 million people in 10 separate studies. Compared to non-owners, dog owners had a 24% reduced risk of dying from any cause; a 31% reduced risk of dying from cardiovascular-related issues; and a 65% reduced risk dying after a heart attack. The study did not account for factors such as better fitness or an overall healthier lifestyle that could be associated with dog ownership, said co-author Caroline Kramer, an endocrinologist and clinician scientist at Leadership Sinai Centre for Diabetes at Mount Sinai Hospital in Toronto. “The results, however, were very positive.” As a dog owner herself, Kramer said adopting her miniature schnauzer, Romeo, “increased my steps and physical activity each day, and he has filled my daily routine with joy and unconditional love.” Tove, however, cautioned more research needs to be done before people are prescribed dogs for health reasons. “Moreover, from an animal welfare perspective, dogs should only be acquired by people who feel they have the capacity and knowledge to give the pet a good life.”

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his has proven a banner year for ConnextCare. Headquartered in Pulaski, the nonprofit healthcare provider celebrated its 50th anniversary in May. ConnextCare also expanded its reach to serve more residents of rural areas, which are typically underserved when it comes to health care. Many areas — especially rural areas — face a provider shortage. Despite this fact, ConnextCare recently added six primary care providers as well as a child physiatrist to support its practices. Since it’s a federally qualified health center, ConnextCare was able to get the funds to support some of the new positions through the federal Health Resources and Services Administration. “It’s been our goal to provide immediate access to behavioral health when a patient has come for primary care,” said Dan Dey, president and CEO. The organization operates sites in Pulaski, Mexico, Parish, Phoenix, Oswego and Fulton. Referring patients outside the facility may limit access to care, as some patients may struggle to obtain transportation or understand why it’s important to connect with those resources. Among the hirings are licensed clinical social workers — hiring them represents a big achievement for a rural care provider, according to ConnextCare officials. To support these professionals — who cannot do everything that a psychiatrist can do, such as prescribe medication —ConnextCare has contracted with a psychiatrist and pediatric psychiatrist from SUNY Upstate Medical University to provide services for one day each week. “I think the reason we’re successful in recruiting is we provide a balanced life culture here for our providers and for our staff,” Dey said. “We are attentive to offer family-friendly policies to our staff as well as to our contracted providers. It gives a mission to our providers that leads to greater practice satisfaction.” Attracting providers to live and work in a rural area is difficult for many health systems. ConnextCare likes to emphasize the perks of rural life. Providers don’t struggle with traffic nor have problems finding parking space. The family practices offer a few evening hours, but most of the time it’s regular office hours. Syracuse’s culture and conveniences aren’t far away, either. Dey said that the pay and benefits packages are also attractive, especially health insurance, for which ConnextCare covers nearly the entire cost. ConnextCare’s status as a federally qualified health center offers its workers advantages. Providers can obtain malpractice protection through the Federal Tort Claims Act because they’re treated as federal employees. Day said that employees like working at ConnextCare for the quality of care it provides. ConnextCare follows a comprehensive quality management program submitted annually to the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services. The organization is also Joint Commission accredited, an industry-recognized hallmark of quality and accountability as well as Patient-Centered Medical Home Level 3 designated. The organization’s leadership

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ConnextCare’s headquarteres in Pulaski. The federally qualified health center has grown from six primary care providers, four nurse practitioners and one dentist to currently 17 medical doctors, 25 nurse practitioners and physician’s assistants, four dentists and six dental hygienists. The organization recently add several healthcare professional to its team.

ConnextCare Expanding in Oswego County

As it turns 50, healthcare provider adds a number of new health professionals, including social workers, physicians By Deborah Jeanne Sergeant has also received a few accolades that make ConnextCare stand out, such as the Chief Advanced Practice Provider Elaine Shaben, a nurse practitioner. Upstate Medical University named her “Outstanding Voluntary Faculty” for her role as a faculty preceptor for students in the nurse practitioner program.

There’s also Senior Vice President and Chief Medical Officer Patrick Carguello, DO, who received The Paul Ramos Award from the Community Health Care Association of New York for his work in expanding access to quality healthcare in the community. Dey said that offering training

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

opportunities in conjunction with Upstate has helped in attracting complementary providers. ConnextCare also recruits from St. Joseph’s. “Many candidates were trained on site in our practices and we’ve gone on to recruit them,” he said. “Because they’ve been already linked to ConnextCare, the providers experienced a smoother transition into employment,” added Tricia Peter Clark, executive vice president and chief operating officer. “They already know the organization’s culture and how ConnextCare practices. New graduate hires also receive a longer on-boarding period when joining the practice. Each is paired with a seasoned provider who acts as a continuous resource for them, as they build their skills and confidence as new providers.” Once every spring, five dental residents rotate for a week each at the Pulaski ConnextCare dental office, which Dey said serves as a recruitment platform. The areas where ConnextCare operates have been designated as underserved. “We qualify for national health service corps loan forgiveness,” Dey said. “If those providers practice for a certain amount of time, those providers’ can apply for loan forgiveness. Most stay after their commitment is fulfilled.” Since these are usually younger providers at the beginning of their career, this often fills a position longterm. Consolidating healthcare has “brought more resources and support and funding to expand complementary services within our organization,” Dey said. “It also gives us the stature and scope to collaborate with our community partners to integrate all the facets of healthcare to meet the needs of our community.” At present, ConnextCare has 250 contracted and employed workers. The Health Resources Administration recently awarded ConnextCare a grant of close to $300,000 for oral health to reconfigure some components of the Pulaski office to increase its accessibility. Tricia Peter-Clark, executive vice president and chief operating officer, anticipates completion in June 2020. Another goal for the year is opening another school-based health center to serve schoolchildren in Mexico by September 2020. Under Dey’s leadership for the past 12 years, ConnextCare has grown from six primary care providers, four nurse practitioners and one dentist to currently 17 medical doctors, 25 nurse practitioners and physician’s assistants, four dentists and six dental hygienists. Both acquiring other practices and recruitment has helped ConnextCare grow. Dey calls Jan. 1, 2013, a “tipping point” for ConnextCare. Then known as Northern Oswego County Health Services, Inc., the organization acquired Fulton Health Center and Oswego Health Center from Oswego County Opportunities. ConnextCare also assumed three practices from Oswego Hospital in Mexico, Phoenix and Parish. These steps more than doubled ConnextCare’s size. Dey said that these acquisitions were funding “through a variety of resources,” including grants from the federal government, and grants from the New York State Department of Health and the New York State Health Foundation.

H ealth News Oswego now offers robotics-assisted knee arthroplasty Orthopedic surgeons from the Center for Orthopedic Care at Oswego Health are the only surgeons in Oswego County to bring robotically-assisted knee arthroplasty to the surgery center. The NAVIO Surgical System incorporates Diaz hand-held robotics and 3-D images of the patient’s knee. This allows the surgeon to collect patient-specific information, establish spatial boundaries for the surgical instrument, and allow for more accuracy removing the damaged surfaces of the knee. The system assists with properly balancing the ligaments of the joint and accurately positioning the implant leading to potentially better outcomes and longevity. Unlike other robotics systems, patients are not required to undergo a pre-operative CT scan with the NAVIO Surgical System from Smith & Nephew. Physician Michael Diaz was instrumental in bringing this state-ofthe-art technology to Oswego Health and has extensive experience in performing this level of surgery. “Not only are we achieving a greater level of accuracy with the use of robotically assisted systems, but with our primary focus being on patient care, our patients receive cutting-edge care with shortened recovery times,” said Diaz. “Our goal is to provide robotically assisted total knee on an outpatient basis.” Said Michael Harlovic, president & CEO at Oswego Health: “Patient-centered care is the core of our mission at Oswego Health. Whether that be recruiting top medical professionals such as Dr. Diaz to meet the healthcare needs of our community, or purchasing state-of-the-art technology, we are making these investments to ensure the highest level of quality healthcare needed is provided right at home in Oswego County.”

Loretto launches peritoneal dialysis treatment Loretto is now offering peritoneal dialysis, a daily treatment for kidney failure that filters patients’ blood inside their own body. Unlike the more common “hemodialysis” which removes blood from the body in order to filter it and is typically performed at a hospital or dedicated dialysis center three days a week this peritoneal dialysis is less invasive, can be performed during the day or while the patient sleeps, requires fewer diet restrictions, allows for greater flexibility and improved rehabilitation. Loretto is the only healthcare system to offer peritoneal dialysis

in a 73-mile radius. Binghamton is the next closest location to offer this service. “Our rehabilitation residents can now receive peritoneal dialysis in a more homelike environment, which gets patients out of the hospital and rehab faster, and will help lower hospital readmissions,” said Meredith Boss, director of nursing at Loretto. “We have seen a high demand for this service in Central New York, and we already receiving calls from people in the Oswego and Watertown areas, too.” “Having the ability to deliver peritoneal dialysis at Loretto enables patients to continue on their existing peritoneal dialysis regimen, while starting the rehabilitation they need,” said physician Salil Gupta, president of Nephrology Hypertension Associates of CNY, P.C. “This alleviates the need for another procedure (hemodialysis) and transporting the patient to an outside facility which means their stay at rehab is much more conducive to their healthcare.”

Upstate’s Thoracic Oncology Program turns 20

SUNY Upstate’s Thoracic Oncology Program — or TOP, as it’s known by medical providers — is celebrating 20 years this November. It follows a multidisciplinary team approach. Specialists from multiple disciplines comprise the team, which meets formally to collaborate on the care of individual thoracic oncology patients. Team members include medical, surgical and radiation oncologists, pathologists, imaging specialists, pulmonary specialists, nurse practitioners with specialized training, nutritionists, social workers and patient navigators. Such a team approach — which is typical at major cancer institutes — has been shown to significantly boost a patient’s survival. The Upstate Cancer Center has several multidisciplinary teams for various types of cancers, including breast cancer, head and neck cancers, gastric and esophageal cancers, and pediatric cancers. Physician Leslie Kohman championed the team concept at Upstate two decades ago because ”it gives better care to the patient, and it saves the patients a tremendous amount of time getting around to all of those Kohman different appointments,” she says. “Also, almost all cancer patients need more than one modality. Very few patients are treated with just surgery or just chemotherapy or just radiation,” Kohman says. “To have experts from all those disciplines discuss treatment up front is very beneficial to the patient.” Thoracic surgeon Jason Wallen is medical director for TOP. He says the team approach means every patient

Physicians shown in the photo are Mark Charlamb of the Cardiovascular Group of Syracuse; Robert Corona, chief executive officer of Upstate University Hospital; and G. Randall Green, division chief of cardiac surgery and director of the Upstate Heart Institute.

Cardiovascular Group of Syracuse Joins Upstate Medical University

pstate Medical University has announced an agreement to have the Cardiovascular Group of Syracuse, a comprehensive cardiology practice in Central New York, join its faculty. The move was effective Sept. 1. The move to add the practice that includes eight cardiologists to the Upstate medical faculty is a key step in Upstate continuing to build its heart institute and increases its number of outpatient cardiology sites to six locations. The Upstate Heart Institute unites the expertise and advanced technologies of cardiac surgeons, and cardiovascular and cardiology specialists, set

has every option open for discussion. “It’s kind of like getting eight or 10 second opinions all at once, in a single visit.” Such team care is natural at an academic medical center, where doctors and caregivers are encouraged Wallen to seek input from one another.

Loretto announces promotion, new hires Loretto, a leader in comprehensive healthcare services in Central New York, which provides care to close to 10,000 people, recently announced a promotion and the hiring of two professionals. • Meredith Boss has been promoted to the role of director of nursing at Loretto Health & Rehabilitation. Previously assistant director of nursing for short-term rehabilitation, Boss was an integral part of the planning and opening of Loretto’s restorative care unit and is continuing to work to bring new innovations and technology to expand the quality of care at Loretto. Boss holds an Applied Science November 2019 •

within the resources of the region’s only academic medical university. For patients, the addition of the new cardiologists at Upstate will put into place the expanded medical team to create streamlined care, with greater access to other experts and treatments as needed. The expansion also secures the safety net services for vulnerable patients and provides more support for the specific needs of older patients. More faculty also provides the ability to create new programs, such as a women’s heart program, and strengthens the setting where a patient’s interrelated issues can be addressed by the team. Degree in nursing from Crouse Hospital College of Nursing and a Bachelor of Science in nursing from Keuka College. She is expected to complete her master’s degree in nursing and Boss become an advanced practice family nurse practitioner in June 2020. She also holds certifications in advanced cardiovascular life support and cardiopulmonary resuscitation from the Red Cross, as well as certification in adults with autism from the Rochester Regional Center for Autism Spectrum Disorders. Loretto has also hired two healthcare professionals: • Shelley Schlie was hired to serve as director of nursing at The Nottingham RHCF. Previously she was director of nursing for an assisted living facility in Manlius. She brings extensive experience in both long-term Schlie

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H ealth News

Rendering of Oswego Health’s new behavioral health services facility at 29 E. Cayuga St. in Oswego. The project will be completed by September 2020.

New Behavioral Health Services Facility Coming to Oswego

swego County is a step closer to having a facility exclusively designed for mental health treatment. Oswego Health recently held a ground-breaking ceremony to mark the conversion of the vacant Price Chopper building on the east side of Oswego into a modern behavioral health services site. The health system is renovating 42,000 square feet of the former grocery store, to feature 32 inpatient beds and related outpatient behavioral health clinic facilities at 29 E. Cayuga St. The facility is expected to be complete by September 2020. Oswego Health in 2017 was awarded a $13 million grant from the New York State Department of Health for the transformation of its behavioral health services in the county. Oswego Health is the only behavioral health services inpatient and outpatient provider in Oswego County. According to the hospital, the purposes of the project are to: • Improve the overall financial condition and long-term sustainability of Oswego Health;

• Transform behavioral health services to a new model of care with the resulting impact of enhancing behavioral health services in Oswego County; and • Preserve behavioral health services within the county. According to a news release, patients will find the new location offers a welcoming, soothing and healing environment that includes secure outdoor spaces, comfortable interior areas and a kitchen area. The building itself will be landscaped to match the neighborhood and will be well-maintained. To assist those that utilize these services become healthier overall, primary care services will be available onsite. Services that are offered currently at the Behavioral Health Services Bunner Street location, the outpatient clinic and Assertive Community Treatment (ACT) Team also will be relocated to the new facility. The facility is a short drive from the Oswego Hospital emergency room, making it more convenient for physicians and other staff members.

care and acute care. She was a clinical instructor for OCM BOCES’ LPN program, and was instrumental in opening a rehab unit and developing a resident assistant program for a local long-term care facility. Schlie holds an Applied Science Degree of nursing from St. Joseph’s College of nursing and a Bachelor of Science in Nursing from LeMoyne College. She also holds certifications in advanced cardiovascular life support and cardiopulmonary resuscitation from the Red Cross, as well as certification in geriatrics. She is also a certified CNA trainer. • Anna Nelson was hired to serve as nurse practitioner in employee health at Loretto Health & Rehabilitation. Nelson was previously a nurse practitioner at Crouse Hospital’s employee health Nelson office. She has 20 years of experience as a nurse practitioner in multiple settings, including occupational medicine and employee health. She holds a Master of Science in nursing and family nurse practice from Barry University in Miami Shores, Florida. She is a board-certified family nurse practitioner in New York state.

St. Joe’s opens medical center in Camillus

A community open house in October marked the opening of St. Joseph’s Health Medical Center in Camillus, located at 5301 W. Genesee St. “This expansion into Camillus is part of our continued commitment to bring care closer to the community members we serve,” said Leslie Paul Luke, president and CEO at St. Joseph’s Health. “The western suburbs are an expanding market with great

schools, abundant retail and dining options, and growing families. As that neighborhood grows, we want to bring more health care services to the community in a way that’s convenient for them.” The 16,000 square foot St. Joseph’s Health medical office in Camillus currently offers cardiology services, primary care and obstetrics. There are 16 exam rooms, two procedure rooms, the capacity to build six more exam rooms. Neurology services will become available in November, and the building has capacity to add more services in 2020. Current practitioners at the Camillus location include: physician Ryan Planer, primary care/obstetrics; nurse practitioner Roman Batyuk, primary care; physician James Connelly, cardiology; nurse practitioner Lynn O’Donnell, cardiology; physician Karen Odrzywolski, neurology; and physician Savita Kumari, neurology, The new location also features a new corridor concept instead of the traditional patient exam room layout. Exam room “pods” will have two entrances: one for patients and a second for medical staff. Nurses’ stations are located in between the patient rooms to allow staff to circulate more efficiently in a “staff only” corridor equipped with workstations for a more efficient workflow, and a more economical and less cluttered overall footprint. Patients will also notice another difference in the exam rooms at this new medical office: instead of the traditional exam tables, the rooms will have medical grade chairs that recline allowing the patient to sit comfortably while waiting for the provider but recline easily for his or her exam. A community open house will also be held Thursday, Oct. 17, 2019 from 5 to 7 pm. The office is currently accepting new patients for all services and is actively recruiting for additional primary care staff.

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H ealth News

Physicians, nurses and assistants at Crouse Cardiology team.

Crouse Cardiology Team Marks 100th Watchman Implant The team at Crouse Health’s Miron Cardiac Care Center recently celebrated its100th Watchman left atrial appendage closure implant since 2017. The Watchman implant offers an alternative for patients with atrial fibrillation (AFib) who take warfarin on a long-term basis to help prevent blood clots and possible stroke. The implant acts as a safety net by closing off the left atrial appendage and catching harmful blood clots before they enter the bloodstream. Crouse was the first hospital in the area to offer the Watchman, which is a mesh device inserted through a catheter in the femoral vein in the groin and guided into the patient’s heart, where it can filter potential blood clots and prevent

possible stroke. “This is a milestone that underscores the cardiac care team’s commitment to offering leading-edge technology to ensure the best possible outcomes for our patients,” said physician Seth Kronenberg, Crouse chief medical officer and chief operating officer. Crouse cardiologists Joseph Battaglia, Kwabena Boahene, and Matthew Gorman were the first in the region to offer the implant to patients with AFib. About five million people in the United States suffer from AFib, which occurs when the upper and lower chambers of the heart stop beating in harmony. Instead, the upper chambers beat irregularly and stop moving blood through and out of the heart.

Crouse physicians Kevin Johnson and Alann Weissman-Ward.

Crouse Health Celebrates National Coming Out Day Each year, National Coming Out Day is celebrated to promote a safe world for LGBTQ individuals to live truthfully and openly. To celebrate, Crouse Health’s diversity and inclusion committee held a ‘lunch and learn’ event featuring Crouse physicians Kevin Johnson and Alann Weissman-Ward. Both spoke to their colleagues and guests about coming out and coming out as transgender in the workplace. Johnson, a psychiatrist for Crouse substance use disorder treatment, spoke about what coming out means and how we can support people when they come out. “I happen to be fortunate to work in an environment where I can be out as a gay man but many people aren’t that lucky,” said Johnson. Weissman-Ward, medical direc-

tor of Crouse’s Commonwealth Place for inpatient substance use disorder treatment, shared information about coming out as transgendered and offering support to the trans community. “It’s actually pretty normal for people to feel depressed when they don’t feel like they fit into what normal society expects you to be,” Weissman-Ward said. After both presentations, the doctors took questions and comments from their colleagues, some of whom shared their own experiences with coming out. Crouse Health’s diversity and inclusion committee, comprised of Crouse staff from across the organization, was formed in 2014 with a goal to better serve our organization and our community.

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