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Can You Actually Die from a ‘Broken Heart’? ALSO INSIDE: Top 10 things to improve heart health



PRIMARY CARE New primary care physician at Crouse — Paraskos Araouzos (Dr. ‘Perry’) —talks about shifts in the medical industry and shares tips for people to stay healthy

PEDIATRIC HEARING LOSS Among children aged 6 to 19, 14.9% have some level of hearing loss. Local experts discuss the issue

URGENT CARE Vs. EMERGENCY If you or your child need healthcare, how do you determine the urgency of the need? Local experts discuss when people should to to the ER or the urgent care


Foods to Boost Your Mood

What you eat matters for every aspect of your health —including your mental health. Find out what types of food can help you fight the winter blues. P. 20

New Drugs Getting FDA’s Blessing Faster, But Is That a Good Thing? P. 9

Oh, tofu. Poor, misunderstood tofu. It gets such a bad rap. But what exactly is tofu?

P. 19

Yes, We Do Sleep More in Winter Study shows many Americans spend more time sleeping during this cold, dark season

P. 3


Why more people say …

#TakeMeToCrouse One Team. Second to None. More than 150 experienced, passionate emergency medicine physicians, nurses, physician assistants, nurse practitioners, pharmacists, social workers, care managers and support staff.

Cardiac Emergencies. We Put Our Heart into Saving Yours. •

Door-to-cardiac treatment times among the lowest in the region

Only area hospital designated by American Heart Association (AHA) as a Mission: Lifeline Gold provider

Strong teamwork with our local and regional EMS partners

Joseph Battaglia, MD Chief of Cardiology Miron Cardiac Care Center

Comprehensive Stroke Center “Crouse is the place you go when you have a stroke.

It’s that simple.”

One of just 15 in New York State

Aggressive door-to-treatment times exceed national average

Earned Gold Plus–Elite Honor Roll status from AHA

— CNY musician Todd Hobin

Proud to be the official healthcare provider of Syracuse Athletics. Best of luck this season to Coach Boeheim and the Orange! #CrouseForTheCuse ®

crouse.org Page 2

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020




New Study Reports Alarming Surge in E-Scooter Accidents


lectric scooter accidents are sending droves to emergency rooms — especially young adults, a new study finds. As e-scooters’ popularity has exploded, so have injuries — skyrocketing 222% between 2014 and 2018 to more than 39,000. Hospital admissions also soared — 365% to nearly 3,300. Head injuries made up about a third of the injuries, twice the rate seen in bicycle accidents, researchers said. Men suffered about two-thirds of the injuries. Most riders hurt for the first time were between 18 and 34 years old, researchers found. “E-scooters are a fast and convenient form of transportation and help to lessen traffic congestion, especially in dense, high-traffic areas,” said senior author Benjamin Breyer, a urologist at the University of California, San Francisco. “But we’re very concerned about the significant increase in injuries and hospital admissions that we documented, particularly during the last year, and especially with young people, where the proportion of hospital admissions increased 354%,” he added in a university news release.

Health officials nationwide are alarmed by the number of fractures, dislocations and head injuries showing up in trauma centers from e-scooter accidents, researchers noted. A likely reason: Few regulations for e-scooter use exist, particularly about the need to wear a helmet. Only 2% to 5% of injured riders wore helmets, the study found. Researchers think mandatory helmet use would dramatically reduce the number of head injuries from e-scooter accidents. For the study, they reviewed data from a nationwide injury reporting system. Between 2014 and 2018, almost 40,000 injuries from powered scooters were reported nationwide, the study found. The accident rate more than tripled over that period — from six per 100,000 people in 2014 to 19 in 2018. The Most common injuries were fractures (27%); scrapes and bruises (23%); and cuts (14%). In all, 78% of injuries happened in cities. The report was published online Jan. 8 in the journal JAMA Surgery.

Many Americans Sleep More in Winter L ike the mighty grizzly bear that hibernates in winter, many people spend more time sleeping during this cold, dark season, a new survey reveals. According to the American Academy of Sleep Medicine (AASM), 34% of Americans say they sleep more in winter, compared with 10% who claim they sleep less during this time of year. In summer, these numbers are turned around, with 36% saying they sleep less and 9% saying they sleep more than usual. “The shorter days during the winter create a great, natural opportunity to spend more time sleeping,” physician Kelly Carden, president of the AASM, said in an academy news release. “Getting quality sleep of adequate duration can improve physical and mental health, overall performance and mitigate safety risks,” she added. Here are some tips for getting a good night’s sleep regardless of the season:

You’re invited Join us for a special event dedicated to heart health!



Keep your heart at its healthiest. Learn from our expert speakers and enjoy new ways to bring more exercise, good food, and stress management into your life–at any age.

Upstate Heart Institute Keynote speakers Lifestyle Is Medicine You can start a healthier life today. Heart disease is different in women, but the right choices now can reduce risk by up to 80%. Cardiologist Amy Tucker, MD What A (Healthy) Girl Wants — At Any Age Explore what food can do for heart health, and compare the evidence on diets. Learn the real effects of caffeine, chocolate, wine and more. Cardiologist Theresa Waters, DO

™ Free mini sessions on

The Art and Heart of Journaling Tai Chi for Strong Hearts Drumming for the Heart Learn the Moves of Chair Yoga

™ Enjoy heart healthy snacks and drinks

Sample new tastes for salt-free cooking and superfoods Make your own heart healthy spice mix–sweet or savory

™ Additional event features • Set a bedtime that allows you to get enough sleep. • Avoid screens and electronics before bed. Exposure to light at night can disrupt the sleep cycle. • Avoid caffeine after lunch and alcohol near bedtime — both can disrupt sleep. • Relax before bed by taking a warm bath, drinking tea, journaling or meditating. • Make your bedroom comfortable. It should be cave-like — quiet, dark and a little cool. • If you have sleep problems, see your doctor.

Blood pressure testing Visit health information tables Relax with a new craft

RSVP Today by calling Upstate Connect at (315) 464-8668 or visit www.upstate.edu/SWSH Presented by

February 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Feb. 3, March 11

Free, unbiased Medicare discussion in Auburn Overwhelmed by all the mail, calls and Medicare options? The Cayuga County Office for the Aging offers complimentary monthly classes to help you make sense of Medicare. Here you will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches. You’ll learn about how Part D drug plans work and whether EPIC co-pay assistance is an option for you. If your income is limited, we’ll provide information about programs to help pay for your insurance covDiscover

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Frozen Fire & Lights Bonfires, Kites Flying, Cardboard Sled Races, Fireworks & more! Inlet’s Winter Festival

Cross-country Skiing, Snowshoeing, Ice Skating, Skishoeing & Sledding

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Live Snow Cams

InletSnow.com Check out these webcams in the Inlet, NY area.

Alzheimer’s Association announces support group meetings Alzheimer’s Association support groups provide an opportunity for people to share personal experiences and feelings, and coping strategies. The power of the group lies within the connections made between participants, who develop a bond that bridges the emotional void faced by caregivers. The relationships formed within the group often extend beyond the monthly meetings. In addition to caregiver support groups, the CNY chapter of offers early-stage support groups. These provide peer-to-peer conversation and support for individuals living in the disease’s early stages. Groups are open to the individual living with dementia and their caregiver, and advanced screening is recommended prior to attending by calling the Alzheimer’s Association office. The chapter also offers specialized support groups that address the specific caregiving concerns felt by LGBT caregivers, spousal caregivers, and care partners of those living with younger-onset Alzheimer’s disease. Page 4

erage, as well as a listing of the free and low-cost preventive care under Medicare. All classes will be held in the basement training room of the Cayuga County office building. The current schedule is from 2 to 4 p.m. Feb 3, and from 1 to 3 p.m. Mar 11. Check The Citizen and the Cayuga County Office for the Aging’s Senior News & Views details on future classes. Registration is required. For more information or to register, please call the Cayuga County Office for the Aging at 315-253-1226, or visit the website at cayugacounty.us/507/ office-for-the-aging under the News & Activities section.

Feb. 4

“Ask the Audiologists” one of the topics discussed at HLAA meeting Hearing Loss Association of America Rochester Chapter invites anyone interested in hearing loss to any or all of several events on Tuesday, Feb. 4. All programs are held at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester, across from the George Eastman Museum. The schedule is as follows: • 10 a.m. “Hearing Other People’s Experiences.” Church Vestry Room. Prospective, new or experienced hearing aid users can share their experiences, questions, and hearing loss journeys in an informal round table discussion facilitated by retired audiologist and hearing aid All support groups are free of charge to attend and facilitated by trained individuals. For more information, call 1-800-272-3900 or email cny-programs@alz.org.    

February/March meetings

Cayuga County

• Auburn Sts. Peter and John Episcopal Church, 69 Genesee St. 2 p.m., first Thursday, Feb. 6, March 5  

Madison County

• Canastota Madison County Office for the Aging, 138 Dominic Bruno Blvd. 10 a.m., third Friday, Feb. 21, March 20 • Cazenovia Community Resources for Independent Seniors, 12 Mill St. 6 p.m., second Wednesday, Feb. 12, March 11

Onondaga County

• Baldwinsville Baldwinsville Methodist Church, 17 W. Genesee St. 6:30 p.m. second Tuesday, Feb. 11, March 10 • Clay Immanuel Lutheran Church, 4947 state Route 31 3 p.m. fourth Thursday, Feb. 27,

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

user Joseph Kozelsky. • 11 a.m. to 1 p.m. “Ask the Audiologists.” Parish Hall. Program begins at noon. Bring your questions and audiologist John McNamara will answer them. The event is an opportunity to clarify and discover what you’ve wanted to know about hearing loss in real time. McNamara has owned Ontario Hearing Center since 1990. • 9 p.m. “Relationships/Communication Between Those With and Without Hearing Loss.” Parish Hall. Program begins at 8 p.m. With registered nurse Lisa Brooks, a home care nurse for Home Care of Rochester, and her husband Dan Brooks, president of HLAA New York state and co-chairman of Healthy Living with Hearing Loss (HLHL2). Discussing barriers to communication, they hope that people with hearing loss bring to the meeting spouses, children, co-workers, friends and other loved ones. They say, “Together we can strive to make hearing loss OUR barrier and together learn ways to communicate better with one another.” For more information, view the organization website at hearinglossrochester.org or call 585 266 7890.

Feb. 8

Taste of Chocolate event to benefit food pantry A new Taste of Chocolate event, which will help Lafayette Outreach, the local pantry, will take place from 9:30 a.m. to noon, Saturday, Feb. 8, in the Columbian Presbyterian Church Session Building. The church is located on the corner of routes 11 and 20, Lafayette. This is a food-sampling event where participants can purchase samples of dozens of homemade goodies with one thing in common: Chocolate. Choose from white, dark or milk chocolate in cookies, muffins, candies, breads and more. Samples are only $.50 — or 22 March 26 Support group for spousal caregivers • DeWitt Pebble Hill Presbyterian Church 5299 Jamesville Road. 4:30 p.m. third Wednesday, Feb. 19, March 18 Support group for individuals with early-stage dementia and their care partners. Advanced screening is recommended prior to attending by calling 315-472-4201. • Liverpool Liverpool First Presbyterian Church, 603 Tulip St. 11 a.m., second Saturday, Feb. 8, March 14 • Manlius Manlius Public Library, 1 Arkie Albanese Way 6:30 p.m., fourth Tuesday, Feb. 25, March 24 • North Syracuse The Gathering Place at NSBC, 420 S. Main St. 3:15 p.m., third Tuesday, Feb. 18, March 17 • Skaneateles Grace Chapel, 1674 U.S. Route 20 2 p.m. last Thursday, Feb. 27, March 26 • Syracuse Alzheimer’s Association, Central New York Chapter, 441 W. Kirkpatrick St.

samples for $10. Fifty percent of the proceeds will be donated to the local food pantry. Taste some treats here, then fill a box for your sweetheart. For more information, call 315-6773293 and send an email to cpresbyt@ twcny.rr.com.

April 4

20K Series in Oswego announces dates and opens The Third Annual “Make It Happen 20k Race Series” in Oswego is kicking off 2020 withthe dates of the upcoming four part event and opening registration. The “Make It Happen 20k” combines long standing 5K races of the Oswego County Autism Task Force, Oswego Little League, Oswego Health Foundation, and the Buc Boosters, into one 20k series. New this year, the series will include both a runners and walkers prize categories at the conclusion of the four events. The first 5K of the series will kick off on Saturday, April 4, with the Out Run Autism 5K, followed by the Oswego Little League 5K on June 21, the Oswego Health Foundation on Aug. 8, ending with the Buc Booster “Go BUCS” 5K on Oct. 4. Participants once again will compete in all four individual events with an overall race series winner. The overall winners in both running and walking categories will be based on age group divisions and race time results from all four events combined. “It is our hope that both avid runners and walkers and anyone looking to kick start optimal health and wellness in 2020 will consider participating in the series thus supporting these great community organizations,” said Julie Chetney, series committee member. Visit www.auyertiming.com to register for the series or any event individually. Anyone interested in the series must register prior to first event on April 4. 5:30 p.m., second Wednesday, Feb. 12, March 11 Support group for caregivers of people with younger-onset (under 65 years old) Alzheimer’s disease or other dementia • The Centers at St. Camillus, 813 Fay Rd. 5:30 p.m., third Tuesday, Feb. 18, March 17 • The Hearth on James, 830 James St. 1 p.m., first and third Thursday, Feb. 6 and 20, March 5 and 19 • SAGE Upstate, 431 E. Fayette St. 3 p.m., second Tuesday, Feb. 11, March 10

LGBT caregivers support group Oswego County

• Central Square First Universalist Church of Central Square, 3243 Fulton Ave. 7 p.m., fourth Monday, Feb. 24, March 23 • Oswego The Manor at Seneca Hill, 20 Manor Dr. 6 p.m. fourth Wednesday, Feb. 26, March 25

97 97 97

“I lost 60 pounds. I feel better, I move better. I can get on and off the floor” - Stephen Goodrich, retired, Sackett’s Harbor

“I feel more confident and relaxed. I don’t stress about failure. I lost 29lbs.in past 2 months. AMAZING!” -Jeannine Bermond

“I was a size 10. I am now a size 4. I know that this is a permanent change for me” - Sue Bullock, Brewerton “After my 1st session I noticed a change in my behavior: I started exercising more and enjoying it, food that was tasting good was tasting better than ever!” - Jim Purcell, Engineering sales, Central Square “I have lost 20 pounds and 35 inches, with the confidence & self-help to continue this adventure.” - Cindy Woodard Retired RN, Clayton “Almost immediately I began sleeping well and the carbs and junk I was craving through the past began to diminish.” - Jessica Baker, Financial, Watertown “The pounds came off easy! Thanks to this program I am feeling so much better” - Bonnie Perkins, Retired Teacher, Alex Bay

“ Ive lost 35lbs and kept it off. To be healthy and the size you want to be the rest of your life is almost priceless.” – Peg Markbam

“Without Hypnosis I would be a basket case” - Tania Taylor, Photographer, Evens Mills “I am most grateful for the change in my attitude which gives me the energy I was lacking. I love the change in me.” - Marry Herbert, Retired Teacher, Heavelton “I no longer have intense cravings; I no longer drink soda” - Tina Keck, massage therapist, Adams “I feel great, I am completely eating whole foods. I sleep better.” - Meg Gilimore, LCSW, Lycoming

“After the first session it felt amazing! I have no cravings or withdraws.” - Craig Haines, technician, Oswego

“I ve lost 47lbs. with hypnosis. I feel confident, I feel at ease when I am in public” – Jeanne Jeslyn

“I will be forever grateful to this program.” – Lesley Hughes, Educator, Pulaski

“I have been amazed by how easy it is to totally immerse yourself in the program.” - Melody Meroni, Educator, Syracuse

“This has been the best decision I have made for myself.” - Pamela Still, RN Supervisor, Lisbon

“After hypnosis. I truly eat like a thin person and enjoy improved health and wellbeing. - Joseph Spano, Business Owner, Pulaski

“My experience with hypnosis has helped me to change my attitude towards food and emotional eating.” - Ruth Ann Ward, Tech Service, Camillus

“Now my eating habits & physical exercise come easily to me.” - S.Laroberdiere, Retired, Parish

“No more midnight snacks and food hangovers in the A.M.!” - Irene Mcintyre, Student, Minoa

“The Fee was nothing compared to the other programs, I would recommend North Country Hypnosis to anybody, it’s just wonderful.” - Leslie Golwitzer, RN, Syracuse “I love myself, I’m in control of myself. I think of myself as a thin person.” - Dawn, Watertown “I lost 67 pounds 12 “I have control over all years ago and kept of my decisions and do it off. This is the not allow others to alter simplest thing I’ve or change my plans. ever done.” - Sharron Gorman, – Mike Lasurdo LCSW, Sackets Harbor “I feel that there are health benefits that I’ve received that are lifelong positive changes.” - Joanne Shelby, RN, Cazenovia “I can finally say that I feel I have control of my eating.” -Patricia Okoniweski, Nurse Practitioner, Fulton “I have lost 77 pounds. I highly recommend this program very highly.” – Ella Mae Welshelvo, Machinist, Williamstown “Hypnosis is fun, relaxing and rewarding.” – Deb Hamilton, Teacher, Pulaski “After one week, my energy has returned as well as my desire to participate in life.” - Sheryl Distsfano, P.A., Philadelphia Ny

“I hope there are many others like me will try this program and realize their potential to be a healthy thin person.” - Michelle E, PA, Altmar

“I’ve lost 5” off my waist and 35 lbs since starting this program.” - Bradley Kyser, Truck driver, Ellisburg “When you sit down to eat you don’t eat as much because hypnosis lets you know you don’t want too.” - Pam Brown, Retired, Theresa “Immediately I had no cravings for a cigarette. Best thing I ever did for myself.” – Renee Thomas, Secretary, Baldwinsville “I went to North Country Hypnosis in 1986 and never had another cigarette! That was 33yrs ago.” - Kari Starkweather, Retired “I have not smoked at all since my first session. It made me feel more in control of my life.” - Robin Kelley, Accountant, Liverpool “I haven’t had a cigarette since I left your office in 2005. I brag about it to this day and North Country Hypnosis gets full credit. – Lorraine Lasalle Williamstown

destinyhypnosis.com February 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 5


Your Doctor

By Chris Motola

Paraskos ‘Perry’ Araouzos, M.D.

Fewer Americans Have a PCP Now ‘There has been something of a convenience revolution in primary care,’ doc says


he number of Americans who have a primary care physician is shrinking — with potential consequences for their health, researchers say. Their new study found that in 2015, an estimated 75% of Americans had a primary care provider — down from 77% in 2002. The declines were most pronounced among people under 60: For Americans in their 30s, for example, the figure dropped from 71% to 64%. The study, published Dec. 16 in JAMA Internal Medicine, could not dig into the reasons. But the new “convenience culture” could be one driver of the trend, said lead researcher David Levine, a physician at Brigham and Women’s Hospital in Boston. Especially for people who are younger and in better health, walkin clinics — promising fast service at nontraditional hours — may be more appealing than an old-style primary care appointment. “There has been something of a convenience revolution in primary care,” Levine said. “And that’s likely one of the things going on in younger populations.” If that is the case, is it necessarily a bad thing? “Continuity of care — having a provider who knows you, and knows your history — is very important,” Levine said. In a study published earlier this year, he and his colleagues found that Americans with a primary care doctor were more likely to receive “high-value” types of care. That, Levine said, includes things like flu shots, counseling on weight loss and smoking cessation, blood pressure checks and standard cancer screening. There are, however, other culprits in Americans’ gradual departure from primary care. “Everywhere else in the world,” Levine said, “’primary care first’ is the health care model.” But in the United States, people often see specialists — who, in the medical world, reign in pay and prestige, Levine noted. And that draws many new doctors into specialties, and away from primary care.

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New primary care physician at Crouse talks about shifts in the medical industry and shares 10 tips for people to stay healthy Q: How did you come to work at Crouse? A: I’m a board-certified family medicine physician. Crouse got word that I was available; they knew me, I knew them. It seemed like a good fit. I truly appreciate the professional working relationships with all my colleagues at Crouse Medical Practice. Many have known me through the years, and to be part of this team is very special to me. There is great leadership here and the administration has been so supportive. It is a blessing to be here. Q: What kinds of patients do you see? A: At Crouse Medical Practice, I’m a primary care physician seeing patients 18 and older. In my new practice at our Manlius office, I’m enjoying the best of both worlds: I’m able to see my former patients and also welcome new individuals to my practice. Q: With the changing shape of the medical industry, have you experienced the role of primary care changing during your time in practice? A: With the passage of the Affordable Care Act, there’s definitely been a shift toward preventive care. This is particularly gratifying for providers who’ve concentrated on primary care, with its main purpose of keeping people as healthy as they can be for as long as possible. We know that lifestyle choices can play a major role in preventing certain diseases or conditions. If we advise our primary care patients on how to make healthier choices, and to work with them to monitor existing conditions, we’ve played a role in keeping them healthier. Aside from the patient care model, preventive care also helps to reduce our nation’s overall healthcare spending. The CDC has estimated that chronic diseases that are avoidable through preven-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

tive care services comprise about 75% of healthcare spending in the U.S., totaling billions of dollars. Q: Any other changes as a result of the Affordable Care Act? A: An unintended consequence in this shift toward more preventive services has also increased the need for primary care physicians and providers, locally across the state and nationwide. Many physicians are now at or nearing retirement age, and the number of new younger doctors to take their places is not keeping pace with the need. Crouse Medical Practice is actively recruiting additional physicians, as well as physician assistants and nurse practitioners, to proactively service the needs of our community. Q: What tactics do you think work for attracting people like you, or in your case keeping you, in areas with shortfalls? A: For a primary care physician like myself, great satisfaction comes about when we can do the best and what’s right for our patients. A practice needs to provide employed physicians and all providers with an environment in which we can achieve longevity of service, an exceptional continuity of care and build a strong rapport with patients. Q: How do you go about building good rapport? A: In any healthy relationship, trust must exist. And this is especially true in the patient-provider relationship. You can build immediate trust with patients, and individuals in general, through active listening, showing you care and treating each patient and family member with respect and dignity. Q: You’re from downstate, but you’ve been in the CNY community for a while. A: I graduated from Upstate in 2001. I finished my family medicine residency at St. Joe’s

in 2004. I worked at the Syracuse Community Health Center until 2007, then opened a private practice. I worked at a local nursing home and urgent care. So, I’m going back to my primary care roots. Q: What are some of the differences working in those different contexts? A: There’s a balance when you’re doing urgent care, geriatric care or primary care. You get to see the full spectrum of healthcare, everything from common problems to acuity. The most important common thread is preventive care and the doctor-provider relationship. Q: What do you see as the primary care physician’s role in preventative care? A: Preventive care is the most important aspect of the primary care provider’s role. It’s vital for a physician to invite a patient into a partnership in order to establish individual wellness goals and achieve the best health possible. The partnership needs to be built on mutual trust and respect. Q: What kind of an impact are you trying to have on local health? A: It would be really great to be known as a community doc who cares for and respects patients and to expand Crouse Medical Practice’s reputation for exceptional primary and specialty care. Crouse Health is also working diligently to help expand access to quality care in our community; I’m proud to be a part of this effort. Q: What do you advise patients to do in order to stay healthy? A: I actually have 10 tips, which you can find on a blog post I did recently for the Crouse Connects blog: eat healthy; exercise; get plenty of sleep; have regular medical and dental exams; practice personal safety; schedule regular screenings; don’t smoke or do drugs; drink alcohol in moderation; wear sunscreen and avoid excess sun exposure; and strive to achieve positive mental and emotional health. As a primary care physician, I can help my patients make better choices that are preventive in nature. Q: When you’re not caring for patients, how do you relax? A: Spending time with my family and gaming with my kids. I also love music — it’s one of my biggest pastimes…guitar, anything from classic rock to more upbeat pop, to hard rock, especially from the late ‘80s and early ‘90s.


Name: Paraskos ‘Perry’ Araouzos, M.D. Position: Primary Care Physician at Crouse Medical Practice in Manlius Hometown: Bronx Education: SUNY Upstate Medical University Affiliation: Crouse Health Career: Syracuse Community Health Center (2004-2007), family physician; FamilyCare Medical Group, PC (20072010), family physician; James Square Nursing (2007-2012), attending physician; Family Medical Care of DeWitt (2010-2012), family physician, owner; Immediate Medical Care of CNY (2008-2013), urgent care physician; St. Joseph’s Health (2013-2019), urgent care physician Organizations: American Academy of Family Physicians Family: Married, two children Hobbies: Music, science fiction, Marvel movies

February 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Say hello to healthy.

66 dedicated physicians and healthcare providers. Say hello to a more convenient way to stay healthy in Oswego County. 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. Page 8

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

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.

New Drugs Getting FDA’s Blessing Faster, But Is That a Good Thing? Eight out of 10 new drugs in 2018 benefited by special programs that streamline FDA’s approval process


ew drugs have been approved by the U.S. Food and Drug Administration for patients based on less and less solid evidence, thanks to incentive programs that have been created to promote drug development, a new study shows. Researchers report that more than eight out of 10 new drugs in 2018 benefited from at least one special program that streamlines the approval process. The result is that patients are being prescribed pricey new medications that have not been tested as rigorously, said lead researcher Jonathan Darrow, an assistant professor at Harvard Medical School. “The evidence standards have changed, but it’s not clear that physicians, let alone patients, understand either the basic FDA approval standard or that requirements have become increasingly flexible over the past 40 years,” Darrow said. The share of new drugs support-

ed by two strong clinical trials, rather than just one, decreased from 81% to 53% between the 1990s and the 2010s, researchers found. The time that the FDA spent reviewing each new drug dropped during the same period, from 2.8 years in the late 1980s to about 7.6 months in 2018, Darrow added. This might be good news if highly effective new drugs were reaching the market quicker, but other research has found that the large majority of newly approved drugs offer modest benefits over existing therapies, he said. “In many cases, you can get almost all of the benefit of the new drugs by taking older drugs,” such as generics, Darrow said. The programs also haven’t really improved the number of new drugs approved each year, either. “Even with that flexibility, there has been no strong upward trend in the number of drug approvals, which

on average has remained about 30 new drugs approved per year since the 1980s,” Darrow said. The average annual number of new drug approvals was 34 from 1990-1999, decreasing to 25 from 2000-2009 and then increasing to 41 from 2010-2018, researchers found. The FDA did not respond to a request for comment, nor did PhRMA, a trade group representing the pharmaceutical industry. Since the 1980s, various programs have been enacted by U.S. Congress or developed by the FDA to promote the creation of drugs for rare diseases or accelerate approval of promising medications that could benefit multitudes, researchers said in background notes. “In 2018, more than 80% of new drugs benefited from at least one special program,” Darrow said. These programs have weakened the review process by requiring the FDA to accept more flexible evidence, he said. For example, evidence of a drug’s effect on cholesterol lev-

els or tumor size can be used to get it approved, rather than evidence that the drug helped people live longer or feel better or avoid emergencies such a heart attacks, Darrow said. But there’s been no benefit from these programs in terms of how long it takes a company to create a new drug, he said. “We found there was a relatively stable period between when clinical trials began and when drugs were approved. We did not see a steep decline in the clinical development period,» Darrow said. Disturbingly, the FDA has also become more financially reliant on money from pharmaceutical companies, researchers found. The amount of the FDA budget that comes from the pharmaceutical industry has increased from about $300 million in the 1990s to just over $4 billion in the 2010s, researchers found. These fees are used to accelerate review times, researchers said.

Healthcare in a Minute

By George W. Chapman

Impact of Hospital Mergers: Higher Prices, No Significant Quality Improvement


he New England Journal of Medicine recently published a study concluding hospital mergers and acquisitions have had little positive impact on the quality of care and typically drive up prices in the market. The study compared 246 hospitals that were merged or acquired with 1,986 hospitals that weren’t, for: patient experience, mortality, readmissions and clinical process. As expected, the insurance industry was quick to pounce and agree with the study while the hospital industry was quick to rebut. Regardless, many mergers and

acquisitions have virtually salvaged financially challenged hospitals that would otherwise be closed. Many rural hospitals would not be open for business if they weren’t affiliated with a larger hospital or hospital system. Mergers make it easier for hospitals to attract, employ and retain scarce nurses and providers while offering a broader more expansive range of services to the consumers of the smaller, more remote or financially strapped facility. The department of justice monitors mergers and acquisitions for any untoward impact on prices.

Bill to Cut Drug Costs Stalled

Bill to End Surprise Billing Stalled

The bilateral bill passed by the House, which would empower Medicare to negotiate prices on 250 drugs over the next 10 years, is buried in the pile of 275-plus bills sitting on Senate majority leader Mitch McConnell’s desk. McConnell has “ruled out” taking up the bill which would lower Medicare spending by $456 billion over 10 years. With only two Republican congressmen voting for the bill, it will assuredly die anyway in the Republican controlled Senate. All the talk by elected officials to control and lower drug costs is stifled by the drug lobby.  

Both houses of Congress thought ending surprise billing would be a no brainer. But that was before a barrage of last-minute lobbying by non participating providers and healthcare staffing companies that make money via surprise billing. Congress reached a “compromise” by establishing benchmark rates and an arbitration “backstop” for charges above $750. Vested interests in the status quo will continue to thwart efforts to reform healthcare and lower costs.    

ACA Fate Undetermined

President Trump continues to vow to terminate the Affordable Care Act (Obamacare) without offering a viable replacement. Twenty million Americans are insured via the ACA. There has never been an outcry over the ACA from any of the major stakeholders, designers, or founders — including insurance companies, hospitals, physicians and consumers — because it is working. The courts have ruled the individual mandate to carry insurance was unconstitutional because the penalty to not carry insurance was considered an illegal tax. States against the ACA argue the whole law should be thrown out since the individual mandate was declared unconstitutional. A threejudge panel agrees the individual mandate is unconstitutional but has asked the lower courts to review whether or not the entire ACA should be declared unconstitutional. If the entire ACA is tossed, so will be coverage of pre-existing conditions.  

NYS Medicaid Problems

NYS has the most expensive Medicaid program per capita in the country. Most of that can be attributed to relatively generous benefits and some of that can be attributed to fraud and mismanagement. Roughly: the federal government pays 50%, NYS pays 25% and local municipalities pay the remaining 25%. NYS enrollment has been steady at about 6.2 million people since 2015 thru 2020 (projected). The budget for the same period has increased from $60 billion in 2015 to a projected $74.5 billion this year. That means the per capita cost has increased from $9,677 February 2020 •

in 2015 to a projected $12,000 this year. NYS is expecting an overall budget shortfall of $4 billion for the fiscal ending March 31,2020.  

Genetic Testing Scam

Scammers are targeting seniors. They offer genetic testing kits, then ask for what they really want … your Medicare number. The scammers can be online, on the phone or in person at health fairs and senior centers. Never agree to genetic testing unless ordered by your physician.

Gun Violence Funding

Congress has authorized $25 million in funding for the Centers for Disease Control and National Institutes of Health to study gun violence, which has become one of the leading causes of death. Forty thousand Americans a year die via gun violence. Sixty percent — or about 24,000 of the deaths — are suicides. Although a relatively paltry amount (we spend over a trillion a year on healthcare) the bipartisan bill was seen as at least a start at addressing the issue and getting some evidence-based data for possible solutions. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Touch: One of Life’s Essential Ingredients


kiss. A hug. A gentle touch. No, this is not a column about romance in anticipation of Valentine’s Day. I am writing, instead, about a related matter: the importance of touching and being touched. Both are essential to our sense of well-being. This subject is especially relevant for those who live alone, because — on our own — we can be susceptible to touch deprivation. When that happens, we miss out on all the benefits of healthy human contact. I’m no expert in this area, but others are, and their research has shown that touch is absolutely essential for emotional and physical health and development. Studies conducted by the University of Miami’s Touch Research Institute revealed that touch can do so much good: it can help reduce pain, anxiety and depression, lower heart rate and depression and even promote immune function and healing. But I don’t need a study to con-

vince me of the value of touch and affection. I have my own proof and it is revealed to me whenever I am touched or touch another. A friend’s warm hug can lift my spirits, a reassuring hand on my shoulder can hold the demons at bay, even a handshake can be affirming. Those who live alone can often unwittingly, almost unconsciously, neglect this vital component of a happy, healthy life. It’s easy to do, especially if you have a tendency toward isolation or are without a significant other in your life. If that’s the case, I encourage you to take notice. Is touch absent in your life? Has it been weeks or months since you enjoyed the warmth of an embrace? When was the last time you felt the comfort of a soothing caress? Or, exchanged backrubs with a friend? Below are a few tips to “keep in touch.” They have worked for me, and it’s my hope that you, too, will benefit from incorporating positive, loving touch into your life.

• Become a hugger. It’s not for everyone, but if you’re not a hugger, consider becoming one. A little practice is all it takes. Hugging didn’t come naturally to me. It wasn’t something I grew up with, so it felt awkward at first. I was forever bumbling the embrace: leaning left, when I should have been leaning right; knocking heads; or sending glasses askew. So, years ago, I made a deliberate decision to become a hugger. Intuitively, I knew I was missing out on this natural form of human expression. The good news? I got better at it over time, and life is sweeter as a result. • Volunteer to touch. The benefits of “loving touch” are not just for the ones receiving it. Those who deliver it also reap great personal rewards and satisfaction. If you look around, there are plenty of opportunities to administer positive, healthy touch to someone in need. Many hospitals have volunteer “rockers” for newborns, and nursing homes are often looking for volunteers to make personal connections with residents who may not have family nearby. Just an hour visiting with a resident, while applying hand lotion, could make her day. To volunteer in this way can be a healing act of kindness, one that says we are in this life together. What soothes one soothes us all. • Own a pet. Study after study has shown that petting a dog or gently stroking a cat can have a calming effect on people by lowering blood pressure and reducing anxiety. Again, I don’t need a study to validate my own experience. Petting my beloved springer spaniel Scout or snuggling with her

on the couch has an immediate and relaxing effect on me. After a busy day, almost nothing is as grounding as a few minutes with my affectionate pooch. • Get in touch with yourself. Self-gratification for pleasure or with the goal to sooth, heal or relieve tension is natural and can be a healthy expression of self-care and affirmation. When you “love the one you’re with,” something profound and restorative can result. • Splurge for a massage. I read recently that, “Massage is to the human body what a tune-up is for a car.” Among its many benefits, therapeutic massage can bring relief from anxiety, reduce stress, fight fatigue and increase your capacity for tranquil thinking and creativity. If touch is absent in your life, this form of safe, non-intimate human contact can refocus the body’s natural ability to heal and regenerate itself. Plus, it just feels wonderful! You can make a conscious effort to bring more touch into your daily life and, in doing so, bring more happiness to yourself and those around you. Touch enhances bonding and gives us a sense of belonging — important essentials for everyone, but especially for those who live alone. Gwenn Voelckers leads Alone and Content empowerment workshops for women held in Mendon and 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 workshops, to purchase her book, or invite her to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.



IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020


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Upstate Hospital Opening Inpatient Mental Health Unit for Teens By Payne Horning


ore people killed themselves in 2017 than killed others: 47,173 suicides in 2017 compared to 19,510 homicides, according to figures from the Centers of Disease Control (CDC). The problem is even more acute with younger generations. Suicide is the second-leading cause of death for those aged 10-34. And it’s getting worse. Data from the CDC shows that the suicide rate overall has increased by 31 percent since 2001. In response, Upstate University Hospital is opening an eight-bed inpatient unit to offer mental health services for adolescents in crisis. A staff comprised of child and adolescent psychiatrists, nurses, mental health therapists, and others will provide around-the-clock care for patients aged 12-17. The goal is intervention and stabilization for those with suicidal or self-destructive tendencies. Physician Joseph Biedrzycki, medical director of the Upstate adolescent inpatient psychiatric unit, says this unit is opening at a time in which Central New York, like much of the nation, is experiencing a shortage of mental healthcare providers, especially child psychiatrists. “Access to care can be a big barrier because sometimes it can take several months to get connected with a psychiatrist or someone who can prescribe medication that for some conditions are really an essential part of the treatment,” Biedrzycki said. “There’s a younger population of children that need an inpatient facility to address their needs.” This unit is designed to do just that. It will cater to patients who have unsuccessfully attempted suicide or those who are expressing suicidal thoughts. However, Biedrzycki says who is referred to their program will depend on whether they are good fit for the particular treatment that will be offered, called DBT: dialectical behavioral therapy. It’s a specialized program for those suffering from depression, anxiety, post-traumatic stress syndrome, and

injurious behaviors. The objective with DBT, says Biedrzycki, is to help patients better cope and regulate their emotions. The entire staff working in the unit have been trained in DBT, part of Upstate’s comprehensive approach. Patients won’t just be treated by psychiatrists, they will also interact with nurse practitioners, social workers, clinical social workers, psychologists, and even a school teacher. “We have an excellent staff who are very caring and have a good understanding of what needs to be done to provide a supportive environment,” he said. Attention to detail was key when Upstate designed the $3.8 million eight-bed unit. According to Biedrzycki, they eliminated as many methods and means for patients to intentionally harm themselves as possible. Additionally, each patient will have private rooms and bathrooms complete with comforting features like muted lighting, music, and weighted blankets. Staff wanted to create a welcoming environment so patients don’t feel like they are being institutionalized. Upstate expects the average stay in the unit will be no more than a week. Once a patient is discharged, they will be connected with child and adolescent mental health resources in the community. Central New York medical and government officials are praising the creation of this new unit at Upstate, but many say this is just one piece of the puzzle to address the mental health epidemic. More medical professionals and resources are needed. “The unit is a small step in addressing a critical need here in Central New York for mental health services for our youth,” said in a press release Upstate Interim President Mantosh Dewan, a psychiatrist by training. “Our commitment to this pressing need does not end with this unit’s opening. Upstate will continue to be part of the community discussion moving this important issue forward with great urgency.”

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Page 11

Addressing Pediatric Hearing Loss Among children aged 6 to 19, 14.9% have some level of hearing loss By Deborah Jeanne Sergeant


very baby born in a US hospital receives a hearing screening. Of those, only a fraction — .16% — have some level of hearing loss, according to the Centers for Disease Control and Prevention. But among children aged 6 to 19, 14.9% have some level of hearing loss because of later onset hearing issues. Addressing children’s communication needs as young as possible is very important and bears lifelong effects. “A child’s brain is very elastic in the first three years of life,” said Arlene Balestra-Marko, audiologist and owner of Hear 2 Learn in East Syracuse. “They’re learning language. The brain is starting to wire itself for all of the sensory components. Hearing begins in the womb. A child who is born with hearing loss has not heard clearly for a few months of life. If we cannot give them proper stimulation in the auditory cortex, the brain organizes itself more for visual and other sensory avenues.” She added that missing aspects of language acquisition without any means of intervention to improve communication can delay children’s

learning, cognitive abilities, social development and eventual employment opportunities. Fitting with hearing aids represents the most widely selected choice for mild to moderate hearing loss; however, some parents of children with severe to profound hearing loss choose to use sign language to complement their children’s growing communication skills. However children acquire communication skills, it’s important to start early. “A variety of techniques have been developed that allow us to assess hearing loss, the degree of hearing loss and better enable us to fit hearing aids,” said Doug Brown, audiologist with Audiology Associates, PC in Syracuse. “Primarily, it’s through objective measurements. Instrumentation now allows us to measure what the brain is receiving from the hearing aid and that way we can assess how they’re doing. As they get older, then the abilities of the child themselves to participate improves as well.” Working with a professional after they receive their child’s hearing loss

diagnosis can help parents navigate. Brown added that hearing aids for babies differ quite a bit from those intended for adults. To make them appeal to children, hearing aids come in bright colors and patterns, similar to the effect of fun options for glasses. They also have low battery lights so parents know when to charge or change the battery. Their tamper-resistant battery doors help prevent ingestion. Children’s hearing aids are also compatible with hearing assistive technology (HAT) systems that allow parents’ or teachers’ voices to transmit directly from a microphone into the hearing aid, which reduces the effect of ambient noise interfering with the message. Fitting hearing aids is also different for children compared with adults. Parents are more involved for pediatric fittings and device care, especially for infants who are both incapable of expressing their experience accurately and lack normal hearing experience for comparison. Audiologist Balestra-Marko added that usually, infants receive a full prescription, unlike adults, who have to slowly adjust to hearing aids. Infants are seen every three to four months for adjustments as they grow. By about age 5 for most children, their ear canals are at adult size. Manufacturers make children’s hearing aids more durable than their adult counterparts, in case children remove them. “What I’ve found through my experience is if they’re fitted correctly, there’s no reason for the child not to use it,” Brown said. “Children aren’t born with diapers, yet they wear them. Hearing aids should be the same way. It’s a matter of fitting them correctly and working with

the parents to figure out the best way that works for the child to wear them. It can be a challenge.” Many parents use a clip similar to that of a pacifier to keep hearing aids together and attached to the infant’s clothing so they don’t get lost. Some parents use headbands, hats or aids with attachments that “hug” the child’s ear. Working closely with an audiologist helps parents from learning of their child’s diagnosis through ongoing hearing aid care, device adjustments and obtaining the support the child needs at school and for extracurricular activities. In-school supports are available to make sure children with hearing loss can have every opportunity possible to learn, such as speech therapists and aides to ensure they have their particular needs met. “Even though a child may pass a newborn hearing screening, that doesn’t mean they can’t acquire a hearing loss later on as a child or adult,” Brown said. “Parents shouldn’t have the assumption is once they pass the screening they’re home free.” Though disease-related hearing loss such as mumps and measles have been greatly reduced thanks to immunization, untreated middle ear infection represents a possible cause of childhood hearing loss. “We want parents to be aware of how children behave when they have a hearing problem,” Brown said. “Moms are the No. 1 indicators. If parents suspect a problem, such as the child is not as responsive or consistent or those types of behaviors, we want that child to be seen.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020



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ast month, I wrote about my New Year’s resolutions. What I failed to recognize is resolutions are for middle-aged or old people. No one does resolutions anymore. Somewhere between mastering thirdgrade geometry and testing the best way to get gingerbread house glue off my son’s favorite pants, I missed a trend. Today, it’s all about highlight reels. Social media is the perfect place to culminate a thing such as a highlight reel. It already documents the very best occurrences in our lives. If you checked out my social media feed, you would think my kids were always smiling and we always lived life to its fullest. You also may think I was a pro runner and a gourmet chef. A braver person than me would come clean about how often we eat boxed macaroni and cheese and how, even if I manage to sneak out for the occasional run, I typically forget to wear deodorant. So, that brings me to the even trendier trend. At some point, the internet started crying foul on the highlight reel. People started posting what their real lives looked like, after they removed the “perfection filter.” Although I appreciated those real reels, they weren’t nearly real enough for me. So, in the name of being honest and staying on track with the newest of trends, I offer you my parenting reality reel. Enjoy the realities of my 2019. • Cleaning and organizing the house from sun-up to sundown I don’t mean to brag, but I’ve kind of turned laundry into a competitive sport. I also know how to slay most of a Saturday putting things back where they belong and keeping my home a step above “roach-less.” My husband even contributes to this recurring highlight. It’s all glory. • My husband threatening to take Santa away The best thing about this highlight is we got to experience it multiple times. Telling kids they are clearly on the naughty list and will not be getting gifts is a solid strategic threat during November and December. Like the much-contested New England Patriots pulling a perfect play out of nowhere, my husband knew exactly when to execute this gem. Which leads me to the next highlight. • My children tying for the


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title of “best bickerer” I like to think of my family as being forerunners in a lot of those ways. One of those ways is a little scientific study we conduct around our home and in the car. It’s called, “Can an adult literally die from exposure to childish bickering?” The answer, despite how my brain feels, is no. We are in a phase I will call “iterate your findings.” • My daughter getting her first cavity Despite winning the “do we really need to brush our 7-year-olds teeth for her” argument with my husband, my daughter still got a cavity. Although she was a real trouper during the dental procedure, I can’t leave this one off the reel. • My son eating chocolate pudding for breakfast every morning If I asked my son to draw a balanced breakfast, he would draw a bowl of pudding with equal parts store-bought pudding and whipped cream from a canister. Go ahead, judge me. But there’s something else you should know; my daughter rotates between a croissant with Nutella and toaster pastries at breakfast time. • Yelling at my kids to stop yelling This one is pure parenting gold. If you don’t do this at least once in a while, can you really earn your parenting badge? This act is one of the highest forms of parental hypocrisy, yet it’s unavoidable. I’m looking forward to feeling guilty about this one far into 2020. • Losing the donation paperwork This one was a real proud moment. I signed up to donate items to my kids’ school. I said I could bring anything they needed. They sent home the requests on separate sheets of paper (because I have two kids). I promptly misplaced one, but I wasn’t certain I ever actually had two. I tore apart the house to no avail. Spoiler alert: there were two. Lucky for me the school got more than enough donations. • Telling someone I have two kids, ages 3 and 5 My daughter is 8. My son is 5. But, let’s be honest, does anyone asking this question truly care about the answer? So, I hope you enjoyed the realness of my reel. Here’s to all of the beautiful foibles awaiting me in 2020

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Page 13

My Turn Keepsake Ultrasounds of Your Baby: Why You Should Be Wary By Eva Briggs


ack when my kids were born — and I know I’m dating myself here — having an ultrasound of your baby wasn’t routine. Most people didn’t even have one ultrasound during pregnancy. If one was ordered by their physician, it was usually for a specific reason, not as a routine thing. Now that more is known about the technology and its use, most women get several ultrasounds during pregnancy. The first is in the first trimester to confirm the due date. Usually there’s a second ultrasound at approximately 18 to 22 weeks to evaluate for normal anatomy and the baby’s sex. (My daughter expresses horror at the thought that I had no idea whether I was having a girl or a boy until she was born. “How,” she asked with incredulity, “did you know how to decorate my nursery?!”) Mothers with the certain medical conditions, such as diabetes or hypertension, may need additional ultrasounds. Or if there is a problem with the baby’s growth or anatomy, a doctor will order additional ultrasounds. Now a whole commercial business has grown up offering “keepsake” ultrasounds. Parents are willing to pay for photos and videos

of their babies that look more lifelike than the 2-D ultrasounds offered at their doctor’s office. But there are several reasons to be wary. First, a quick explanation. 2-D ultrasounds are the type that are most usually done by medical professionals during pregnancy. Those show a cross-sectional view of the developing baby. Although there can be a wealth of information for the trained provider, they may be confusing to the average parent. A 3-D ultrasound pieces together images taken from various angles to form a three-dimensional image. This creates a picture that looks more like a typical photograph. 4-D adds motion, so that you can see the baby moving and kicking. Why don’t medical professionals use 3-D and 4-D ultrasound routinely? First, 2-D is quicker and more efficient. Experts developed standards for normal growth and development using 2-D ultrasound. Professionals do use 3- D images to better evaluate certain abnormalities, and also to better explain findings to parents. Second, ultrasound waves create heat. There isn’t any evidence that the small amount of heat generated by a 2-D ultrasound harms an unborn child. But it’s not known for

sure whether prolonged exposure to ultrasound used by a commercial enterprise could be harmful. Medical professionals prefer to limit unnecessary exposure. They are trained to minimize the amount of time your baby is exposed to ultrasound, and to use the lowest power settings on the machine. In a medical setting, the operator of an ultrasound machine is focused on assessing your baby’s health. In a commercial setting, for a keepsake ultrasound, the operator focuses on getting the prettiest picture. The commercial ultrasonographer likely does not have the same rigorous training that a certified ultrasound facility demands for its sonographers. If they see something that looks abnormal, they may not be trained to provide you with information, support or follow-up. Commercial ultrasound can also offer false reassurance. An untrained ultrasonographer might not notice abnormalities with the baby, placenta or umbilical





cord. That’s what recently happened to a relative. She had a commercial ultrasound and was told that the baby was normal; a medical ultrasound less than two weeks later showed serious fetal abnormalities that weren’t recognized. So, if you decide to pay for an ultrasound at a commercial establishment in order to obtain a keepsake 3-D picture of your baby, don’t skimp on your visits to your OB-GYN doctor and recommended medical ultrasounds. Eva Briggs is a medical doctor who works at two urgent care centers in the Syracuse region.

Upstate New York’s 2018 uninsured rate is among the lowest ever recorded. According to recently released numbers from the U.S. Census Bureau, the uninsured rate in upstate New York was just 3.5 percent in 2018, compared with a New York state uninsured rate of 5.4 percent and a national rate of 8.9 percent. Low health-care costs are a key factor in upstate New York’s low uninsured rate.

For private insurance, Rochester and Syracuse are ranked as having among the lowest health care spending rates among 306 hospital referral regions across the country.* Upstate New York has a proud history of affordable, high-quality health care. It’s the result of regional partnerships and a commitment to nonprofit health care. It helps make our community a great place to live and work.

*Source: “The Experts Were Wrong About the Best Places for Better and Cheaper Health Care.” The New York Times, December 15, 2015 A nonprofit independent licensee of the Blue Cross Blue Shield Association

Page 14

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

Urgent Care Vs.

Emergency Room How Urgent Is Your Health Need? By Deborah Jeanne Sergeant


f you or your child need healthcare, how do you determine the urgency of the need? Should you wait for a primary care provider appointment, rush to the local urgent care center or call an ambulance for an emergency room visit? Local experts offered a few guidelines:

— From Matt Cambareri, family physician, West Taft Family Care, Liverpool: • “The ER is for emergencies: a child that’s short of breath, [showing] symptoms of dehydration like they’re not making tears or an infant with sunken eyes or a sunken fontanel— the ‘soft spot’ — or a child that’s lethargic, not interested in playing or eating or ‘off.’ • “ The ER is for broken bones or a concern that someone has broken a bone. One of the classic things is if it’s a lower extremity and they can’t bear weight. You’re better off going to the ER because they can get an orthopedic consult. If someone has an injury and there’s a lot of swelling and pain and they can still walk on it or move it, it might be a good thing for an urgent care. They can do X-rays on the spot and simple casting of something that’s a small fracture. • “If someone has low back pain for a few months and it’s a bad flare-up, start with a talk with their primary care. Most low back pain doesn’t need to be dealt with in an ER unless there’s severe loss of sensation, bowel/bladder function or inability to walk. • “Urgent care is when you can’t get into your primary. • “I reassure my patients that if they’re still eating, drinking, peeing,

pooping and playing, they’ll probably be OK, even if there’s a fever. As long as they’re drinking and not lethargic, we can see them tomorrow. Kids will have fevers, snotty noses and throw up. Those who are wheezing and asthmatic, that can be an emergency. • “If they’re under 1 month and have a fever, that’s an emergency. They have no immune system except borrowed from Mom through breast milk and what Mom passed on through the blood. Meningitis in a less-than-a-month old can go south in a hurry. Dehydration is a major issue to these kids. We take it super serious in the setting of a newborn.” — From Physician Wayne Chou, St. Joseph’s Health Urgent Care: • “The role of the urgent care is to see acute care issues that can be resolved relatively quickly. Urgent cares best deal with complaints such as a cut, injury, fall, a urinary tract infection, a recent cold or sinus infection, a mild upset stomach, or a sudden exacerbation of a chronic condition such as worsening asthma. • “We often see patients with the common cough and cold. Depending on the urgent care and their capabilities, urgent cares can take care of some more problematic issues such as pneumonias and influenza cases. At urgent cares where there are more testing modalities, such as St. Joseph’s Health Urgent Care, more issues can be evaluated and treated such as some abdominal pains, nausea and diarrhea, and kidney stones. • “If people are experiencing symptoms that may be consistent with heart attack or stroke, such as chest pains, numbness or fainting,

they should always go to the emergency room. Also, if a patient has a chronic complaint that has been going on for a long time, the urgent care is not the best place to be evaluated. • “During flu season, we recommend anybody who has coughing, congestion, high fevers and body aches to be evaluated by their physician or at urgent care within 48 hours of the symptoms starting. It’s best if anti-flu medications are administered within 48 hours of symptoms starting, otherwise the benefits do not outweigh the possible risks of side effects.” — From Tyler Greenfield, doctor of osteopathic medicine, medical director of pediatric emergency department, Upstate University Hospital: • “There is great value in maintaining a good relationship and having open communication with your child’s primary care physician. Utilize your child’s primary care physician on call or triage nurse to help you decide whether it can wait. • “Have your child evaluated immediately when your child is having difficulty breathing. • “Is your child able to stay well hydrated? Is your child not drinking and urinating well? Sick children tend to eat less but are they still drinking and urinating multiple times in a day. • “Is your child lethargic or difficult to arouse? • “If there’s a fever, call your child’s primary care physician to discuss the symptoms, behavior and length of fever. Your child’s primary care doctor or triage nurse can help ensure you know the proper weight

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based doses of acetaminophen and ibuprofen. They can help you decide if an ED or urgent care evaluation is needed immediately. • “If your child is getting worse instead of gradually getting better after the onset of viral symptoms and/ or fever, you may need to go to the ED or urgent care, but call to discuss with your primary. • “For broken bones with obvious deformities, go to pediatric ER instead of urgent care, as the broken bone may need to be reduced (set) under sedation. • “When there is acute worsening, check with your child’s doctor, primary or sub-specialist to help determine if you should be evaluated in the ED or urgent care. Your doctor often calls us in the ED to give us a heads up since they are aware of the course and what they may be concerned about today requiring an urgent evaluation. • “In the ED or urgent care, your child will be evaluated by the emergency department or urgent care team, not the pediatric subspecialist. Your child’s primary care doctor is your best initial advocate to place a referral and contact the subspecialist. In the ED and when a child is admitted, we involve the subspecialists for their opinion and help with acute or worsening problems. • “Your child should be promptly evaluated in the ED if there are any concerning symptoms with head injury like loss of consciousness, mental status changes, severe headache, vomiting, gait changes, vision changes, neck or spine pain. • “New onset or acutely worsening abdominal pain should be evaluated in the ED.”

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February 2020 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 15


Things You Need to Know About SAD

Seasonal affective disorder affects people every year during winter By Ernst Lamothe Jr.


easonal change can be a nice change of scenery for a split second, but the long-term effects are not always pleasing to everyone. Seasonal affective disorder (SAD), which typically occurs during the winter, is a mood disorder characterized by depression. Mostly caused when there is less sunlight and the weather is colder, it can have a crippling and overwhelming sensation in the lives of affected people. “Seasonal affective disorder has a distinct effect on people, especially those who live in areas where they go for long periods without seeing sunlight,” said physician Ahmed Nizar, medical director of the comprehensive psychiatric emergency program at St. Joseph’s Health Hospital in Syracuse. “This is definitely the case if you live in Upstate New York.” Nizar talks about five important facts to seasonal affective disorder.


SAD is not something that can be controlled

Effects of SAD is directly related to the weather, specifically wintertime when we experiment frigid temperatures and cloudy, shorter days. The condition affects people living in northern states. For example, 1% of those who live in Florida and 9% of those who live in New England or Alaska suffer from SAD, according to the National Institute of Mental Health. In some people with bipolar disorder, spring and summer can bring on symptoms of mania or a less

intense form of mania, while fall and winter can be a time of depression. “Many times I have heard patients have this idea of mind over matter or that they can just control the condition,” said Nizar. “There are scientific facts that connect to why some people suffer from the condition. You can’t just will it away.” Nizar suggests that people talk with their physicians if they feel different due to seasonal change. “You know yourself better than anyone. If you feel that you are sleeping more or that your mood has changed, you should consult with your doctor and not feel embarrassed about bringing this up.”


People who are affected

About half a million people in the United States suffer from winter SAD, while 10 to 20% may suffer from a milder form of winter blues, according to the Cleveland Clinic. Three-quarters of the sufferers are women, and the depression usually starts in early adulthood. SAD also can occur in children and adolescents. Older adults are less likely to experience SAD. Medical experts and psychologists say less exposure to sunlight alters the internal biological clock that regulates mood, sleep, and hormones is shifted. Exposure to light may reset the biological clock. Some of the symptoms include having low energy, hypersomnia, overeating, weight gain, craving carbohydrates and social withdrawal.

“With people wanting carbohydrates, feeling tired and sluggish and wanting to eat more, many times those who have SAD gain weight during the season,” said Nizar. “That can also lead to being more depressed.” Another theory is that brain chemicals such as serotonin that transmit information between nerves may be changed in people with SAD. It is believed that exposure to light can correct these imbalances.


It is not related to temperature or the holidays Another false theory is SAD occurs because of sadness around the holidays. That has been found to be untrue. In addition, another myth is that seasonal affective disorder has to do with the colder climate. “It has nothing to do with the temperature. It has everything to do with the sunlight,” said Nizar. “You could have a 10-degree day but if the sun is shining brightly, then someone who suffers from SAD might be fine. But you could have a 40-degree day that is cloudy all day and depression might set in.”


Coping strategies

People who seek help for SAD typically receive counseling as they normally would with a depressive disorder. Not only can counseling help, but the patient has to be willing to want the change.

Physician Ahmed Nizar, medical director of the comprehensive psychiatric emergency program at St. Joseph’s Health Hospital. In addition, light therapy is a way to treat seasonal affective disorder and certain other conditions by exposure to artificial light. During light therapy, a person sits or works near a device called a light therapy box. The box gives off bright light that mimics natural outdoor light. Light therapy is thought to affect brain chemicals linked to mood and sleep, easing SAD symptoms. Using a light therapy box may also help with other types of depression, sleep disorders and other conditions. “It has been shown to work where you need an hour or so of the light box every morning,” said Nizar, “It can make a world of difference.”


Disorder is not new

When people hear of SAD, many believe that it is something new that hasn’t affected many people. That is far from the case. “This is something that is more common than people think. We likely have a lower number of people who report being affected, but it is something that is happening to people worldwide,” said Nizar.

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Page 17

Antioxidant Use During Chemotherapy Risky for Breast Cancer Patients


reast cancer patients who take the dietary supplements known as antioxidants, as well as iron, vitamin B12, and omega-3 fatty acids, during chemotherapy may be at

Page 18

increased risk of disease recurrence and death, according to new study results appearing in the “Journal of Clinical Oncology.” Led by researchers at the SWOG

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

Cancer Research Network, a cancer clinical trials network funded by the National Cancer Institute (NCI) through the National Institutes of Health, the study confirms previous

medical guidance advising cautious use of any supplements, other than a multivitamin, for cancer patients undergoing chemotherapy. A small but growing body of research in the last 20 years shows that, despite their cancer-fighting reputation, antioxidants such as vitamin E, beta-carotene and selenium can actually increase risk of some cancers, cause some cancers to return after treatment or interfere with the effects of chemotherapy. As part of the nation’s oldest and largest publicly-funded cancer research network, SWOG has conducted some of this work. Its landmark Selenium and Vitamin E Cancer Prevention Trial (SELECT) showed that vitamin E supplementation increases the risk of prostate cancer in healthy men. What’s unique about the new study, led by Christine B. Ambrosone, Ph.D., of Roswell Park Comprehensive Cancer Center, is that it is the first investigation of the effects of supplement use during breast cancer treatment, and only the second to investigate the effects of supplement use during any kind of cancer treatment. The first was conducted by physician Charles Fuchs, the director of Yale Cancer Center, who found that vitamin C may be helpful for people undergoing chemotherapy treatment for colorectal cancer. “Although this is an observational study and the number of users of supplements was fairly small, the results are compelling,” said Ambrosone, chairwoman of the department of cancer prevention and control at Roswell Park. “Patients using any antioxidant before and during chemotherapy had an increased risk of their breast cancer returning and, to a lesser degree, had an increased risk of death. Vitamin B12, iron, and omega-3 fatty acid use was also associated with poorer outcomes.” Here’s what researchers found: • Patients who reported taking any antioxidant — vitamins A, C, E and carotenoids and Coenyzme Q10 — were 41% more likely to have their breast cancer return when they took the supplements both before and during chemotherapy treatment • Patients had a similar, but weaker, increased risk of death when taking those antioxidants • Patients taking vitamin B12, iron, and omega-3 fatty acid supplements were at significantly greater risk of breast cancer recurrence and death • Patients taking multivitamins showed no signs of poorer or better outcomes after chemotherapy . Ambrosone cautions that her study results are not definitive enough to influence how doctors treat cancer patients. To do that, she notes, the research community would need to run a larger, randomized trial testing groups who do and do not take supplements to get a clear and strong connection. However, she said the results do support the current cautious approach to supplement use for people undergoing chemotherapy.


The skinny on healthy eating

Why You Should Give Tofu a Chance O h, tofu. Poor, misunderstood tofu. It gets such a bad rap. Too mushy, too bland, too unknown. I used to be in that “not-forme” camp, but all that ended when three important things happened: I cut down on my meat consumption; I discovered how to cook with tofu; and I realized how nutritious it was. What exactly is tofu? Tofu is condensed soymilk that has been curdled and pressed into blocks (much like cheese). And why should we be eating it? Environmental reasons notwithstanding — it only takes about 200 gallons of water to produce one gallon of soymilk versus the 1800 gallons it takes to produce one pound of beef — tofu is a nutritional powerhouse. Tofu is an excellent “complete” plant protein source, with an average serving of firm tofu providing about 10 grams. While most Americans get plenty of protein, certain groups — such as dieters restricting calories, the elderly and people with cancer — may have trouble eating as much of this vital nutrient as they need. Over time, a lack of protein can cause swelling, fatigue, a loss of muscle mass, dry skin and hair and mood

changes. This versatile food also packs a solid amount of calcium, an essential mineral that contributes to healthy bones. Although the amount of calcium varies between tofu types and brands, an average serving can deliver between 10-20% of our daily needs. Unlike protein, most Americans don’t get enough calcium in their diets. When this happens, children may not reach their full height potential and adults may have low bone mass, which is a risk factor for osteoporosis. Tofu is remarkably high in manganese, a vital mineral that plays an important role in many bodily functions, including the metabolism of glucose, carbohydrates and cholesterol, the formation of bones, the clotting of blood and the reduction of inflammation. Some research suggests that manganese, when combined with calcium, may act as a natural remedy for easing PMS symptoms. And for people with diabetes, manganese may help lower blood sugar levels. Isoflavones — a type of plant estrogen that is similar in function to human estrogen but with much weaker effects — are abundant in

By Anne Palumbo tofu. At one point, isoflavones were thought to increase the risk of breast cancer, but recent studies have suggested the opposite. In fact, the Shanghai Women’s Health Study revealed that Asian women who ate the most soy had a 59% lower risk of premenopausal breast cancer compared with those who ate the least amount. But that’s but one study; more research is needed. A few more reasons to give tofu a chance? It’s super low in fat, sodium and cholesterol, and fairly low in calories: only 90 per half cup!

Turkish-Spiced Baked Tofu 1 block extra-firm tofu, pressed and drained 2 tablespoons extra-virgin olive oil 1 teaspoon each: coriander, cumin, paprika, garlic powder, dried thyme 1/2 teaspoon each: turmeric, Kosher salt 1/4 teaspoon coarse black pepper 1/8 teaspoon cinnamon Garnishes: pickled onions, shredded carrots, cilantro Preheat oven to 400 degrees. To press and drain tofu: slice block into 4 horizontal slabs, lay some paper towels on a baking sheet, place the slabs side by side on top of the paper towels, cover with another layer of paper towels, place a cutting board on top, and stack something heavy on the cutting board. Let tofu drain for at least 20-30 minutes. Cut tofu slabs into cubes about 3/4-inch thick. Add cubes to large mixing bowl, drizzle with olive oil, and toss gently to coat. Combine all

Having a Doctor Matters.

Helpful tips:

Read tofu nutrition labels carefully as the nutrition differences between silken and firm tofu are pretty big. Once opened, any unused tofu may be stored in plain tap water for up to 10 days. Just make sure the water is clear when ready to use; if cloudy, discard tofu. seasonings in a small bowl, sprinkle over cubes, and toss gently again until the tofu is evenly coated. Turn seasoned tofu out onto a parchment-covered baking sheet, and arrange tofu in an even layer (not overlapping). Bake for 15 minutes. Then remove from oven, and flip the cubes for even cooking. Return to oven for 15 more minutes, or until the tofu reaches your desired level of crispiness. Garnish with topping of choice.

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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February 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 19

“sunshine” vitamin because our body absorbs vitamin D primarily through sun exposure. It’s also called the sunshine vitamin because some studies suggest vitamin D can ease the symptoms of seasonal adjustment disorder (SAD), a form of depression that occurs at the same time each year, usually in the shorter, darker days of winter. According to researcher Peter Horvath of the University at Buffalo, many people have insufficient or deficient amounts of vitamin D during Upstate’s winter months, which over time, may result in a variety of health issues, including cognitive impairment. Maintaining proper levels is crucial to overall good health and can be accomplished by taking vitamin D supplements, increasing sun exposure, and eating foods that contain vitamin D or are fortified with vitamin D, such as oily fish, eggs, soy milk, and enriched cereals, milk and orange juice.

Eat endorphin-releasing foods

Foods to Boost Your Mood What you eat matters for every aspect of your health —including your mental health. Find out what types of food can help you fight the winter blues By Anne Palumbo


ome February, many of us slump into a winter funk. We’re worn down by the weather; we’re overwhelmed with post-holiday bills; and we’re angry with ourselves for already breaking our New Year’s resolutions. Tack on cabin fever and it’s no wonder we find ourselves parked in front of the TV with an open bag of chips. But chips — highly processed, refined-carb chips — are precisely the kinds of foods we should not be eating if we’re feeling blue. Growing evidence shows that getting the right nutrients — as well as implementing some basic nutrition strategies — can improve moods, tame stress, ease anxiety and even help fight depression. What are these nutrients and nutrition strategies? Though research regarding dietary factors and mental health is still inconclusive, there have been strong hints, according to leading experts, that certain foods may play a significant role in our mental well-being. For example, a recent study conducted at Loma Linda University and published in the “International Journal of Food Sciences and Nutrition” revealed that adults who consumed more junk food were more likely to report symptoms of psychological distress than their peers who consumed a healthier diet. Physician Jim E. Banta, lead author of the study, said that the results are similar to studies conduct-

Page 20

ed in other countries that have found a link between depression and the consumption of foods that have been fried or contain high amounts of sugar and processed grains. Research using data from large observations studies — like the Nurses’ Health Study and the Women’s Health Initiative — has also found links between food and mood. A study published in the “American Journal of Clinical Nutrition” found that women who ate more vitamin D-rich foods had a lower risk of depression than those who got less vitamin D in their diets. One diet in particular, however, repeatedly garners more than just “hints” of playing a role in depression: the Mediterranean diet. According to Patricia Chocano-Bedoya, a visiting scientist who participated in nutrition research at the Harvard T.H. Chan School of Public Health, “There is consistent evidence for a Mediterranean-style dietary pattern and lower risk of depression.” What you eat matters for every aspect of your health, including your mental health. On that note, let’s take a look at some well-founded suggestions for ways we might boost our mood with food.

Work more omega-3 fatty acids into your meals Omega-3s, a major building block of the brain, play an important role in sharpening memory

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

and improving mood. Because depression appears less common in nations where people consume large amounts of fish, scientists have zeroed in on this healthy fatty acid that is able to (1) interact with mood-related molecules inside the brain, (2) help promote the production of serotonin — the “feel-good” brain chemical, and (3) provide anti-inflammatory actions that may help relieve depression. Foods with the highest amount of omega-3s include oily fish (such as mackerel, salmon, sardines, tuna and herring), flax seeds, chia seeds, walnuts and soybeans.

Boost your serotonin levels An important neurotransmitter, serotonin communicates “happy” messages to your brain. Basically, the more serotonin circulating in your bloodstream, the better your mood. But higher blood serotonin levels — which can result from eating foods rich in the amino acid tryptophan — is but a piece of the feel-good puzzle. Tryptophan must cross into the brain to help serotonin work its magic, a crossing that is greatly facilitated by the consumption of carbohydrates. While any carb will do, experts recommend smart carbs, like whole grains, fruits, vegetables and legumes for their additional health benefits. Foods rich in tryptophan include poultry, eggs, oily fish, tofu, cheese, seeds and nuts. Also, too little folic acid in our diets can cause lower levels of serotonin in our brains. Some experts suggest that eating folate-rich foods — like asparagus, spinach, beans and lentils — may help some people who suffer from depression.

Get enough vitamin D Vitamin D is known as the

Naturally produced by the nervous system, endorphins are chemicals that act as a pain reliever and happiness booster. The wellknown “runner’s high,” for example, is due to an increase in endorphin levels after vigorous exercise. Certain foods can also boost endorphin levels. Although no food products contain whole endorphins for easy consumption, several foods contain high levels of the nutrients needed for boosting your brain’s endorphin production and encouraging its release. Chocolate-lovers, are you sitting down? Dark chocolate, with at least 70% cocoa solids, tops the list! Experts say it could be because of the antioxidants found in dark chocolate. Me? I’ll go with taste! Other foods that may influence the release of this “happy hormone” include strawberries, oranges, nuts, seeds, and anything spicy.

Move to a Mediterranean diet A lifestyle rather than merely a diet, the Mediterranean diet is associated with getting regular exercise, eating with family and friends, and practicing a balanced, healthy eating pattern that includes most, if not all, of the nutrients linked to easing or preventing depression. It’s also the diet that for the third year in a row has been named the best diet overall in the “U.S. News & World Report” annual rankings. The foundation of the diet is plant-based, not meat-based, and is built around daily consumption of vegetables, fruits, whole grains, and healthy fats (i.e., olive oil, nuts); weekly intake of fish, poultry, beans and eggs; moderate portions of dairy products; and limited intake of red meat. Red wine, in moderation, is also part of this highly recommended diet. As we all know, improving our mood by eating certain foods won’t happen overnight. But by moving away from junk food and toward foods that research has linked to better mental health, perhaps we stand a better chance of waking up on the right side of the bed! Anne Palumbo is the author of SmartBites column, published in this newspaper every issue.

Heart Month

LOVE YOUR HEART 10 Things to Improve Heart Health By Deborah Jeanne Sergeant


he American Heart Association lists three major risks for heart disease that you can’t alter: increasing age, gender (men have greater risk than women and tend to have attacks earlier in life), and heredity (those with heart disease in their family or who are of black, Mexican, American Indian, native Hawaiian and some Asian descent). While these can’t change, you can mitigate your risk with lifestyle. Here are 10 tips from local health providers: Don’t rely on quick fixes. “To improve one’s lifestyle, there are usually two main factors: diet and exercise,” said Andrew M. Weinberg, doctor of osteopathic medicine, cardiologist with the Upstate Cardiovascular Group and medical director of the Non-Invasive Vascular Lab. “Adhering to a heart healthy diet and regular exercise is the best way to stay healthy and reduce one’s chances for developing chronic conditions such as hypertension, hyperlipidemia, diabetes mellitus and atherosclerotic disease: coronary artery disease, carotid artery disease/ stroke and lower extremity peripheral arterial disease.” Be proactive. “Identify high-risk behavior and change it before the onset of an illness or disease begins,”



8. said Russell Silverman, cardiologist with St. Joseph’s Health. “A single intervention can prevent a number of life-shortening diseases. Secondary prevention involves screening for a disease if you are at-risk for that disease. This includes chest CT scans to detect lung cancer in smokers or being evaluated for the possibility of cardiovascular disease if you present risk factors.”

3.Control existing conditions.

“This may mean better controlling diabetes, better controlling cholesterol, better controlling blood pressure, quitting smoking, and routine examinations for diseases,” Silverman said. Limit alcohol. “Alcohol consumption is allowed, but in moderation only,” Silverman said. “This mean no more than two alcoholic drinks daily.” Eat right. “Eat plenty of protein to help skin and muscle stay strong,” Silverman said. “Healthy protein sources include chicken, fish, eggs, beans, nuts and soy products. Limit your red meat consumption. Avoid high fat foods and saturated fats, especially those foods labeled as trans-fat. These are particularly unhealthy and are found in fast foods and some butter substitutes. They are much less common than they

4. 5.

Can You Actually Die from a ‘Broken Heart’? F By Katie Coleman

ebruary is American Heart Month and a good time to consider your heart health, both physical and emotional. Traumatic life events, stress and grief can affect the human body in so many ways — such as sleep problems, fatigue, inflammation and weakened immunity — but in extreme instances of physical or emotional stress, our hearts can temporarily “break.” The condition is called takotsubo cardiomyopathy, also known as broken heart syndrome or stress cardiomyopathy, and was first described in Japan in 1990. Together, takotsubo means octopus trap in Japanese and was coined to describe the shape of the heart’s left ventricle when present with the condition. Although not fully understood, some experts think the flood of hormones produced during a

health promotion and wellness at SUNY Oswego. “Perform dynamic movements so movements that utilize multiple muscle groups such as walking, swimming or cross-country skiing. You do not have to go to the gym to keep your heart healthy. New research now states that even getting your 30 minutes in a day can be negated if you are sitting all day. Therefore, it is better or equally important to be active all day. Therefore, get up and move for five minutes every hour. It can be something as simple as walking up the stairs a few times every hour or something to get the large muscle groups of the body moving every hour.” Avoid tobacco. “Tobacco is a big risk factor for heart disease,” said Joshua W. Harrison, cardiologist with Crouse Medical Practice. “A year after quitting, risk drops to half that of a smoker.” Get check-ups. “You’d be surprised how many people don’t visit a physician regularly or check their blood pressure,” Harrison said. “At least check it at the drug store. Longstanding hypertension is a risk factor for heart disease. Untreated diabetes is a significant cardiac risk factor.” . Don’t overdo. “Mental health is very important,” Harrison said. “Reduce stress, anxiety and depression. All are associated with heart disease. Exercise, meditation and yoga help some. See a counselor if you have problems with anxiety or depression. Aim for seven to eight hours of sleep at night. Sleep apnea is an under-diagnosed problem. If you fall asleep while doing things or feel tired all day, talk with your doctor about potential sleep apnea or disorder. Too little or even too much is associated with heart disease.”

stressful situation, is what affects the heart. It can happen when people or pets die, during medical treatments, after a job loss or other overwhelming stressors. Mohan Madhusudanan is a cardiology specialist at Trinity Medical WNY in Buffalo who has treated a handful of patients with broken heart syndrome. “One of my patients was very close with her sister and the sister passed away. She came in with shortness of breath and chest pain, and I thought she was having a heart attack. We did everything for her and found no blockages. That’s when we realized this could be broken heart syndrome,” Madhusudanan said. When someone’s heart “breaks,” the left ventricle, which is the heart’s main pumping chamber, weakens or balloons and stresses the heart. It’s a condition that is usually temporary

have been in the past. Limit salty foods and avoid sugary soft drinks and other highly sweetened foods. Always try to reduce sugar intake.” Control your weight. “The morbidity and mortality associated with being overweight — body mass index (BMI) of 25 to 29.9 kg/ m² for greater than 30 kg/m² for obesity — have been known to the medical profession for thousands of years,” Silverman said. “The optimal BMI is greater than or equal to 18.5 kg/m² and less than 25 kg/m² in a healthy Hispanic, black, or Caucasian individual, according to the World Health Organization and National Institutes of Health. It is equally unhealthy to be underweight with a BMI of less than 18.5 kg/m². Waist circumference is also a measure of obesity. Waists that measure greater than 40 inches in men and greater than 35 inches in women is considered elevated.” Get active. “According to the American College of Sports Medicine guidelines, you should be get 150 minutes of moderate activity or 75 minutes of vigorous activity per week,” said Amy Bidwell, Ph.D, associate professor and chairwoman of department of



and complications mimic those of a heart attack (without any clogging of the arteries), causing chest pain and shortness of breath. “Patients may have low heart function and it may not be normal. They may be in heart failure, so we tend to provide the treatment based on what’s needed at that time,” Madhusudanan said. “It’s something you can easily miss if you’re not paying attention. In medical literature, we say this is a diagnosis exclusion: You have to exclude other findings before you can say it’s broken heart syndrome,” Madhusudanan said.

More research needed “A lot more research needs to happen. It’s very hard to diagnose. If you take all the people who present with heart attack symptoms, only 1% to 2% have it and you can easily miss it if you don’t pay attention or follow up,” Madhusudanan said. The New England Journal of Medicine published a study in 2015 in which 1,750 patients with takotsubo cardiomyopathy were studied. Of those patients, 89.8% were women February 2020 •



at an average age of 66. Physical triggers were more common than emotional triggers. “It predominately affects elderly women and is often preceded by an emotional or physical trigger, but the condition has also been reported with no evident trigger,” the study stated. There are certain exams and tests to rule out a heart attack and deter mine if someone has broken heart syndrome: an electrocardiogram, which measures the heart’s electrical activity; an echocardiogram, which produces an image of the Madhusudanan heart; and a coronary angiogram, which gives doctors a detailed look at patients’ blood vessels. Because symptoms do mimic that of a heart attack, if you suspect you have broken heart syndrome, you should call 911.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 21

Heart Month

‘Heart Healthy’: Is It Hype or Helpful? Many products have big labels proclaiming they are ‘heart healthy’ — but are they? By Deborah Jeanne Sergeant “Heart Healthy” — you’ve seen it on products from breakfast cereal to snack foods. Many products proclaim this status with a bright, red heart on the package to drive the message home. But is that claim accurate or just clever marketing to push consumers to buy certain brands? “We’re looking for foods low in fat, cholesterol and sodium,” said Joshua W. Harrison, cardiologist with Crouse Medical Practice. “Lowering LDL is shown to lower risk of heart disease and sodium leads to hypertension.” A handy claim of “low fat” or “low cholesterol” may seem easy shorthand to attract health-conscious consumers; however, Harrison said that oftentimes, foods with these labels contain higher levels of carbohydrates and sugar. “These lead to more diabetes and weight gain,” Harrison said. “The other criticism is that these companies that sell these different foods are often paying big donations to the American Heart Association. There’s a conflict of interest there. The labels are helpful, especially when looking at processed foods.” He added that eating more whole

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foods presents a sounder strategy than going by label claims. Russell Silverman, cardiologist with St. Joseph’s Health, also believes that label claims can be misleading. “Many people have the misconception that claims made on labels are translatable into positive health outcomes,” Silverman said. Silverman added that there are three categories of claims defined by law and FDA regulations that can be used on food and dietary supplement labels: health claims, nutrient claims, structure/function claims. “It is important that you read the calorie claims, sugar claims, fat claims, cholesterol claims, sodium claims and dietary fiber claims,” Silverman said. “Terms such as ‘free’ means the food has the least possible amounts of something. ‘Very low’ or ‘low’ means the food has a little more than foods labeled as free. “‘Reduced’ or ‘less’ means the food has 25% less of a specific nutrient than the regular product. ‘More,’ ‘fortified,’ ‘enriched,’ ‘added,’ ‘extra,’

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

or ‘plus,’ means that the food has 10% or more of the daily value than the regular product. This is reserved for protein, minerals, vitamins, dietary fiber and potassium.” It’s also important to realize that some ingredients go by different names. Silverman said that as an example, sugar may be listed as high fructose corn syrup, corn syrup, agave nectar, barley malt syrup or dehydrated cane sugar, to name just a few. “Trans-fat is less common than it has been but nonetheless is still present and is extremely unhealthy. It will not be listed as trans fat, per se, but may be listed as partially hydrogenated oil of some sort.” Kim Vespi, clinical dietitian for The Nottingham, part of Loretto, distinguishes between the type of fat in foods. “Choose ‘heart healthy’ fat,” she said. “It is important to limit saturate fat found in animal-based foods. Fatty meats, bacon, sausage, marbled beef and whole fat dairy foods — limit these fats. The other type to avoid is trans fats. It’s mainly in processed foods like baked goods, fried foods, anything with margarine or shortening. Partially hydrogenated oil: avoid it. That’s a trans fat.” Instead, eat moderate amounts of heart healthy fat, like salmon and tuna, walnuts and flaxseed, which

have omega-3 fatty acids. Despite their fat content, “these are beneficial,” Vespi said, unlike foods such as gummy bears that bear a “fat free” label, but have no nutrients. “Choose your grains and carbohydrate carefully,” she added. “Avoid processed flour and white sugar. a lot of hidden sugar is in beverages we drink. If you change your beverages, you can eliminate a lot of sugar.” Andrew M. Weinberg, doctor of osteopathic medicine, is one of the general cardiologists with the Upstate Cardiovascular Group and is the medical director of Upstate’s Non-Invasive Vascular Lab. “We as consumers have to advocate for ourselves but also have to make the best possible health decisions,” Weinberg said. When he reads nutrition labels, he typically looks at the serving size, total fat, calories from fat, total calories and total carbohydrates. He advised sticking with produce and lower fat foods to support heart health and avoiding processed carbohydrates and items high in saturated fat, sodium and added sugars. “Foods that are typically healthy for us — fruits, vegetables, fish and lean meats — typically have low total fat, calories from fat, total calories and carbohydrates,” Weinberg said. “Foods high in fiber and protein-fruits, grains, oats are also very healthy for us.” To find these good foods and skip the less healthful options, shop the store’s perimeter. Generally, that’s the area lacking pre-packaged foods and providing more healthful items like produce.

By Jim Miller

How to Choose the Right Hospital for You Dear Savvy Senior, I need to get a hip replacement, and want to find a good, safe hospital to have it done in. What resources can you recommend for evaluating hospitals? I don’t currently have a doctor. Shopping Around

Dear Shopping, Most people spend more time shopping for a kitchen appliance or flat-screen TV than choosing a hospital. But selecting the right one can be as important as the doctor you choose. Here are some tips and resources to help you research the hospitals in your area.

Hospital Shopping While you may not always have the opportunity to choose your hospital, especially in the case of an emergency, having a planned procedure can offer you a variety of choices. When shopping for a hospital, the most important criteria is to choose one that has a strong department in treating your area of need. A facility that excels in coronary bypass surgery, for example, may not be the best choice for a hip replacement. Research shows that patients tend to have better results when they’re treated in hospitals that have extensive experience with their specific condition. In order to choose a hospital that’s best for you, it is important to discuss your concerns and alternatives with the doctor who is treating you. Some doctors may be affiliated with several hospitals from which you can choose. Or, if you’ve yet to select a doctor, finding a top hospital that has expertise with your condition can help you determine which physician to actually choose. Another important reason to do some research is the all too frequent occurrence of hospital infections, which kill around 75,000 people in the U.S. each year. So, checking your hospital’s infection rates and cleanliness procedures is also a smart move.

Free Researching Tools There are a number of free online

resources that can help you evaluate and compare hospitals in your area, including: • Medicare’s Hospital Compare (Medicare.gov/HospitalCompare): Operated by the Centers for Medicare and Medicaid Services, this tool has data on more than 4,000 U.S. hospitals. • Why Not The Best (WhyNotTheBest.org): Created by the Commonwealth Fund, this is a private foundation that provides performance data on all U.S. hospitals. • The Leapfrog Group (LeapfrogGroup.org): This national, nonprofit organization grades more than 2,000 U.S. hospitals on quality and safety. These websites use publicly available data to rate hospitals on various measures of performance like death rates from serious conditions such as heart failure and pneumonia, frequency of hospital-acquired infections, patient satisfaction and more. On these websites, you plug in your location to find hospitals in your area. You can then check to see how well or poorly each hospital manages patients in various conditions. Two other good sites that can help you choose a good facility include U.S. News & World Report (USNews.com/best-hospitals) and Healthgrades (Healthgrades.com). U.S News & World Report is an online publication that publishes a hospital ranking in 17 medical specialties like cancer, orthopedics and urology, and rates common procedures and conditions, such as heart bypass surgery, hip and knee replacement and COPD. They also rank hospitals regionally within states and major metro areas. And Healthgrades, which is a private for-profit organization, provides free hospital ratings on patient safety and medical procedures, and scores hospitals using a 5-star scale. They also provide comprehensive information on most U.S. doctors including their education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records, office locations and insurance plans.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Beware of Social Security Scams By Deborah Banikowski

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cammers go to great lengths to trick you out of your personal information. We want to help you protect your information by helping you recognize a Social Security imposter. There’s a widespread telephone scam involving callers claiming they’re from Social Security. The caller ID may even show a government number. These callers may tell you there’s a problem with your Social Security number. They may also threaten to arrest you unless you pay a fine or fee using gift cards, prepaid debit cards, a wire transfer or cash. That call is not from us. If you receive a suspicious call from someone alleging to be from Social Security, please: • Hang up right away. • Never give your personal information, money or retail gift cards. • Report the scam at oig.ssa. gov/ to Social Security’s law enforcement team at the Office of the Inspector General.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

Q: What is the average Social Security retirement payment that a person receives each month? A: The average monthly Social Security benefit for a retired worker in 2020 is $1,503 (up from $1,479 in 2019). The average monthly Social Security benefit for a disabled worker in 2020 is $1, 258 (up from $1,238 in 2019). As a reminder, eligibility for retirement benefits still requires 40 credits (usually about 10 years of work). Q: Do Members of Congress have to pay into Social Security? A: Yes, they do. Members of Congress, the president and vice president, federal judges, and most political appointees, have paid taxes into the Social Security program since January 1984. They pay into the system just like everyone else, no matter how long they have been in office. Q: Will my son be eligible to receive benefits on his retired father’s record while going to college? A: No. At one time, Social Security did pay benefits to eligible

• Call you to demand an immediate payment. • Ask you for credit or debit card numbers over the phone. • Require a specific means of debt repayment, like a prepaid debit card, a retail gift card, or cash. • Demand that you pay a Social Security debt without the ability to appeal the amount you owe. • Promise a Social Security benefit approval, or increase, in exchange for information or money. • Request personal or financial information through email, text messages, or social media.

Social Security will:

• Sometimes call you to confirm you filed for a claim or to discuss other ongoing business you have with them. • Mail you a letter if there is a problem. • Mail you a letter if you need to submit payments that will have detailed information about options to make payments and the ability to appeal the decision. • Use emails, text messages, and social media to provide general information (not personal or financial information) on its programs and services if you have signed up to receive these messages. Please share this information with your family and friends. college students. But the law changed in 1981. We now pay benefits only to students taking courses at grade 12 or below. Normally, benefits stop when children reach age 18 unless they are disabled. However, if children are still full-time students at a secondary (or elementary) school at age 18, benefits generally can continue until they graduate or until two months after they reach age 19, whichever is first. Q: It’s hard for me to get around because of my disability. Can I apply for disability benefits from home? A: Yes. In fact, the best way to apply for disability benefits is online. Our online disability application is convenient and secure. You can apply for benefits online at www. socialsecurity.gov/applyfordisability. If you do not have internet access, you can call us at 1-800-772-1213 (TTY 1-800-325-0778) to schedule an appointment to visit your local Social Security office to apply. However you decide to apply, begin by looking at our Disability Starter Kit at www. socialsecurity.gov/disability/disability_starter_kits.htm. It will help you prepare for your application or interview.

A Place They Call Home Silver Fox Senior Social Club, a senior day service provider, opened in Fayetteville in April. It’s already considering expanding the facility By Margaret McCormick


t’s cold and snowy outside but warm and cozy inside at the Silver Fox Senior Social Club in Fayetteville. At a round table, a couple of the club’s regular attendees sip coffee and chat on a recent morning while a couple others color and play word games. The smell of roasting chicken wafts from the kitchen, where chef James Alderman prepares crowd-pleasing, mostly comfort food meals each day. Since 2007, the nonprofit Silver Fox Senior Social Club in Baldwinsville has welcomed senior men and women in need of adult day services. Now, seniors in the eastern Central New York area, including Madison County, don’t have to travel as far to take advantage of the club’s offerings. In April, the Silver Fox opened a second location at Good Shepherd Lutheran Church, on Highbridge Road (Route 92), in Fayetteville. It’s a fairly contemporary building with easy access for those with physical limitations. It’s also the home of Meals on Wheels in the eastern suburbs. Executive Director Jennifer Mellone says there is great demand for adult day services in the Fayetteville-Manlius area. Already, she says, the club is looking to expand its presence in the church in order to accommodate more members. The club bills itself as “the gold standard” of senior day service providers. It calls itself a club — rather than a center — because it provides something more specialized and exclusive to seniors: a home-like environment where members can enjoy activities, chef-prepared meals and companionship, all in a professionally supervised, safe environment. All Silver Fox staff members are certified home health aides or certified nurse aides. “They’re a member of a club,’’ Mellone says. “They’re not a client or a patient. It makes them feel like they’re part of something.’’ Activities are designed to meet the individual, social and cognitive needs of members and include things like trivia, bingo, jigsaw puzzles, Scrabble, Jeopardy, Cranium Crunches and other games designed to promote brain health. Staff members assist with therapeutic activity, modest exercise (like stretches, chair exercises and balloon volleyball), medications and personal care, including toileting and showering, if needed. Member birthdays and other milestones are celebrated with cake and family members are invited to celebrate Halloween, “Friendsgiving,’’ Christmas and other holidays. In nice weather, members take supervised walks outside. The food prepared on site is a big draw, Mellone says. A typical day might begin with coffee, juice and hot oatmeal or cereal from the breakfast bar. Lunch is eagerly anticipated and might include chicken cordon bleu, spaghetti and meatballs, Salisbury steak with mushroom gravy or

Mary, a member of Silver Fox Senior Social Club. Photo provided.

Members of the Silver Fox Senior Social Club in Fayetteville chatting recently. The club provides a home-like environment where members can enjoy activities, chef-prepared meals and companionship, all in a professionally supervised, safe environment. Photo by Margaret McCormick. scrambled eggs with home fries — plus dessert. Some members like to assist with meal prep and cleanup. Members have the option of taking home a bag supper so they don’t

have to cook. “We have some members who after lunch like to relax and close their eyes for a bit,’’ Mellone says. “Others have a lot of energy and just keep February 2020 •

going. We send them home well fed. Our goal is they go home, relax and have a good night’s sleep.’’ Laurie Myhill, of Manlius, takes her father-in-law to Silver Fox east three times a week. After his wife died several years ago, he spent a lot of time at the Manlius Senior Center, where he would take yoga and art classes, stay for lunch, participate in activities and sometimes go on daytrips. He loved it, but as he grew older and developed dementia, they were concerned about him being home alone for unstructured periods of time. Her father-in-law’s primary care doctor told Myhill about Silver Fox. They scheduled a day visit and her father-in-law has been a regular since fall. “He went in very skeptical because he doesn’t like change but he came out feeling super happy,’’ Myhill says. “He thrives on the routine, it’s incredibly convenient and he’s been gaining weight because the food is so good. Everyone there is friendly, accommodating and kind. He comes home happy and that’s the most important thing to me.’’ The Silver Fox operates weekdays only. Transportation is not provided, but staff members can help arrange it. Out-of-pocket cost for a day at the club is about $80, Mellone says. Financial assistance is available for eligible members through the Veterans Administration, Onondaga County Office of the Aging, Oswego County Office of the Aging and many insurance plans. On average, eight to nine members a day attend the Silver Fox, usually a mix of women and men. Ages of members range from late-60s to mid-90s. Some members attend three days a week, while others attend every day. “Some days it’s more of a men’s club, some days it’s a ladies club with a couple of men,’’ Mellone says. “They form bonds and get to know each other.’’ The reasons for becoming a member at the Silver Fox are as diverse as the members themselves, Mellone says. Some members live on their own, away from family and friends, and attend for reasons of socialization. Studies have shown that social isolation and loneliness can lead to cognitive decline and risk of dementia and Alzheimer’s disease, impaired mobility, high blood pressure and other long-term problems. Caregivers of the elderly, who often juggle the demands of work and home, are also at risk of loneliness and depression, experts say. Being a family caregiver is a major commitment and can result in lost work time and little time for relaxation and social events – which in turn can lead to loneliness, anxiety and depression. “Family members are so appreciative that we’re here,’’ Mellone says. “Just this morning we had a client come in who said, ‘I just thank you all for being here. I can go to work and be at peace that my loved one is not home alone.’”

More Info on Silver Fox Silver Fox Senior Social Club is at 7248 Highbridge Road (Route 92), Fayetteville, and 22 E. Genesee St., Baldwinsville. Information: 315-6355335, https://silverfoxseniors.org

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 25

New Medication for Migraines By Deborah Jeanne Sergeant

Deadline to submit application is Feb. 14


f you suffer from migraine headaches, a new medication recently approved by the FDA may offer help. Ubrelvy (ubrogepant) tablets are indicated for treatment of migraine with or without aura, a visual effect concurring with many migraines. Unlike preventive migraine medication, patients prescribed to take ubrogepant can take it upon onset of a migraine as needed. Ubrogepant represents the first drug in the class of oral calcitonin gene-related peptide receptor antagonists that the FDA has approved for treating acute migraine. The FDA announced ubrogepant’s approval Dec. 23. Awss Zidan, neurologist and pain management specialist with Upstate Medical University, said that ubrogepant works by blocking the effect of a brain chemical called calcitonin-gene-related peptide — or CGRP. “During migraine attacks, CGRP is produced in abundance and is believed to be a key player in the cascade that leads to the debilitating pain in migraine,” he said Previously, only a single kind of medication, triptans, could be taken to stop migraines one they’ve begun. Triptan class medication works by blocking another player in migraine formation: serotonin, a different brain chemical. “Because serotonin receptors are ubiquitous in the human body and the cardiovascular system, triptans may produce some unwanted side effects such as somnolence, dizziness, tingling and chest tightness,” Zidan said. He added that this kind of medication isn’t a good choice for people already at high risk for stroke and heart attacks. Since age is one of the risk factors for these cardiovascular issues, older adults who suffer migraines had difficulty in finding relief. Ubrogepant doesn’t affect the cardiovascular system. “Ubrogepant has been incredibly well tolerated in the clinical trials

N that evaluated its safety and efficacy,” Zidan said. “Nausea, somnolence and dry mouth were the most reported side effects. However, the incidence of these side effects did not differ significantly from those reported with placebo — sugar pill — making it the most tolerated treatment when it comes to rescue medications for acute migraine.” People who take certain other medications metabolized by the liver should avoid taking ubrogepant, as well as those with liver disease and women who are pregnant or breastfeeding. Dashrath Dulal, pharmacist at Alexander Pharmacy in Rochester, said that this class of medication is becoming popular as a class since its mechanism is different. Many other migraine medications constrict blood vessels, which can contribute to higher risk of stroke and heart attack, unlike the oral calcitonin class. Though Dulal hasn’t seen demand at his pharmacy for the medication yet since it is so new, he said, “It will be interesting to see how people will respond to it. It may be something for people who have no other choices may try it. It’s something that’s an alternative for people. Something like this might be a good try for them.” Having many options available can provide better therapies for people who cannot tolerate or do not wish to experience unwanted side effects of their migraine medication.

Migraine at Glance According to the Migraine Research Foundation based New York City, migraine affects 39 million men, women and children in the U.S. and 1 billion worldwide. • Migraine is the third most prevalent illness in the world. • Nearly one in four U.S. households includes someone with migraine. • Twelve percent of the population — including children — suffers from migraine. • Eighteen percent of American women, 6% of men, and 10% of children experience migraines. • Migraine is most common between the ages of 18 and 44. • Migraine tends to run in families. About 90% of migraine sufferers have a family history of migraine. • Migraine is the 6th most disabling illness in the world. • Every 10 seconds, someone in the U.S. goes to the emergency room complaining of head pain, and approximately 1.2 million visits are for acute migraine attacks. Page 26

Nonprofits Urged to Apply for $115,000 in Grants Offered by Excellus

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

onprofit organizations in Upstate New York can apply for Excellus BlueCross BlueShield Community Health Award grants totaling $115,000 to help fund the health and wellness programs they offer local residents. Nonprofit, 501(c)(3) organizations in Excellus BlueCross BlueShield’s 31-county Upstate New York region are invited to apply for an award of up to $4,000 each. The award can be used for programs that have clear goals to improve the health or health care of a specific population. Programs that improve the health status of the community, reduce the incidence of specific diseases, promote health education and further overall wellness will be considered. The deadline to submit an application to be considered for the award is Friday, Feb. 14. For additional information and the online application, go to ExcellusBCBS.com/ Community. Award recipients will be announced in March. “The company’s Community Health Awards demonstrate a corporate commitment to support local organizations that share our mission

as a nonprofit health plan,” said Jim Reed, regional president, Excellus BlueCross BlueShield. “These awards complement our existing grants and sponsorships with agencies that work to enhance quality of life, including health status, in upstate New York.” Last year, eight Central New York organizations were selected to receive Excellus BlueCross BlueShield Community Health Awards from among more than 30 applications that were submitted by organizations in the five-county Central New York region. The winning organizations were Aurora of Central New York, Hospice of Central New York and Person to Person, all in Syracuse; Clear Path for Veterans, Chittenango; Cortland County Health Department, Cortland; Foodnet Meals on Wheels, Ithaca; Integrated Community Planning of Oswego County and Oswego YMCA, both in Oswego. Excellus BlueCross BlueShield divides its 31-county Upstate New York operating area into four regions: Central New York, Central New York Southern Tier, Rochester and Utica r

5 Tips for Staying Healthy in the Winter Submitted by Loretto


pstate New York gets cold in the winter— award-winning cold. Syracuse and Buffalo have been winners of the Golden Snowball Awards since the 1940s. But the extreme weather can be challenging for older adults.

and help prevent heart disease. The AHA also recommends breaking up long periods of sitting as often as possible. It can be as simple as walking from one room to another or standing to read the newspaper, a magazine or the rest of this article.

Loretto offers the following tips to manage your health this winter:

Get vaccinated 4. Our immune system weakens as we get older and make us

Stay hydrated. 1. It’s easy to forget to drink enough liquid when we barely

break a sweat for days. Tea is a great alternative, and studies have shown that plant chemicals and antitoxins in black and green tea have health benefits. Avoid sugary drinks, though, because high sugar intake can lead to other health issues such as high blood sugar or diabetes.

Be mindful of your diet. 2. Consider adding fruits and vegetables to every meal. Fruits like

oranges and kiwi in season during the winter are great ways to start the day. And don’t forget to eat enough protein and fiber. The goal is to cut back on big, rich meals, but your body always needs enough nutrition.

Move more, sit less. 3. The American Heart Association emphasizes that light activities, even just five or 10 minutes a day, can increase blood flow in the body

more vulnerable to infections. With flu season each winter, the National Foundation for Infectious Diseases recommends older adults getting the flu shot and stay up to date on other vaccines throughout the year.

out for the “winter 5.IfWatch blues” your energy level took a nosedive along with the temperature, the reason may be more serious than you think. Seasonal affective disorder (SAD) — or the “Winter Blues” — affects about 5% of adults in the US. This is why social activities are important for our mental health, especially during the long, winter months. The American Psychiatric Association recommends spending time connecting with someone. A nice conversation with a friend or loved one can lift your spirits. In-person interactions are preferred, but phone or video calls are also helpful.

H ealth News E

Brad Marmon (left) and Christopher Dunham recently graduated from FEMA’s National emergency Management Basic Academy.

Upstate Emergency Management Team Graduates from FEMA Program


hristopher Dunham, director of Upstate Medical University’s emergency management department (right), and Brad Marmon, graduated from FEMA’s National Emergency Management Basic Academy — a series of training courses offering education in the principles of emergency management and planning, disaster, exercise and evaluations, and public information. In total, the academy includes 112 hours of training designed to offer federal-level education to local

municipalities and organizations in support of overall community resiliency. The academy, the first to take place in New York state, is sponsored by the New York State Division of Homeland Security and Emergency Services in partnership with the Emergency Management Institute in Emmitsburg, Maryland. Upstate’s emergency management department coordinates the institution’s preparedness and response for disasters of all types.

St. Joe’s Center for Wound Care gets accreditation

The rigorous accreditation process took approximately six months to ensure the highest standards of quality care are achieved. UHMS sent a team of experts to examine the Wound Care Center’s staffing and training, equipment installation, operation and maintenance, facility and patient safety, and standard of care. The Wound Care Center was awarded accreditation with distinction after this comprehensive review. The Wound Care Center has partnered with Healogics since 2004, offering community specialized care for chronic or non-healing wounds. Healogics-managed Wound Care Centers effectively utilized HBOT and other advanced modalities to treat more than 300,000 wounds last year. HBOT is a safe and evidence-based treatment proven to speed the healing process in certain types of wounds. This therapy can help reduce swelling, fight infection and build new blood vessels, ultimately producing healthy tissue. Additionally, it is effective in fighting certain types of infections, improving circulation and stimulating growth of new blood vessels.  

St. Joseph’s Health’s Center for Wound Care and Hyperbaric Medicine has received full accreditation with distinction from the Undersea and Hyperbaric Medical Society (UHMS). This accreditation is awarded to centers that meet or exceed highest industry standards and best practices in hyperbaric treatment. Out of 1,100 wound care centers nationwide, the Center for Wound Care and Hyperbaric Medicine is one of only 51 in the nation to be awarded the title of Accreditation with Distinction. “Providing quality care is a top priority for us,” said physician Joseph Byrne, medical director. “We are very proud of receiving accreditation with distinction, the highest level of accreditation available through UHMS, and we’re committed to seeing that our facility serves as an industry benchmark for high standards and exceptional care.” The Wound Care Center is operated with the assistance of Healogics, Inc., which represents approximately 28% of all the UHMS-accredited wound care programs nationwide, more than any other single organization. The 7,330 sq.-ft. state-of-theart facility is the largest in Upstate New York, boasting four hyperbaric chambers and 12 treatment rooms. The staff can treat up to 880 patients each month.

New director appointed at Physician Care, P.C. Kim Dec has recently been appointed as the new executive director of Physician Care, P.C., a multi-specialty medical group of Oswego Health, offering the community accessible, high quality medical care. The group consists of cardiology, or-

New Chief Medical Officer at Oswego Health

ffective Jan. 1, physician Duane Tull, has assumed the position of chief medical o at Oswego Health. Physician Michael Stephens will be the new associate chief medical officer. With over 20 years of surgical experience, Tull has been with Oswego Health since 2018 and will continue as one of the general surgeons at Surgical Associates, based in Seneca Hill Health Services Duane Center in addition to taking on the responsibilities of chief medical officer. “I have practiced in large and small hospital settings, been employed by large surgical centers and even ran my own practice. My hope in this new role is to reflect on my leadership experience and the lessons learned to help move Oswego Health forward,” said Tull. In addition, Tull was also appointed as president of Physician Care P.C. which is a multi-specialty medical group offering the community accessible, high quality medical care. physician care p.c. consists of primary care, medical Specialists and Surgical Specialists who maintain an affiliation and presence with Oswego Hospital. Tull earned his bachelor’s degree from Hampden-Sydney College and his Medical Doctorate from Eastern Virginia Medical School. He then completed both his general surgical internship and residency at the Christiana Care Health System in Wilmington, Delaware.

Physician Michael Stephens brings over 20 years of experience to the position of associate chief medical officer for Oswego Health. Stephens began his medical career in 1997 in British Columbia and has clinical experience ranging from emergency medicine, family medicine, hospice care, assisted living and skilled nursing facility. Along with his Oswego Health duties, Stephens also provides care to patients at Oswego Family Physicians, P.C., an affiliate of Oswego Health, allowing him to keep current on health trends in the community at large. “I am very well versed with Oswego Health and the healthcare needs of this community as I was one of the managing partners of Oswego Family Physicians prior to it being purchased in Stephens October 2018 by Oswego Health. In addition,” said Stephens, “I was previously on the board of directors and served as vice chair.  I am honored to have this opportunity and I look forward to working with Dr. Tull, the board of directors and the 1,200+ Oswego Health employees to continue to provide accessible, quality care right here in Oswego County.” Stephens earned his bachelor’s degree from the University of Guelph and his Doctor of Medicine from the University of Western Ontario. He later completed his degree of family medicine from University of British Columbia in 1997.

thopedic, primary care and surgical specialists. Dec has 20 years of healthcare administration and management experience working at various hospitals and medical practices throughout Central New York. “In this leadership role, Kim will Dec support the development of strong physician partnerships that lead to positive organizational culture and continuous clinical improvements,” said Physician Care P.C. President Duane Tull, a physician. “This includes direct oversight and leadership of primary care and specialty practice operations as well as playing an integral role in the recruitment and retention of all providers and staff.” Along with her work responsibilities, Dec is involved with the Ameri-

can College of Healthcare Executives and the Medical Group Management Association. She earned her Bachelor of Arts in sociology with a minor in business administration from SUNY Albany and her Master of Public Health degree from the University of Rochester, School of Medicine and Dentistry.

February 2020 •

Oswego Health welcomes new psychiatrist Oswego Health welcomes psychiatrist Damon A. Tohtz to its behavioral health services department. Tohtz has extensive experience working with adult and geriatric patients in both outpatient and inpatient setTohtz tings including spending 10 years at the Syracuse VA

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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H ealth News and most recently serving as a staff psychiatrist at Helio Health System. Tohtz completed his fellowship in forensic psychiatry and his residency in psychiatry, both at Tulane University in New Orleans. He earned his medical degree from the University of Vermont College of Medicine in Burlington, Vermont. Growing up, Tohtz always knew he wanted to be in the field of psychiatry. His goal has always been to support his patients by providing a holistic view and to truly make a difference. “When Dr. Colon, behavioral health medical director for Oswego Health, contacted me about this opportunity, I instantly was captivated by his energy and vision for providing mental health care in the community. Everyone truly cares here at Oswego Health and I’m excited to be a part of the team,” said Dr. Tohtz. Tohtz will provide outpatient care at the Oswego Health behavioral health services office in the Fulton Medical Building, located at 522 S. Fourth St., Fulton.

St. Joseph’s has new director of payer strategies  Sheri Rodriguez has joined St. Joseph’s Health as its new director of payer strategies. In this role, Rodriguez is responsible for payer relations and managed care contracts and developing strategies focused on managed-care payers. She reports to chief financial officer Meredith Price. Rodriguez Prior to joining St. Joseph’s Health, Rodriguez served as director of behavioral health contracts and operations at metropolitan family services in


Jim and Juli Boeheim Foundation Supports ER Pediatrics at Oswego Health


he Jim and Juli Boeheim Foundation is enabling Oswego Health to accommodate the hospital’s youngest emergency department patients by providing a $10,000 donation to design a pediatric friendly room. Oswego Hospital’s emergency services department is staffed 24 hours a day by board-certified physicians, nurse practitioners, physician assistants and nurses. In 2018 alone, the emergency department treated 2,823 patients younger than 13 years old and 1,485 patients between the ages of 14-18.

Chicago. While there, she oversaw clinical teams that support managed care, provider network contracts, and population health initiatives. Rodriguez also developed actionable business strategies to increase revenue.   Rodriguez also worked as a project manager at Loyola University Medical Center in Chicago, working closely with senior leaderships to manage several clinically integrated network (CIN) and accountable care organization (ACO) projects.  Rodriguez earned a master’s degree in liberal arts from the University of Chicago in Chicago and a bachelor’s degree in marketing from Columbia College in Chicago. She also holds a project management strategy certificate from the University of Chicago.   Rodriguez started on Oct. 21.

Crouse Health Foundation director of development The Crouse Health Foundation recently appointed Kimberly Pietro of Pompey to the position of director

“By providing both a comfortable environment and age-appropriate activities they will be more at ease.” With the support from the Jim and Juli Boeheim Foundation along with a previous donation from Little Lukes in 2018, the renovations to create a kid-friendly space will begin in 2020.

of development. In her new role, she will design, implement and manage Crouse’s major gift program and the annual activities that serve as a pipeline for such charitable contributions. Pietro She will also work to engage current and prospective donors, board and committee members, senior and department leadership, physicians and other key constituents in the foundation’s fundraising efforts. Pietro previously served as assistant dean for advancement in the School of Information Studies at Syracuse University; vice president for college relations/institutional advancement at SUNY Cortland; and associate vice president for development at Onondaga Community

College. A native of New Jersey, Pietro holds a Master of Business Administration from Le Moyne College; a Master of Science in higher education administration from Syracuse University; and a Bachelor of Science in physical education from the University of South Carolina. She was a recipient of a 2012 Business Journal “40 Below 40” award. “We are pleased to have Kim Pietro join our team,” says Carrie Berse, president of Crouse Health Foundation. “She brings close to 20 years of fundraising experience and a proven track record of success in resource development, along with a deep knowledge about and interest in the Central New York community.”

Auburn’s OB-GYN Eileen Murphy joins St. Joe’s St. Joseph’s Health welcomes Eileen Murphy, a physician special-

CNY Pomeroy Appraisers Donates Professional Dress Clothing To Catholic Charities

NY Pomeroy Appraisers, Manlius, recently donated a large quantity of men’s and women’s professional/career dress clothing to Catholic Charities of Oswego County. “We are extremely grateful to CNY Pomeroy Appraisers for this donation,” said Mary-Margaret Pekow, CCOC executive director, (left). “This type of clothing will be of tremendous assistance for those seeking attire for a job interview or for their work day.” Making the donation are Susan D. Baldwin, president, CNY Pomeroy Appraisers; and James Davenport, senior appraiser. For more information on supporting CCOC, contact Catholic Charities of Oswego County at 315-598-3980.

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“As you can imagine we have a significant number of pediatric patients each year in the emergency department and it’s important to the physicians and staff that while these young patients are here that they are as comfortable as possible,” said physician Wajeeh Sana, Oswego Health emergency services medical director.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

Oswego Health presents Morgan Engle, RN with an I CARE Award for going above and beyond for her patients and for continuously having a positive attitude.

Nurse Morgan Engle Recognized With an I CARE Award at Oswego Health


swego Health established an opportunity for patients, their families, faculty, staff and volunteers to recognize a medical staff member or employee for going above and beyond and providing exceptional services. Comment cards are collected monthly throughout the healthcare system and an individual or department is

presented with an I CARE Award. For the month of January, Oswego Health presented the I CARE Award to Morgan Engle, a registered nurse who was nominated by her fellow Med Surge nurses, as they felt she has a positive attitude and is an individual who is always willing to extend a helping hand.

H ealth News izing in obstetrics and gynecology, to its team. The addition of Murphy and her practice to St. Joseph’s Health Women’s Health Services is part of St. Joseph’s Health’s continuous effort to streamline women’s health care process. St. Joseph’s Health Women’s Health Services brings together all the services a woman may need throughout her life to one all-inclusive system. This system ensures patients receive individualized and integrated health services such as breast care, obstetrics, gynecology and neonatal care within one network.   Prior to joining St. Joseph’s Health, Murphy held her own practice, Women’s Health Specialists in Auburn. She will continue to serve patients in Auburn. Murphy is a board-certified obstetrician and gynecologist and obesity medicine specialist with more than 30 years of experience in women’s health. She specializes in comprehensive gynecologic services that include menopause and osteoporosis management as well as female urology services. Murphy also has expertise in weight loss services including nutritional and wellness counseling. Murphy earned her Doctor of Medicine from SUNY Upstate Medical Center in Syracuse and completed her residency in obstetrics and gynecology at the Medical College of Pennsylvania in Philadelphia.  Murphy is a diplomat of the American Board of Obstetrics and

Gynecology and a fellow of the American College of Obstetricians and Gynecologists. She is a certified physician by the American Board of Obesity Medicine and the International Society of Densitometry with a focus on clinical measurement and interpretation of bone density measurements.

Samaritan recognized for spine surgery Excellus BlueCross BlueShield has selected Samaritan Medical Center as a Blue Distinction Center for Spine Surgery, as part of the Blue Distinction Specialty Care program. Blue Distinction Centers are nationally designated healthcare facilities shown to deliver improved patient safety and better health outcomes, based on objective measures that were developed by Blue Cross and Blue Shield companies with input from the medical community. Hospitals designated as Blue Distinction Centers for Spine Surgery demonstrate expertise in cervical and lumbar fusion, cervical laminectomy and lumbar laminectomy/discectomy procedures, resulting in fewer patient complications and hospital readmissions compared to other hospitals. Designated hospitals must also maintain national accreditation to be designated.

Mammography makes a stop in Parish. From far right at the top of the stairs are Kerrie Randall, Tiffany Caesar, Kerry Hazen, Jennifer MacBlane and Michelle Pavlovitz. Bottom row, from left: Tricia Peter Clark, Chelsea Forney, Heather Gigon, Jennifer McGrew, Nancy Deavers and Sheri Guilds.

Mobile Mammo Makes a Stop in Parish


onnextCare partnered with Upstate University Hospital and the Oswego County Cancer Services Program Nov. 14 to offer women breast cancer screenings utilizing the mobile mammography unit. The mammography van was set up at ConnextCare’s Parish office located at 7 Carlton Drive in Parish. Women were offered breast exams as well as pap smears at the ConnextCare office and then escorted to the mammography van for their state of the art 3-D digital mammogram. Mammograms were done by certified mammography technologists and once completed the images were sent

electronically to Upstate University Hospital to be read by a radiologist specializing in women’s imaging. “We were happy to partner with Upstate on this local initiative, bringing much needed services to women right in their back yard, at a location that they are already comfortable with,” said Nancy Deavers, senior vice president and chief nursing and quality officer at ConnextCare. Due to the success of the event, ConnextCare and Upstate University Hospital plan to partner quarterly and continue to bring this life-saving screening service to Oswego County to reach more residents.

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First BEE Award Presented to Crouse Nursing Assistant

ince 2013, Crouse has been a DAISY hospital, an international program that rewards and celebrates extraordinary nursing care. As part of this initiative, the BEE Award — Being Extraordinary Everyday — was created to honor non-nursing staff who support registered nurses at Crouse by meeting the hospital’s mission of providing the best in patient care. Any colleague outside of nursing is eligible for the BEE Award. The inaugural BEE Award was recently presented to Kirsten Coon, a nursing assistant on the Neuroscience Intensive Care Unit. Coon was nominated by registered nurse

February 2020 •

Dylan Frank, who highlighted her work ethic in providing Crouse patients with excellent care. “She has an amazing work ethic and is consistently anticipating ways in which she can help both patients and nursing staff,” said Frank, referring to Kirsten Coon. “There have been multiple occasions where Kirsten has taken it upon herself to assist with a difficult patient situation and provide an extra set of hands when the nursing staff needs it most.” He added, “Kirsten maintains a positive attitude on the unit which is infectious. She is truly extraordinary every day.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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New Minimum Purchase Age for Tobacco Expected to Reduce Youth Use by Deborah Jeanne Sergeant


ccess to tobacco just became more difficult for youth. New York increased its minimum purchase age for buying tobacco from 18 to 21 in November. President Trump signed into law a new nationwide minimum age of 21 as part of an amendment to the Federal Food, Drug, and Cosmetic Act, beginning Jan. 1. The law includes cigars, cigarettes and e-cigarettes. The increased minimum age should offer a number of benefits, according to area experts. “Raising the minimum smoking age to 21 will mean a reduction in youth use of tobacco products because kids won’t have access to it,” said Caitlin O’Brien, government relations director for the American Heart Association in New York. “We know kids get tobacco products from friends and siblings. More kids know 18-year-olds than 21-year-olds, so raising the age limits access for younger kids. This will help keep tobacco out of their hands. It also attaches the social stigma back to tobacco use.” Many 18-year-olds still attend high school and therefore have lots of exposure to younger teens. Since

many young adults leave home around age 21, those who smoke take their tobacco habit with them — away from younger siblings and their visiting friends. “It is important to note that 95% of smokers start before the age of 21


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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2020

and 90% of tobacco products used by youth are supplied by young adults ages 18 to 21,” said Christopher Owens, director of the CNY Regional Center for Tobacco Health Systems at St. Joseph’s Health. Those statistics mirror electronic cigarettes, commonly called e-cigs, vapes or JUULs, a popular brand name. The numbers speak to the ease at which teens can become addicted to nicotine. Owens added that the increased minimum purchase age could save $212 billion in medical costs. The Institute of Medicine reported in 2015 that increasing the tobacco sale age to 21 would reduce smoking by 12%; reduce smoking related deaths by 10%; cause 223,000 fewer premature deaths and 50,000 fewer lung cancer deaths; and prevent 4.2 million years of life lost because of tobacco use. Karyn Johnson, program coordinator of Tobacco-free CNY, a program of the Onondaga County Health Department, views the raised minimum age as complementary to the FDA crackdown on mint and fruit flavored vaping liquids, which research shows particularly attract youth. The 2019 National Youth Tobacco Survey (NYTS) indicates

that more than 5 million U.S. middleand high-school students are current e-cigarette users. Most of these say they usually use cartridge products. “We do know that places that have put these sorts of laws in place have seen huge decreases in smoking,” Johnson said. “The smoking in their community was cut in half among youth. It’s promising we should make some huge gains in e-cigarette and tobacco use.” Enforcing a national minimum age prevents youth from traveling to neighboring states with lower minimum ages to acquire tobacco products. The only caveat Johnson sees is the possibility of young people equating tobacco use as an adult activity on the same level as alcohol use, which has the same minimum purchase age. “That is a small possibility, but restricting the ability to get tobacco is a big deal,” Johnson said. “If you’re 14 or 15, you’ll be less likely to access those products if there’s more of a barrier. We’re hoping that contradicts anything that makes it more of an ‘adult’ type activity.”

Blue Cross and Blue Shield Joins Forces with Civica Rx to Lower Cost of Generic Medication


he Blue Cross Blue Shield Association (BCBSA), 18 independent and locally-operated Blue Cross and Blue Shield (BCBS) companies and Civica recently announced their partnership to create a new subsidiary dedicated to lowering the cost of select generic drugs. The subsidiary was formed in response to the impact of high drug costs on the health of Americans and the overall affordability of health care. Other health plans, employers, retail partners and health care innovators who share the belief that patients and their needs come first, are invited to join the initiative. “We believe everyone should have access to health care, no matter who they are or where they live,” said Scott P. Serota, president and CEO of BCBSA. “Through this

partnership, we will push toward the vital objective of providing greater access to much-needed medications. As BCBS companies and Civica embark on this important work, we hope others will join us to achieve the change Americans want to see in the health care system.” Bringing together the brand that invented health insurance more than 90 years ago and an innovative nonprofit company that has already seen success helping to stabilize drug supplies within hospitals, the groundbreaking partnership between BCBS companies and Civica will expand on Civica’s mission by focusing on the affordability of generic medications outside of the hospital setting. BCBS companies have decades of collective experience providing health insurance to members in every ZIP code across the country.

Onondaga, Oswego, Cayuga and Madison Counties

CNY’s Healthcare Newspaper

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

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

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

That is why Dr. Frederick “Fritz” Parker and his wife Ginny have included the Upstate Foundation in their estate plans. Fritz retired from Upstate Medical University in 2001 as chair of the Department of Surgery. In his 30-year career, Fritz pioneered the cardiac surgery department, earning a reputation as the region’s preeminent cardiac surgeon.

“ We’ve been blessed. There’s no question.”

Ginny impacted the lives of countless young people through a long career in education, as co-founder and former co-director of the Kynda Montessori School.

“We want to leave a legacy that reflects our love for our community,” Ginny explained. “Our hope is that our gift will continue to strengthen Upstate and serve as an inspiration to others who are considering their own legacies.” Creating a legacy is easier than you think! Contact our planned giving professionals at 315-464-6490 or Hamiltol@upstate.edu. To learn more about the Parkers, visit www.UpstateFoundation.org/legacy.

February 2020 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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